bluuebunny/crossref_metadata_2025 huggingface dataset:
O jardim de objetos: introduzindo a questão
Authors: Aragão Solange De , Sandeville Jr. Euler
Published: May 2020

Tornou-se comum no jardim brasileiro, especialmente naquele cultivado pelos próprios moradores, o emprego de enfeites e elementos como fontes, bichos de porcelana e anõezinhos de jardim. Nesse sentido, pode-se falar em um “jardim de objetos”, às vezes com um significado lúdico, outras vezes com um significado místico, e outras vezes ainda com um significado de memória ou um significado afetivo para os seus proprietários. Um jardim que, inevitavelmente, integra o panorama atual da sociedade de consumo, embora sua origem remonte, no Brasil, ao século XIX. O objetivo aqui é colocar e discutir algumas questões relacionadas a esse jardim, como a questão do kitsch, a questão da cultura de massa e a questão do simulacro, a partir de leituras e análises de alguns exemplares. A intenção é instigar questões acerca desse jardim, partícipe da paisagem da capital paulista e de outras cidades brasileiras, e apresentar algumas asserções sobre o tema. De um modo geral, observa-se nesse jardim a criação de cenários emoldurados pela vegetação e protagonizados pelos objetos que os constituem, o que acaba por conferir a esses espaços uma complexidade maior em seu arranjo se comparados a outros jardins, mais simples, cultivados pelos próprios moradores. Seus proprietários, ao introduzir fontes, sinos do vento, cores e texturas, trabalham também a percepção sensorial daqueles que os observam, despertando sua curiosidade e sua imaginação
Rios urbanos, águas baianas
Authors: Amorim Nayara Cristina Rosa
Published: May 2020

O artigo evidencia o processo de canalização dos rios em Salvador, Bahia, discutindo como as recentes intervenções viárias em áreas de preservação permanente podem e devem contribuir para a melhoria das condições ambientais e sociais das áreas fluviais, o que não tem acontecido na capital baiana. O texto apresenta o desenvolvimento e a aplicação de uma metodologia de caracterização de rios após intervenções de macrodrenagem, evidenciando vulnerabilidades, riscos, demandas sociais e potencialidades de intervenção. Apresenta, ainda, como objeto de estudo, o rio Mocambo e a relação com seu entorno: um aterro controlado desativado e o bairro de Canabrava, um contexto de fragilidade ambiental e social. A metodologia tem como premissa sua aplicabilidade por associações de moradores, grupos sociais, ONGs, gestores e projetistas, podendo fomentar lutas e reivindicações por compensações socioambientaismpensações socioambientais.
Hippocampal Contribution to Ordinal Psychological Time in the Human Brain
Authors: Gauthier Baptiste , Prabhu Pooja , Kotegar Karunakar A. , van Wassenhove Virginie
Published: May 2020

The chronology of events in time–space is naturally available to the senses, and the spatial and temporal dimensions of events entangle in episodic memory when navigating the real world. The mapping of time–space during navigation in both animals and humans implicates the hippocampal formation. Yet, one arguably unique human trait is the capacity to imagine mental chronologies that have not been experienced but may involve real events—the foundation of causal reasoning. Herein, we asked whether the hippocampal formation is involved in mental navigation in time (and space), which requires internal manipulations of events in time and space from an egocentric perspective. To address this question, we reanalyzed a magnetoencephalography data set collected while participants self-projected in time or in space and ordered historical events as occurring before/after or west/east of the mental self [Gauthier, B., Pestke, K., & van Wassenhove, V. Building the arrow of time… Over time: A sequence of brain activity mapping imagined events in time and space. Cerebral Cortex, 29, 4398–4414, 2019]. Because of the limitations of source reconstruction algorithms in the previous study, the implication of hippocampus proper could not be explored. Here, we used a source reconstruction method accounting explicitly for the hippocampal volume to characterize the involvement of deep structures belonging to the hippocampal formation (bilateral hippocampi [hippocampi proper], entorhinal cortices, and parahippocampal cortex). We found selective involvement of the medial temporal lobes (MTLs) with a notable lateralization of the main effects: Whereas temporal ordinality engaged mostly the left MTL, spatial ordinality engaged mostly the right MTL. We discuss the possibility of a top–down control of activity in the human hippocampal formation during mental time (and space) travels.
Total Devotion: Dismantling Religious Practices and Training Devotion in 2 Kings 22-23
Authors: Feldt Laura
Published: May 2020

The demise and disappearance of religions are processes rarely analysed or
theorised in depth in the study of religions. This article engages the
discussion of how religious traditions disappear by focusing on religious demise
as an active process and suggests that this can also teach us about religious
persistence. Using memory and emotion perspectives, I focus on processes of
religious change in Judaism in the Persian-Hellenistic era by analysing a case
study from the Hebrew Bible that involves an active dismantling of previous
religious practices and their replacement with a new programme for religious
devotion: the narrative of 2 Kgs 22-23. I argue that the new total devotion
programme involves the active erasure of previous religious practices as a key
part of the new identity. On the basis of the analyses, I discuss religious
changes in Second Temple Judaism and suggest a novel reframing of some of the
key changes in terms of memory, media, and emotions.
A Gang of Pentecostals
Authors: Johnson Andrew
Published: May 2020

