bluuebunny/crossref_metadata_2025 huggingface dataset:
Dilemmas, Conflicts, and Worldview Diversity: Exploring the Relevance of Clare Grave’s Legacy for Planning Practice and Education
Authors: Ferreira António
Published: July 2020

This article presents the intellectual legacy of Clare Graves, an American professor of psychology, and its relevance for planning as an academic and professional field characterized by worldview diversity and, therefore, also by dilemmas and conflicts. The argument is structured by the sequential answers to four questions: how to determine the most appropriate worldview for a given planning situation; how to navigate in planning contexts characterized by worldview diversity; how to manage worldview-based conflicts; and how to educate planners for effectively dealing with worldview diversity. A discussion on planning ethics concludes the article.
Christian Education and Spiritual Formation: Recent History and Future Prospects
Authors: Setran David , Wilhoit Jim
Published: July 2020

Throughout the 1980s and 1990s, Christian education and spiritual formation existed in an uneasy tension, running on parallel tracks but also developing mutual points of intersection. This article traces the growing connections between these movements in the last two decades of the twentieth century, the changing emphases in this relationship since 2000, and the need for further cross-fertilization between the two fields as ministries face the challenges of the twenty-first century.
Effect of different exposure times on physicochemical, mechanical and biological properties of PGS scaffolds treated with plasma of iodine-doped polypyrrole
Authors: Martín-Pat Gaspar Eduardo , Rodriguez-Fuentes Nayeli , Cervantes-Uc J Manuel , Rosales-Ibáñez Raúl , Carrillo-Escalante Hugo Joel , Ku-Gonzalez Angela F , Avila-Ortega Alejandro , Hernandez-Sanchez Fernando
Published: July 2020

Polyglycerol sebacate (PGS) scaffolds obtained using a leaching technique were modified with iodine-doped polypyrrole (PPy-I) in a plasma reactor in order to study the effect of exposure time on the cell viability of hDPSCs. SEM analysis showed the formation and growth of PPy-I particles as the exposure time was increased, while FTIR and XPS analysis revealed the presence of -NH- and N+ groups in the chemical composition of the surfaces, relating to the increase in the amount of PPY-I particles. The water contact angle measurements showed an increase in the scaffold’s hydrophilicity with greater exposure times which was also attributed to the rising of PPy-I particles. It was also observed that PPy-I promotes the rigidity of the treated PGS scaffolds. when in direct contact with treated PGS scaffolds, cell viability improved with respect to non-treated scaffolds, however only at shorter time exposures. Extracts of plasma-treated PGS scaffolds showed high cytotoxicity as the time exposure to plasma treatment was increased.
Pacific Islands Families Study: Patterns of Intimate Partner Violence Among Pacific Mothers
Authors: Paterson Janis , Prah Philip , Tautolo El-Shadan , Iusitini Leon
Published: July 2020

Intimate partner violence (IPV) is a widespread social problem affecting all populations regardless of gender, race, and socioeconomic status. The aims of this study were to examine (a) patterns of IPV among Pacific women living in New Zealand and (b) the risk and protective factors associated with IPV perpetration and victimization. As part of the longitudinal Pacific Islands Families (PIF) Study, maternal interviews, which included reports about IPV, acculturation, and sociodemographic characteristics, were administered at phases 6 weeks, 2, 6, 11, and 14 years postpartum. Age had a significant effect on perpetration of both minor and severe perpetration of IPV, and on being a victim of minor IPV. However, no significant effect was found for severe victimization. Cultural alignment also had a significant effect on perpetration of IPV with Pacific mothers who were strongly aligned to their traditional Pacific culture being significantly less likely to report minor or severe IPV perpetration compared with Pacific mothers who were closely aligned to western culture. Single mothers reported significantly more minor victimization, and those mothers who were more highly educated and were in a higher income bracket were significantly less likely to report severe physical IPV victimization. These findings can inform the timing and targeting of culturally appropriate violence prevention efforts in adolescence and young adulthood that focus on the development of healthy intimate partner relationships and effective methods of conflict resolution.
Predictors of Disclosure Recipients’ Social Reactions to Victims’ Disclosures of Dating and Sexual Violence: A Longitudinal Study of College Students
Authors: Edwards Katie M. , Ullman Sarah E. , Waterman Emily A. , Dardis Christina M.
Published: July 2020

