bluuebunny/crossref_metadata_2025 huggingface dataset:
Stress, anxiety, depressive disorders, and somatisation among lawyers
Authors: Chrobak-Kasprzyk Katarzyna , Jośko-Ochojska Jadwiga
Published: August 2020

Wstęp

American Bar Association opublikowało niepokojące dane, iż 28% prawników w USA cierpi na depresję, 19% wykazuje objawy lęku, 21% nadużywa alkoholu. Niewiele wiadomo na temat stresu, lęku, zaburzeń depresyjnych i somatyzacji wśród polskich adwokatów, zatem prezentowana praca jest pierwszą oceną stanu psychicznego i emocjonalnego wspomnianej grupy zawodowej.

Materiał i metody

Badaniem objęto 206 adwokatów, członków Okręgowej Rady Adwokackiej w Katowicach. Badanie przeprowadzono anonimowo za pomocą kwestionariusza 4DSQ.

Wyniki

Blisko 22% adwokatów deklaruje podwyższony poziom stresu, w tym 2% mocno podwyższony. Somatyzacja korelowała silnie ze stresem, depresją oraz lękiem i występowała u około 21%. Badanie wykazało istnienie istotnego statystycznie związku pomiędzy tygodniową liczbą godzin pracy a podskalami: lęku (r = 0,17; p = 0,01) stresu (r = 0,17; p = 0,01) oraz depresji (r = 0,16; p = 0,02). Przeprowadzona analiza wykazała istnienie istotnej statystycznie różnicy w poziomie depresji pomiędzy kobietami i mężczyznami (t = 2,14; p = 0,03).

Wnioski

Przeprowadzone badanie jest pierwszą oceną somatyzacji, stresu, lęku i zaburzeń depresyjnych wśród adwokatów w Polsce. U badanych stwierdzono wysoki poziom stresu, który najsilniej korelował z somatyzacją ze strony układu mięśniowo-szkieletowego, pokarmowego, neurologicznego oraz sercowo-naczyniowego. Niepokój i zaburzenia depresyjne występowały w tej grupie zawodowej częściej niż w populacji ogólnej i wraz ze wzrostem ich nasilenia narastała liczba objawów somatycznych. Zaburzenia depresyjne występowały częściej wśród mężczyzn.
La Relation Banque-Entreprise Au Cameroun : Exploration Empirique Des Fondements
Authors: Mbida Joachim Christel
Published: August 2020

Lâ€™on assiste au cours des derniÃ¨res dÃ©cennies Ã  de grandes mutations socio-Ã©conomiques qui soulÃ¨vent dâ€™importants dÃ©fis Ã©pistÃ©mologiques en lâ€™occurrence la question de la collaboration des banques avec les entreprises en quÃªte de financement. Lâ€™ambition de la prÃ©sente recherche est de contribuer Ã  lâ€™intelligence des facteurs de lâ€™engagement des banques et des entreprises dans des relations financiÃ¨res. Pour ce faire, les thÃ©ories des conventions et de la dÃ©pendance envers les ressources sont mobilisÃ©es. Cette approche sâ€™inscrit dans une perspective dyadique. Le matÃ©riau empirique est constituÃ© des donnÃ©es issues Ã  la fois des banques et des entreprises. Les rÃ©sultats suggÃ¨rent principalement que de quelque cÃ´tÃ© quâ€™on se trouve lâ€™engagement des acteurs repose sur des facteurs Ã  la fois objectifs et subjectifs.
Over the past few decades, we have witnessed major socio-economic changes which raise important epistemological challenges, in this case the question of the collaboration of banks with companies seeking financing. The aim of thisresearch isto contribute to the understanding of the factorsinvolved in the engagement of banks and businesses in financial relationships. To do this, the theories mobilized are: theories of conventions, of dependence on resources. Our approach is part of a dyadic perspective. The empirical material is made up of data from both banks and companies. The results mainly suggest that wherever we are, stakeholder engagement is based on both objective and subjective factors.
Project Management and Performance of Rural Road Construction Projects in Machakos County, Kenya
Authors: Wandiri Cornelius , James Rosemary
Published: August 2020

This paper explores the influence of project management practices on performance of rural road construction projects in Machakos County, Kenya. Rural road construction projects experience challenges that impede them from being successfully completed within the allocated cost budget, set timelines and to the desired quality. This study specifically investigated how project planning, project execution and project monitoring and control influence the performance of rural construction projects. The study conducted a census of all the 18 rural road construction projects in Machakos County by census. These projects were at various stages of completion. The number of respondents selected was 100 and in order to narrow down on these respondents, simple random sampling technique was used. The study used descriptive and causal research designs and applied a semi-structured questionnaire in collection of data. The study found out that project planning, project execution and project monitoring and control all had a positive and significant relationship with project performance. However, it was also found out that these project management practices were not being applied effectively in the road projects under study. The study concludes that project management practices greatly influence the performance of rural road construction projects. The study recommends that project management practices of project planning, project execution and project monitoring and control which form more than 85% of the project life cycle, should be effectively applied throughout the life cycle of implementing rural road construction projects in order to ensure that the projects meet the performance goals.
Indigenous Entrepreneurship and Economic Development: The Moderating Effect of Post-Conflict Reconstruction in Turkana County, Kenya
Authors: Kingâ€™ongâ€™o Wambui , Ogutu Martin , Nyandemo Samuel
Published: August 2020

