bluuebunny/crossref_metadata_2025 huggingface dataset:
An Assessment of the Dubai Metro Service’s Performance Using SCOR Model and ARENA Simulation
Authors: Kamarudeen Niyazudeen , Sundarakani Balan , Manikas Ioannis
Published: September 2020

Metro service operations have become challenging in modern urban environments due to the dynamics of population, service levels, accuracy and other operational issues. This research applies the supply chain operations reference (SCOR) model combined with the ARENA model simulation to examine the service performance in the Dubai Metro. The proposed approach takes into consideration the real-time flows of metro service operations and simulates the passengers’ service time in selected terminals. The researchers measure the actual time spent by passengers and estimate various possible scenarios as outcome. The researchers assessed the average time spent in the system and the performance improvement as a visualized outcome, with suggestions for improvements, such as: onboard card recharge, automatic checkout using radio-frequency identification (RFID) systems, integration of systems using the Internet of things (IOT) and blockchain and a dedicated lane system. The proposed recommendations have the potential to contribute to service performance improvement of the metro rail, as Dubai plans for its operational expansion process towards Expo 2020. This research methodology and these results can be extended to metro service operations of other urban centres, to better understand passengers’ behaviour in the future. In view of this, the research contributes to both the theory and practice of travel behaviour in the metro transportation service.
Purchase Preferences and Buying Influences on Religious Occasions
Authors: Khan Md. Rahat , Sharma Kritika
Published: September 2020

The present study responds to calls from global agencies, regulators and activist groups to understand the impacts of religion on purchase decisions. The study reveals the purchase preferences and behaviour of consumers on occasions of a religious festival, that is, Eid-al-Fitr in an emerging market. The study aims to explore consumption patterns along with the specific reasons and factors influencing the purchasing behaviour of Muslim consumers during Eid-al-Fitr . The study is conducted as an ethnographic research in Bangladesh. Observations and interviews (on 100 event actors) were conducted between July 2014 and June 2018. The results reveal that Muslims undergo a shopping spree during their biggest religious festival Eid-al-Fitr. Purchase behaviour among Muslim society in Bangladesh is influenced by the head of family or senior citizens of the society. The study also tries to address the link among market, goods, services and consumers during the Eid-al-Fitr. Finally, the study identifies several key factors such as biological, neighbouring countries and issues of affiliation which may affect the purchasing behaviour of consumers during the religious occasions.
The Design of Clustered Observational Studies in Education
Authors: Page Lindsay C. , Lenard Matthew A. , Keele Luke
Published: September 2020

Clustered observational studies (COSs) are a critical analytic tool for educational effectiveness research. We present a design framework for the development and critique of COSs. The framework is built on the counterfactual model for causal inference and promotes the concept of designing COSs that emulate the targeted randomized trial that would have been conducted were it feasible. We emphasize the key role of understanding the assignment mechanism to study design. We review methods for statistical adjustment and highlight a recently developed form of matching designed specifically for COSs. We review how regression models can be profitably combined with matching and note best practices for estimates of statistical uncertainty. Finally, we review how sensitivity analyses can determine whether conclusions are sensitive to bias from potential unobserved confounders. We demonstrate concepts with an evaluation of a summer school reading intervention in a large U.S. school district.
Evaluating transgender youth and parent interest and preferences regarding support groups
Authors: Lawlis Shauna Marie , Butler Patrick , Middleman Amy
Published: September 2020

The purpose of this cross-sectional survey study is to explore transgender teens’ and their parents’ interest in and preferences regarding support groups in an effort to optimally serve the entire family’s needs. The aims of the study were to: (1) describe transgender teens interest level and preferences regarding support groups; (2) describe parents of transgender teens interest level and preferences regarding support groups; and (3) compare responses based on demographics including teens versus parent, natal sex, and gender identity. De-identified surveys were collected from a convenience sample of transgender patients (N = 26), ages 13-18 years, and their parents (N = 20). Overall level of interest in support groups was 7.20/10 for youth and 7.95/10 for parents where 0 is not interested and 10 is very interested. Both groups endorsed benefits of a support group, including help with managing school issues, learning about local resources for transgender teens, and providing peer support. Both groups indicated “no time” as the most common potential barrier to attendance. Both groups expressed moderate interest in support groups, with minor differences between youths and parents noted in preferred support group structure. Further examination is warranted to determine optimal support group characteristics aimed specifically at parents and, separately, for youth. Additional support services might complement groups for a more comprehensive approach to support resources for this community.
The LPI as an Effective Ground-level Strategy for the Deinstitutionalisation and Quality Alternative Care of Children
Authors: Sudesh G. A. Wasana
Published: September 2020

Deinstitutionalisation and quality alternative care is a topic that is widely discussed in search of policies, strategies and good practices. This issue affects all children directly or indirectly. It is very pertinent to the South Asia region. Children who are in institutional care require deinstitutionalisation process that involves both prevention and a range of alternative care options that are community-based, family-based or family-like care. The Local Process Initiative (LPI), which was implemented in the Devinuwara Divisional Secretariat Division (DSD) in the Matara District of Sri Lanka, is an effective strategy that demonstrates deinstitutionalisation and quality alternative care. SOS Children’s Villages of Sri Lanka in seven locations including Devinuwara DSD since 2017 have carried out the LPI process successfully. It has generated positive outcomes especially in terms of strengthening the ground-level state mechanism for deinstitutionalisation and alternative care for children. The divisional secretary is the lead person in the ‘locational circle’ formed in this process, which composes of a range of field-level government officers involved in childcare and community development as they are the first point of contact for issues related to children and families. The government officers are considered the ‘change agents’, and their empowerment is at the centre of the LPI strategy and its success.

