bluuebunny/crossref_metadata_2025 huggingface dataset:
Phenotypic and molecular characterization of Hessian fly resistance in diploid wheat, Aegilops tauschii
Authors: Nemacheck Jill A. , Schemerhorn Brandon J. , Scofield Steven R. , Subramanyam Subhashree
Published: October 2019

Background

The Hessian fly (Mayetiola destructor), belonging to the gall midge family (Cecidomyiidae), is a devastating pest of wheat (Triticum aestivum) causing significant yield losses. Despite identification and characterization of numerous Hessian fly-responsive genes and associated biological pathways involved in wheat defense against this dipteran pest, their functional validation has been challenging. This is largely attributed to the large genome, polyploidy, repetitive DNA, and limited genetic resources in hexaploid wheat. The diploid progenitor Aegilops tauschii, D-genome donor of modern-day hexaploid wheat, offers an ideal surrogate eliminating the need to target all three homeologous chromosomes (A, B and D) individually, and thereby making the functional validation of candidate Hessian fly-responsive genes plausible. Furthermore, the well-annotated sequence of Ae. tauschii genome and availability of genetic resources amenable to manipulations makes the functional assays less tedious and time-consuming. However, prior to utilization of this diploid genome for downstream studies, it is imperative to characterize its physical and molecular responses to Hessian fly.

Results

In this study we screened five Ae. tauschii accessions for their response to the Hessian fly biotypes L and vH13. Two lines were identified that exhibited a homozygous resistance response to feeding by both Hessian fly biotypes. Studies using physical measurements and neutral red staining showed that the resistant Ae. tauschii accessions resembled hexaploid wheat in their phenotypic responses to Hessian fly, that included similarities in larval developmental stages, leaf and plant growth, and cell wall permeability. Furthermore, molecular responses, characterized by gene expression profiling using quantitative real-time PCR, in select resistant Ae. tauschii lines also revealed similarities with resistant hexaploid wheat.

Conclusions

Phenotypic and molecular characterization of Ae. tauschii to Hessian fly infestation revealed resistant accessions that shared similarities to hexaploid wheat. Resembling the resistant hexaploid wheat, the Ae. tauschii accessions mount an early defense strategy involving defense proteins including lectins, secondary metabolites and reactive oxygen species (ROS) radicals. Our results reveal the suitability of the diploid progenitor for use as an ideal tool for functional genomics research in deciphering the wheat-Hessian fly molecular interactions.
Comparison of postoperative pain between patients who underwent primary and repeated cesarean section: a prospective cohort study
Authors: Duan Guangyou , Yang Guiying , Peng Jing , Duan Zhenxin , Li Jie , Tang Xianglong , Li Hong
Published: October 2019

Background

The differences in post-operative pain are unclear between the primiparas who underwent a primary cesarean section and multiparas who underwent their first repeat cesarean section. The study aimed to explore the possible differences in postoperative pain between primiparas and multiparas.

Methods

A prospective cohort study was performed only including women who underwent cesarean deliveries under spinal anesthesia. Postoperative patient-controlled intravenous analgesia (PCIA) was administered to all subjects with 0.2 mg/kg hydromorphone and 4 mg/kg flurbiprofen; the pump was programmed as 2.0 mL/h background infusion with a loading dose of 1 mL and a lockout period of 15 min. Postoperative incision and visceral pain intensity were evaluated using the visual analogue scale, and inadequate analgesia was defined as a visual analogue scale score ≥ 40 during 48 h post-operation. Additionally, the patients’ pain statuses in postoperative week 1 and week 4 were also assessed during follow-up via telephone.

Results

From January to May 2017, a total of 168 patients (67 primiparas and 101 multiparas) were included. The relative risk for multiparas to experience inadequate analgesia on incision pain was 0.42 (95% CI: 0.25 to 0.74) compared to primiparas. In patients aged < 30 years, inadequate analgesia on visceral pain was higher in multiparas than in primiparas (RR, 3.56 [1.05 to 12.04], P = 0.025). There was no significant difference in the combined incidence of inadequate analgesia in both types of pain between the multiparas and primiparas (33.7% vs. 40.2%, P = 0.381). No difference was found in PCIA use between the two groups (111.1 ± 36.0 mL vs. 110.9 ± 37.3 mL, P = 0.979). In addition, a significantly higher incidence of pain was noted 4 weeks post-surgery in primiparas than that in multiparas (62.2% vs. 37.7%, P = 0.011).

Conclusion

Multiparas who underwent their first repeat cesarean section have a lower for inadequate analgesia on incision pain during the first 48 h after surgery than primiparas. Multiparas aged under 30 years may be more prone to experiencing postoperative inadequate analgesia on visceral pain.

Trail Registration

ClinicalTrial.gov: NCT03009955, Date registered: December 30, 2016.
Canadian in-hospital mortality for patients with emergency-sensitive conditions: a retrospective cohort study
Authors: Berthelot Simon , Lang Eddy S. , Quan Hude , Stelfox Henry T.
Published: October 2019

Background

The emergency department (ED) sensitive hospital standardized mortality ratio (ED-HSMR) measures risk-adjusted mortality for patients admitted to hospital with conditions for which ED care may improve health outcomes. This study aimed to describe in-hospital mortality across Canadian provinces using the ED-HSMR.

