bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of regularities in a random environment
Authors: Rey Arnaud , Bogaerts Louisa , Tosatto Laure , Bonafos Guillem , Franco Ana , Favre Benoit
Published: July 2020

Regularity detection, or statistical learning, is regarded as a fundamental component of our cognitive system. To test the ability of human participants to detect regularity in a more ecological situation (i.e., mixed with random information), we used a simple letter-naming paradigm in which participants were instructed to name single letters presented one at a time on a computer screen. The regularity consisted of a triplet of letters that were systematically presented in that order. Participants were not told about the presence of this regularity. A variable number of random letters were presented between two repetitions of the regular triplet, making this paradigm similar to a Hebb repetition task. Hence, in this Hebb-naming task, we predicted that if any learning of the triplet occurred, naming times for the predictable letters in the triplet would decrease as the number of triplet repetitions increased. Surprisingly, across four experiments, detection of the regularity only occurred under very specific experimental conditions and was far from a trivial task. Our study provides new evidence regarding the limits of statistical learning and the critical role of contextual information in the detection (or not) of repeated patterns.
Ageing, working memory, and mental imagery: Understanding gestural communication in younger and older adults
Authors: Arslan Burcu , Göksun Tilbe
Published: July 2020

Ageing has effects both on language and gestural communication skills. Although gesture use is similar between younger and older adults, the use of representational gestures (e.g., drawing a line with fingers on the air to indicate a road) decreases with age. This study investigates whether this change in the production of representational gestures is related to individuals’ working memory and/or mental imagery skills. We used three gesture tasks (daily activity description, story completion, and address description) to obtain spontaneous co-speech gestures from younger and older individuals ( N = 60). Participants also completed the Corsi working memory task and a mental imagery task. Results showed that although the two age groups’ overall gesture frequencies were similar across the three tasks, the younger adults used relatively higher proportions of representational gestures than the older adults only in the address description task. Regardless of age, the mental imagery but not working memory score was associated with the use of representational gestures only in this task. However, the use of spatial words in the address description task did not differ between the two age groups. The mental imagery or working memory scores did not associate with the spatial word use. These findings suggest that mental imagery can play a role in gesture production. Gesture and speech production might have separate timelines in terms of being affected by the ageing process, particularly for spatial content.
Poststroke shoulder pain in subacute patients and its correlation with upper limb recovery after robotic or conventional treatment: A secondary analysis of a multicenter randomized controlled trial
Authors: Aprile I , Germanotta M , Cruciani A , Pecchioli C , Loreti S , Papadopoulou D , Montesano A , Galeri S , Diverio M , Falsini C , Speranza G , Langone E , Carrozza MC , Cecchi F
Published: July 2020

Background and aims

Poststroke shoulder pain is a common complication. We aimed to investigate the prevalence of poststroke shoulder pain, with attention to the neuropathic component, and the relationship between poststroke shoulder pain and upper limb improvement in motor function, strength, disability, and quality of life after upper limb rehabilitation.

Methods

This is a secondary analysis of a multicenter randomized controlled trial to compare upper limb conventional or robotic rehabilitation on 224 patients enrolled in eight rehabilitation centers. We assessed poststroke shoulder pain (using the Numerical Rating Scale and the Douleur Neuropathique 4), and upper limb motor function, strength, disability, and quality of life at baseline (T0), after 30 rehabilitation sessions (T1), and three months after the end of rehabilitation (T2).

Results

A moderate/severe poststroke shoulder pain was reported by 28.9% of patients, while 19.6% of them showed a neuropathic component. At T0, the intensity of pain was higher in women and in patients with neglect syndrome, positively correlated with the time since stroke and disability and negatively correlated with motor function, strength, and the physical aspects of the quality of life. Moderate/severe pain and neuropathic component significantly reduced after both treatments and this reduction was maintained at T2. Finally, the intensity of pain at baseline was negatively correlated with the improvement of upper limb motor function.

Conclusions

Poststroke shoulder pain negatively impact on motor performance, strength, disability, and physical aspects of the quality of life as well as on upper limb motor recovery; however, it can be reduced after a robotic or a conventional rehabilitation. Therefore, we suggest considering poststroke shoulder pain when planning the rehabilitation intervention.
Constructing young citizens’ deontic authority in participatory democracy meetings
Authors: Magnusson Simon
Published: July 2020

Young citizens are increasingly being invited to take part in participatory democracy meetings as joint decision-making has grown popular in public administration. The backbone of participatory democracy is that some authority is granted to the citizenry and by drawing on video data (38 hours) from a year-long participatory project, this conversation analytic study shows that the adolescents are instructed to a deontic role rooted in epistemics, benefactive considerations, as well as temporal aspects relating to future citizenship and hope. The institutional representatives perform actions that determine how the adolescents should, in their turn, perform actions of influence. In this way, authority is ascribed through an ambivalent configuration in which compliance with the directives is supposed to establish a strengthened deontic position.
LABA/LAMA fixed-dose combinations versus LAMA monotherapy in the prevention of COPD exacerbations: a systematic review and meta-analysis
Authors: Chen Ching-Yi , Chen Wang-Chun , Huang Chi-Hsien , Hsiang Yi-Ping , Sheu Chau-Chyun , Chen Yung-Che , Lin Meng-Chih , Chu Kuo-An , Lee Cheng-Hung , Wei Yu-Feng
Published: July 2020

Background:

Long-acting muscarinic antagonist (LAMA) monotherapy is recommended for chronic obstructive pulmonary disease (COPD) patients with high risk of exacerbations. It is unclear whether long-acting β2-agonist (LABA)/LAMA fixed-dose combinations (FDCs) are more effective than LAMAs alone in preventing exacerbations. The aim of this study was to systematically review the literature to investigate whether LABA/LAMA FDCs are more effective than LAMA monotherapy in preventing exacerbations.

