bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between cigarette smoking attitudes and social capital among Iranian health and medical students: a cross-sectional study
Authors: Zahedi Hamideh , Sahebihagh Mohammad Hasan , Sarbakhsh Parvin , Gholizadeh Leila
Published: July 2021

Background

Smoking remains a leading public health challenge globally. As a psychosocial determinant of health, social capital can influence health attitudes and behaviors, and thus it may have the capacity to reduce smoking rates. The aim of this research was to examine the association between social capital and attitudes towards smoking among university students.

Methods

This cross-sectional study was conducted among 538 health and medical students, recruited using the proportionate sampling method. Participants’ social capital and attitudes toward smoking were assessed using the social capital questionnaire (SCQ) and the scale of cigarette smoking attitude (CSA). Data were analyzed using descriptive statistics, Pearson correlation coefficient, and the multiple regression analysis.

Results

About one in four health and medical students reported smoking, either currently or in the past, and 30% had either positive or indifferent attitudes towards smoking. The mean scores of the SCQ and the CSA were 105.1 ± 19.7 and 48.6 ± 11.2, respectively. There was a statistically significant negative association between the SCQ and the CSA scores (r = − 0.24; p < 0.001). In the regression analysis, the SCQ scores were also negatively and statistically significantly associated with the CSA scores, after controlling potential confounders (B: -0.09; 95% CI: − 0.13 to − 0.004).

Conclusions

As future healthcare providers, who are expected to take the primary role in reducing smoking rates in the community, health and medical students should be supported to develop appropriate attitudes towards smoking. Promoting positive social capital among university students has the capacity to improve their attitudes towards smoking. Possessing negative attitudes towards smoking should hopefully reduce smoking behaviors among future health professionals and improve their participation in anti-smoking campaigns.
Comparative short-term and long-term outcomes between internal and external intestinal plication in the management of small bowel obstruction
Authors: Liu Song , Hu Qiongyuan , Shao Lihua , Lu Xiaofeng , Shen Xiaofei , Ai Shichao , Zeng Ping , Wang Meng , Guan Wenxian
Published: July 2021

Background

Small bowel obstruction (SBO) is common and usually requires surgical intervention. Intestinal plication is a traditional but critical strategy for SBO in certain scenarios. This study is to compare the short-term and long-term outcome between internal and external plications in the management of SBO.

Methods

All patients receiving intestinal plication in our hospital were retrospectively collected. Short-term outcome including postoperative complications, reoperation, postoperative ICU stay, starting day of liquid diet and postoperative hospitalization, as well as long-term outcome including recurrence of obstruction, readmission, reoperation and death were compared between groups. Gut function at annual follow-up visits was evaluated as well.

Results

Nine internal and 11 external candidates were recruited into each group. The major causes of plication were adhesive obstruction, abdominal cocoon, volvulus and intussusception. Lower incidence of postoperative complication (p = 0.043) and shorter postoperative hospitalization (p = 0.049) was observed in internal group. One patient receiving external plication died from anastomosis leakage. During the 5-year follow-up period, the readmission rate was low in both groups (22.2 % vs. 9.1 %), and none of patients required reoperation or deceased. None of patients exhibited gut dysfunction, and all patients restored normal gut function after 4 years. Patients in external group demonstrated accelerated recovery of gut function after surgery.

Conclusions

This study compares short-term and long-term outcome of patients receiving internal or external intestinal plication. We suggest a conservative attitude toward external plication strategy. Surgical indication for intestinal plication is critical and awaits future investigations.
Readiness towards online learning among physiotherapy undergraduates
Authors: Ranganathan Harikrishnan , Singh Devinder Kaur Ajit , Kumar Saravana , Sharma Shobha , Chua Siew Kuan , Ahmad Nabilah Binti , Harikrishnan Kamalambal
Published: July 2021

Background

Online learning is an attractive option for educators, especially as means of overcoming the challenges posed by the global pandemic. Although it is best to evaluate student readiness prior to commencement of an online course, to ensure successful development and delivery of student-centric teaching and learning strategies, readiness towards online learning among physiotherapy undergraduates is unknown. The main aim of this study was to examine physiotherapy undergraduates’ readiness towards online learning.

Methods

In this cross-sectional study, participants were selected through a combination of total population and convenience sampling. The Student Online Learning Readiness questionnaire was distributed among physiotherapy undergraduates from two public and two private universities in Malaysia to investigate their technical, social and communication competencies. Information about device characteristics were obtained to evaluate their equipment readiness. Descriptive and group comparisons were conducted using independent t-test, and analysis of variance with p < 0.05 as level of significance.

Results

A total of 352 physiotherapy undergraduates participated. The response rate was 81.6%. The results showed that physiotherapy undergraduates in these four institutions had moderate levels of readiness towards technical competencies (M = 3.7 ± 0.5), social competencies with instructor (M = 3.7 ± 0.6), social competencies with classmates (M = 3.8 ± 0.6) and communication competencies (M = 3.6 ± 0.5) related to online learning. The overall readiness for these four competencies was moderate (M = 3.7 ± 0.4), however the physiotherapy undergraduates had high (> 80% possessed smartphones and laptop) level of equipment readiness. Institution and gender had no significant effect on the level of readiness (p > 0.05). Year 1 and 2 had significantly higher levels of social competencies with instructor compared to final year physiotherapy undergraduates (p < 0.05).