The role of entrepreneurship in post-conflict reconstruction is largely understudied. Micro and Small livestock enterprises play an important economic and socio-cultural role amongst many Kenyan communities. The objective of this study was to establish the moderating effect of post-conflict reconstruction on the relationship between indigenous entrepreneurship and economic development in Turkana County. This study is anchored on institutional theory. Positivism and phenomenology paradigms and a cross sectional research design was adopted. The target population was all micro and small livestock enterprises that are registered members of the Livestock Marketing Association (LMA) in Turkana County; comprising of 598 livestock enterprises. A sample of 339 micro and small livestock enterprises were selected for the study using simple random sampling techniques. Data collected were analyzed using descriptive and inferential statistics like mean, standard deviation, cumulative variance, Skewness, Kurtosis, ANOVA and regression analyses. The results revealed that Post-conflict reconstruction has a significant moderating effect on the relationship between indigenous entrepreneurship and economic development in Turkana county, (F=50.22, P=0.000). The study suggests legislation of laws and policies by the national and County governments, prohibiting acquisition of small arms. Policy initiatives should support indigenous livestock enterprises for instance, creation of a suitable environment for these businessesto obtain credit. Itstime both levels of governments enhance their environmental factors to lower uncertainty, raise indigenous livestock entrepreneurs to participate at the global economy, attracting FDI, private sector development, employment, increased exports and finally spur economic development through huge investments in health, education while impacting wealth levels.
Models of Analysis of the European Commission Leadership
Authors: Farcas Raluca
Published: August 2020

This paper aims to analyze the leadership models of the European Commission in terms of the function of setting the agenda of the European Union and in terms of political leadership. In this context, at the European level leadership is shared between several actors, making it difficult for the European Commission to exercise leadership traditionally, mostly for its lack of direct decision-making powers. Thus, the most relevant political roles of the President of the European Commission are to set the European agenda and to persuade and influence the other stake-holders to follow his directions for deepening European integration. In this regard, the article comparatively analyzes the leadership of Jacques Delors, Jean-Claude Juncker, and Ursula von der Leyen to identify the leadership model proposed at the beginning of their term, and to what extent, they exercised a political role. The tools used in the analysis are the inaugural speeches and the following three variables: how they organized the Commission to strengthen the political role of the President, how they mobilized resources from the other institutions of the European Union, and the formation of coalitions and networks. The article concluded that the leadership model proposed by Ursula von der Leyen falls within the supranational pattern of Delors' time, moving away from the model of political leadership proposed by Juncker. The accuracy of the research is limited by the fact that Ursula von der Leyen is only in her first year as President of the European Commission.
Muslims in Contemporary American English 1990-2017: Representation of Muslims in News Media
Authors: Al-Qattan Abdullah , Abuemira Reham
Published: August 2020

Previous research studies show that there is a negative portrayal of Islam and Muslims in the United States of America among many other countries, some of which approach how the media in the United States contributes to this negative representation and leads to prejudice against Muslims, especially after the attacks of September 11, 2001. Using the COCA corpus, a corpus-assisted analysis is conducted in this study to investigate the portrayal of Muslims in different contexts compared to Christians and Jews in contemporary American English from 1990 to 2017, as well as the role of media in associating negative attributes to Muslims. By examining collocations, the findings demonstrate that Muslims are highly associated with negative portrayals compared to Christians or Jews and that the media contributes considerably to portraying Muslims negatively in various contexts.
Efficacy of Integrative Behavioural Couples Therapy and Cognitive Behavioural Therapy in Reducing Conflict and Violence-Related Marital Distress
Authors: Doh Fia Stephen
Published: August 2020

This study investigated the ability of Integrative Behavioural Couples Therapy and Cognitive Behavioural Therapy in reducing conflict-related and violence-related marital distress among couples in the Church of Pentecost in the Cape Coast Metropolis in the Central Region of Ghana. The researcher employed a quantitative research method, using a pre-test, post-test control group, a kind of quasi-experimental research design. The researcher selected 60 respondents who were severely distressed out of 215 married couples using a compendium of instruments on Conceptualising and Measuring â€œHealthy Marriagesâ€ for Empirical Research and Evaluation Studies (Task One Part II). Participants were put into three groups of 10 couples each, two for the treatment groups and the third one for the control group. The data were analysed using means, standard deviations and two-way mixed ANOVA. The results showed that both therapies reduced conflict-related and violencerelated marital distress. However, Integrative Behavioural Couples Therapy was more effective than Cognitive Behavioural Therapy.
Perspectivas de controle e gestão das fundações de amparo à pesquisa com o marco legal da ciência, tecnologia e inovação
Authors: Silva Nilton Oliveira da , Freire Fátima de Sousa , Nascimento Junior Antônio
Published: August 2020