This article uses ethnographic data from two of Rio de Janeiro’s inmate-led prison churches to examine how they function. It also highlights the structural and functional parallels of these churches with prison gangs. I argue that the gang-like characteristics of these churches are an important reason for the success of Pentecostalism inside Rio de Janeiro’s penal system. The results of this research can inform future scholarly investigation and prison ministry initiatives.
Questioning the Revival
Authors: Gildow Douglas M.
Published: May 2020

A common narrative of Buddhist monasticism in modern China is that monastic institutions were virtually eliminated during the Cultural Revolution period (1966–1976) but have undergone continuous revival since that time. This simplistic narrative highlights differences in state-monastic relations between the Maoist and post-Maoist eras, even as it oversimplifies various developments. In this article, I analyze the notion of revival and assess the state of Han Buddhist monasticism in the prc. My focus is on clarifying the “basic facts” of monasticism, including the numbers and types of monastics and monastic institutions. I draw on studies published since Holmes Welch’s works as well as on my own fieldwork conducted in China since 2006.

This article questions the revival metaphor and shows that it is misleading. First, as Welch noted for the Republican period, recent developments are characterized by innovations as much as by revivals. Second, evidence for the growth of monasticism from around the year 2000 is weak. Yet in two aspects, monasticism today revives characteristics of Republican-period monasticism: ritual performance is central to the monastic economy, and Buddhist seminaries are important for monastic doctrinal education.
Cooperation in the mental health treatment of patients with outpatient commitment
Authors: Løvsletten Maria , Lossius Husum Tonje , Haug Elisabeth , Granerud Arild
Published: May 2020

Background:

Patients with outpatient commitment have a decision on coercive treatment from the specialist health services even if they are in their own home and receive municipal health services.

Objective:

The aim of this study is to gain more knowledge about how the outpatient commitment system works in the municipal health service and specialist health services, and how they collaborate with patients and across service levels from the perspectives of healthcare professionals.

Methods:

This is a qualitative study collecting data through focus group interviews with health personnel from the municipal health service and specialist health services.

Results:

The results describe the health personnel’s experiences with follow-up and interactions with the patients with outpatient commitment decisions, and their experiences with collaboration between service levels.

Conclusion:

The study show that outpatient commitment makes a difference in the way patients with this decision are followed up. The legislative amendment with new requirements for consent competence was challenging. Collaboration between services levels was also challenging.
Use of whole-genome sequence data and novel genomic selection strategies to improve selection for age at puberty in tropically-adapted beef heifers
Authors: Warburton Christie L. , Engle Bailey N. , Ross Elizabeth M. , Costilla Roy , Moore Stephen S. , Corbet Nicholas J. , Allen Jack M. , Laing Alan R. , Fordyce Geoffry , Lyons Russell E. , McGowan Michael R. , Burns Brian M. , Hayes Ben J.
Published: May 2020

Background

In tropically-adapted beef heifers, application of genomic prediction for age at puberty has been limited due to low prediction accuracies. Our aim was to investigate novel methods of pre-selecting whole-genome sequence (WGS) variants and alternative analysis methodologies; including genomic best linear unbiased prediction (GBLUP) with multiple genomic relationship matrices (MGRM) and Bayesian (BayesR) analyses, to determine if prediction accuracy for age at puberty can be improved.

Methods

Genotypes and phenotypes were obtained from two research herds. In total, 868 Brahman and 960 Tropical Composite heifers were recorded in the first population and 3695 Brahman, Santa Gertrudis and Droughtmaster heifers were recorded in the second population. Genotypes were imputed to 23 million whole-genome sequence variants. Eight strategies were used to pre-select variants from genome-wide association study (GWAS) results using conditional or joint (COJO) analyses. Pre-selected variants were included in three models, GBLUP with a single genomic relationship matrix (SGRM), GBLUP MGRM and BayesR. Five-way cross-validation was used to test the effect of marker panel density (6 K, 50 K and 800 K), analysis model, and inclusion of pre-selected WGS variants on prediction accuracy.

Results

In all tested scenarios, prediction accuracies for age at puberty were highest in BayesR analyses. The addition of pre-selected WGS variants had little effect on the accuracy of prediction when BayesR was used. The inclusion of WGS variants that were pre-selected using a meta-analysis with COJO analyses by chromosome, fitted in a MGRM model, had the highest prediction accuracies in the GBLUP analyses, regardless of marker density. When the low-density (6 K) panel was used, the prediction accuracy of GBLUP was equal (0.42) to that with the high-density panel when only six additional sequence variants (identified using meta-analysis COJO by chromosome) were included.