Conclusion

Physiotherapy undergraduates in these four institutions had moderate to high levels of readiness towards online learning. Technical, social and communication competencies could be further enhanced with appropriate strategies.

Significance

This study provides an insight into the level of readiness towards online learning among physiotherapy undergraduates. The findings of our study shed light on issues to consider when designing online courses. A pre-course training for undergraduates prior to the commencement of online courses may be useful.

Trial registration

Not Applicable.
The effect of group-dynamics, collaboration and tutor style on the perception of profession-based stereotypes: a quasi-experimental pre- post-design on interdisciplinary tutorial groups
Authors: Hammar Chiriac Eva , Sjøvold Endre , Björnstjerna Hjelm Alexandra
Published: July 2021

Background

Group processes in inter-professional Problem-Based Learning (iPBL) groups have not yet been studied in the health-care educational context. In this paper we present findings on how group-dynamics, collaboration, and tutor style influence the perception of profession-based stereotypes of students collaborating in iPBL groups. Health-care students are trained in iPBL groups to increase their ability to collaborate with other healthcare professionals. Previous research focusing iPBL in healthcare implies that more systematic studies are desired, especially concerning the interaction between group processes and internalized professional stereotypes. The aim of this study is to investigate whether changes in group processes, collaboration, and tutor style, influence the perception of profession-based stereotypes of physician- and nursing-students.

Methods

The study is a quasi-experimental pre- post-design. The participants included 30 students from five different healthcare professions, mainly medicine and nursing. Other professions were physiotherapy, occupational therapy and speech therapy. The students were divided into four iPBL groups, each consisting of six to nine students and a tutor. Data were collected through systematic observation using four video-recorded tutorials. SPGR (Systematizing the Person Group Relation), a computer-supported method for direct and structured observation of behavior, was used to collect and analyze the data.

Results

Traditional stereotypical profession-based behaviors were identified in the first observed group meeting. Although the groups followed different paths of development, the group-dynamics changed in all groups over the 6 weeks of collaboration. Two of the groups became more cohesive, one became more fragmented and one became more polarized. Stereotypical behaviors became less frequent in all groups. Our findings indicate that tutor behavior has a strong influence on the development of the group’s dynamics.

Conclusion

Our findings strongly suggest iPBL is a means of reducing stereotypical behaviors, and may positively increase members’ ability to engage in inter-professional collaboration. Although the pattern of dynamics took different forms in different groups, we argue that iPBL forces students to see the colleague behind his or her profession, thus breaking professional boundaries. The tutor style significantly influenced the iPBL groups’ development. This study contributes to our field by emphasizing the effect of group-processes in increasing mutual understanding across professions.
PCAT6 may be a new prognostic biomarker in various cancers: a meta-analysis and bioinformatics analysis
Authors: Shi Song-bo , Cheng Qing-hao , Gong Shi-yi , Lu Ting-ting , Guo Shi-fang , Song Shao-ming , Yang Yu-ping , Cui Qi , Yang Ke-hu , Qian Yao-wen
Published: July 2021

Background

LncRNA prostate cancer-associated transcript 6 (PCAT6) has been reported to be dysregulated in several cancers and is associated with tumor progression. Here, we have performed a meta-analysis to assess the general prognostic role of PCAT6 in malignancies.

Methods

Four public databases (Embase, Pubmed, Web of Science, Cochrane Library) were used to identify eligible studies, then data was extracted and associations between prognostic indicators and clinical characteristics were combined to estimate hazard ratio (HR) or odds ratio (OR) with a 95% confidence interval (CI). Publication bias was measured using the Begg's test, and the stability of the combined results was measured using sensitivity analysis. Subsequently, results were validated using Gene Expression Profiling Interactive Analysis (GEPIA) and the National Genomics Data Center (NGDC).

Results

Ten studies were considered eligible for inclusion. In total, 937 patients and eight types of cancer were included. Our results revealed that overexpression of PCAT6 was significantly associated with a shorter OS (HR = 1.82; 95% CI, [1.40, 2.38]; P < 0.0001) and progression-free survival (PFS) (HR = 1.66; 95% CI, [1.22, 2.25]; P < 0.0001) in cancer patients, and that PCAT6 overexpression was significantly associated with individual tumor clinicopathological parameters, including TNM stage (OR = 0.29; 95% CI, [0.09, 0.94]; P = 0.04), gender (OR = 1.84; 95% CI, [1.31, 2.59]; P = 0.0005), and whether the tumor was metastatic (OR = 5.02; 95% CI, [1.36, 18.57]; P = 0.02). However, PCAT6 overexpression was not correlated with patient age and tumor differentiation. PCAT6 expression was significantly up-regulated in four types of cancer, which was validated using the GEPIA cohort. Combining OS and disease-free survival (DFS) of these four types of cancer revealed a shorter OS and DFS in patients with PCAT6 overexpression. PCAT6 expression in various types of cancer was also validated in NGDC. A total of eight cancers were analyzed and PCAT6 was highly expressed in all eight cancers. Further functional predictions suggest that PCAT6 is correlated with tumor prognosis, and that PCAT6 may be useful as a new tumor-specific marker.