Methods:

We searched several databases and manufacturers’ websites to identify relevant randomized clinical trials comparing LABA/LAMA FDC treatment with LAMAs alone ⩾24 weeks. Outcomes of interest were time to first exacerbation and rates of moderate to severe, severe and all exacerbations.

Results:

We included 10 trials in 9 articles from 2013 to 2018 with a total of 19,369 patients for analysis in this study. Compared with LAMA monotherapy, LABA/LAMA FDCs demonstrated similar efficacy in terms of time to first exacerbation [hazard ratio, 0.96; 95% confidence interval (CI) 0.79–1.18; p = 0.71], moderate to severe exacerbations [risk ratio (RR), 0.96; 95% CI 0.90–1.03; p = 0.28], severe exacerbations (RR, 0.92; 95% CI 0.81–1.03; p = 0.15), and a marginal superiority in terms of all exacerbations (RR, 0.92; 95% CI 0.86–1.00; p = 0.04). The incidence of all exacerbation events was lower in the LABA/LAMA FDC group for the COPD patients with a history of previous exacerbations and those with a longer treatment period (52–64 weeks).

Conclusion:

This study provides evidence that LABA/LAMA FDCs are marginally superior in the prevention of all exacerbations compared with LAMA monotherapy in patients with COPD. The reviews of this paper are available via the supplemental material section.
Relationship between medication adherence and psychosocial adjustment in patients with type 2 diabetes: A cross-sectional study
Authors: Kes Duygu , Gökdoğan Feray
Published: July 2020

Adherence to drug treatment is a multidimensional concept. It is affected by many factors, such as physiological, psychological, family, environmental and social conditions. However, relatively little is known about the relationship between adherence to medication and psychosocial adjustment. The aim was to explore the relationship between adherence to antidiabetic drugs and the psychosocial adjustment of patients with type 2 diabetes mellitus. This cross-sectional descriptive correlational study was conducted between March and June 2018. A convenience sample of participants was recruited from seven internal disease outpatient clinics at a public tertiary hospital, located in a large city that serves as a gateway to nearby rural and urban areas in the north-west region of Turkey. Data were collected using the Adherence to Refills and Medications Scale (ARMS-7), and the Psychosocial Adjustment to Illness Scale–Self Report (PAIS–SR). This study is reported in accordance with STROBE. Pearson’s correlation analysis found a significant weak positive correlation between all domains of the PAIS–SR and the total scores on the ARMS‐7. The participants’ scores on medication refill were found to be significantly and positively correlated with all of the PAIS–SR domain scores except the sexual relationships domain. Psychosocial care could play a crucial role in improving drug regimen adherence among patients with diabetes. Therefore, nurses should integrate psychosocial care into daily practice.
COVID-19 Pandemic in India: Present Scenario and a Steep Climb Ahead
Authors: Pal Rimesh , Yadav Urmila
Published: July 2020

Amid the ongoing COVID-19 pandemic, India has witnessed a massive surge of cases in the past 3 weeks. As of April 30, 33 610 confirmed cases and 1075 deaths have been reported from 32 states/union territories in India. Apart from the nationwide lockdown, India has increased its testing rate and has markedly strengthened the health care sector to combat COVID-19. With India’s population of more than 1.3 billion people at a significant population density compared with the rest of the world, the lack of universal access to clean water and overall poor socioeconomic status, all have posed a major challenge to India’s fight against COVID-19. Failure to contain the pandemic in India could have disastrous consequences with widespread cases and thousands of deaths that could easily overwhelm the health care infrastructure. Unabated spread of the pandemic could make India the next COVID-19 hotspot; hence the World Health Organization has recently stated that the “future of the pandemic will depend on how India handles it.” Here, we have summarized the present scenario of the pandemic in India and the myriad challenges being faced by the country in its fight against COVID-19.
The New Nollywood: Professionalization or Gentrification of Cultural Industry
Authors: Ezepue Ezinne M.
Published: July 2020