O estudo verificou a aderência ao novo marco legal da inovação nas fundações brasileiras de apoio à pesquisa quanto ao controle por resultados. A promulgação da lei visa simplificar processos e maximizar o sistema de inovação especialmente o controle e prestação de contas. Foram analisados artigos científicos, documentos e sítio das fundações no período de 2018 e 2019. O nível de aderência foi medido por um índice gerado a partir de uma lista de verificação de pontos. Os resultados apresentaram que, em média, as fundações têm um nível de aderência insatisfatório e que novas exigências da lei obtiveram menor aderência. Em suma, as fundações ainda não apresentaram repostas efetivas ao novo processo de gestão voltado a resultados.
Sequence stratigraphical study of the Tournaisian strata in Belgium and Southern China
Authors: SMEESTERS An , MUCHEZ Philippe , HANCE Luc
Published: August 2020

Strata of late Devonian and Tournaisian age in Belgium and Southern China were studied sedimentologically. This detailed study integrated into a biostratigraphical framework, based on foraminiferal zonation, allowed the construction of a sequence stratigraphical model for both areas. Based on these models a correlation on the scale of third order sequences between these two widely separated depositional environments can be made. This indicates the eustatic nature of the sea-level changes that caused the sedimentological changes during the Tournaisian.
Effect of Chitosan Supplementation in Commercial Feed For Specific Growth Rate and Protein Retention of Litopenaeus vannamei
Authors: Ekaputri Rani Andrianti , Arief Muhammad , Rahardja Boedi Setya
Published: August 2020

Litopenaeus vannamei is a leading commodity whose economic value. Targets of vannamei’s production increasing every year. One of important factor in the success of shrimp farming is feed. Research about feed fish directed to the creation of feed fish whose economical and safe for the environment, therefore is required an efforts to provide alternative feed through feed supplement. One of the material that can be supplemented in feed is chitosan. Chitosan can increase the specific growth rate and protein retention of vannamei. This study aims to determine the effect of chitosan supplementation in commercial feed for specific growth rate and protein retention of Litopenaeus vannamei. The research method used was completely randomized design (RAL) and performed with five treatments chitosan supplementation (0%, 1%, 2%, 3% dan 4%) experimental animal used was ten shrimps as five replication in each treatment. The main parameters were observed are specific growth rate and protein retention of vaname. Supporting parameters were observed is water quality. The results showed that chitosan supplementation in commercial feed for 30 days of maintenance give an effect on the specific growth rate and protein retention of vaname. The highest specific growth rate was obtained in treatment with 4% chitosan supplementation that not significantly different with treatment 3% chitosan supplementation. Protein retention was incresed in treatment with 4% chitosan supplementation that not significantly different with treatment 3% chitosan supplementation.
Effect of washing time and storage of raw Material on Surimi and Kamaboko of Tilapia (Oreochromis sp.)
Authors: Saputra Eka
Published: August 2020

This study aim was to determine the effect of washing and raw materials on frozen storage on the quality of surimi and kamaboko from raw material of tilapia (Oreochromis sp). There were three types of raw materials used, namely minced fish, surimi, and surimi with addition of sorbitol, with three washing treatments and four weeks frozen storage period observed every week. The method used consisted of measurements of pH, water content, bite test, and folding test. Then the results obtained for the best kamaboko tilapia (Oreochromis sp) were obtained from fillet raw materials compared to the raw material of Minced fish and raw materials of Minced Fish + Sorbitol, with a frequency of washing once and frozen storage for 3 weeks.
Application of Good Manufacturing Practices (GMP) in Frozen Squid company, PT Starfood Lamongan, East Java
Authors: Bimantara Agil Putra , Triastuti Juni
Published: August 2020

Freezing is one of processing of fishery products intended to preserve food by inhibiting the growth of microorganisms, resist chemical reactions and enzyme activity. Program eligibility freezing base in the industry is needed to ensure food safety, namely sanitation standard operating procedures (Sanitation Standard Operating Procedures / SSOP) and the good food production (Good Manufacturing Practices / GMP). Good Manufacturing Practices (GMP) are the basic requirements that should be met by a company that wants to produce quality and safe food consistently. These requirements include the production requirements, locations, buildings and facilities, production equipment and employees. Research implementation goals are to know directly how the application of GMP, knowing the factors that affect the application of GMP, know and understand the problems or obstacles that arise in the implementation of GMP in the freezing squid (Loligo vulgaris). The research was carried out at PT. Starfood International, located in Kandang Semangkon village, District Paciran, Lamongan, East Java Province on 18th January to 18th February, 2016. The work method was implemented as the descriptive method with collecting data through observation, documentation, interview, and active participation. PT. Starfood International is a branch of PT. Kelola Mina Laut which is a national private company that is form of limited company engages in the processing of fishery products. This company has three operational activity units including surimi managing unit, frozen fish managing unit and fish meal managing unit. The implementation of GMP is done by assessing some aspects include plant location, the building, the final product, processing equipment, production materials, personal hygiene, process control processing, sanitation facilities, label, product description, storage, maintenance of treatment facilities and sanitation activities, laboratory, packaging and transportation.
Prospects and Opportunities for Microsystems and Microfluidic Devices in the Field of Otorhinolaryngology
Authors: Hwang Se Hwan , Gonzalez-Suarez Alan M. , Stybayeva Gulnaz , Revzin Alexander
Published: August 2020

