bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Impacting the Implementation of a Psychoeducation Intervention Within the Mental Health System: a Multisite Study Using the Consolidation Framework for Implementation Research
Authors: Higgins Agnes , Murphy Rebecca , Downes Carmel , Barry Jennifer , Monahan Mark , Hevey David , Kroll Thilo , Doyle Louise , Gibbons Patrick
Published: August 2020

Background Despite a strong evidence base and policy recommendation supporting the implementation of psychoeducation interventions within the mental health system, equitable access for many service users and family members has not been achieved. To enhance translation, developing an evidence-base around the factors that influence implementation of interventions is critical.Methods The aim of the study was to explore the factors influencing implementation of a group cofacilitated recovery focused psychoeducation intervention. The study design was explorative qualitative descriptive, involving the collection of data through individual and focus group interviews with key stakeholders (n=75) involved with the implementation within 14 mental health sites in the Republic of Ireland. The Consolidation Framework for Implementation Research (CFIR) was used as a conceptual framework to guide data collection and analysis. Results Key enablers and barriers were identified across all CFIR domains of the framework with some factors (depending on context) being both an enabler and a barrier. National policy; structural stability with national systems; leadership at all levels; peer payment system; local champions and support from multidisciplinary team members; evidence strength and quality of the programme design; availability of resources; referral pathways; knowledge, beliefs and self-efficacy of facilitators, as well as local culture influenced implementation. While some were specific to the programme, many barriers reflected systemic and structural challenges within health services more generally. Conclusion: Findings from this study provide an enhanced understanding of the different layers of determinants to implementation of an intervention. Overcoming challenges will involve positive and ongoing engagement and collaboration across the full range of stakeholders that are active within each domain, including policy and operational levels. The quality of leadership at each domain level is of crucial importance to successful implementation.
Incident Reports Involving Hospital Administrative Staff: Analysis of Data From a Japan Council for Quality Healthcare Nationwide Database
Authors: Akiyama Naomi , Akiyama Tomoya , Hayashida Kenshi , Koeda Keisuke
Published: August 2020

Background: Task shifting and task sharing in healthcare are rapidly becoming more common as the shortage of physicians increases. However, previous research has not examined the changing roles of hospital administrative staff. This study clarified: (1) adverse incidents caused by hospital administrative staff and the direct and indirect impact of these incidents on patient care, and (2) which incidents directly involved hospital administrative staff. Methods: This study used secondary analysis of case report data from the Japan Council for Quality Healthcare collected from April 1, 2010, to March 31, 2019, which consisted of quantitative and text data from 85 case reports that were analyzed in terms of direct and indirect effects of hospital incidents. Differences in the direct and indirect impact of hospital incidents were statistically assessed using the χ2 test and Fisher’s exact test. Results: Thirty-nine reports (45.9%) involved direct impact on patient care, while 46 (54.1%) involved indirect impact on patient care. Most incidents that directly impacted patient care involved administrative staff writing prescriptions on behalf of a doctor (n = 24, 61.5%). Most reported errors that indirectly affected patient care were related to system administration, information, and documentation used by administrative staff (n = 22, 47.8%), including 14 cases of patient misidentification (16.5% of all cases examined).Conclusions: Incidents involving hospital administrative staff can lead to severe consequences for patients. As such staff are members of medical treatment teams, improvements in patient care may require the submission and review of more incident reports involving administrative staff.
Development and Implementation of a Patient Assistance Fund: A Descriptive Study
Authors: Soffe Burke W. , Miranda Justine E. , Fang Jenny , Epperson Daniel G. , Lara Roberto A. , Williamson Hazel L. , Lipsky Martin S.
Published: August 2020

Background: The purpose of this descriptive study is to outline the Roseman University of Health Sciences (RUHS) College of Dental Medicines’ Patient Assistance Fund development, organization and outcomes. The description and reported results provide insight to others considering similar health professions programs.Methods: The Patient Assistance Fund (PAF) affords dental students an opportunity to petition for and obtain financial assistance for their most disadvantaged patients. This study used a mixed methods research design using quantitative analyses for data collected as part of the PAFs operation and qualitative analyses to evaluate the patient experiences.Results: A total of 16 student advocates, consisting of 6 males and 10 females from the D3 and D4 classes made 26 presentations to the PAF board committee. The combined amount requested from the PAF was $47,428.00 (“Cost of Treatment Plan”) representing an average request per patient of $1,824.15 (range $324.00 to $4070.00). The approved procedures and treatment plans totaled $21,278.36 (“Cost of Approved Procedures”) with an average of $818.40 (range $204.00 to $2434.00) per patient. Patients and students expressed a high degree of satisfaction with the program.Conclusions: This study provides an overview of the structure, funding sources, expenditures and patient services supported by a dental student managed patient assistance fund. The experiences at RUHS College of Dental Medicine (CODM) suggest that other healthcare professions schools can develop similar type programs that yield benefit both to students and to patients in need. Trial Registration: Not applicable
Effect of Methanol Fixation on Single-Cell RNA Sequencing Data
Authors: Wang Xinlei , Yu Lei , Wu Angela Ruohao
Published: August 2020

