bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening young athletes for diseases at risk of sudden cardiac death: role of stress testing for ventricular arrhythmias
Authors: Zorzi Alessandro , Vessella Teresina , De Lazzari Manuel , Cipriani Alberto , Menegon Vittoria , Sarto Gianmarco , Spagnol Rachele , Merlo Laura , Pegoraro Cinzia , Marra Martina Perazzolo , Corrado Domenico , Sarto Patrizio
Published: December 2019

Aims

The athletic preparticipation evaluation (PPE) protocol proposed by the European Society of Cardiology includes history, physical examination and resting electrocardiogram (ECG). The aim of this study was to assess the results of adding constant-load ECG stress testing (EST) to the protocol for the evaluation of ventricular arrhythmias (VA) inducibility.

Methods

We evaluated a consecutive cohort of young athletes with history, physical examination, resting ECG and EST. Athletes with VA induced by EST underwent 24-hour 12-lead Holter monitoring and echocardiography. Cardiac magnetic resonance (CMR) was reserved for those with frequent, repetitive or exercise-worsened VA, and for athletes with echocardiographic abnormalities.

Results

Of 10,985 athletes (median age 15 years, 66% males), 451 (4.1%) had an abnormal history, physical examination or resting ECG and 31 (0.28%) were diagnosed with a cardiac disease and were at risk of sudden cardiac death. Among the remaining 10,534 athletes, VA at EST occurred in 524 (5.0%) and a previously missed at-risk condition was identified in 23 (0.22%); the most common ( N = 10) was an echocardiographically silent non-ischaemic left-ventricular fibrosis evidenced by CMR. The addition of EST increased the diagnostic yield of PPE by 75% (from 0.28% to 0.49%) and decreased the positive predictive value by 20% (from 6.9% to 5.5%). During a 32 ± 21 months follow-up, no cardiac arrests occurred among either eligible athletes or non-eligible athletes with cardiovascular disease.

Conclusions

The addition of exercise testing for the evaluation of VA inducibility to history, physical examination and ECG resulted in an increase of the diagnostic yield of PPE at the expense of an increase in false-positive findings.
The Potential for Anthropomorphism in Communicating Science: Inspiration from Japan
Authors: Wood Matthew
Published: December 2019

Anthropomorphism—the attribution of human characteristics to non-human animals or inanimate objects—is commonplace in many cultures around the world, but is particularly prominent and pervasive in Japan. Talking furniture on children's TV, vegetable mascots for city governments, an animated letter ‘e’ to promote online tax returns—there seems to be no limit to what can be anthropomorphized, and no corner of the culture where it is considered out of place. This of course includes efforts to communicate science, where we can find test tube narrators, angry viruses, friendly chemical elements, and a whole lot more. Scientists, on the other hand, are less enthusiastic about anthropomorphism in scientific discussions and tend to consider it to be inaccurate and unscientific. In science, thinking or communicating in anthropomorphic terms is generally derided. Where, then, does this leave the talking microbes and smiling proteins of Japanese science communication? While the literature has quite a lot to say about anthropomorphism, there is nothing specifically about its use for science communication. This paper draws on examples from Japan to consider the potential roles of anthropomorphism in the communication of science and related issues.
The Landscape of Science Communication in Contemporary Canada: A Focus on Anglophone Actors and Networks
Authors: Riedlinger Michelle , Barata Germana , Schiele Alexandre
Published: December 2019

The landscape of contemporary media presents challenges and opportunities for science writers and communicators. These issues have not yet been fully understood. This paper presents the findings of collaborative work conducted to identify the growth in numbers of social media communicators who are writing about science for the Canadian public. We used emerging media research tools, including Altmetrics, and traditional survey tools. Our goal was to help Canada's professional member associations—Science Writers and Communicators of Canada (SWCC) and the Association des Communicateurs Scientifiques du Québec (ACS)— map the changing science communication landscape in Canada. Using an online survey tool, we compared survey responses from social media science communicators we identified to those of professional science communication members of SWCC and the ACS. We found that Canadian social media science communicators were younger, were paid less (or not at all) for their science communication activities, and had been communicating science for fewer years than other science communicators. They were more likely to have a science background (rather than communication, journalism or education) and were less likely to be members of professional associations. They tended to communicate with one another through their own informal networks. These findings provide professional science communication organizations in Canada with an empirical base from which to develop training, support and outreach activities aimed at improving the quality of public engagement with science in Canada.
Effects of nano-engineered surfaces on osteoblast adhesion, growth, differentiation, and apoptosis
Authors: Miralami Raheleh , Sharp John G , Namavar Fereydoon , Hartman Curtis W , Garvin Kevin L , Thiele Geoffrey M
Published: December 2019

