bluuebunny/crossref_metadata_2025 huggingface dataset:
Survival prediction models since liver transplantation - comparisons between Cox models and machine learning techniques
Authors: Kantidakis Georgios , Putter Hein , Lancia Carlo , de Boer Jacob , Braat Andries E , Fiocco Marta
Published: October 2020

Background: Predicting survival of recipients after liver transplantation is regarded as one of the most important challenges in contemporary medicine. Hence, improving on current prediction models is of great interest.Nowadays, there is a strong discussion in the medical field about machine learning (ML) and whether it has greater potential than traditional regression models when dealing with complex data. Criticism to ML is related to unsuitable performance measures and lack of interpretability which is important for clinicians.Methods: In this paper, ML techniques such as random forests and neural networks are applied to large data of 62294 patients from the United States with 97 predictors selected on clinical/statistical grounds, over more than 600, to predict survival from transplantation. Of particular interest is also the identification of potential risk factors. A comparison is performed between 3 different Cox models (with all variables, backward selection and LASSO) and 3 machine learning techniques: a random survival forest and 2 partial logistic artificial neural networks (PLANNs). For PLANNs, novel extensions to their original specification are tested. Emphasis is given on the advantages and pitfalls of each method and on the interpretability of the ML techniques.Results: Well-established predictive measures are employed from the survival field (C-index, Brier score and Integrated Brier Score) and the strongest prognostic factors are identified for each model. Clinical endpoint is overall graft-survival defined as the time between transplantation and the date of graft-failure or death. The random survival forest shows slightly better predictive performance than Cox models based on the C-index. Neural networks show better performance than both Cox models and random survival forest based on the Integrated Brier Score at 10 years.Conclusion: In this work, it is shown that machine learning techniques can be a useful tool for both prediction and interpretation in the survival context. From the ML techniques examined here, PLANN with 1 hidden layer predicts survival probabilities the most accurately, being as calibrated as the Cox model with all variables.
Range and niche expansion through multiple interspecific hybridization - a Genotyping by Sequencing analysis of Cherleria (Caryophyllaceae)
Authors: Moore Abigail Jane , Messick Jennifer A. , Kadereit Joachim W.
Published: October 2020

Background: Cherleria (Caryophyllaceae) is a circumboreal genus that also occurs in the high mountains of the northern hemisphere. In this study, we focus on a clade that diversified in the European High Mountains, which was identified using nuclear ribosomal (nrDNA) sequence data in a previous study. With the nrDNA data, all but one species was monophyletic, with little sequence variation within most species. Here, we use genotyping by sequencing (GBS) data to determine whether the nrDNA data showed the full picture of the evolution in the genomes of these species.Results: The overall relationships found with the GBS data were congruent with those from the nrDNA study. Most of the species were still monophyletic and many of the same subclades were recovered, including a clade of three narrow endemic species from Greece and a clade of largely calcifuge species. The GBS data provided additional resolution within the two species with the best sampling, C. langii and C. laricifolia, with structure that was congruent with geography. In addition, the GBS data showed significant hybridization between several species, including species whose ranges did not currently overlap. Conclusions: The hybridization led us to hypothesize that lineages came in contact on the Balkan Peninsula after they diverged, even when those lineages are no longer present on the Balkan Peninsula. Hybridization may also have helped lineages expand their niches to colonize new substrates and different areas. Not only do genome-wide data provide increased phylogenetic resolution of difficult nodes, they also give evidence for a more complex evolutionary history than what can be depicted by a simple, branching phylogeny.
Perception survey of Crisis and Emergency Risk Communication in an acute hospital in the management of COVID-19 pandemic in Singapore
Authors: Yong Lai Meng Ow , Xin Xiaohui , Wee Jennifer Mei Ling , Poopalalingam Ruban S/O , Kwek Kenneth Yung Chiang , Thumboo Julian
Published: October 2020

Background: Emergency risk communication is a critical component in emergency planning and response. It has been recognised as significant for planning for and responding to public health emergencies. While there is a growing body of guidelines and frameworks on emergency risk communication, it remains a relatively new field. There has also been limited attention on how emergency risk communication is being performed in public health organisations, such as acute hospitals, and what the associated challenges are. This article seeks to examine the perception of crisis and emergency risk communication in an acute hospital in response to COVID-19 in Singapore and to identify its associated enablers and barriers. Methods: A 13-item Crisis and Emergency Risk Communication (CERC) Survey, based on the US Centers for Disease and Control (CDC) CERC framework, was developed and administered to hospital staff during February 24-28, 2020. The survey also included an open-ended question to solicit feedback on areas of CERC in need of improvement. Chi-square test was used for analysis of survey data. Thematic analysis was performed on qualitative feedback. Results: Of the 1154 participants who responded to the survey, most (94.1%) reported that regular hospital updates on COVID-19 were understandable and actionable. Many (92.5%) stated that accurate, concise and timely information helped to keep them safe. A majority (92.3%) of them were clear about the hospital’s response to the COVID-19 situation, and 79.4% of the respondents reported that the hospital had been able to understand their challenges and address their concerns. Sociodemographic characteristics such as occupation, age, marital status, work experience, gender, and staff’s primary work location influenced the responses to hospital CERC. Local leaders within the hospital would need support to better communicate and translate hospital updates in response to COVID-19 to actionable plans for their staff. Better communication in executing resource utilisation plans, expressing more empathy and care for their staff, and enhancing communication channels, such as through the use of secure text messaging rather than emails would be important. Conclusions: CERC is relevant and important in the hospital setting to managing COVID-19 and should be considered concurrently with hospital emergency response domains.
Navigation-assisted anchor insertion in shoulder arthroscopy: a validity study
Authors: Jung Kyunghwa , Kim Hyojune , Kholinne Erica , Park Dongjun , Choi Hyunseok , Lee Seongpung , Shin Myung-Jin , Kim Dong-Min , Hong Jaesung , Koh Kyoung-Hwan , Jeon In-Ho
Published: October 2020

