bluuebunny/crossref_metadata_2025 huggingface dataset:
Routine health information system in the health facilities in Yaoundé–Cameroon: assessing the gaps for strengthening
Authors: Tamfon Brian Bongwong , Bilounga Ndongo Chanceline , Bataliack Serge Marcial , Ngoufack Marie Nicole , Nguefack-Tsague Georges
Published: December 2020

Background

Management of health data and its use for informed-decision making is a challenging health sector aspect in developing countries. Monitoring and evaluation of health interventions for meeting health-related Sustainable Development Goals (SDGs), and Cameroon Health Sector Strategy (HSS) targets is facilitated through evidence-based decision-making and public health action. Thus, a routine health information system (RHIS) producing quality data is imperative. The objective of this study was to assess the RHIS in the health facilities (HFs) in Yaoundé in order to identify gaps and weaknesses and to propose measures for strengthening.

Methods

A health facility-based cross-sectional descriptive study was carried out in the six health districts (HDs) of Yaoundé; followed by a qualitative aspect consisting of in-depth interviews of key informants at the Regional Health Office. HFs were selected using a stratified sampling method with probability proportional to the size of each HD. Data were collected (one respondent per HF) using the World Health Organization and MEASURE Evaluation RHIS rapid assessment tool. Data were entered into Microsoft Excel 2013 and analyzed with IBM-SPSS version 20.

Results

A total of 111 HFs were selected for the study. Respondents aged 24–60 years with an average of 38.3 ± 9.3 years; 58 (52.3%) male and 53(47.7%) female. Heads of HFs and persons in charge of statistics/data management were most represented with 45.0% and 21.6% respectively. All the twelve subdomains of the RHIS were adequately functioning at between 7 and 30%. These included Human Resources (7%), Data Analysis (10%), Information and Communication Technology (11%), Standards and System Design (15%), Policies and Planning (15%), Information Dissemination (16%), Data Demand and Use (16%), Management (18%), Data Needs (18%), Data Quality Assurance (20%), Collection and Management of Individual Client Data (26%), Collection, Management, and Reporting of Aggregated Facility Data (30%).

Conclusions

The level of functioning of subdomains of the RHIS in Yaoundé was low; thus, immediate and district-specific strengthening actions should be implemented if health-related SDGs and HSS targets are to be met. A nation-wide assessment should be carried out in order to understand the determinants of these poor performances and to strengthen the RHIS.
Objective structural clinical examination for evaluating learning efficacy of Cultural Competence Cultivation Programme for nurses
Authors: Lee Yu-Hsia , Lin Shu-Chuan , Wang Pao-Yu , Lin Mei-Hsiang
Published: December 2020

Background

Culture serves as an adhesive to bind the lives of people. There are no objective, useful tools to assess cultural competence and practice. In this study, we evaluated whether the cultural competence of nurses was strengthened through the Cultural Competence Cultivation Programme.

Methods

A quasi-experimental research design was used to evaluate nurses working at a medical centre in Taiwan. They were randomly allocated into an experimental group (n = 47), which received the Cultural Competence Cultivation Programme, or a control group (n = 50), which did not receive the educational programme. After the intervention, learning efficacy of the participants was assessed using an Objective Structured Clinical Examination (OSCE). The research data were statistically analysed on SPSS.

Results

The average score of the experimental group was significantly higher in the ‘communication ability and skill’ category. Furthermore, OSCE scores and Standardised Patient Survey assessment and total scores were significantly and positively correlated.

Conclusion

The findings of this study can serve as a reference for designing future clinical education programmes.
Developing a specialist children’s nursing workforce in sub-Saharan Africa: a descriptive programme evaluation
Authors: Ruthe Jennifer , North Natasha
Published: December 2020

Background

Achieving Universal Health Coverage in low and lower-middle income countries requires an estimated additional five and a quarter million nurses. Despite an increasing focus on specialist nursing workforce development, the specialist children’s workforce in most African countries falls well below recommended densities. The Child Nursing Practice Development Initiative was established with the aim of building the children’s nursing workforce in Southern and Eastern Africa, and Ghana. The purpose of this evaluation was to enable scrutiny of programme activities conducted between 2008 and 2018 to inform programme review and where possible to identify wider lessons of potential interest in relation to specialist nursing workforce strengthening initiatives.

Methods

The study took the form of a descriptive programme evaluation. Data analysed included quantitative programme data and contextual information from documentary sources. Anonymised programme data covering student enrolments between January 2008 and December 2018 were analysed. Findings were member-checked for accuracy.

Results

The programme recorded 348 enrolments in 11 years, with 75% of students coming from South Africa and 25% from other sub-Saharan African countries. With a course completion rate of 94, 99% of known alumni were still working in Africa at the end of 2018. Most graduates were located at top-tier (specialist) public hospital facilities. Nine percent of known alumni were found to be working in education, with 54% of graduates at centres that offer or plan to offer children’s nursing education.