Methods

Hospital discharge data were analyzed from April 2009 to March 2012. The ED-HSMR was calculated as the ratio of observed deaths among patients with emergency-sensitive conditions in a hospital during a year (2010–11 or 2011–12) to the expected deaths for the same patients during the reference year (2009–10), multiplied by 100. The expected deaths were estimated using predictive models fitted from the reference year. Aggregated provincial ED-HSMR values were calculated. A HSMR value above or below 100 respectively means that more or fewer deaths than expected occurred within a province.

Results

During the study period, 1,335,379 patients were admitted to hospital in Canada with an emergency-sensitive condition as the most responsible diagnosis. More in-hospital deaths (95% confidence interval) than expected were respectively observed for the years 2010–11 and 2011–12 in Newfoundland [124.3 (116.3–132.6); & 117.6 (110.1–125.5)] and Nova Scotia [116.4 (110.7–122.5) & 108.7 (103.0–114.5)], while mortality was as expected in Prince Edward Island [99.9 (86.5–114.8) & 100.7 (87.5–115.3)] and Manitoba [99.2 (94.5–104.1) & 98.3 (93.5–103.3)], and less than expected in all other provinces and territories.

Conclusions

Our study revealed important variation in risk-adjusted mortality for patients admitted to hospital with emergency-sensitive conditions among Canadian provinces. The ED-HSMR may be a useful outcome indicator to complement existing process indicators in measuring ED performance.

Trial registration

N/A – Retrospective cohort study.
BUGSnet: an R package to facilitate the conduct and reporting of Bayesian network Meta-analyses
Authors: Béliveau Audrey , Boyne Devon J. , Slater Justin , Brenner Darren , Arora Paul
Published: October 2019

Background

Several reviews have noted shortcomings regarding the quality and reporting of network meta-analyses (NMAs). We suspect that this issue may be partially attributable to limitations in current NMA software which do not readily produce all of the output needed to satisfy current guidelines.

Results

To better facilitate the conduct and reporting of NMAs, we have created an R package called “BUGSnet” (Bayesian inference Using Gibbs Sampling to conduct a Network meta-analysis). This R package relies upon Just Another Gibbs Sampler (JAGS) to conduct Bayesian NMA using a generalized linear model. BUGSnet contains a suite of functions that can be used to describe the evidence network, estimate a model and assess the model fit and convergence, assess the presence of heterogeneity and inconsistency, and output the results in a variety of formats including league tables and surface under the cumulative rank curve (SUCRA) plots. We provide a demonstration of the functions contained within BUGSnet by recreating a Bayesian NMA found in the second technical support document composed by the National Institute for Health and Care Excellence Decision Support Unit (NICE-DSU). We have also mapped these functions to checklist items within current reporting and best practice guidelines.

Conclusion

BUGSnet is a new R package that can be used to conduct a Bayesian NMA and produce all of the necessary output needed to satisfy current scientific and regulatory standards. We hope that this software will help to improve the conduct and reporting of NMAs.
Family medicine vocational training and career satisfaction in Hong Kong
Authors: Lee K. P. , Wong C. , Chan D. , Kung K. , Luk L. , Wong M. C. S. , Chao D. , Leung V. , Chan C. W. , Ko W. , Leung T. F. , Chan Y. H. , Fung H. T. , Lee M. K. , Wong S. Y. S.
Published: October 2019

Background

Postgraduate vocational training in family medicine (FM) is essential for physicians to build capacity and develop quality primary care. Inadequate standards in training and curriculum development can contribute to poor recruitment and retention of doctors in primary care. This study aimed to investigate: 1) the satisfaction level of doctors regarding vocational training in family medicine and associated demographics; and 2) the satisfaction level of doctors regarding their family medicine career and associated factors.

Method

This is a cross sectional study of all family medicine physicians across all government-funded primary care clinics (GOPCs). The study questionnaire consisted of items from a standardized and validated physician survey named the Physician Worklife Survey (PWS) (Konrad et al., Med Care, 1999). We selected three scales (7 items) relating to global job satisfaction, global career satisfaction and global specialty (family medicine) satisfaction with additional items on training and demographics. All significant variables in bivariate analyses were further examined using stepwise logistic regression.

Results

Out of 424 eligible family medicine physicians, 368 physicians successfully completed the questionnaire. The response rate was 86.8%. Most participants were male (52.6%), were aged between 35 and 44 years (55.5%), were FM specialists (42.4%), graduated locally (86.2%), and had postgraduate qualifications. Eighty-two percent (82%) of participants were satisfied with their training. Having autonomy and protected time for training were associated with satisfaction with FM training. Satisfaction with family medicine as a career was correlated with physicians’ satisfaction with their current job. Doctors who did not enroll in training (p < 0.001) and physicians who were older (p = 0.023) were significantly less satisfied. Stepwise multivariate regression showed that doctors who subjectively believed their training as “broad and in depth’ had higher career satisfaction (p < 0.001).