Modifying implant surfaces to improve their biocompatibility by enhancing osteoblast activation, growth, differentiation, and induction of greater bone formation with stronger attachments should result in improved outcomes for total joint replacement surgeries. This study tested the hypothesis that nano-structured surfaces, produced by the ion beam-assisted deposition method, enhance osteoblast adhesion, growth, differentiation, bone formation, and maturation. The ion beam-assisted deposition technique was employed to deposit zirconium oxide films on glass substrates. The effects of the ion beam-assisted deposition technique on cellular functions were investigated by comparing adhesion, proliferation, differentiation, and apoptosis of the human osteosarcoma cell line SAOS-2 on coated versus uncoated surfaces. Ion beam-assisted deposition nano-coatings enhanced initial cell adhesion assessed by the number of 4′,6-diamidino-2-phenylindole–stained nuclei on zirconium oxide nano-coated surfaces compared to glass surfaces. This nano-modification also increased cell proliferation as measured by mitochondrial dehydrogenase activity. Moreover, the ion beam-assisted deposition technique improved cell differentiation as determined by the formation of mineralized bone nodules and by the rate of calcium deposition, both of which are in vitro indicators of the successful bone formation. However, programmed cell death assessed by Annexin V staining and flow cytometry was not statistically significantly different between nano-surfaces and glass surfaces. Overall, the results indicate that nano-crystalline zirconium oxide surfaces produced by the ion beam-assisted deposition technique are superior to uncoated surfaces in supporting bone cell adhesion, proliferation, and differentiation. Thus, surface properties altered by the ion beam-assisted deposition technique enhanced bone formation and may increase the biocompatibility of bone cell–associated surfaces.
Can the planet be saved in Time? On the temporalities of socionature, the clock and the limits debate
Authors: Kolinjivadi Vijay , Vela Almeida Diana , Martineau Jonathan
Published: December 2019

The tendency of capitalist modernity to impose predictable, homogenous and linear representations of time for economic productivity has made it increasingly difficult, if not impossible, to effectively respond to catastrophic environmental changes that are emergent, sudden, non-linear and unpredictable. A confusion between the actions and consequences of environmental change, and socialized representations of time and space within which humans must respond to such changes, not only paralyses possible solutions within fixed imaginaries but is also out of synch with the perpetual coming-into-being of socionature entanglements. The multiple temporalities coordinating interactions of humans and non-human natures are instead fetishized and made governable, commensurable and reproducible through the mechanistic intervals of the clock. We argue that the desire for transformative system change can be found in temporal desynchronizations to clock Time (capital T) and that political strategies to responding to socio-ecological crises reside in alter-temporalities (lower t time) of emergent socionature relations. Through an example of the desynchronized temporalities of tinawon rice production, we show how alter-temporalities emerge to reclaim cultural and food sovereignty from the otherwise flattening effects of modernity. We highlight the futuring potentials of such temporalities and their implication within ongoing debates between ecomodernists and those advocating limits to growth. Given that continuing to act in the Time of capital evidently fails to bring about system change and even aids in perpetuating our crises, we claim that responding in time (lower t) is itself a political act in raising the possibility for more convivial and life-affirming futures.
Evaluation of Antimalarial Activity of the 80% Methanolic Stem Bark Extract of Combretum molle Against Plasmodium berghei in Mice
Authors: Mulaw Tafere , Wubetu Muluken , Dessie Bekalu , Demeke Gebreselassie , Molla Yalew
Published: December 2019

Background.

People are dependent on the traditional use of medicinal plants for the treatment of malaria without scientific validations. Therefore, this study aimed to evaluate the antimalarial activity of methanolic stem bark extract of Combretum molle in mice.

Methods.

After being infected with Plasmodium berghei, the mice were randomly divided into 5 groups (n = 5). In all cases, group I mice were treated as negative control and received 3% Tween 80; group II mice were treated with 25 mg/kg chloroquine; and groups III, IV, and V mice were treated with 100 mg/kg, 200 mg/kg, and 400 mg/kg of crude extract, respectively. Data were analyzed using one-way analysis of variance followed by Tukey’s post hoc analysis.

Results.

In the chemosuppressive test, the parasitic suppression effect of the crude extract was found to be significant ( P < 0.05) as compared with the negative control. In the curative experiment, the average parasitic level of those mice treated by the 3 doses of the crude extract was significantly suppressed at days 5, 6, and 7 of treatment ( P < 0.001). Besides, the crude extract had been found to have a chemoprophylactic role as it inhibited the parasite level significantly relative to the negative control ( P < 0.001). Moreover, the crude extract had preventive effects on packed cell volume reduction in the 3 tests ( P < 0.001).

Conclusions.

The findings of the present study has supported the folklore use of the leaves of Combretum molle in the treatment of malaria. Therefore, further fractionation and characterization of the crude extract is necessary to identify the responsible lead compound(s) responsible for antiplasmodial activity.
American Society of Hematology 2019 guidelines for sickle cell disease: cardiopulmonary and kidney disease
Authors: Liem Robert I. , Lanzkron Sophie , D. Coates Thomas , DeCastro Laura , Desai Ankit A. , Ataga Kenneth I. , Cohen Robyn T. , Haynes Johnson , Osunkwo Ifeyinwa , Lebensburger Jeffrey D. , Lash James P. , Wun Theodore , Verhovsek Madeleine , Ontala Elodie , Blaylark Rae , Alahdab Fares , Katabi Abdulrahman , Mustafa Reem A.
Published: December 2019

Background:

Prevention and management of end-organ disease represent major challenges facing providers of children and adults with sickle cell disease (SCD). Uncertainty and variability in the screening, diagnosis, and management of cardiopulmonary and renal complications in SCD lead to varying outcomes for affected individuals.