Dating violence (DV) and sexual violence (SV) are pernicious issues among college students that lead to deleterious outcomes, which are more likely when victims receive more negative social reactions (e.g., blaming the victim) and fewer positive social reactions to disclosure (e.g., providing emotional support). Most research studies have examined victims’ reports of social reactions to their assault disclosures, with only a few cross-sectional studies of predictors of disclosure recipients’ provision of positive and negative social reactions to victims. The purpose of the current study was to address these gaps in the literature. Participants were 481 college students (76.4% women, 89.2% White/Non-Hispanic) who reported being a disclosure recipient during the past six months (measured at Time 2 to cross-sectionally and longitudinally predict their social reactions to victims’ disclosures). Results suggested that both victim and disclosure recipient characteristics (e.g., gender, race), disclosure recipient perceptions of victims (e.g., empathy for victim, blame of victim, victims’ coping) and both disclosure recipient and victim behavior at the time of disclosure (e.g., drinking, distress) were related to disclosure recipient social reactions. These findings underscore the need for programs for potential informal disclosure recipients that target psychological variables (e.g., post-traumatic stress disorder) and behavior at the time of disclosure, as well as their perceptions of victims more generally, in addition to improving their knowledge and ability to respond with positive social reactions and avoid negative social reactions.
Intimate Partner Violence Predicts Posttraumatic Stress Disorder Severity Independent of Early Life and Deployment-Related Trauma in Deployed Men and Women Veterans
Authors: Pierce Meghan E. , Fortier Catherine , Fonda Jennifer R. , Milberg William , McGlinchey Regina
Published: July 2020

Intimate partner violence (IPV) refers to emotional, physical, and/or sexual abuse perpetrated by a current or former partner. IPV affects both genders, though little is known about its effects on men as victims. The aims of this study were to determine if IPV is a factor contributing to posttraumatic stress disorder (PTSD) severity independently of deployment-related trauma, and to determine if there are gender differences in these associations. Participants were 46 female and 471 male post-9/11 veterans. Four sequential regressions were employed to examine the independent contribution of IPV among multiple trauma types on PTSD severity in men and women at two epochs, post-deployment (participants were anchored to deployment-related PTSD symptoms) and current (within the past month). Models were significant for both epochs in men ( ps < .001) but not in women ( ps > .230). In men, IPV independently predicted PTSD severity in both epochs (β > .093). However, in women, early life trauma (β = .284), but not IPV was a significant and independent predictor for current PTSD. Thus, there are distinct gender differences in how trauma type contributes to PTSD symptom severity. Although the statistical models were not significant in women, we observed similar patterns of results as in men and, in some cases, the β was actually higher in women than in men, suggesting a lack of power in our analyses. More research is clearly needed to follow-up these results; however, our findings indicate that IPV is a contributing factor to PTSD severity in veterans.
The Perceptions of Spirituality and Spiritual Care Among People From Chinese Backgrounds Living in England: A Grounded Theory Method
Authors: Niu Yanping , Mcsherry Wilfred , Partridge Martin
Published: July 2020

Introduction: There has been a growing number of people from Chinese backgrounds entering England and their perceptions of spirituality and spiritual care need to be addressed when their cultural context changes. Methodology: A Straussian grounded theory method was used. Twenty-five participants were recruited, after which point data saturation was reached. Results: Four themes emerged showing participants’ perceptions of the terms: holistic; family involvement; religious care; abstract and sensitive. Discussion: Participants held holistic and culturally sensitive perspectives of spirituality, which demonstrates that patient-centered care is important. Also, health care professionals need to consider methods to involve family member and use religious or cultural values to support their spiritual needs. Particularly, when implementing spiritual care, they need to be aware that people from Chinese backgrounds blend Confucianism, Buddhism, and Daoism together in their understanding of the terms and may provide contradictory information about their religious belief.
Destructuration of saturated natural loess: From experiments to constitutive modeling
Authors: Fu Yukai , Gao Zhiwei , Hong Yi , Li Tonglu , Garg Akhil
Published: July 2020