Background: Single-cell RNA sequencing (scRNA-seq) has led to remarkable progress in our understanding of tissue heterogeneity in health and disease. Recently, the need for scRNA-seq sample fixation has emerged in many scenarios, such as when samples need long-term transportation, or when experiments need to be temporally synchronized. Methanol fixation is a simple and gentle method that has been routinely applied in scRNA-seq. Yet, concerns remain that fixation may result in biases which may change the RNA-seq outcome. Results: We adapted an existing methanol fixation protocol and performed scRNA-seq on both live and methanol fixed cells. Analyses of the results show methanol fixation can faithfully preserve biological related signals, while the discrepancy caused by fixation is subtle and relevant to library construction methods. By grouping transcripts based on their lengths and GC content, we find that transcripts with different features are affected by fixation to different degrees in full-length sequencing data, while the effect is alleviated in Drop-seq result.Conclusions: Our deep analysis reveals the effects of methanol fixation on sample RNA integrity and elucidates the potential consequences of using fixation in various scRNA-seq experiment designs.
Genome-wide Mutation Landscape of SARS-CoV-2
Authors: Yang Xiaofei , Lv Li , Ye Kai
Published: August 2020

Background: SARS-CoV-2 has become a pandemic and researchers have built phylogenetic trees to trace the spread of the virus. However, the accumulation rate of variations and mutational hotspots remain largely unclear. Results: We collected more than 3,100 SARS-CoV-2 genome sequences from GISAID and profiled the landscape of whole genome variations. We detected 2,096 single nucleic variants (SNVs) and seven short deletions. 1,224 of them (58.4%) are missenses variation, altering the corresponding residues. We found the accumulation rate of SNVs in the current spreading situation is 6.36e-2/day. We found 15 missenses SNVs are extremely high frequent (existing in more than 100 genome sequences, p < 1e-5), effecting ORF1ab, S, ORF3a, M, ORF8, and N. Moreover, one frequent substitution at locus 23,403 changes the 614th amino acid of spike glycoprotein from D to G, potentially effecting the functions of this key protein. Conclusion: Our study provided the genome-wide mutation landscape of SARS-CoV-2. We found the continent specific mutational patterns and 15 missenses high frequent SNVs effecting 6 genes of the virus, may promoting the adaption of the virus during evolving.
Factors influencing decision-making to accept elective caesarean section in a hospital in Ghana: A descriptive cross-sectional study
Authors: Bam Victoria , Lomotey Alberta Yemotsoo , Diji Abigail Kusi-Amponsah , Budu Hayford Isaac , Bamfo-Ennin Dorothy , Mireku Georgina
Published: August 2020

Background Elective caesarean section rates are on the rise and socioeconomic status, perceptions of safety, cultural and social influences are contributory factors. Inspite of the benefits of medically-indicated caesarean section, some women refuse this due to a complexity of factors. This study aimed at determining the factors that influence women to accept medically-indicated caesarean section in a district hospital in Ghana.MethodsA descriptive cross-sectional study was conducted among 163 purposively-sampled postnatal women in a hospital. A questionnaire was used for data collection after the women gave their consent to participate. Data was analyzed using SPSS version 25.0, Chi-square test was done to determine the association between the factors that facilitated respondents’ acceptance of caesarean section and the duration of decision-making. ResultsMajor factors influencing their decision-making process were support from their husbands/relatives (39.3%), their baby’s life being at risk (24.5%), history of previous caesarean section and knowledge about the procedure (19.6%). Age (R2 = 0.19, p< 0.001); previous caesarean section (R2 = 0.14, p<0.001) are the major predictors of the duration of the decision-making process.ConclusionMost women will make decisions to accept elective caesarean section within a week’s duration based on consultation with relatives. There is the need to involve relatives during the antenatal care period in order for younger women in particular to be readily supported to make the decision early to avoid any complications and allay their fears.
Genome-Wide Survey and Identification of AP2/ERF Genes Involved in Shoot and Leaf Development in Liriodendron Chinense
Authors: Zong Yaxian , Hao Ziyuan , Tu Zhonghua , Shen Yufang , Zhang Chengge , Wen Shaoying , Yang Lichun , Ma Jikai , Li Huogen
Published: August 2020

Background: Liriodendron chinense is a distinctive ornamental tree species due to its unique-shaped leaves and tulip-like flowers. The discovery of genes involved in leaf development and morphogenesis is critical for uncovering the underlying genetic basis of these traits. Genes in the AP2/ERF family were recognized as plant-specific transcription factors contributing to plant growth, hormone-induced development, ethylene response factors and stress responses. Results: In this study, we identified 104 putative AP2/ERF genes in the recently released Liriodendron genome database and RNA-seq dataset. Accordingly, all 104 genes were grouped into four subfamilies, including the AP2, ERF, RAV and Soloist subfamilies. This classification was further supported by the results of gene structure and conserved motif analyses. Moreover, based on the expression profiles of various tissues and organs, we discovered three LcAP2 genes as well as two VIII group genes that were significantly enriched in a shoot-specific manner by applying expression pattern and category enrichment analyses. Of these five genes, the relative expression levels of LcERF 94, LcERF 96 and LcERF 98 in the RT-qPCR assay were highly consistent with the RNA-seq results. Furthermore, we illustrated by dissection of Liriodendron shoots and subsequent qPCR assays that LcERF 94, LcERF 96 and LcERF 98 were expressed extensively in the early stage of leaf primordium development but rarely in tender leaves. In addition, these three genes displayed nuclear subcellular localizations through transient transformation of tobacco epidermal cells. Conclusions: Taken together, we identified all the AP2/ERF family members at the genome-wide level and provided candidates that might participate in the development and morphogenesis of the leaf primordium in L. chinense.
Self-perceived preparedness of dental school graduates and the impact of COVID-19 pandemic on their confidence
Authors: Alraheam Islam Abd , Alashqar Mays A. , Hattar Susan , AlHadidi Abeer , Alhaddad Alaa , Sawair FA
Published: August 2020

