bluuebunny/crossref_metadata_2025 huggingface dataset:
Believing, Bonding, Behaving, and Belonging: The Cognitive, Emotional, Moral, and Social Dimensions of Religiousness across Cultures
Authors: Saroglou Vassilis , Clobert Magali , Cohen Adam B. , Johnson Kathryn A. , Ladd Kevin L. , Van Pachterbeke Matthieu , Adamovova Lucia , Blogowska Joanna , Brandt Pierre-Yves , Çukur Cem Safak , Hwang Kwang-Kuo , Miglietta Anna , Motti-Stefanidi Frosso , Muñoz-García Antonio , Murken Sebastian , Roussiau Nicolas , Tapia Valladares Javier
Published: August 2020

Based on theorization on the four basic dimensions of religiousness, Believing, Bonding, Behaving, and Belonging, and corresponding cognitive, emotional, moral, and social motives and functions of religion, we developed a measure and investigated cross-cultural consistency of the four dimensions as well interindividual and cross-cultural variability. Data were collected from 14 countries varying in religious heritage: Catholicism, Protestantism, Orthodox Christianity, Judaism, Islam, and Buddhism/Taoism ( N = 3,218). Beyond their high interrelation and common personality correlates, that is, agreeableness and conscientiousness, the four dimensions were distinct across cultures and religions, less interrelated in Eastern Asia compared to the West, differentially preferred across cultural zones, and characterized by distinct features. Believing and bonding, to which spirituality was primarily related, were preferred in Western secular societies. Behaving and belonging, valued in religious societies, were importantly related to fundamentalism, authoritarianism, and low openness. Bonding and behaving were primordial in, respectively, Israel and Turkey. Furthermore, belonging (marked by extraversion) and bonding were uniquely associated with increased life satisfaction, whereas believing was uniquely related to existential quest and decreased life satisfaction. Thus, the multidimensionality of religiousness seems deeply rooted in distinct psychological dispositions evident at both the individual and the cultural levels.
Investigation of the spray formation and breakup process in an open-end swirl injector
Authors: Chen Chen , Tang Zhigong
Published: August 2020

The spray formation and breakup process in an open-end swirl injector were studied through experiments and numerical simulations. A high-speed shadowgraph system and a high-speed backlight system were adopted to record the spray. Volume of fluid was used as the interface tracking method to capture the evolution process. The filling process of the liquid film inside the injector was captured. The air core formation process as observed in the experiments differed from that depicted by the numerical simulation results. The results revealed that the spray pattern of the cross-section at the tangential inlets also varied during the filling process. The evolution of the holes on the liquid film and ligaments was observed. It was determined that the liquid sheet repeatedly exhibited thinning, instability, shedding, breakup, and coalescence in the spray formation and breakup process. The spray pattern underwent the distorted pencil stage, onion stage, tulip stage, and fully developed stage with the increased injection pressure drop. The formation process of the open-end swirl injector also underwent these four stages under an injection pressure drop of 0.5 MPa.
The role of ultrasonography in the diagnosis of talocalcaneal coalitions
Authors: Wang Tiezheng , Qi Hengtao , Rong Kai , Zhang Shuqian , Bao Shougang , Cheng Tianqing , Teng Jianbo
Published: August 2020

Background

Patients with talocalcaneal coalitions (TCC) often undergo computed tomography (CT). However, ultrasonography diagnosis of TCC has been seldom done according to the literature.

Purpose

To investigate the accuracy of ultrasonography in diagnosing TCC compared to CT.

Material and Methods

Ninety-seven consecutive patients with a clinical suspicion of TCC were included. Ultrasonography was used to assess the classification and complication of TCC. The main sonographic criteria for a positive diagnosis in cases of osseous coalition were the joint space between the medial surface of talar head and the underlying sustentaculum tali of calcaneus disappearing and being replaced by a continuous hyperechoic bony structure. In cases of fibrous coalition, ultrasonography revealed a reduced space of the joint associated with an irregular, angular appearance of its outline and hypoechoic fibrous tissue inside. These data were compared with CT findings. κ statistic was applied to determine the level of agreement. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography as a diagnostic method were assessed.

Results

Ultrasonography findings were positive in 20 of 97 patients with a clinical suspicion of TCC. The diagnosis was confirmed by CT in 21 patients. There were one false-positive result and two false-negative results by ultrasonography. The κ value was 0.907. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography were 90.5%, 98.7%, 95.0%, 97.4%, 96.9%, and 0.892, respectively.