From the LPI process in the Devinuwara DSD, it is expected to develop a model to avoid family separation. In here, it is expected to develop a ground-level deinstitutionalisation and a quality alternative care strategy which incorporate solutions from biological, psychological and sociological perspectives to build confidence of stakeholders on deinstitutionalisation and quality alternative care for children, and document evidence including success stories in order to support deinstitutionalisation and quality alternative care of children. This article offers an LPI process in the Devinuwara DSD as an effective strategy for the deinstitutionalisation and quality alternative care of children in South Asia.
Bordetella Holmesii: An Unusual Cause of Endogenous Endophthalmitis in a Patient With Sickle Cell Disease
Authors: Pegany Roma B. , George Roshan T. , Zhang Alice Yang
Published: September 2020

Purpose:

This case report describes a rare organism causing endogenous endophthalmitis in a patient with sickle cell disease.

Methods:

A case report was conducted.

Results:

A 41-year-old man with sickle cell disease presented with acute onset of blurry vision of the right eye. His visual acuity was counting fingers in the right eye and 20/20 in the left eye. He had ophthalmic findings of hypopyon and vitritis in the right eye, consistent with endophthalmitis. He was treated with intravitreal and systemic antibiotics. Vitreous cultures grew Bordetella holmesii. His visual acuity at follow-up visits improved to 20/40 in the setting of improved vitritis.

Conclusions:

This is the first case describing B holmesii, a rare causative organism of endogenous endophthalmitis, in a patient with sickle cell disease. More studies are needed to improve the early detection and treatment of this unusual organism.
Hydroxyplumbopyrochlore, (Pb1.5,□0.5)Nb2O6(OH), a new member of the pyrochlore group from Jabal Sayid, Saudi Arabia
Authors: Li Ting , Li Ziying , Fan Guang , Fan Honghai , Zhong Jun , Jahdali Naser S. , Qin Mingkuan , Jehani Abdullah M. , Wang Fenggang , Nahdi Mubarak M.
Published: September 2020

A new mineral species of the pyrochlore supergroup, hydroxyplumbopyrochlore (IMA2018-145), (Pb1.5,□0.5)Nb2O6(OH), has been discovered in the Jabal Sayid peralkaline granitic complex of the Arabian Shield, Saudi Arabia. It is associated with quartz, microcline, ‘biotite’, rutile, zircon, calcite, rhodochrosite, columbite-(Fe), goethite, thorite, bastnäsite-(Ce), xenotime-(Y), samarskite-(Y), euxenite-(Y), hydropyrochlore and fluornatropyrochlore. Hydroxyplumbopyrochlore usually shows euhedral octahedra, slightly rhombic dodecahedra and cubes or their combination (0.01–0.06 mm). The mineral is pale yellow to pale brown, transparent with white streak, and has adamantine to transparent lustre. It is brittle with conchoidal fracture. No cleavage or parting are observed. It is isotropic and non-fluorescent. The average microhardness is 463.4 kg mm–2. The calculated density is 6.474 g cm–3.

Hydroxyplumbopyrochlore belongs to the cubic crystal system and exhibits the space group Fd$\bar{3}$m with unit-cell parameters a = 10.5456(6) Å, V = 1172.8(2) Å3 and Z = 8. Electron microprobe analysis gave (6-point average composition, wt.%): CaO 0.32, SrO 0.16, FeO 0.17, Ce2O3 0.07, Pr2O3 0.02, PbO 51.69, Nb2O5 40.06, SiO2 0.05, TiO2 1.68, Ta2O5 4.74, H2Ocalc 0.95, total 99.90, yielding the empirical formula (Pb1.34Ca0.03Fe0.01Sr0.01□0.61)Σ2(Nb1.75Ti0.12Ta0.12Si0.01)Σ2O6(OH0.53O0.08□0.39)Σ1, where □ = vacancy. The Raman spectrum of hydroxyplumbopyrochlore contains the characteristic bands of O–H vibrations and no bands for H2O vibrations.
Platelet activation and platelet-monocyte aggregate formation trigger tissue factor expression in patients with severe COVID-19
Authors: Hottz Eugenio D. , Azevedo-Quintanilha Isaclaudia G. , Palhinha Lohanna , Teixeira Lívia , Barreto Ester A. , Pão Camila R. R. , Righy Cassia , Franco Sérgio , Souza Thiago M. L. , Kurtz Pedro , Bozza Fernando A. , Bozza Patrícia T.
Published: September 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emergent pathogen responsible for the coronavirus disease 2019 (COVID-19). Since its emergence, the novel coronavirus has rapidly achieved pandemic proportions causing remarkably increased morbidity and mortality around the world. A hypercoagulability state has been reported as a major pathologic event in COVID-19, and thromboembolic complications listed among life-threatening complications of the disease. Platelets are chief effector cells of hemostasis and pathological thrombosis. However, the participation of platelets in the pathogenesis of COVID-19 remains elusive. This report demonstrates that increased platelet activation and platelet-monocyte aggregate formation are observed in severe COVID-19 patients, but not in patients presenting mild COVID-19 syndrome. In addition, exposure to plasma from severe COVID-19 patients increased the activation of control platelets ex vivo. In our cohort of COVID-19 patients admitted to the intensive care unit, platelet-monocyte interaction was strongly associated with tissue factor (TF) expression by the monocytes. Platelet activation and monocyte TF expression were associated with markers of coagulation exacerbation as fibrinogen and D-dimers, and were increased in patients requiring invasive mechanical ventilation or patients who evolved with in-hospital mortality. Finally, platelets from severe COVID-19 patients were able to induce TF expression ex vivo in monocytes from healthy volunteers, a phenomenon that was inhibited by platelet P-selectin neutralization or integrin αIIb/β3 blocking with the aggregation inhibitor abciximab. Altogether, these data shed light on new pathological mechanisms involving platelet activation and platelet-dependent monocyte TF expression, which were associated with COVID-19 severity and mortality.
Evaluation of the college-based HIV/AIDS education policy in Beijing, China: a mixed method approach
Authors: Zheng Yunting , Zhang Xin , Sun Xinying , Shi Yuhui , Chang Chun
Published: September 2020