Conclusion

The programme has made a quantifiable, positive and sustained contribution to the capacity of the specialist clinical and educational children’s nursing workforce in nine African countries. Data suggest there may be promising approaches within programme design and delivery in relation to very high course completion rates and the retention of graduates in service which merit further consideration. Outputs from this single programme are however modest when compared to the scale of need. Greater clarity around the vision and role of specialist children’s nurses and costed plans for workforce development are needed for investment in specialist children’s nursing education to realise its potential in relation to achievement of Universal Health Coverage.
A standardized framework to evaluate the quality of studies using TDABC in healthcare: the TDABC in Healthcare Consortium Consensus Statement
Authors: Etges Ana Paula Beck da Silva , Polanczyk Carisi Anne , Urman Richard D.
Published: December 2020

Background

This Consensus Statement introduces a standardized framework, in a checklist format, to support future development and reporting of TDABC studies in healthcare, and to encourage their reproducibility. Additionally, it establishes the first formal networking of TDABC researchers through the creation of the TDABC in Healthcare Consortium.

Methods

A consensus group of researchers reviewed the most relevant TDABC studies available in Medline and Scopus databases to identify the initial elements of the checklist. Using a Focus Group process, each element received a recommendation regarding where in the scientific article section it should be placed and whether the element was required or suggested. A questionnaire was circulated with expert researchers in the field to provide additional recommendations regarding the content of the checklist and the strength of recommendation for each included element.

Results

The TDABC standardized framework includes 32 elements, provides recommendations where in the scientific article to include each element, and comments on the strength of each recommendation. All 32 elements were validated, with 21 elements classified as mandatory and 11 as suggested but not mandatory.

Conclusions

This is the first standardized framework to support the development and reporting of TDABC research in healthcare and to stablish a community of experts in TDABC methodology. We expect that it can contribute to scale strategies that would result in cost-savings outcomes and in value-oriented strategies that can be adopted in healthcare systems and institutions.
Impact of suspending minimum volume requirements for knee arthroplasty on hospitals in Germany: an uncontrolled before–after study
Authors: de Cruppé Werner , Ortwein Annette , Kraska Rike Antje , Geraedts Max
Published: December 2020

Background

In 2004, the Federal Joint Committee, supreme decision-making body in German healthcare, introduced minimum volume requirements (MVRQs) as a quality instrument. Since then, MVRQs were implemented for seven hospital procedures. This study evaluates the effect of a system-wide intermission of MVRQ for total knee arthroplasty (TKA), demanding 50 annual cases per hospital.

Methods

An uncontrolled before–after study based on federal-level data including the number of hospitals performing TKA, and TKA cases from the external hospital quality assurance programme in Germany (2004–2017). Bi- and multivariate analyses based on hospital-level secondary data of TKA cases and TKA quality indicators extracted from hospital quality reports in Germany (2006–2014).

Results

The number of TKAs performed in Germany decreased by 11% after suspending the TKA-MVRQ in 2011, and rose by 13% after its reintroduction in 2015. The number of hospitals with less than 50 cases rose from 10 to 25% and their case share from 2 to 5.5% during suspension. Change in hospital volume after the suspension of TKA-MVRQ was not associated with hospital size, ownership, or region. All four evaluable quality indicators increased significantly in the year after their first public reporting. Compared to hospitals meeting the TKA-MVRQ, three indicators show slight but statistically significant better quality in hospitals below the TKA-MVRQ.

Conclusions

In Germany, TKA-MVRQs seem to induce in-hospital caseload adjustments rather than foster regional inter-hospital case transfers as intended.
Invitations and incentives: a qualitative study of behavioral nudges for primary care screenings in Armenia
Authors: Gong Estelle , Chukwuma Adanna , Ghazaryan Emma , de Walque Damien
Published: December 2020

Background

Non-communicable diseases account for a growing proportion of deaths in Armenia, which require early detection to achieve disease control and prevent complications. To increase rates of screening, demand-side interventions of personalized invitations, descriptive social norms, labeled cash transfers, and conditional cash transfers were tested in a field experiment. Our complementary qualitative study explores factors leading to the decision to attend screening and following through with that decision, and experiences with different intervention components.

Methods

Informed by the Health Belief Model as our conceptual framework, we collected eighty in-depth interviews with service users and twenty service providers and analyzed them using open coding and thematic analysis.

Results

An individual’s decision to screen depends on 1) the perceived need for screening based on how they value their own health and perceive hypertension and diabetes as a harmful but manageable condition, and 2) the perceived utility of a facility-based screening, and whether screening will provide useful information on disease status or care management and is socially acceptable. Following through with the decision to screen depends on their knowledge of and ability to attend screenings, as well as any external motivators such as an invitation or financial incentive.

Conclusions

Personalized invitations from physicians can prompt individuals to reconsider their need for screening and can, along with financial incentives, motivate individuals to follow through with the decision to screen. The effect of descriptive social norms in invitations should be further studied. Efforts to increase preventive screenings as an entry point into primary care in Armenia may benefit from implementation of tailored messages and financial incentives.

