bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of GLP1 in Rat Steatotic and Non-Steatotic Liver Transplantation from Cardiocirculatory Death Donors
Authors: Avalos-de León Cindy G. , Jiménez-Castro Mónica B. , Cornide-Petronio María Eugenia , Casillas-Ramírez Araní , Peralta Carmen
Published: December 2019

In liver transplantation (LT), organ shortage has led to the use of steatotic and non-steatotic grafts from donors after cardiocirculatory death (DCD). However, these grafts, especially those with steatosis, exhibit poor post-operative outcomes. To address this problem, we investigated the roles of gut-derived glucagon-like peptide 1 (GLP1) and dipeptidyl peptidase 4 (DPP4), the serine protease that cleaves it, in steatotic and non-steatotic LT from DCDs. Using Zucker rats, liver grafts from DCDs were cold stored and transplanted to recipients. GLP1 was administered to donors. The levels of GLP1 in intestine and of both GLP1 and DDP4 in circulation were unaltered following cardiocirculatory death (CD). In steatotic livers from DCD, increased GLP1 and decreased DPP4 were recorded, and administration of GLP1 caused a rise in hepatic GLP1 and a reduction in DDP4. This protected against inflammation, damage, and proliferation failure. Conversely, low GLP1 and high DDP4 were observed in non-steatotic livers from DCD. The exogenous GLP1 did not modify hepatic DDP4, and the accumulated GLP1 exerted harmful effects, increasing damage, inflammation, and regeneration failure. Herein, we show that there are differences in GLP1/DDP4 regulation depending on the type of liver implanted, suggesting that GLP1 can be used as a novel and effective therapy in steatotic grafts from DCDs but that it is not appropriate for non-steatotic DCDs.
Developing Future Clinical Pharmacy Leaders in the Interprofessional Care of Children with Special Health Care Needs and Medical Complexity (CSHCN-CMC) in a Pediatric Pulmonary Center
Authors: Hobart Catherine B. , Daines Cori L. , Phan Hanna
Published: December 2019

The health care needs of children with special health care needs and medical complexity (CSHCN-CMC) are multifaceted and often require the expertise of various disciplines. The medication-related needs of this population can be further complicated with off-label medication use, polypharmacy, and vulnerability to medication errors. Although clinical pharmacists are increasingly becoming a common part of inpatient, pediatric interprofessional patient care teams, their presence remains lacking in the outpatient or ambulatory care realm. Pediatric clinical pharmacists in the ambulatory care setting have the potential to help optimize medication use and safety through collaborative efforts as part of the interprofessional team. Since the late 1960s, Pediatric Pulmonary Centers (PPCs) provide training programs designed to develop interprofessional leaders who will improve the health status of CSHCN-CMC, specifically those with chronic respiratory and sleep-related conditions. The addition of pharmacists not only provides a more comprehensive care model for CSHCN-CMC, it creates an avenue to encourage the career paths of pediatric pharmacists in the ambulatory care setting. Here, we describe the addition of clinical pharmacy as part of an interprofessional patient care team and the development and implementation of a maternal child health (MCH) pharmacy discipline training model designed to mentor future pharmacist leaders in the care of CSHCN-CMC.
Artificial Patination of Copper and Copper Alloys in Wet Atmosphere with Increased Content of SO2
Authors: Bureš Richard , Klajmon Martin , Fojt Jaroslav , Rak Pavol , Jílková Kristýna , Stoulil Jan
Published: December 2019

Natural copper patina is usually formed over several decades. This work investigates the possibility of obtaining a stable artificial patina based on brochantite in a more reasonable time. The patination process was based on patina formation from a humid atmosphere containing sulphur dioxide. The studied parameters were humidity (condensation and condensation/drying), sulphur dioxide concentration (4.4–44.3 g·m−3) and surface pre-treatments (grinding, pre-oxidation and pre-patination) prior to the patination process. Samples were evaluated by mass change, digital image analysis, spectrophotometry, scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS) and X-ray diffraction (XRD). A resistometric method was employed in order to observe the patina formation continuously during the exposure. Conditions inside the chamber were monitored during the exposure (pH of water and concentration of SO2 in gaseous phase). According to XRD, it was possible to deliberately grow a brochantite patina of reasonable thickness (approx. 30 µm), even within a couple of days of exposure. The drying phase of the condensation cycle increased the homogeneity of the deposited patina. Formation kinetics were the fastest under a condensation/drying cycle, starting with 17.7 g·m−3 sulphur dioxide and decreasing dosing in the cycle, with an electrolyte pH close to 3. The higher sulphur dioxide content above 17.7 g·m−3 forms too aggressive a surface electrolyte, which led to the dissolution of the brochantite. The pre-oxidation of copper surface resulted in a significant improvement of patina homogeneity on the surface.
Non-Evaporable Getter Ti-V-Hf-Zr Film Coating on Laser-Treated Aluminum Alloy Substrate for Electron Cloud Mitigation
Authors: Wang Jie , Gao Yong , You Zhiming , Fan Jiakun , Zhang Jing , Qiao Zhaopeng , Wang Sheng , Xu Zhanglian
Published: December 2019