Background

From 2010 to 2015, there was a twofold growth of new HIV/AIDS infection in Beijing among young students aged 15–24. HIV/AIDS education was found effective in promoting positive behavior change related to HIV/AIDS prevention. However, little evidence was found on the evaluation of HIV/AIDS education policy. This study aimed to evaluate the college-based HIV/AIDS education policy in Beijing.

Methods

By using a mixed method approach, the current study reviewed college-based HIV/AIDS education policy at national level and in Beijing from 1985 to 2016 and conducted policy content analysis to evaluate the policy ability to structure implementation. Cross-sectional surveys in 2006 and 2016 were used to evaluate college’s implementation of relevant policies. T test, χ2 test, and logistic regression were used to analyze college students’ perception of HIV/AIDS education provided in their colleges and their knowledge of HIV/AIDS and their risk factors.

Results

Fourteen pieces of national policy and four pieces of Beijing’s policy were identified. Policy’s ability to structure implementation was at moderate level. The percentage of students in Beijing who ever perceived HIV/ADIS education at colleges decreased from 71.14 to 39.80%, and the percentage of students with comprehensive knowledge of HIV/AIDS dropped from 50.00% in 2006 to 40.42% in 2016.

Conclusions

HIV/AIDS education in college had drawn considerable attentions from the Chinese government, while the policy implementation needs further strengthening.
Multi-compartment chemical characterization and risk assessment of chemicals of emerging concern in freshwater systems of western Kenya
Authors: Kandie Faith Jebiwot , Krauss Martin , Massei Riccardo , Ganatra Akbar , Fillinger Ulrike , Becker Jeremias , Liess Matthias , Torto Baldwyn , Brack Werner
Published: September 2020

Background

Within the last decades, there has been increasing research on the occurrence of chemicals of emerging concern (CECs) in aquatic ecosystems due to their potential adverse effects on freshwater organisms and risk to human health. However, information on CECs in freshwater environments in sub-Saharan countries is very limited. Here, we investigated the occurrence of CECs in snails and sediments collected from 48 sites within the Lake Victoria South Basin, Kenya, which have been previously investigated for water contamination. Samples were analyzed by liquid chromatography coupled to high-resolution mass spectrometry (LC-HRMS) with a target list of 429 compounds.

Results

In total, 30 compounds have been detected in snails and 78 in sediment samples, compared to 79 previously identified compounds in water. By extending the monitoring of CECs to snails and sediments, we found 68 compounds that were not previously detected in water. These compounds include the anti-cancer drug anastrozole, detected for the first time in the Kenyan environment. Individual compound concentrations were detected up to 480 ng/g wet weight (N-ethyl-o-toluenesulfonamide) in snails and 110 ng/g organic carbon (pirimiphos-methyl) in sediments. Higher contaminant concentrations were found in agricultural sites than in areas not impacted by anthropogenic activities. Crustaceans were the organisms at greatest toxic risk from sediment contamination [toxic unit (TU) up to 0.99] with diazinon and pirimiphos-methyl driving this risk. Acute and chronic risks to algae were driven by diuron (TU up to 0.24), whereas fish were found to be at low-to-no acute risk (TU up to 0.007).

Conclusions

The compound classes present at the highest frequencies in all matrices were pesticides and biocides. This study shows substantial contamination of surface water in rural western Kenya. By filling data gaps on contamination of sediments and aquatic biota, our study reveals that CECs pose a substantial risk to environmental health in Kenya demanding for monitoring and mitigation.
Urban heat resilience at the time of global warming: evaluating the impact of the urban parks on outdoor thermal comfort
Authors: Aram Farshid , Solgi Ebrahim , Garcia Ester Higueras , Mosavi Amir
Published: September 2020

Background

In densely populated urban centers, increased air temperature due to urban heat island (UHI) effect can undermine the thermal comfort and health of citizens. Research has shown that large urban parks can mitigate the effect of UHIs and improve thermal comfort, especially in the warmer months of the year when temperature changes are more noticeable. This study investigated the cooling effect intensity (CEI) of the Retiro Park in the center of Madrid at three different distances from its southern edge and the impact of this cooling effect on thermal comfort from physiological and psychological perspectives. This investigation was performed by measuring microclimate data and conducting a survey simultaneously during the summer days.