Trial registration

The protocol was approved on January 11, 2019 by the Institutional Review Board of the Center of Medical Genetics and Primary Health Care in Armenia (02570094).https://www.socialscienceregistry.org/trials/3776.
React and act: a qualitative study of how nursing home leaders follow up on staff-to-resident abuse
Authors: Myhre Janne , Saga Susan , Malmedal Wenche , Ostaszkiewicz Joan , Nakrem Sigrid
Published: December 2020

Background

Elder abuse in nursing homes is a complex multifactorial problem and entails various associations across personal, social, and organisational factors. One way leaders can prevent abuse and promote quality and safety for residents is to follow up on any problems that may arise in clinical practice in a way that facilitates learning. How nursing home leaders follow up and what they follow up on might reflect their perceptions of abuse, its causal factors, and the prevention strategies used in the nursing home. The aim of this study was to explore how nursing home leaders follow up on reports and information regarding staff-to-resident abuse.

Methods

A qualitative explorative design was used. The sample comprised 43 participants from two levels of nursing home leadership representing six municipalities and 21 nursing homes in Norway. Focus group interviews were conducted with 28 care managers, and individual interviews took place with 15 nursing home directors. The constant comparative method was used for the analyses.

Results

Nursing home leaders followed up incidents of staff-to-resident abuse on three different levels as follows: 1) on an individual level, leaders performed investigations and meetings, guidance, supervision, and occasionally relocated staff members; 2) on a group level, feedback, openness, and reflection for shared understanding were strategies leaders used; and 3) on an organisational level, the main solutions were to adjust to available resources, training, and education. We found that leaders had difficulties defining harm and a perceived lack of power to follow up on all levels. In addition, they did not have adequate tools for evaluating the effect of the measures that were taken.

Conclusions

Nursing home leaders need to be clear about how they should follow up incidents of elder abuse on different levels in the organisation and about their role in preventing elder abuse. Evaluation tools that facilitate systematic organisational learning are needed. Nursing homes must operate as open, blame-free cultures that acknowledge that incidents of elder abuse in patient care arise not only from the actions of individuals but also from the complex everyday life of which they are a part and in which they operate.
Ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus
Authors: Zhou Hai , Zhang Ge , Li Ming , Qu Xiangyang , Cao Yujiang , Liu Xing , Zhang Yuan
Published: December 2020

Background

To evaluate the clinical and radiographic outcomes of ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus (TFDH).

Methods

Twenty-seven patients with displaced TFDH were successfully treated by the ultrasonography-guided closed reduction during January 2012 to December 2016 and were retrospectively reviewed. After the mean follow-up of 34.88 months, the clinical and radiographic outcomes of patients were evaluated. The cubitus varus of the affected elbows was also assessed at the latest follow-up.

Results

The successful rate of ultrasonography-guided closed reduction in the treatment of displaced TFDH was 84% (27/32). The twenty-seven patients with successful reduction were included for the following analysis. There were 20 males and 7 females included in the study, and the mean age at treatment was 15.39 ± 3.10 months; seventeen fractures occurred in the right side elbow and ten in the left side. At the last follow-up, there were significant decreases in the elbow flexion (3°,P= 0.027) and range of motion (5°,P= 0.003) between the injured and uninjured elbow, respectively, whereas no difference in elbow extension was detected (P= 0.110). Flynn’s criteria assessment showed that all the patients achieved excellent or good outcomes both in the functional and cosmetic categories. The clinical and radiographic carrying angles at the last follow-up were 11.67 ± 3.11° and 10.46 ± 3.88°, respectively. And the incidence of cubitus varus after treatment was 7.4% at the last follow-up.

Conclusion

The ultrasonography-guided closed reduction in the treatment of displaced TFDH is an effective procedure; the adequate fracture reduction can be acquired with the advantages of real-time, non-radioactive, and simple utilization. With the percutaneous pining fixation, satisfactory clinical and radiographic outcomes can be achieved with a low incidence of postoperative cubitus varus.
FDA efficiency for approval process of COVID-19 therapeutics
Authors: Cassidy Christine , Dever Danielle , Stanbery Laura , Edelman Gerald , Dworkin Lance , Nemunaitis John
Published: December 2020

Coronavirus disease 19 (COVID-19) is an infection caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The pandemic spread of SARS-CoV-2 has resulted in significant health, economic, and social ramifications. There are no U.S. Food and Drug Administration (FDA)-approved prophylactic or therapeutic treatment options for COVID-19. This puts unprecedented product development pressure on the medical science community to define treatment options. Additionally, in the United States of American (USA) further regulatory and quality assurance pressures impact the FDA. The regulatory therapeutic development process is complex as it relates to product mechanism, toxicity profile, and level of efficacy. The advert of a worldwide pandemic however, advanced efficiencies within many of the regulatory agencies worldwide in order to facilitate COVID-19 treatment option development within the USA. Clinical drug development pathways can include several established approaches: investigational new drug (IND), expanded access IND, emergency IND, treatment IND, and emergency use authorization (EUA). Remdesivir, an investigational drug, and hydroxyloroquine, an FDA-approved drug for autoimmune diseases, were the two early potential therapies. This review article examines the expedited FDA review process for remdesivir and hydroxychloroquine, and analyzes data and results from early clinical studies of both drugs.
Quantifying the shift in social contact patterns in response to non-pharmaceutical interventions
Authors: McCarthy Zachary , Xiao Yanyu , Scarabel Francesca , Tang Biao , Bragazzi Nicola Luigi , Nah Kyeongah , Heffernan Jane M. , Asgary Ali , Murty V. Kumar , Ogden Nicholas H. , Wu Jianhong
Published: December 2020