It has been well recognized that unsaturated natural loess shows significant volume contraction upon wetting due to its metastable internal structure. But the structural effect on stress–strain relationship of saturated natural (undisturbed) loess is much less explored. Few attempts have been made in proposing a constitutive model for saturated natural loess. This study presents both laboratory tests and constitutive modeling of a saturated natural loess, with special focus on the structural effect and evolution of structure damage during loading. Oedometer and drained triaxial compression tests have been carried out on undisturbed and remolded saturated loess samples. It is found that the natural soil structure has dramatic influence on mechanical behavior of loess, including the compressibility, dilatancy, and shear strength. Destructuration, which is the damage of soil structure with deformation, is observed in both oedometer and triaxial tests. A constitutive model is proposed for saturated loess based on the experimental observations. The model is established within the theoretical framework of subloading and superloading surface concepts. Destructuration of loess is assumed to be affected by both plastic volumetric and shear strain. A new method for determining the initial degree of structure is proposed. The model can reasonably predict the compression and shear behavior of both undisturbed and remolded saturated loess.
COVID-19 Pulmonary and Olfactory Dysfunctions: Is the Chemokine CXCL10 the Common Denominator?
Authors: Oliviero Antonio , de Castro Fernando , Coperchini Francesca , Chiovato Luca , Rotondi Mario
Published: July 2020

COVID-19 is an ongoing viral pandemic that emerged from East Asia and quickly spread to the rest of the world. SARS-CoV-2 is the virus causing COVID-19. Acute respiratory distress syndrome (ARDS) is definitely one of the main clinically relevant consequences in patients with COVID-19. Starting from the earliest reports of the COVID-19 pandemic, two peculiar neurological manifestations (namely, hyposmia/anosmia and dysgeusia) were reported in a relevant proportion of patients infected by SARS-CoV-2. At present, the physiopathologic mechanisms accounting for the onset of these symptoms are not yet clarified. CXCL10 is a pro-inflammatory chemokine with a well-established role in the COVID-19-related cytokine storm and in subsequent development of ARDS. CXCL10 is also known to be involved in coronavirus-induced demyelination. On these bases, a role for CXCL10 as the common denominator between pulmonary and olfactory dysfunctions could be envisaged. The aim of the present report will be to hypothesize a role for CXCL10 in COVID-19 olfactory dysfunctions. Previous evidences supporting our hypothesis, with special emphasis to the role of CXCL10 in coronavirus-induced demyelination, the anatomical and physiological peculiarity of the olfactory system, and the available data supporting their link during COVID-19 infections, will be overviewed.
They Are Not Romeo Pimps, They Are Traffickers: Overcoming the Socially Dominant Discourse to Prevent the Sex Trafficking of Youth
Authors: Merodio Guiomar , Duque Elena , Axt Peña Juan Carlos
Published: July 2020

Innovative research on sex trafficking is increasingly focusing on the relevance of social relationships in the process of recruitment of young women into sex trafficking. Within the dimension of social interactions, concern is growing about coercive and deceptive intimate relationship–based strategies that traffickers use to recruit young women. To research this recruitment process, the analysis and background on the Language of Desire has allowed us to identify, through qualitative methodology, the standardized use of terms such as Loverboys or Romeo pimps to refer to these traffickers. The extended use of these terms in research, preventive programs, and in general society makes it difficult to reject these violent recruiters and therefore reproduces the vulnerability of young girls to sex traffickers. The qualitative research on sex trafficking presented in this article suggests that they are not Romeo pimps or Loverboys, but traffickers, critically questioning the dominant social discourse imposed on them.
White Whispers 2: An Asian Experience
Authors: Lee Karen V.
Published: July 2020

The author writes an evocative autoethnography about living through another racist experience that dislodges pain, shock, anger, and sadness. Her firsthand article, White Whispers (2008) had already exposed another moment of suffering. As teacher, writer, mother, musician, and daughter, she reflects, again, on living in both a culture of diversity and culture of racism despite social efforts at advancing equity for people of color. Overall, she tries to make sense of the cultural and social phenomena of racism as, “one’s own storytelling can be a source of healing.”
Contextual Factors Impact the Variability in ADHD Symptoms in Preschoolers with Situational Hyperactivity
Authors: Hwang-Gu Shoou-Lian , Ni Hsing-Chang , Liang Sophie Hsin-Yi , Lin Hsiang-Yuan , Tsao Li , Lin Chiao-Fan , Gau Susan Shur-Fen
Published: July 2020