Conclusion

Ultrasonography could be a reliable, accurate, and non-radioactive diagnostic imaging method in diagnosis of patients with suspected TCC.
Optimization of pipeline system with multi-hoop supports for avoiding vibration, based on particle swarm algorithm
Authors: Liu Xudong , Sun Wei , Gao Ye , Ma Hui
Published: August 2020

In the dynamics design of aero-engine pipeline systems, it is necessary to avoid the excitation frequency of the engine (mainly including the rotational frequencies of high pressure and low pressure rotor systems) to improve the operational reliability of the pipeline system. In this study, a single-pipe system with multi-hoop supports was chosen as the research object, and a method based on the particle swarm algorithm was developed to optimize the layout of the hoops for effectively avoiding vibration of the pipeline system. A finite element model (FEM) of the pipeline system was created and the group of spring elements with non-uniform distribution of stiffness values was used to simulate the hoop support for improving the analysis accuracy of the model in the modeling process. Taking the hoop position as design variable, an optimization model of the pipe hoop layout was established, which aims at avoiding one or two excitation frequencies at the same time. Furthermore, the calculation procedure of optimizing pipe hoop layout using the particle swarm algorithm was given. Finally, a case study was carried out, the rationality of the created FEM was validated by experiments, and the optimal layout of hoops was obtained using the proposed optimization method.
How to be “groupy” matters: Groups with shared traits and shared goals engender distinct patterns of social judgments
Authors: Dang Jianning , Liu Li
Published: August 2020

By bringing in the Big-Two model of social perception, the present research extended previous literature regarding how people perceive homogeneous and cohesive groups from the process level to the content level. We compared the effects of intragroup similarity and interaction on warmth and competence judgments about groups. The similarity or interaction (high or low) of the novel groups (Study 1) and an international group (Study 2) was manipulated by descriptions. Participants were asked to rate the target groups on warmth- and competence-related traits. Consistent with our hypotheses, similarity polarized both warmth and competence judgments, whereas interaction polarized warmth judgments but enhanced competence judgments. The current research not only advances group perception research but also provides practical implications for improving group image and intergroup relations.
Place of death among older people in Finland and Norway
Authors: Forma Leena , Aaltonen Mari , Raitanen Jani , Anthun Kjartan S. , Kalseth Jorid
Published: August 2020

Aims: This study aimed to find out how place of death varied between countries with different health and social service systems. This was done by investigating typical groups (concerning age, sex and end-of-life trajectory) of older people dying in different places in Finland and Norway. Methods: The data were derived from national registers. All those who died in Finland or Norway at the age of ⩾70 years in 2011 were included. Place of death was analysed by age, sex, end-of-life trajectory and degree of urbanisation of the municipality of residence. Two-proportion z-tests were performed to test the differences between the countries. Multinomial logistic regression analyses were performed separately for both countries to find the factors associated with place of death. Results: The data consisted of 68,433 individuals. Deaths occurred most commonly in health centres in Finland and in nursing homes in Norway. Deaths in hospital were more common in Norway than they were in Finland. In both countries, deaths in hospital were more common among younger people and men. Deaths in nursing homes were commonest among frail older people, while most of those who had a terminal illness died in health centres in Finland and in nursing homes in Norway. Conclusions: Both Finland and Norway have a relatively low share of hospital deaths among older people. Both countries have developed alternatives to end-of-life care in hospital, allowing for spending the last days or weeks of life closer to home. In Finland, health centres play a key role in end-of-life care, while in Norway nursing homes serve this role.
Transcriptome profiling revealed potentially important roles of defensive gene expression in the divergence of insect biotypes: a case study with the cereal aphid Sitobion avenae
Authors: Wang Da , Liu Deguang , Shi Xiaoqin , Yang Yujing , Zhang Na , Shang Zheming
Published: August 2020

Background

Many insects can develop differential biotypes on variable host plants, but the underlying molecular factors and mechanisms are not well understood. To address this issue, transcriptome profiling analyses were conducted for two biotypes of the cereal aphid, Sitobion avenae (Fabricius), on both original and alternative plants.

Results

Comparisons between both biotypes generated 4174 differentially expressed unigenes (DEGs). In their response to host plant shift, 39 DEGs were shared by both biotypes, whereas 126 and 861 DEGs occurred only in biotypes 1 and 3, respectively. MMC (modulated modularity clustering) analyses showed that specific DEGs of biotypes 1 and 3 clustered into five and nine transcriptional modules, respectively. Among these DEGs, defense-related genes underwent intensive expression restructuring in both biotypes. However, biotype 3 was found to have relatively lower gene transcriptional plasticity than biotype 1. Gene enrichment analyses of the abovementioned modules showed functional divergence in defensive DEGs for the two biotypes in response to host transfer. The expression plasticity for some defense related genes was showed to be directly related to fecundity of S. avenae biotypes on both original and alternative plants, suggesting that expression plasticity of key defensive genes could have significant impacts on the adaptive potential and differentiation of S. avenae biotypes on different plants.

Conclusions

The divergence patterns of transcriptional plasticity in defense related genes may play important roles in the phenotypic evolution and differentiation of S. avenae biotypes. Our results can provide insights into the role of gene expression plasticity in the divergence of insect biotypes and adaptive evolution of insect populations.
Soluble neprilysin and long-term clinical outcomes in patients with coronary artery disease undergoing percutaneous coronary intervention: a retrospective cohort study
Authors: Choi Ik Jun , Lim Sungmin , Hwang Youngdeok , Lee Dongjae , Lee Won Jik , Lee Kwan Yong , Kim Mi-Jeong , Jeon Doo Soo
Published: August 2020

Background

Neprilysin has an essential role in regulating fluid balance and vascular resistance, and neprilysin inhibitors have shown beneficial effects in patients with heart failure. However, the potential predictive value of neprilysin levels as a biomarker for cardiovascular risk remains unclear. The aim of this study was to assess the prognostic value of soluble neprilysin (sNEP) levels in patients with ischemic heart disease.

