bluuebunny/crossref_metadata_2025 huggingface dataset:
STUDENT AND TEACHER PERSPECTIVES ON FACTORS TO SUCCESS AND ATTRITION IN ENGINEERING MINI-MOOC USING TECHNOLOGY ACCEPTANCE MODEL (TAM)
Authors: Yee Lee Gwyneth Ka
Published: August 2019

Purpose: To keep abreast of the latest educational development and to enrich student learning. Vocational Training Council (VTC) is among the first vocational institutions in Hong Kong for piloting massive open online courses (MOOCs) (which are being referred as mini-MOOCs here) on various disciplines. This paper examines one of the mini-MOOCs we have developed for the Engineering discipline. The aim of this study is to gather information and investigate the influencing factors that contribute to the success and attrition in the Engineering mini-MOOC.

Methodology: These insights come from the empirical study conducted in a mini-MOOC titled “Unauthorized Buildings Works” (UBWs), which was being implemented as a blended activity in the module. Two groups of second-year students from the higher diploma in construction were selected to participate in non-MOOC (i.e., the control group) and MOOC (i.e., the experimental group) classes over two years. The mini-MOOC subjects were invited to complete questionnaires and attend a focus group interview upon completion of the activity.

Main Findings: The analysis yielded striking results, which led to a discussion on the contributing factors to success and attrition in the Engineering mini-MOOC using Technology Acceptance Model (TAM).

Implications: Due to limited resources in the research, the methods of data collection were different over two years of study. An implication of this is that an enhanced methodology is needed to determine the academic effectiveness of the mini-MOOC and achieve the consistency of the findings.

Novelty/Originality: The present study contributes to significant findings in how TAM factors and external variables influenced the usage of mini-MOOC from the perspectives of both learners and teachers.
MEANINGFULNESS OF WORK AND PERCEIVED ORGANIZATIONAL PRESTIGE AS PRECURSORS OF ORGANIZATIONAL CITIZENSHIP BEHAVIOR
Authors: Sharma Abhishek
Published: August 2019

Purpose of the study: The present study explores the impact of meaningfulness of work and perceived organizational prestige on organizational citizenship behavior of managerial employees. Methodology: The study was conducted on 75 mid-level managerial employees working in various organizations in India with the help of convenient sampling method. Standardized questionnaires were used to complete this research. Bivariate Correlation analysis was performed to assess the relationship between meaningfulness of work, perceived organizational prestige, and organizational citizenship behavior. Linear Regression analysis was used to determine the direct contribution of meaningfulness of work and perceived organizational prestige in organizational citizenship behavior of managerial employees. Main findings: The results showed that the meaningfulness of work and perceived organizational prestige were positively correlated. The outcomes explained the significant positive variance in organizational citizenship behavior and described how important it is to focus on these two constructs. The originality of the study: The results contribute to the concerned literature by explaining and emphasizing the importance of meaningfulness of work and perceived organizational prestige and facilitate a reflection on the links that motivate employees to work beyond their prescribed duties. Organizations and management should focus on and align their policies to create and maintain conditions responsible for nurturing the habit of organizational citizenship behavior among their employees.
A REVIEW OF INDIAN GOVERNMENT INCLUSIVE INITIATIVES: POVERTY ON THE DECLINE
Authors: Mundra Dr. Sheetal
Published: August 2019

Purpose of the study: The ineffectiveness of the Indian development planning model reflected in India’s largest share in the count of poor people for the year 2016. This paper depicts the current poverty situation and the importance of poverty reduction in India. It also explores the socioeconomic determinants affecting poverty across different states of India and the possible reasons of the recent decline in the poverty ratio in India during the Modi reform era (2015-2018). Methodology: The study is based on secondary data. The data of 28 Indian states for the year 2009-10 and 2011-12 have been considered on key inclusive socioeconomic indicators, namely, Human Development Index (HDI), Work Participation Rate, Gini-coefficient, Gross State Domestic Product, Mahatma Gandhi National Rural Employment Guarantee Act expenditure, and Poverty Head Count Ratio. The variation in the poverty headcount ratio, having the combined effect of these indicators, has been measured through the multiple regression model and presented with the help of SPSS. Main Findings: The paper concludes that HDI is the most significant determinant in both years (2009-10 and 2011-12) across different states of India. It underlines the fact that major inclusive initiatives during the Modi reform era have been coincidentally directed towards the improvement of health and education and the generation of income, resulting in poverty reduction. Thus, right initiatives require the right direction for their effectiveness. Applications of this study: This study will help in highlighting the key inclusive initiatives of performance and in supporting these initiatives to reduce poverty in India. India can be considered as a model for many developing countries to follow such inclusive initiatives, identify the significant determinant of poverty, and get rid of it. Novelty/Originality of this study: This paper sheds light on key determinants of poverty in the Indian context. The paper examines the government inclusive initiatives in the context of identifying the determinants that help in supporting the right initiatives towards the right direction, resulting in the reduction of poverty in India.
ONLINE FORUMS: COMMUNICATION MODEL, CATEGORIES OF ONLINE COMMUNICATION REGULATION AND NORMS OF BEHAVIOR
Authors: Bylieva Daria , Lobatyuk Victoria , Safonova Alla
Published: August 2019

Purpose of the study: The paper addresses the issue of regulating Internet communication activities in the context of online forums. The study aims to create a forum communication model identifying the areas subject to social regulation and defining the most common types of norms

Methodology: The study draws upon the semiotic method to develop a new communication model based on classical theories. Quantitative empirical studies are also used. The rules and guidelines of 1,205 online forums were analyzed to identify the most common norms.