Purpose This study aimed to compare conventional and navigation-assisted arthroscopic rotator cuff repair in terms of anchor screw insertion.Methods The surgical performance of five operators were compared while using conventional system and the proposed navigation-assisted system in a phantom surgical model and cadaveric shoulders. The participating operators were divided into two groups: expert (n = 3) and novice (n = 2) groups. In phantom model, the experimental tasks included anchor insertion into the rotator cuff footprint and sutures retrieval. Motion analysis camera system was used to track surgeons’ hand movements. Surgical performance metric included total path length, count of movements, and duration of surgery. In cadaveric experiments, repeatability and reproducibility of anchor insertion angle were compared among three experts and the feasibility of the navigation-assisted anchor insertion was validated.Results There was no significant difference in the total path length, the count of movements and time taken, between the conventional system and the proposed system in phantom model. In cadaveric shoulders, however, the clustering of the anchor insertion angle indicated that the proposed system enabled both novice and expert operators to reproducibly insert anchor with an angle close to the predetermined target angle, resulting in an angle error of less than two degrees (P = 0.0002).Conclusion The proposed navigation-assisted system improved the surgical performance of novice to expert level. All experts achieved a high repeatability and reproducibility for anchor insertion. Navigation-assisted system may help to make surgeons be familiar to insertion of suture anchors in right direction easily, even in-experienced, by providing better guidance for anchor orientation.Level of Evidence A retrospective study (level 2)
Attendants’ experience with the Personalized citizen assistance for social participation (APIC)
Authors: Gagnon Karine , Levasseur Mélanie
Published: October 2020

Abstract
Background : To promote healthy aging, the social participation needs of older adults must be better met. Previous studies have shown the benefits of the Personalized citizen assistance for social participation (APIC), but few explored its influence on attendants. This study explored the assistance experience of attendants when providing the APIC to older adults with disabilities.
Methods : A qualitative design inspired by a phenomenological approach was used with six female attendants who participated in individual interviews.
Results : The APIC attendants felt useful, developed meaningful relationships with their older adults, and improved their self-knowledge. Attendants had the opportunity to reflect on their lives and self-aging. They contributed to older adults’ functional independence, motivation, and participation in social activities. Attendants encountered challenges related to withdrawn behavior in older adults, such as refusing to participate in activities.
Conclusions : Considering the identified benefits of the APIC for attendants, further studies should explore personalized assistance to preserve older adults’ health.
Keywords: Community participation, individualized assistance, aging, community integration, health promotion
Degenerative central lumbar spinal stenosis: Is endoscopic decompression through bilateral transforaminal approach sufficient?
Authors: Zhang Bin , Kong Qingquan , Yan Yuqing , Feng Pin
Published: October 2020

Background: At present, few reports of percutaneous endoscopic transforaminal decompression surgery have been reported to solve central lumbar spinal stenosis (CLSS). Is endoscopic decompression through bilateral transforaminal approach decompression sufficient for degenerative CLSS?Methods: This retrospective study included 47 cases of CLSS patients who underwent percutaneous endoscopic decompression through bilateral transforaminal approach. Clinical outcomes such as ODI, back and leg VAS, the Macnab criteria were evaluated. Surgical results including operative time, postoperative hospital stay, recurrence, and surgical complications were also studied. Radiologically, lumbar stability was assessed and lumbar dural sac dimension was compared preoperatively and postoperatively.Results：All 47 patients were followed up. The average follow-up period was 24.5 months. The average operation time was 116 minutes. The mean VAS of leg and back pain, and the mean ODI improved from 7.81, 2.53, and 77.03% at baseline to a final 1.94 (P=0.00), 2.47 (P=0.71), and 19.40 % (P=0.00), respectively. According to the Macnab criteria, 97.9% of patients achieved excellent and good results. There were 2 cases of dural tear and 3 cases of transient postoperative dysthesia. The cross-sectional area of the dural sac was significant enlargement at the last fellow up (74.28±13.08 mm2 vs.104.91±12.40 mm2, P=0.00).Conclusions: Except for the main pathogenic factors on the dorsal side of the dural sac, percutaneous endoscopic decompression through a bilateral transforaminal approach is sufficient for CLSS. It is a feasible, safe, and clinically effective minimally invasive procedure.
The effect of the community midwifery model on maternal and newborn health service utilization and outcomes in Busia County of Kenya: A quasi-experimental study
Authors: Shikuku Duncan Ndombi , Tanui Geofrey , Wabomba Mercy , Wanjala Dennis , Friday Josephine , Peru Taphroze , Atamba Evelyne , Sisimwo Kenneth
Published: October 2020