Methods

Neprilysin levels were measured in 694 consecutive patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). These patients were classified into two groups according to their serum levels of neprilysin and categorized into the lower neprilysin group (n = 348) and the higher neprilysin group (n = 346). The primary clinical endpoint was all-cause mortality, and the secondary endpoint was a composite of major adverse cardiac events (MACE).

Results

The median sNEP level was 76.0 pg/ml. The median sNEP levels were higher in patients with left ventricular ejection fraction (LVEF) ≥40% (77.6 pg/ml, interquartile range 46.6–141.3) than in those with LVEF < 40% (70.0 pg/ml, interquartile range 47.1–100.6;P = 0.032). Among all patients, each clinical outcome and MACE did not differ significantly according to the groups divided into median, tertile, or quartile of sNEP levels during a median follow-up of 28.4 months. We did not find a significant relationship between sNEP levels and clinical outcomes in multivariate Cox regression analysis. Among patients with LVEF < 40%, an increased sNEP level was associated with a higher rate of all-cause death (adjusted hazard ratio 2.630, 95% confidence interval 1.049–6.595,P = 0.039).

Conclusion

Serum sNEP levels are not associated with long-term mortality or cardiovascular outcomes after PCI in patients with CAD. In the LVEF < 40% group, increased sNEP levels may be associated with a higher risk of all-cause death.
The Durham Initiative for Stomach Health (DISH): a pilot community-based Helicobacter pylori education and screening study
Authors: Crankshaw Sydnee , Butt Julia , Gierisch Jennifer M. , Barrett Nadine J. , Mervin-Blake Sabrena , Oeffinger Kevin , Patierno Steven , Worthy Valarie , Godbee Ronald , Epplein Meira
Published: August 2020

Background

Approximately 15% of all cancers are due to infection. The bacteriaHelicobacter pyloriis the single leading carcinogenic infectious agent and the main cause of stomach cancer. Prevalence ofH. pylori, and, correspondingly, stomach cancer incidence and mortality, is significantly greater among African Americans than whites in the United States. In the present study, we conducted a pilot community-engagedH. pylorieducation and screening study in partnership with a predominantly African American church in Durham, North Carolina.

Methods

Initially, we consulted with community advisory boards and convened stakeholder meetings with local community members and primary care physicians. We then developed this pilot study through an iterative collaboration with church partners. Our main outcomes were feasibility and acceptability as measured by participation in a one-dayH. pyloriscreening initiative, and participation in follow-up for those who tested positive. We also sought to determine prevalence and determinants of activeH. pyloriinfection in this population.

Results

Community engagement informed the event logistics, messaging, educational materials provided, and follow-up plans. A total of 92 individuals participated in the primary study event, 25% of whom had a currentH. pyloriinfection. Of those, 87% returned for the follow-up events, among whom 70% had successfully cleared their infection.

Conclusions

Through community engagement, community-basedH. pyloriscreening and stomach cancer prevention is feasible and acceptable. This is a necessary step in order to move stomach cancer prevention forward to population-based precisionH. pyloriscreening and eradication.
Clinical characteristics and risk factors of patients with severe COVID-19 in Jiangsu province, China: a retrospective multicentre cohort study
Authors: Liu Songqiao , Luo Huanyuan , Wang Yuancheng , Cuevas Luis E. , Wang Duolao , Ju Shenghong , Yang Yi
Published: August 2020

Background

Coronavirus Disease-2019 (COVID-19) pandemic has become a major health event that endangers people health throughout China and the world. Understanding the factors associated with COVID-19 disease severity could support the early identification of patients with high risk for disease progression, inform prevention and control activities, and potentially reduce mortality. This study aims to describe the characteristics of patients with COVID-19 and factors associated with severe or critically ill presentation in Jiangsu province, China.

Methods

Multicentre retrospective cohort study of all individuals with confirmed Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infections diagnosed at 24 COVID-19-designated hospitals in Jiangsu province between the 10th January and 15th March 2020. Demographic, clinical, laboratory, and radiological data were collected at hospital admission and data on disease severity were collected during follow-up. Patients were categorised as asymptomatic/mild/moderate, and severe/critically ill according to the worst level of COVID-19 recorded during hospitalisation.

Results

A total of 625 patients, 64 (10.2%) were severe/critically ill and 561 (89.8%) were asymptomatic/mild/moderate. All patients were discharged and no patients died. Patients with severe/critically ill COVID-19 were more likely to be older, to be single onset (i.e. not belong to a cluster of cases in a family/community, etc.), to have a medical history of hypertension and diabetes; had higher temperature, faster respiratory rates, lower peripheral capillary oxygen saturation (SpO2), and higher computer tomography (CT) image quadrant scores and pulmonary opacity percentage; had increased C-reactive protein, fibrinogen, and D-dimer on admission; and had lower white blood cells, lymphocyte, and platelet counts and albumin on admission than asymptomatic/mild/moderate cases. Multivariable regression showed that odds of being a severe/critically ill case were associated with age (year) (OR 1.06, 95%CI 1.03–1.09), lymphocyte count (109/L) (OR 0.25, 95%CI 0.08–0.74), and pulmonary opacity in CT (per 5%) on admission (OR 1.31, 95%CI 1.15–1.51).