Main Findings: Communicators and moderators access the forum communication space via user accounts and create a sign system. Some categories, such as a ban on deceptive or offensive content, are similar to those used in offline life. Other regulations are Internet-specific in that they are determined by inherent challenges of online communication (for example, account cloning) or by the way a forum is structured.

Applications of this study: The findings related to the forum rules are presented in a summarized manner, although the rules vary slightly in reality, depending on the forum topic. The prevalence of deviant behaviors on online forums was also beyond the scope of this study. The study was based on the rules of Russian- and English-speaking forums, and it should be noted that language differences could influence the results.

Social Implications: The evolving social interactions on the Web require regulations, which can differ significantly from those used offline. The study of social norms on the Internet allows us to trace what types of online behavior are now considered deviant and examine the current potential of Internet self-regulation.

Novelty/Originality of this study: The study developed a new communication model for categorizing online communication norms. Major categories of online communication behavior regulation were identified and the most popular types of social norms were determined.
LEADING CHANGE: CONVINCING PEOPLE AGAINST THE STATUS QUO
Authors: E. Evans Gerald , G. Evans Michael
Published: August 2019

Purpose: The purpose of this study is to investigate resistance to change. This is a well-documented phenomenon in the change literature. Overcoming this resistance is a critical component to effective change leadership.

Methodology: A structured interview technique was employed using a survey instrument that guided the interview pro- cess. Interviews were completed with 89 individuals. A snowball sampling technique was employed beginning with 30 undergraduate students who each completed the interview.

Main Findings: This research indicates that individuals who are dissatisfied with the status quo are less likely to resist change.  Individuals who perceived that the current status served them well and met their current needs were less likely  to embrace or support proposed changes to the status quo. This perception demonstrates risk aversion to potential losses. Conversely, individuals who perceived that the current state did not serve them well or meet their current needs and interests were more likely to embrace and support proposed changes to the status quo demonstrating risk - seeking in the face of potential gains.

Implications: The results can be applied as an effective method for moving people through the change process by convinc- ing them that the current situation has low utility.

Novelty: This paper is one of only a few instances where Prospect Theory and loss aversion has been linked to resistance to change.
Genome-wide identification, molecular evolution, and expression analysis provide new insights into the APETALA2/Ethylene Responsive Factor (AP2/ERF) transcription factor superfamily in Dimocarpus longan Lour
Authors: Zhang Shuting , Zhu Chen , Lyu Yumeng , Chen Yan , Zhang Zihao , Lai Zhongxiong , Lin Yuling
Published: August 2019

Backgroud: APETALA2/Ethylene Responsive Factor (AP2/ERF) transcription factors perform indispensable roles in various biological processes, and it has been identified in many plants. However, little is known about the AP2/ERF superfamily in longan (Dimocarpus longan Lour.). The release of the whole-genome sequence of longan provided us an opportunity to perform a genome-wide investigation of AP2/ERF superfamily.
Results: In the present study, we performed a genome-wide survey of AP2/ERF superfamily longan (DlAP2/ERF), including the gene structure, motif composition, phylogenetic, cis-acting element, single nucleotide polymorphisms (SNPs), insertions and deletions (InDels), alternative splicing (AS) events and the expression patterns. In total, 125 DlAP2/ERF genes were identified and classified into four families, including AP2 (19 members), ERF (101 members), RAV (four members) and Soliost (one member) in the longan genome. The AP2 and soloist genes possessed one to ten introns, while 87 genes within the ERF and RAV family had no introns. A large number of hormone signaling and stress response cis-acting elements were also identified. Besides, a large number of SNPs existed in the DlAP2/ERF superfamily, they may be deverse in the early somatic embryogenesis and stem of longan. However, the numbers of InDels was far less than SNPs. In addition, the AP2 family members existed a large number of AS events in different developmental processes of longan. Expression patterns analysis revealed that the AP2 family may promote the early somatic embryogenesis of longan, and DlAP2/ERF genes were specifically expressed in various organs such as seed, root, flower and young-fruit. The DlAP2/ERF genes can response to exogenous phytohormones, such as 2,4-Dichlorophenoxyacetic acid (2,4-D), Abscisic acid (ABA), Methyl jasmonate (MeJA) and Salicylic acid (SA). Protein interactions prediction indicated that the Baby Boom (BBM) protein may interacted with LALF/AGL15 network and was up-regulated expression at the transcriptional level in the early somatic embryogenesis of longan.
Conclusions: A comprehensive analysis of molecular evolution and expression patterns showed that AP2/ERF superfamily played an important role in longan, especially in the early somatic embryogenesis, seed, root, flower and young-fruit. This systematic analysis provided the foundation for further functional characterization of AP2/ERF superfamily with an aim of longan improvement.
Determinants of Dietary Diversity among Pregnant Women Attending Public Health Facilities in Hossana town,South Ethiopia
Authors: Kobiro Degefa Helamo , Delil Romedan , Zinab Beakal , Tamiru Desalegn
Published: August 2019