For improving the vacuum and mitigating the electron clouds in ultra-high vacuum chamber systems of high-energy accelerators, the deposition of Ti-V-Hf-Zr getter film on a laser-treated aluminum alloy substrate was proposed and exploited for the first time in this study. The laser-treated aluminum surface exhibits a low secondary electron yield (SEY), which is even lower than 1 for some selected laser parameters. Non-evaporable getter (NEG) Ti-V-Hf-Zr film coatings were prepared using the direct current (DC) sputtering method. The surface morphology, surface roughness and composition of Ti-V-Hf-Zr getter films were characterized and analyzed. The maximum SEY of unactivated Ti-V-Hf-Zr getter film on laser-treated aluminum alloy substrates ranged from 1.10 to 1.48. The X-ray photoelectron spectroscopy (XPS) spectra demonstrate that the Ti-V-Hf-Zr coated laser-treated aluminum alloy could be partially activated after being heated at 100 and 150 °C, respectively, for 1 h in a vacuum and also used as a pump. The results were demonstrated initially and the potential application should be considered in future particle accelerators.
Finite Element Simulation of Multi-Slip Effects on Unsteady MHD Bioconvective Micropolar Nanofluid Flow Over a Sheet with Solutal and Thermal Convective Boundary Conditions
Authors: Ali Liaqat , Liu Xiaomin , Ali Bagh , Mujeed Saima , Abdal Sohaib
Published: December 2019

In this article, the intention is to explore the flow of a magneto-hydrodynamic (MHD) bioconvective micro-polar Nanofluid restraining microorganism. The numerical solution of 2-D laminar bioconvective boundary layer flow of micro-polar nanofluids are presented. The phenomena of multi-slip, convective thermal and Solutal boundary conditions have been integrated. A system of non-linear partial differential equations are transformed into the system of coupled nonlinear ordinary differential equations by applying appropriate transformations, the transformed equations are then solved by applying the variational finite element method (FEM). The fascinating features of assorted velocity parameter, microrotation, temperature, microorganism compactness, solutal and nanoparticles concentration have been inspected. The rate of heat transfer, the skin friction coefficient, couple stress and Sherwood number for microorganisms have also been discussed graphically and numerically. The investigations illustrated that increase in material parameters causes a reduction in microorganism compactness, concentration and temperature. As a result of enhancement in the unsteadiness parameter, the fluid velocity, concentration of microorganisms and the temperature are observed to be declines. Energy and microorganism compactness profile affected by the improvement in the buoyancy ratio parameter. As the improvement in results of buoyancy ratio parameter effects on improvement in the energy and the microorganism compactness profile while the velocity profile is condensed. In the end, rationalized convergence of the finite element solution has been inspected; the computations are found out via depreciating the mesh size.
On Friction Reduction by Surface Modifications in the TEHL Cam/Tappet-Contact-Experimental and Numerical Studies
Authors: Marian Max , Weikert Tim , Tremmel Stephan
Published: December 2019

The overall energy efficiency of machine elements and engine components could be improved by using new technologies such as surface modifications. In the literature, surface engineering approaches like micro-texturing and the application of diamond-like carbon (DLC) coatings were frequently studied separately, with focus on a specific model contact and lubrication conditions. The contribution of the current study is to elucidate and compare the underlying friction reduction mechanisms of the aforementioned surface modifications in an application-orientated manner. The study applied the operating conditions of the thermo-elastohydrodynamically lubricated (TEHL) cam/tappet-contact of the valve train. Therefore, tribological cam/bucket tappet component Stribeck tests were used to determine the friction behavior of ultrashort pulse laser fabricated microtextures and PVD/PECVD deposited silicon-doped amorphous carbon coatings. Moreover, advanced surface characterization methods, as well as numerical TEHL tribo-simulations, were utilized to explore the mechanisms responsible for the observed tribological effects. The results showed that the DLC-coating could reduce the solid and fluid friction force in a wide range of lubrication regimes. Conversely, micro-texturing may reduce solid friction while increasing the fraction of fluid friction.
Synthesis, X-ray Crystal Structure and Antimicrobial Activity of Unexpected Trinuclear Cu(II) Complex from s-Triazine-Based Di-Compartmental Ligand via Self-Assembly
Authors: Soliman Saied M. , Lasri Jamal , Haukka Matti , Sholkamy Essam N. , Al-Rasheed Hessa H. , El-Faham Ayman
Published: December 2019

The synthesis and X-ray crystal structure of the trinuclear [Cu3(HL)(Cl)2(NO3)(H2O)5](NO3)2 complex of the s-triazine-based di-compartmental ligand, 2-methoxy-4,6-bis(2-(pyridin-2-ylmsethylene)hydrazinyl)-1,3,5-triazine (H2L), are presented. The Cu1 and Cu2 are penta-coordinated with CuN3ClO coordination environment, distorted square pyramidal coordination geometry while Cu3 is hexa-coordinated with CuN2O4 coordination sphere, and distorted octahedral geometry. The complex crystallized in the primitive P-1 triclinic crystal system with two molecular units per unit cell. Its packing is dominated by the O–H (35.5%) and Cl–H (8.8%) hydrogen bonding interactions as well as the π–π stacking (2.3%) and anion–π-stacking interactions (3.7%). The different coordination interactions were analyzed using atoms in molecules (AIM) theory, and the number of charge transferences from the ligand group to Cu(II) were determined using natural bond orbital calculations. The effect of the free ligand and its Cu(II) complex on the tested pathogenic microbes (Staphylococcus aureus, S. epidermidis, Enterococcus faecalis, Escherichia coli, Salmonella typhi and Pseudomonas aeruginosa) and one fungal isolate (Candida albicans) is presented. Both have wide spectrum antimicrobial activity against the selected microorganism. It is observed that the free ligand at 180 µg/mL was more effective than its Cu(II) complex and showed close results compared to the positive control gentamicin. At higher concentrations (1 mg/mL), the Cu(II) complex was found to be more active against S. epidermidis, E. coli and C. albicans than the lower concentration. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values are also lower for the Cu(II) complex than the free ligand.
Patterns of Heart Rate Dynamics in Healthy Aging Population: Insights from Machine Learning Methods
Authors: Makowiec Danuta , Wdowczyk Joanna
Published: December 2019