Conclusions

Severe or critically ill patients with COVID-19 is about one-tenths of patients in Jiangsu. Age, lymphocyte count, and pulmonary opacity in CT on admission were associated with risk of severe or critically ill COVID-19.
Staphylococcal endocarditis in a quadricuspid aortic valve following uncomplicated dengue infection: a case report
Authors: Weerasooriya Nilusha , Fernando Tharanga , Serasinghe Pasan , Alahakoon Buddhika , Madurapperuma Chirath , Jayanaga Ananda
Published: August 2020

Background

Dengue fever is endemic and a leading health problem in Sri Lanka. Increased incidence of concurrent bacteremia in patients with dengue infection is a recognized complication. However, Staphylococcal endocarditis following dengue fever is uncommon. Quadricuspid aortic valve (QAV) is a rare congenital anomaly and few cases of infective endocarditis have been reported in QAV.

Case presentation

A 32-year-old Sri Lankan male presented to the National Hospital of Sri Lanka with recurrence of fever and acute left hemiplegia following an uncomplicated recovery of dengue fever. He was diagnosed to have Staphylococcal infective endocarditis of quadricuspid aortic valve, with septic emboli to brain and spleen. He was managed with intravenous vancomycin initially, however, due to inadequate response, intravenous linezolid was added. He developed rhabdomyolysis with very high creatine phosphokinase leading to acute kidney injury, which settled with the cessation of linezolid. The patient succumbed to his illness despite aggressive antimicrobial therapy and maximum supportive care while being assessed for aortic valve replacement.

Conclusions

This case illustrates three clinical issues that a clinician should be aware of. Firstly, the possibility of a serious secondary bacterial infection as a cause for recurrence of fever following dengue infection. Secondly, this case highlights the importance of identifying QAV as a cause for complicated infective endocarditis of increased severity. The report also denotes the value of being vigilant of linezolid induced rhabdomyolysis which had a causal relationship with the commencement of the drug and its cessation.
Quick assessment of influenza a virus infectivity with a long-range reverse-transcription quantitative polymerase chain reaction assay
Authors: Nakaya Yuki , Fukuda Takashi , Ashiba Hiroki , Yasuura Masato , Fujimaki Makoto
Published: August 2020

Background

The polymerase chain reaction (PCR) is commonly used to detect viral pathogens because of its high sensitivity and specificity. However, conventional PCR methods cannot determine virus infectivity. Virus infectivity is conventionally examined with methods such as the plaque assay, even though such assays require several days. Long-range reverse-transcription quantitative PCR (RT-qPCR) has previously been suggested for the rapid assessment of RNA virus infectivity where the loss of infectivity is attributable to genomic fragmentation.

Methods

IAV was irradiated with 253.7 nm ultraviolet (UV) rays to induce genomic strand breaks that were confirmed by a full-length RT-PCR assay. The IAV was then subjected to plaque assay, conventional RT-qPCR and long-range RT-qPCR to examine the relationship between infectious titer and copy number. A simple linear regression analysis was performed to examine the correlation between the results of these assays.

Results

A long-range RT-qPCR assay was developed and validated for influenza A virus (IAV). Although only a few minutes of UV irradiation was required to completely inactivate IAV, genomic RNA remained detectable by the conventional RT-qPCR and the full-length RT-PCR for NS of viral genome following inactivation. A long-range RT-qPCR assay was then designed using RT-priming at the 3′ termini of each genomic segment and subsequent qPCR of the 5′ regions. UV-mediated IAV inactivation was successfully analyzed by the long-range RT-qPCR assay especially when targeting PA of the viral genome. This was also supported by the regression analysis that the long-range RT-qPCR is highly correlated with plaque assay (AdjustedR2 = 0.931,P = 0.000066).

Conclusions

This study suggests that IAV infectivity can be predicted without the infectivity assays. The rapid detection of pathogenic IAV has, therefore, been achieved with this sensing technology.
Feasibility study of using simultaneous multi-slice RESOLVE diffusion weighted imaging to assess parotid gland tumors: comparison with conventional RESOLVE diffusion weighted imaging
Authors: Jiang Jia-Suo , Zhu Liu-Ning , Wu Qian , Sun Yi , Liu Wei , Xu Xiao-Quan , Wu Fei-Yun
Published: August 2020

Background

To evaluate the feasibility of using simultaneous multi-slice (SMS) readout segmentation of long variable echo-trains (RESOLVE) diffusion-weighted imaging (DWI) to assess parotid gland tumors, compared with conventional RESOLVE DWI.