Abstract
Background: Dietary diversity refers to increasing the consumption of a variety of foods across and within the food groups, adequate and diversified diets during pregnancy is essential for fetus health, body maintenance and enhancement of maternal health through protection of infectious and non-communicable diseases. Hence, this study was targets to assess dietary diversity and its determinants among pregnant women of public health facilities in Hossana town, south Ethiopia
Methods: Facility based cross-sectional study was applied among selected 303 pregnant women in Hossana town from June 1 to July 15, 2018. Systematic random sampling procedure was employed to recruit study participants. Data were collected using an interviewer administered pretested semi-structured questionnaire, one week dietary consumption was used to compute women dietary diversity score. Descriptive statistics and multivariable logistic regression were done to isolate predictors of dietary diversity.
Result: The prevalence of low, medium and high women’s dietary diversity was 9.2, 48.2 and 42.6% respectively. Educational status (AOR=2.1; 95%CI: 4.8, 15.2), monthly income (AOR=2.1; 95% CI: 4.8, 15.2), nutritional education (AOR=2.3; 95% CI: 1.2, 4.4) and frequency of eating (AOR=12.9; 95% CI: 3.1, 52) were meaningfully associated with women dietary diversity.
Conclusions: In this study women educational status, monthly income, receiving nutritional education and frequency of eating were determinants of women dietary diversity. Efforts should be strengthened towards improving women educational level, delivery of nutritional education and enhance frequency of eating among pregnant women to advance dietary diversity.
Keywords: Dietary diversity, Determinants, Pregnancy
Diet quality and its relationship with body weight status and laboratory parameters in breast cancer patients undergoing treatment
Authors: LS Krystal Ng , Mun Chan Yoke , MS Zalilah
Published: August 2019

Background

To determine whether diet quality was associated with body weight status and laboratory parameters among breast cancer patients undergoing treatment.

Methods

A cross sectional study comprises of 169 patients was conducted from January to May 2017. Diet quality and level of physical activity of patients were ascertained using Healthy Eating Index (HEI)-2015 and International Physical Activity Questionnaire (IPAQ)-short form, respectively. Data were available on body mass index and biochemical data, including of serum albumin, serum hemoblogbin and neutrophils count. Logistic regression was performed to identify the association between diet quality with body weight status, serum albumin, serum hemoglobin and neutrophils count.

Results

The mean total HEI score (standard deviation) of the breast cancer patients was 63.86 (8.75). More than 80% of the subjects did not adhere to the dietary guidelines for whole grains, dairy, refined grains, ratio of poly- and mono-unsaturated fatty acids to saturated fatty acids components. In the multivariate model, those who perceived higher score of total HEI-2015 were less likely to experience overweight (Q4 vs Q1: OR=0.36; 95% CI=0.13, 0.99) while reported higher concentration of serum hemoglobin (Q4 vs Q1: OR=0.36; 95% CI=0.13, 0.98; Q3 vs Q1: OR=0.35; 95% CI=0.13, 0.92). Non-significant associations of diet quality were shown for serum albumin and neutrophils count.

Conclusions

A majority of breast cancer patients require dietary modification, especially for fatty acids, grains and dairy products. A better diet quality was related with lower likelihood of overweight and low level of hemoglobin. Improving the quality of cancer care in breast cancer patients should emphasize on dietary intervention.
Sexual dysfunction in polycystic ovary syndrome: a systematic review and meta-analysis
Authors: Loh Huai Heng , Yee Anne , Loh Huai Seng , Kanagasundram Sharmilla , Francis Benedict , Lim Lee-Ling
Published: August 2019

Background

Polycystic ovarian syndrome is a common disorder characterized by clinical or biochemical hyperandrogenism and ovulary dysfunction. Female sexual dysfunction can have adverse effects on quality of life and interpersonal relationship.

Methods

We conducted a meta-analysis to evaluate the prevalence and severity of sexual dysfunction in women with PCOS.

Results

Compared to women without PCOS, those with PCOS were younger (28.90±3.11 versus 31.42±3.37 years; p<0.0001) and had higher body mass index (27.76±3.79 versus 24.95±3.71 kg/m2; p=0.002), Ferriman-Gallwey score (9.90±3.37 versus 4.11±2.17; p<0.0001) and serum total testosterone level (2.26±0.59 versus 1.51±0.49 nmol/L; p<0.0001). There was no significant difference in mean total FSFI score (25.72±2.33 versus 26.62±3.38; p=0.608) in women with and without PCOS. For the FSFI subscales, women with PCOS had a lower score for the pain subscale than women without PCOS (4.60±0.71 versus 5.24±0.39; p<0.001). Other subscales were not significantly different between the two groups. Women with PCOS had a 1.39 higher odds (95% CI 1.13, 1.72; p=0.002, I2 11.9%) of having FSD than women without PCOS.

Conclusion

FSD is a prevalent and disabling condition in young women with PCOS. Sensitive probing into the intimate aspects of their sex lives is needed to further understand the struggles that afflict women with PCOS. Parallel efforts should be undertaken to investigate the impact of new treatment strategies.
A Post-Method Condition Analysis of Using Ensemble Machine Learning for Cancer Prognosis and Diagnosis: a systematic review
Authors: Kavousi Kaveh , Mirsadeghi Leila , Hosseini Reza Haji , Banaei-Moghaddam Ali Mohammad , Beh-Afarin Seyed Reza
Published: August 2019

Background

Ensemble methods are supervised learning approaches that integrate different types of data or multiple individual classifiers. It has been shown that these methods can improve professional performance.