Conclusions

LncRNA PCAT6 is highly expressed in multiple cancer types and its upregulation was significantly associated with patient prognosis and poorer clinical features, thereby suggesting that PCAT6 may be a novel prognostic factor in multiple cancer types.
Relationship between PD-L1 expression, CD8+ T-cell infiltration and prognosis in intrahepatic cholangiocarcinoma patients
Authors: Deng Min , Li Shao-Hua , Fu Xu , Yan Xiao-Peng , Chen Jun , Qiu Yu-Dong , Guo Rong-Ping
Published: July 2021

Background

Programmed death- ligand 1 (PD-L1) seems to be associated with the immune escape of tumors, and immunotherapy may be a favorable treatment for PD-L1-positive patients. We evaluated intrahepatic cholangiocarcinoma (ICC) specimens for their expression of PD-L1, infiltration of CD8+ T cells, and the relationship between these factors and patient survival.

Methods

In total, 69 resections of ICC were stained by immunohistochemistry for PD-L1, programmed death factor-1 (PD-1), and CD8+ T cells. CD8+ T-cell densities were analyzed both within tumors and at the tumor-stromal interface. Patient survival was predicted based on the PD-L1 status and CD8+ T-cell density.

Results

The expression rate of PD-L1 was 12% in cancer cells and 51% in interstitial cells. The expression rate of PD-1 was 30%, and the number of CD8+ T-cells increased with the increase of PD-L1 expression (p < 0.05). The expression of PD-L1 in the tumor was correlated with poor overall survival(OS) (p = 0.004), and the number of tumor and interstitial CD8+ T-cells was correlated with poor OS and disease-free survival (DFS) (All p < 0.001).

Conclusions

The expression of PD-L1 in the tumor is related to poor OS, and the number of tumor or interstitial CD8+ T-cells is related to poor OS and DFS. For patients who lose their chance of surgery, PD-L1 immunosuppressive therapy may be the focus of future research as a potential treatment.
A psychometric evaluation of the Caregiver Contribution to Self-Care of Heart Failure Index in a Thai population
Authors: Srisuk Nittaya , Wichit Nutchanath , Thompson David R. , Ski Chantal F.
Published: July 2021

Background

Caregivers are major contributor to the self-care of patients with heart failure. The Caregiver Contribution to Self-Care of Heart Failure Index (CC-SCHFI) measures these contributions across three scales: self-care maintenance (symptom monitoring and treatment adherence); self-care management (dealing with symptoms); and confidence in contributing to the self-care (self-efficacy in managing self-care) of patients with heart failure. Informal caregivers play a vital role in supporting family members with heart failure in Thailand, yet no validated tool exists to measure their contribution. We examined the psychometric properties of the CC-SCHFI in a Thai population.

Methods

The CC-SCHFI was translated into Thai using a standard forward and backward translation procedure. A cross-sectional design was used to examine the psychometric properties of the Thai version of the CC-SCHFI in 100 family caregivers of heart failure patients in Southern Thailand. Confirmatory factor analysis was used to assess construct validity, and factor score determinacy coefficients were computed to evaluate internal consistency reliability.

Results

The Thai version of the CC-SCHFI demonstrated acceptable internal consistency (composite reliability of each scale ranged from 0.76 to 0.99). Reliability estimates were adequate for each scale (McDonald’s omega ranged from 0.75 to 0.96). Confirmatory factor analysis supported the original factor structure of the instrument, with good fit indices for all three scales (comparative fit index = 0.98–1.00; root-mean-square error of approximation = 0.00–0.07).

Conclusions

The Thai version of the CC-SCHFI appears to be a valid and reliable instrument for measuring caregiver contributions to self-care maintenance and self-care management as well as contributing to caregiver confidence in the self-care of Thai heart failure patients.
Low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study
Authors: Zeng Ziyang , Li Kang , Wang Xianze , Ouyang Siwen , Zhang Zimu , Liu Zhen , Sun Juan , Ye Xin , Kang Weiming , Yu Jianchun
Published: July 2021

Background

An abrupt increase of thyroid cancer has been witnessed paralleling the supplemented iodine intake in formerly iodine-deficient countries. And increased iodine intake has been linked to the rising incidence rate of papillary thyroid cancer (PTC). However, the correlation between iodine and clinicopathological features of PTC has not been well-characterized. This study aimed to investigate the associations between iodine intake and the clinicopathological features of PTC patients.

Methods

Three hundred and fifty-nine PTC patients who received surgical treatment in Peking Union Medical College Hospital from May 2015 to November 2020 were retrospectively reviewed. The associations between urinary iodine (UI), urinary iodine/creatinine ratio (UI/U-Cr), and the clinicopathological features of PTC were analyzed. Univariate and multivariate analysis were performed to investigate the relationship between UI level and central lymph node metastasis (CLNM).

Results

There were no significant differences in UI in different groups according to the variables studied, except that patients with CLNM had higher UI level than CLNM(−) patients. No associations were found between UI/U-Cr and clinicopathological features except variant subtypes (classic/follicular). After dividing patients into high-iodine group and low-iodine group, more patients were found to have CLNM in the high-iodine group (p = 0.02). In addition, younger age, larger tumor size, and classic variant were positively correlated with CLNM (p < 0.05). Univariate analysis showed that insufficient iodine intake (≤ 99 μg/L) was associated with decreased CLNM risk in PTC. And after defining insufficient iodine intake as ≤ 109 μg/L and above requirements as ≥ 190 μg/L, multivariate analysis showed that lower iodine was associated with CLNM in total population of PTC (OR 0.53, 95% CI 0.31–0.91) and in PTC < 1 cm (papillary thyroid microcarcinoma, PTMC) (OR 0.43, 95% CI 0.21–0.87).