Methods

From September 2018 to December 2018, 20 consecutive patients with parotid tumors who underwent MRI scan for pre-surgery evaluation were enrolled. SMS-RESOLVE DWI and conventional RESOLVE DWI were scanned with matched imaging parameters, respectively. The scan time of two DWI sequences was recorded. Qualitative (anatomical structure differentiation, lesion display, artifact, and overall image quality) and quantitative (apparent diffusion coefficient, ADC; ratio of signal-to-noise ratio, SNR ratio; ratio of contrast-to-noise ratio, CNR ratio) assessments of image quality were performed, and compared between SMS-RESOLVE DWI and conventional RESOLVE DWI by using Paired t-test. Two-sided P value less than 0.05 indicated significant difference.

Results

The scan time was 3 min and 41 s for SMS-RESOLVE DWI, and 5 min and 46 s for conventional RESOLVE DWI. SMS-RESOLVE DWI produced similar qualitative image quality with RESOLVE DWI (anatomical structure differentiation, P = 0.164; lesion display, P = 0.193; artifact, P = 0.330; overall image quality, P = 0.083). Meanwhile, there were no significant difference on ADCLesion (P = 0.298), ADCMasseter (P = 0.122), SNR ratio (P = 0.584) and CNR ratio (P = 0.217) between two DWI sequences.

Conclusion

Compared with conventional RESOLVE DWI, SMS-RESOLVE DWI could provide comparable image quality using markedly reduced scan time. SMS could increase the clinical usability of RESOLVE technique for DWI of parotid gland.
The use of activated vitamin D and risks of hospitalization for infection and amputation in incident hemodialysis patients in Taiwan: a nationwide population-based cohort study
Authors: Chao Jo-Yen , Li Chung-Yi , Wang Ming-Cheng , Kao Yang Yea-Huei
Published: August 2020

Background

Hemodialysis patients have a high risk of mortality. The most common causes of death are cardiovascular disease and infection. The potential hazard or benefit associated with vitamin D use and cardiovascular or infection outcome is poorly characterized.

Methods

We conducted a retrospective observational cohort study by recruiting 52,757 patients older than 20 years from Taiwan National Health Insurance Research Database (NHIRD) who initiated maintenance hemodialysis between 2001 and 2009. Patients who were prescribed activated vitamin D before the 360th day from hemodialysis initiation were defined as vitamin D users. The primary outcome of interest includes occurrence of acute myocardial infarction (AMI), ischemic stroke, lower limb amputation, and hospitalization for infection, respectively, while death events are treated as competing events. We conducted competing risk analysis using subdistribution hazard regression model to estimate subdistribution hazard ratios (SHRs) in relation to various outcomes.

Results

During the median follow-up of 1019 days, the vitamin D users had a lower crude mortality rate, lower incidences of AMI, ischemic stroke, amputation, and hospitalization for infection compared with non-users. Taking into consideration competing events of death, vitamin D users were associated with a lower hazard of lower limb amputation (SHR 0.84 [95% CI, 0.74–0.96]) and hospitalization for infection (SHR 0.90 [95% CI, 0.87–0.94]), but not AMI or ischemic stroke, after adjustment for potential confounders. Subgroup analyses and dose response evaluation both showed a consistent association of activated vitamin D treatment with decreased risk of amputation and infection.

Conclusion

The findings suggest that therapeutic activated vitamin D use in hemodialysis patients may be beneficial for decreasing infection events and amputation, of which the latter is a complication of peripheral vascular disease, rather than reducing major atherosclerotic cardiovascular events such as AMI or ischemic stroke.
Predictors of persistent disease activity following anti-VEGF loading dose for nAMD patients in Singapore: the DIALS study
Authors: Tan Colin S. , Lim Louis W. , Ngo Wei Kiong , Pannirselvam Pandiyan , See Clarence , Chee Wai Kitt , Saxena Nakul
Published: August 2020

Background

To determine the frequency of persistent disease activity following 3 loading doses of anti- vascular endothelial growth factor (VEGF) agents, and the anatomic and demographic predictors of early persistent disease activity among patients with neovascular age-related macular degeneration (nAMD).

Methods

In a retrospective real-world cohort study, 281 consecutive patients with nAMD were reviewed at baseline and after 3 anti-VEGF injections for pre-defined indicators of disease activity. Optical coherence tomography (OCT) features such as subretinal fluid, intraretinal cysts and intraretinal fluid were assessed by reading-center certified graders. Multiple logistic regression was performed on demographic and anatomic factors.

Results

At month 3, 66.1% of patients had persistent disease activity. The best-corrected visual acuity (BCVA) improvement was 0.16 LogMAR for those with no disease activity compared to 0 for patients with persistent activity (p < 0.001). The significant risk factors for persistent activity at 3 months were male gender (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.32–0.93, p = 0.025), intraretinal cysts at baseline (OR 2.95, 95% CI 1.67–5.20, p < 0.001) and subretinal fluid at baseline (OR 3.17, 95% CI 1.62–6.18, p = 0.002). At 3 months, 58% of patients had features of activity on OCT. Patients with intraretinal cysts and intraretinal fluid at baseline had worse BCVA at month 3 compared to patients without these OCT features (0.69 vs. 0.43, p < 0.001, and 0.62 vs. 0.43, p < 0.001, respectively).