Conclusion

Overall, the satisfaction level of physicians on current family medicine training in Hong Kong was high. Having autonomy and protected time for training is associated with higher training satisfaction levels. Perceiving FM training as “broad and in-depth” is associated with higher family medicine career satisfaction.
Prevalence and determinants of frailty in the absence of disability among older population: a cross sectional study from rural communities in Nepal
Authors: Yadav Uday Narayan , Tamang Man Kumar , Thapa Tarka Bahadur , Hosseinzadeh Hassan , Harris Mark Fort , Yadav Krishna Kumar
Published: October 2019

Background

Longevity and frailty have significant implications for healthcare delivery. They increase demands for healthcare service and surge risk of hospitalization. Despite gaining global attention, determinants of frailty have remained unmeasured in the rural community settings in Nepal. This study aimed to address this gap by accessing the prevalence and determinants of frailty in the absence of disability among older population living in rural communities in eastern Nepal.

Methods

We conducted a cross-sectional analytical study of 794 older adults aged ≥60 living in the rural part of Sunsari and Morang district of eastern Nepal between January and April in 2018. Multi-stage cluster sampling was applied to recruit the study participants. Study measures included socio-demographics; Frail Non-disabled scale (FiND) measuring frailty, Barthel’s Index measuring basic activities of daily living and Geriatric depression scale. Determinants of frailty in the absence of disability were identified using generalized estimating equation (GEE).

Results

About 65% of the participants self-reported the presence of frailty in the absence of disability. In the adjusted models, those from underprivileged ethnic groups, lack of daily physical exercise, presence of depressive symptoms and those not getting enough social support from family were found to be significantly associated with frailty among older participants.

Conclusions

The prevalence of frailty in the absence of disability was high among rural community old population living in eastern Nepal. Our findings suggest that need of frailty awareness (both for clinicians and general public), so as to avoid negative consequences. To reduce the healthcare burden early screening frailty in primary care has potentials to prevent implications of frailty in Nepal.
Low seroprevalence of Zika virus infection among adults in Southern Taiwan
Authors: Chien Yu-Wen , Ho Tzu-Chuan , Huang Pei-Wen , Ko Nai-Ying , Ko Wen-Chien , Perng Guey Chuen
Published: October 2019

Background

We recently conducted a serosurvey of newly arrived workers in Taiwan from four Southeast Asian countries which revealed that 1% of the migrant workers had laboratory-confirmed recent Zika virus (ZIKV) infection. Taiwan, whereAedesmosquitoes are prevalent, has a close relationship with Southeast Asian countries. Up to now, 21 imported cases of ZIKV infection have been reported in Taiwan, but there has been no confirmed indigenous case. The aim of this serosurvey was to assess whether there was unrecognized ZIKV infections in Taiwan.

Methods

A total of 212 serum samples collected in a cross-sectional seroepidemiologic study conducted during the end of the 2015 dengue epidemic in Tainan, Taiwan, were analyzed. Anti-ZIKV IgM and IgG were tested using commercial enzyme-linked immunosorbent assays (ELISAs). Plaque reduction neutralization tests (PRNTs) for ZIKV and four dengue virus (DENV) serotypes were performed for samples with positive anti-ZIKV antibodies. A confirmed case of ZIKV infection was defined by ZIKV PRNT90titer ratio ≥ 4 compared to four DENV serotypes.

Results

The mean age of the 212 participants was 54.0 years (standard deviation 13.7 years), and female was predominant (67.0%). Anti-ZIKV IgM and IgG were detected in 0 (0%) and 9 (4.2%) of the 212 participants, respectively. For the 9 samples with anti-ZIKV IgG, only 1 sample had 4 times higher ZIKV PRNT90titers compared to PRNT90titers against four dengue virus serotypes; this individual denied having traveled abroad.

Conclusions

The results suggest that undetected indigenous ZIKV transmission might have occurred in Taiwan. The findings also suggest that the threat of epidemic transmission of ZIKV in Taiwan does exist due to extremely low-level of herd immunity. Our study also indicates that serological tests for ZIKV-specific IgG remain a big challenge due to cross-reactivity, even in dengue non-endemic countries.
Hepatitis C virus infection: a challenge in the complex management of two cases of multidrug-resistant tuberculosis
Authors: Musso Maria , Mosti Silvia , Gualano Gina , Mencarini Paola , Urso Rocco , Ghirga Piero , Rianda Alessia , Del Nonno Franca , Goletti Delia , Palmieri Fabrizio
Published: October 2019

Background

Multidrug-resistant tuberculosis (MDR-TB) requires lengthy use of second-line drugs, burdened by many side effects. Hepatitis C virus (HCV) chronic infection increases risk of drug-induced liver injury (DILI) in these patients. Data on MDR-TB patients with concurrent HCV chronic infection treated at the same time with second-line antitubercular drugs and new direct-acting antivirals (DAAs) are lacking. We evaluate if treating at the same time HCV infection and pulmonary MDR-TB is feasible and effective.

Cases presentation

In this study, we described two cases of patients with pulmonary MDR-TB and concurrent HCV chronic infection cured with DAAs at a Tertiary Infectious Diseases Hospital in Italy. During antitubercular treatment, both patients experienced a DILI before treating HCV infection.

After DAAs liver enzymes normalized and HCV RNA was undetectable. Then antitubercular regimen was started according to the institutional protocol, drawn up following WHO MDR-TB guidelines. It was completed without further liver side effects and patients were declared cured from both HCV infection and MDR-TB.