Results

The results showed that the CEI of the park varies with distance from its edge. Because of this effect, air temperature within the 130 m and 280 m distance of the park was, respectively, 1.6 °C and 0.9 °C lower than the temperature at the 520 m distance (the nearest heat island). After examining the effect of the park in terms of physiological equivalent temperature (PET), it was found that the PET at the 130 m and 280 m distance of the park was 9.3% and 5.4% less than the PET in the heat island domain. More than 81% of the respondents (in all three areas) had a mental image of the park as the place where they would experience the highest level of outdoor thermal comfort, and this rate was higher in the areas closer to the park. The analysis of citizens’ responses about perceived thermal comfort (PTC) showed that citizens in areas with higher CEI had perceived a higher degree of thermal comfort from the psychological perspective.

Conclusion

This study demonstrates the significant role of large urban parks located in the core of the populated cities in providing thermal comfort for citizens from both physiological and psychological perspectives. Additionally, the results of this study demonstrated that among the environmental (natural and artificial) factors around the park (topography, urban structure, etc.), the aspect ratio has the greatest impact on thermal comfort.
Comprehensive host-pathogen protein-protein interaction network analysis
Authors: Khorsand Babak , Savadi Abdorreza , Naghibzadeh Mahmoud
Published: September 2020

Background

Infectious diseases are a cruel assassin with millions of victims around the world each year. Understanding infectious mechanism of viruses is indispensable for their inhibition. One of the best ways of unveiling this mechanism is to investigate the host-pathogen protein-protein interaction network. In this paper we try to disclose many properties of this network. We focus on human as host and integrate experimentally 32,859 interaction between human proteins and virus proteins from several databases. We investigate different properties of human proteins targeted by virus proteins and find that most of them have a considerable high centrality scores in human intra protein-protein interaction network. Investigating human proteins network properties which are targeted by different virus proteins can help us to design multipurpose drugs.

Results

As host-pathogen protein-protein interaction network is a bipartite network and centrality measures for this type of networks are scarce, we proposed seven new centrality measures for analyzing bipartite networks. Applying them to different virus strains reveals unrandomness of attack strategies of virus proteins which could help us in drug design hence elevating the quality of life. They could also be used in detecting host essential proteins. Essential proteins are those whose functions are critical for survival of its host. One of the proposed centralities named diversity of predators, outperforms the other existing centralities in terms of detecting essential proteins and could be used as an optimal essential proteins’ marker.

Conclusions

Different centralities were applied to analyze human protein-protein interaction network and to detect characteristics of human proteins targeted by virus proteins. Moreover, seven new centralities were proposed to analyze host-pathogen protein-protein interaction network and to detect pathogens’ favorite host protein victims. Comparing different centralities in detecting essential proteins reveals that diversity of predator (one of the proposed centralities) is the best essential protein marker.
GMIEC: a shiny application for the identification of gene-targeted drugs for precision medicine
Authors: Malagoli Tagliazucchi Guidantonio , Taccioli Cristian
Published: September 2020

Background

Precision medicine is a medical approach that takes into account individual genetic variability and often requires Next Generation Sequencing data in order to predict new treatments. Here we present GMIEC, Genomic Modules Identification et Characterization for genomics medicine, an application that is able to identify specific drugs at the level of single patient integrating multi-omics data such as RNA-sequencing, copy-number variation, methylation, Chromatin Immuno-Precipitation and Exome/Whole Genome sequencing. It is also possible to include clinical data related to each patient. GMIEC has been developed as a web-based R-Shiny platform and gives as output a table easy to use and explore.

Results

We present GMIEC, a Shiny application for genomics medicine. The tool allows the users the integration of two or more multiple omics datasets (e.g. gene-expression, copy-number), at sample level, to identify groups of genes that share common genomic and corresponding drugs. We demonstrate the characteristics of our application by using it to analyze a prostate cancer data set.

Conclusions

GMIEC provides a simple interface for genomics medicine. GMIEC was develop with Shiny to provide an application that does not require advanced programming skills. GMIEC consists of three sub-application for the analysis (GMIEC-AN), the visualization (GMIEC-VIS) and the exploration of results (GMIEC-RES). GMIEC is an open source software and is available at https://github.com/guidmt/GMIEC-shiny
Correlation of serum N-Acetylneuraminic acid with the risk and prognosis of acute coronary syndrome: a prospective cohort study
Authors: Li Miao-Nan , Qian Shao-Huan , Yao Zhuo-Ya , Ming Sheng-Ping , Shi Xiao-Jun , Kang Ping-Fang , Zhang Ning-Ru , Wang Xiao-Jing , Gao Da-Sheng , Gao Qing , Zhang Heng , Wang Hong-Ju
Published: September 2020

Background

N-acetylneuraminic acid (Neu5Ac) is a functional metabolite involved in coronary artery disease (CAD). We aimed to evaluate the relationship between serum Neu5Ac and the risk and prognosis of acute coronary syndrome (ACS) in a real-world prospective study.