Nollywood is further gaining popularity due to its transformations, which bear resemblances to the processes of gentrification and professionalization. This is formalizing the industry as well as attracting professionals and instigating existing filmmakers to improve on their art. So far, filmmakers have continued to avail themselves for further trainings, aligning themselves with the emerging new and professionalizing Nollywood. This study is interested in finding out whether these changes within the industry are simply a professionalization process or a regeneration that can potentially gentrify the industry. Gentrification, an urban development term which captures the process that alters the structure of a district to suit middle- or upper-class taste, is burdened with the baggage of displacement and so attracts negativity. This study adopts gentrification as a metaphor. Thus, it captures a process where a once-not-so-aesthetic item available exclusively to the general masses becomes fanciful as a result of middle- or upper-class engagement. This study contextualizes the concepts of gentrification and professionalization to put in perspective class separation, formalization of Nollywood, emergence of the new Nollywood, and other transformations reshaping Nollywood and bringing about sectoring within the industry. This study concludes that Nollywood is currently gentrifying as well as professionalizing. Its gradual progression from its old, traditional form into a new quality and aesthetics conscious nature results from availability of resources for production and distribution, and an interaction with corporate bodies and between new film professionals and existing industry players who avail themselves for further trainings.
Ambivalent Sexism and Reported Relationship Qualities in Emerging Adult Heterosexual Dating Couples
Authors: Leaper Campbell , Gutierrez Brenda C. , Farkas Timea
Published: July 2020

We investigated the relations between the endorsement of ambivalent sexism and relationship qualities in heterosexual romantic couples during emerging adulthood. The sample included 94 heterosexual emerging adult dating couples attending a public university ( Mage = 21 years; 39% White, 25% Latinx, 11% Asian, and 18% Other). Each partner separately completed survey measures of ambivalent sexism and perceived relationship satisfaction and conflict. Dyadic analyses were performed using structural equation modeling. Results indicated men’s hostile sexism predicted lower satisfaction and more conflict for men and their partners, whereas men’s benevolent sexism (BS) predicted more satisfaction and lower conflict for men and their partners. Women’s BS was negatively related to the length of the couple’s relationship. The results are discussed in relation to ways that ambivalent sexism may affect the dating relationships of many emerging adults in college settings and how these effects may change over time in relationships and at later life stages.
The Implication of Blockchain as a Disruptive Technology for Construction Industry
Authors: Sharma Mohita Gangwar , Kumar Sunil
Published: July 2020

Adoption of blockchain technology has been widely construed as disruptive. Blockchain is a distributed ledger technology. It is secure by design because of its cryptography and distributed consensus mechanism, which also offers anonymity, persistence, auditability and resilience. The construction industry adopts a project-based approach and globally has been considered as a fragmented sector, predominantly in unorganised space. Given these characteristics, the technology adoption has been slow. This study looks at the challenges and adopts interpretive structural modelling technique to understand the linkages between these barriers. This study can provide managerial insights into designing strategies for overcoming the barriers for adoption of this disruptive technology.
BankBuddy.ai—Business Expansion and Marketing Dilemma: A Case Study to Discuss the Ansoff Growth Matrix Concepts Combined with Business Expansion Strategies for Expanding into Emerging Markets
Authors: Chintalapati Srikrishna
Published: July 2020

Five more days to go until the new year, it was a warm, pleasant and busy morning in Dubai, United Arab Emirates. As the clock ticked 10 times, Aditya Bhagat (Aditya), a young, ambitious, passionate entrepreneur, is seemingly intrigued and curious. Exactly 30 minutes from now, he is scheduled to meet Surya Prasad (Surya), his friend, counterpart and co-founder of BankBuddy ( www.bankbuddy.ai ). Half the office is already empty as most of the associates had left for the year-end holidays, Aditya wanted to use this time to carefully brainstorm, methodically plan and articulate his business strategies and get them ready for execution in the new year. Marketing strategy is of particular importance, arguably the most critical and complex element that also needs the most attention in the overall exercise. He clearly understands that their current business strategy of being headquartered in Dubai and staying focused on artificial intelligence 1 (AI) powered solutions for the banking industry has paid off so well in their current geographical focus—Middle Eastern and African countries. The time now to look at next wave of business expansion. This inadvertently raises the decision dilemma of choosing the most productive and promising growth path—where and what to expand? Should they expand into more geographies? Or should they diversify the product line and add more offerings? In which country and city should they set up the new base (centroid) and which countries do they target for expansion? Which are the other promising products/offerings they should be adding to their existing lines of business? Aditya knows that today is the time to address the ‘elephant in the room’—where to invest my marketing money?
Hypertonic glucose inhibits growth and attenuates virulence factors of multidrug-resistant Pseudomonas aeruginosa
Authors: Chen Tao , Xu Ye , Xu Wenya , Liao Wenli , Xu Chunquan , Zhang Xiucai , Cao Jianming , Zhou Tieli
Published: July 2020

Background

Pseudomonas aeruginosa is the most common Gram-negative pathogen responsible for chronic wound infections, such as diabetic foot infections, and further exacerbates the treatment options and cost of such conditions. Hypertonic glucose, a commonly used prolotherapy solution, can accelerate the proliferation of granulation tissue and improve microcirculation in wounds. However, the action of hypertonic glucose on bacterial pathogens that infect wounds is unclear. In this study, we investigated the inhibitory effects of hypertonic glucose on multidrug-resistant P. aeruginosa strains isolated from diabetic foot infections. Hypertonic glucose represents a novel approach to control chronic wound infections caused by P. aeruginosa.