Background: Poor women in hard-to-reach areas are least likely to receive healthcare and thus carry the burden of maternal and perinatal mortality from complications of childbirth. This study evaluated the effect of an enhanced community midwifery model on skilled attendance during pregnancy/childbirth as well as on maternal and perinatal outcomes against the backdrop of protracted healthcare workers' strikes in rural Kenya.
Methods: The study used a quasi-experimental (one-group pretest-posttest) design. The study spanned three time periods: December 2016-February 2017 when doctors were on strike (P1), March-May 2017 when no healthcare providers were on strike (P2), and June-October 2017 when nurses/midwives were on strike (P3), which was also the period when the project enhanced the capacity of community midwives (CMs) to provide services at the community level. Analysis entailed comparison of frequencies/means of maternal and newborn health service utilization data across the three periods.
Results: The monthly average number of clients obtaining services from CMs across the three time periods was: first antenatal care (ANC) (P1-1.8, P2-2.3, P3-9.9), fourth ANC (P1-1.4, P2-1.0, P3-7.1), skilled birth (P1-1.5, P2-1.7, P3-13.1) and the differences in means were statistically significant (p<0.05). Over the period, the monthly average number of clients obtaining services from health facilities was: first ANC (P1-55.7, P2-70.8, P3-4.0), fourth ANC (P1-29.6, P2-38.1, P3-1.2) and skilled birth (P1-63.1, P2-87.4, P3-5.6), p<0.05. There were no statistically significant differences in the average number of clients obtaining services from CMs or health facilities between P1 and P2 (p>0.05). There was, however, a statistically significant increase in the average number of clients obtaining services from CMs in P3 accompanied by a statistically significant decline in the average number of clients obtaining services from health facilities (p<0.05). First ANC increased by 68%, fourth ANC by 75%, skilled births by 68%, and postnatal care by 33% in P3 (p<0.0001). There was a non-significant decline in macerated stillbirths and neonatal deaths in P3.
Conclusions: The findings underscore the importance of integrating community-level health service providers (CMs and health volunteers) into the primary health care system to complement service delivery according to their level of expertise, especially in low-resource settings.
Surface Deformation Evolution in the Pearl River Delta between 2006 and 2011 derived from the ALOS1/PALSAR images
Authors: Li Genger , Feng Guangcai , Xiong Zhiqiang , Liu Qi , Xie Rongan , Zhu Xiaoling , Luo Shuran , Du Yanan
Published: October 2020

This study monitors the land subsidence of the whole Pearl River Delta (PRD) (area: ~40,000 km2) in China using the ALOS1/PALSAR data (2006-2011) through the SBAS-InSAR method. We also analyze the relationship between the subsidence and the coastline change, river distribution, geological structure as well as the local terrain. The results show that (1) the land subsidence with the average velocity of 50 mm/year occurred in the low elevation area in the front part of the delta and the coastal area, and the area of the regions subsiding fast than 30 mm/year between 2006 and 2011 is larger than 122 km2; (2) the subsidence order and area estimated in this study are both much larger than that measured in previous studies; (3) the areas along rivers suffered from surface subsidence, due to the thick soft soil layer and frequent human interference; (4) the geological evolution is the intrinsic factor of the surface subsidence in the PRD, but human interference (reclamation, ground water extraction and urban construction) extends the subsiding area and increases the subsiding rate.
Bioclimatic zonation and potential distribution of Spodoptera frugiperda (Lepidoptera: Noctuidae) in South Kivu Province, DR Congo
Authors: Cokola Marcellin Cuma , Mugumaarhahama Yannick , Bisimwa Espoir Basengere , Grégoire Noël , Bugeme David Mugisho , Chuma Géant Basimine , Byamungu Adrien Ndeko , Francis Frédéric
Published: October 2020

Background: the fall Armyworm (FAW) Spodoptera frugiperda (JE Smith), is currently a devastating pest throughout the world due to its dispersal capacity and voracious feeding behaviour on several crops. A MaxEnt species distributions model (SDM) was developed based on collected FAW occurrence and environmental data’s. Bioclimatic zones were identified and the potential distribution of FAW in South Kivu, eastern DR Congo, was predicted.Results: Mean annual temperature (bio1), annual rainfall (bio12), temperature seasonality (bio4) and longest dry season duration (llds) mainly affected the FAW potential distribution. The average area under the curve value of the model was 0.827 demonstrating the model efficient accuracy. According to Jackknife test of variable importance, the annual rainfall was found to correspond to the highest gain when used in isolation. FAWs’ suitable areas where this pest is likely to be present in South Kivu province are divided into two corridors. The Eastern corridor covering the Eastern areas of Kalehe, Kabare, Walungu, Uvira and Fizi territories and the Western corridor covering the Western areas of Kalehe, Kabare, Walungu and Mwenga.Conclusions: This research provides important information on the distribution of FAW and bioclimatic zones in South Kivu. Given the rapid spread of the insect and the climatic variability observed in the region that favor its development and dispersal, it would be planned in the future to develop a monitoring system and effective management strategies to limit it spread and crop damage.
Ability to use of Robinia pseudoacania L fruit extract as a natural corrosion inhibitor in the protection of historical bronze objects
Authors: pourzarghan vahid , nasab bahman fazeli
Published: October 2020