Methods

This study is an attempt to provide an in-depth review on 45 most relevant articles and aims to introduce 42 ensemble classifier (EC) machine learning methods used for the detection of 18 different types of cancer. Compared to other types of cancer, breast cancer, and the 22 ensemble methods introduced for its identification, is extensively investigated. The purpose of this study was to identify, map, and analyze the current academic discourse on EC machine learning methods in order to: 1. identify overarching themes emerging from empirical studies regarding EC methods, 2. determine their input data and decision-making strategies, and 3. evaluate relevant statistical procedures.

Results

By comparing various approaches, we can introduce Relevance Vector Machine (RVM)-based ensemble learning method that can provide optimal solutions for problems such as curse the dimensionality and high-dimensionality of feature space without missing data values.

Conclusions

To obtain robust performance and achieve better results, it is tactfully suggested to use multi-omics data integration, which has demonstrated to identify cancers and their subtypes more efficiently.
Sulforaphane Inhibits Self-renewal of Lung Cancer Stem Cells Through the Modulation of Polyhomeotic Homolog 3 and Sonic Hedgehog Signaling Pathways
Authors: Wang FanPing , Zhong Jiateng , Wang Shanshan , Qiao Caijuan , Li Xiangyang , Meng Li , Li Qianna , Wang Mingyong , Yan Chunxia
Published: August 2019

Background: Sulforaphane (SFN), an active compound in cruciferous vegetables has been characterized for its antiproliferative capacity. We investigated the role and molecular mechanism through which SFN regulates proliferation and self-renewal of lung cancer stem cells.
Methods: Lung cancer stem cells (CD133-positive cells) were isolated by MACs and then measured by flow cytometry. The ability of cell proliferation was assessed by MTT assays and tumorsphere formation assays. The expressions of Sonic Hedgehog (Shh), Smoothened (Smo), Gli1 and Human Polyhomeotic Homolog 3 (PHC3) in cells were measured by quantitative reverse transcription polymerase chain reaction (qPCR) and western blot assays. The expression of transcription factor SOX2 in lung cancer stem cells was also determined by western blot assay. Shh was knocked down by siRNA to further study the role of SFN and Shh signaling pathways in lung cancer.
Results: SFN inhibited the proliferation of lung cancer cells and lung cancer stem cells simultaneously. Meanwhile, we observed that Sonic Hedgehog (SHH) signaling pathway, SOX2 and Polyhomeotic Homolog 3 (PHC3) were highly activated in lung cancer stem cells. Knock-down of Shh led to reduced H460 and A549 cells proliferation. Furthermore, we observed that SFN inhibited the activity of PHC3 and SHH signaling pathways in the lung cancer stem cells. In addition, SFN combined with Knock-down of Shh gene showed a greater effect on the proliferation of lung cancer cells.
Conclusion: SFN is an effective new drug which can inhibit proliferation of lung cancer stem cells through the modulation of PHC3 and SHH signaling pathways. It provides a novel target for improving therapeutic efficacy for lung cancer stem cells.
Survival analysis of Rural Clinical School of Western Australia graduates: the long-term work of building a long-term rural medical workforce
Authors: Gupta Surabhi , Ngo Hanh , Burkitt Tessa , Puddey Ian , Playford Denese
Published: August 2019

Abstract
Objective –Deficits in the size of the rural medical workforce is an international issue. In Australia, The Rural Clinical School intervention is effective for initial recruitment of rural doctors. However, the extent of retention is not yet established. This paper summarises rural retention over a 10-year period.
Methods –Rural Clinical School graduates of STATE NAME were surveyed annually, 2006-2015, and post Graduate Years (PGY) 3-12 included. Survival was described as “tours of service”, where a tour was either a period of ≥1 year, or a period of at ≥2 weeks, working rurally. A tour ended with a rural work gap of ≥52 weeks. Considering each exit from urban as an event, semi-parametric repeated measures survival models were fitted.
Results – Of 468 graduates, using the ≥2 weeks definition, 239 PGY3-12 graduates spent at least one tour rurally (average 61.1, CI 52.5 – 69.7 weeks), and a total length of 14,607 weeks. Based on the tour definition of ≥1 year, 120 graduates completed at least one tour (average 1.89, 1.69 – 2.10 years), and a total of 227 years’ rural work. For both definitions, the number of tours increased from one to four by PGY10/11, giving 17,786 total weeks (342 years) across all PGYs for the ≥2 weeks tour definition, and 256 years total for ≥1 year. Significantly more graduates exited from urban work for the 2007-09 middle cohort compared with 2010-11 (HR 1.876, p=0.022), but no significant difference between 2002-06 and 2010-11. Rural origin, age and gender were not statistically significant.
Conclusions – PGY3 – 12 RCS graduates contributed substantially to the rural workforce: 51% did so by short rotations, which have not previously been described, while 26% contributed whole years of service. There was an apparent peak in entry and retention for the middle cohort and decline thereafter, likely attributable to lack of rural advanced/specialist vocational training. These data indicate a real commitment to rural practice by RCS graduates, and the need for rural postgraduate vocational training in the rural context as a key element of a successful rural retention strategy.
Isolation and Identification of Streptococcus suis from sick pigs in Bali, Indonesia
Authors: Besung Nengah I. K. , Suarjana Gusti Ketut , Agustina Karang Kadek , Winaya Oka Ida Bagus , Soeharsono Hamong , Suwiti Ketut Ni , Mahardika Gusti Ngurah
Published: August 2019