Conclusions

While BayesR consistently outperforms other methods in terms of prediction accuracies, reasonable improvements in accuracy can be achieved when using GBLUP and low-density panels with the inclusion of a relatively small number of highly relevant WGS variants.
Dexmedetomidine for prevention of postoperative pulmonary complications in patients after oral and maxillofacial surgery with fibular free flap reconstruction:a prospective, double-blind, randomized, placebo-controlled trial
Authors: Liu Yun , Zhu Xi , Zhou Dan , Han Fang , Yang Xudong
Published: May 2020

Background

Postoperative pulmonary complications (PPCs) are common and significant problems for oral and maxillofacial surgery patients. Dexmedetomidine (DEX), an α2-adrenoreceptor agonist, has been proven having lung protection effects. However, since now, there has not been final conclusion about whether DEX can reduce the incidence of PPCs. We hypothesize that, in oral and maxillofacial surgery with fibular free flap reconstruction patients, DEX may decrease the incidence of PPCs.

Methods

This was a prospective, double-blind, randomized, placebo-controlled, single-centered trial with two parallel arms. A total of 160 patients at intermediate-to-high risk of PPCs undergoing oral and maxillofacial surgery with fibular free flap reconstruction and tracheotomy were enrolled and randomized to receive continuous infusion of either DEX or placebo (normal saline). 0.4 μg/kg of DEX was given over 10mins as an initial dose followed by a maintaining dose of 0.4 μg/kg/h till the second day morning after surgery. At the same time, the normal saline was administered a similar quantity. The primary outcome was the incidence of PPCs according to Clavien-Dindo score within 7 days after surgery.

Results

The two groups had similar characteristics at baseline. 18(22.5%) of 80 patients administered DEX, and 32(40.0%) of 80 patient administered placebo experienced PPCs within the first 7 days after surgery (relative risk [RR] 0.563,95% confidence interval [CI] 0.346–0.916; P = 0.017). In the first 7 days after surgery, the DEX group had a lower incidence of PPCs and a better postoperative survival probability (Log-rank test, P = 0.019), and was less prone to occur PPCs (Cox regression, P = 0.025, HR = 0.516). When the total dose of DEX was more than 328 μg, the patients were unlikely to have PPCs (ROC curve, AUC = 0.614, P = 0.009).

Conclusions

For patients undergoing oral and maxillofacial surgery with fibular free flap reconstruction and tracheotomy who were at intermediate or high risk of developing PPCs, continuous infusion of DEX could decrease the occurrence of PPCs during the first 7 days after surgery and shorten the length of hospital stay after surgery, but did not increase the prevalence of bradycardia or hypotension.

Trial registration

Chinese Clinical Trial Registry, www.chictr.org.cn, number: ChiCTR1800016153; Registered on May 15, 2018.
Identification of transcription factors MYC and C/EBPβ mediated regulatory networks in heart failure based on gene expression omnibus datasets
Authors: Wang Haiwei , Wang Xinrui , Xu Liangpu , Cao Hua
Published: May 2020

Background

Heart failure is one of leading cause of death worldwide. However, the transcriptional profiling of heart failure is unclear. Moreover, the signaling pathways and transcription factors involving the heart failure development also are largely unknown. Using published Gene Expression Omnibus (GEO) datasets, in the present study, we aim to comprehensively analyze the differentially expressed genes in failing heart tissues, and identified the critical signaling pathways and transcription factors involving heart failure development.

Methods

The transcriptional profiling of heart failure was identified from previously published gene expression datasets deposited in GSE5406, GSE16499 and GSE68316. The enriched signaling pathways and transcription factors were analyzed using Database for Annotation, Visualization and Integrated Discovery (DAVID) website and gene set enrichment analysis (GSEA) assay. The transcriptional networks were created by Cytoscape.

Results

Compared with the normal heart tissues, 90 genes were particularly differentially expressed in failing heart tissues, and those genes were associated with multiple metabolism signaling pathways and insulin signaling pathway. Metabolism and insulin signaling pathway were both inactivated in failing heart tissues. Transcription factors MYC and C/EBPβ were both negatively associated with the expression profiling of failing heart tissues in GSEA assay. Moreover, compared with normal heart tissues, MYC and C/EBPβ were down regulated in failing heart tissues. Furthermore, MYC and C/EBPβ mediated downstream target genes were also decreased in failing heart tissues. MYC and C/EBPβ were positively correlated with each other. At last, we constructed MYC and C/EBPβ mediated regulatory networks in failing heart tissues, and identified the MYC and C/EBPβ target genes which had been reported involving the heart failure developmental progress.

Conclusions

Our results suggested that metabolism pathways and insulin signaling pathway, transcription factors MYC and C/EBPβ played critical roles in heart failure developmental progress.
Comprehensive analysis of T-cell receptor repertoire in patients with acute coronary syndrome by high-throughput sequencing
Authors: Liu Sudong , Zhong Zhixiong , Zhong Wei , Weng Ruiqiang , Liu Jing , Gu Xiaodong , Chen Yongyu
Published: May 2020

Background

This study aims to investigate the T-cell receptor (TCR) repertoire in patients with acute coronary syndrome (ACS).

Methods

The TCR repertoires of 9 unstable angina patients (UA), 14 acute myocardial infarction patients (AMI) and 9 normal coronary artery (NCA) patients were profiled using high-throughput sequencing (HTS). The clonal diversity of the TCR repertoires in different groups was analyzed, as well as the frequencies of variable (V), diversity (D) and joining(J) gene segments.