Background: The phenomenon of bronze disease is considered as the most important factor in the destruction of bronze objects. Different methods have been proposed to cope with it. The most important inhibitors used in this regard are BTA and AMT(5-ami- no-2-mercapto-1,3,4-thiadiazole). While these inhibitors control the corrosion, they are toxic and cancerous. In the ideal conditions, these inhibitors are able to slow down the activity of chlorine ion, but they leave some side effects after a period of treatment. Today, plant extracts are used for this purpose. In this study, Robinia pseudoacania L extract was selected for this purpose.Material and methods: Natural inhibitor of Robinia fruit at concentrations of 200 ppm to 1800 ppm was evaluated in a corrosive solution of sodium chloride 0.5 M on a bronze alloy with a percentage similar to ancient alloys (Cu-10Sn) using potentiostat, weight loss method, and humidifier area.Results: Given the data derived from potentiostate device showed that Robinia pseudoacania L Inhibitory power at 1000 ppm with corrosion rate of 12.78% is 55% and the classic method of weight loss inhibitory power after four week at 1800 ppm Robinia pseudoacania L in contrast a corrosive solution of sodium chloride 0.5 M is 92% for bronze alloy (Cu-10Sn). In addition, SEM images suggest that the formation of film on the coupon has been flacked. While the results of the analyses suggest the inhibitory power of Robinia pseudoacania L, granular corrosion is evident on the coupons surfaces in SEM-EDX(Scanning Electron Microscope-Energy Dispersive X-rays) images and analysis.Conclusion: According to the SEM-EDX method, the acetate potential device and the classical weight loss method on bronze (Cu-10sn), the results show that the corrosion rate in the acetate potential method is 55%, while in the classical method the reduction is shown. The weight of this figure reaches 92%. It is important to note that the SEM images show a kind of grain boundary separation on the coupons of this alloy, which is due to the presence of this substance in the corrosive solution of sodium chloride.
Role of interleukin 6 as a predictive factor for a severe course of Covid-19: retrospective data analysis of patients from a Long-term Care Facility during Covid-19 Outbreak
Authors: Sabaka Peter , Koščálová Alena , Straka Igor , Hodosy Julius , Lipták Robert , Kmotorková Barbora , Kachlíková Mária , Kušnírová Alica
Published: October 2020

Background: Covid-19 is a disease with high morbidity and mortality among elderly residents of long-term care facilities (LTCF). During an outbreak of SARS-CoV-2 infection in the LTCF an effective screening tool is essential to identify the patients at risk for severe illness and death. We explored the role of interleukin 6 (IL-6) as a predictor for severe disease during the outbreak of Covid-19 in one LTCF in Slovakia. Methods: We conducted a retrospective data analysis of cases of COVID-19, diagnosed during the outbreak in one LTCF in Slovakia between April 11, 2020, and May 5, 2020. Within 24 hours after the diagnosis of Covid-19, clinical and laboratory screening was performed in the LTCF to identify patients in need of hospitalization. Patients with oxygen saturation below 90% were immediately referred to the hospital. Patients staying in the LFTC were monitored daily and those that developed hypoxemia were transferred to the hospital. We analyzed the association between the IL-6 at the initial assessment and development of hypoxemia during follow up and determined the cut-off of the IL-6 able to predict the development of hypoxemia requiring oxygen therapy. Results : Fifty-three patients (11 men, 42 women) with diagnosed Covid-19 were included in the analysis. 19 (53%) patients developed hypoxemia during the disease. Patients with hypoxemia had significantly higher concentrations of IL-6, C-reactive protein, procalcitonin, fibrinogen, total bilirubin, aspartate aminotransferase and alanine aminotransferase at initial screening. ROC analyses identified IL-6 as the most robust predictor of hypoxemia. The concentration of IL-6 > 24 pg/mL predicted the development of hypoxemia with the sensitivity of 100% and specificity of 88.9%. The positive and negative predictive values were 76.9%, and 100% respectively. Conclusions : The concentration of IL-6 > 24 pg/mL at initial assessment predicted the development of hypoxemia requiring hospitalization with excellent sensitivity and good specificity. IL-6 appears as a potential predictor for the development of the severe Covid-19 and might serve for early identification of patients in need of hospitalization. Further studies are needed to evaluate the robustness of the use of IL-6 as an effective screening tool for the severe course of Covid-19.
Do alternative capability instruments capture differing aspects of mental health and quality of life in comparison to the EQ-5D for schizophrenic patients with depression?
Authors: Helter Timea Mariann , Coast Joanna , Łaszewska Agata , Stamm Tanja , Simon Judit
Published: October 2020