Conclusions

In a real-world study, 66.1% of nAMD patients have persistent disease activity after the initial loading dose, with poorer BCVA compared to those without. Baseline OCT features (intraretinal cysts and subretinal fluid) are useful predictors of persistent disease activity at month 3.
Multi-parametric evaluation of autologous cultivated Limbal epithelial cell transplantation outcomes of Limbal stem cell deficiency due to chemical burn
Authors: Selver Ozlem Barut , Gurdal Mehmet , Yagci Ayse , Egrilmez Sait , Palamar Melis , Cavusoglu Turker , Veral Ali , Guven Cagri , Ates Utku , Wang Zheng , Wolosin J. Mario
Published: August 2020

Background

The sparsity of established tools for the grading of limbal stem cell deficiency hinder objective assessments of the clinical outcome of cultivated limbal epithelial cell transplantation. To advance towards the development of standards for the comparison of the outcomes of these bio-surgical protocols we have now applied a battery of recognized objective and patient-declared subjective outcome criteria to the autologous modality of cultivated limbal epithelial cell transplantation.

Methods

The prospective study involved ten patients (M/F = 9/1; mean age = 42.1 years) displaying overt unilateral limbal stem cell deficiency complying with the inclusion criteria described in Methods. Limbal biopsies were obtained from the contralateral eye and their outgrowths after 2-week cultures were transplanted on the affected eye after pannus resection. Outcomes were followed up for 12 months. The objective tests were scores for best-corrected visual acuity (BCVA); using the LogMAR scale, a multiparametric ocular surface score (OSS), and the Schirmer’s test. Subjective scores were based on patient answers to a) perception of visual improvement/pain; b) the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ 25); and c) the 12-item Ocular Surface Disease Index Questionnaire (OSDI). All procedures were performed under good manufacture practices using solely xeno-free reagents. In all cases, a single biopsy was divided into two pieces and they were expanded in order to prevent outgrowth failure. In 5 patients, both biopsies generated healthy culture sheet. In those cases the lesser outgrowth were used for immune-histological characterization.

Results

The experimental parallel outgrowth samples showed a similar percent of p63α+ cells. PreOp and 12-month PostOp BCVAs and OSSs were, respectively, 1.15 ± 0.70; 0.21 ± 0.13 and 7.40 ± 2.01; 2,30 ± 1.30, (p < 0.05). Patient’s responses to all three question sets except ocular pain were consistent with significant improvement (p < 0.05).

Conclusion

Objective clinical metrics demonstrate that in patients with limbal stem cell deficiency, cultivated limbal epithelial cell transplantation improves vision and ocular surface health and subjective visual perceptions.
Psychiatric inpatient beds for youths in China: data from a nation-wide survey
Authors: Geng Feng , Jiang Feng , Rakofsky Jeffrey , Liu Tingfang , Liu Yuanli , Liu Huanzhong , Tang Yi-lang
Published: August 2020

Background

The development of child psychiatric services in China has been slow and very limited resources have been allocated to support its growth. This study set out to investigate the child and adolescent inpatient psychiatric resources currently available in top-tier psychiatric hospitals in China and the characteristics of youth patients hospitalized on an adult unit.

Methods

As part of an official national survey, 29 provincial tertiary psychiatric hospitals in China were selected. Data from 1975 inpatients discharged from these hospitals from March 19 to 31, 2019 were retrieved and analyzed.

Results

The mean number of youth psychiatric beds was 27.7 ± 22.9 in these hospitals and 6/29 hospitals had no youth beds. There were significantly more youth beds in developed regions than in less developed regions (P < 0.05). Most of the discharged youth patients were teenagers with severe mental illnesses, including schizophrenia, depressive disorder and bipolar disorder. 7.5% (149) of the 1975 discharged patients were children or adolescents, however youth beds only accounted for 3.2% (804/25,136) of all psychiatric beds. 45.6% (68) of youth patients were discharged from adult psychiatric units.

Conclusion

Our findings highlight the lack of adequate youth psychiatric inpatient services for children and adolescents living in China, especially in less developed regions. There is an urgent need to build more child and adolescent psychiatric units in provinces where there are none, and to increase the number of beds within the units that exist presently.
Pathogenesis, diagnosis and management of dentin hypersensitivity: an evidence-based overview for dental practitioners
Authors: Liu Xiu-Xin , Tenenbaum Howard C. , Wilder Rebecca S. , Quock Ryan , Hewlett Edmond R. , Ren Yan-Fang
Published: August 2020