Costa et. al (Frontiers in Physiology (2017) 8255) proved that abnormal features of heart rate variability (HRV) can be discerned by the presence of particular patterns in a signal of time intervals between subsequent heart contractions, called RR intervals. In the following, the statistics of these patterns, quantified using entropic tools, are explored in order to uncover the specifics of the dynamics of heart contraction based on RR intervals. The 33 measures of HRV (standard and new ones) were estimated from four hour nocturnal recordings obtained from 181 healthy people of different ages and analyzed with the machine learning methods. The validation of the methods was based on the results obtained from shuffled data. The exploratory factor analysis provided five factors driving the HRV. We hypothesize that these factors could be related to the commonly assumed physiological sources of HRV: (i) activity of the vagal nervous system; (ii) dynamical balance in the autonomic nervous system; (iii) sympathetic activity; (iv) homeostatic stability; and (v) humoral effects. In particular, the indices describing patterns: their total volume, as well as their distribution, showed important aspects of the organization of the ANS control: the presence or absence of a strong correlation between the patterns’ indices, which distinguished the original rhythms of people from their shuffled representatives. Supposing that the dynamic organization of RR intervals is age dependent, classification with the support vector machines was performed. The classification results proved to be strongly dependent on the parameters of the methods used, therefore determining that the age group was not obvious.
Comparison of Heat-Pipe Cooling System Design Processes in Railway Propulsion Inverter Considering Power Module Reliability
Authors: Lee June-Seok , Choi Ui-Min
Published: December 2019

In this paper, the effect of the heat-pipe cooling system design processes on the reliability of the power module in a railway propulsion inverter was investigated. The existing design processes for the heat-pipe cooling system guarantee that the junction temperature of power devices does not exceed the maximum allowable junction temperature when the railway propulsion inverter operates under its mission profile; therefore, each step of the design process was reviewed to analyze the effect of the heat-pipe cooling system. Based on the processes, in the calculation for the required thermal resistance of the heat-pipe cooling system, two difference losses were considered with the thermal resistances of the insulated gate bipolar mode transistor (IGBT) module and the thermal grease at an interface between the baseplate of IGBT module and heat-pipe cooling system. The control scheme and mission profile of the train were taken into account to calculate the power losses. Then, the designed heat-pipe cooling systems were compared in terms of the size and weight. In addition, the junction temperatures and lifetimes of the power module with heat-pipe cooling systems designed by different power losses were estimated and compared. Finally, guidelines for a heat-pipe system cooling design are proposed.
Initial Rhodonia placenta Gene Expression in Acetylated Wood: Group-Wise Upregulation of Non-Enzymatic Oxidative Wood Degradation Genes Depending on the Treatment Level
Authors: Kölle Martina , Ringman Rebecka , Pilgård Annica
Published: December 2019

Acetylation has been shown to delay fungal decay, but the underlying mechanisms are poorly understood. Brown-rot fungi, such as Rhodonia placenta (Fr.) Niemelä, K.H. Larss. & Schigel, degrade wood in two steps, i.e., oxidative depolymerization followed by secretion of hydrolytic enzymes. Since separating the two degradation steps has been proven challenging, a new sample design was applied to the task. The aim of this study was to compare the expression of 10 genes during the initial decay phase in wood and wood acetylated to three different weight percentage gains (WPG). The results showed that not all genes thought to play a role in initiating brown-rot decay are upregulated. Furthermore, the results indicate that R. placenta upregulates an increasing number of genes involved in the oxidative degradation phase with increasing WPG.
Drift of Larval Darters (Family Percidae) in the Upper Roanoke River Basin, USA, Characterized Using Phenotypic and DNA Barcoding Markers
Authors: Buckwalter Joseph , Angermeier Paul L. , Argentina Jane , Wolf Skylar , Floyd Stephen , Hallerman Eric M.
Published: December 2019