Results

Four multidrug-resistant P. aeruginosa clinical strains isolated from diabetic foot ulcers from a tertiary hospital in China and the reference P. aeruginosa PAO1 strain were studied. Hypertonic glucose significantly inhibited the growth, biofilm formation, and swimming motility of P. aeruginosa clinical strains and PAO1. Furthermore, hypertonic glucose significantly reduced the production of pyocyanin and elastase virulence factors in P. aeruginosa. The expression of major quorum sensing genes (lasI, lasR, rhlI, and rhlR) in P. aeruginosa were all downregulated in response to hypertonic glucose treatment. In a Galleria mellonella larvae infection model, the administration of hypertonic glucose was shown to increase the survival rates of larvae infected by P. aeruginosa strains (3/5).

Conclusions

Hypertonic glucose inhibited the growth, biofilm formation, and swimming motility of P. aeruginosa, as well as reduced the production of virulence factors and quorum sensing gene expression. Further studies that investigate hypertonic glucose therapy should be considered in treating chronic wound infections.
Global analysis of expression profile of members of DnaJ gene families involved in capsaicinoids synthesis in pepper (Capsicum annuum L)
Authors: Fan Fang Fei , Liu Fawan , Yang Xian , Wan Hongjian , Kang Yunyan
Published: July 2020

Background

The DnaJ proteins play critical roles in plant development and stress responses. Recently, seventy-six DnaJ genes were identified through a comprehensive bioinformatics analysis in the pepper genome. However, there were no reports on understanding of phylogenetic relationships and diverse expression profile of pepper DnaJ genes to date. Herein, we performed the systemic analysis of the phylogenetic relationships and expression profile of pepper DnaJ genes in different tissues and in response to both abiotic stress and plant hormones.

Results

Phylogenetic analysis showed that all the pepper DnaJ genes were grouped into 7 sub-families (sub-family I, II, III, IV, V, VI and VII) according to sequence homology. The expression of pepper DnaJs in different tissues revealed that about 38% (29/76) of pepper DnaJs were expressed in at least one tissue. The results demonstrate the potentially critical role of DnaJs in pepper growth and development. In addition, to gain insight into the expression difference of pepper DnaJ genes in placenta between pungent and non-pungent, their expression patterns were also analyzed using RNA-seq data and qRT-PCR. Comparison analysis revealed that eight genes presented distinct expression profiles in pungent and non-pungent pepper. The CaDnaJs co-expressed with genes involved in capsaicinoids synthesis during placenta development. What is more, our study exposed the fact that these eight DnaJ genes were probably regulated by stress (heat, drought and salt), and were also regulated by plant hormones (ABA, GA3, MeJA and SA).

Conclusions

In summary, these results showed that some DnaJ genes expressed in placenta may be involved in plant response to abiotic stress during biosynthesis of compounds related with pungency. The study provides wide insights to the expression profiles of pepper DanJ genes and contributes to our knowledge about the function of DnaJ genes in pepper.
Assignment of pre-event ASA physical status classification by pre-hospital physicians: a prospective inter-rater reliability study
Authors: Tønsager Kristin , Rehn Marius , Krüger Andreas J. , Røislien Jo , Ringdal Kjetil G.
Published: July 2020

Background

Individualized treatment is a common principle in hospitals. Treatment decisions are made based on the patient’s condition, including comorbidities. This principle is equally relevant out-of-hospital. Furthermore, comorbidity is an important risk-adjustment factor when evaluating pre-hospital interventions and may aid therapeutic decisions and triage. The American Society of Anesthesiologists Physical Status (ASA-PS) classification system is included in templates for reporting data in physician-staffed pre-hospital emergency medical services (p-EMS) but whether an adequate full pre-event ASA-PS can be assessed by pre-hospital physicians remains unknown. We aimed to explore whether pre-hospital physicians can score an adequate pre-event ASA-PS with the information available on-scene.

Methods

The study was an inter-rater reliability study consisting of two steps. Pre-event ASA-PS scores made by pre- and in-hospital physicians were compared. Pre-hospital physicians did not have access to patient records and scores were based on information obtainable on-scene. In-hospital physicians used the complete patient record (Step 1). To assess inter-rater reliability between pre- and in-hospital physicians when given equal amounts of information, pre-hospital physicians also assigned pre-event ASA-PS for 20 of the included patients by using the complete patient records (Step 2). Inter-rater reliability was analyzed using quadratic weighted Cohen’s kappa (κw).

Results

For most scores (82%) inter-rater reliability between pre-and in-hospital physicians were moderate to substantial (κw 0,47-0,89). Inter-rater reliability was higher among the in-hospital physicians (κw 0,77 to 0.85). When all physicians had access to the same information, κw increased (κw 0,65 to 0,93).