Methods

Patients with suspected ACS who underwent coronary angiography were included. Serum Neu5Ac was measured at admission. Coronary lesion severity was evaluated by Gensini Score. GRACE risk stratification was performed at admission. Major adverse cardiac events (MACEs) were recorded during follow-up.

Results

A total of 766 patients, including 537 with unstable angina (UAP), 100 with myocardial infarction (MI), and 129 without CAD were included. The circulating Neu5Ac level was significantly higher in patients with MI (median [1QR]: 297[220, 374] ng/ml) than in those with UAP (227 [114, 312] ng/ml) or without CAD (207 [114, 276] ng/ml; both p < 0.001). Serum level of Neu5Ac was positively correlated with age, hypertension, serum uric acid, creatinine, MB isoform of creatine kinase (CK-MB), and Gensini score (all p < 0.05). Receiver operating characteristic curve analysis showed that a higher serum Neu5Ac was potentially associated with MI and high-risk GRACE stratification in ACS patients. Logistic analysis identified only elevated serum Neu5Ac as an independent predictor of MACEs in these patients (odds ratio [OR]: 1.003, 95% confidence interval [CI]: 1.002–1.005, p < 0.001).

Conclusions

Serum Neu5Ac is associated with myocardial injury, GRACE risk category, and prognosis in ACS patients.
Chronic Obstructive Pulmonary Disease (COPD) management in the community: how could primary care team contribute?
Authors: Chen X. R. Catherine , Leung S. H. , Li Y. C.
Published: September 2020

Background

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease commonly encountered in primary care. This study aimed to audit COPD care at primary care clinics of Hong Kong and to work out improvement strategies.

Method

All COPD patients aged 40 or above who had been followed up at 13 public primary care clinics of Kowloon Central Cluster (KCC) under the Hospital Authority of Hong Kong (HAHK) were included in this clinic audit. Evidence-based audit criteria and performance standards were established after thorough literature review. Phase 1 was from 1st April 2016 to 31st March 2017, with deficiencies of care identified. It was followed by a one-year implementation phase through which a series of improvement strategies were executed. Outcome of the enhancement was reviewed during Phase 2 from 1st April 2018 to 31st March 2019. Chi-square test and student’s t test were used to detect statistically significant changes between Phase 1 and Phase 2.

Results

A total of 2358 COPD cases were identified in Phase 1 where 658 of them were smokers. Of those smokers, 332 (50.5%) had been referred to Smoking Counselling and Cessation Service (SCCS) and 289 (43.9%) actually attended it. 991 cases (42%) received Seasonal Influenza Vaccine (SIV) and 938 cases (39.8%) received Pneumococcal Vaccine (PCV). 698 patients (29.6%) had spirometry done before and 423 patients (17.9%) had been admitted to hospital due to acute exacerbation of COPD (AECOPD). With the concerted effort taken during the implementation phase, Phase 2 data showed significant improvement in nearly all criteria. There was a marked increase in the SIV and PCV uptake rate, spirometry performance rate and most importantly, a significant reduction in AECOPD rate leading to hospital admission (13.5%, P = 0.000043). However, the referral rate and attendance rate of SCCS among smokers remained stagnant (P > 0.05).

Conclusion

Via a systematic team approach, COPD care at primary care clinics of KCC under HAHK had been significantly improved for most of the audit criteria, which in turn reduced the burden of the healthcare system.
Decision-making for receiving paid home care for dementia in the time of COVID-19: a qualitative study
Authors: Giebel Clarissa , Hanna Kerry , Cannon Jacqueline , Eley Ruth , Tetlow Hilary , Gaughan Anna , Komuravelli Aravind , Shenton Justine , Rogers Carol , Butchard Sarah , Callaghan Steve , Limbert Stan , Rajagopal Manoj , Ward Kym , Shaw Lisa , Whittington Rosie , Hughes Mishca , Gabbay Mark
Published: September 2020

Background

The lockdown imposed in the UK on the 23rd of March and associated public health measures of social distancing are likely to have had a great impact on care provision. The aim of this study was to explore the decision-making processes of continued paid home care support for dementia in the time of COVID-19.

Methods

Unpaid carers caring for a person living with dementia (PLWD) who were accessing paid home care before COVID-19 and residing in the UK were eligible to take part. Participants were interviewed over the phone and asked about their experiences of using paid home care services before and since COVID-19, and their decision-making processes of accessing paid home care since the outbreak and public health restrictions.

Results

Fifteen unpaid carers, who were also accessing paid care support for the PLWD before COVID-19, were included in the analysis. Thematic analysis identified three overarching themes: (1) Risk; (2) Making difficult choices and risk management; and (3) Implications for unpaid carers. Many unpaid carers decided to discontinue paid carers entering the home due to the risk of infection, resulting in unpaid carers having to pick up the care hours to support the person living with dementia.