Conclusions

We suggest to consider treatment of chronic hepatitis C with DAAs as a useful intervention for reintroduction of second-line antitubercular agents in those patients who developed DILI, reducing the risk of treatment interruption when re-exposed to these drugs.
Comparison of conventional and Si-photomultiplier-based PET systems for image quality and diagnostic performance
Authors: Oddstig Jenny , Leide Svegborn Sigrid , Almquist Helen , Bitzén Ulrika , Garpered Sabine , Hedeer Fredrik , Hindorf Cecilia , Jögi Jonas , Jönsson Lena , Minarik David , Petersson Richard , Welinder Annika , Wollmer Per , Trägårdh Elin
Published: October 2019

Background

A new generation of positron emission tomography with computed tomography (PET-CT) was recently introduced using silicon (Si) photomultiplier (PM)-based technology. Our aim was to compare the image quality and diagnostic performance of a SiPM-based PET-CT (Discovery MI; GE Healthcare, Milwaukee, WI, USA) with a time-of-flight PET-CT scanner with a conventional PM detector (Gemini TF; Philips Healthcare, Cleveland, OH, USA), including reconstruction algorithms per vendor’s recommendations.

Methods

Imaging of the National Electrical Manufacturers Association IEC body phantom and 16 patients was carried out using 1.5 min/bed for the Discovery MI PET-CT and 2 min/bed for the Gemini TF PET-CT. Images were analysed for recovery coefficients for the phantom, signal-to-noise ratio in the liver, standardized uptake values (SUV) in lesions, number of lesions and metabolic TNM classifications in patients.

Results

In phantom, the correct (> 90%) activity level was measured for spheres ≥17 mm for Discovery MI, whereas the Gemini TF reached a correct measured activity level for the 37-mm sphere. In patient studies, metabolic TNM classification was worse using images obtained from the Discovery MI compared those obtained from the Gemini TF in 4 of 15 patients. A trend toward more malignant, inflammatory and unclear lesions was found using images acquired with the Discovery MI compared with the Gemini TF, but this was not statistically significant. Lesion-to-blood-pool SUV ratios were significantly higher in images from the Discovery MI compared with the Gemini TF for lesions smaller than 1 cm (p < 0.001), but this was not the case for larger lesions (p = 0.053). The signal-to-noise ratio in the liver was similar between platforms (p = 0.52). Also, shorter acquisition times were possible using the Discovery MI, with preserved signal-to-noise ratio in the liver.

Conclusions

Image quality was better with Discovery MI compared to conventional Gemini TF. Although no gold standard was available, the results indicate that the new PET-CT generation will provide potentially better diagnostic performance.
Half-body MRI volumetry of abdominal adipose tissue in patients with obesity
Authors: Linder Nicolas , Solty Kilian , Hartmann Anna , Eggebrecht Tobias , Blüher Matthias , Stange Roland , Busse Harald
Published: October 2019

Background

The purpose of this study was to determine to what extent the whole volumes of abdominal subcutaneous (ASAT) and visceral adipose tissue (VAT) of patients with obesity can be predicted by using data of one body half only. Such a workaround has already been reported for dual-energy x-ray absorption (DEXA) scans and becomes feasible whenever the field of view of an imaging technique is not large enough.

Methods

Full-body abdominal MRI data of 26 patients from an obesity treatment center (13 females and 13 males, BMI range 30.8–41.2 kg/m2, 32.6–61.5 years old) were used as reference (REF). MRI was performed with IRB approval on a clinical 1.5 T MRI (Achieva dStream, Philips Healthcare, Best, Netherlands). Segmentation of adipose tissue was performed with a custom-made Matlab software tool. Statistical measures of agreement were the coefficient of determination R2 of a linear fit.

Results

Mean ASATREF was 12,976 (7812–24,161) cm3 and mean VATREF was 4068 (1137–7518) cm3. Mean half-body volumes relative to the whole-body values were 50.8% (48.2–53.7%) for ASATL and 49.2% (46.3–51.8%) for ASATR. Corresponding volume fractions were 56.4% (51.4–65.9%) for VATL and 43.6% (34.1–48.6%) for VATR. Correlations of ASATREF with ASATL as well as with ASATR were both excellent (R2 > 0.99, p < 0.01). Corresponding correlations of VATREF were marginally lower (R2 = 0.98 for VATL, p < 0.01, and R2 = 0.97 for VATR, p < 0.01).

Conclusions

In conclusion, abdominal fat volumes can be reliably assessed by half-body MRI data, in particular the subcutaneous fat compartment.
Adverse effects of endometriosis on pregnancy: a case-control study
Authors: Miura Mayo , Ushida Takafumi , Imai Kenji , Wang Jingwen , Moriyama Yoshinori , Nakano-Kobayashi Tomoko , Osuka Satoko , Kikkawa Fumitaka , Kotani Tomomi
Published: October 2019

Background

Endometriosis is a common disease occurring in 1–2% of all women of reproductive age. Although there is increasing evidence on the association between endometriosis and adverse perinatal outcomes, little is known about the effect of pre-pregnancy treatments for endometriosis on subsequent perinatal outcomes. Thus, this study aimed to evaluate maternal and neonatal outcomes in pregnant women with endometriosis and to investigate whether pre-pregnancy surgical treatment would affect these outcomes.

Methods

This case-control study included 2769 patients who gave birth at Nagoya University Hospital located in Japan between 2010 and 2017. Maternal and neonatal outcomes were compared between the endometriosis group (n = 80) and the control group (n = 2689). The endometriosis group was further divided into two groups: patients with a history of surgical treatment such as cystectomy for ovarian endometriosis, ablation or excision of endometriotic implants, or adhesiolysis (surgical treatment group, n = 49) and those treated with only medications or without any treatment (non-surgical treatment group, n = 31).