Larval fish ecology is poorly characterized because sampling is difficult and tools for phenotypically identifying larvae are poorly developed. While DNA barcoding can help address the latter problem, ‘universal’ primers do not work for all fish species. The Roanoke River in the southeastern United States includes seven darters (Family Percide: Tribe Etheostomatini). We made 393 collections of larval fishes in 2015 and 2018, examined darter larvae for morphometric and pigmentation traits, developed PCR primers amplifying darter DNA, and evaluated three gear types for collecting larval darters. Amplified DNA sequences for 1351 larvae matched archived mitochondrial cytochrome oxidase I sequences for darters occurring in the ecosystem. Larval darters were classified to genus with 100% accuracy using the ratio of pectoral fin length to body length; however, identification to species using morphometrics alone was subject to a misclassification rate of 11.8%, which can be resolved by considering pigmentation patterns. Gear-types varied considerably in their capture efficacy for larval darters; most Percina larvae were collected in drift nets. Larval Percina species appeared in the drift before Etheostoma species in both study years. Application of molecular genetic and phenotypic tools to larval fish identification can advance understanding of larval darter ecology.
Doxycycline and Monocaprin In Situ Hydrogel: Effect on Stability, Mucoadhesion and Texture Analysis and In Vitro Release
Authors: Patlolla Venu Gopal Reddy , Peter Holbrook William , Gizurarson Sveinbjorn , Kristmundsdottir Thordis
Published: December 2019

The aim of this study was to develop a stable aqueous formulation containing a combination of doxycycline and monocaprin in clinically relevant concentrations. Increase in expression of Matrix metalloproteinases (MMPs) and microbial role in oral diseases is well established and the combination of above active ingredients could be potentially beneficial in treatment of oral mucosal conditions. The hydrogels containing different concentrations of doxycycline and monocaprin in the presence and absence of stabilizing excipients were developed and their stabilities were studied at 4 °C for up to 1 year. The drug–drug interaction was evaluated using Fourier-transform infrared spectroscopy (FTIR). The addition of monocaprin on doxycycline in situ hydrogel’s mucoadhesiveness, texture properties and drug release mechanism was studied. The addition of monocaprin negatively affected the doxycycline stability and was concentration dependent, whereas monocaprin was stable up to 1 year. Doxycycline did not interfere with the anti-Candidal activity of monocaprin. Furthermore, the presence of monocaprin significantly affected the formulation hardness, compressibility and adhesiveness. Monocaprin and doxycycline release followed zero order kinetics and the release mechanism was, by anomalous (non-Fickian) diffusion. The addition of monocaprin increased the drug release time and altered the release mechanism. It is possible to stabilize doxycycline in the presence of monocaprin up to 1 year at 4 °C.
Detecting the Past: Detective Novels, the Nazi Past, and Holocaust Impiety
Authors: Berberich Christine
Published: December 2019

Crime writing is not often associated with Holocaust representations, yet an emergent trend, especially in German literature, combines a general, popular interest in crime and detective fiction with historical writing about the Holocaust, or critically engages with the events of the Shoah. Particularly worthy of critical investigation are Bernhard Schlink’s series of detective novels focusing on private investigator Gerhard Selb, a man with a Nazi background now investigating other people’s Nazi pasts, and Ferdinand von Schirach’s The Collini Case (2011) which engages with the often inadequate response of the post-war justice system in Germany to Nazi crimes. In these novels, the detective turns historian in order to solve historic cases. Importantly, readers also follow in the detectives’ footsteps, piecing together a slowly emerging historical jigsaw in ways that compel them to question historical knowledge, history writing, processes of institutionalised commemoration and memory formation, all of which are key issues in Holocaust Studies. The aims of this paper are two-fold. Firstly, I will argue that the significance of this kind of fiction has been insufficiently recognised by critics, perhaps in part because of its connotations as popular fiction. Secondly, I will contend that these texts can be fruitfully analysed by situating them in relation to recent debates about pious and impious Holocaust writing as discussed by Gillian Rose and Matthew Boswell. As a result, these texts act as exemplars of Rose’s contention that impious Holocaust literature succeeds by using new techniques in order to shatter the emotional detachment that has resulted from the use of clichés and familiar tropes in traditional pious accounts; and by placing detectives and readers in a position of moral ambivalence that complicates their understanding of the past on the one hand, and their own moral position on the other.
Periodontitis and Tooth Loss Have Negative Systemic Impact on Circulating Progenitor Cell Levels: A Clinical Study
Authors: Isola Gaetano , Giudice Antonino Lo , Polizzi Alessandro , Alibrandi Angela , Patini Romeo , Ferlito Sebastiano
Published: December 2019

The aim of the present study was to investigate the association and impact of periodontitis and tooth loss on a subtype of endothelial progenitor cell (EPC) levels (CD133+/KDR+). Furthermore, the objective was to determine if the periodontal status influenced CD133+/KDR+ levels. In all, 88 patients with periodontitis and 79 healthy controls (HCs) were enrolled in the study. Enrolled patients were examined and characterized by clinical and blood sample analysis. Spearman’s correlation test was applied in order to assess the interdependence between CD133+/KDR+ levels and all periodontal parameters. In order to estimate a statistically significant trend (p-trend) for ordered CD133++/KDR+ quartiles, the Jonckheere–Terpstra test was applied for all variables. Patients in the periodontitis group presented significantly lower CD133+/KDR+ levels (66.4 (45.5–269.6 cells/µL)) compared to the HC group (76.7 (24.3–313.2 cells/µL), p < 0.001). Lower CD133+/KDR+ levels negatively correlated with C-reactive protein (CRP), with the number of teeth, and with all periodontal parameters (p < 0.001). Moreover, there was a proportional increase in CD133+/KDR+ levels with a progressive increase in number of teeth (p-trend < 0.001), while there was a proportional decrease in CD133+/KDR+ levels with a proportional increase in clinical attachment level (CAL, p-trend = 0.003), probing depth (PD, p-trend = 0.007), and bleeding sites (bleeding on probing (BOP), p-trend < 0.001) as an extent measure of periodontitis. This study demonstrated that patients with periodontitis presented significantly lower CD133+/KDR+ levels compared to HCs. Moreover, all patients presented an increase in the CD133+/KDR+ EPC levels with an extended level of periodontitis and tooth loss.
Non-Syndromic Cleft Lip with or without Cleft Palate: Genome-Wide Association Study in Europeans Identifies a Suggestive Risk Locus at 16p12.1 and Supports SH3PXD2A as a Clefting Susceptibility Gene
Authors: van Rooij Iris ALM , Ludwig Kerstin U , Welzenbach Julia , Ishorst Nina , Thonissen Michelle , Galesloot Tessel E , Ongkosuwito Edwin , Bergé Stefaan J , Aldhorae Khalid , Rojas-Martinez Augusto , Kiemeney Lambertus ALM , Vermeesch Joris Robert , Brunner Han , Roeleveld Nel , Devriendt Koen , Dormaar Titiaan , Hens Greet , Knapp Michael , Carels Carine , Mangold Elisabeth
Published: December 2019