Conclusions

This is the first study to report on the impact of COVID-19 on paid home care changes in dementia. Findings raise implications for providing better Personal Protective Equipment for paid carers, and to support unpaid carers better in their roles, with the pandemic likely to stay in place for the foreseeable future.
Functional Independence Measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit
Authors: D’Andrea A. , Le Peillet D. , Fassier T. , Prendki V. , Trombert V. , Reny J-L , Roux X.
Published: September 2020

Background

Age alone is not a robust predictor of mortality in critically ill elderly patients. Chronic health status and functional status before admission could be better predictors. This study aimed to determine whether functional status, assessed using the Functional Independence Measure (FIM), could be an independent predictor of mortality in a geriatric population admitted to an intermediate care unit (IMCU).

Methods

A monocentric, retrospective, observational study of all patients aged ≥75 years old admitted to Geneva University Hospitals’ geriatric IMCU between 01.01.2012 and 31.05.2016. The study’s primary outcome metrics were one-year mortality’s associations with a pre-admission FIM score and other relevant prospectively recorded prognostic variables.

Results

A total of 345 patients were included (56% female, mean age 85 +/− 6.5 years). Mean FIM score was 66 +/− 26. One-year mortality was 57%. Dichotomized low (≤ 63) and high FIM (> 63) scores were associated with one-year mortalities of 68 and 44%, respectively. Logistic regression calculations found an association between pre-admission FIM score and one-year mortality (p <  0.0001), including variables usually associated with mortality (e.g., age, sex, comorbidities, mini-mental health state score, renal function). Multivariate survival analysis showed a significant difference between groups, with a hazard ratio of 0.29 (95% CI: 0.13–0.65) for patients with high FIM scores.

Conclusions

In the present study, higher functional status, assessed using the FIM tool before admission to an IMCU, was significantly and independently associated with lower one-year mortality. This opens up perspectives on the potential value of FIM for establishing a finer prognosis and better triage of critically ill older patients.
Risk prediction for coronary heart disease by a genetic risk score - results from the Heinz Nixdorf Recall study
Authors: Pechlivanis Sonali , Lehmann Nils , Hoffmann Per , Nöthen Markus M. , Jöckel Karl-Heinz , Erbel Raimund , Moebus Susanne
Published: September 2020

Background

A Genetic risk score for coronary artery disease (CAD) improves the ability of predicting coronary heart disease (CHD). It is unclear whether i) the use of a CAD genetic risk score is superior to the measurement of coronary artery calcification (CAC) for CHD risk assessment and ii) the CHD risk assessment using a CAD genetic risk score differs between men and women.

Methods

We included 4041 participants (age-range: 45–76 years, 1919 men) of the Heinz Nixdorf Recall study without CHD or stroke at baseline. A standardized weighted CAD genetic risk score was constructed using 70 known genetic variants. The risk score was divided into quintiles (Q1-Q5). We specified low (Q1), intermediate (Q2-Q4) and high (Q5) genetic risk groups. Incident CHD was defined as fatal and non-fatal myocardial infarction, stroke and coronary death. The association between the genetic risk score and genetic risk groups with incident CHD was assessed using Cox models to estimate hazard ratios (HR) and 95%-confidence intervals (CI). The models were adjusted by age and sex (Model1), as well as by established CHD risk factors (RF) and CAC (Model2). The analyses were further stratified by sex and controlled for multiple testing.

Results

During a median follow-up time of 11.6 ± 3.7 years, 343 participants experienced CHD events (219 men). Per-standard deviation (SD) increase in the genetic risk score was associated with 18% increased risk for incident CHD (Model1: p = 0.002) which did not change after full adjustment (Model2: HR = 1.18 per-SD (p = 0.003)). In Model2 we observed a 60% increased CHD risk in the high (p = 0.009) compared to the low genetic risk group. Stratifying by sex, only men showed statistically significantly higher risk for CHD (Model2: HR = 1.23 per-SD (p = 0.004); intermediate: HR = 1.52 (p = 0.04) and high: HR = 1.88 (p = 0.008)) with no statistically significant risk observed in women.

Conclusion

Our results suggest that the CAD genetic risk score could be useful for CHD risk prediction, at least in men belonging to the higher genetic risk group, but it does not outbalance the value of CT-based quantification of CAC which works independently on both men and women and allows better risk stratification in both the genders.
High BANCR expression is associated with worse prognosis in human malignant carcinomas: an updated systematic review and meta-analysis
Authors: Fang Shixu , Liu Zhou , Guo Qiang , Chen Cheng , Ke Xixian , Xu Gang
Published: September 2020

Background

BRAF-activated noncoding RNA (BANCR) is aberrantly expressed in various tumor tissues and has been confirmed to function as a tumor suppressor or oncogene in many types of cancers. Considering the conflicting results and insufficient sampling, a meta-analysis was performed to explore the prognostic value of BANCR in various carcinomas.

Methods

A comprehensive literature search of PubMed, Web of Science, EMBASE, Cochrane Library and the China National Knowledge Infrastructure (CNKI) was conducted to collect relevant articles.