Background: There is increasing evidence that assessing outcomes in terms of capability wellbeing provides information beyond that of health-related quality of life measures for evaluation in mental health research. This paper aimed to contribute to the utilisation of capability-based measures relative to health status measures in mental health research, by exploring the empirical relationship between the OxCAP-MH, the ICECAP-A, and the EQ-5D instruments against condition-specific measures and each other for schizophrenic patients with depression. Methods: Using trial data for 100 patients from the UK, the properties of the instruments were compared in terms of convergent validity, including correlations between the OxCAP-MH, the ICECAP-A, the EQ-5D-5L descriptive system and the EQ-5D VAS scores; and a line of central tendency between two variables was plotted on locally weighted smoothing curves. Exploratory factor analysis (EFA) investigated the extent to which the instruments measured complementary or overlapping constructs. Responsiveness was assessed in terms of standardised response mean and correlation between change scores (baseline to endpoint) of the instruments. Results: Correlation between the OxCAP-MH and ICECAP-A baseline scores was strong (0.682) and between change scores was moderate (0.401). The baseline scores of both capability instruments correlated more with condition-specific (0.481-0.718) than with generic (0.344-0.425) instruments. Their change scores weakly correlated with change scores of the generic health-related scales (0.183-0.247), but moderately with those of condition-specific instruments (0.339-0.557). The EFA found that while the EQ-5D-5L descriptive system loaded onto one factor, the items of the ICECAP-A loaded onto two additional factors and the items of the OxCAP-MH loaded onto three additional factors. Conclusions: The capability instruments had stronger convergent validity with each other than with any of the other instruments. Assessing outcomes in terms of capabilities for schizophrenic patients with depression proved to capture broader relevant information than the EQ-5D-5L both by the OxCAP-MH and the ICECAP-A, albeit to different extent. When comparing the two capability instruments, the OxCAP-MH tended to have stronger correlations with condition-specific instruments most likely due to its origin from mental health outcome measurement, while the ICECAP-A had slightly stronger correlation with the EQ-5D VAS.
Influence of shear effects on the characteristics of axisymmetric wave propagation in a buried fluid-filled pipe
Authors: Lu Ping , Sheng Xiaozhen , Gao Yan , Wang Ruichen
Published: October 2020

The acoustic propagation characteristics of axisymmetric waves have been widely used in leak detection of liquid-filled pipes. The related acoustic methods and equipment are gradually coming to the market, but their theoretical research obviously lags behind the field practice, which seriously restricts the breakthrough and innovation of this technology. Based on the fully three-dimensional effect of the surrounding medium, a coupled motion equation of axisymmetric wave of buried liquid-filled pipes is derived in detail, a contact coefficient is used to express the coupling strength between surrounding medium and pipe, then, a general equation of motion was derived which contain the pipe soil lubrication contact, pipe soil co mpact contact and pipe in water and air. Finally, the corresponding numerical calculation model is established and solved used numerical method. The shear effects of the surrounding medium and the shear effects at the interface between surrounding medium and pipe are discussed in detail. The output indicates that the surrounding medium is to add mass to the pipe wall, but the shear effect is to add stiffness. With the consideration of the contact strength between the pipe and the medium, the additional mass and the pipe wall will resonate at a specific frequency, resulting in a significant increase in the radiation wave to the surrounding medium. The research contents have great guiding effect on the theory of acoustic wave propagation and the engineering application of leak detection technology in the buried pipe.
Low Rates of All-Cause Revision in Displaced Subcapital Femoral Neck Fractures Treated with Hip Hemiarthroplasty - A Retrospective Review of 4516 Patients from a Single Institute
Authors: Yeung Chi-Yung , Tsai Shang-Wen , Wu Po-Kuei , Chen Cheng-Fong , Chang Ming-Chau , Chen Wei-Ming
Published: October 2020

Background: Femoral neck fracture (FNF) is among the commonest fractures affecting the geriatric population. Hemiarthroplasty (HA) is a standard treatment procedure and has been performed by hip surgeons for decades. Recently, primary total hip replacement has proved advantageous for the treatment of such fractures. The aim of this study is to retrospectively review all causes of failure of all patients who underwent HA in our institute and reevaluated whether HA remains a favourable choice of treatment for patients with displaced FNFs.Methods: A total of 4516 patients underwent HA at our centre from 1998 to 2017. The HA implants included unipolar and bipolar prostheses. Patients diagnosed with displaced FNF, underwent primary HA initially, required second revision procedures, and followed up for a minimum of 36 months were included in this study. Data were collected and comprehensively analysed.Results: In 4516 cases, 99 patients underwent second surgeries. The revision rate was 2.19%. Reasons for failure were acetabular wear (n = 30, 30.3%), femoral stem subsidence (n = 24, 24.2%), periprosthetic fracture (n = 22, 22.2%), infection (n = 16, 16.2%), and recurrent dislocation (n = 7, 7.1%). The mean follow-up period was 78.1 months. The interval between failed HA and revision surgery was 22.8 months.Conclusion: HA has a low revision rate and remains a favourable choice of treatment for patients with displaced FNFs.Levels of Evidence: Level III, Retrospective Cohort Study, Therapeutic Study
Changes in cerebrospinal fluid interleukin-10 levels display better performance in predicting disease relapse than conventional magnetic resonance imaging in primary central nervous system lymphoma 
Authors: Zhang Yan , Zou Dongmei , Yin Jingjing , Zhang Li , Zhang Xiao , Wang Wei , Zhang Meifen , Zhou Daobin , Zhang Wei
Published: October 2020