Non-syndromic cleft lip with or without cleft palate (nsCL/P) ranks among the most common human congenital malformations, and has a multifactorial background in which both exogenous and genetic risk factors act in concert. The present report describes a genome-wide association study (GWAS) involving a total of 285 nsCL/P patients and 1212 controls from the Netherlands and Belgium. Twenty of the 40 previously reported nsC/LP susceptibility loci were replicated, which underlined the validity of this sample. SNV-based analysis of the data identified an as yet unreported suggestive locus at chromosome 16p12.1 (p-value of the lead SNV: 4.17 × 10−7). This association was replicated in two of three patient/control replication series (Central European and Yemeni). Gene analysis of the GWAS data prioritized SH3PXD2A at chromosome 10q24.33 as a candidate gene for nsCL/P. To date, support for this gene as a cleft gene has been restricted to data from zebrafish and a knockout mouse model. The present GWAS was the first to implicate SH3PXD2A in non-syndromic cleft formation in humans. In summary, although performed in a relatively small sample, the present GWAS generated novel insights into nsCL/P etiology.
Nanopore Targeted Sequencing for Rapid Gene Mutations Detection in Acute Myeloid Leukemia
Authors: Cumbo Cosimo , Minervini Crescenzio Francesco , Orsini Paola , Anelli Luisa , Zagaria Antonella , Minervini Angela , Coccaro Nicoletta , Impera Luciana , Tota Giuseppina , Parciante Elisa , Conserva Maria Rosa , Spinelli Orietta , Rambaldi Alessandro , Specchia Giorgina , Albano Francesco
Published: December 2019

Acute myeloid leukemia (AML) clinical settings cannot do without molecular testing to confirm or rule out predictive biomarkers for prognostic stratification, in order to initiate or withhold targeted therapy. Next generation sequencing offers the advantage of the simultaneous investigation of numerous genes, but these methods remain expensive and time consuming. In this context, we present a nanopore-based assay for rapid (24 h) sequencing of six genes (NPM1, FLT3, CEBPA, TP53, IDH1 and IDH2) that are recurrently mutated in AML. The study included 22 AML patients at diagnosis; all data were compared with the results of S5 sequencing, and discordant variants were validated by Sanger sequencing. Nanopore approach showed substantial advantages in terms of speed and low cost. Furthermore, the ability to generate long reads allows a more accurate detection of longer FLT3 internal tandem duplications and phasing double CEBPA mutations. In conclusion, we propose a cheap, rapid workflow that can potentially enable all basic molecular biology laboratories to perform detailed targeted gene sequencing analysis in AML patients, in order to define their prognosis and the appropriate treatment.
Experiences of Dysphagia after Stroke: An Interview Study of Stroke Survivors and Their Informal Caregivers
Authors: Eltringham Sabrina A. , Pownall Sue , Bray Ben , Smith Craig J. , Piercy Laura , Sage Karen
Published: December 2019

(1) Background: Swallowing difficulties (dysphagia) after stroke are not uncommon and is a consistent risk factor for stroke-associated pneumonia. This interview study explores the perspectives of stroke survivors, who had their swallowing assessed in the first few days of admission to hospital, and their informal caregivers. (2) Methods: A participatory approach was used involving people affected by stroke in the interpretation and analysis of the interview data. Data was thematically analysed and six themes were identified. (3) Results: These themes included how past-future experiences may influence a person’s emotional response to events; understanding what is happening and adjustment; the impact of dysphagia; attitudes to care; communication to patients and procedural issues. (4) Conclusion: The findings highlight the importance of effective public health messages to improve people’s responsiveness to the signs of stroke, standardisation of assessment and management procedures, effective communication to patients about the consequences of dysphagia, and the impact of dysphagia on the person who had the stroke and their informal caregiver.
Growth Charts for Height, Weight, and BMI (6–18 y) for the Tuscany Youth Sports Population
Authors: Mascherini Gabriele , Galanti Giorgio , Massetti Luciano , Calà Piergiuseppe , Modesti Pietro Amedeo
Published: December 2019