Objective
Streptococcus suis (S. suis) is a causative agent for various syndromes in pigs. It can be transmitted to humans with typical symptoms of meningitis and death. Data in Bali Referral Hospital showed more than 40 confirmed human cases of S. suis meningitis in 2014. Cases of S. suis infection in pigs have never been confirmed in the province. Here we provide evidence of the bacteria in sick pigs in that world tourist destination province.
Results
The S. suis was confirmed in eight out of 30 cases. Prominent histopathological lesions of confirmed cases were meningitis, endocarditis, pericarditis, bronchopneumonia, enteritis, and glomerulonephritis. The dominant inflammatory cells were neutrophils and macrophages. Further research is needed to understand the risk factor of human infection. Awareness of the community on the risk of contracting S. suis is needed to prevent human infections.
Multi-drug Resistant Extended Spectrum Beta-Lactamase Producing E. coli and Salmonella on Raw Vegetable Salads Served at Hotels and Restaurants in Bharatpur, Nepal
Authors: Sapkota Sanjeep , Adhikari Sanjib , Pandey Asmita , Khadka Sujan , Adhikari Madhuri , Kandel Hemraj , Pathak Sandhya , Pandey Asmita
Published: August 2019

Objective
Antimicrobial resistance among the bacteria present in ready-to-eat foods like vegetable salads is an emerging concern today. The current study was undertaken to investigate the presence of multi-drug resistant extended-spectrum β-lactamase (ESBL) producing E. coli and Salmonella spp. in raw vegetable salads served at hotels and restaurants in Bharatpur. A total of 216 salad samples were collected from three different grades of hotels and restaurants and examined for the presence of E. coli and Salmonella spp. in Microbiology laboratory of Birendra Multiple Campus by conventional microbiological techniques.
Results
Out of 216 samples, 66 samples (35.2%) showed the presence of Salmonella spp. whereas E. coli was recovered from 29(13.4%) samples of which 3 samples harbored E. coli O157: H7. Antibiotic susceptibility testing revealed that 9(13.6%) Salmonella and 4(13.8%) E. coli isolates were detected as multi-drug resistant. Total ESBL producers reported were 5(7.57%) Salmonella and 4(13.8%) E. coli. The study also assessed a significant association between occurrence of E. coli and Salmonella with different grades of hotels and restaurants, personal hygiene as well as with the literacy rate of chefs (p<0.05). The findings suggest an immediate need of attention by the concerned authorities to prevent food-borne infections and emerging antimicrobial resistance
Predictive risk factors of postoperative pneumonia after heart transplantation
Authors: Vidal Charles , Pasqualotto Romain , James Arthur , Dureau Pauline , Rasata Julie , Coutance Guillaume , Varnous Shaida , Leprince Pascal , Amour Julien , Bouglé Adrien
Published: August 2019

Background

Pneumonia is a frequent complication in patients undergoing heart transplantation (HTx) which increases morbidity and mortality in this population. Nevertheless, risk factors of postoperative pneumonia (POP) are still unknown. The aim of this study was to investigate the predictive risk factors of POP in HTx recipients.

Materials and methods

In this retrospective study, all patients undergoing HTx between January 2014 and December 2015 were included. All POP occurring until hospital discharge were investigated. The primary end point was the risk factors of POP determined by a Cox model in uni- and multivariate analysis. Data are expressed in OR [95% CI]. P<0.05 was necessary to reject the null hypothesis.

Results

At all, 175 patients were included without any loss of follow-up and 89 POP were diagnosed in 59 (34%) patients. Enterobacteriaceae and Pseudomonas aeruginosa were mainly involved. In multivariate analysis, main risk factors were preoperative mechanical ventilation (OR 1.42[1.12-1.80], P<0.01) and perioperative blood transfusion (OR 1.42[IC95:1.20-1.70], P<0.01). Duration of mechanical ventilation, time of veno-arterial extracorporeal membrane oxygenation weaning and length of stay in intensive care unit consistently increased the risk of POP which impacted the mortality at 30 days (Odd Ratio: 4[1.3 - 12.4], P=0.01) and 1 year (OR: 6.8[2.5-8.4], P<0.01). In sensitized recipients (53%), plasmapheresis exchanges and intravenous immunoglobulins did not increase the risk of POP.