Conclusions

Pre-hospital physicians can score an adequate pre-event ASA-PS on-scene for most patients. To further increase inter-rater reliability, we recommend access to the full patient journal on-scene. We recommend application of the full ASA-PS classification system for reporting of comorbidity in p-EMS.
Cap-assisted endoscopy increases ampulla of Vater visualization in high-risk patients
Authors: Silva Leonardo Correa , Arruda Rondinelle Martins , Botelho Paula Fortuci Resende , Taveira Leonardo Nogueira , Giardina Kelly Menezio , de Oliveira Marco Antonio , Dias Julia , Oliveira Cleyton Zanardo , Fava Gilberto , Guimarães Denise Peixoto
Published: July 2020

Background

Periampullary adenocarcinoma is a major clinical problem in high-risk patients including FAP population. A recent modification for visualizing the ampulla of Vater (AV) involves attaching a cap to the tip of the forward-viewing endoscope. Our aim was to compare the rates of complete visualization of AV using this cap-assisted endoscopy (CAE) approach to standard forward-viewing endoscopy (FVE). We also determined: (i) the rates of complications and additional sedation; (ii) the mean time required for duodenal examination; and (iii) the reproducibility among endoscopists performing this procedure.

Methods

We performed esophagogastroduodenoscopy for AV visualization in 102 > 18 years old using FVE followed by CAE. Video recordings were blinded and randomly selected for independent expert endoscopic evaluation.

Results

The complete visualization rate for AV was higher in CAE (97.0%) compared to FVE (51.0%) (p <  0.001). The additional doses of fentanyl, midazolam, and propofol required for CAE were 0.05, 1.9 and 36.3 mg. in 0.9, 24.5, and 77.5% patients, respectively. The mean time of duodenal examination for AV visualization was lower on CAE compared to FVE (1.41 vs. 1.95 min, p <  0.001). Scopolamine was used in 34 FVE and 24 CAE, with no association to AV complete visualization rates (p = 0.30 and p = 0.14). Three more ampullary adenomas were detected using CAE compared to FVE. Cap displacement occurred in one patient, and there was no observed adverse effect of the additional sedatives used. Kappa values for agreement between endoscopists ranged from 0.60 to 0.85.

Conclusions

CAE is feasible, reproducible and safe, with a higher success rate for complete visualization compared to FVE.

Trial registration: ClinicalTrials.gov, NCT02867826, 16 August 2016.
Interventions to improve appropriate antibiotic prescribing in long-term care facilities: a systematic review
Authors: Crayton Elise , Richardson Michelle , Fuller Chris , Smith Catherine , Liu Sunny , Forbes Gillian , Anderson Niall , Shallcross Laura , Michie Susan , Hayward Andrew , Lorencatto Fabiana
Published: July 2020

Background

Overuse of antibiotics has contributed to antimicrobial resistance; a growing public health threat. In long-term care facilities, levels of inappropriate prescribing are as high as 75%. Numerous interventions targeting long-term care facilities’ antimicrobial stewardship have been reported with varying, and largely unexplained, effects. Therefore, this review aimed to apply behavioural science frameworks to specify the component behaviour change techniques of stewardship interventions in long-term care facilities and identify those components associated with improved outcomes.

Method

A systematic review (CRD42018103803) was conducted through electronic database searches. Two behavioural science frameworks, the Behaviour Change Wheel and Behaviour Change Technique Taxonomy were used to classify intervention descriptions into intervention types and component behaviour change techniques used. Study design and outcome heterogeneity prevented meta-analysis and meta-regression. Interventions were categorised as ‘very promising’ (all outcomes statistically significant), ‘quite promising’ (some outcomes statistically significant), or ‘not promising’ (no outcomes statistically significant). ‘Promise ratios’ (PR) were calculated for identified intervention types and behaviour change techniques by dividing the number of (very or quite) promising interventions featuring the intervention type or behaviour change technique by the number of interventions featuring the intervention type or behaviour change technique that were not promising. Promising intervention types and behaviour change techniques were defined as those with a PR ≥ 2.

Results

Twenty studies (of19 interventions) were included. Seven interventions (37%) were ‘very promising’, eight ‘quite promising’ (42%) and four ‘not promising’ (21%). Most promising intervention types were ‘persuasion’ (n = 12; promise ratio (PR) = 5.0), ‘enablement’ (n = 16; PR = 4.33) and ‘education’ (n = 19; PR = 3.75). Most promising behaviour change techniques were ‘feedback on behaviour’ (n = 9; PR = 8.0) and ‘restructuring the social environment’ (e.g. staff role changes;n = 8; PR = 7.0).

Conclusion

Systematic identification of the active ingredients of antimicrobial stewardship in long-term care facilities was facilitated through the application of behavioural science frameworks. Incorporating environmental restructuring and performance feedback may be promising intervention strategies for antimicrobial stewardship interventions within long-term care facilities.
Effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in Beijing, China
Authors: Dai Lili , Yu Xiaochun , Shao Ying , Wang Yali , Li Zaicun , Ye Jiangzhu , Bai Shaoli , Guo Xiaoling , Wang Jianyun , Su Bin , Jiang Taiyi , Zhang Tong , Wu Hao , Scott Sarah Robbins , Liu An , Sun Lijun
Published: July 2020

Background

This paper introduces a comprehensive case management model uniting doctors, nurses, and non-governmental organizations (NGOs) in order to shorten the time from HIV diagnosis to initiation of antiviral therapy, improve patients’ adherence, and ameliorate antiretroviral treatment (ART)-related outcomes.