Social contact mixing plays a critical role in influencing the transmission routes of infectious diseases. Moreover, quantifying social contact mixing patterns and their variations in a rapidly evolving pandemic intervened by changing public health measures is key for retroactive evaluation and proactive assessment of the effectiveness of different age- and setting-specific interventions. Contact mixing patterns have been used to inform COVID-19 pandemic public health decision-making; but a rigorously justified methodology to identify setting-specific contact mixing patterns and their variations in a rapidly developing pandemic, which can be informed by readily available data, is in great demand and has not yet been established. Here we fill in this critical gap by developing and utilizing a novel methodology, integrating social contact patterns derived from empirical data with a disease transmission model, that enables the usage of age-stratified incidence data to infer age-specific susceptibility, daily contact mixing patterns in workplace, household, school and community settings; and transmission acquired in these settings under different physical distancing measures. We demonstrated the utility of this methodology by performing an analysis of the COVID-19 epidemic in Ontario, Canada. We quantified the age- and setting (household, workplace, community, and school)-specific mixing patterns and their evolution during the escalation of public health interventions in Ontario, Canada. We estimated a reduction in the average individual contact rate from 12.27 to 6.58 contacts per day, with an increase in household contacts, following the implementation of control measures. We also estimated increasing trends by age in both the susceptibility to infection by SARS-CoV-2 and the proportion of symptomatic individuals diagnosed. Inferring the age- and setting-specific social contact mixing and key age-stratified epidemiological parameters, in the presence of evolving control measures, is critical to inform decision- and policy-making for the current COVID-19 pandemic.
Potato consumption and risk of cardio-metabolic diseases: evidence mapping of observational studies
Authors: So Jisun , Avendano Esther E. , Raman Gowri , Johnson Elizabeth J.
Published: December 2020

Background

Recent systematic review of clinical trials concluded that there was no convincing evidence to suggest an association between potatoes and risk of cardio-metabolic diseases.

Objective

Summarize observational study data related to potato intake and cardio-metabolic health outcomes in adults using evidence mapping to assess the need for a future systematic review.

Methods

We searched MEDLINE®, Commonwealth Agricultural Bureau, and bibliographies for eligible observational studies published between 1946 and July 2020. Included studies evaluated potato intake in any form or as part of a dietary pattern with risk for cardio-metabolic diseases. Outcomes of interest included cardiovascular disease (CVD), cerebrovascular diseases, diabetes, hypertension, blood lipids, and body composition.

Results

Of 121 eligible studies, 51 reported two different methods to quantify potato intake (30 studies quantified intake as either grams or serving; 20 studies reported times per week; one reported both methods) and 70 reported potato as part of a dietary pattern and compared higher vs. lower intake, linear change, or difference in potato intake among cases and controls. Studies that quantified potato intake as either grams or serving reported the following outcomes: diabetes (8 studies); cerebrovascular stroke (6 studies); five studies each for CVD, systolic and diastolic blood pressure, and hypertension; three studies each for body mass index, body weight, CVD mortality; two studies for myocardial infarction; and one study each for blood glucose, HOMA-IR, and blood lipids. Higher potato intake was associated with an increased risk for blood pressure and body weight, and the results of all other outcomes observed no association. Potato consumption as part of dietary pattern studies reported a negative association between fried form of potato and all or most cardio-metabolic risk factors and diseases.

Conclusion

Evidence mapping found sufficient data on the association between potato intake and cardio-metabolic disease risk factors to warrant for a systematic review/meta-analysis of observational studies.
Crowding effects on the dynamics of COVID-19 mathematical model
Authors: Zhang Zizhen , Zeb Anwar , Alzahrani Ebraheem , Iqbal Sohail
Published: December 2020

A disastrous coronavirus, which infects a normal person through droplets of infected person, has a route that is usually by mouth, eyes, nose or hands. These contact routes make it very dangerous as no one can get rid of it. The significant factor of increasing trend in COVID19 cases is the crowding factor, which we named “crowding effects”. Modeling of this effect is highly necessary as it will help to predict the possible impact on the overall population. The nonlinear incidence rate is the best approach to modeling this effect. At the first step, the model is formulated by using a nonlinear incidence rate with inclusion of the crowding effect, then its positivity and proposed boundedness will be addressed leading to model dynamics using the reproductive number. Then to get the graphical results a nonstandard finite difference (NSFD) scheme and fourth order Runge–Kutta (RK4) method are applied.
An evidence map of actigraphy studies exploring longitudinal associations between rest-activity rhythms and course and outcome of bipolar disorders
Authors: Scott Jan , Colom Francesc , Young Allan , Bellivier Frank , Etain Bruno
Published: December 2020

Background

Evidence mapping is a structured approach used to synthesize the state-of-the-art in an emerging field of research when systematic reviews or meta-analyses are deemed inappropriate. We employed this strategy to summarise knowledge regarding longitudinal ecological monitoring of rest-activity rhythms (RAR) and disease modifiers, course of illness, treatment response or outcome in bipolar disorders (BD).