Microfluidic systems can be used to control picoliter to microliter volumes in ways not possible with other methods of fluid handling. In recent years, the field of microfluidics has grown rapidly, with microfluidic devices offering possibilities to impact biology and medicine. Microfluidic devices populated with human cells have the potential to mimic the physiological functions of tissues and organs in a three-dimensional microenvironment and enable the study of mechanisms of human diseases, drug discovery and the practice of personalized medicine. In the field of otorhinolaryngology, various types of microfluidic systems have already been introduced to study organ physiology, diagnose diseases, and evaluate therapeutic efficacy. Therefore, microfluidic technologies can be implemented at all levels of otorhinolaryngology. This review is intended to promote understanding of microfluidic properties and introduce the recent literature on application of microfluidic-related devices in the field of otorhinolaryngology.
Perception, memory, and imagination as propositional attitudes
Authors: Niiniluoto Ilkka
Published: August 2020

Jaakko Hintikka started in 1969 the study of the logic of perception as a spe- cial case of his more general approach to propositional attitudes by means of the possible worlds semantics. His students and co-workers extended this study to the logic of memory and imagination. The key elements of this approach are the distinction between physical and perspectival cross-identification and the related two kinds of quantifiers, which allow a formulation of the syntax and semantics of various types of statements about perceiving, re- membering and imagining. This paper surveys the main results of these logical investigations.
A three-arm, multicenter, open-label randomized controlled trial of hydroxychloroquine and low-dose prednisone to treat recurrent pregnancy loss in women with undifferentiated connective tissue diseases: Protocol for the immunosuppressant regimens for Living FEtuses (ILIFE) Trial
Authors: Yang Shaoying , Ni Ruoning , Lu Yikang , Wang Suli , Xie Feng , Zhang Chunyan , Lu Liangjing
Published: August 2020

Background: Undifferentiated connective tissue disease (UCTD) is known to induce adverse pregnancy outcomes, and even recurrent spontaneous abortion (RSA) by placental vascular damage and inflammation activation. Anticoagulation can prevent pregnancy morbidities. However, it is unknown whether the addition of immune suppressant to anticoagulation can prevent spontaneous pregnancy loss in UCTD patients. The purpose of this study is to evaluate the efficacy of hydroxychloroquine (HCQ) and low-dose prednisone on recurrent pregnancy loss for women with UCTD.Methods: The Immunosuppressant for Living Fetuses (ILIFE) Trial is a three-arm, multicenter, open-label randomized controlled trial with the primary objective of comparing hydroxychloroquine combined with low-dose prednisone and anticoagulation with anticoagulation alone in treating UCTD women with recurrent spontaneous abortion. The third arm of using hydroxychloroquine combined with anticoagulant for secondary comparison. A total of 426 eligible patients will be randomly assigned to each of the three arms with a 1:1:1 allocation ratio. The primary outcome is the rate of live births. Secondary outcomes include adverse pregnancy outcomes and progression of UCTD.Discussion: This is the first multi-center, open-label, randomized controlled trial which evaluates the efficacy of immunosuppressant regimens on pregnancy outcomes and UCTD progression. It will provide evidence on whether the immunosuppressant ameliorates the pregnancy prognosis in UCTD patients with RSA and the progression into defined connective tissue disease. Trial registration: ClinicalTrials.gov, NCT03671174. Registered on 14 September 2018. https://www.clinicaltrials.gov/ct2/show/NCT03671174
Building research capacity in musculoskeletal health: qualitative evaluation of a graduate Nurse and Allied Health Professional internship programme
Authors: Wright David , Fry Mary , Adams Jo , Bowen Catherine
Published: August 2020

Background: Evidence based practice enhances service planning and delivery, clinical decision making and patient care. However, health professionals often lack the time and opportunity to access or generate evidence. Research capacity building is thus an important mechanism for improving health service delivery. This study evaluates the effectiveness of a UK-wide Nurse and Allied Health Professional musculoskeletal research internship programme in which graduates applied to undertake their internship through one of five Higher Education Institutions. The evaluation explores the experiences of interns and their mentors. Methods: Sixteen new graduates completed the internship programme (September 2015 – August 2018). Twelve interns and thirteen mentors participated in the evaluation. The evaluation used qualitative asynchronous email-based interviews to explore the experiences of interns and mentors. Interpretive phenomenological analysis of coded transcripts identified principal themes. Results: Early research outputs from the interns include three peer reviewed publications and 21 conference abstract presentations. Two interns were in full time research at the time of interview or had a research component in their clinical role. Nine interns in clinical posts disclosed plans to return to research in the near future. Seven themes were identified: the impact on interns’ careers; personal impact (for example, influence on self-confidence); impact on clinical practice; drivers for applying; intervention design (for example, attitudes concerning the timing and duration of the intervention); mentorship and networking (including general support provided and quality of career advice); challenges. Conclusion: The internship programme is an effective model in building research capacity in musculoskeletal research for Nurses and Allied Health Professionals, influencing careers, building confidence and improving clinical practice. The internship programme has the potential to be replicable to other clinical contexts nationally and internationally.
miR-188 promotes Oxaliplatin resistances through targeting RASA1 in colon cancer cells
Authors: Zhu Xijia , Luo Xishun , Song Zhike , Jiang Shiyu , Long Xiangkai , Gao Xuanyuan , Xie Xinyang , Zheng Laijian , Wang Haipeng
Published: August 2020