Objective:

These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in their decisions about screening, diagnosis, and management of cardiopulmonary and renal complications of SCD.

Methods:

ASH formed a multidisciplinary guideline panel that included 2 patient representatives and was balanced to minimize potential bias from conflicts of interest. The Mayo Evidence-Based Practice Research Program supported the guideline development process, including performing systematic evidence reviews up to September 2017. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, including GRADE evidence-to-decision frameworks, to assess evidence and make recommendations, which were subject to public comment.

Results:

The panel agreed on 10 recommendations for screening, diagnosis, and management of cardiopulmonary and renal complications of SCD. Recommendations related to anticoagulation duration for adults with SCD and venous thromboembolism were also developed.

Conclusions:

Most recommendations were conditional due to a paucity of direct, high-quality evidence for outcomes of interest. Future research was identified, including the need for prospective studies to better understand the natural history of cardiopulmonary and renal disease, their relationship to patient-important outcomes, and optimal management.
2019 sickle cell disease guidelines by the American Society of Hematology: methodology, challenges, and innovations
Authors: Murad M. Hassan , Liem Robert I. , Lang Eddy S. , Akl Elie A. , Meerpohl Joerg J. , DeBaun Michael R. , Tisdale John F. , Brandow Amanda M. , Lanzkron Sophie M. , Chou Stella T. , Webb Starr , Mustafa Reem A.
Published: December 2019

The American Society of Hematology (ASH) convened 5 guideline panels to develop clinical practice recommendations addressing 5 management areas of highest importance to individuals living with sickle cell disease: pain, cerebrovascular complications, pulmonary and kidney complications, transfusion, and hematopoietic stem cell transplant. Panels were multidisciplinary and consisted of patient representatives, content experts, and methodologists. The Mayo Clinic Evidence-Based Practice Center conducted systematic reviews based on a priori selected questions. In this exposition, we describe the process used by ASH, including the GRADE approach (Grades of Recommendations, Assessment, Development and Evaluation) for rating certainty of the evidence and the GRADE Evidence to Decision Framework. We also describe several unique challenges faced by the guideline panels and the specific innovations and solutions used to address them, including a curriculum to train patients to engage in guideline development, dealing with the opioid crisis, and working with indirect and noncomparative evidence.
American Society of Hematology 2019 guidelines for management of venous thromboembolism: prevention of venous thromboembolism in surgical hospitalized patients
Authors: Anderson David R. , Morgano Gian Paolo , Bennett Carole , Dentali Francesco , Francis Charles W. , Garcia David A. , Kahn Susan R. , Rahman Maryam , Rajasekhar Anita , Rogers Frederick B. , Smythe Maureen A. , Tikkinen Kari A. O. , Yates Adolph J. , Baldeh Tejan , Balduzzi Sara , Brożek Jan L. , Ikobaltzeta Itziar Etxeandia- , Johal Herman , Neumann Ignacio , Wiercioch Wojtek , Yepes-Nuñez Juan José , Schünemann Holger J. , Dahm Philipp
Published: December 2019

Background:

Venous thromboembolism (VTE) is a common source of perioperative morbidity and mortality.

Objective:

These evidence-based guidelines from the American Society of Hematology (ASH) intend to support decision making about preventing VTE in patients undergoing surgery.

Methods:

ASH formed a multidisciplinary guideline panel balanced to minimize bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline-development process, including performing systematic reviews. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment.

Results:

The panel agreed on 30 recommendations, including for major surgery in general (n = 8), orthopedic surgery (n = 7), major general surgery (n = 3), major neurosurgical procedures (n = 2), urological surgery (n = 4), cardiac surgery and major vascular surgery (n = 2), major trauma (n = 2), and major gynecological surgery (n = 2).

Conclusions:

For patients undergoing major surgery in general, the panel made conditional recommendations for mechanical prophylaxis over no prophylaxis, for pneumatic compression prophylaxis over graduated compression stockings, and against inferior vena cava filters. In patients undergoing total hip or total knee arthroplasty, conditional recommendations included using either aspirin or anticoagulants, as well as for a direct oral anticoagulant over low-molecular-weight heparin (LMWH). For major general surgery, the panel suggested pharmacological prophylaxis over no prophylaxis, using LMWH or unfractionated heparin. For major neurosurgery, transurethral resection of the prostate, or radical prostatectomy, the panel suggested against pharmacological prophylaxis. For major trauma surgery or major gynecological surgery, the panel suggested pharmacological prophylaxis over no prophylaxis.
An improved random forest-based computational model for predicting novel miRNA-disease associations
Authors: Yao Dengju , Zhan Xiaojuan , Kwoh Chee-Keong
Published: December 2019

Background

A large body of evidence shows that miRNA regulates the expression of its target genes at post-transcriptional level and the dysregulation of miRNA is related to many complex human diseases. Accurately discovering disease-related miRNAs is conductive to the exploring of the pathogenesis and treatment of diseases. However, because of the limitation of time-consuming and expensive experimental methods, predicting miRNA-disease associations by computational models has become a more economical and effective mean.