Structure

We had two key aims: (1) to determine the number and type of actigraphy studies of in BD that explored data regarding: outcome over time (e.g. relapse/recurrence according to polarity, or recovery/remission), treatment response or illness trajectories and (2) to examine the range of actigraphy metrics that can be used to estimate disruptions of RAR and describe which individual circadian rhythm or sleep–wake cycle parameters are most consistently associated with outcome over time in BD. The mapping process incorporated four steps: clarifying the project focus, describing boundaries and ‘coordinates’ for mapping, searching the literature and producing a brief synopsis with summary charts of the key outputs. Twenty-seven independent studies (reported in 29 publications) were eligible for inclusion in the map. Most were small-scale, with the median sample size being 15 per study and median duration of actigraphy being about 7 days (range 1–210). Interestingly, 17 studies comprised wholly or partly of inpatients (63%). The available evidence indicated that a discrete number of RAR metrics are more consistently associated with transition between different phases of BD and/or may be predictive of longitudinal course of illness or treatment response. The metrics that show the most frequent associations represent markers of the amount, timing, or variability of RAR rather than the sleep quality metrics that are frequently targeted in contemporary studies of BD.

Conclusions

Despite 50 years of research, use of actigraphy to assess RAR in longitudinal studies and examination of these metrics and treatment response, course and outcome of BD is under-investigated. This is in marked contrast to the extensive literature on case–control or cross-sectional studies of actigraphy, especially typical sleep analysis metrics in BD. However, given the encouraging findings on putative RAR markers, we recommend increased study of putative circadian phenotypes of BD.
Assessment of knowledge on abortion law and factors affecting it among regular undergraduate female students of Ambo University, Oromia Region, Ethiopia, 2018: a cross sectional study
Authors: Mekuria Mulugeta , Daba Dechasa , Girma Teka , Birhanu Adamu
Published: December 2020

Background

Knowledge of abortion law is a key determinant of the utilization of safe abortion services. Neglecting it can lead to high social and economic costs, both immediately and in the future. One of the major reasons for not utilizing the safe abortion by the youth female is inadequate knowledge about the abortion law. Therefore the aim of this study was to assess knowledge on abortion law and associated factors among female regular undergraduate students of Ambo University.

Methodology

Institutional-based cross-sectional study was conducted on 795 randomly selected undergraduate female students of Ambo University using structured and pre-tested questionnaire from March, 28-May, 18, 2018.The result of the analysis was presented by tables using descriptive frequency percentage and odd ratios. The result was presented using tables. Bivariate and multivariate logistic regression was done between dependent and independent variables at 95% confident interval and P value < 0.05.

Result

Majority (79%) of the study participants were not able to identify all the conditions under which abortion is legally available in Ethiopia. In this study receiving health education on abortion law (AOR = 7.382, 95% CI: (1.118–48.761), knowing where safe abortion can be performed (AOR = 3.116, 95% CI: (1.854–5.239)) and being member of health club in the university (AOR = 2.092, 95% CI:1.256–3.484) were the predictors of abortion law knowlwdge .

Conclusion

The study concluded that knowledge of female student’s on abortion law is low in the study area. In this study, participates who received health education on abortion law and having involving in the health club at university were found to be the predictors of knowledge on abortion law .
Pediatric hypertension: an updated review
Authors: Ashraf Mohd , Irshad Mohd , Parry Nazir Ahmed
Published: December 2020

Globally hypertension in adults is among the leading preventable cause of premature death, where a graded association from the childhood hypertension is well recognised. With the concurrent rise in obesity and pediatric hypertension (HTN) during the past decade in developed countries, a parallel trend is emerging in developing countries that has a potential for exponential rise in cardiovascular, cerebrovascular and renal tragedies. A cumulative incidence of pediatric HTN in China and India is 50–70 and 23% respectively, is quite disturbing. New guidelines for the detection, evaluation and management of hypertension in children and adolescents published in 2017, where a jump in prevalence of pediatric HTN is observed, rings a call to address this under-attended burning problem; for which a review in pediatric hypertension and its management is warranted.
Expression of interleukin-6 (IL-6), signal transducer and activator of transcription-3 (STAT-3) and telomerase in choriocarcinomas
Authors: Pietro Luciana , Bottcher-Luiz Fátima , Velloso Lício Augusto , Morari Joseane , Nomura Marcelo , Lucci De Angelo Andrade Liliana A.
Published: December 2020

Blastocyst implantation and neoplastic invasion have some common properties related to tissue invasion, mediated by various cytokines.

Aim

To compare the expression of IL-6, STAT-3 and telomerase in material of abortions in the first trimester of pregnancy, at term placentas and in choriocarcinomas.