Background: One main drawback of chemotherapy application in colon cancer clinically is drug resistance. miR-188-5p has been shown to be down-regulated in various types of cancer. The aim of this study was to explore the molecular mechanism of miR-188-5p in drug resistant cancer cells. Methods: we examined the effects of miR-188-5p on the sensitivity of colon cancer cells to oxaliplatin (OXA) by using SW480/OXA cell line. The target of miR-188-5p was determined by luciferase activity assay. The cell cycle distribution were detected by flow cytometry. The expression of p21, Hoechst 33342 staining and Annexin V assays were used to detect the cell apoptosis. Results: The expression of miR-188-5p was significantly increased in SW480/OXA cells compared with SW480 cells. By luciferase assay we found that miR-188-5p miRNA binds to RASA1 (Ras GTPase-activating protein 1, also known as p120RasGAP), and overexpression of miR-188-5p inhibited RASA1 expression by binding to the 3'-untranslated region of RASA1 mRNA. In addition, suppression of miR-188-5p enhanced the chemosensitivity of the oxaliplatin-resistant colon cancer cells. Furthermore, suppression of RASA1 abrogated the increasement of cell apoptosis induced by miR-188-5p inhibitor, while, overexpression of RASA1 induced cell apoptosis in SW480/OXA cells. Our results suggested that miR-188-5p played chemoresistant role in colon cancer through regulating RASA1 expression. Conclusion: The findings of our study suggest that target miR-188-5p is capable of enhancing the chemosensitivity of colon cancer cells by promoting RASA1.
National mapping of soil-transmitted helminth and schistosome infections in Ethiopia
Authors: Leta Gemechu Tadesse , Mekete Kalkidan , Wuletaw Yonas , Gebretsadik Abeba , Sime Heven , Mekasha Sindew , Woyessa Adugna , Shafi Oumer , Vercruysse Jozef , Grimes Jack ET , Gardiner Iain , French Michael , Levecke Bruno , Drake Lesley , Harrison Wendy , Fenwick Alan
Published: August 2020

Background: An accurate understanding of the geographical distributions of both soil-transmitted helminths (STHs; Ascaris lumbricoides, Trichuris trichiura, and the hookworms (Necator americanus and Ancylostoma duodenale) and schistosomes (SCH; Schistosoma mansoni and S. haematobium) is pivotal to be able to effectively design and implement mass drug administration (MDA) programs. The objective of this study was to provide up-to-date data on the distribution of both STH and SCH in Ethiopia to inform the design of the national control program and to be able to efficiently achieve the 75% MDA coverage target set by the WHO.Methods: Between 2013 and 2015, we assessed the distributions of STH and SCH infections in a nationwide survey covering 153,238 school-aged children (aged five to 15 years), from 625 woredas (districts), representing all nine Regional States and two City Administrations of Ethiopia. Nationwide disease maps were developed at the woreda level to enable recommendations on the design of the national MDA program.Results: The prevalence of any STH infection across the study population was 21.7%, with A. lumbricoides (12.8%) being the most prevalent STH, followed by hookworms (7.6%) and T. trichiura (5.9%). The prevalence for any SCH was 4.0% in areas where both SCH species were evaluated. S. mansoni was the most prevalent SCH (3.5% vs. 0.3%). STHs were more prevalent in southwest Ethiopia, whereas SCH was found mostly in the west and northeast of the country. The prevalence of moderate-to-heavy intensity infections was 2.0% for STHs and 1.6% for SCH. For STH, a total of 251 woredas were classified as moderately (178) or highly endemic (73), and therefore qualify for an annual and biannual MDA program, respectively. For SCH, 67 woredas were classified as endemic and 8 as highly endemic, and hence they require every two years and annual MDA program, respectively. Conclusions: The results confirm that Ethiopia is endemic for both STHs and SCH, posing a significant public health problem. Following WHO recommendations on mass drug administration, 18 and 14 million school-aged children are in need of MDA for STHs and SCH respectively based on the number of SACs that live on the eligible geographic areas.
Development of a Core Outcome Set for Fetal MyelomenIngoCele (COSMiC): study protocol
Authors: Altoukhi Samar , Whitehead Clare L , Ryan Greg , Deprest Jan , Joyeux Luc , Gallagher Katie , Drake James , Church Paige , Horn Daphne , Diambomba Yenge , Carvalho Jose CA , Mieghem Tim Van
Published: August 2020