Results

ACS patients including UA and AMI, showed reduced TCRβ diversity than NCA patients. ACS patients presented higher levels of clonal expansion. The clonotype overlap of complementarity determining region 3(CDR3) was significantly varied between different groups. A total of 10 V genes and 1 J gene were differently utilized between ACS and NCA patients. We identified some shared CDR3 amino acid sequences that were presented in ACS but not in NCA patients.

Conclusions

This study revealed the distinct TCR repertoires in patients with ACS and demonstrated the presence of disease associated T-cell clonotypes. These findings suggested a role of T cells in ACS and provided a new way to explore the mechanisms of ACS.
Elevated hemoglobin A1c is associated with the presence of pancreatic cysts in a high-risk pancreatic surveillance program
Authors: Bar-Mashiah Ariel , Aronson Anne , Naparst Monica , DiMaio Christopher J. , Lucas Aimee L.
Published: May 2020

Background

Emerging evidence demonstrates that surveillance of individuals at high-risk (HRIs) of developing pancreatic adenocarcinoma allows for identification and treatment of resectable tumors with improved survival. Population-based data suggest that hyperglycemia may be present up to three years before the development of pancreatic cancer. We investigated whether elevated hemoglobin A1c (HbA1c) is associated with the development of pancreatic cysts in a pancreatic surveillance program.

Methods

We performed a retrospective study of HRIs who underwent pancreatic surveillance at a single institution between May 2013 and March 2019, according to published criteria. We collected demographic information, clinical data including HbA1c, and imaging results. We compared data using univariable and multivariable analyses. Our primary outcome was the presence of pancreatic cysts on initial surveillance in patients with elevated HbA1c.

Results

Ninety-eight patients underwent surveillance imaging via EUS or MRCP and seventy-four patients met inclusion criteria. Thirty patients were found to have cysts on initial imaging. Older age (p < 0.01) and HbA1c in the prediabetic range or higher (p = 0.01) were associated with the presence of cysts or solid lesions on univariable analysis. After controlling for confounders, age (aOR 9.08, 95% CI 2.29–36.10), and HbA1c > 5.7% (aOR 5.82, 95% CI 1.50–22.54) remained associated with presence of cysts and solid lesions in HRIs. In patients with cysts or solid lesions there was a strong association between increased age and elevated HbA1c (p < 0.01).

Conclusion

HRIs with elevated HbA1c were more likely to have pancreatic cysts compared to individuals with lower HbA1c on initial imaging in a pancreatic surveillance program. These findings may help tailor the surveillance protocols for those at increased risk of developing pancreatic adenocarcinoma.
High-density lipoprotein cholesterol to low-density lipoprotein cholesterol ratio in early assessment of disease severity and outcome in patients with acute pancreatitis admitted to the ICU
Authors: Wu Qin , Zhong Xi , Fu Min , Yang Hao , Bo Hong , Liao Xuelian , Hu Zhi , Wang Bo , Zhang Zhongwei , Jin Xiaodong , Kang Yan
Published: May 2020

Background

Patients with acute pancreatitis usually exhibit dyslipidemia and oxidative stress. However, the significance of high-density lipoprotein cholesterol (HDL-C) level, low-density lipoprotein cholesterol (LDL-C) level and the HDL-C/LDL-C ratio (H/L ratio) as markers for disease progression remain unknown.

Aim

The aim of this study was to evaluate the role of HDL-C levels, LDL-C levels and the H/L ratio as markers of disease progression in patients admitted to the intensive cate unit with acute pancreatitis.

Methods

This retrospective study was conducted at a tertiary critical care center in China. Plasma HDL-C and LDL-C levels were measured in 166 patients with acute pancreatitis. The associations between HDL-C, LDL-C, H/L ratio, as well as other inflammatory index and mortality, were analyzed. Multivariate cox analysis based on two models was used to determine the independent prognostic factor. Predictive ability of in-hospital mortality for variables was determined using the receiver operating characteristics curves.

Results

Significantly higher H/L ratios at admission were observed in patients with acute pancreatitis who died compared with survivors (0.93 vs. 0.64, p < 0.001). The area under the ROC curve for H/L ratio–based prediction of mortality was 0.658. When clinical confounders were included in multivariable cox regression analysis, the association was preserved (Model A HR = 1.587, p = 0.011; Model B HR = 1.332, p = 0.032). The mortality risk in different groups defined by an H/L ratio cutoff value was significantly different, based on survival curve analysis.

Conclusion

The H/L ratio at the time of admission to the ICU appears to be a biomarker of disease progression in patients with acute pancreatitis.
The effect of oral care intervention on pneumonia hospitalization, Staphylococcus aureus distribution, and salivary bacterial concentration in Taiwan nursing home residents: a pilot study
Authors: Chiang Tien-Cheng , Huang Ming-Shyan , Lu Po-Liang , Huang Shun-Te , Lin Ying-Chu
Published: May 2020

Background

Elevated Staphylococcus aureus and oral bacterial concentrations are known to correlate with pneumonia hospitalization in nursing home residents. However, the effects of a professional oral care intervention on these factors remain unclear. The aims of this quasi-experimental study were to compare bacterial concentrations in saliva and sputum, oral health status, distribution of Staphylococcus aureus, and pneumonia status before and after a professional oral care intervention.