Backgroud: Establishing diagnostic and prognostic biomarkers of primary central nervous system lymphoma (PCNSL) is a challenge. This study evaluated the value of dynamic interleukin (IL)-10 cerebrospinal fluid (CSF) concentrations for prognosis and relapse prediction in PCNSL. Methods: Consecutive 40 patients newly diagnosed with PCNSL between April 2015 and April 2019 were recruited, and serial CSF specimens were collected by lumbar punctures (LP) or by Ommaya reservoir at diagnosis, treatment, and follow-up phase.Results: We confirmed that an elevated IL-10 cutoff value of 8.2 pg/mL for the diagnosis value of PCNSL showed a sensitivity of 85%. A persistent detectable CSF IL-10 level at the end of treatment was associated with poor progression-free survival (PFS) (836 vs. 481 days, p = 0.049). Within a median follow-up of 13.6 (2–55) months, 24 patients relapsed. IL-10 relapse was defined as a positive conversion in patients with undetectable IL-10 or an increased concentration compared to the last test in patients with sustained IL-10. IL-10 relapse was detected a median of 67 days (28–402 days) earlier than disease relapse in 10/16 patients. Conclusion: This study highlights a new perspective that CSF IL-10 relapse could be a surrogate marker for disease relapse and detected earlier than conventional magnetic resonance imaging (MRI) scan. Further evaluation of IL-10 monitoring in PCNSL follow-up is warranted.
Comparative analysis of some bioactive compounds in leaves of different Aloe species
Authors: Andrea Bunea , Rugina Dumitrita , Florina Copaciu , Francisc Dulf , Anastasia Veres , Socaci Sonia , Adela Pintea
Published: October 2020

Although a vast number of Aloe species are known, only the Aloe vera and Aloe arborescens species are currently used by cosmetic and pharmaceutical industries. Therefore, the current study aims to complete the existent literature data with new information on the phytochemical composition of some lesser-known Aloe species, with the main focus on carotenoids and fatty acids. Among the analyzed species, Aloe aculeata and Aloe ferox had the highest content in carotenoids, the major pigments being lutein and β -carotene (according to HPLC analysis). The fatty acid profile of each Aloe species was analysed by GC-MS. Linolenic and linoleic acids were the major polyunsaturated fatty acids found in higher percent in Aloe ferox , Aloe spectabilis and Aloe marlothii . Instead, Aloe aculeata proved to have a distinct fatty acid profile, rich in monounsaturated fatty acids. Species such as Aloe arborescens and Aloe marlothii proved to have the highest antioxidant potential according to data of DPPH, ORAC, HPS assays, even if the richest one in vitamin C was found to be Aloe spectabilis. Though the scientific research is mainly focused on the common species Aloe barbadensis , current data suggests that other Aloe species could receive more attention from industry part, being great sources of bioactive compounds.
Relevant beliefs for HIV Testing and Counselling Services among Tuberculosis Suspected patients in Kassala State, Sudan
Authors: Idris Almutaz Mohamed , Crutzen Rik , Borne H.W. Van den
Published: October 2020

Background: There is limited information about the psychosocial (sub-) determinants regarding the use of HIV Testing and Counselling (HTC) services among Tuberculosis(TB) suspected patients in Sudan. This study aimed to assess the psychosocial beliefs related to the intention to use HTC services among TB suspected patients and to establish the relevance of these beliefs for developing behaviour change interventions. Methods: TB suspected patients (N= 383) completed a cross-sectional questionnaire from four separate TB facilities. The questionnaire was based on the Reasoned Action Approach theory. Eligibility criteria included attending Tuberculosis Management Units in Kassala State as suspected TB patients and aged 18-64 years. A Confidence Interval Based Estimation of Relevance (CIBER) analysis approach was employed to investigate the effects of the beliefs on the intention to use the HTC services and to establish their relevance to be targeted in behaviour change interventions. Results: The CIBER results showed the beliefs included in the study accounted for 59% to 70% of the variance in intention to use HTC services. The belief "My friends think I have to use the HTC services" was positively associated with the intent to use HTC, and it is highly relevant for interventions. The belief “If I would fear to be stigmatized if I get HIV positive result" was negatively related to the intention to use the HTC services and highly relevant belief. The belief “If I use HTC services, the health care providers will keep my HIV test result confidential" was strongly associated with the intention to use HTC services. However, it was not a very low relevant belief. Past experience with HTC services was weakly associated with the intention to use HTC services. Conclusion: The intention to use HTC was a function of psychosocial beliefs. The belief investigated varied in their relevance for interventions designed to encourage the use of HTC services. Interventions to intention to use HIV testing and counselling services should address the most relevant beliefs (sub-determinants). Further study is needed to establish the relevance of sub-determinants of the intention to use HTC services.
The feasibility of bedside ultrasound in confirmation of Endotracheal tube position in neonates compared with CXR 
Authors: Khalesi Nasrin , Dehgan Marzie , Zarei Elham
Published: October 2020