Results

The pooled results showed a strong relationship between high BANCR expression and poor overall survival (OS) (HR (hazard ratio) =1.60, 95% confidence interval (CI): 1.19–2.15, P = 0.002) and recurrence-free survival (RFS) (HR = 1.53, 95% CI: 1.27–1.85, P < 0.00001). In addition, high BANCR expression predicted advanced tumor stage (OR (odds ratio) =2.39, 95% CI: 1.26–4.53, P = 0.008), presence of lymph node metastasis (OR = 2.03, 95% CI: 1.08–3.83, P = 0.03), positive distant metastasis (OR = 3.08, 95% CI: 1.92–4.96, P < 0.00001) and larger tumor sizes (OR = 1.63, 95% CI: 1.09–2.46, P = 0.02). However, no associations were found for smoking status (OR = 1.01, 95% CI: 0.65–1.56, P = 0.98), age (OR = 0.88, 95% CI: 0.71–1.09, P = 0.236) and sex (OR = 0.91, 95% CI: 0.72–1.16, P = 0.469). The sensitivity analysis of OS showed that the results of each publication were almost consistent with the combined results, and the merged results have high robustness and reliability.

Conclusions

The results showed that elevated BANCR expression was associated with unfavorable prognosis for most cancer patients, and BANCR could serve as a promising therapeutic target and independent prognostic predictor in most of cancer types.
1-Methyl-D-tryptophan activates aryl hydrocarbon receptor, a pathway associated with bladder cancer progression
Authors: Matheus Luiz Henrique Gomes , Dalmazzo Stephanie Vanin , Brito Rodrigo Barbosa Oliveira , Pereira Lucas Alves , de Almeida Robson José , Camacho Cleber Pinto , Dellê Humberto
Published: September 2020

Background

Indoleamine 2, 3-dioxygenase-1 (IDO1) is a promising target for immunotherapy in bladder cancer (BC). IDO1 breaks-down tryptophan to generate kynurenine derivatives, which may activate the aryl hydrocarbon receptor (AHR). AHR is an important target for carcinogens, but its association with BC progression was unknown. Two IDO1 inhibitors used in clinical trials are 1-methyl-D-tryptophan (MT) and INCB240360. Because MT is an aromatic hydrocarbon, it may be a ligand for AHR. We hypothesized that AHR could be associated with BC progression and that MT could activate AHR in BC.

Methods

BC patients (n = 165) were selected from the Gene Expression Omnibus database. A cut-off point for relative expression of AHR and cytochrome 450 enzymes (CYP1A1, CYP1A2, and CYP1B1; markers of AHR activation) was determined to compare with the grade, stage, and tumor progression. For in vitro experiments, RT4 (grade 1) and T24 (grade 3) BC cells were incubated with MT and INCB240360 to evaluate the expression of AHR and CYP1A1.

Results

AHR activation was associated with grade, stage, and progression of BC. T24 cells express more CYP1A1 than RT4 cells. Although IDO1 expression and kynurenine production are elevated in T24 cells concomitantly to CYP1A1 expression, IDO1 inhibitors were not able to decrease CYP1A1 expression, in contrast, MT significantly increased it in both cell lines.

Conclusion

In conclusion, it is rational to inhibit IDO1 in BC, among other factors because it contributes to AHR activation. However, MT needs to be carefully evaluated for BC because it is an AHR pathway agonist independently of its effects on IDO1.
The frequencies and disparities of adverse childhood experiences in the U.S.
Authors: Giano Zachary , Wheeler Denna L. , Hubach Randolph D.
Published: September 2020

Background

Adversity experienced during childhood manifests deleteriously across the lifespan. This study provides updated frequency estimates of ACEs using the most comprehensive and geographically diverse sample to date.

Methods

ACEs data were collected via BRFSS (Behavioral Risk Factor Surveillance System). Data from a total of 211,376 adults across 34 states were analyzed. The ACEs survey is comprised of 8 domains: physical/emotional/sexual abuse, household mental illness, household substance use, household domestic violence, incarcerated household member, and parental separation/divorce. Frequencies were calculated for each domain and summed to derive mean ACE scores. Findings were weighted and stratified by demographic variables. Group differences were assessed by post-estimation F-tests.

Results

Most individuals experienced at least one ACE (57.8%) with 21.5% experiencing 3+ ACEs. F-tests showed females had significantly higher ACEs than males (1.64 to 1.46). Multiracial individuals had a significantly higher ACEs (2.39) than all other races/ethnicities, while White individuals had significantly lower mean ACE scores (1.53) than Black (1.66) or Hispanic (1.63) individuals. The 25-to-34 age group had a significantly higher mean ACE score than any other group (1.98). Generally, those with higher income/educational attainment had lower mean ACE scores than those with lower income/educational attainment. Sexual minority individuals had higher ACEs than straight individuals, with significantly higher ACEs in bisexual individuals (3.01).

Conclusion

Findings highlight that childhood adversity is common across sociodemographic, yet higher in certain categories. Identifying at-risk populations for higher ACEs is essential to improving the health outcomes and attainment across the lifespan.
COVID-19 clinical outcomes and nationality: results from a Nationwide registry in Kuwait
Authors: Hamadah Hala , Alahmad Barrak , Behbehani Mohammad , Al-Youha Sarah , Almazeedi Sulaiman , Al-Haddad Mohannad , Jamal Mohammad H. , Al-Sabah Salman
Published: September 2020

Background

In light of the COVID-19 pandemic, many have flagged racial and ethnic differences in health outcomes in western countries as an urgent global public health priority. Kuwait has a unique demographic profile with two-thirds of the population consisting of non-nationals, most of which are migrant workers. We aimed to explore whether there is a significant difference in health outcomes between non-Kuwaiti and Kuwaiti patients diagnosed with COVID-19.