Methods

Immunohistochemical reactions were performed on formalin fixed and included in paraffin samples from 3 groups: abortions, normal at term placentas and choriocarcinomas. Western Blot and Real-Time PCR assays were performed on fresh material from BeWo cell line and in primary culture cells of normal placenta.

Results

Immunohistochemical reactions: IL-6 expression was moderate in the first trimester abortion samples and high in at term placentas and choriocarcinomas. STAT-3 was strongly positive in all groups. Telomerase expression was absent in normal at term placentas but was increased in BeWo cells.

Conclusion

IL-6 and STAT-3 are present in the invasion process of the normal placental development and they are maintained during the malignant transformation to choriocarcinoma. The intense telomerase expression observed in BeWo cells was strongly associated with the malignant phenotype, confirming it as a good marker for cell transformation and tumor progression.
Functional near-infrared spectroscopy can detect low-frequency hemodynamic oscillations in the prefrontal cortex during steady-state visual evoked potential-inducing periodic facial expression stimuli presentation
Authors: Wang Meng-Yun , Yuan Anzhe , Zhang Juan , Xiang Yutao , Yuan Zhen
Published: December 2020

Brain oscillations are vital to cognitive functions, while disrupted oscillatory activity is linked to various brain disorders. Although high-frequency neural oscillations (> 1 Hz) have been extensively studied in cognition, the neural mechanisms underlying low-frequency hemodynamic oscillations (LFHO) < 1 Hz have not yet been fully explored. One way to examine oscillatory neural dynamics is to use a facial expression (FE) paradigm to induce steady-state visual evoked potentials (SSVEPs), which has been used in electroencephalography studies of high-frequency brain oscillation activity. In this study, LFHO during SSVEP-inducing periodic flickering stimuli presentation were inspected using functional near-infrared spectroscopy (fNIRS), in which hemodynamic responses in the prefrontal cortex were recorded while participants were passively viewing dynamic FEs flickering at 0.2 Hz. The fast Fourier analysis results demonstrated that the power exhibited monochronic peaks at 0.2 Hz across all channels, indicating that the periodic events successfully elicited LFHO in the prefrontal cortex. More importantly, measurement of LFHO can effectively distinguish the brain activation difference between different cognitive conditions, with happy FE presentation showing greater LFHO power than neutral FE presentation. These results demonstrate that stimuli flashing at a given frequency can induce LFHO in the prefrontal cortex, which provides new insights into the cognitive mechanisms involved in slow oscillation.
Tackling myths of common prescribing patterns in schizophrenia amongst Egyptian psychiatrists
Authors: Abolmagd Samir , Aly El-Gabry Dina , Elkholy Hussien , Abdel Aziz Karim
Published: December 2020

Background

There is limited data related to how psychiatrists actually choose amongst different medications, especially in Egypt. Our aim was to survey a sample of psychiatrists regarding common patterns of antipsychotic prescribing practices and review how these vary from the evidence-based. We conducted a qualitative, cross-sectional survey of 124 psychiatrists of different grades from hospitals across Cairo, Egypt. Questions were asked to elicit attitudes towards common antipsychotic prescribing practices and the use of treatment guidelines in schizophrenia.

Results

A total 77.4% participants said they would prescribe atypical antipsychotics as first-line treatment if cost were not an issue, 42.7% said they commonly add anticholinergics from the start with antipsychotics, 50% said they would maintain patients on anticholinergics for as long as they were receiving antipsychotics, 93.5% said they commonly or in some situations combine typical depot antipsychotics with oral atypical antipsychotics, 88.7% said they commonly or in some situations use antipsychotics in small doses for sedation, and 55.6% sometimes add a mood stabilizer to enhance the effect of antipsychotic drugs. Using logistic regression, physician grade significantly predicted whether participants commonly add anticholinergic medication from the start with antipsychotics (p= 0.001). Age and gender significantly predicted whether participants sometimes add a mood stabilizer to enhance the effect of antipsychotics (p< 0.05).

Conclusions

We demonstrated that several antipsychotic prescribing practices were not evidence-based, yet appeared to be prevalent in a large proportion of participants. A number of demographic and psychiatrist-related factors predicted certain prescribing patterns.
Exploration of anti-breast cancer effects of Terminalia chebula extract on DMBA-induced mammary carcinoma in Sprague Dawley rats
Authors: Henry Deena Priscilla , Ranjan Jasmine , Murugan Rajesh Kumar , Sivanantham Annapoorani , Alagumuthu Manikandan
Published: December 2020

Background

Plant extracts are effectively acting as the natural medicinal cocktail, non-side effective, efficacious, and freely available. The present study aimed to unveil the pharmacological and medicinal effects of Terminalia chebula plant extract in 7,12-dimethylbenzanthracene (DMBA)-induced mammary carcinoma in Sprague Dawley rats. The plant extract obtained was subjected to in vivo antioxidant and anticancer studies in various concentrations after an analytical technique such as FTIR, GCMS, and HPLC-based chemo-profiling in Sprague Dawley rats.