Conclusions

Low iodine was a protective factor for CLNM in papillary thyroid cancer, particularly in those < 1 cm. These results indicated that iodine may not only be an initiator of tumorigenesis, but also a promoter of the development of PTC.
Measuring self-reliance among refugee and internally displaced households: the development of an index in humanitarian settings
Authors: Seff Ilana , Leeson Kellie , Stark Lindsay
Published: July 2021

Background

Humanitarian practitioners have recently expanded their focus from the provision of assistance only to working to ensure refugees and internally displaced peoples (IDPs) can develop sustained ‘self-reliance’. However, few tools measure self-reliance, and even fewer capture non-financial dimensions of self-reliance or measure the construct within refugee and IDP populations. To help address these gaps in measurement and provide organizations with a tool to track households’ self-reliance over time, the Self-Reliance Index (SRI) was developed. The index component of the tool comprises 12 domains of self-reliance, including housing, food, education, healthcare, health status, safety, employment, financial resources, assistance, debt, and savings, and social capital. This paper presents the methodology used to evaluate the tool’s internal consistency and scoring validity, shares the corresponding findings, and offers a practical approach for developing a culturally relevant and robust tool for humanitarian settings.

Results

Data were collected from 57 and 59 refugee households in Nairobi, Kenya, and Palenque, Mexico, respectively; repeat follow-up interviews were held with 34 and 33 households in Kenya and Mexico after a period of 3 months. Cronbach’s alpha was found to be 0.66 in Kenya and 0.64 in Mexico, both of which met the a priori minimum threshold for internal consistency of 0.6. A data-driven process was used to inform the design of the scoring rubric for the SRI, prioritizing the tool’s validity such that the final score would signal useful information about a household’s overall level of self-reliance while also keeping the process as straightforward for users as possible. Final descriptive statistics and score distributions, considered alongside organizational knowledge of sample households and sensitivity analyses, suggest good score validity.

Conclusions

The SRI aims to serve as an important step in measuring the complex subject of self-reliance in a comprehensive way and over time. Results suggest that, with some contextualizing for each setting, the universal tool offers a measurement approach that is feasible, reliable, and valid. By encouraging relevant stakeholders to more holistically conceptualize and measure self-reliance, the SRI also aims to promote a more cross-sector, all-inclusive approach to programming.
A call to safeguard sexual and reproductive health information and services during Ebola outbreaks
Authors: Tran Nguyen Toan , Lichtenstein Désirée , Black Benjamin , Rosmini Alice , Schulte-Hillen Catrin
Published: July 2021

The recent Ebola virus disease (EVD) outbreaks in 2021 exemplify how sexual and reproductive health services are too often considered unessential during health emergencies. Bleeding for reasons other than EVD, such as pregnancy complications or rape, can be construed as EVD symptoms, reinforcing fear and stigmatisation, and delaying timely access to adequate care. In this commentary, we urgently call on all humanitarian actors to integrate the Minimum Initial Services Package for Sexual and Reproductive Health in Crisis Situations into current and future EVD preparedness and response efforts.
Transcription-coupled structural dynamics of topologically associating domains regulate replication origin efficiency
Authors: Li Yongzheng , Xue Boxin , Zhang Mengling , Zhang Liwei , Hou Yingping , Qin Yizhi , Long Haizhen , Su Qian Peter , Wang Yao , Guan Xiaodong , Jin Yanyan , Cao Yuan , Li Guohong , Sun Yujie
Published: July 2021

Background

Metazoan cells only utilize a small subset of the potential DNA replication origins to duplicate the whole genome in each cell cycle. Origin choice is linked to cell growth, differentiation, and replication stress. Although various genetic and epigenetic signatures have been linked to the replication efficiency of origins, there is no consensus on how the selection of origins is determined.

Results

We apply dual-color stochastic optical reconstruction microscopy (STORM) super-resolution imaging to map the spatial distribution of origins within individual topologically associating domains (TADs). We find that multiple replication origins initiate separately at the spatial boundary of a TAD at the beginning of the S phase. Intriguingly, while both high-efficiency and low-efficiency origins are distributed homogeneously in the TAD during the G1 phase, high-efficiency origins relocate to the TAD periphery before the S phase. Origin relocalization is dependent on both transcription and CTCF-mediated chromatin structure. Further, we observe that the replication machinery protein PCNA forms immobile clusters around TADs at the G1/S transition, explaining why origins at the TAD periphery are preferentially fired.