Conclusion

After HTx, preoperative mechanical ventilation and blood transfusion appear as the main risk factors of POP, enterobacteriaceae and Pseudomonas aeruginosa being mainly involved.
Are Malaysian T2DM patients willing to be trained to speak to their offspring about risk of diabetes and preventive measures?
Authors: Badlishah-Sham Siti Fatimah , Ramli Anis Safura , Isa Mohamad Rodi , Mohd-Zaki Nurzakiah , Whitford David Leonard
Published: August 2019

Background: Offspring of Type 2 Diabetes Mellitus (T2DM) patients have an absolute risk of 20-40% of developing the condition. Therefore, T2DM patients should be encouraged to speak to their offspring regarding diabetes risk and prevention strategies. The Health Belief Model (HBM) conceptualises that the higher the perceived risk, the more likely an individual will modify their behaviour. The objectives of this study were to i) determine the distribution of T2DM patients according to their willingness to accept training to speak to their offspring, ii) determine the distribution of T2DM patients according to their willingness to accept training based on the HBM and iii) to determine the factors associated with their willingness to accept training. Methods: This was a cross-sectional study amongst T2DM patients attending two primary care clinics in Malaysia. Data on socio-demography and knowledge of diabetes risk factors were collected. The adapted, translated and validated Diabetes Mellitus in the Offspring Questionnaire-Malay version (DMOQ-Malay) was self-administered. Statistical analysis included descriptive statistics, univariate and multiple logistic regression (MLogR). Results: A total of 425 participants were recruited. Of these, 61.6% were willing to accept training. In MLogR, six variables were found to be significantly associated with willingness to accept training. These were i) positive family history (Adj. OR 2.06 (95% CI: 1.27, 3.35)), ii) having the correct knowledge that being overweight is a risk factor (Adj. OR 1.49 (95%CI: 1.01, 2.29)), iii) correctly identifying age of more than 40 years old as a risk factor (Adj. OR 1.88 (95%CI: 1.22, 2.90)), iv) agreeing that speaking to their offspring would help them to prevent T2DM (Adj. OR 4.34 (95%: 1.07, 17.73)), v) being neutral with the statement ‘I do not have much contact with my offspring’ (Adj. OR: 0.31 (95% CI: 0.12, 0.810)) and vi) being neutral with the statement ‘my offspring are not open to advice from me’ (Adj. OR: 0.63 (95% CI: 0.31, 0.84)). Conclusion: The majority of T2DM patients were willing to accept training to speak to their offspring to prevent diabetes. A training module should be designed to enhance their knowledge, attitude and skills to become family health educators.
Hyperuricemia is associated with progression of CKD: uric acid aggravates renal function
Authors: Fan Shulei , Zou Yang , Wang Amanda Y , Xu Mingjie , Li Guisen , Hong Daqing
Published: August 2019

Background: With the change of living standard and dietary structure, the incidence of hyperuricemia is on the rise. Hyperuricemia has become one of the metabolic diseases threatening human health. There is paucity of literature on the association between serum uric acid levels and the progression of CKD. This study aimed at assessing the effect of serum baseline uric acid level on the progression of CKD.
Methods: This retrospective study included 800 CKD patients in our center. The information on baseline and follow-up characteristics were collected from our Renal Treatment System (RTS) database. Cox regression analysis was used to evaluate the risk factors for CKD progression. The Kaplan–Meier analysis was used to test associations between serum uric acid levels and renal survival rates.
Results: A total of 800 patients were included in the study, and the mean age at entry was 36.6±14.4 years. There was no significant difference in gender distribution. The mean eGFR, Cr, serum uric acid at baseline were 99.23±31.54 ml/min/1.73㎡, 82.08±41.40 μmol/L, 371.60±103.18 μmol/L, respectively. 306 (38.3%) patients had HUA and 494 (61.7%) had non-HUA. We established different adjusted models and found that HUA was a risk factor for CKD patients to reach the composite endpoint after adjustment in six models. All models show that HUA was a risk factor for the progression of CKD. Among them, model 4 (adjusted for Cr + Alb + age + BP + gender) was the best model with the largest HR value (HR:2.010, 95%CI:1.310-3.084, P<0.05). The cumulative survival rate of non-hyperuricemia group was higher than that of hyperuricemia group (P<0.001).
Conclusions: Hyperuricemia was not only widespread in patients with CKD, but also a risk factor for the progression of CKD. Anti-hyperuricemia therapy may need to be considered in CKD patients to slow the disease progression, which needs to be tested further in clinical studies.

Key words: hyperuricemia, chronic kidney disease, renal function, progression
Musculoskeletal consequences in cyber-addicted students - Is it really a matter of health? A ROC curve analysis for prioritizing risk factors
Authors: Moghadam Rashid Heidari , Babamiri Mohammad , Ghasemi Fakhradin , Ghaffari Mohammad Ebrahim , Razie Mahdi , Bandehelahi Khadijeh , Mortezapour Alireza
Published: August 2019

Background

The high prevalence and also multiple consequences of addiction to various online content, including online games and social networks, have become a major challenge. The ability to predict musculoskeletal disorders from this addiction can help reveal in students' health status in the near future. The aim of this study was to determine the prevalence of this addiction and the ability to predict neck pain from this matter in students.

Methods

This study was carried out among 665 students. Data collection was performed through three questionnaires on problematic use of online games, social networking addiction, and Nordic musculoskeletal disorders. Data were compared with Chi-square and independent T-test, and the logistic regression model was then presented at a significant level of 0.05. Finally, the area under the receiver operating characteristic (ROC) curve and Discriminant analysis with SPSS and STATA software were conducted to clarify associations.

Results

The prevalence of Internet-related content addiction was 32.8%. The results showed that addiction to social networks and online games can increase the risk of neck disorder. Also 0.58 area under ROC curve depicted the ability to predict neck pain from this addiction.