BackgroundTo study self-perceived preparedness of dental school graduates and the impact of COVID-19 on their preparedness.MethodAn online survey was designed and sent electronically to students who are graduating in 2020, dentists who graduated in 2019 and doing their prelicensure training, and dentists who graduated before 2019. Four- point Likert scale was used to assess participants’ perception.Results209 participants responded to the online questionnaire. The mean total preparedness score (TPS) for the 209 participants was 97.6 (SD ± 9.7) with a range of 69 to 120. The mean TPS of the different classes of participants was 99.5 for the class graduated before 2019, 98.1 for the 2020 class, and 95.1 for the 2019 class. Participants felt they are confident and extremely confident doing the majority of the required competencies. Weakness was mainly reported in surgical extraction for 2020 graduates due to the 8 weeks loss of their training. COVID-19 has considerable impact on 59.7% of the participants and marginal to no impact on 40.3%. The highest prevalence of those who thought it had some to severe impact on their confidence were those who graduated in year 2019 (73.4%). Of the participants 95.2% agreed that problem-based learning is a good educational tool and 58.5% agreed that competency-based assessment is a good educational and grading tool.ConclusionsThe graduates of University of Jordan felt confident in performing the majority of general dentistry procedures. COVID-19 pandemic negatively impacted the confidence of all the classes of participants even those graduated before 2019.
Costs and Healthcare Utilisation of Patients With Heart Failure in Spain
Authors: Escobar Carlos , Varela Luis , Palacios Beatriz , Capel Margarita , Sicras Antoni , Sicras Aram , Hormigo Antonio , Alcazar Roberto , Manito Nicolas , Botana Manuel
Published: August 2020

Background: To evaluate the cumulative costs and healthcare utilisation in heart failure (HF) patients in Spain. This was also analyzed among the DAPA-HF like population.Methods: Observational, retrospective, population-based study using BIG-PAC database, which included data from specialized and primary care of people aged ≥18 years, from 7 autonomous communities in Spain, who received care for HF between 2015 and 2019. The healthcare and medication costs were summarized on a yearly basis starting from the index date (1st January 2015), and then cumulatively until the last year of follow-up (2019).Results: We identified 17,163 patients with HF (year 2015: mean age 77.3±11.8 years, 53.5% men, 51.7% systolic HF and 43.6% on NYHA functional class II). During the 2015-2019 period, total HF associated costs reached 15,373 Euros per person, being cardiovascular disease hospitalizations the most important determinant (75.8%), particularly HF hospitalizations (51.0%). Total medication cost accounted for 7.0% of the total cost. During this period, there was a progressive decrease of cardiovascular disease hospital costs per year (from 2,834 Euros in 2015 to 2,146 Euros in 2019, P<0.001), as well as cardiovascular and diabetic medication costs. Hospitalization and medication costs were higher in the DAPA-HF like population.Conclusions: During the 2015-2019 period, costs of patients with HF in Spain were substantial, being HF hospitalizations the most important determinant. Medication costs represented only a small proportion of total HF costs. Improving HF management, particularly through the use of those drugs that reduce HF hospitalization may be helpful to reduce HF burden.
MAIT cells regulate NK cell mediated tumor immunity
Authors: Petley Emma , Koay Hui-Fern , Henderson Melissa , Sek Kevin , Todd Kirsten , Keam Simon , Lai Junyun , House Imran , Zethoven Magnus , Chen Amanda , Oliver Amanda , Michie Jessica , Freeman Andrew , Giuffrida Lauren , Chan Jack , Pizzolla Angela , Mak Jeffrey , Souza-Fonseca-Guimaraes Fernando , Kearney Conor , Millen Rosemary , Ramsay Rob , Huntington Nicholas , McCluskey James , Oliaro Jane , Fairlie David , Neeson Paul , Godfrey Dale , Beavis Paul (A.) , Darcy Phillip
Published: August 2020

MR1-restricted mucosal-associated invariant T (MAIT) cells recognize microbial metabolites and play an important role in immunity to infection, however, the role they play in tumor immunity is unclear. Here we show that MAIT cell-deficient mice are more resistant to subcutaneous and lung metastasis B16F10 tumor growth compared to control mice, an effect that was associated with enhanced NK cell numbers and was NK cell-dependent. Analysis of this interplay in cancer patients also revealed that a high expression of a novel MAIT gene signature negatively impacted the prognostic significance of NK cells. Paradoxically, pre-pulsing tumors with MAIT cell antigens, or antigen-mediated MAIT cell activation in vivo, enhanced immunity against B16F10 and E0771 lung tumor metastasis. Furthermore, MAIT cell activation effectively reduced metastatic burden in a more stringent model of established lung metastases in mice. These effects were associated with enhanced NK cell responses and increased expression of both IFNγ-dependent and inflammatory genes in NK cells, which was neutralized by IFNγ blockade. Importantly, activated human MAIT cells also enhanced the function of NK cells isolated from patient tumor samples. These findings provide insight into the contrasting roles that MAIT cells can play in controlling anti-tumor immune responses depending on their activation status, in both mice and humans, and suggest potential therapeutic avenues for exploiting their potential anti-tumor properties for cancer treatment.
Evaluation of the Pediatric Life Support Instructors Courses
Authors: Lopez-Herce Jesus , Carrillo Angel , Urbano Javier , Manrique Gema , Mencía Santiago , Pediátricos Grupo Madrileño Cuidados Intensivos
Published: August 2020