Results

Apart from the antiproliferative effect on breast cancer cell line (MCF-7) and normal breast epithelial cells (MCF-10a), we have measured the changes in body weight, along with other tumor parameters such as tumor volume, tumor incidence, tumor weight, tumor burden, serum biochemical parameters, and histopathological findings of breast tissue. As the oxidative stress further enhances the development of cancer, the antioxidant property of the plant extract demonstrates its use against cancer treatment. One hundred fifty milligrams per milliliter (IC50 250 μg/mL) concentration of the ethanolic extract was vital for the proliferation of MCF-7 cell lines (Fig. 7a). Meanwhile, 300 μg/mL (IC50 150 μg/mL) was an effective dose to attain a maximum HDAC inhibition of 78%. Also, the normal liver and kidney functioning revealed the non-toxicity nature of the plant.

Conclusion

Terminalia chebula could be one of the effective naturally obtained anti-breast cancer medications. Isolation and characterization of individual bioactive compounds of T. chebula would be the future perspective.
Preoperative topical testosterone for penile hypospadias repair `a comparative study`
Authors: Wali Islam Mahmoud , AbouZeid Amr Abdelhamid , Radwan Nehal Ahmed , GadAllah Mohamed Abdel Sattar , Ghanem Wael Ahmed , El-Naggar Osama
Published: December 2020

Background

Although the outcome of hypospadias repair has much improved, repair of a small-sized phallus is still challenging. Whether preoperative hormonal therapy is beneficial remains controversial.

In this report, we prospectively conducted a clinical trial comparing two groups of patients regarding the effect of preoperative topical testosterone application on the outcome of primary hypospadias repair.

Results

The study included 40 cases of primary hypospadias with a small glans. Their age ranged from 6 months to 3 years. Patients were divided into two equal groups. Group A were treated by local application of testosterone topical gel 1% for 30–40 days and stopped one month before operation, while cases in group B did not receive preoperative hormonal treatment. Genital skin biopsies were taken for histopathological examination. For group A, penile measurements were documented before and after hormonal therapy.

There was a significant increase in all penile parameters after hormonal stimulation in group A. Interestingly, the ventral penile length proximal to the meatus showed more growth in response to hormonal stimulation compared to ventral penile length distal to meatus.

We did not find significant difference between both groups regarding the rate of postoperative complications. Also, the cosmesis and parent satisfaction were ‘more or less’ similar. On the histopathological level, we could not detect a difference between both groups regarding micro-vessel density using CD31, which is a vascular marker indicating neovascularization supposed to play a fundamental role in the healing process.

Conclusion

The use of preoperative topical testosterone significantly increases the size of the hypospadiac phallus. However, this increase in size appears to be disproportionate on the ventral penile surface and has not been reflected on improving the surgical outcome.

Level of evidence

This is a case control study (level III evidence).
Electroencephalography in systemic lupus erythematosus patients with neuropsychiatric manifestations
Authors: Mansour Howaida E. , Habeeb Reem A. , El-Azizi Noran O. , Afeefy Heba H. , Nassef Marwa A. , Abd Alkader Ahmed A. , Afifi Naglaa
Published: December 2020

Background

Neuropsychiatric manifestations are frequently reported in systemic lupus erythematosus (SLE) patients. This study was done to describe electroencephalographic (EEG) findings in SLE patients with neuropsychiatric manifestation (NPSLE).

Results

Among 60 SLE patients, there were 50 females (83.3%) and 10 males (16.7%). EEG abnormalities were reported in 12 patients out of 30 (40%) with NPSLE, while all patients with non-NPSLE (n = 30) had no EEG abnormalities; diffuse slowing (20%) was the most common abnormalities, followed by generalized epileptiform activity (13.3%), and lastly temporal epileptiform activity (6.7%). Seizure was the most reported neuropsychiatric disorder in 13 patients (43.3%); 8 of them had abnormal EEG (61.5%). Periventricular white matter lesion (23.3%) followed by infarction (13.3%) were the most common MRI brain findings among 53.3% of NPSLE group. Half of the cases with EEG abnormality had normal brain MRI. SLEDAI score and ACL IgM positivity were higher in the NPSLE group than the non-NPSLE group. EEG is not a sensitive or specific test for detecting NPSLE with sensitivity (37.5%) and specificity (57.1%).

Conclusion

Not all patients with NPSLE must have abnormal brain MRI or EEG. EEG is a useful assistant tool in the assessment of different manifestations of NPSLE, but it cannot be used as a screening test alone and must be supplemented by neuroimaging studies.
Our community needs us, and we need you
Authors: Burk Katie
Published: December 2020

As the pandemic continues to impact our lives, and as aggressive energy transition discussions ensue, the future for our geophysical community has never felt so unpredictable. These are challenging times for us all, and we hope you're in good spirits and health. While there is a lot of uncertainty, please know that SEG and the SEG Foundation are doing everything possible to continue to provide much needed services and programs to our members. Now, more than ever, our community needs us, and we need you.