Results

In the univariate analysis, placenta previa and postpartum hemorrhage were significantly increased in the endometriosis group compared to the control group (12.5% vs. 4.1%, p <  0.01 and 27.5% vs. 18.2%, p = 0.04, respectively). In the multivariate analysis, endometriosis significantly increased the odds ratio (OR) for placenta previa (adjusted OR, 3.19; 95% confidence interval [CI], 1.56–6.50, p <  0.01) but not for postpartum hemorrhage (adjusted OR, 1.14; 95% CI, 0.66–1.98, p = 0.64). Other maternal and neonatal outcomes were similar between the two groups. In patients with endometriosis, patients in the surgical treatment group were significantly associated with an increased risk of placenta previa (OR. 4.62; 95% CI, 2.11–10.10, p <  0.01); however, patients in the non-surgical treatment group were not associated with a high risk (OR, 1.63; 95% CI, 0.19–6.59, p = 0.36). Additionally, other maternal and neonatal outcomes were similar between the two groups.

Conclusion

Women who have had surgical treatment for their endometriosis appear to have a higher risk for placenta previa. This may be due to the more severe stage of endometriosis often found in these patients. However, clinicians should be alert to this potential increased risk and manage these patients accordingly.
Examining internal migration effects on short versus long interbirth intervals in Cotonou, Benin Republic
Authors: Banougnin Boladé Hamed
Published: October 2019

Background

The literature on migration-fertility relationship uses various measures of fertility, such as fertility rates, actual fertility and family size preferences. This study introduces a different measure—interbirth intervals over women’s reproductive years—to examine how internal migration is associated with short interbirth intervals (less than 24 months) and long interbirth intervals (greater than 60 months) in Cotonou, the largest city of Benin Republic.

Methods

The paper uses primary data on 2852 live births to 1659 women aged 15–49 years from the 2018 Fertility and Migration Survey in Cotonou. Competing-risks models were fitted for the analysis.

Results

Nineteen percent of live births were of short interbirth intervals and 16% were of long interbirth intervals. The prevalence of short interbirth intervals was higher among migrants who spent less than 5 years in Cotonou (29%) than among non-migrants (19%) and earlier migrants (18%). Non-migrants had the highest proportion of long interbirth intervals (19%). Within the first 5 years following the migration to Cotonou, migrants had higher subhazard ratio (SHR) of short interbirth intervals (SHR: 1.71, 95% CI: 1.33–2.21) and lower SHR of long interbirth intervals (SHR: 0.64, 95% CI: 0.47–0.87) than non-migrants. This association holds after controlling for socioeconomic characteristics—but with a slightly reduced gap between migrants who spent less than 5 years in Cotonou and non-migrants. Afterwards and irrespective of women’s socioeconomic backgrounds, migrants who spent 5 or more years in Cotonou and non-migrants had similar risks of short and long interbirth intervals. Finally, from 5 years of stay in Cotonou, migrants for reasons other than school or job were less likely to experience short interbirth intervals (SHR: 0.65, 95% CI: 0.46–0.98 for migrants who spent 5–10 years in Cotonou, and SHR: 0.74, 95% CI: 0.54–1.02 for migrants who spent more than 10 years in Cotonou) than non-migrants.

Conclusion

Family planning programmes should mainly target migrants in the early years after their arrival in Cotonou. Moreover, non-migrants need to be sensitised on the adverse health outcomes of long interbirth intervals.
Measuring physical and mental health during pregnancy and postpartum in an Australian childbearing population - validation of the PROMIS Global Short Form
Authors: Slavin Valerie , Gamble Jenny , Creedy Debra K. , Fenwick Jennifer , Pallant Julie
Published: October 2019

Background

Health related quality of life is a critical concept during the perinatal period but remains under-researched. The International Consortium for Health Outcomes Measurement have included the Patient Reported Outcomes Measurement Information System (PROMIS®) Global Short Form (GSF) in their core outcome set for pregnancy and childbirth to measure health related quality of life. The PROMIS GSF has not been fully evaluated as a valid and reliable instrument in this population. This study assessed the psychometric properties of the PROMIS GSF during pregnancy and postpartum period.

Methods

PROMIS GSF was administered to a sample of 309 pregnant women at four time-points during pregnancy (≤ 27 and 36-weeks) and postpartum (6- and 26-weeks). The structural validity, internal consistency reliability, construct validity, and responsiveness of the PROMIS GSF were evaluated. The internal structure of the PROMIS GSF was explored using Rasch Measurement Theory. Response format, item fit, differential item functioning (item bias), dimensionality of the scale and its targeting were assessed.

Results

Two revised subscales (Mental Health: four items; and Physical Health: five items) showed good fit to the Rasch model. The revised mental health subscale demonstrated good internal consistency reliability during pregnancy and postpartum period (α = .88 and .87, respectively). The internal consistency reliability of the physical health subscale was adequate (α = .76 and .75, respectively). The revised mental health subscale was sensitive to group differences according to a history of mental health disorder, income, smoking status, drug use, stress levels and planned versus unplanned pregnancy. Differences in scores on the revised physical subscale were detected for groups based on obesity, income, drug use, smoking status, stress, and history of mental health disorders. Scores on both subscales recorded significant changes across the four time-points, spanning pregnancy and postpartum period.