Objective
To evaluate the results and quality of pediatric cardiopulmonary resuscitation (CPR) instructor training courses.
Methods
A retrospective analysis was performed of the results of 24 pediatric CPR instructor courses held over 21 years (1999 to 2019). The results of participants’ evaluation of theory and practice sessions were analyzed. In addition, participants were asked to answer an anonymous survey to assess their opinion on the quality of theory and practice lessons, course organization and methodology, and instructor training. The results were compared by professional groups.
Results
A total of 560 participants completed the instructor course. Of them, 554 passed theory and practice tests (98.9%). The mean score obtained in theory tests was 9.2 (0.8) out of 10. The mean score obtained in all practice tests was > 3.5 out of 5. Participants evaluated all the aspects of the course (theory and practice content, organization, teaching methodology, and instructors) with mean scores over 8 out of 10.
Conclusions
Specific pediatric and neonatal CPR instructor courses are a cornerstone in the process of CPR training and ensuring the homogeneity and quality of training. Most of the participants obtained the qualification of instructors and their evaluation of the course was very positive.
Ultrasound-Assisted Extraction for Simultaneous Quantitation of Potential Sweetening Compounds from Derris reticulata Aqueous Extracts: A Response Surface Methodology Approach
Authors: Thamapan Keerati , Laohakunjit Natta , Kerdchuchen Orapin , Vongsawasdi Punchira , Mingvanish Withawat
Published: August 2020

Background: Derris reticulata or Oi Sam Saun is a highly sweet Thai plant, rich in bioactive compounds, and widely used for its medicinal properties. In this study, sweet aqueous extracts from the stems of Oi Sam Saun were extracted using ultrasound-assisted extraction (UAE). Phenolic, flavonoid, and sugar compound extraction was optimized using the Box-Behnken design (BBD) and response surface methodology (RSM). Methods: Three independent variables—extraction temperature (40–80°C), sonication time (20–60 min), and extraction ratio (1:10–1:30 g/mL)—were investigated, and the optimal condition was used to determined phenolics, flavonoid and 18β-glycyrrhetinic acid by High performance liquid chromatography-diode array detector (HPLC-DAD). Sensory evaluation was also performed.Results: The values of 84°C, 64 min, and ratio 1:8 g/mL were found to be optimal. Under these conditions, experimental values were well correlated with predicted values, and phenolic, flavonoid, and sugar contents were determined as 0.4725 mgGAE/gDW, 0.1489 ± 0.033 mgCE/gDW, and 4.802 ± 0.651 mg/gDW, respectively. Gallic acid, p-coumaric acid, quercetin, and kaempferol was also found in optimal condition. Moreover, the extract contained 18β-glycyrrhetinic acid (0.529 ± 0.002 mg/100 mg) and was 166 times sweeter than sucrose.Conclusion: High level of phenolics, flavonoids and sugars was detected in optimal condition of the extract. Therefore, this Thai medicinal plant, which has several pharmacological benefits, is newly potentially and applicable as a sweetening agent or sugar substitute in foods.
Factors Related to the Practice of Vacuum-Assisted Birth: Findings from Provider Interviews in Kigoma, Tanzania
Authors: Dominico Sunday Alfred , Kasanga Mkambu Godfrey , Mwakatundu Nguke , Chaote Paul , Lobis Samantha , Bailey Patricia E.
Published: August 2020

Background: Vacuum-assisted birth is not widely practiced in Tanzania but efforts to re-introduce the procedure suggest some success. Few studies have targeted childbirth attendants to learn how their perceptions of and experiences with the procedure affect practice.This study explores a largely rural cohort of health providers to determine associations between recent practice of the procedure and training, individual and contextual factors.Methods: A knowledge, attitudes and practice cross-sectional survey of 297 providers was conducted in 2019 at 3 hospitals and 12 health centers that provide comprehensive emergency obstetric care. We used descriptive statistics and binary logistic regression to model the probability of having performed a vacuum extraction in the last 3 months. Results: Providers were roughly split between working in maternity units in hospitals and health centers. They included: medical doctors, assistant medical officers (14%); clinical officers (10%); nurse officers, assistant nurse officers, registered nurses (32%); and enrolled nurses (44%). Eighty percent reported either pre-service, in-service vacuum extraction training or both, and 31% reported conducting a vacuum-assisted birth in the last 3 months. Based on 11 training and enabling factors, a positive linear association with recent practice was observed; the single most predictive factor was hands-on solo practice during in-service training (66%). The logistic model showed that for each additional training factor the likelihood of recent performance increased by 52% (OR 1.52, CI 1.327-1.740). A knowledge score based on indications and contra-indications for vacuum extraction showed an 11% increased probability for each item mentioned (OR 1.11, CI 1.033-1.196). Providers who worked in a health center compared to those in a hospital were 2.5 times more likely to have conducted a recent vacuum extraction (OR 2.46, CI 1.325-4.579), and male providers were twice as likely as females (OR 2.0, CI 1.088-3.733).Conclusions: Knowledge and training were positively associated with recent practice of vacuum extraction. Multiple training modalities appear to predict recent practice but hands-on experience during training may be the most critical component. We recommend a low-dose high frequency strategy to skills building with simulation and e-learning. A gender integrated approach to training may help ensure female trainees are exposed to critical training components.
How Breast Cancer Treatments Affect the Quality of Life of Women with Non-metastatic Breast Cancer One Year After Surgical Treatment: A Cross-sectional Study in Greece.
Authors: Yfantis Aris , Sarafis Pavlos , Moisoglou Ioannis , Tolia Maria , Intas George , Tiniakou Ioanna , Zografos Konstantinos , Zografos George , Constantinou Marianna , Nikolentzos Athanasios , Kontos Michalis
Published: August 2020