Results

Inspired by the work of predecessors, we proposed an improved computational model based on random forest (RF) for identifying miRNA-disease associations (IRFMDA). First, the integrated similarity of diseases and the integrated similarity of miRNAs were calculated by combining the semantic similarity and Gaussian interaction profile kernel (GIPK) similarity of diseases, the functional similarity and GIPK similarity of miRNAs, respectively. Then, the integrated similarity of diseases and the integrated similarity of miRNAs were combined to represent each miRNA-disease relationship pair. Next, the miRNA-disease relationship pairs contained in the HMDD (v2.0) database were considered positive samples, and the randomly constructed miRNA-disease relationship pairs not included in HMDD (v2.0) were considered negative samples. Next, the feature selection based on the variable importance score of RF was performed to choose more useful features to represent samples to optimize the model’s ability of inferring miRNA-disease associations. Finally, a RF regression model was trained on reduced sample space to score the unknown miRNA-disease associations. The AUCs of IRFMDA under local leave-one-out cross-validation (LOOCV), global LOOCV and 5-fold cross-validation achieved 0.8728, 0.9398 and 0.9363, which were better than several excellent models for predicting miRNA-disease associations. Moreover, case studies on oesophageal cancer, lymphoma and lung cancer showed that 94 (oesophageal cancer), 98 (lymphoma) and 100 (lung cancer) of the top 100 disease-associated miRNAs predicted by IRFMDA were supported by the experimental data in the dbDEMC (v2.0) database.

Conclusions

Cross-validation and case studies demonstrated that IRFMDA is an excellent miRNA-disease association prediction model, and can provide guidance and help for experimental studies on the regulatory mechanism of miRNAs in complex human diseases in the future.
Genomic and evolutionary features of two AHPND positive Vibrio parahaemolyticus strains isolated from shrimp (Penaeus monodon) of south-west Bangladesh
Authors: Ahmmed Shawon , Khan Md. Abdullah-Al-Kamran , Eshik Md. Mostavi Enan , Punom Nusrat Jahan , Islam Abul Bashar Mir Md. Khademul , Rahman Mohammad Shamsur
Published: December 2019

Background

Due to its rapid lethal effect in the early development stage of shrimp, acute hepatopancreatic necrosis disease (AHPND) has been causing great economic losses, since its first outbreak in southeast China in 2009. Vibrio parahaemolyticus, carrying the pirA and pirB toxin genes is known to cause AHPND in shrimp. The overall objective of this study was to sequence the whole genome of AHPND positive V. parahaemolyticus strains isolated from shrimp (Peneaus monodon) of the south-west region of Bangladesh in 2016 and 2017 and characterize the genomic features and emergence pattern of this marine pathogen.

Results

Two targeted AHPND positive V. parahaemolyticus strains were confirmed using PCR with 16S rRNA, ldh, AP3 and AP4 primers. The assembled genomes of strain MSR16 and MSR17 were comprised of a total of 5,393,740 bp and 5,241,592 bp, respectively. From annotation, several virulence genes involved in chemotaxis and motility, EPS type II secretion system, Type III secretion system-1 (T3SS-1) and its secreted effectors, thermolabile hemolysin were found in both strains. Importantly, the ~ 69 kb plasmid was identified in both MSR16 and MSR17 strains containing the two toxin genes pirA and pirB. Antibiotic resistance genes were predicted against β-lactam, fluoroquinolone, tetracycline and macrolide groups in both MSR16 and MSR17 strains.

Conclusions

The findings of this research may facilitate the tracking of pathogenic and/or antibiotic-resistant V. parahaemolyticus isolates between production sites, and the identification of candidate strains for the production of vaccines as an aid to control of this devastating disease. Also, the emergence pattern of this pathogen can be highlighted to determine the characteristic differences of other strains found all over the world.
A whole canopy gas exchange system for the targeted manipulation of grapevine source-sink relations using sub-ambient CO2
Authors: Smith Jason P. , Edwards Everard J. , Walker Amanda R. , Gouot Julia C. , Barril Celia , Holzapfel Bruno P.
Published: December 2019

Background

Elucidating the effect of source-sink relations on berry composition is of interest for wine grape production as it represents a mechanistic link between yield, photosynthetic capacity and wine quality. However, the specific effects of carbohydrate supply on berry composition are difficult to study in isolation as leaf area or crop adjustments can also change fruit exposure, or lead to compensatory growth or photosynthetic responses. A new experimental system was therefore devised to slow berry sugar accumulation without changing canopy structure or yield. This consisted of six transparent 1.2 m3chambers to enclose large pot-grown grapevines, and large soda-lime filled scrubbers that reduced carbon dioxide (CO2) concentration of day-time supply air by approximately 200 ppm below ambient.