Conclusions

The revised version of the PROMIS GSF was better able to measure mental and physical health during pregnancy and postpartum period compared to the original version. Findings support the clinical and research application of the PROMIS GSF within the International Consortium for Health Outcomes Measurement Standard Set of Outcome Measures for Pregnancy and Childbirth. Ongoing psychometric analysis of the PROMIS GSF is recommended in other maternity populations.
Predictors of cervical cancer screening practice among HIV positive women attending adult anti-retroviral treatment clinics in Bishoftu town, Ethiopia: the application of a health belief model
Authors: Solomon Kalkidan , Tamire Mulugeta , Kaba Mirgissa
Published: October 2019

Background

Cervical cancer is a global public health problem and the second most common cancer causing morbidity and mortality in Ethiopia. Few available evidences revealed that despite distribution and severity of cervical cancer among HIV-positive women and the ease with which it can be prevented, cervical cancer screening practice in Ethiopia among them is considerably low. Thus, this study aims to assess predictors of cervical cancer screening practice among HIV-positive women by applying health belief model concepts.

Methods

Facility based cross-sectional study was conducted in Bishoftu. Data was collected from 475 women who visit the health facilities for anti-retroviral services using interviewer-administered questionnaires. Champion’s revised Health Belief Model sub-scales were used as data collection tools containing sources of information, knowledge, perception on cervical cancer screening and cervical cancer screening practice as variables. Frequencies, percentage, mean and standard deviation were used to describe findings. Multi-variable logistic regression and 95% confidence intervals were considered to identify predictors of cervical cancer screening practice by controlling possible confounders.

Results

Cervical cancer screening practice among HIV-positive women in this study was 25%. Health proffesionals were the main sources of information about cervical cancer and its screening. There was a difference between the ‘ever’ and ‘never’ screened groups in mean scores of their perceived severity, perceived benefit, perceived barrier, perceived self-efficacy, perceived threat and net-benefit towards screening (P < 0.05). Perceived self-efficacy (AOR 1.24, 95%CI 1.13–1.37), perceived threat (AOR 1.08, 95%CI 1.05–1.12) and perceived net-benefit (AOR 1.18, 95% CI 1.12, 1.24) were the predictors of cervical cancer screening practice.

Conclusions

Cervical cancer screening practice in this study was lower than that of the recommended coverage of the target group by the national guideline (80%). This finding has an important implication for public health intervention aimed at cervical cancer prevention. Morever, womens’ perceptions on cervical cancer screening had a significant influence on the utilization of cervical cancer screening service. Therefore, educational programmes geared towards severity of the case, availability of screeningand helpfulness of being screened can significantly improve the uptake of cervical cancer screening.
The diversity between curatively resected pancreatic head and body-tail cancers based on the 8th edition of AJCC staging system: a multicenter cohort study
Authors: Sheng Weiwei , Dong Ming , Wang Guosen , Shi Xiaoyang , Gao Wei , Wang Kewei , Song He , Shi Gang , Tan Xiaodong
Published: October 2019

Background

To our knowledge, there are no studies to systematically compare the detailed clinical significance between curatively resected pancreatic head (ph) and body-tail (pbt) ductal adenocarcinoma based on the new 8th edition of AJCC staging system (8th AJCC stage) that was just applied in clinical practice in 2018.

Methods

Three hundred fifty-one patients with curatively resected pancreatic adenocarcinoma (PC) from three center hospitals were entered into this multicenter cohort study.

Results

Increasing tumor size (P < 0.001), T stage (T1 + T2 vs T3 + T4, P = 0.003), frequent postoperative liver metastasis (PLM) (P = 0.002) and 8th AJCC stage (IA to VI, P < 0.001; I + II vs III + IV, P = 0.002) were closely associated with the progression of pbt cancers compared with that in ph cancer patients. Moreover, tumor size≥3 cm (P = 0.012), 8th AJCC stage (III + IV) (P = 0.025) and PLM (P = 0.010) were identified as independent risk factors in pbt cancers in logistic analysis. Patients with pbt cancers had a significantly worse overall survival compared with ph cancer patients (P = 0.003). Moreover, pbt was an independent unfavorable factor in multivariate analysis (P = 0.011). In addition to lymph nodes metastasis, 8th AJCC stage, vascular invasion and PLM, increasing tumor size and advanced T stage were also closely associated with the poor prognosis in 131 cases of pbt cancer patients compared with Ph cancer patients.

Conclusion

Pbt, as an independent unfavorable factor for the prognosis of PC patients, are much more aggressive than that in ph cancers according to 8th AJCC staging system. 8th AJCC staging system are more comprehensive and sensitive to reflect the malignant biology of pbt cancers.
Atypical femoral fracture in patients with bone metastasis receiving denosumab therapy: a retrospective study and systematic review
Authors: Takahashi Momoko , Ozaki Yukinori , Kizawa Rika , Masuda Jun , Sakamaki Kentaro , Kinowaki Keiichi , Umezu Taro , Kondoh Chihiro , Tanabe Yuko , Tamura Nobuko , Miura Yuji , Shigekawa Takashi , Kawabata Hidetaka , Baba Noriyuki , Iguchi Haruo , Takano Toshimi
Published: October 2019

Background

While denosumab has been shown to prevent skeletal-related events in patients with bone metastasis, there is a concern that it may cause atypical femoral fracture (AFF). While AFF has been reported in patients with osteoporosis receiving denosumab, data are scarce in the context of AFF occurring in patients with bone metastasis receiving monthly denosumab therapy.