Background: The continuously increasing survivorship of female breast cancer makes the monitoring and improvement of patients’ quality of life ever so important. While globally there is a growing body of research on health-related quality of life one year after surgical treatment for non-metastatic breast cancer, up-to-date information regarding Greek patients is scarce.Objective: To measure the level of QoL of non-metastatic BC survivors in Greece 1 year after surgery.Methods: A sample of 200 female breast cancer survivors aged 18 to 75, who followed up as outpatients in five public hospitals were included in this cross-sectional study. All recruited patients agreed to participate in the study (100% response rate). Quality of life data were collected through the EORTC QLQ-C30 as well as BR23 questionnaires.Results: Cronbach’s alpha for all scales of the two questionnaires was from 0.551 to 0.936 indicating very good reliability. According to the Multiple Linear Regression, older patients showed a lower future perspective (p= .031), with those living in rural areas, which was associated with more financial difficulties (p= .001). Women with tertiary education and those who had been hospitalized in a university hospital recorded better on global health status (p= .003 and .000 respectively). Patients who underwent chemotherapy reported better scores in the emotional function sub-scale (p= .025). Women with reconstruction and at least one complication appeared to have significantly better scores in future perspective and social function (p= .005, .002 respectively).Conclusions: Breast cancer survivors were found to have an overall good quality of life, functioning/symptoms scores and were satisfied with the provided care.
Artificial Neural Network-based Predicting the Risk of Complicating Ventricular Tachyarrhythmia After Acute Myocardial Infarction During Hospitalization
Authors: Zheng Xifeng , Nong Weidong , Feng Dehui , Wang Junxian , He Yan
Published: August 2020

An artificial neural network (ANN) model was developed to predict the risks of complicating ventricular tachyarrhythmia (VTA) in patients with acute myocardial infarction (AMI). We enrolled information of 503 patients with 13 risk factors from the affiliated hospital of Guangdong medical university from January 2017 to December 2019. Risk factors were dimensionally reduced and simplified as new variables by principal component analysis (PCA). The cohort were randomly divided into a training set and a testing set at the ratio of 70%:30%. Training set was used to develop a model for the prediction of VTA while testing set was used to evaluate the performance of the model. Three new comprehensive variables by PCA are able to reflect all information of the original data. We determined the prediction model with optimizing parameters by cyclic searching which includes an input layer of three comprehensive variables, a single hidden layer composed of two neurons and a output layer. The area under curve (AUC) is 0.812 in training set and confusion matrix with accuracy 94.60%, sensitivity 63.04%, specificity 99.35%, positive predicative value 93.55%, negative predictive value 94.70%. The model displayed a decreased but medium discrimination with an AUC of 0.688 in the independent testing cohort, confusion matrix with accuracy 87.42%, Sensitivity 39.26%, specificity 98.37%, positive predicative value 84.62%, negative predictive value 87.68%. The research suggests that ANN model could be used to predict the risk of complicating ventricular tachyarrhythmia after acute myocardial infarction while should be further improved.
Visualization of clinical teaching citations using social network analysis
Authors: Hazrati Hakimeh , Bigdeli Shoaleh , Arabshahi Seyed Kamran Soltani , Gavgani Vahideh Zarea , Vahed Nafiseh
Published: August 2020

Background
This study aimed to visualize the co-authorship networks and scientific map of research outputs of clinical teaching and medical education by Social Network Analysis (SNA).
Methods
We Identified 858 publications on clinical teaching through a systematic search strategy in the Scopus (Elsevier), Web of Science (Clarivate Analytics) and Medline (NCBI/NLM) through PubMed. Date of publication was limited to 1980 to 2018.The Ravar PreMap, Netdraw, UCINet and VOSviewer software were used for data visualization and analysis.
Results
Based on the findings of study the network of clinical teaching was weak in term of cohesion and the density in the co-authorship networks of authors (clustering coefficient (CC): 0.749, density: 0.0238) and collaboration of countries (CC: 0.655, density: 0.176). In regard to centrality measures; the most influential authors in the co-authorship network was Rosenbaum ME, from the USA (0.048). More, the USA, the UK, Canada, Australia and the Netherlands have central role in collaboration countries network and has the vertex co-authorship with other that participated in publishing articles in clinical teaching. Nineteen subject clusters were identified in the clinical teaching research network, seven of which were related to the expected competencies of clinical teaching and three related to clinical teaching skills.
Conclusions
Co-authorship between clinicians and medical educator specialists need to be strengthened through research development policies, appropriate academic networks and use of encouraging grants. In addition humanitarian and clinical reasoning need to consider in education of clinical teaching to empower the scientific map from thematic aspects.
Valproate prescription to women of childbearing age in English primary care: repeated cross-sectional analyses and retrospective cohort study
Authors: Gaudio Mariangela , Konstantara Emmanouela , Joy Mark , Vlymer Jeremy Van , de Lusignan Simon
Published: August 2020