Conclusions

In students with internet - related content addiction, neck disorder can be predicted. Given the high prevalence of internet addiction in students, it is essential to take immediate and appropriate interventions to avoid the associated adverse effects such as neck problems.
High-fat dietary consumption promotes disease progression in a surgical joint destabilisation murine model of osteoarthritis: role of systemic eicosanoids and circulating monocytes
Authors: Kozijn Anne Elisabeth , Visser HM de , Tartjiono MT , Casbas F , Ravipati S , Ham F van der , Bacardit J , Bouwman J , Mastbergen SC , Zuurmond AM , Barrett DA , Lafeber FPJ , Bobeldijk I , Stoop R , Mobasheri A , Weinans H
Published: August 2019

Background

In this study we investigated the contribution of high-fat diet-induced metabolic overload to osteoarthritis (OA) progression originally caused by mild mechanical trauma to the mouse knee joint. We hypothesized that metabolic stress would induce a proinflammatory environment by altering systemic lipid levels and immune cell populations.

Methods

Twelve-week-old male C57BL/6J mice (n=20) were given a low-fat diet (LFD, 10%kcal from fat) or high-fat diet (HFD, 45%kcal from fat) for 18 weeks. OA was initiated by transecting the medial meniscotibial ligament of the right knee joint at t=10 weeks. OA severity and changes in M1/M2 polarization of synovial macrophage populations were determined in serial coronal FFPE-mounted sections. Eicosanoid levels and monocyte populations were evaluated before and after ligament transection.

Results

Diet-induced metabolic stress assessed by body weight, systemic cholesterol levels, and insulin resistance index was significantly higher in HFD mice. This group also showed increased cartilage damage, synovitis, and osteophyte formation compared with LFD controls. High-fat feeding elevated systemic arachidonic acid levels, which mainly resulted in increased levels of its cytochrome P450-catalysed diol metabolites 5,6-dihydroxyeicosatrienoic acid (DHET) and 8,9-DHET. High-fat feeding also triggered an increase in pro-inflammatory intermediate CD43++Ly6Cint monocytes after ligament resection. Ligament resection in addition to high-fat feeding induced increased expression of the activation marker CD11c selectively on non-classical CD43++Ly6Clow monocytes. No significant changes in synovial macrophage polarization were observed.

Conclusions

Metabolic stress resulted in a proinflammatory environment and aggravated injury-induced OA progression. Our results suggest that a CYP450-focused eicosanoid metabolism and activated circulating monocytes may be drivers of this metabolic stress-induced OA progression, contributing to the mechanistic understanding and potentially serving as future diagnostic and prognostic biomarkers for metabolic OA.
Controlled Trial to compare the Achilles Tendon load during running in flatfeet subjects using a customized arch support orthoses vs an orthotic heel lift
Authors: Lee Kawin KW , Ling Samuel Ka Kin , Yung Patrick SH
Published: August 2019

Introduction:
Achilles tendinopathy is one of the most common overuse injuries in running,and forefoot pronation, seen in flatfeet subjects, has been proposed to cause additional loading across the Achilles tendon. Foot orthoses are one of the common and effective conservative treatment prescribed for Achilles tendinopathy, it works by correcting the biomechanical malalignment and reducing tendon load Previous studies have shown reduction of Achilles Tendon load (ATL) during running by using customized arch support orthosis (CASO) or an orthotic heel lift (HL). However, there are still little biomechanical evidence and comparative studies to guide orthotic prescriptions for Achilles tendinopathy management. Therefore, this study seeks to investigate the two currently employed orthotic treatment options for Achilles tendinopathy: CASO and HL for the reduction of ATL and Achilles tendon loading rate (ATLR) in recreational runners with flatfeet.

Methods:
12 subjects were recruited and run along the runway in the laboratory for three conditions: (1) without orthoses, (2) with CASO (3) with HL. Kinematic and kinetic data were recorded by 3D motion capturing system and force platform. Ankle joint moments and ATL were computed and compared within the three conditions.

Results:
Subjects who ran with CASO (p=0.001, d=0.43) or HL (p=0.001, d=0.48) associated with a significant reduction in ATL when compared to without orthotics while there was no significant difference between the two types of orthoses, the mean peak ATL of CASO was slightly lower than HL. Regarding the ATLR, both orthoses, CASO (p=0.003, d= 0.93) and HL (p=0.004, d= 0.78), exhibited significant lower value than the control but similarly, no significant difference was noted between them in which the use of CASO yielded a slightly lower loading rate than that of HL.

Conclusions: Both CASO and HL were able to cause a significant reduction in peak ATL and ATLR comparing to without orthotics condition. There were subtle differences in the biomechanical effects between the two types of orthoses. The findings help to quantify the effect of CASO and HL on load reduction of Achilles tendon and suggests that foot orthoses may serve to prevent the incidence of Achilles tendon pathologies.