Conclusion

Our work reveals a new origin selection mechanism that the replication efficiency of origins is determined by their physical distribution in the chromatin domain, which undergoes a transcription-dependent structural re-organization process. Our model explains the complex links between replication origin efficiency and many genetic and epigenetic signatures that mark active transcription. The coordination between DNA replication, transcription, and chromatin organization inside individual TADs also provides new insights into the biological functions of sub-domain chromatin structural dynamics.
Altered skeletal muscle metabolic pathways, age, systemic inflammation, and low cardiorespiratory fitness associate with improvements in disease activity following high-intensity interval training in persons with rheumatoid arthritis
Authors: Andonian Brian J. , Johannemann Andrew , Hubal Monica J. , Pober David M. , Koss Alec , Kraus William E. , Bartlett David B. , Huffman Kim M.
Published: July 2021

Background

Exercise training, including high-intensity interval training (HIIT), improves rheumatoid arthritis (RA) inflammatory disease activity via unclear mechanisms. Because exercise requires skeletal muscle, skeletal muscle molecular pathways may contribute. The purpose of this study was to identify connections between skeletal muscle molecular pathways, RA disease activity, and RA disease activity improvements following HIIT.

Methods

RA disease activity assessments and vastus lateralis skeletal muscle biopsies were performed in two separate cohorts of persons with established, seropositive, and/or erosive RA. Body composition and objective physical activity assessments were also performed in both the cross-sectional cohort and the longitudinal group before and after 10 weeks of HIIT. Baseline clinical assessments and muscle RNA gene expression were correlated with RA disease activity score in 28 joints (DAS-28) and DAS-28 improvements following HIIT. Skeletal muscle gene expression changes with HIIT were evaluated using analysis of covariance and biological pathway analysis.

Results

RA inflammatory disease activity was associated with greater amounts of intramuscular adiposity and less vigorous aerobic exercise (both p < 0.05). HIIT-induced disease activity improvements were greatest in those with an older age, elevated erythrocyte sedimentation rate, low cardiorespiratory fitness, and a skeletal muscle molecular profile indicative of altered metabolic pathways (p < 0.05 for all). Specifically, disease activity improvements were linked to baseline expression of RA skeletal muscle genes with cellular functions to (1) increase amino acid catabolism and interconversion (GLDC, BCKDHB, AASS, PYCR, RPL15), (2) increase glycolytic lactate production (AGL, PDK2, LDHB, HIF1A), and (3) reduce oxidative metabolism via altered beta-oxidation (PXMP2, ACSS2), TCA cycle flux (OGDH, SUCLA2, MDH1B), and electron transport chain complex I function (NDUFV3). The muscle mitochondrial glycine cleavage system (GCS) was identified as critically involved in RA disease activity improvements given upregulation of multiple GCS genes at baseline, while GLDC was significantly downregulated following HIIT.

Conclusion

In the absence of physical activity, RA inflammatory disease activity is associated with transcriptional remodeling of skeletal muscle metabolism. Following exercise training, the greatest improvements in disease activity occur in older, more inflamed, and less fit persons with RA. These exercise training-induced immunomodulatory changes may occur via reprogramming muscle bioenergetic and amino acid/protein homeostatic pathways.

Trial registration

ClinicalTrials.gov, NCT02528344. Registered on 19 August 2015.
Erysipelas of the right arm due to Bordetella trematum: a case report
Authors: Lacasse M. , Inyambo K. , Lemaignen A. , Mennecart M. , Gensburger S. , Valentin A. S. , Bernard L. , Fougère B.
Published: July 2021

Background

Bordetella trematum is unknown to most clinicians and microbiologists. However, this Gram-negative opportunistic bacterium can be responsible for ulcer superinfection but also bacteremia and sometimes death by septic shock.

Case report

We report the case of erysipelas due to B. trematum with bacteremia in an immunocompromised 88-year-old Caucasian patient.

Conclusion

In immunocompromised patients, unusual microbial agents such as B. trematum can be responsible for cutaneous and systemic infections, requiring specific antibiotic therapy. Therefore, clinicians should be aware of the need for specific bacterial identification such as matrix-assisted laser desorption ionization time-of-flight mass spectrometry and 16S ribosomal RNA sequencing in the context of atypical evolution of erysipelas in such patients.
An efficient authentication and key agreement protocol for IoT-enabled devices in distributed cloud computing architecture
Authors: Huang Huihui , Lu Siqi , Wu Zehui , Wei Qiang
Published: July 2021

With the widespread use of Internet of Things and cloud computing in smart cities, various security and privacy challenges may be encountered.The most basic problem is authentication between each application, such as participating users, IoT devices, distributed servers, authentication centers, etc. In 2020, Kang et al. improved an authentication protocol for IoT-Enabled devices in a distributed cloud computing environment and its main purpose was in order to prevent counterfeiting attacks in Amin et al.’ protocol, which was published in 2018. However, We found that the Kang et al.’s protocol still has a fatal vulnerability, that is, it is attacked by offline password guessing, and malicious users can easily obtain the master key of the control server. In this article, we extend their work to design a lightweight pseudonym identity based authentication and key agreement protocol using smart card. For illustrating the security of our protocol, we used the security protocol analysis tools of AVISPA and Scyther to prove that the protocol can defend against various existing attacks. We will further analyze the interaction between participants authentication path to ensure security protection from simulated attacks detailedly. In addition, based on the comparison of security functions and computing performance, our protocol is superior to the other two related protocols. As a result, the enhanced protocol will be efficient and secure in distributed cloud computing architecture for smart city.
The prevalence of tuberculosis, malaria and soil-transmitted helminth infection in minority indigenous people of Southeast Asia and the Western Pacific: protocol for a systematic review and meta-analysis
Authors: Gilmour Beth , Alene Kefyalew Addis , Clarke Naomi E. , Clements Archie C. A.
Published: July 2021

Background

Infectious diseases such as tuberculosis (TB), malaria and soil-transmitted helminthiasis continue to impose a significant global health burden and socio-economic impact. Globally, minority indigenous people are disproportionately affected by poverty and are shown to experience a disparate burden of disease and poorer health outcomes than the comparative majority population. Despite these inequalities, countries rarely systematically compile epidemiological data disaggregated by ethnicity to enable the extent of the differential to be quantified.