Methods

To analyze the incidence of AFF in patients with bone metastasis, we reviewed the medical records of patients who had received monthly denosumab (120 mg) treatment from May 2012 to June 2017 at any of the three participant institutions.

Results

The study population consisted of 277 patients who had received a median of 10 doses (range, 1–79) of denosumab. Five patients were diagnosed as having AFF or symptomatic atypical femoral stress reaction (AFSR) needing surgical intervention, representing an incidence rate of 1.8% (95% confidence interval, 0.77–4.2). These patients had received 15, 45, 45, 46 or 47 doses of denosumab, respectively. Four of the patients had received prior zoledronic acid treatment. The results of our analysis suggested that long-term use of denosumab, especially for more than 3.5 years, and prior use of zoledronic acid were risk factors for the development of AFF.

Conclusions

We found the AFF events in 5 patients (1.8%) among 277 cancer patients who had received monthly denosumab (120 mg) treatment. Long-term denosumab treatment and prior zoledronic acid treatment were identified as risk factors for the development of AFF.
The prognostic impact of GSTM1/GSTP1 genetic variants in bladder Cancer
Authors: Albarakati Nada , Khayyat Dareen , Dallol Asharf , Al-Maghrabi Jaudah , Nedjadi Taoufik
Published: October 2019

Background

The glutathione S-transferases (GSTs) are a superfamily of phase II detoxifying enzymes that inactivates a wide variety of potential carcinogens through glutathione conjugation. Polymorphic changes in the GST genes have been reported to be associated with increased susceptibility to cancer development and anticancer drug resistance. In this study, we investigated the association between genetic variants in GSTM1 and GSTP1 and patients’ clinicopathological parameters. The prognostic values of such associations were evaluated among bladder cancer patients.

Methods

Genotyping of GSTM1 and GSTP1 in bladder cancer patients was assessed using polymerase chain reaction followed by DNA sequencing. Overall survival was estimated using the Kaplan-Meier method and multiple logistic regression and correlation analysis were performed.

Results

The GSTM1 null genotype was significantly associated with poor overall survival compared with the wild-type GSTM1 genotype. There was a trend towards better overall survival in patients with wild-type GSTP1 allele (AA) compared with GSTP1 (AG/GG) genotype. Interestingly, Kaplan-meier survival curve for GSTM1 null patients adjusted for sub-cohort with amplified HER2 gene showed poor survival compared with the GSTM1 null/ non-amplified HER2 gene. Also the same population when adjusted with HER2 protein expression, data showed poor survival for patients harboring GSTM1 null/high HER2 protein expression compared with low protein expression.

Conclusion

This study focuses on the impact of GSTM1 null genotype on bladder cancer patients’ outcome. Further investigations are required to delineate the underlying mechanisms of combined GSTM−/− and HER2 status in bladder cancer.
Factors behind healthy snack consumption at school among high-school students: a qualitative study
Authors: Bastami Fatemeh , Zamani-Alavijeh Fereshteh , Mostafavi Firoozeh
Published: October 2019

Background

The prevalence of consuming fast foods and non-nutritious snacks is progressively increasing among adolescents. This study aimed to explore factors behind snack consumption at school among Iranian high-school students.

Methods

This descriptive qualitative study was conducted in 2017 in four boys’ and four girls’ high-schools located in Isfahan, Khorramabad, and Tehran, Iran. Data were collected through 42 in-depth semi-structured interviews and four focus groups with male and female students, their parents, and their school teachers and administrators. The conventional content analysis approach was used for data analysis. Trustworthiness was applied to the study through prolonged engagement, maximum variation sampling, and member checking techniques.

Results

Factors behind students’ snack consumption came into two main groups, namely influential behaviors, and influential emotions and perceptions. Influential behaviors included the behaviors of students, their family members, peers, school administrators, and snack sellers. Moreover, influential emotions and perceptions included positive and negative feelings towards healthy snacks, fear over the consequences of unhealthy snacks, and perceived positive outcomes of healthy snacks.

Conclusions

Students’ snack consumption at school is affected not only by their own behaviors, emotions, and perceptions, but also by significant others’ behaviors and environmental factors. School administrators need to make environmental modifications to turn school environment into a pleasant place for healthy snack consumption and make healthy snack consumption a pleasurable experience for students.
How organisations promoting vaccination respond to misinformation on social media: a qualitative investigation
Authors: Steffens Maryke S. , Dunn Adam G. , Wiley Kerrie E. , Leask Julie
Published: October 2019

Background

Vaccination misinformation is associated with serious public health consequences, such as a decrease in vaccination rates and a risk of disease outbreaks. Although social media offers organisations promoting vaccination unparalleled opportunities to promote evidence and counterbalance misinformation, we know relatively little about their internal workings. The aim of this paper is to explore the strategies, perspectives and experiences of communicators working within such organisations as they promote vaccination and respond to misinformation on social media.