Results

In the first full scale test of the system, the chambers were installed on mature Shiraz grapevines for 14 days from the onset of berry sugar accumulation. Three chambers were run at sub-ambient CO2for 10 days before returning to ambient. Canopy gas exchange, and juice hexose concentrations were determined. Net CO2exchange was reduced from 65.2 to 30 g vine− 1 day− 1, or 54%, by the sub-ambient treatment. At the end of the 10 day period, total sugar concentration was reduced from 95 to 77 g L− 1from an average starting value of 23 g L− 1, representing a 25% reduction. Scaling to a per vine basis, it was estimated that 223 g of berry sugars accumulated under ambient supply compared to 166 g under sub-ambient, an amount equivalent to 50 and 72% of total C assimilated.

Conclusions

Through supply of sub-ambient CO2using whole canopy gas exchange chambers system, an effective method was developed for reducing photosynthesis and slowing the rate of berry sugar accumulation without modifying yield or leaf area. While in this case developed for further investigations of grape and wine composition, the system has broader applications for the manipulation and of study of grapevine source-sink relations.
Time to shape up – assessment and reporting standards for data quality in clinical research using echocardiographic imaging techniques require improvement
Authors: Hensel Kai O.
Published: December 2019

Advanced echocardiography techniques such as speckle tracking imaging are sensitive diagnostic tools frequently used in various clinical and scientific scenarios. Importantly, imperfect reproducibility and dependence of post-processing algorithms on echocardiographic image quality are potential methodological limitations. Therefore, meticulous assessment of data quality and detailed reporting of study methodology, sample specifics, technical peculiarities and measurement conditions are crucial. Unfortunately, despite the recognized importance of this, there is still no broadly accepted standard for assessing the quality of echocardiographic images in clinical research reports. This article quintessentially highlights important shortcomings of data quality assessment and methodological study design, commonly occurring in clinical research reports using advanced echocardiography techniques. Finally, suggestions are made as to how researchers, scientific communities and biomedical journals can contribute to the ever-lasting process of improving the quality of clinical research in cardiovascular imaging.
Determinants of first line antiretroviral therapy treatment failure among adult patients on ART at central Ethiopia: un-matched case control study
Authors: Mulisa Diriba , Tesfa Mulugeta , Mullu Kassa Getachew , Tolossa Tadesse
Published: December 2019

Background

In 2018 in Ethiopia, magnitude of human immunodeficiency virus Acquired Immunodeficiency Syndrome treatment failure was 15.9% and currently the number of patient receiving second line antiretroviral therapy (ART) is more increasing than those taking first line ART. Little is known about the predictors of treatment failure in the study area. Therefore; more factors that can be risk for first line ART failure have to identified to make the patients stay on first line ART for long times. Consequently, the aim of this study was to identify determinants of first line ART treatment failure among patients on ART at St. Luke referral hospital and Tulubolo General Hospital, 2019.

Methods

A 1:2 un-matched case-control study was conducted among adult patients on active follow up. One new group variables was formed as group 1 for cases and group 0 for controls and then data was entered in to Epi data version 3 and exported to STATA SE version 14 for analysis. From binary logistic regression variables withpvalue ≤0.25 were a candidate for multiple logistic regression. At the end variables with ap-value ≤0.05 were considered as statistically significant.

Result

A total of 350 (117 cases and 233 controls) patients were participated in the study. Starting ART after 2 years of being confirmed HIV positive (AOR = 3.82 95% CI 1.37,10.6), nevirapine (NVP) based initial ART (AOR = 2.77,95%CI 1.22,6.28) having history of lost to follow up (AOR 3.66,95%CI 1.44,9.27) and base line opportunistic infection (AOR = 1.97,95%CI 1.06,3.63), staying on first line ART for greater than 5 years (AOR = 3.42,95%CI 1.63,7.19) and CD4 less than100cell/ul (AOR = 2.72,95%CI 1.46,5.07) were independent determinants of first line ART treatment failure.

Conclusion

Lost to follow up, staying on first line ART for greater than 5 years, presence of opportunistic infections, NVP based NNRT, late initiation of ART are determinant factors for first line ART treatment failure. The concerned bodies have to focus and act on those identified factors to maintain the patient on first line ART.
“They turn to you first for everything”: insights into midwives’ perspectives of providing physical activity advice and guidance to pregnant women
Authors: De Vivo Marlize , Mills Hayley
Published: December 2019

Background

The antenatal period is associated with a decline in physical activity among women. Midwives are viewed central to the dissemination of information during pregnancy, however, there is little research relating to their promotion of physical activity. The purpose of this study was to gain insight into midwives’ perspectives of providing physical activity advice and guidance to pregnant women

Methods

Community midwives (N = 10) from ten randomly selected antenatal clinics in England took part in semi-structured interviews which were audio recorded, transcribed and analysed thematically

Results

In relation to perceived role and responsibilities in providing physical activity advice and guidance, midwives emphasised the extent to which their profession has evolved, the perceived burden of responsibility, and the tick box approach to physical activity discussion. Midwives identified a lack of training, knowledge, confidence, time, resources, and perceptions of vulnerability as barriers to effective physical activity promotion. Despite these issues midwives proposed eight opportunities to facilitate pregnant women’s physical activity engagement: (1) recognising and addressing barriers in the uptake and maintenance of physical activities, (2) professional development, (3) inter-professional collaboration, (4) communicating effectively through simple, reliable resources, (5) improved access, availability, and awareness of suitable activities in the local community, (6) encouraging a support network, (7) “selling” physical activity by challenging misconceptions and focusing on benefits, and (8) suitable motivation, incentives and reward.