Overweight during youth is a large-scale public health issue. Engaging in regular physical activity generally reduces weight status. The hypothesis of the study is that organized sport plays an active role in maintaining a correct body weight during youth. The purpose of this study is to trace growth charts by height, weight, and body mass index (BMI) to be applied to the youth sports population. A retrospective study was conducted on 14,700 young athletes (10,469 males and 4231 females) aged between 6 and 18 years from surveillance carried out during the pre-participation screening of sports eligibility. The calculation of the prevalence of overweight and obesity was also performed. The new percentiles for the youth sports population show BMI values at 18 years 21.9 kg/m2 for males and 20.7 kg/m2 for females at the 50th percentile. The male sample shows 12.3% of the subjects were overweight and 1.5% were obese, while the female sample shows 9.8% are overweight and 1.1% obese. The higher prevalence of excess weight is evident up to 12 years old in both sexes and then gradually decreases. The development of the new specific growth charts for the youth sports population could reduce the risk of error in identifying the correct weight status of young athletes.
A Systematic Review of UK Educational and Training Materials Aimed at Health and Social Care Staff about Providing Appropriate Services for LGBT+ People
Authors: Hunt Ros , Bates Christopher , Walker Susan , Grierson Jeffrey , Redsell Sarah , Meads Catherine
Published: December 2019

Background: There is greater dissatisfaction with health services by LGBT people compared to heterosexual and cisgender people and some of this is from lack of equality and diversity training for health professionals. Core training standards in sexual orientation for health professionals have been available since 2006. The purpose of this project is to systematically review educational materials for health and social care professionals in lesbian, gay, bisexual, and transgender (LGBT) issues. Methods: A protocol was developed and searches conducted in six databases. Selection criteria: any studies reporting delivery or evaluation of UK education of health and/or social care professionals in LGBT issues, with no language or setting restrictions. Inclusions and data extraction were conducted in duplicate. Narrative synthesis of educational evaluations was used. Educational materials were assessed using thematic synthesis. Results: From the searches, 165 full papers were evaluated and 19 studies were included in the narrative synthesis. Three were successful action-research projects in cancer services and in residential care. Sixteen sets of educational/training materials have been available since 2010. These varied in length, scope, target audience, and extent of development as classroom-ready materials. Conclusions: Despite the availability of appropriate training programmes for post-qualifying staff, recommendations to undertake training, best practice examples, and statements of good intent, LGBT people continue to report that they are experiencing discrimination or direct prejudice from health and/or social care services. Better training strategies using behaviour change techniques are needed.
Caring for Tuberculosis Patients: Understanding the Plight of Nurses at a Regional Hospital in Limpopo Province, South Africa
Authors: Matakanye Hulisani , Ramathuba Dorah U. , Tugli Augustine K.
Published: December 2019

Tuberculosis (TB) is a disease which is caused by a relatively large, non-motile, rod-shaped pathogen called Mycobacterium tuberculosis. TB is a major cause of illness and death worldwide, especially in Asia and Africa. Despite the fact that TB is a curable illness, the tragedy is that TB remains the biggest killer in the world as a single pathogen. The aim of this study was to determine the experiences of nurses caring for TB patients at a regional hospital in Limpopo Province, South Africa. Qualitative, exploratory, and descriptive designs were used. A non-probability purposive sampling method was used to select the participants. The personal experiences of six nurses with more than five years’ experience caring for TB patients at a regional hospital were explored, and it was guided by data saturation. Data were collected through in-depth individual interviews. Data were analyzed using Colaizzi’s method. Trustworthiness was ensured and ethical considerations were observed in this study. The research findings revealed six major themes from the raw data: challenges of the working environment, problems impacting on the quality of nursing care, fear, anxiety, stress and risk of contracting infection, nurses’ perceptions towards patients, support structure available in the hospital, and support needs for the nurses. Therefore, there is an urgent need to address the challenges experienced by nurses caring for communicable diseases through provision of a positive practice work environment.
Does Loneliness Predict Subsequent Use of Flu Vaccination? Findings from a Nationally Representative Study of Older Adults in Germany
Authors: Hajek André , König Hans-Helmut
Published: December 2019

There is a lack of studies investigating whether loneliness predicts subsequent use of flu vaccination. Therefore, we aimed to clarify this relationship. Data were drawn from two waves (second wave took place in 2002, third wave took place in 2008) of a nationally representative cohort of community-dwelling individuals in Germany. The sample was restricted to individuals ≥60 years for whom flu vaccination is recommended. Loneliness was quantified using the De Jong Gierveld Loneliness Scale (second wave). Flu vaccination in the past 12 months was assessed (third wave). Consequently, older individuals that participated in the second wave and reported flu vaccination in the third wave were included (n = 970). The other waves (e.g., first wave) were excluded for reasons of data availability. Increased loneliness was associated with subsequent decreased use of the flu vaccine. Moreover, the probability of flu vaccination in the third wave was positively associated with being retired (ref.: employed), having a lower income, and the number of physical illnesses in the second wave. Findings stressed the importance of loneliness in the decreased use of the flu vaccine. Preventing loneliness may also help to increase flu vaccination rates.
Designing and Evaluating a Digital Family Health History Tool for Spanish Speakers
Authors: Cerda Diez Maria , E. Cortés Dharma , Trevino-Talbot Michelle , Bangham Candice , Winter Michael R. , Cabral Howard , Norkunas Cunningham Tricia , M. Toledo Diana , J. Bowen Deborah , K. Paasche-Orlow Michael , Bickmore Timothy , Wang Catharine
Published: December 2019