Methods

Using qualitative methods, we purposively sampled 21 participants responsible for routine social media activity and strategy from Australian organisations actively promoting vaccination on social media, including government health departments, local health services, advocacy groups, professional associations and technical/scientific organisations. We conducted semi-structured, in-depth interviews to explore their perspectives and practices. Applying Risk Communication principles as a lens, we used Framework Analysis to explore the data both inductively and deductively.

Results

Organisations promoting vaccination face multiple challenges on social media, including misinformation, anti-science sentiment, a complex vaccination narrative and anti-vaccine activists. They developed a range of sophisticated strategies in response, including communicating with openness in an evidence-informed way; creating safe spaces to encourage audience dialogue; fostering community partnerships; and countering misinformation with care.

Conclusions

We recommend that communicators consider directly countering misinformation because of the potential influence on their silent audience, i.e. those observing but not openly commenting, liking or sharing posts. Refutations should be straightforward, succinct and avoid emphasizing misinformation. Communicators should consider pairing scientific evidence with stories that speak to audience beliefs and values. Finally, organisations could enhance vaccine promotion and their own credibility on social media by forming strong links with organisations sharing similar values and goals.
Sex difference in survival status among antiretroviral therapy users in Yirgalem general hospital, Sidama zone, south nations nationalities and peoples’ region (SNNPR), Ethiopia: retrospective cohort study
Authors: Habte Mahilet Berhanu , Debelew Gurmesa Tura , Abebe Tsedach Alemu
Published: October 2019

Background

Antiretroviral treatment (ART) has been shown to enhance the survival of people living with HIV worldwide. In Ethiopia, the number of ART users has increased from 47,422 in 2005 to 703,516 in 2017; yet, early mortality of patients has presented challenges to the success of the ART program. Because of gender roles, it is assumed that females are at risk of dying earlier after the start of the medications. Hence, this study aimed to assess the sex difference in the survival status among the ART users.

Methods

A retrospective cohort study was conducted in March 2017 among sample of 687 ART users registered from 2010 to 2015. Data were extracted from patient records by using a structured checklist. The extracted data were analyzed by STATA version 13. Survival analysis and Cox regression were used to determine survival status and identify associated factors.

Results

Among 685 reviewed records of ART users, 20 males and 64 females died in the 5 years period of ART initiation. This makes the overall 5 years survival rate of 84.23%. Females had lower survival probability (80.10%) as compared to males (91.18%) (Adjusted Hazard Ratio (AHR) = 1.79; 95% CI: 1.04, 3.06). Divorced individuals as compared to married (AHR = 2.09; 95% CI: 1.10, 3.97), individuals with less education (AHR = 2.54 95% CI: 1.29, 4.98) or those who attended only primary education (AHR = 2.07; 95% CI: 1.18, 3.65) as compared to those who attended secondary or above had low survival probability. Those who never disclosed their HIV status (AHR = 3.62; 95% CI: 1.25, 10.46) as compared to disclosed, bedridden individuals as compared to normal functional status (AHR = 2.7; 95% CI: 1.24, 5.89) and those who had tuberculosis (TB)-co infection (AHR = 2.60; 1.48, 4.45) had lower rates of survival.

Conclusion

Females were at higher risk of dying within 5 years of ART initiation as compared to males. Hence, intervention to further reduce mortality should take sex differences into account. Behavioral interventions and HIV counseling service should also be strengthened to improve rate of disclosure and functional status as well as reduce TB co-infections.
Psychometric properties of the European Portuguese version of the Perceived Risk of HIV Scale in the general population and HIV-uninfected partners from sero-different couples
Authors: Martins Alexandra , Chaves Catarina , Canavarro Maria Cristina , Pereira Marco
Published: October 2019

Background

Perceived risk of HIV plays an important role in the adoption of protective behaviours and HIV testing. However, few studies have used multiple-item measures to assess this construct. The Perceived Risk of HIV Scale (PRHS) is an 8-item measure that assesses how people think and feel about their risk of HIV infection. This cross-sectional study aimed to assess the psychometric properties (reliability and validity) of the European Portuguese version of the PRHS, including the ability of this scale to discriminate between individuals from the general population and HIV-uninfected partners from sero-different couples on their perceived risk of HIV infection (known-groups validity).

Methods

This study included 917 individuals from the general population (sample 1) to assess the psychometric properties of the PRHS. To assess the known-groups validity, the sample comprised 445 participants from the general population who were in an intimate relationship (sub-set of sample 1) and 42 HIV-uninfected partners from sero-different couples (sample 2). All participants filled out a set of questionnaires, which included a self-reported questionnaire on sociodemographic information, sexual behaviours, HIV testing and the PRHS. Sample 1 also completed the HIV Knowledge Questionnaire – 18-item version.

Results

The original unidimensional structure was reproduced both in exploratory and confirmatory factor analyses, and the PRHS demonstrated good reliability (α = .78; composite reliability = .82). The differential item functioning analyses indicated that the items of the PRHS, in general, did not function differently for men and women or according to HIV testing. Significant associations with sexual risk behaviours and HIV testing provided evidence for criterion validity. The known-groups validity was supported.

Conclusions

The PRHS is a suitable scale in the evaluation of the perceived risk of HIV, and its psychometric characteristics validate its use in the Portuguese population. Furthermore, the present study suggests that interventions improving individuals’ HIV risk perceptions may be important since they were associated with different sexual behaviours and the likelihood of HIV testing.