Methods

A purposive sample of residents from two nursing homes was divided into an intervention group that received a weekly professional oral care intervention and a control group. Oral bacterial concentration was determined by real-time polymerase chain reaction. The Staphylococcus aureus distribution was determined by bacterial culture and matrix-assisted laser desorption/ionization–time of flight mass spectrometry. After data collection, a statistical analysis was performed to evaluate the effect of the intervention.

Results

Most residents were unconscious (80%), and most had a history of pneumonia (76%). Baseline demographic data did not significantly differ between the two groups. After the intervention, the intervention group had significant improvements in plaque index (1.66 ± 0.78 vs. 0.94 ± 0.64, p <  0.01), gingival index (2.36 ± 0.76 vs. 1.65 ± 0.83, p <  0.01), tongue coating index (0.96 ± 1.10 vs. 0.16 ± 0.47, p <  0.01), distribution of Staphylococcus aureus in salivary samples (11.11 ± 14.47% vs. 1.74 ± 3.75%, p = 0.02), and salivary bacterial concentration ([4.27 ± 3.65] × 105 vs. [0.75 ± 1.20] × 105, p <  0.01). Sputum bacterial concentration did not significantly differ. The intervention group also had a significantly lower annual prevalence of pneumonia hospitalization (1.24 ± 1.51 vs. 0.48 ± 0.59, p = 0.01), especially in residents whose salivary bacterial concentration exceeded the median. However, the duration of pneumonia hospitalization did not significantly differ between the two groups.

Conclusion

A professional oral care intervention in nursing home residents can improve oral health, reduce levels of salivary bacteria and Staphylococcus aureus, and decrease the annual prevalence of pneumonia hospitalization.

Trial registration

Trial registration: ClinicalTrials.gov, NCT03874962. Registered 12 March 2019 - Retrospectively registered.
Molecular epidemiology and socio-demographic risk factors of sexually transmitted infections among women in Lebanon
Authors: Hanna Jessica , Yassine Ruba , El-Bikai Rana , Curran Martin D. , Azar Mathilde , Yeretzian Joumana , Skaf Rana , Afif Claude , Saber Toufic , Itani Saadeddine , Hubeish Manal , El Jisr Tamima , Hamzeh Fadia , El Chaar Mira
Published: May 2020

Background

Sexually transmitted infections (STIs) cause a major public health problem that affect both men and women in developing and developed countries. The aim of the study was to estimate the prevalence of 11 STIs among women who voluntarily participated in the study, while seeking gynecological checkup. The existence of an association between the presence of pathogens and symptoms and various sociodemographic risk factors was assessed.

Methods

A total of 505 vaginal and cervical specimens were collected from women above 18 years of age, with or without symptoms related to gynecological infections. Nucleic acid was extracted and samples were tested by real-time PCR for the following pathogens: Chlamydia trachomatis,Neisseria gonorrhoeae, Mycoplasma genitalium,Ureaplasma urealyticum,Urealplasma parvum,Trichomonas vaginalis,Mycoplasma hominis,Mycoplasma girerdii,Gardnerella vaginalis,Candida albicans andHuman Papillomavirus(HPV). Positive HPV samples underwent genotyping using a microarray system.

Results

Of the 505 samples, 312 (62%) were screened positive for at least one pathogen. Of these, 36% were positive forGardnerella vaginalis,35% forUreaplasma parvum, 8% forCandida albicans, 6.7% for HPV, 4.6%for Ureaplasma urealyticum, 3.6% forMycoplasma hominis,2% forTrichomonas vaginalis, 0.8% forChlamydia trachomatis, 0.4% forMycoplasma girerdii, 0.2% forMycoplasma genitaliumand 0.2% forNeisseria gonorrhoeae. Lack of symptoms was reported in 187 women (37%), among whom 61% were infected. Thirty-four samples were HPV positive, with 17 high risk HPV genotypes (HR-HPV); the highest rates being recorded for types 16 (38%), 18 (21%) and 51 (18%). Out of the 34 HPV positives, 29 participants had HR-HPV. Association with various risk factors were reported.

Conclusions

This is the first study that presents data about the presence of STIs among women in Lebanon and the MENA region by simultaneous detection of 11 pathogens. In the absence of systematic STI surveillance in Lebanon, concurrent screening for HPV and PAP smear is warranted.
Decision-to-delivery interval of emergency cesarean section in Uganda: a retrospective cohort study
Authors: Hughes Noemi J. , Namagembe Imelda , Nakimuli Annettee , Sekikubo Musa , Moffett Ashley , Patient Charlotte J. , Aiken Catherine E.
Published: May 2020

Background

In many low and medium human development index countries, the rate of maternal and neonatal morbidity and mortality is high. One factor which may influence this is the decision-to-delivery interval of emergency cesarean section. We aimed to investigate the maternal risk factors, indications and decision-to-delivery interval of emergency cesarean section in a large, under-resourced obstetric setting in Uganda.

Methods

Records of 344 singleton pregnancies delivered at ≥24 weeks throughout June 2017 at Mulago National Referral Hospital were analysed using Cox proportional hazards models and multivariate logistic regression models.