Though dentin hypersensitivity (DHS) is one of the most common complaints from patients in dental clinics, there are no universally accepted guidelines for differential diagnosis as well as selection of reliable treatment modalities for this condition. The neurosensory mechanisms underlying DHS remain unclear, but fluid movements within exposed dentinal tubules, i.e., the hydrodynamic theory, has been a widely accepted explanation for DHS pain. As several dental conditions have symptoms that mimic DHS at different stages of their progression, diagnosis and treatment of DHS are often confusing, especially for inexperienced dental practitioners. In this paper we provide an up-to-date review on risk factors that play a role in the development and chronicity of DHS and summarize the current principles and strategies for differential diagnosis and management of DHS in dental practices. We will outline the etiology, predisposing factors and the underlying putative mechanisms of DHS, and provide principles and indications for its diagnosis and management. Though desensitization remains to be the first choice for DHS for many dental practitioners and most of desensitizing agents reduce the symptoms of DHS by occluding patent dentinal tubules, the long-term outcome of such treatment is uncertain. With improved understanding of the underlying nociceptive mechanisms of DHS, it is expected that promising novel therapies will emerge and provide more effective relief for patients with DHS.
Attitudes towards Interprofessional education in the medical curriculum: a systematic review of the literature
Authors: Berger-Estilita Joana , Fuchs Alexander , Hahn Markus , Chiang Hsin , Greif Robert
Published: August 2020

Background

There is agreement among educators and professional bodies that interprofessional education needs to be implemented at the pre-registration level. We performed a systematic review assessing interprofessional learning interventions, measuring attitudes towards interprofessional education and involving pre-registration medical students across all years of medical education.

Methods

A systematic literature review was performed using PubMed, PsycINFO, EThOS, EMBASE, PEDro and SCOPUS. Search terms were composed of interprofession*, interprofessional education, inter professional, inter professionally, IPE, and medical student. Inclusion criteria were 1) the use of a validated scale for assessment of attitudes towards IPE, and results for more than 35 medical students; 2) peer-reviewed articles in English and German, including medical students; and 3) results for IPE interventions published after the 2011 Interprofessional Education Collaborative (IPEC) report. We identified and screened 3995 articles. After elimination of duplicates or non-relevant topics, 278 articles remained as potentially relevant for full text assessment. We used a data extraction form including study designs, training methods, participant data, assessment measures, results, and medical year of participants for each study. A planned comprehensive meta-analysis was not possible.

Results

This systematic review included 23 articles with a pre-test-post-test design. Interventions varied in their type and topic. Duration of interventions varied from 25 min to 6 months, and interprofessional groups ranged from 2 to 25 students. Nine studies (39%) reported data from first-year medical students, five (22%) from second-year students, six (26%) from third-year students, two (9%) from fourth-year students and one (4%) from sixth-year students. There were no studies including fifth-year students. The most frequently used assessment method was the Readiness for Interprofessional Learning Scale (RIPLS) (n = 6, 26%). About half of study outcomes showed a significant increase in positive attitudes towards interprofessional education after interventions across all medical years.

Conclusions

This systematic review showed some evidence of a post-intervention change of attitudes towards IPE across different medical years studied. IPE was successfully introduced both in pre-clinical and clinical years of the medical curriculum. With respect to changes in attitudes to IPE, we could not demonstrate a difference between interventions delivered in early and later years of the curriculum.

Trial registration

PROSPERO registration number: CRD42020160964.
E-health literacy and associated factors among chronic patients in a low-income country: a cross-sectional survey
Authors: Shiferaw Kirubel Biruk , Tilahun Binyam Chakilu , Endehabtu Berhanu Fikadie , Gullslett Monika Knudsen , Mengiste Shegaw Anagaw
Published: August 2020

Background

Chronic patients persistently seek for health information on the internet for medication information seeking, nutrition, disease management, information regarding disease preventive actions and so on. Consumers ability to search, find, appraise and use health information from the internet is known as eHealth literacy skill. eHealth literacy is a congregate set of six basic skills (traditional literacy, health literacy, information literacy, scientific literacy, media literacy and computer literacy). The aim of this study was to assess eHealth literacy level and associated factors among internet user chronic patients in North-west Ethiopia.

Methods

Institutional based cross-sectional study design was conducted. Stratified sampling technique was used to select 423 study participants among chronic patients. The eHealth literacy scale (eHEALS) was used for data collection. The eHEALS is a validated eight-item Likert scaled questionnaire used to asses self-reported capability of eHealth consumers to find, appraise, and use health related information from the internet to solve health problems. Statistical Package for Social science version 20 was used for data entry and further analysis. Multivariable logistic regression was used to examine the association between the eHealth literacy skill and associated factors. Significance was obtained at 95% CI and p < 0.05.

Result

In total, 423 study subjects were approached and included in the study from February to May, 2019. The response rate to the survey was 95.3%. The majority of respondents 268 (66.3%) were males and mean age was 35.58 ± 14.8 years. The multivariable logistic regression model indicated that participants with higher education (at least having the diploma) are more likely to possess high eHealth literacy skill with Adjusted Odds Ratio (AOR): 3.48, 95% CI (1.54, 7.87). similarly, being government employee AOR: 1.71, 95% CI (1.11, 2.68), being urban resident AOR: 1.37, 95% CI (0.54, 3.49), perceived good health status AOR: 3.97, 95% CI (1.38, 11.38), having higher income AOR: 4.44, 95% CI (1.32, 14.86), Daily internet use AOR: 2.96, 95% CI (1.08, 6.76), having good knowledge about the availability and importance of online resources AOR: 3.12, 95% CI (1.61, 5.3), having positive attitude toward online resources AOR: 2.94, 95% CI (1.07, 3.52) and higher level of computer literacy AOR: 3.81, 95% CI (2.19, 6.61) were the predictors positively associated with higher eHealth literacy level.