Methods

All newly diagnosed human immunodeficiency virus (HIV) cases at Beijing YouAn Hospital from January 2012 to December 2013 were selected as the control group, while all newly diagnosed HIV-infected patients from January 2015 to December 2016 were selected as the intervention group, receiving the comprehensive case management model.

Results

4906 patients were enrolled, of which 1549 were in the control group and 3357 in the intervention group. The median time from confirming HIV infection to ART initiation in the intervention group was 35 (18–133) days, much shorter than the control group (56 (26–253) days, P < 0.001). Participants in the intervention group had better ART adherence compared to those in the control group (intervention: 95.3%; control: 89.2%; p < 0.001). During the 2 years’ follow-up, those receiving case management were at decreased odds of experiencing virological failure (OR: 0.27, 95%CI: 0.17–0.42, P < 0.001). Observed mortality was 0.4 deaths per 100 patient-years of follow-up for patients in the control group compared with 0.2 deaths per 100 patient-years of follow-up in the intervention group.

Conclusions

People living with HIV engaged in the comprehensive case management model were more likely to initiate ART sooner and maintained better treatment compliance and improved clinical outcomes compared to those who received routine care. A comprehensive case management program could be implemented in hospitals across China in order to reduce the HIV disease burden in the country.
Isolation and characterization of WUPyV in polarized human airway epithelial cells
Authors: Wang Chao , Wei Tianli , Huang Yiman , Guo Qiong , Xie Zhiping , Song Jingdong , Chen Aijun , Zheng Lishu
Published: July 2020

Background

Washington University polyomavirus (WUPyV) is a novel human polyomavirus detected in childwith acute respiratory infection in 2007. However, the relationship between WUPyV and respiratory diseases has yet to be established for lacking of a suitable in vitro culture system.

Methods

To isolate WUPyV with human airway epithelial (HAE) cells, the positive samples were incubated in HAE, and then the nucleic acid, VP1 protein and virions were detected using real-time PCR, immunofluorescence and electron microscopy respectively.

Results

The result showed that WUPyV could replicate effectively in HAE cells and virions with typical polyomavirus characteristics could be observed. Additionally, the entire genome sequence of the isolated strain (BJ0771) was obtained and phylogenetic analysis indicated that BJ0771 belongs to gene cluster I.

Conclusions

Our findings demonstrated clinical WUPyV strain was successfully isolated for the first time in the world and this will help unravel the etiology and pathogenic mechanisms of WUPyV in respiratory infection diseases.
Prevalence of and factors associated with unplanned pregnancy among women in Koshu, Japan: cross-sectional evidence from Project Koshu, 2011–2016
Authors: Huynh Son Trung , Yokomichi Hiroshi , Akiyama Yuka , Kojima Reiji , Horiuchi Sayaka , Ooka Tadao , Shinohara Ryoji , Yamagata Zentaro
Published: July 2020

Background

Unplanned pregnancy is a public health issue with adverse consequences for maternal and neonatal health. In Japan, the prevalence of unplanned pregnancy was 46.2% in 2002. However, few studies have investigated this topic, and there is little recent data from Japan. We described and examined the prevalence and determinants of unplanned pregnancy among rural women in Japan from 2011 to 2016.

Methods

We used cross-sectional data from a community-based cohort study (Project Koshu). Data were collected from 2011 to 2016 via a self-report questionnaire included in the Maternal and Child Health Handbook of Japan. Pregnancy intention was measured as a binary variable (planned or unplanned). Univariate and multivariate logistic regression analyses were performed to examine factors associated with unplanned pregnancy, with results reported as odds ratios (ORs) and 95% confidence intervals (CIs). We conducted sensitivity analyses with different definitions of pregnancy intention to assess the robustness of the results. The significance level was set at 5%.

Results

Of the 932 participants (mean ± standard deviation age at baseline: 31.3 ± 5.2 years), 382 (41%) pregnancies were reported as unplanned. The multivariate analyses showed that maternal age (+ 1 year: OR = 0.94, 95% CI: 0.92–0.97, p <  0.001), ‘other’ family structure (OR = 2.76, 95% CI: 1.12–6.76, p = 0.03), three or more pregnancies (OR = 2.26, 95% CI: 1.66–3.08, p <  0.001), current smoking (OR = 2.60, 95% CI: 1.26–5.35, p = 0.01), balanced diet (OR = 0.62, 95% CI: 0.47–0.83, p <  0.001) and current depression (OR = 1.63, 95% CI: 1.24–2.16, p <  0.001) were strongly associated with unplanned pregnancy. These associations were consistent across definitions of pregnancy intention, supporting the robustness of our results.

Conclusions

The prevalence of unplanned pregnancy in the study population was high (41%). Risk factors for unplanned pregnancy were age, number of pregnancies, smoking, having a balanced diet and current depression. These results suggest greater efforts are needed to enhance sex education for young people, improve access to family planning services and provide comprehensive health care for high-risk women to help reduce unplanned pregnancies.
Symptoms of ocular surface disease in construction workers: comparative study with office workers
Authors: Hernandez-Llamas Sergio , Paz-Ramos Ana Karen , Marcos-Gonzalez Patricio , Amparo Francisco , Garza-Leon Manuel
Published: July 2020

Background

To investigate and contrast the prevalence of dry eye symptoms in construction workers and office workers using the OSDI questionnaire.