Conclusions

These opportunities identified by midwives provide foundations from which improvements in practice can result. Whilst midwives are ideally placed to promote physical activity as part of a healthy pregnancy, this is likely to be most effective as part of a wider network of practitioners that share consistent and confident messages regarding physical activity engagement. This notion has far reaching implications for practice, policy, research and the normalisation of active pregnancies in the wider population.
Identification of recurrence marker associated with immune infiltration in prostate cancer with radical resection and build prognostic nomogram
Authors: Rui Xin , Shao Siliang , Wang Li , Leng Jiangyong
Published: December 2019

Background

Some historic breakthroughs have been made in immunotherapy of advanced cancer. However, there is still little research on immunotherapy in prostate cancer. We explored the relationship between immune cell infiltration and prostate cancer recurrence and tried to provide new ideas for the treatment of prostate cancer.

Methods

Prostate cancer RNA-seq data and clinical information were downloaded from the TCGA database and GEO database. The infiltration of 24 immune cells in tissues was quantified by ssGSEA. Univariate Cox regression analysis was used to screen for immune cell types associated with tumor recurrence, weighted gene co-expression network analysis (WGCNA) and LASSO were used to identify hub genes which regulate prognosis in patients through immune infiltration. Then, the nomogram was constructed based on the hub gene to predict the recurrence of prostate cancer, and the decision curve analysis (DCA) was used to compare the accuracy with the PSA and Gleason prediction models.

Result

Analysis showed that Th2 cells and Tcm related to prostate cancer recurrence after radical prostatectomy, and they are independent protective factors for recurrence. Through WGCNA and Lasso, we identified that NDUFA13, UQCR11, and USP34 involved in the infiltration of Th2 cells and Tcm in tumor tissues, and the expression of genes is related to the recurrence of patients. Based on the above findings, we constructed a clinical prediction model and mapped a nomogram, which has better sensitivity and specificity for prostate cancer recurrence prediction, and performed better in comparison with PSA and Gleason’s predictions.

Conclusion

The immune cells Th2 cells and Tcm are associated with recurrence of PCa. Moreover, the genes NDUFA13, UQCR11, and USP34 may affect the recurrence of PCa by affecting the infiltration of Th2 cells and Tcm. Moreover, nomogram can make prediction effectively.
The Therapeutic Engagement Questionnaire (TEQ): a service user-focused mental health nursing outcome metric
Authors: Chambers Mary , McAndrew Sue , Nolan Fiona , Thomas Ben , Watts Paul , Grant Robert , Kantaris Xenya
Published: December 2019

Background

Therapeutic engagement (TE) has been described as the crux of mental health nursing but despite its perceived importance, to date, there is no measurement tool that captures it. As a result, there is no way of determining the contribution of mental health nursing interaction to service user recovery, in acute inpatient mental health settings or the wider care quality agenda.

Methods

To develop and validate a TE measurement tool in partnership with Service Users (SUs) and Registered Mental Health Nurses (RMHNs). The TEQ was developed in 3 stages: 1) item generation (and pre-testing), 2) item reduction using Principal Component Analysis (PCA), and 3) validation across Mental Health Trusts in England.

Results

The final questionnaire has two versions, (SU and RMHN version), each scored within two contexts (1–1 SU-RMHN interactions and overall environment and atmosphere of the ward) and includes 20 items with two sub-scales (care interactions and care delivery). Psychometric evaluation of the TEQ shows high inter-scale correlations (0.66–0.95 SU; 0.57–0.90 RMHN), sound sub-scale internal consistency (> 0.95), concurrent validity (> 0.60) and adequate score variability for both versions of the TEQ. In summary, the TEQ behaves well as a measurement tool.

Conclusions

The TEQ can determine the collaborative and empathic nature of RMHN-SU interactions, capture if SUs are treated with dignity and respect and recognise that the principles of the recovery approach are being respected. The TEQ can also provide robust monitoring of nursing activity, offer opportunity for transparency of activity, feed into healthcare organizations’ key performance indicators and provide reassurance about the nature and quality of nurses’ work.
Prevalence of asymptomatic malaria parasitaemia following mass testing and treatment in Pakro sub-district of Ghana
Authors: Ndong Ignatius Cheng , Okyere Daniel , Enos Juliana Yartey , Mensah Benedicta A. , Nyarko Alexander , Abuaku Benjamin , Amambua-Ngwa Alfred , Merle Corinne Simone C. , Koram Kwadwo Ansah , Ahorlu Collins Stephen
Published: December 2019

Background

Global efforts to scale-up malaria control interventions are gaining steam. These include the use of Long-Lasting Insecticide Nets, Indoor Residual Spraying, Intermittent Preventive Treatment and Test, Treat and Track. Despite these, the drive for malaria elimination is far from being realistic in endemic communities in Africa. This is partly due to the fact that asymptomatic parasite carriage, not specifically targeted by most interventions, remains the bedrock that fuels transmission. This has led to mass testing, treatment and tracking (MTTT) as an alternative strategy to target asymptomatic individuals. We report the impact of MTTT on the prevalence of asymptomatic malaria parasitaemia over a one-year period in Ghana, hypothesizing that implementing MTTT could reduce the rate of asymptomatic parasitaemia.