Results

An emergency cesarean section was performed every 104 min and the median decision-to-delivery interval was 5.5 h. Longer interval was associated with preeclampsia and premature rupture of membranes/oligohydramnios. Fetal distress was associated with a shorter interval (p < 0.001). There was no association between decision-to-delivery interval and adverse perinatal outcomes (p > 0.05). Mothers waited on average 6 h longer for deliveries between 00:00–08:00 compared to those between 12:00–20:00 (p < 0.01). The risk of perinatal death was higher in neonates where the decision to deliver was made between 20:00–02:00 compared to 08:00–12:00 (p < 0.01).

Conclusion

In this setting, the average decision-to-delivery interval is longer than targets adopted in high development index countries. Decision-to-delivery interval varies diurnally, with decisions and deliveries made at night carrying a higher risk of adverse perinatal outcomes. This suggests a need for targeting the improvement of service provision overnight.
A novel pancreatic tumour and stellate cell 3D co-culture spheroid model
Authors: Norberg K. J. , Liu X. , Fernández Moro C. , Strell C. , Nania S. , Blümel M. , Balboni A. , Bozóky B. , Heuchel R. L. , Löhr J. M.
Published: May 2020

Background

Pancreatic ductal adenocarcinoma is a devastating disease with poor outcome, generally characterized by an excessive stroma component. The purpose of this study was to develop a simple and reproducible in vitro 3D-assay employing the main constituents of pancreatic ductal adenocarcinoma, namely pancreatic stellate and cancer cells.

Method

A spheroid assay, directly co-culturing human pancreatic stellate cells with human pancreatic tumour cells in 3D was established and characterized by electron microscopy, immunohistochemistry and real-time RT-PCR. In order to facilitate the cell type-specific crosstalk analysis by real-time RT-PCR, we developed a novel in vitro 3D co-culture model, where the participating cell types were from different species, human and mouse, respectively. Using species-specific PCR primers, we were able to investigate the crosstalk between stromal and cancer cells without previous cell separation and sorting.

Results

We found clear evidence for mutual influence, such as increased proliferation and a shift towards a more mesenchymal phenotype in cancer cells and an activation of pancreatic stellate cells towards the myofibroblast phenotype. Using a heterospecies approach, which we coined virtual sorting, confirmed the findings we made initially in the human-human spheroids.

Conclusions

We developed and characterized different easy to set up 3D models to investigate the crosstalk between cancer and stroma cells for pancreatic cancer.
Knowledge, attitudes and practices of South Asian immigrants in developed countries regarding oral cancer: an integrative review
Authors: Saraswat Nidhi , Pillay Rona , Everett Bronwyn , George Ajesh
Published: May 2020

Background

Oral cancer is a growing problem worldwide, with high incidence rates in South Asian countries. With increasing numbers of South Asian immigrants in developed countries, a possible rise in oral cancer cases is expected given the high prevalence in their source countries and the continued oral cancer risk behaviours of immigrants. The aim of this review is to synthesise existing evidence regarding knowledge, attitudes and practices of South Asian immigrants in developed countries regarding oral cancer.

Methods

Five electronic databases were systematically searched to identify original, English language articles focussing on oral cancer risk knowledge, attitudes and practices of South Asian immigrants in developed countries. All studies that met the following inclusion criteria were included: conducted among South Asian immigrants in developed countries; explored at least one study outcome (knowledge or attitudes or practices); used either qualitative, quantitative or mixed methods. No restrictions were placed on the publication date, quality and setting of the study.

Results

A total of 16 studies involving 4772 participants were reviewed. These studies were mainly conducted in the USA, UK, Italy and New Zealand between 1994 and 2018. Findings were categorised into themes of oral cancer knowledge, attitudes and practices. General lack of oral cancer risk knowledge (43–76%) among participants was reported. More than 50% people were found engaging in one or more oral cancer risk practices like smoking, betel quid/pan/gutka chewing. Some of the participants perceived betel quid/pan/gutka chewing habit good for their health (12–43.6%).

Conclusion

This review has shown that oral cancer risk practices are prevalent among South Asian immigrants who possess limited knowledge and unfavourable attitude in this area. Culturally appropriate targeted interventions and strategies are needed to raise oral cancer awareness among South Asian communities in developed countries.
The structural effect of high intensity ultrasound on peritoneal tissue: a potential vehicle for targeting peritoneal metastases
Authors: Mikolajczyk Agata , Khosrawipour Tanja , Kulas Joanna , Migdal Pawel , Arafkas Mohamed , Nicpon Jakub , Khosrawipour Veria
Published: May 2020

Background

High-intensity ultrasound (HIUS) has been increasingly investigated as a possible tool in the treatment of multiple tumor entities. However, there is only little knowledge on the effect of HIUS on the peritoneum. This preliminary study aims to investigate HIUS’ potential for altering the peritoneal surface and potentially improving current treatments for peritoneal metastases. For this purpose, HIUS’ qualitative and quantitative structural effects on the peritoneal tissue were analyzed by means of light, fluorescence and electron microscopy.