Background: Open spina bifida (OSB) is one of the most common congenital central nervous system defects and leads to long-term physical and cognitive disabilities. Open fetal surgery for OSB improves neurological outcomes and reduces the need for ventriculoperitoneal shunting, compared to postnatal surgery, but is associated with a significant risk of prematurity and maternal morbidity. Fetoscopic surgery comes with less maternal morbidity yet the question remains whether the procedure is neuroprotective and reduces prematurity. Comparison of outcomes between different treatment options is challenging due to inconsistent outcome reporting. We aim to develop and disseminate a core outcome set (COS) for fetal OSB, to ensure that outcomes relevant to all stakeholders are collected and reported in a standardised fashion in future studies. Methods: The COS will be developed using a validated Delphi methodology. A systematic literature review will be performed to identify outcomes previously reported for prenatally diagnosed OSB. We will assess will maternal (primary and subsequent pregnancies), fetal, neonatal and childhood outcomes until adolescence. In a second phase, we will conduct semi-structured interviews with stakeholders, to ensure representation of additional relevant outcomes that may not have been reported in the literature. We will include patients and parents, as well as health professionals involved in the care of these pregnancies and children (fetal medicine specialists, fetal surgeons, neonatologists/paediatricians, and allied health). Subsequently, an international group of key stakeholders will rate the importance of the identified outcomes using three sequential online rounds of a modified Delphi Survey. Final agreement on outcomes to be included in the COS, their definition and measurement will be achieved through a face-to-face consensus meeting with all stakeholder groups. Dissemination of the final COS will be ensured through different media and relevant societies. Discussion: Development and implementation of a COS for fetal OSB will ensure consistent outcome reporting in future clinical trials, systematic reviews, and clinical practice guidelines. This will lead to higher quality research, better evidence-based clinical practice and ultimately improved maternal, fetal and long term childhood outcomes.Trial registration: Core Outcome Measures in Effectiveness Trials (COMET): 1187. International Prospective Register of Systematic Reviews (PROSPERO): CRD42018104880.
Once the child is delivered, he is no more your baby,” Exclusive Breastfeeding experiences of first-time mothers in Kassena-Nankana Municipality, Ghana - a qualitative study
Authors: Adda Louisa , Opoku-Mensah Kwabena , Dako-Gyeke Phyllis
Published: August 2020

Background

Exclusive Breastfeeding (EBF) for the first six months of life is globally accepted as the preferred method for infant feeding. In Ghana, an estimated 84% of children < 2 months old are exclusively breastfed. But by age 4 to 5 months, only 49% continue to receive EBF. This situation continues to deteriorate. Thus, the need to explore perceptions, practices as well as factors that influence EBF in Ghana.

Method

Using a qualitative design, four focus group discussions were conducted among first-time mothers and eight in-depth interviews with health workers and traditional birth attendants. The study was conducted in four communities in the Kassena-Nankana municipality of Ghana. Discussions and interviews were recorded and later transcribed verbatim to English language. The transcribed data was then coded with the aid of analysis computer software (Nvivo version 10.0) and later analyzed for the generation of themes.

Result

Exclusive breastfeeding is practiced among first-time mothers due to its perceived benefits; which include nutritional advantage, ability to enhance growth whilst boosting immunity and its economic value. However misconceptions as well as, certain cultural practices (e.g. giving herbal concoctions, breastmilk purification rites), and relational influences, may threaten a mother’s intention to exclusively breastfeed. Relational influences are mainly from mother in-laws, traditional birth attendants, grandmothers, herbalists and other older adults in the community.

Conclusion

Although first time mothers attempt EBF, external influences make it practically challenging. The availabilty and utilization of information on EBF was found to positively influence perceptions towards EBF, leading to change in attitude towards the act.

Recommendations

The provision of education on EBF should be targeted to mothers during antenatal and postnatal clinics in order to help address misconceptions of EBF. Again, the practice of community based health services should be strengthened to provide support to first-time mothers as well as continuous education to mother in laws, female elders and community leaders who influence decision making on breastfeeding of infants.
Ultrathin Gold Nanowires to Enhance Radiation Therapy
Authors: Bai Lin , Jiang Fangchao , Wang Renjie , Lee Chaebin , Wang Hui , Zhang Weizhong , Jiang Wen , Li Dandan , Ji Bin , Li Zibo , Gao Shi , Xie Jin , Ma Qingjie
Published: August 2020

Background: Radiation therapy is a main treatment option for cancer. Due to normal tissue toxicity, radiosensitizers are commonly used to enhance RT. In particular, heavy metal or high-Z materials, such as gold nanoparticles, have been investigated as radiosensitizers. So far, however, the related studies have been focused on spherical gold nanoparticles. In this study, we assessed the potential of ultra-thin gold nanowires as a radiosensitizer, which is the first time. Methods: Gold nanowires were synthesized by the reduction of HAuCl4 in hexane. The as-synthesized gold nanowires were then coated with a layer of PEGylated phospholipid to be rendered soluble in water. Spherical gold nanoparticles coated with the same phospholipid were also synthesized as a comparison. Gold nanowires and gold nanospheres were first tested in solutions for their ability to enhance radical production under irradiation. They were then incubated with 4T1 cells to assess whether they could elevate cell oxidative stress under irradiation. Lastly, gold nanowires and gold nanoparticles were intratumorally injected into a 4T1 xenograft model, followed by irradiation applied to tumors (3 Gy/per day for three days). Tumor growth was monitored and compared. Results: Our studies showed that gold nanowires are superior to gold nanospheres in enhancing radical production under X-ray radiation. In vitro analysis found that the presence of gold nanowires caused elevated lipid peroxidation and intracellular oxidative stress under radiation. When tested in vivo, gold nanowires plus irradiation led to better tumor suppression than gold nanospheres plus radiation. Moreover, gold nanowires were found to be gradually reduced to shorter nanowires by glutathione, which may benefit fractionated radiation. Conclusion: Our studies suggest that gold nanowires are a promising type of radiosensitizer that can be safely injected into tumors to enhance radiotherapy. While the current study was conducted in a breast cancer model, the approach can be extended to the treatment of other cancer types.
How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.
Authors: Sim Sai Zhen - , Koh Hui Li , Lee Sabrina Poay Sian , Young Doris Yee Ling , Lee Eng Sing
Published: August 2020