Background: Endotracheal intubation is a common procedure in the neonatal intensive care unit (NICU). Rapid and accurate confirmation of the endotracheal tube (ETT) position is critical . Routinely CXR is used for evaluation of ETT position that has some disadvantages . So there has been a considerable interest to find alternative modality with minimal complication and acceptable accuracy. The purpose of our study is the evaluation of ultrasound efficacy in confirmation of ETT position in neonates comparison to CXR.Methods: This cross-sectional study was conducted on 66 intubated neonates in NICU of Ali -Asghar children Hospital, between January 2018 and January 2019. To determine the ETT position, CXR and ultrasound were requested at the same time. Each neonate had a bedside ultrasound (US) with a high-frequency linear transducer. Accuracy, sensitivity, specificity, negative predicted value (NPV), positive predicted value (PPV) and Kappa agreement coefficient was used to compare the US and CXR results. Results: Sixty-six intubated neonates included in this study had a mean gestational age of 34.98 ±3.7 weeks and mean birth weight of 2284.7 ± 915g. US images were taken a mean of 3 ±0.6 h after CXR. The ETT was visualized by the US in all newborns examined.US revealed a sensitivity of 88% (95% CI, 68.78% to 97.45%), specificity of 84 % (95% CI, 63.92% 95.46%), PPV of 84.62% (95% CI, 68.89% to 93.18%), NPV of 87.50 % (95% CI, 70.49% to 95.35%), diagnostic accuracy of 86%(95% CI, 73.26% to 94.18%), positive likelihood ratio of 5.50 (95% CI 2.21 to 13.66), and Negative Likelihood Ratio of 0.14 (95% CI 0.05 to 0.46) compared to chest radiography. Overall, the Kappa value showed very good agreement in confirming the correct position of the tracheal tube placement (Kappa coefficient 0.72, p-value <0.001).The mean time taken for confirmation of ETT position by US 4 minutes and by CXR was 20 minutes.Conclusion: The findings of this study demonstrate ultrasound has acceptable accuracy for confirmation of ETT position in neonates and is a safer and faster method in comparison to CXR .
Demand- and Supply-side Factors Associated with the Use of Contraceptive Methods in Pakistan: A Comparative Study of Demographic and Health Surveys, 1990–2018
Authors: Jabeen Sadia , Rathor Adnan , Riaz Maria , Zakar Rubeena , Fischer Florian
Published: October 2020

Background: A remarkable decline in fertility rates has been observed in many countries, with a primary determinant being an increase in the use of contraceptives. However, the birth rate in Pakistan is still higher compared to the other countries of the region. Therefore, this study aims to assess the effect of demand- and supply-side factors associated with the use of contraceptive measures in Pakistan.Methods: Secondary data analysis of four data series of the Pakistan Demographic and Health Surveys (PDHS 1990–91, 2006–07, 2012–13 and 2017–18) were used. The data includes ever-married women aged 15–49 years who had given birth in the previous five years and participated in the family planning module of the PDHS. A total of 25,318 women were included in the analysis. Data were analysed by investigating the associations between independent variables (demand- and supply-side factors) and the use of contraceptive measures through unadjusted odds ratios (OR) and adjusted OR (AOR).Results: The results among demand-side factors indicated that in 2012–13, women without media exposure were less likely to use contraceptives and the trend remains almost constant for 2017–18 (AOR = 0.664, 95 % CI: 0.562–0.784) in 2012–13 and (AOR = 0.654, 95 % CI: 0.483–0.885) in 2017–18; however, they still show a lower likelihood of using contraceptives without media exposure. The results among supply-side factors indicated that absence of transport (2012–13) and limited visits by family planning workers over the previous 12 months (2006–07, 2012–13 and 2017–18) remained significant factors for not using contraceptive methods.Conclusions: The results of the study indicate that certain demand- and supply-side factors are associated with the use of contraceptive measures in Pakistan. It highlights the need for the provision of family planning resources and further structural factors, particularly in remote areas.
A comparison of the relationship between parental efficacy and social support systems of single teen mothers across different family forms in South Africa low socioeconomic communities
Authors: Coert Samantha Linn , Adebiyi Babatope O. , Rich Edna , Roman Nicolette V.
Published: October 2020

Background: Teenage parenting is recognised as one of the greatest health and social problems in South Africa. Research in South Africa has shown that by the age of 18 years, more than 30% of teens have given birth at least once. Teen mothers may feel disempowered because they are ‘othered’ and consequently, may develop forms of resistance which in most cases may inhibit their ability to parent. Social support is therefore, an imperative intervention for successful teen parenting but this is not clearly understood in South Africa. This study aimed to compare the relationship between parental efficacy and social support systems of single teen mothers across different family forms. Methods: A quantitative methodology with a cross-sectional comparative correlation design was conducted with 160 single teen mothers who resided with a family in a low socio-economic community. The participants completed a self-report questionnaire that comprised of the Social Provisions Scale (SPS), and the Parenting Sense of Competence (PSOC) scale. Descriptive statistics and Pearson correlation were used to investigate the data. Results: A significant positive relationship between social support and parental efficacy was found. When comparing different family forms, single teen mothers’ residing with one parent reported greater levels of parental efficacy and single teen mothers’ residing with two parents, re-counted high levels of social support under the subscales; guide, reliable and nurture. However, when computing for guardian-skip generation, results show that there is no significant relationship between parental efficacy and social support. As well as no correlation across subscales of social support. Conclusion: The positive relationships between social support and parental efficacy are important for planning and applying parenting programmes amongst single teen mothers and facilitating awareness regarding the importance of social support and family forms when considering parenting practices.
Cancer cells invasion to the gastric bare area adipose tissue: a poor prognostic predictor for gastric cancer
Authors: Chen Yongming , Xu Shuhang , Huang Chunyu , Ling Yihong , Liang Chengcai , Miao Yuhua , Sun Xiaowei , Li Yuanfang , Zhou Zhiwei
Published: October 2020

Background: The relationship between gastric bare area adipose tissues invasion (GBAI) confirmed pathologically and the prognosis of gastric cancer (GC) patients is undefined. Till present, there hasn’t been literature investigating this phenomenon. Here, we aimed at analyzing the implication of GBAI in GC.