Methods

Proportional sections were cut from the fresh postmortem swine peritoneum. Peritoneal surfaces were covered with a 6 mm thick liquid film of 0.9% NaCl. HIUS was applied in all tissue samples for 0 (control), 30, 60, 120 and 300 s. Peritoneal tissues were analyzed using light-, fluorescence and electron microscopy to detect possible structural changes within the tissues.

Results

Following HIUS, a superficial disruption of peritoneal tissue was visible in light microscopy, which amplified with increased time of HIUS’ application. Fluorescence microscopy showed both peritoneal and subperitoneal disruption with tissue gaps. Electron microscopy revealed structural filamentation of the peritoneal surface.

Conclusion

Our data indicate that HIUS causes a wide range of effects on the peritoneal tissue, including the formation of small ruptures in both peritoneal and subperitoneal tissues. However, according to our findings, these disruptions are limited to a microscopical level. Further studies are required to evaluate whether HIUS application can benefit current therapeutic regimens on peritoneal metastases and possibly enhance the efficacy of intraperitoneal chemotherapy.
A cost-of-illness analysis of β-Thalassaemia major in children in Sri Lanka – experience from a tertiary level teaching hospital
Authors: Reed-Embleton Hamish , Arambepola Savinda , Dixon Simon , Maldonado Behrouz Nezafat , Premawardhena Anuja , Arambepola Mahinda , Khan Jahangir A. M. , Allen Stephen
Published: May 2020

Background

Sri Lanka has a high prevalence of β-thalassaemia major. Clinical management is complex and long-term and includes regular blood transfusion and iron chelation therapy. The economic burden of β-thalassaemia for the Sri Lankan healthcare system and households is currently unknown.

Methods

A prevalence-based, cost-of-illness study was conducted on the Thalassaemia Unit, Department of Paediatrics, Kandy Teaching Hospital, Sri Lanka. Data were collected from clinical records, consultations with the head of the blood bank and a consultant paediatrician directly involved with the care of patients, alongside structured interviews with families to gather data on the personal costs incurred such as those for travel.

Results

Thirty-four children aged 2–17 years with transfusion dependent thalassaemia major and their parent/guardian were included in the study. The total average cost per patient year to the hospital was $US 2601 of which $US 2092 were direct costs and $US 509 were overhead costs. Mean household expenditure was $US 206 per year with food and transport per transfusion ($US 7.57 and $US 4.26 respectively) being the highest cost items. Nine (26.5%) families experienced catastrophic levels of healthcare expenditure (> 10% of income) in the care of their affected child. The poorest households were the most likely to experience such levels of expenditure.

Conclusions

β-thalassaemia major poses a significant economic burden on health services and the families of affected children in Sri Lanka. Greater support is needed for the high proportion of families that suffer catastrophic out-of-pocket costs.
Development and validation of bile acid profile-based scoring system for identification of biliary atresia: a prospective study
Authors: Zhao Dongying , Zhou Kejun , Chen Yan , Xie Wei , Zhang Yongjun
Published: May 2020

Background

Early distinguishing biliary atresia from other causes of infantile cholestasis remains a major challenge. We aimed to develop and validate a scoring system based on bile acid for identification of biliary atresia.

Methods

In a prospective study, a total of 141 infants with cholestasis were enrolled in two sets (derivation cohort, n = 66; validation cohort, n = 75) from 2014 to 2018. Variables with significant difference between biliary atresia and non-biliary atresia infants were selected in the derivation cohort. Then, a scoring system including those variables was designed and validated.

Results

Among 66 patients in the derivation cohort, 34 (51.5%) had biliary atresia. A scoring system was proposed with the following variables: glycochenodeoxycholic acid/chenodeoxycholic acid, clay stool, and gamma-glutamyl transferase. The total score ranged from 0 to 41, and a cutoff value of 15 identified biliary atresia with an area under receiver operating characteristic curve of 0.87 (95% confidence interval, 0.77–0.94), sensitivity of 85.3%, and specificity of 81.3% in the derivation cohort; these values were also confirmed in a validation cohort with a sensitivity of 90.0% and specificity of 80.0%.

Conclusions

The proposed simple scoring system had good diagnostic accuracy for estimating the risk of biliary atresia in infants with cholestasis.
Responsiveness and minimal important change of the QuickDASH and PSFS when used among patients with shoulder pain
Authors: Rysstad Tarjei , Grotle Margreth , Klokk Lars Petter , Tveter Anne Therese
Published: May 2020

Background

The Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) and the Patient-Specific Functional Scale (PSFS) are commonly used outcome instruments for measuring self-reported disability in patients with shoulder pain. To date, few studies have evaluated the responsiveness and estimated their minimal important change (MIC). Further assessment will expand the current knowledge and improve the interpretability of these instruments in clinical and research practice. The purpose of this prospective cohort study with 3 months follow-up was to evaluate the responsiveness of the QuickDASH and PSFS in patients with shoulder pain, and to estimate their MICs by using two different anchor-based methods.

Methods

Patients with shoulder pain recruited at a multidisciplinary hospital outpatient clinic completed the QuickDASH and PSFS at baseline and at 3 months follow-up. The responsiveness was evaluated by using a criterion approach with the area under the receiver operating characteristic curve (AUC) and a construct approach by testing 9 a-priori hypotheses. The MIC was assessed using two anchor-based MIC methods.