Background: Valproate is teratogenic drug that should be avoided during the preconception period and pregnancy. The aim was to explore GPs’ prescription patterns over time, describe trends, and explore inter-practice variation within primary care. Methods: We identified women of childbearing age (12-46 years old) in the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) sentinel network. We performed repeated cross-sectional analyses from 2004 to 2018 to determine rates of prescription and a retrospective cohort estimated the prevalence of use of valproate during pregnancy. Results: In 2004, 0.31% (95% Confidence Interval (95%CI):0.18 to 0.44%) women were prescribed valproate, decreasing to 0.16% (95%CI:0.07 to 0.24%) by 2018. Among women with epilepsy, the rate fell from 15.2% (95%CI:14.4 to 16.0%) to 8.8 % (95% CI:8.2 to 9.7%) over the same period. In 2018, almost two thirds (62.2%) of women who were prescribed valproate had epilepsy only, whereas bipolar disorder and migraine accounted for 15.8% and 7.4% respectively. Contraceptive prescriptions did not increase over time, and only in 2018 was there greater odds of being prescribed contraception (OR 1.41, 95%CI:1.08 to 1.45). Just under a fifth (19.7%) of women were prescribed valproate during their pregnancy; two out of three of these pregnancies were preceded by folic acid prescription (5 mg). While some practices reduced their rate of valproate prescription, others did not.Conclusions: Regulatory guidelines have changed GPs' prescription patterns in women of childbearing potential for valproate but not for contraception. Further research is needed to identify the barriers of GPs and women of childbearing potential to undertaking contraception.
Association between maternal serum lipids during late pregnancy and adverse birth outcomes
Authors: Dai Meng-Yi , Wang Lu-Lin , Wu Yun-Tao , Li Huan , Xia Jian-Hong , Wu Li , Tian Yaohua
Published: August 2020

Background: Adverse birth outcomes have short- and long-term impacts on maternal and child health. Maternal dyslipidemia during late pregnancy has been found to be associated with increased risk of adverse birth outcomes. However, similar evidence on association between maternal blood lipid levels and adverse birth outcomes is limited in China.Methods: The data were extracted from Guangdong Women and Children Hospital Information System from September 2014 to March 2018. A total of 3951 mother-newborn pairs were included in our study. Logistic regression model and linear trend analysis were conducted to analyze the correlation between maternal blood lipid levels and adverse birth outcomes after controlling potential confounders including gestational age, pre-pregnancy body mass index, fetal sex, and parity. Results: Among the 3951 subjects, the rates of macrosomia, large-for-gestational age (LGA), low birth weight infants (LBW), and preterm birth were 3.9% (154/3951), 8.5% (334/3951), 9.5% (377/3951), and 9.8% (388/3951), respectively. LDL was a risk factor for preterm birth (OR: 1.20; 95% CI: 1.08-1.34) while HDL was a protective factor (OR: 0.73; 95% CI: 0.55-0.96) after adjusting for covariates. As every unit increase in TG, the risk of macrosomia and LGA increased by 25% (adjusted OR: 1.25; 95% CI: 1.12-1.38) and 16% (adjusted OR: 1.16; 95% CI: 1.07-1.26), respectively. However, every unit increase in HDL concentration was associated with decreased risk for LGA (adjusted OR: 0.60; 95% CI: 0.44-0.81) and macrosomia (adjusted OR: 0.64; 95% CI: 0.41-0.99). High LDL concentrations were associated with a decreased risk of macrosomia (adjusted OR: 0.82; 95% CI: 0.68-0.99) and LGA (adjusted OR: 0.86; 95% CI: 0.76-0.98) but an increased risk of LBW (adjusted OR: 1.16; 95% CI: 1.04-1.30). The results of linear trend analysis were similar to those of logistic regression model.Conclusions: Maternal dyslipidemia during the third trimester is closely related to adverse birth outcomes. Monitoring and managing maternal blood lipid levels in an appropriate range may help to reduce the burden of adverse birth outcomes.
Longitudinal Episodes of Under nutrition and its Predictors among HIV Positive Adults in Public Hospitals, Guraghe Zone: Linear Mixed model
Authors: Abdu Abdu Oumer , Mekonnen Berhanu Abebaw
Published: August 2020