Background Multimorbidity is of increasing prevalence and importance. It has been negatively associated with health-related quality of life (HrQoL) especially in the elderly population. Despite substantial multimorbidity for the middle-aged population, defined as those between 40-64 years old, there is a paucity of research investigating the impact of multimorbidity in this population. This study aimed to investigate the association between multimorbidity and HrQoL in the middle-aged primary care population in Singapore. Methods A cross-sectional study was conducted at a primary care centre in Singapore. Interviewer-administered questionnaires were used to collect data regarding the participants’ sociodemographic characteristics, chronic conditions, and HrQoL, as measured by the EuroQol five dimensions 3-levels questionnaire (EQ5D). We defined multimorbidity as the presence of three or more conditions, out of a list of 14 chronic conditions. The associations between multimorbidity and the components of the EQ5D were assessed using multivariable regression analyses. Results The study included 297 participants, aged 40-64 years, of which 124 (41.7%) had multimorbidity. After adjusting for sociodemographic factors, participants with multimorbidity had significantly lower EQ5D UI, (β-coefficient -0.064 (C.I -0.125, -0.003), p = 0.04), but not significantly lower EQ5D VAS, (β-coefficient -0.045 (C.I 0.102, 0.012), p = 0.12). Additionally, participants with multimorbidity had higher odds (OR = 2.41, p = 0.01) of reporting problems due to pain/discomfort. Conclusion Multimorbidity was not significantly associated with the overall health state, as measured by the EQ5D VAS, in middle-aged primary care patients. However, it was associated with the EQ5D UI which is a composite measure of five specific domains of HrQoL. Specifically, there was a statistically significant association between multimorbidity and the pain domain. Further studies are required to understand the relationship between multimorbidity and pain to enable physicians to better manage pain and HrQoL in this population
Identifying Community Physical Activity and Health Resources for Treatment of Back Pain by Utilizing Members of a Physical Activity Network
Authors: Sedney Cara L. , Haggerty Treah , Zizzi Sam , Dekeseredy Patricia
Published: August 2020

Background: Back pain is one of the leading causes of health care expenditure in the US and is linked to an increased body mass index. Many evidence-based modalities for the prevention and treatment of back pain closely mirror recommendations for weight loss and include physical activity and health maintenance activities (PAHM). The primary aim of this study was to ascertain community assets, and perceptions of the use of PAHM in the treatment of back pain by West Virginia Physical Activity Network (WVPAN) members. Methods: Participants for the study were recruited from the West Virginia Physical Activity Network. This grassroots organization is filled with volunteers from various sectors who were recruited from various workshops, conferences, or coalition meetings over a period of several years. This network was purposely selected as the study population because of the statewide reach and their familiarity with resources in their local communities. A brief survey instrument was designed to gather their scaled perceptions about various treatment modalities related to back pain, and to gather their local knowledge related to specific providers in their communities. In addition, participants were given a free text box to list any local assets or resources for the nine treatments listed, and county of residence, and the nature of their connection to the physical activity network. Descriptive analyses were used to describe overall patterns of survey data. The qualitative data were compiled manually by the research team to show themes of specific treatments mentioned across different parts of the state. Results: Participants overwhelmingly supported physical therapy, flexibility training, yoga, and core strengthening as treatments for back pain. The majority of respondents were “undecided” about other treatments such as cognitive behavioral therapies and acupuncture. Conclusions: The implementation of PAHM interventions in communities could help treat patients with back pain, and may reduce reliance on the pharmacological treatment for back pain. The current study’s data support the potential of such approaches in many West Virginia counties. Also, local resources, and context can be gleaned from community leader surveys utilizing previously developed infrastructure for PAHM promotion.
Differences in Achilles tendon stiffness in people with gout: a pilot study
Authors: Otter Simon , Catherine Payne , Anna-Marie Jones , Nick Webborn , Peter Watt
Published: August 2020