Methods: The data of 1822 patients who underwent radical surgery between January 2000 and December 2013 at the Sun Yat-sen University Cancer Center were retrieved. Pathologically, tumor deposits (TDs) located >5mm from the leading edge of the primary tumor and the lymph nodes (LNs) station number 1, 2, 7, and 9 were considered as GBAI. Kaplan-Meier method, log-rank test and Cox’s proportional hazards model were employed to analyze.

Results: 205 (11.3%) patients were pathologically diagnosed with GBAI, which was more commonly found in proximal or linitis lastica than distal GC (P<0.001). There was significant difference in 5-year survival between patients with and without GBAI for stages IIB, IIIA, IIIB, IIIC, respectively (P<0.009 for IIB, IIIA and IIIB, P=0.021 for IIIC). Among the 205 GBAI patients, 61 had detailed radiological follow-up data in which 26 (34.7%) were found to have retroperitoneal infiltration, 27 (36.0%) had peritoneal metastasis, 10 (13.3%) had hematogenous metastasis, 16 (21.3%) had lymphatic metastasis, and 16 (21.3%) had others.

Conclusions: GBAI was identified as a predictor of unfavourable prognosis for GC and was more commonly found in the proximal or linitis plastica of the stomach than in distal stomach. Retroperitoneal infiltration was one of the most commonly identified metastatic route for GC associated with GBAI after radical surgery.
Leukemia mortality in children from Latin America: Trends and predictions to 2030
Authors: Torres-Roman J. Smith , Valcarcel Bryan , Guerra-Canchari Pedro , Santos Camila Alves Dos , Barbosa Isabelle Ribeiro , Vecchia Carlo La , McGlynn Katherine A. , de Souza Dyego Leandro Bezerra
Published: October 2020

Background: Reports suggest that Latin American and Caribbean (LAC) countries have not reduced in leukemia mortality compared to high-income countries. However, updated trends remain largely unknown in the region. Given that leukemia is the leading cause of cancer-related death in LAC children, we evaluated mortality trends in children (0-14y) from 15 LAC countries for the period 2000-2017 and predicted mortality to 2030.Methods: We retrieved cancer mortality data using the World Health Organization Mortality Database. Mortality rates (standardized to the world standard SEGI population) were analyzed for 15 LAC countries. We evaluated the average mortality rates for the last 5 years (2013-2017). Joinpoint regression analysis was used to evaluate leukemia mortality trends and provide an estimated annual percent change (EAPC). Nordpred was utilized for the calculation of predictions until 2030.Results: Between 2013 and 2017, the highest mortality rates were reported in Venezuela, Ecuador, Nicaragua, Mexico, and Peru. Upward mortality trends were reported in Nicaragua (EAPC by 2.9% in boys, and EAPC by 2.0% in girls), and Peru (EAPC by 1.4% in both sexes). Puerto Rico experienced large declines in mortality among both boys (EAPC by −9.7%), and girls (EAPC by −6.0%). Leukemia mortality will increase in Argentina, Ecuador, Guatemala, Panama, Peru, and Uruguay by 2030.Conclusion: Leukemia mortality is predicted to increase in some LAC countries by 2030. Interventions to prevent this outcome should be tailor to reduce the socioeconomic inequalities and ensure universal healthcare coverage.
Early change in prostate-specific antigen levels as a predictive marker for overall survival during vintage hormonal therapy for metastatic hormone-sensitive prostate cancer
Authors: Nakanishi Shotaro , Goya Masato , Tamaki Mitsuyoshi , Oshiro Takuma , Saito Seiichi
Published: October 2020

Background

The effect of early changes in prostate-specific antigen (PSA) levels after androgen deprivation therapy (ADT) in metastatic hormone-sensitive prostate cancer (mHSPC) patients has not been well investigated. Here, we evaluated the effect of factors that lead to castration-resistant prostate cancer (CRPC) progression and overall survival (OS) in mHSPC.
Methods

Medical records of 71 consecutive primary mHSPC patients treated with ADT were analyzed. Factors predicting the time to CRPC and OS in these patients were evaluated at 3 months after ADT induction.
Results

The median times to CRPC and OS were 15 months and 92 months, respectively. In multivariate analysis using Cox proportional hazards regression, a Gleason score of 8 or more (p = 0.004), extent of disease value (EOD) of 2 or more (p = 0.004), and a PSA level of 1% or more of the pretreatment levels after 3 months of ADT (p = 0.017) were independent predictors of shorter time to CRPC. For OS, a PSA level of 1% or more after 3 months of ADT was the independent predictor (p = 0.004).
Conclusion

% PSA was an important factor that correlated with poor prognosis at 3 months after ADT induction.