Conclusion

Besides the mounting indication of efficacy, the present data confirm that internet use and eHealth literacy level of chronic patients in this setting is relatively low which clearly implicate that there is a need to fill the skill gap in eHealth literacy among chronic patients which might help them in finding and evaluating relevant online sources for their health-related decisions.
Foot care knowledge and practices among Japanese nurses and care workers in home care and adult service center: a cross- sectional study
Authors: Fujii Kashiko , Komoda Takuyuki , Maekawa Atsuko , Nishikawa Mariko
Published: August 2020

Background

Foot care knowledge and practices among nurses and care workers in the community greatly impact foot health maintenance and prevention of foot-related problems among older people. This study aimed to explore and examine the current foot care knowledge, practices, and perceptions among nurses and care workers at home care and adult day service center, along with their demographic characteristics and daily care for clients.

Methods

This study analyzed 232 randomly selected front-line nurses and care workers working at home care or adult day service center in one of the selected cities, Aichi Prefecture, Japan. Data were obtained using questionnaires and subsequently analyzed using descriptive statistics, t-tests, Chi-square tests, Wilcoxon rank-sum tests, and Spearman’s rank correlation tests.

Results

Among the 305 surveyed, 232 (62 nurses; 170 care workers) provided data. Although 57 nurses (91.9%) and 142 care workers (83.5%) showed interest in foot care, 33 nurses (53.2%) and 133 care workers (78.2%) stated that foot care education was insufficient. Knowledge and practice scores were associated with working status.

Higher accuracy differences in the early detection of foot problems and skin tears on lower limbs in knowledge category were observed between nurses and care workers. The nurses as well as the care workers had low accuracy rates of knowledge questions regarding the use of shoes and socks subscale.

For practice, both nurses and care workers had low mean scores for checking client’s shoes (2.0/5.0 and 2.1/5.0, respectively), method for reducing ingrown nail pain (2.6/5.0 and 1.9/5.0, respectively), and opportunity for discussing foot care with others (2.7/5.0 and 2.2/5.0, respectively). A significant correlation between knowledge and practice scores was observed among nurses (0.331, p < 0.05) and care workers (0.339, p < 0.001).

Conclusions

Despite the presence of several barriers toward enhanced care delivery to clients needing it most, nurses and care workers clearly understood the importance of foot care. These findings indicate that foot care should be focused by nurses and care workers to improve the knowledge and practice of foot care and to suggest future implications that efficient and understandable tools are needed considering their current working situation.
Consolidating strategic information to monitor progress against the UNAIDS 90–90–90 targets: evaluating the operational feasibility of an electronic HIV testing register in Cape Town, South Africa
Authors: Jacob Nisha , Rice Brian , Kalk Emma , Heekes Alexa , Morgan Jennie , Brinkmann Samantha , Hargreaves James , Orgill Marsha , Boulle Andrew
Published: August 2020

Background

HIV diagnosis in South Africa is based on a point-of-care testing (PoCT) algorithm with paper-based record-keeping. Aggregated testing data are reported routinely. To facilitate improved HIV case-based surveillance, the Western Cape Province implemented a unique pilot intervention to digitise PoCT results, at an individual level, and generate an electronic register using the newly developed Provincial Health Data Centre (PHDC). We describe the intervention (phased) and present an evaluation of the operational feasibility of the intervention. We also offer implementation insights into establishing electronic capture of individual level testing data.

Methods

Cross-sectional analyses were conducted on records of all patients attending a local Community Health Centre who had an HIV-PoCT during the study period. Data from the intervention were linked to the PHDC using a unique identifier and compared with aggregate data from the paper-based register. Correlation coefficients were calculated to quantify the correlation between the two monthly datasets. To support an understanding of the findings, the Department of Health project management team generated reflections on the implementation process, which were then grouped thematically into implementation lessons.

Results

In total, 11,337 PoCT records were digitised (70% (7954) during Phase I; and 30% (3383) during Phase II). Linkage of forms to the PHDC was 96% in Phase I and 98% in Phase II. Comparison with aggregate data showed high correlation during Phase I, but notable divergence during Phase II. Divergence in Phase II was due to stringent data quality requirements and high clinical staff turnover. Factors supporting implementation success in Phase I included direct oversight of data capturing by a manager with clinical and operational insight. Implementation challenges included operational, health system, and high cost-related issues.

Conclusions

We demonstrate that rapid digitisation of HIV PoCT data, without compromising currently collected aggregate data, is operationally feasible, and can contribute to person-level longitudinal HIV case-based surveillance. To take to scale, we will need to improve PoCT platforms and clerical and administrative systems. Although we highlight challenges, we demonstrate that electronic HIV testing registers can successfully replace manual registers and improve efforts to monitor and evaluate HIV testing strategies.