Results

134 patients participated at baseline and 117 (87.3%) at 3 months follow-up. The AUC was acceptable for both QuickDASH (0.75) and PSFS (0.75). QuickDASH met 7 (77.8%) and PSFS 8 (88.9%) of the hypotheses. None of the instruments showed signs of floor and ceiling effects. The MIC estimates ranged from 10.8 to 13.6 for QuickDASH and from 1.9 to 2.0 for PSFS, depending on the method used.

Conclusion

This study demonstrates that both the QuickDASH and PSFS are responsive measures of disability in patients with shoulder pain. The estimated MIC values were presented.
Risk assessment of neuromuscular stimulation by energy-based transurethral resection devices: an ex vivo test standard
Authors: Biber Ulrich , Jurjut Ovidiu , Enderle Markus D. , Aicher Wilhelm K.
Published: May 2020

Background

During transurethral resection of bladder tumours (TURB), radio-frequency (RF) currents can lead to adverse neuromuscular stimulation (NMS). Here we present a novel ex vivo method to determine the risk of RF generators and their bipolar TURB modes to cause NMS. We aimed to develop an experimental platform for safety evaluation of new RF generators and their modes with a newly established test standard, suitable for replacement or reduction of animal testing.

Methods

We tested four contemporary RF generators with their bipolar modes for TURB in saline. A two-stage ex vivo approach was pursued: First, we recorded voltages at possible positions of the obturator nerve behind a porcine bladder wall in a TURB model using 18 RF applications per generator. Second, these voltage records were used as stimuli to evoke nerve compound action potentials (CAPs) in isolated porcine axillary nerves. The NMS potential was defined as the ratio between the observed area under the CAPs and the theoretical CAP area at maximum response and a firing rate of 250 Hz, which would reliably induce tetanic muscle responses in most human subjects. The measurement protocol was tailored to optimise reproducibility of the obtained NMS potentials and longevity of the nerve specimens.

Results

As prerequisite for the clinical translation of our results, the robustness of our test method and reproducibility of the NMS potential are demonstrated with an excellent correlation (r = 0.93) between two sets of identical stimuli (n = 72 each) obtained from 16 nerve segments with similar diameters (4.2 ± 0.37 mm) in the nerve model. The RF generators differed significantly (p < 0.0001) regarding NMS potential (medians: 0–3%).

Conclusions

Our test method is suitable for quantifying the NMS potential of different electrosurgical systems ex vivo with high selectivity at a reasonable degree of standardization and with justifiable effort. Our results suggest that the clinical incidence of NMS is considerably influenced by the type of RF generator. Future generations of RF generators take advantage from the proposed test standard through higher safety and less animal testing. Health professionals and treated patients will benefit most from improved RF surgery using generators with a low NMS risk.
Measures of evidence-informed decision-making competence attributes: a psychometric systematic review
Authors: Belita Emily , Squires Janet E. , Yost Jennifer , Ganann Rebecca , Burnett Trish , Dobbins Maureen
Published: May 2020

Background

The current state of evidence regarding measures that assess evidence-informed decision-making (EIDM) competence attributes (i.e., knowledge, skills, attitudes/beliefs, behaviours) among nurses is unknown. This systematic review provides a narrative synthesis of the psychometric properties and general characteristics of EIDM competence attribute measures in nursing.

Methods

The search strategy included online databases, hand searches, grey literature, and content experts. To align with the Cochrane Handbook of Systematic Reviews, psychometric outcome data (i.e., acceptability, reliability, validity) were extracted in duplicate, while all remaining data (i.e., study and measure characteristics) were extracted by one team member and checked by a second member for accuracy. Acceptability data was defined as measure completion time and overall rate of missing data. The Standards for Educational and Psychological Testing was used as the guiding framework to define reliability, and validity evidence, identified as a unified concept comprised of four validity sources: content, response process, internal structure and relationships to other variables. A narrative synthesis of measure and study characteristics, and psychometric outcomes is presented across measures and settings.

Results

A total of 5883 citations were screened with 103 studies and 35 unique measures included in the review. Measures were used or tested in acute care (n = 31 measures), public health (n = 4 measures), home health (n = 4 measures), and long-term care (n = 1 measure). Half of the measures assessed a single competence attribute (n = 19; 54.3%). Three measures (9%) assessed four competence attributes of knowledge, skills, attitudes/beliefs and behaviours. Regarding acceptability, overall missing data ranged from 1.6–25.6% across 11 measures and completion times ranged from 5 to 25 min (n = 4 measures). Internal consistency reliability was commonly reported (21 measures), with Cronbach’s alphas ranging from 0.45–0.98. Two measures reported four sources of validity evidence, and over half (n = 19; 54%) reported one source of validity evidence.

Conclusions

This review highlights a gap in the testing and use of competence attribute measures related to evidence-informed decision making in community-based and long-term care settings. Further development of measures is needed conceptually and psychometrically, as most measures assess only a single competence attribute, and lack assessment and evidence of reliability and sources of established validity evidence.

Registration

PROSPERO #CRD42018088754.