Background: More than one-fourth of adult HIV patients had malnutrition which has high risk of relapse after treatment. Hence, assessing the longitudinal episodes and its predictors has great importance. Therefore, this study was aimed to assess the longitudinal trends of under nutrition and its predictors among HIV positive adults attending Public Hospitals in southwest Ethiopia, 2019. Methods: Longitudinal study with repeated measure was conducted among 519 randomly selected records of adult HIV clients who were on treatment. Malnutrition was assessed using the records of weight and height at different points of follow up (0, 6, 12, 18 and 24 months of ART follow up). Analysis of variance, analysis of covariance and spaghetti plot were done to compare the mean change in BMI across different repeated measures. To assess predictors of malnutrition episodes, linear mixed model was used considering fixed and random variables. Thus, parameter estimate, and p-value with 95% confidence interval was estimated via maximum likelihood method. From the model information criteria, Akaikes information criteria (AIC) were used to assess model fitness with smaller value as indicative of better model fit.Results: a total of 480 records were reviewed with mean age of 36 years (± 9 years). A total of 354(73.8%) of clients mentioned that they got dietary counseling. While, 34.6% of them got nutritional support. Statistical significant increasing trend of mean BMI score across the five follow up intervals (F statistics = 13.9, p value = 0.0001) were observed. Being male (β = -0.72; P = 0.044), with problem of eating difficulty (β = -1.61; p = 0.0001), having anemia (β = -1.51; p = 0.003), shorter follow up interval (β = 0.04.; p = 0.129), not getting nutritional counselling (β = 0.63; p =0.32) and diarrheal disease (β = -0.04; p = 0.129) were negatively associated with improvement in BMI indices. Conclusions: Improvement was seen in nutritional status after initiation of ART. Presence of eating disorder, anemia, not getting nutritional counseling, short follow interval were predictors of under nutrition. In addition to giving better nutritional counseling, the health professionals working in ART clinic should emphasize for early detection, and treatment of eating disorders, diarrheal disease and others.
Evaluation of Earth Systems Models and Atmospheric Inversions using Total Column CO2 Observations from GOSAT and OCO-2
Authors: Patra Prabir K , Hajima Tomohiro , Saito Ryu , Chandra Naveen , Yoshida Yukio , Ichii Kazuhito , Kawamiya Michio , Kondo Masayuki , Ito Akihiko , Crisp David
Published: August 2020

The measurements of one of the major greenhouse gases, carbon dioxide (CO 2 ), are being made using dedicated satellite remote sensing since the launch of the greenhouse gases observing satellite (GOSAT) by JAXA in 2009 and NASA’s Orbiting Carbon Observatory-2 (OCO-2). In the past 10 years, estimation of CO 2 fluxes from land and ocean using the earth system models (ESMs) and inverse modelling of in situ atmospheric CO 2 data have also made significant progress. In this article, we attempt, for the first time, to evaluate the CO 2 fluxes simulated by an earth system model (MIROC-ES2L) using GOSAT observations and the fluxes estimated by an inverse model (MIROC4-Inv) for the period 2009-2014. Further, we use the OCO-2 measurements for testing the consistency of inversion results for the period 2014-2018, along with the GOSAT data. Both MIROC-ES2L and MIROC4-Inv fluxes are used in the MIROC4-atmospheric chemistry transport model (referred to as ACTM_ES2LF and ACTM_InvF, respectively) for calculating CO 2 concentrations that are sampled at the time and location of the satellite measurements. Our results suggest the inverse model using in situ data are more consistent with the OCO-2 retrievals, compared to those of the GOSAT XCO 2 data, suggesting possible improvements in the present GOSAT retrieval system by better accounting for the degradation correction of the TANSO-FTS. The ACTM_ES2LF simulation shows a slightly weaker seasonal cycle for the meridional profiles of CO 2 fluxes, compared to that from the ACTM_InvF. This difference is revealed by greater ACTM_ES2LF vs GOSAT differences, compared to those of ACTM_InvF vs GOSAT. We also find that the simulated seasonal cycle amplitude of XCO 2 by ACTM_ES2LF are slightly weaker compared to those observed by GOSAT or ACTM_InvF. Using remote sensing based global products of leaf area index (LAI) and gross primary productivity (GPP) over land, we show a weaker sensitivity of MIROC-ES2L biospheric activities to the weather and climate in the tropical regions. Our results clearly suggest the usefulness of XCO 2 measurements by satellite remote sensing for evaluation of large-scale ESMs, which so far remained untested by the sparse in situ data.
How oral health educators conceptualise health promotion: a qualitative study.
Authors: Bracksley-O'Grady Stacey , Anderson Karen , Masood Mohd
Published: August 2020

Background: Dental diseases, dental caries and periodontal disease, place a significant burden on individual and population health level. These diseases are largely preventable; health promotion initiatives have been shown to decrease the disease rates. However, there is limited implementation of health promotion in dentistry, this could be due to a number of factors, the ethos and philosophy of dentistry is focused on a curative, individualised approach to oral diseases, there is confusion around health promotion as a concept. However, dental professionals are well placed to implement health promotion, but there is a lack of understanding about the training and what dental professionals understand about health promotion.The aim was to explore conceptualization of health promotion among oral health educators and identifying the barriers and opportunities for health promotion in practiceMethods: Nominal group technique (NGT), a highly structured face-to-face meeting, was conducted with 24 oral health educators to explore how they conceptualize health promotion and the barriers and opportunities for health promotion in practice. An additional 4 questions were emailed to oral health educators after the NGT to gather additional data, 6 oral health educators were involved. The data was analyzed using thematic analysis.Results: The oral health educators in this study discussed health promotion in a holistic way, however, health education and behaviour change were mentioned more than other aspects of health promotion. Collaboration with other health professionals and getting involved in already existing health promotion programs were the identified opportunities for health promotion practice. However, the barriers of health promotion practice were identified as the curative approach that underpins dentistry and the lack of funding, time and value placed on health promotion.Conclusions: This study moves beyond a problem describing to problem solving in this space. Collaboration with other health professionals is an opportunity to be capitalised on. However, to see the biggest improvement in health promotion the curative, individualised approach to dentistry needs to be challenged.
Prevention of lumbar disc degeneration through co-manipulation of insulin-like growth factor 1 and vascular endothelial growth factor
Authors: Zhao Shan , Ye Zuo-Zhou , Liu Zuo-qing
Published: August 2020