Each year, the SEG Foundation raises funds to support many of the Society's excellent programs. SEG Foundation-funded programs are influential to the education of geophysics students and to the growth and development of thousands of practicing professionals around the world. None of this would be possible without the generous support of our donors.
Induced earthquake potential in geothermal reservoirs: Insights from The Geysers, California
Authors: Martínez-Garzón Patricia , Kwiatek Grzegorz , Bentz Stephan , Bohnhoff Marco , Dresen Georg
Published: December 2020

Geothermal reservoir production and associated induced seismicity may experience pronounced attention in the near future, given the ambitious plans for reducing greenhouse gas emissions toward a carbon-neutral economy and society. At some geothermal sites, the occurrence of hazard- and risk-prone induced earthquakes caused by or associated with reservoir stimulation has resulted in project shutdown (e.g., Pohang, South Korea, and Basel Deep Heat Mining, Switzerland). At other geothermal sites, the maximum event magnitudes were successfully maintained below a threshold defined by local authorities (e.g., Helsinki St1 Deep Heat project in Helsinki, Finland). In this study, we review some of our results from seismological and geomechanical reservoir characterization at The Geysers geothermal reservoir in California, USA, the largest producing geothermal field worldwide. We relate our findings to other geothermal sites to better understand the variability of reservoir behavior. In particular, we obtain a constant and relatively low seismic injection efficiency at The Geysers, which is interpreted to be related to the large energy dissipation through thermal processes and additional dissipation through aseismic slip, the latter now being considered to play a fundamental role in earthquake nucleation. We discuss some characteristics of the seismicity from The Geysers that suggest stable reservoir seismic injection efficiency and possibly low potential to rupture into large induced earthquakes, reducing the associated seismic hazard.
The Effects of Ivacaftor on Bone Density and Microarchitecture in Children and Adults with Cystic Fibrosis
Authors: Putman Melissa S , Greenblatt Logan B , Bruce Michael , Joseph Taisha , Lee Hang , Sawicki Gregory , Uluer Ahmet , Sicilian Leonard , Neuringer Isabel , Gordon Catherine M , Bouxsein Mary L , Finkelstein Joel S
Published: December 2020

Context

Cystic fibrosis (CF) transmembrane conductance (CFTR) dysfunction may play a role in CF-related bone disease (CFBD). Ivacaftor is a CFTR potentiator effective in improving pulmonary and nutritional outcomes in patients with the G551D-CFTR mutation. The effects of ivacaftor on bone health are unknown.

Objective

To determine the impact of ivacaftor on bone density and microarchitecture in children and adults with CF.

Design

Prospective observational multiple cohort study.

Setting

Outpatient clinical research center within a tertiary academic medical center.

Patients or Other Participants

Three cohorts of age-, race-, and gender-matched subjects were enrolled: 26 subjects (15 adults and 11 children) with CF and the G551D-CFTR mutation who were planning to start or had started treatment with ivacaftor within 3 months (Ivacaftor cohort), 26 subjects with CF were not treated with ivacaftor (CF Control cohort), and 26 healthy volunteers.

Interventions

All treatments, including Ivacaftor, were managed by the subjects’ pulmonologists.

Main Outcome Measures

Bone microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT), areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry (DXA) and bone turnover markers at baseline, 1, and 2 years.

Results

Cortical volume, area, and porosity at the radius and tibia increased significantly in adults in the Ivacaftor cohort. No significant differences were observed in changes in aBMD, trabecular microarchitecture, or estimated bone strength in adults or in any outcome measures in children.

Conclusions

Treatment with ivacaftor was associated with increases in cortical microarchitecture in adults with CF. Further studies are needed to understand the implications of these findings.
After the Panic: Are Financial Crises Demand or Supply Shocks? Evidence from International Trade
Authors: Benguria Felipe , Taylor Alan M.
Published: December 2020

Are financial crises a negative shock to aggregate demand or supply? This is a fundamental question for research and policy making. Arguments for stimulus usually presume demand-side shortfalls; arguments for tax cuts or structural reform look to the supply side. Resolving the question requires models with both mechanisms, and empirical tests to tell them apart. We develop a small open economy model, where a country is subject to deleveraging shocks that impose binding credit constraints on households and/or firms. These financial crisis events leave distinct statistical signatures in the time series record that divide sharply between each type of shock. Empirical analysis reveals a clear picture: after financial crises the dominant pattern is that imports contract, exports hold steady or even rise, and the real exchange rate depreciates. History shows financial crises are predominantly a negative shock to demand. (JEL F14, F31, F41, G01, N10, N20, N70)
School Effects on Socioemotional Development, School-Based Arrests, and Educational Attainment
Authors: Jackson C. Kirabo , Porter Shanette C. , Easton John Q. , Blanchard Alyssa , Kiguel Sebastián
Published: December 2020

Using value-added models on data from Chicago Public Schools, we find that high schools impact students' self-reported socioemotional development (SED) by enhancing social well-being and promoting hard work. Conditional on their test score impacts, schools that improve SED in ninth grade reduce school-based arrests and increase high school completion and college going. For most longer-run outcomes, using both SED and test score value added more than doubles the variance of the explained school effect relative to using test score value added alone. Results suggest that high school impacts on SED can be captured using self-report surveys and SED can be fostered by schools to improve longer-run outcomes. (JEL I21, J24, K42)