Methods

A cross-sectional, observational study was conducted using the OSDI questionnaire to evaluate dry eye symptoms and associated risk factors. Sampled size calculation with a power of 80% and a 95% degree of confidence suggested the inclusion of 298 participants.

Results

We studied 304 subjects (149 construction workers and 155 office workers). More than half (55%) of the participants presented dry eye symptoms (OSDI > 12). The average OSDI score was 21.30 ± 22.20 points, being lower in the group of construction workers (12.45 ± 17.50) than in-office workers (28.51 ± 22.99) (p <  0.001). Considering participants who had moderate and severe symptoms (23 to 100 points in OSDI), office workers presented dry eye symptoms 4.15 times more frequently than construction workers (OR 4.15, 95% CI 2.52, 6.85). Women presented statistical evidence of higher OSDI scores than men (32.47 ± 23.72 vs. 14.87 ± 18.48, respectively).

Conclusions

construction workers have four times less risk of presenting dry eye symptoms than people working in the average office space. This highlights the pernicious effects on the ocular surface of the office environment, which poses a significant risk for the development or worsening of dry eye symptoms.
Psychometric properties and contextual appropriateness of the German version of the Early Development Instrument
Authors: Georg Sabine , Bosle Catherin , Fischer Joachim E. , De Bock Freia
Published: July 2020

Background

Assessing the early development of children at a population level in educational settings, may be useful for public health and policy decision making. In this study, we evaluated the psychometric properties and the contextual appropriateness of a German language version of the Early Development Instrument (EDI), a survey-based instrument originally developed in Canada, which assesses developmental vulnerability for children in preschool settings.

Methods

Sixty preschool teachers from six preschool organizations (22% of organizations contacted) in three cities in southwest Germany participated. They administered a German version of the EDI (GEDI) to 225 children (51% of eligible children). We assessed internal consistency, test-retest and interrater reliability. Preschool teachers assisted in determining face-validity by reviewing item coverage and comprehensibility. Exploratory factor analysis (EFA) was used to evaluate convergent validity. Concurrent validity was measured using correlations and agreements (Bland-Altman plots) between GEDI and other validated instrument scores. Additionally, we compared associations between GEDI domain scores and sociodemographic characteristics with similar associations in EDI studies worldwide.

Results

GEDI domains showed good to excellent internal consistency (0.73 < α > 0.99) and moderate to good test-retest and interrater reliability (0.50 to 0.81 and 0.48 to 0.71, respectively [p-value < 0.05]). Face validity was considered acceptable. EFA showed a factor structure similar to the original EDI. Correlations (range: 0.32 to 0.67) and agreements between GEDI scores and other German language instruments suggested good external reliability. Scoring within the lowest 10th percentile was strongly associated with age.

Conclusions

Our psychometric assessment suggests good reliability and consistency of the GEDI. Differences in the age distribution of children, pedagogical objectives and educational system features of German preschools require future work to determine score thresholds indicative of vulnerability. Aside from dropping selected items from the original EDI that were inconsistent with features of the German educational system, the distribution of values in the language and cognitive development domain also suggested that context-specific cut-offs must be established for the German version. Such efforts are needed to account for relevant contextual differences between the educational systems.
Knowledge, attitude, and practices toward chronic kidney disease among care providers in Jimma town:cross-sectional study
Authors: Wolide Amare Desalegn , Kumela Kabaye , Kerga Fantu , Debalke Serkadis , Seboka Meskerem , Edilu Birtukan , Gashe Fanta , Bobassa Eshetu Mulisa
Published: July 2020

Background

Chronic kidney disease (CKD) is a common and growing health problem that requires adequate Knowledge by health care providers to reduce the progress of the disease. Thus, this study aimed to assess the care provider’s Knowledge, attitude, and practices toward CKD.

Method

A cross-sectional study conducted among 326 care providers at Jimma University Specialized hospital and three medium to higher clinics found in Jimma Town. Collected data entered into Epi-Data version 3.1 and exported to SPSS version 21 for windows for data analysis. Descriptive statistics and generalized linear modal used to analyze the data.

Result

The mean age and service year of the participants were 29.68(±4.877) and 4.28(±4.561), respectively. The overall weighted Knowledge, attitude, and practice score of the study participant were 9.0971(8.77, 9.42), 2.53(2.4, 2.65), 10.14(9.94, 10.33) respectively. Over half of the care providers had the awareness to use eGFR to assess kidney function and patient referral to Nephrologists. Also, many care providers knew the five-stage of CKD and the risk factors of CKD, such as diabetes, long-term alcohol consumption, anemia, and cardiovascular disorders, respectively. Care providers had an understanding of late detection, and referral of CKD would increase kidney disease complications. Besides, 275(84.4%) of them are worried about treatment costs related to CKD. Over half of the care providers, 238(73.0%), believed that the Ethiopian ministry of health gave less attention to the problem. Furthermore, 234(71.8%) are interested in studying more on CKD management. Majority 256(78.5%), very likely or likely refer the patient to senior physician and Nephrologist.