Background: Gout has been associated with weaker foot/leg muscles and altered gait patterns. There is also evidence of on-going foot pain and an increased risk of tendinopathy, with the Achilles and patellar tendons most frequently affected in gout. Additionally, the inflammation associated with gout may change tissue elasticity. Ultrasound imaging utilising shear wave elastography (SWE) offers a non-invasive method of quantifying changes in tendon stiffness. SWE findings have not previously been reported in individuals with gout. We sought to determine differences in Achilles tendon stiffness in people with gout compared to controls (non-gout).Methods: A cross sectional study comparing 24 people with gout and 26 age/sex-matched controls. Clinical and demographic data were collated, and US imaging used to determine tendon thickness, presence of gouty tophi and/or aggregates and levels of angiogenesis. Ten shear wave elastography (SWE) measures were taken along the centre of a longitudinal section of the mid-portion of each Achilles tendon. Prior to data collection, intra-observer error was good (0.75). Data were summarised using descriptive statistics and a repeated measures ANCOVA was used to compare SWE measures between the two groups for the left and right foot separately after accounting for Body Mass Index (BMI).Results: A small proportion of those with gout presented with intra-tendon aggregates and/or intra-tendon tophi in one or both tendons. There was no statistically significant difference in tendon thickness between groups. Neo-vascularity was present in a third of gout participants. SWE findings demonstrated significantly reduced tendon stiffness in those with gout compared to controls: right Achilles mdiff =1.04m/s (95% CI (0.38 to 1.7) p=0.003 and left Achilles mdiff = 0.7m/s (95% CI 0.09 to 1.32) p=0.025. No relationship between the presence of tophi and SWE values were detected.Conclusion: Subjects with chronic gout show significantly reduced Achilles tendon stiffness compared to non-gout controls. From a clinical standpoint, our findings were similar to SWE measurements in subjects with Achilles tendinopathy and who did not have gout.
Prevalence and factors associated with severe depressive symptoms in older West African people living with HIV
Authors: Bernard Charlotte , Font Hélène , Diallo Zélica , Ahonon Richard , Tine Judicaël Malick , Abouo Franklin N'guessan , Tanon Aristophane , Messou Eugène , Seydi Moussa , Dabis François , de Rekeneire Nathalie
Published: August 2020

Background: Depression is one of the most common psychiatric disorders in people living with HIV (PLHIV). Depression has a negative impact on both mental and physical health and is mainly associated with suboptimal HIV treatment outcomes. To encourage successful aging and the achievement of the 3x90 objectives in older PLHIV, the psychological domain must not be neglected. In this context and as data are scarce in West Africa, this study aimed to evaluate the prevalence and the factors associated with severe depressive symptoms in older PLHIV living in West Africa. Methods: Data from PLHIV aged ≥50 years and on ART since ≥6 months were collected in three clinics (two in Côte d’Ivoire, one in Senegal) participating in the West Africa International epidemiological Databases to Evaluate AIDS (IeDEA) collaboration. The severity of depressive symptoms was measured using the Center for Epidemiological Studies Depression scale (CES-D), and associated factors were identified using logistic regressions.Results: The median age of the 334 PLHIV included in the study was 56.7 (53.5-61.1), 57.8% were female, and 87.1% had an undetectable viral load. The prevalence of severe depressive symptoms was 17.9% [95% Confidence Interval (95%CI): 13.8 - 22.0]. PLHIV with severe depressive symptoms were more likely to be unemployed (adjusted Odd Ratio (aOR)=2.8; 95%CI: 1.4-5.7), and to be current or former tobacco smokers (aOR=2.6; 95% CI: 1.3-5.4) but were less likely to be overweight or obese (aOR=0.4; 95%CI: 0.2-0.8).Conclusions: The prevalence of severe depressive symptoms is high among older PLHIV living in West Africa. Unemployed PLHIV and tobacco smokers should be seen as vulnerable and in need of additional support. Further studies are needed to describe in more details the reality of the aging experience for PLHIV living in SSA. The integration of screening and management of depression in the standard of care of PLHIV is crucial.
Protective effects of DPP-4 inhibitor on podocyte injury in glomerular diseases
Authors: Kubo Ayano , Hidaka Teruo , Nakayama Maiko , Sasaki Yu , Takagi Miyuki , Suzuki Hitoshi , Suzuki Yusuke
Published: August 2020

Background

Dipeptidyl peptidase-4 (DPP-4) is a serine protease that inhibits the degradation of glucagon-like peptide 1. DPP-4 inhibitors are used worldwide to treat type 2 diabetes mellitus and were recently shown to have pleiotropic effects such as anti-oxidant, anti-inflammatory, and anti-fibrotic actions. DPP-4 inhibitors improve albuminuria and renal injury including glomerular damage independent of its hypoglycemic effect. Although DPP-4 is mainly expressed in the kidney, the physiological function of DPP-4 remains unclear.

Methods

The localization of renal DPP-4 activity was determined in human renal biopsy specimens with glycyl-1-prolyl-4-methoxy-2-naphthylamide and the effects of a DPP-4 inhibitor were examined in human cultured podocyte.

Results

DPP-4 activity under normal conditions was observed in some Bowman's capsular epithelial cells and proximal tubules, but not in the glomerulus. DPP-4 activity was observed in crescent formation in anti-neutrophil myeloperoxidase cytoplasmic antigen antibody nephritis, nodular lesions in diabetic nephropathy, and some podocytes in focal segmental glomerulosclerosis. Notably, the DPP-4 inhibitor saxagliptin suppressed DPP-4 activity in podocytes and the proximal tubules. To assess the effect of DPP-4 inhibitor on podocytes, human cultured podocytes were injured by Adriamycin, which increased DPP-4 activity; this activity was dose-dependently suppressed by saxagliptin. Treatment with saxagliptin maintained the structure of synaptopodin and RhoA. Saxagliptin also improved the detachment of podocytes.

Conclusions

DPP-4 activity induces degradation of synaptopodin and reduction of RhoA, resulting in destruction of the podocyte cytoskeleton. Saxagliptin may have pleiotropic effects to prevent podocyte injury.