Methods

The systematic review will be reported in accordance with The Preferred Reporting Items for Systematic Review and Meta- Analyses (PRISMA) guidelines. Systematic searches will be conducted in EMBASE, Medline, Scopus and Web of Science for studies reporting data which enable the prevalence of TB, malaria, and/or soil-transmitted helminth (STH) infections amongst minority indigenous populations within the Southeast Asia Region (SEAR) and Western Pacific Region (WPR) to be calculated.

Where studies provide data on disease prevalence for both minority indigenous and other populations within the same study, a comparative analysis will be undertaken. In addition to a narrative synthesis, where sufficient data are available, a random-effects meta-analysis will be conducted to obtain a pooled estimate value for each disease/infection by country and mortality stratum.

Heterogeneity between studies will be examined using the Cochran’s Q test and quantitatively measured by the index of heterogeneity squared (I2) statistics. The methodological quality of the included studies will be assessed using a modified Newcastle-Ottawa Scale.

Discussion

This systematic review aims to analyse the available data on the prevalence of TB, malaria and STH infections within minority indigenous populations of the SEAR and WPR.

Registration

Open Science Framework registration: osf.io/m6sqc
The impact of Greenfield investment on domestic entrepreneurship
Authors: Ha Tung Son , Chu Vu Tuan , Nguyen Mai Tuyet Thi , Nguyen Dung Hoai Thi , Nguyen Anh Ngoc Thi
Published: July 2021

The FDI-entrepreneurship nexus has received growing attention over the last decade. However, the empirical findings on their relationship have been inconsistent at best. This study seeks to examine how the inflows of Greenfield investment influence entrepreneurship of the host country. Using panel data from 110 countries during the period 2001-2018, we find that growing level of Greenfield investment brings detrimental impact on the level of total and opportunity-driven entrepreneurial activities in the host countries while the impact on necessity-driven entrepreneurship have been mixed. The results regarding the impact of Greenfield investment on total entrepreneurial activities and opportunity-based entrepreneurial activities are robust across different econometric settings, different time span, and different categories of control variables.
Utility of NT-proBNP as an objective marker of postoperative heart failure after coronary artery bypass surgery: a prospective observational study
Authors: Jiang Huiqi , Holm Jonas , Friberg Örjan , Vanky Farkas , Vidlund Mårten , Tajik Bashir , Yang Yanqi , Svedjeholm Rolf
Published: July 2021

Background

Postoperative heart failure (PHF) is the main cause for mortality after cardiac surgery but unbiased evaluation of PHF is difficult. We investigated the utility of postoperative NT-proBNP as an objective marker of PHF after coronary artery bypass surgery (CABG).

Methods

Prospective study on 382 patients undergoing isolated CABG for acute coronary syndrome. NT-proBNP was measured preoperatively, the first (POD1) and third postoperative morning (POD3). A blinded Endpoints Committee used prespecified criteria for PHF. Use of circulatory support was scrutinized.

Results

After adjusting for confounders PHF was associated with 1.46 times higher NT-proBNP on POD1 (p = 0.002), 1.54 times higher on POD3 (p < 0.0001). In severe PHF, NT-proBNP was 2.18 times higher on POD1 (p = 0.001) and 1.81 times higher on POD3 (p = 0.019). Postoperative change of NT-proBNP was independently associated with PHF (OR 5.12, 95% CI 1.86–14.10, p = 0.002). The use of inotropes and ICU resources increased with incremental quartiles of postoperative NT-proBNP.

Conclusions

Postoperative NT-proBNP can serve as an objective marker of the severity of postoperative myocardial dysfunction. Due to overlap in individuals, NT-proBNP is useful mainly for comparisons at cohort level. As such, it provides a tool for study purposes when an unbiased assessment of prevention or treatment of PHF is desirable.

Trial registration

ClinicalTrials.gov Identifier: NCT00489827https://clinicaltrials.gov/ct2/show/NCT00489827?term=glutamics&draw=2&rank=1.
Embolization with MVP (Micro Vascular Plug®): experience on 104 patients in emergent and elective scenarios
Authors: Giurazza Francesco , Ierardi Anna Maria , Contegiacomo Andrea , Corvino Fabio , Carrafiello Giampaolo , Niola Raffaella
Published: July 2021

Aim

To describe a 3 years experience of peripheral arterial embolization with Micro Vascular Plug (MVP) (Medtronic, USA).

Materials and methods

The following parameters were investigated: type of vascular injury, anticoagulation therapy at time of procedure, anatomical district, caliper of the target artery, course of the landing zone, additional embolics, technical and clinical success, device related clinical complications. Technical success was defined as complete embolization without deployment of additional embolics after MVP release. Primary clinical success was considered as hemodynamic stability in emergency setting and resolution of the underlying vascular pathology in elective cases; secondary clinical success was considered clinical success after a second embolization session.