Digital family health history tools have been developed but few have been tested with non-English speakers and evaluated for acceptability and usability. This study describes the cultural and linguistic adaptation and evaluation of a family health history tool (VICKY: VIrtual Counselor for Knowing Your Family History) for Spanish speakers. In-depth interviews were conducted with 56 Spanish-speaking participants; a subset of 30 also participated in a qualitative component to evaluate the acceptability and usability of Spanish VICKY. Overall, agreement in family history assessment was moderate between VICKY and a genetic counselor (weighted kappa range: 0.4695 for stroke—0.6615 for heart disease), although this varied across disease subtypes. Participants felt comfortable using VICKY and noted that VICKY was very likeable and possessed human-like characteristics. They reported that VICKY was very easy to navigate, felt that the instructions were very clear, and thought that the time it took to use the tool was just right. Spanish VICKY may be useful as a tool to collect family health history and was viewed as acceptable and usable. The study results shed light on some cultural differences that may influence interactions with family history tools and inform future research aimed at designing and testing culturally and linguistically diverse digital systems.
Association Between Sugar-Sweetened Beverage Consumption as Meal Substitutes, Workload, and Obesity in Nurses: A Cross-Sectional Study
Authors: Lin Ting-Ti , Guo Yue Leon , Gordon Christopher , Cayanan Elizabeth , Chen Yi-Chuan , Ouyang Chung-Mei , Shiao Judith Shu-Chu
Published: December 2019

Background: High occupational stress has been associated with altered eating behaviors and obesity. Occupational stress is reported to be high in Asian countries. Furthermore, many Asian countries are increasingly consuming Western-type foods (e.g., incorporating drinks with meals) which collectively may also be contributing to obesity. Therefore, the aim of this study was to examine (a) associations between sugar-sweetened beverage (SSB) consumption as meal replacement and obesity and (b) associations between workload and substituting meals with SSB in nurses. Methods: A representative sample of 854 hospital-based nurses completed a structured questionnaire about SSB consumption, workload, and body mass index (BMI). Log binomial regression models were employed to test associations between SSBs and obesity rates and associations between workload and SSBs. Results: Most participants (57.6%) consumed SSBs as meal replacements during work. This was related to high workloads during shifts. Substituting SSBs for meals was significantly associated with increased likelihood of obesity (aPRR = 1.4, 95% CI (1.1, 1.7)). Workload was positively associated with SSB intake as meal substitutes (aPRR = 1.4, 95% CI (1.2, 1.6)). Conclusions: Our findings show that SSBs are used as meal substitutes and is due to the workload demands. Sugar-sweetened beverage consumption is also positively associated with the increased likelihood of obesity. Interventions that modify workloads and decrease SSB consumption may improve workers’ eating behaviors and health.
Public Health from the Middle-Out: A New Analytical Perspective
Authors: Kranzler Yannai , Parag Yael , Davidovitch Nadav
Published: December 2019

Obstacles to collaborative public health frameworks such as Health in All Policies continue to emerge. Partnership-based public health programs present opportunities to study how public servants and practitioners address these barriers in real time. To this end, we utilized “Middle-Out,” a socio-technical analytical approach that highlights the importance of Middle Actors-stakeholders positioned between policymakers and grassroots—to policy diffusion, innovation and collaboration in public health. We conducted participatory observation in administrative settings of Israel’s National Program to Promote Active, Healthy Lifestyle, 30 stakeholder interviews and document analysis. We examined two dimensions of impact from the Middle-Out: Directions of Influence—Middle-Up, Middle-Down and Sideways, and Modes of Influence—Enabling, Mediating and Aggregating. Through Middle-Out’s lens, our analysis transcends visible benchmarks such as legislation and macro-level resource-allocation, focusing, instead, on elusive administrative spaces within which Middle Actors shape policies, steer funding and facilitate continuity. Incorporating Middle-Out into public health’s conceptual toolbox, we conclude, can improve understanding of complex public health policy arenas, increase recognition of critical socio-technical changemakers and catalyze more effective design of policy tools and strategies that specifically harness Middle Actors’ strengths and qualities.
The Effect of Prophylactic Adnexectomy on the Quality of Life and Psychosocial Functioning of Women with the BRCA1/BRCA2 Mutations
Authors: Stanisz Marta , Panczyk Mariusz , Kurzawa Rafał , Grochans Elżbieta
Published: December 2019

The main purpose of this study was to analyze the effect of risk-reducing salpingo-oophorectomy (RRSO) on the quality of life (QoL) and psychosocial functioning of patients with the BRCA1/BRCA2 mutations. This survey-based study was conducted using the Blatt-Kupperman Index, the Women’s Health Questionnaire, the Perceived Stress Scale, the State-Trait Anxiety Inventory, the Beck Depression Inventory-II, and the authors’ questionnaire. All calculations were done using Statistica 13.3. The QoL after RRSO was statistically significantly lower in most domains compared with the state before surgery. The greatest decline in the QoL was observed in the vasomotor symptoms domain (d = 0.953) and the smallest in the memory/concentration domain (d = 0.167). We observed a statistically significant decrease in the level of anxiety as a state (d = 0.381), as well as a statistically significant increase in the severity of climacteric symptoms (d = 0.315) and depressive symptoms (d = 0.125). Prophylactic surgeries of the reproductive organs have a negative effect on the QoL and psychosocial functioning of women with the BRCA1/2 mutations, as they increase the severity of depressive and climacteric symptoms. At the same time, these surgeries reduce anxiety as a state, which may be associated with the elimination of cancerophobia.
The Combined Effect of Poor Perceived Indoor Environmental Quality and Psychosocial Stressors on Long-Term Sickness Absence in the Workplace: A Follow-Up Study
Authors: Finell Eerika , Nätti Jouko
Published: December 2019