Methods

A population of about 5000 individuals in seven communities in the Pakro sub-district of Ghana participated in this study. A register was developed for each community following a census. MTTT engaged trained community-based health volunteers who conducted house-to-house testing using RDTs every 4 months and treated positive cases with Artemisinin–based Combination Therapy. Between interventions, community-based management of malaria was implemented for symptomatic cases.

Results

MTTT Coverage was 98.8% in July 2017 and 79.3% in July 2018. Of those tested, asymptomatic infection with malaria parasites reduced from 36.3% (1795/4941) in July 2017 to 32.9% (1303/3966) in July 2018 (p = 0.001). Prevalence of asymptomatic parasitaemia among children under 15 years declined from 52.6% (1043/1984) in July 2017 to 47.5% (820/1728) in July 2018 (p = 0.002). Implementing MTTT significantly reduced asymptomatic parasitaemia by 24% from July 2017 to July 2018 after adjusting for age, ITN use and axillary temperature (OR = 0.76, CI = 0.67, 0.85 p ≤ 0.001).

Conclusion

This study has demonstrated that implementing MTTT is feasible and could reduce the prevalence of asymptomatic malaria parasitaemia in children under 15 years of age. Furthermore, the use of community-based health volunteers could ensure high coverage at lower cost of implementation.

Trial registration

NCT04167566, Date 14/11/2019. Retrospective registration.
Development of a high-precision bladder hyperthermic intracavitary chemotherapy device for bladder cancer and pharmacokinetic study
Authors: Ba Mingchen , Cui Shuzhong , Long Hui , Gong Yuanfeng , Wu Yinbing , Lin Kunpeng , Tu Yinuo , Zhang Bahuo , Wu Wanbo
Published: December 2019

Background

Bladder hyperthermic intracavitary chemotherapy (HIVEC) has good effectiveness for bladder cancer, but conventional HIVEC systems lack precision and convenient application. To test the safety of a new HIVEC device (BR-TRG-II-type) in pigs and to perform a preliminary clinical trial in patients with bladder cancer.

Methods

This device was tested on six pigs to optimize the temperature and time parameters. Then, 165 patients (HIVEC after transurethral resection (TUR), n = 128; or HIVEC, n = 37) treated between December 2006 and December 2016 were recruited. Mitomycin C (MMC) was the chemotherapeutic agent. A serum pharmacokinetic study was performed. The primary endpoints were tumor recurrence, disease-free survival (DFS), and cumulative incidence rate (CIR) during follow-up. The adverse effects were graded.

Results

The animal experiment showed that 45 °C for 1 h was optimal. HIVEC was successful, with the infusion tube temperature stably controlled at about 45 °C, and outlet tube temperature of about 43 °C in all patients, for three sessions. Serum MMC levels gradually increased during HIVEC and decreased thereafter. The mean DFS was 39 ± 3.21 months (ranging from 8 to 78 months), and the DFS rate was 89.1% during follow-up. No adverse events occurred.

Conclusion

The use of the BR-TRG-II-type HIVEC device is feasible for the treatment of bladder cancer. Future clinical trials in patients with different stages of bladder cancer will further confirm the clinical usefulness of this device.

Trial registration

chictr.org.cn: ChiCTR1900022099 (registered on Mar. 252,019). Retrospectively registered.
Comparing dental plaque microbiome diversity of extrinsic black stain in the primary dentition using Illumina MiSeq sequencing technique
Authors: Chen Lulu , Zhang Qiong , Wang Yan , Zhang Keke , Zou Jing
Published: December 2019

Background

Extrinsic black stain (EBS) is characterized by discrete dark dots or lines on the tooth surface. The relationship between EBS and oral microbiota in children remains elusive. The aim of this study was to compare dental plaque microbiome in EBS children with that in EBS-free children in the primary dentition.

Methods

The Illumina MiSeq sequencing technique was utilized in the cross-sectional pilot study to investigate the diversity and composition of the supragingival plaque microbiota from 10 EBS-positive and 10 EBS-free children. The results were analysed with nonparametric Mann-Whitney U test, Pearson Chi-Square test, Fisher’s Exact test and one-way ANOVA tests.

Results

We identified 13 different phyla, 22 classes, 33 orders, 54 families, 105 genera, and 227 species from a total of 52,646 high-quality sequences. Between two groups, no statistical differences were observed in the estimators of community richness and diversity at 97% similarity, as well as in the Unweighted Unifrac principal co-ordinates analysis (PCoA). At the species level, higher level of relative abundance of Actinomyces naeslundii and lower level of relative abundance of a species belonging to Candidate_division_TM7 was observed in dental plaque of EBS-positive subjects, compared to dental plaque of EBS-free subjects (P < 0.05). This indicated that some species might be involved in the EBS process.