Results

116 MVP have been released in 104 patients (67 males and 37 females; mean age 61.3 years). The pullback release technique was adopted in each case. 85 patients were treated in emergent settings while in 19 patients the procedure was scheduled. The overall technical success was 75%. Primary clinical success was 96.1%, secondary clinical success 3% and clinical failure 0.9%. No statistical differences in terms of effectiveness were observed among patients assuming anticoagulation (p-value = 0.6). A straight and longer landing zone were statistically associated with higher technical success compared to curved and shorter ones, (p-values < 0.001 and = 0.048 respectively). MVP-3 and MVP-5 were the most frequently adopted models in this sample, in 29.8% and 49% of the patients respectively. No clinically adverse events directly related to MVP occurred; in 3 cases device migration was registered without clinical complications.

Conclusion

MVP is a safe and effective embolic agent. While eventual concomitant anticoagulation therapy did not influence the technical outcome, straight course and length of the landing zone are essential parameters to evaluate before deployment.
AutoShare: Virtual community solar and storage for energy sharing
Authors: Lee Stephen , Shenoy Prashant , Ramamritham Krithi , Irwin David
Published: July 2021

Residential solar installations are becoming increasingly popular among homeowners. However, renters and homeowners living in shared buildings cannot go solar as they do not own the shared spaces. Community-owned solar arrays and energy storage have emerged as a solution, which enables ownership even when they do not own the property or roof. However, such community-owned systems do not allow individuals to control their share for optimizing a home’s electricity bill. To overcome this limitation, inspired by the concept of virtualization in operating systems, we propose virtual community-owned solar and storage—a logical abstraction to allow individuals to independently control their share of the system. We argue that such individual control can benefit all owners and reduce their reliance on grid power. We present mechanisms and algorithms to provide a virtual solar and battery abstraction to users and understand their cost benefits. In doing so, our comparison with a traditional community-owned system shows that our AutoShare approach can achieve the same global savings of 43% while providing independent control of the virtual system. Further, we show that independent energy sharing through virtualization provides an additional 8% increase in savings to individual owners.
Financial Toxicity During Breast Cancer Treatment: A Qualitative Analysis to Inform Strategies for Mitigation
Authors: Gharzai Laila A. , Ryan Kerry A. , Szczygiel Lauren , Goold Susan , Smith Grace , Hawley Sarah , Pottow John , Jagsi Reshma
Published: July 2021

PURPOSE:

Financial toxicity from cancer treatment is a growing concern. Its impact on patients requires refining our understanding of this phenomenon. We sought to characterize patients' experiences of financial toxicity in the context of an established framework to identify knowledge gaps and strategies for mitigation.

METHODS:

Semistructured interviews with patients with breast cancer who received financial aid from a philanthropic organization during treatment were conducted from February to May 2020. Interviews were transcribed and coded until thematic saturation was reached, and findings were contextualized within an existing financial toxicity framework.

RESULTS:

Thirty-two patients were interviewed, of whom 58% were non-Hispanic White. The mean age was 46 years. Diagnoses ranged from ductal carcinoma in situ to metastatic breast cancer. Concordant with an established framework, we found that direct and indirect costs determined objective financial burden and subjective financial distress stemmed from psychosocial, behavioral, and material impact of diagnosis and treatment. We identified expectations as a novel theme affecting financial toxicity. We identified knowledge gaps in treatment expectations, provider conversations, identification of resources, and support-finding and offer strategies for mitigating financial toxicity on the basis of participant responses, such as leveraging support from decision aids and allied providers.

CONCLUSION:

This qualitative study confirms an existing framework for understanding financial toxicity and identifies treatment expectations as a novel theme affecting both objective financial burden and subjective financial distress. Four knowledge gaps are identified, and strategies for mitigating financial toxicity are offered. Mitigating patients' financial toxicity is an important unmet need in optimizing cancer treatment.
Fetal Cardiac Lipid Sensing Triggers an Early and Sex-related Metabolic Energy Switch in Intrauterine Growth Restriction
Authors: Maréchal Loïze , Sicotte Benoit , Caron Véronique , Brochu Michèle , Tremblay André
Published: July 2021

Context

Intrauterine growth restriction (IUGR) is an immediate outcome of an adverse womb environment, exposing newborns to developing cardiometabolic disorders later in life.

Objective

This study investigates the cardiac metabolic consequences and underlying mechanism of energy expenditure in developing fetuses under conditions of IUGR.

Methods

Using an animal model of IUGR characterized by uteroplacental vascular insufficiency, mitochondrial function, gene profiling, lipidomic analysis, and transcriptional assay were determined in fetal cardiac tissue and cardiomyocytes.