Background: Poor perceived indoor environmental quality (IEQ) can generate conflicts and experiences of injustice in workplaces. Therefore we examined whether the combined effect of poor IEQ and self-reported psychosocial stressors (low social support from supervisors and experiences of injustice) increase the risk of employees’ long-term sickness absence (more than 10 days) in comparison to employees who report only poor perceived IEQ and no psychosocial stressors. Methods: Using negative binomial modelling, we analysed a representative sample of the working-age population in Finland (N = 16,084) from the Finnish Quality of Work Life Surveys (FQWLS) from 1997, 2003, 2008 and 2013, combined with register-based follow-up data on employees’ long-term absences covering a period of one to three years after each FQWLS was collected. Results: After background variables were included in the model, employees who reported poor IEQ and low social support had 1.18 (incidents rate ratios; 95% CI 1.05–1.33) higher rates of long-term absence than those who reported poor IEQ and high support. Similarly, employees who reported poor IEQ and experiences of injustice had 1.31(incidents rate ratios; 95% CI 1.15–1.48) higher rates of absence than those who reported poor IEQ and no injustice. Conclusions: Employees who reported poor perceived IEQ and a psychosocial stressor had higher rates of long-term sickness absence one to three years later, in comparison with those who report only poor perceived IEQ and no psychosocial stressors. These findings demonstrate the importance of taking account of psychosocial stressors as well, when resolving indoor environmental problems.
Prevalence of Human Papillomavirus (HPV) and Other Sexually Transmitted Infections (STIs) among Italian Women Referred for a Colposcopy
Authors: Martinelli Marianna , Musumeci Rosario , Sechi Illari , Sotgiu Giovanni , Piana Andrea , Perdoni Federica , Sina Federica , Fruscio Robert , Landoni Fabio , Cocuzza Clementina E.
Published: December 2019

Sexually transmitted infections (STIs) represent a major cause of morbidity in women and men worldwide. Human Papillomavirus (HPV) infections are among the most prevalent STIs and persistent infections with high-risk HPV (hrHPV) genotypes can cause cervical dysplasia and invasive cervical cancer. The association of other STIs with HPV cervical infection and/or dysplasia has however not yet been fully elucidated. The aim of this study was to assess the prevalence of HPV and other STIs among women presenting with an abnormal cervical cytology. Cervical infections with 28 HPV genotypes and seven other sexually transmitted pathogens were evaluated in 177 women referred for a colposcopy after an abnormal Pap smear. Positivity for at least one hrHPV genotype was shown in 87% of women; HPV 16 was the most prevalent (25.0%), followed by HPV 31 and HPV 51. The overall positivity for other STIs was 49.2%, with Ureaplasma parvum being the most prevalent microrganism (39.0%). Co-infections between hrHPV and other STIs were demonstrated in 17.5% of women; no significant association was demonstrated between multiple infections and the colposcopy findings. This study provides new epidemiological data on the prevalence of cervical infections associated with HPV and seven other common sexually transmitted pathogens in a population of women presenting with an abnormal cervical cytology.
Peripheral Vision Tests in Sports: Training Effects and Reliability of Peripheral Perception Test
Authors: Schumacher Nils , Schmidt Mike , Reer Rüdiger , Braumann Klaus-Michael
Published: December 2019

Various studies suggest the importance of peripheral vision (PV) in sports. Computer-based test systems provide objective methods to measure PV. Nevertheless, the reliability and training effects are not clarified in detail. The purpose of this investigation was to present a short narrative non-systematic review on computer-based PV tests and to determine the reliability and the training effects of peripheral perception sub-test (PP) of the Vienna test system (VTS) in a test–retest design. N = 21 male athletes aged between 20 and 30 years (M = 26.15; SD = 3.1) were included. The main outcome parameters were peripheral reaction (PR), PR left (PRL), PR right (PRR), field of vision (FOV), visual angle left (VAL), and visual angle right (VAR). Reliability was assessed using intraclass correlation coefficient (ICC) and Bland–Altman plots. Training effects were determined by students t-test. Good reliability was observed in PR, PRL, and PRR. Moderate reliability was found in FOV, VAL, and VAR. Significant improvements between T0 and T1 were found in PRL with a mean difference of 0.04 s (95% CI [0.00–0.07]) and in PR with a mean difference of 0.02 s (95% CI [0.00–0.05]). For PRR, FOV, VAL, VAR, no significant differences were detected. These results indicate that PP can be applied to asses PV abilities in sports. Future research is needed to clarify the influence of test repetitions on visuomotor learning in PP. Moreover, PV tests should be cross-validated with sport-specific measurements (e.g., on-field and/or ‘virtual reality’ approaches).