Methods

We used a prospective COVID-19 registry of all patients (symptomatic and asymptomatic) in Kuwait who tested positive from February 24th to April 20th, 2020, collected from Jaber Al-Ahmad Al-Sabah Hospital, the officially-designated COVID-19 healthcare facility in the country. We ran separate logistic regression models comparing non-Kuwaitis to Kuwaitis for death, intensive care unit (ICU) admission, acute respiratory distress syndrome (ARDS) and pneumonia.

Results

The first 1123 COVID-19 positive patients in Kuwait were all recruited in the study. About 26% were Kuwaitis and 73% were non-Kuwaiti. With adjustments made to age, gender, smoking and selected co-morbidities, non-Kuwaitis had two-fold increase in the odds of death or being admitted to the intensive care unit compared to Kuwaitis (OR: 2.14, 95% CI 1.12–4.32). Non-Kuwaitis had also higher odds of ARDS (OR:2.44, 95% CI 1.23–5.09) and pneumonia (OR: 2.24, 95% CI 1.27–4.12).

Conclusion

This is the first study to report on COVID-19 outcomes between Kuwaiti and non-Kuwaiti patients. The current pandemic may have amplified the differences of health outcomes among marginalized subpopulations. A number of socioeconomic and environmental factors could explain this health disparity. More research is needed to advance the understanding of policymakers in Kuwait in order to make urgent public health interventions.
The impact of pre-evacuation ultrasound examination in histologically confirmed hydatidiform mole in missed abortion
Authors: Tang Yunhui , Zhu Chenqi , Zhu Chen , Liang Feng , Lee Arier , Yao Xiaoying , Chen Qi
Published: September 2020

Background

Early detecting hydatidiform mole in missed abortion is challenge. In this retrospective observational study, we analysed the sensitivity of detecting hydatidiform mole by pre-evacuation ultrasound examination or naked eye after surgical uterine evacuation in missed abortion.

Methods

Data on 577 cases with histologically confirmed hydatidiform mole were collected over a 10-year period and analysed. Data included serum β-hCG level before surgical evacuation, the ultrasound examination findings, histology findings and naked eye findings. In addition, serum β-hCG level on 2398 cases without hydatidiform mole was also collected.

Results

The median maternal age was 29 (range, 17–53) years and the range of gestational age was 6 to 12 weeks. The sensitivity of detecting hydatidiform mole by ultrasound examination or by naked eye was 25% or 60% respectively. This sensitivity was not increased by the combination of ultrasound and naked eye. There was no difference in the sensitivity of detecting subtypes of hydatidiform mole. The higher β-hCG level was seen in cases with hydatidiform mole, compared to cases without hydatidiform mole. However, there was a lot of overlap in the distributions of β-hCG between the two groups.

Conclusions

In this study, we found lower sensitivity of detecting hydatidiform mole by ultrasound in missed abortion. β-hCG level was higher in hydatidiform mole than in non- hydatidiform mole in missed abortion. Although higher sensitivity of detecting hydatidiform mole is seen by naked eye (60%), in order to minimise missed opportunity of detecting hydatidiform mole, our study suggests that routine histopathological examination is necessary in missed abortion.
Correction to: Survey: smartphone-based assessment of cardiovascular diseases using ECG and PPG analysis
Authors: Shabaan Muhammad , Arshid Kaleem , Yaqub Muhammad , Jinchao Feng , Zia M. Sultan , Boja Giridhar Reddy , Iftikhar Muazzam , Ghani Usman , Ambati Loknath Sai , Munir Rizwan
Published: September 2020

An amendment to this paper has been published and can be accessed via the original article.
Nurses’ burden caused by sleep disturbances of nursing home residents with dementia: multicenter cross-sectional study
Authors: Wilfling Denise , Dichter Martin N. , Trutschel Diana , Köpke Sascha
Published: September 2020

Background

Sleep disturbances are common in people with dementia. In nursing homes, this is frequently associated with residents’ challenging behavior and potentially with nurses’ burden. This study examined nurses’ burden associated with nursing home residents’ sleep disturbances.

Methods

A multicenter cross-sectional study was conducted. Nurses’ burden associated with residents’ sleep disturbances was assessed using the Sleep Disorder Inventory (SDI). Additionally, the proportion of nurses’ total burden associated with sleep disturbances of residents with dementia was assessed. A linear mixed regression model was used to investigate the association with nurses’, residents’ and institutional characteristics.

Results

One hundred eleven nurses from 38 nursing homes were included. 78.4% stated to be regularly confronted with residents’ sleep disturbances during nightshifts, causing distress. The mean proportion of nurses‘ total burden caused by residents‘ sleep disturbances was 23.1 % (SD 18.1). None of the investigated characteristics were significantly associated with nurses’ total burden.

Conclusions

Nurses report burden associated with sleep disturbances as common problem. There is a need to develop effective interventions for sleep problems and to train nurses how to deal with residents’ sleep disturbances.