Results

IUGR fetuses exhibited an upregulation of key genes associated with fatty acid breakdown and β-oxidation (Acadvl, Acadl, Acaa2), and mitochondrial carnitine shuttle (Cpt1a, Cpt2), instigating a metabolic gene reprogramming in the heart. Induction of Ech1, Acox1, Acox3, Acsl1, and Pex11a indicated a coordinated interplay with peroxisomal β-oxidation and biogenesis mainly observed in females, suggesting sexual dimorphism in peroxisomal activation. Concurring with the sex-related changes, mitochondrial respiration rates were stronger in IUGR female fetal cardiomyocytes, accounting for enhanced adenosine 5′-triphosphate production. Mitochondrial biogenesis was induced in fetal hearts with elevated expression of Ppargc1a transcript specifically in IUGR females. Lipidomic analysis identified the accumulation of arachidonic, eicosapentaenoic, and docosapentaenoic polyunsaturated long-chain fatty acids (LCFAs) in IUGR fetal hearts, which leads to nuclear receptor peroxisome proliferator-activated receptor α (PPARα) transcriptional activation in cardiomyocytes. Also, the enrichment of H3K27ac chromatin marks to PPARα-responsive metabolic genes in IUGR fetal hearts outlines an epigenetic control in the early metabolic energy switch.

Conclusion

This study describes a premature and sex-related remodeling of cardiac metabolism in response to an unfavorable intrauterine environment, with specific LCFAs that may serve as predictive effectors leading to IUGR.
Synthesis of Flower-Like Structured Calcium Silicide and Its Application in the Preparation of Palladium-Loaded Catalyst
Authors: Kamegawa Takashi , Kawakami Shoki , Okamoto Misumi , Katsumi Ryoichi
Published: July 2021

A flower like structured CaSi2 (f-CaSi2) was successfully prepared by a simple treatment of bulk CaSi2 powder in aqueous NaOH solution. Small and highly dispersed Pd nanoparticles were formed on f-CaSi2 by using unique properties of CaSi2 and H2 reduction, which also worked as a heterogeneous catalyst.
The Association between Conditional Cash Transfer Programmes and Cohort Fertility: Evidence from Brazil
Authors: Ferreira Soares Camila , Emanuel Campos de Lima Everton
Published: July 2021

Brazil’s Bolsa Família Programme (BFP) aims to combat poverty and social inequalities through monetary transfers to families. A much-discussed indirect effect of the programme was its correlation to the fertility of the beneficiary families. In this paper, we use a cohort fertility approach with parity progression ratios that differs from existing literature, which mainly used period fertility measures, to better understand the relationship between fertility and the BFP. This study analyses the relationship between the BFP and the reproduction of Brazilian women. We use data from the 2010 Brazilian micro-censuses, the only census after the start of the BFP in 2004, to reconstruct the childbirth history of women with incomplete reproductive cycles (women aged 25 to 29), and estimate parity progression ratios (PPRs) and cohort fertility rates (CFR). In addition, we estimate propensity score matching (PSM) models comparing fertility outcomes of beneficiaries and non-beneficiaries of the programme. Our results show distinct differences in CFRs and PPRs. On average, BFP beneficiaries had more children than women not covered by the programme. This finding remained consistent even after controlling for educational gradients and other covariates. Our empirical findings show that women opt for a “rational” strategy, where they tend to have children in more rapid succession up until three children. These findings contradict the recent literature that has not found any correlation between BFP and fertility. The results also suggest that cohort analyses may fill certain gaps left by previous studies of period fertility. This paper is one of a few that have analysed the relationship between a conditional income transfer programme and cohort measures in Brazil.
Enabling patients with learning disabilities to self-manage lower limb lymphoedema
Authors: Taylor Kathryn
Published: July 2021

Kathryn Taylor, Lymphoedema Clinical Nurse Specialist and Service Lead, Community Lymphoedema Service, Manchester Local Care Organisation ( kathryn.taylor3@mft.nhs.uk ), was runner-up in the Chronic Oedema Nurse of the Year category in the BJN Awards 2021
The never-ending story of Never Events in the NHS
Authors: Tingle John
Published: July 2021

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses several recent publications on Never Events in the NHS
Safety in nutrition nursing—a need to protect patients and professionals
Authors: Cole Suzy , Welsh Natalie
Published: July 2021

Suzy Cole, National Nurses Nutrition Group Committee Member ( suzy.cole@nhs.net ) and Natalie Welsh, Vice Chair National Nurses Nutrition Group, outline recent work from several nutrition professional groups
Sustainable resourcing
Authors: White Hilary
Published: July 2021

Learning resources constitute a significant part of any early years setting. This makes them a good place to start if you are planning to make your setting more sustainable.
Communication and language through active play
Authors: Swift Tania
Published: July 2021

Movement and active play is central to children's learning, as is communication and langauge. Tania Swift considers ways in which we can support active development of communication and language through both child and adult-directed learning.
Enya's Childcare
Authors: Celinska Angelica
Published: July 2021

This month EYE'S editor interviews Enya Mooney, the co-founder and director of education at Enya's Childcare, a Reggio-inspired setting offering Forest School provision and working hard on sustainability and eco-friendly practice.
Countdown to Summer
Authors: Harries Judith
Published: July 2021

Take your pick from this selection of number and counting books with accompanying activities to keep the children in your setting busy over the summer, exploring numbers in a variety of ways.
Expressing our emotions - we are unique
Authors: Hart Karen
Published: July 2021

The EAD activities here primarily look at emotions and what makes us unique; using ways of encouraging children to think about how they feel as individuals.
The Arctic
Authors: Harries Judith
Published: July 2021

Many opportunities exist to discuss sustainability when learning about the arctic and investigating ice, whilst also developing personally, socially and emotionally. And of course, perfect for keeping children cool in the summer months!