Conclusion

Changes in dental plaque microbiota is possibly relevant to the process of EBS in the primary dentition.
Patient perceptions in quality of care: report from university veterans clinic
Authors: Rai Nayanjot K. , Tyrrell Heidi , Carey Clifton , Tiwari Tamanna
Published: December 2019

Background

The Heroes Clinic is a unique dental clinic housed at the University of Colorado School of Dental Medicine that offers military veterans dental care at no or minimal cost. The aim of this study is to collect patient feedback on their perception of the quality of care they receive at the Heroes clinic.

Methods

A cross-sectional study design was used to gather patient feedback on empathy and quality of care using Service Quality Measures (SERVQUAL) and Dental Satisfaction Questionnaire (DSQ) frameworks. Mean scores were calculated to determine the average of positive or negative responses. Fisher’s exact test was conducted to test any significant differences between the patients’ perception of quality of care they receive at the Heroes clinic (outcome variable) and the SERVQUAL and DSQ independent variables.

Results

One hundred and seventy-seven veterans responded to the survey with a response rate of 35%. Over 50% of patients were between the ages of 20–35 years and 63% were students. The mean scores demonstrated high levels of all variables. Bivariate analysis for SERVQUAL data determined that veterans agreed to conditions demonstrated by four scales of empathy and all scales of responsiveness (p < 0.05). DSQ bivariate analysis revealed that veterans agreed to conditions demonstrated by four scales of quality of care, two scales of pain management, one scale of accessibility, and also general satisfaction pertaining to the received dental care (p < 0.05).

Conclusions

Heroes clinic has provided quality dental care to veterans as attested by the patients.
Challenges and opportunities in the continuity of care for hypertension: a mixed-methods study embedded in a primary health care intervention in Tajikistan
Authors: Chukwuma Adanna , Gong Estelle , Latypova Mutriba , Fraser-Hurt Nicole
Published: December 2019

Background

Hypertension, a significant risk factor for ischemic heart disease and other chronic conditions, is the third-highest cause of death and disability in Tajikistan. Thus, ensuring the early detection and appropriate management of hypertension is a core element of strategies to improve population health in Tajikistan. For a strategy to be successful, it should be informed by the causes of gaps in service delivery and feasible solutions to these challenges. The objective of this study was to undertake a systematic assessment of hypertension case detection and retention in care within Tajikistan’s primary health care system, and to identify challenges and appropriate solutions.

Methods

Our mixed methods study drew on the cascade of care framework to examine patient progression through the recommended stages of hypertension care. We triangulated data from household surveys and facility registries within Tajikistan’s Health Services Improvement Project (HSIP) to describe the cascade. Focus group discussions with local HSIP stakeholders identified the barriers to and facilitators for care. Drawing on global empirical evidence on effective interventions and stakeholder judgments on the feasibility of implementation, we developed recommendations to improve hypertension service delivery that were informed by our quantitative and qualitative findings.

Results

We review the results for the case detection stage of the cascade of care, which had the most significant gaps. Of the half a million people with hypertension in Khatlon and Sogd Oblasts (administrative regions), about 10% have been diagnosed in Khatlon and only 5% in Sogd. Barriers to case detection include misinformation about hypertension, ambiguous protocols, and limited delivery capacity. Solutions identified to these challenges were mobilizing faith-based organizations, scaling up screening through health caravans, task-shifting to increase provider supply, and introducing job aids for providers.

Conclusions

Translating findings on discontinuities in care for hypertension and other chronic diseases to actionable policy insights can be facilitated by collaboration with local stakeholders, triangulation of data sources, and identifying the intersection between the feasible and the effective in defining solutions to service delivery challenges.
Medical infrared thermal imaging of canine appendicular bone neoplasia
Authors: Sung J. , Loughin C. , Marino D. , Leyva F. , Dewey C. , Umbaugh S. , Lesser M.
Published: December 2019

Background

Medical infrared thermal imaging (MITI) is a noninvasive imaging modality used in veterinary medicine as a screening tool for musculoskeletal and neurological disease processes. An infrared camera measures the surface body heat and produces a color map that represents the heat distribution. Local trauma or disease can impair the autonomic nervous system, which leads to changes in the local dermal microcirculation and subsequent alteration of surface body heat. Disruption of autonomic flow to the cutaneous vasculature at deeper levels can also result in asymmetric thermographic results. The purpose of this study was to evaluate surface temperature differences between limbs affected by bone neoplasia and their normal contralateral limbs.

Results

A statistically significant difference in average temperature was noted between regions of interest of the two groups (paired difference: 0.53 C° ± 0.14; P = 0.0005). In addition, pattern recognition analysis yielded a 75–100% success rate in lesion identification.

Conclusions

Significant alterations noted with average temperature and thermographic patterns indicate that MITI can document discernible changes associated with the presence of canine appendicular bone tumors. While MITI cannot be used as the sole diagnostic tool for bone cancer, it can be used as a screening modality and may be applicable in early detection of cancer.