Background:

Associated with abnormal angiogenesis and disc dysfunction, Lumbar disc degeneration (LDD) appears to be an important disease suffered by aged people. Previous studies have highlighted the importance of insufficient insulin-like growth factor 1 (IGF1) and excessive vascular endothelial growth factor (VEGF) in the development and progression of LDD, whereas a practical therapeutic strategy is lacking.
Results:

Here, we did a gene therapy approach using adeno-associated virus (AAV) carrying both IGF1 and shVEGF (AAV-IGF1/shVEGF), which simultaneously corrected IGF1 and VEGF issues in a rat model for LDD.We found that AAV-IGF1/shVEGF significantly reduced disc cell death in the vertebral pulp and annulus fibrosus and significantly improved the lumbar proteoglycan and collagen II levels. Therefore, this approach effectively prevented the development of LDD.
Conclusions:

Our study presents a novel therapeutic approach on LDD, which is clinically translatable.
Characteristics and Metabolic Patterns of Soil Methanogenic Archaea Communities in the High Latitude Natural Wetlands of China
Authors: Wu Di , Zhao Caihong , Bai Hui , Feng Fujuan , Sui Xin , Sun Guangyu
Published: August 2020

Background: Soil methanogenic microorganisms are one of the primary methane-producing microbes in wetlands. However, we still poorly understand the community characteristic and metabolic patterns of these microorganisms according to vegetation type and seasonal changes. Therefore, to better elucidate the effects of the vegetation type and seasonal factors on the methanogenic community structure and metabolic patterns, we detected the characteristics of the soil methanogenic mcrA gene from three types of natural wetlands in different seasons in the Xiaoxing'an Mountain region, China. Result: The results indicated that the distribution of Methanobacteriaceae (hydrogenotrophic methanogens) was higher in winter, while Methanosarcinaceae and Methanosaetaceae accounted for a higher proportion in summer. Hydrogenotrophic methanogenesis was the dominant trophic pattern in each wetland. The results of principal coordinate analysis and cluster analysis showed that the vegetation type considerably influenced the methanogenic community composition. The methanogenic community structure in the Betula platyphylla – Larix gmelinii wetland was relatively different from the structure of the other two wetland types. Indicator species analysis further demonstrated that the corresponding species of indicator operational taxonomic units from the Alnus sibirica wetland and the Betula ovalifolia wetland were closer. Network analysis showed that cooperative and competitive relationships exist both within and between the same or different trophic methanogens. The core methanogens with higher abundance in each wetland were conducive to adaptation to environmental disturbances. Conclusions: This information is crucial for the assessment of metabolic patterns of soil methanogenic archaea and future fluxes in the wetlands of the Xiaoxing'an Mountain region given their vulnerability.
Construction of Hyperuricemia Model Rats with Yeast Extract Combined with Oteracil Potassium
Authors: Xilifu Dilidaer , Kateer Alimu , Rehemu Nijiati , Li Zhao-yong , Jiang jie , Zhou Xin-rong , Wang Bao-zhu , Li Fa-peng , Zhang Jian , Li Yan , Zhu Jia-jun , Maitusong Buamina , Zhang Xiang-yang , Sun Hui-ping
Published: August 2020

Background: Hyperuricemia is the most important risk factor for gout, hypertension, coronary artery disease and other cardiovascular diseases. The incidence of hyperuricemia gradually increased in recent years and it is very necessary to explore the medications of the prevention and treatment of hyperuricemia using hyperuricemia animal models. Objective: The objective of present study is to explore the optimal dose of yeast extract and oteracil potassium in the establishment of hyperuricemia rat model. Method: Sixty-four male rats were randomly divided into 8 experimental groups. Rats were treated with yeast extract by intraperitoneal injection or yeast extract by intraperitoneal injection combined with various doses of oteracil potassium by intragastric feeding or intraperitoneal injection for 28 days. The serum uric acid, urea nitrogen and creatinine levels of different groups were measured at 0th day, 7th day, 14th day, 21th day and 28th day. Results: The serum levels of uric acid in the groups of intraperitoneal injection with yeast extract alone, yeast extract by intraperitoneal injection combined with 50-200 mg/kg oteracil potassium by intragastric feeding and yeast extract by intraperitoneal injection combined with 50-100 mg/kg oteracil potassium by intraperitoneal injection were higher than that in the control group. But we found no significant effect on rat kidney, heart or artery in the above groups. In the group of yeast extract by intraperitoneal injection combined with 200 mg/kg oteracil potassium by intraperitoneal injection, we observed the significantly high level of serum uric acid and morphological and pathological changes in rat kidney, heart and artery. Conclusion: In the present study, we found that continuously treated with yeast extract combined with oteracil potassium is an effective method to establish rat hyperuricemia model. Intraperitoneal injection of yeast extract combined with 200 mg/kg oteracil potassium is an optimal dosage for the construction of a persistent and stable hyperuricemia animal model.