Conclusion

Care providers showed enough Knowledge, a favorable attitude, and practice toward CKD.
Occurrence and quantification of Anelloviruses and Herpesviruses in gingival tissue in Chinese Shanghai sub-population
Authors: Yu Tian , Pan Shaokun , Zhang Yu , Pei Jun , Liu Jing , Xie Youhua , Feng Xiping
Published: July 2020

Background

Herpesvirusesand bacteria and their interplay have long been believed to play important roles in the pathogenesis of periodontitis, but other microbial entities in the oral environment might also be involved.Anellovirusesare commonly detected in human, including in oral samples. The aim of the present study was to explore the occurrence and co-occurrence ofhuman cytomegalovirus(HCMV),Epstein–Barr virus(EBV), andhuman anelloviruses(HTTVs) in gingival tissue samples collected from participants recruited in Shanghai, China.

Methods

Gingival tissues were collected from 159 participants (57 with aggressive periodontitis (AP), 59 with chronic periodontitis (CP) and 43 with healthy periodontal status). The presence of HCMV, EBV,torque teno virus(TTV),torque teno mini virus(TTMV) andtorque teno midi virus(TTMDV) DNA was detected by nested-PCR. The virus loads were quantified by real-time PCR.

Results

The detection rates of EBV, TTV, TTMV and TTMDV were significantly higher in the AP and CP groups compared to the healthy group (allP < 0.01). A statistically significant association was found between EBV, TTV and TTMV virus load and periodontitis (allP < 0.05). Participants infected with EBV showed significantly higher infection rates and higher virus loads of TTV and TTMV than the EBV-negative group (allP < 0.05). The coexistence rates of EBV andanellovirusesand the coexistence of three HTTVs were significantly higher in AP and CP groups (allP < 0.01).

Conclusions

Collectively, results obtained in this study suggest that HTTVs and the coexistence of EBV and HTTVs in particular, may be associated with periodontitis. Possible mechanisms of the interaction betweenherpesvirusesandanellovirusesin the context of periodontitis require further investigation.
Enhanced character-level deep convolutional neural networks for cardiovascular disease prediction
Authors: Zhang Zhichang , Qiu Yanlong , Yang Xiaoli , Zhang Minyu
Published: July 2020

Background

Electronic medical records contain a variety of valuable medical information for patients. So, when we are able to recognize and extract risk factors for disease from EMRs of patients with cardiovascular disease (CVD), and are able to use them to predict CVD, we have the ability to automatically process clinical texts, resulting in an improved accuracy of supporting doctors for the clinical diagnosis of CVD. In the case where CVD is becoming more worldwide, predictive CVD based on EMRs has been studied by many researchers to address this important aspect of improving diagnostic efficiency.

Methods

This paper proposes an Enhanced Character-level Deep Convolutional Neural Networks (EnDCNN) model for cardiovascular disease prediction.

Results

On the manually annotated Chinese EMRs corpus, our risk factor identification extraction model achieved 0.9073 of F-score, our prediction model achieved 0.9516 of F-score, and the prediction result is better than the most previous methods.

Conclusions

The character-level model based on text region embedding can well map risk factors and their labels as a unit into a vector, and downsampling plays a crucial role in improving the training efficiency of deep CNN. What’s more, the shortcut connections with pre-activation used in our model architecture implements dimension-matching free in training.
Japanese nurse practitioners’ legal liability ambiguity regarding their medical practice: a qualitative study
Authors: Sugiyama Shoko , Asakura Kyoko , Takada Nozomu
Published: July 2020

Background

Nurse practitioners’ role is always expanding. The Japanese Nurse Practitioner (JNP) system was initiated in 2015 to shift some aspects of doctors’ work to various other healthcare professionals, including nurses. JNPs’ fulfillment of their roles was shown to have a certain degree of efficacy and provide positive outcomes for patients (e.g., shortening hospitalization period). Nurse practitioners are considered legally liable for their medical practices because they are performed on doctors’ behalf; however, in real life, there is ambiguity regarding such practice. It is necessary to clarify nurse practitioners’ legal liability in order to ensure the safety of their medical practice and protect them in medical procedures performed on physicians’ behalf. This study aimed to clarify how JNPs understand their own legal liability in medical practice.

Methods

A qualitative, inductive research design was adopted to record participants’ opinions. The survey was conducted from October 2017 to February 2018. Participants were nurses working as JNPs at general hospitals in eastern Japan. We recruited participants via snowball sampling.

Results

With regard to JNPs’ legal liability in their medical practice, three themes understanding were observed: “determining whether the JNP has the ability to perform the assigned medical procedure,” “exercising caution when performing medical procedures on a doctor’s behalf” and “an urge to follow up with appropriate medical practice until the end of care.”

Conclusions

We demonstrated that JNPs recognized their own legal liability in medical practice. They had to protect themselves because their legal position was ambiguous. Furthermore, JNPs accepted that diagnosis and drug prescription could be performed on behalf of doctors if trusting relationships had been previously established.