Trial: NCT04003870_clinicaltrials.gov, retrospectively_registered
Disparities in the utilization of ischemic stroke inpatient services in China: the role of urban basic health insurance
Authors: yang Yong , Man Xiaowei , Li Shuo , Bai Qian , Zhang Peiwen , Huang Lieyu , Wang Xi , Guo Yiwei , Ma Yong , Shi Xuefeng
Published: August 2019

Background
As one major disease threatening human health, stroke has placed a heavy financial burden on patients worldwide. This study aims to confirm whether there are disparities and inequity in the utilization of inpatient health services for stroke inpatients covered by different health insurance schemes.
Methods
We conducted statistical analysis based on the data containing urban employee-based basic medical insurance scheme (UEBMI) and urban resident-based basic medical insurance scheme (URBMI) groups, supplied by the China Health Insurance Research Association (CHIRA). Descriptive analysis was the main method to finish this analysis.
Results
Of the 56485 inpatients who had been diagnosed with ischemic stroke, extracted from the CHIRA claimed database, 64.6% (36487) were covered by UEBMI and 35.4% (19998) were covered by URBMI; the mean age of UEBMI subgroup was slightly older than URBMI subgroup (68.64 and 67.45 years old). The annual frequency of hospitalization of UEBMI subgroup was 1.21 times and 1.15 times for URBMI subgroup. The average length of stay of UEBMI subgroup(13.93days) was longer than URBMI subgroup (10.82 days). The UEBMI group had a higher hospitalization costs but fewer out-of-pocket costs: for the UEBMI subgroup, the average hospitalization cost was RMB11187.64($1724.02), the average total out-of-pocket costs was RMB2646.42($407.81). While for the URBMI subgroup, the average hospitalization cost was RMB6402.27($986.59) and the average total out-of-pocket costs was RMB2746.10($423.17). All the above differences were significant(P<0.001). Meanwhile, patients with UEBMI had higher reimbursement rate (82.65% and 63.82%).
Conclusions
We found that there were nonnegligible disparities in the utilization of inpatient health services between UEBMI and URBMI as well as health inequity and financial protection inequity. Thus, our results call for a systemic strategy to improve the fragmented social health insurance system and narrow the gap in health insurance schemes in China.
Feasibility of Using Masticatory Muscles to Assess Skeletal Muscle Mass in Patients with Oral Cavity Cancer
Authors: Chang Sheng-Wei , Hsu Cheng-Ming , Tsai Yuan-Hsiung , Chang Geng-He , Tsai Ming-Shao , Huang Ethan I. , Fang Ku-Hao , Chang Kai-Ping , Tsai Yao-Te
Published: August 2019

Background

Sarcopenia is typically assessed using abdominal computed tomography (CT) scans, which are not obtained routinely in patients with oral cavity cancer. In order to investigate the feasibility of using masticatory muscles to assess general skeletal muscle mass (SMM) in oral cancer patients, we aimed to correlate the masticatory SMM evaluated on head and neck CT-images with the SMM measurement at the level of L3 on abdominal CT-scans.

Methods

The abdominal and head and neck CT-scans of the oral cavity squamous cell carcinoma (OSCC, n = 54) and trauma (n = 50) patients were analyzed retrospectively. All muscles at the L3 level were delineated on abdominal CT scans, and skeletal muscles at the mandibular notch level and C3 level were delineated on head and neck CT scans. Cross-sectional area (CSA) of the muscles at the mandibular notch and C3 level were compared to skeletal muscle CSA at the L3 level using linear regression, and a multivariate linear regression model was also calculated.

Results

The OSCC patients had significantly smaller muscle CSA at the mandibular notch level than trauma patients (1221.4 vs. 1512.2 mm2, p = 0.006). Masticatory muscle CSA strongly predicted the L3 muscle CSA (r = 0.880, p < 0.001), and this correlation was stronger in the multivariate model including age, body weight, and sex (r = 0.898, p < 0.001).

Conclusions

Evaluation of the masticatory skeletal muscle mass on head and neck CT images is simple, feasible, and may be an alternative to abdominal CT scans. Assessment of masticatory muscle at mandibular notch can be performed using routinely obtained scans without additional imaging or cost. Identifying patients at risk of being sarcopenic may select oral cancer patients for nutritional intervention and appropriate treatment modality to improve their prognosis.
Preoperative anemia and hospitalization time are the independent factors of preoperative deep venous thromboembolism in Chinese elderly with hip fracture
Authors: Feng Long , Yuan Weixiu , Duan Mingda , Jin Chaohai , Xu Longhe , Xu Zhipeng , Feng Ze-Guo , Zhang Hong
Published: August 2019

Aim This study was designed to explore the prevalence condition and risk factors of preoperative deep venous thromboembolism (DVT) in Chinese elderly with hip fracture. Methods From January 1, 2012, to December 31, 2018, 273 elderly over 70 years old with elective hip surgery were collected from the electronic medical records. Collected Data included demographic characteristics, comorbidities, ASA classification, types of surgeries, types of anesthesia, operation time, fracture to operation time, perioperative blood transfusion, preoperative hemoglobin level, anemia, blood-gas analysis, cardiac function, electrocardiograph, lower limb venous ultrasound and hospitalization time. Results In all patients, 15 patients (5.6%) had venographic evidence of DVT in affected limbs before surgery. Three of all patients received an temporary inferior vena cave filter placement. Fracture to surgery time, preoperative hemoglobin level, anemia, pulmonary disease and hospitalization time were statistically different between DVT group and non-DVT group (P<0.05 for all). Moreover, preoperative anemia (OR: 0.144, 95%CI: 0.026-0.799, P=0.027) and hospitalization time (OR: 1.135; 95%CI: 1.023-1.259, P=0.017) were the two independent risk factors for preoperative DVT. Conclusion Preoperative anemia and hospitalization time were independent risk factors for venous DVT in Chinese elderly with hip fracture.