Objective: This study examined preschoolers with teacher-reported or parent-reported situational hyperactivity, and whether they differed in terms of behavioral problems, attentional problems, and parenting perceptions. Method: We used the Conners’ Kiddie Continuous Performance Test and the Color Flanker Task to assess 99 preschoolers with pervasive high-ADHD-symptoms (42), school-situational high-ADHD-symptoms (30), or home-situational high-ADHD-symptoms (27), plus 111 preschoolers with pervasive low-ADHD-symptoms. Parents and teachers reported externalizing/internalizing behavioral problems. Parenting perceptions were measured with the Parenting Stress Index-Short Form and a parenting perceptions scale. Results: Preschoolers with school-situational high-ADHD-symptoms had deficits in attentional control. Parents of preschoolers with home-situational high-ADHD-symptoms had higher levels of parental stress and perceived their parenting to be harsher. Preschoolers with pervasive high-ADHD-symptoms had deficits in attentional control, increased parental stress, and parents with harsher parenting perceptions. Conclusion: Preschoolers with situational high-ADHD-symptoms may have different contextual risk factors related to ADHD symptoms reported by parents versus teachers.
Sprint acceleration mechanical profiling of international cricketers
Authors: Ahmun Robert , Scott Philip , Jones Thomas W , Tallent Jamie
Published: July 2020

Sprinting and speed is a fundamental skill and physical attribute crucial in seam bowlers and batters within cricket. The aim of this study was to assess differences in mechanical properties during sprinting between youth and senior international cricketers and between seam bowlers and batters. Retrospective 40 m sprint times and anthropometric measures of 56 international cricketers (19 senior seam bowlers, 7 under-19 seam bowlers, 16 senior batters, 14 under-19 batters) were used to calculate the theoretical maximal force (F0), theoretical maximal velocity (V(0)), theoretical maximal power (Pmax), slope of the force-velocity relationship (F-V slope), maximal ratio of horizontal-to-resultant force (RFmax), decrease in the ratio of horizontal-to-resultant force (DRF) and optimum velocity (Vopt). There were no significant (P > 0.05) differences in sprint times nor sprint mechanical profile variables between position or age. However, there was a moderately greater F0 (N/Kg) (ES = 0.78; 90% CI 0.19–1.34) and RFmax (ES = 0.75; 90% CI 0.11–1.35) in senior seam bowlers when compared to batters. Furthermore, FV Slope (ES = 0.79; 90% CI 0.15–1.40) and DRF (ES = 0.75; 90% CI 0.11–1.35) were moderately greater in senior compared to under-19 batters. When expressed relative to body mass, it appears that senior international seam bowlers show trends towards a more force biased profile during sprinting when compared to batters. These findings will help coaches to optimise physical preparation strategies in youth and senior international cricketers.
Guidelines for Frontline Health Care Staff Safety for COVID-19
Authors: Baker Terrance L. , Greiner Jack V. , Maxwell-Schmidt Elizabeth , Lamothe P. Henri , Vesonder Modesta
Published: July 2020

This document establishes safety guidelines for physicians, nurses, and allied health care and facility staff who may be exposed to patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a health care facility. SARS-CoV-2 infection is highly contagious and places health care workers at risk for infection resulting in coronavirus disease (COVID-19). Physicians, nurses, and allied health care and facility staff in all frontline environments must be provided and utilize necessary personal protective equipment (PPE). It is important that health care staff adopt a universal set of guidelines in which to conduct themselves in order to minimize infection with the SARS-CoV-2 contagion. The establishment of these guidelines is necessary in this viral pandemic since such directives can create a standard of safety that is universally accepted. These guidelines establish a framework to provide consistency among health care facilities and staff from the time the staff member arrives at the health care facility until they return home. These guidelines provide a practical description of the minimum necessary protection for physicians, nurses, and allied health care and facility staff against SARS-CoV-2 infection.
Effects of Emotional Expressions, Gaze, and Head Orientation on Person Perception in Social Situations
Authors: Kaisler Raphaela E. , Marin Manuela M. , Leder Helmut
Published: July 2020

When an observer perceives and judges two persons next to each other, different types of social cues simultaneously arise from both perceived faces. Using a controlled stimulus set depicting this scenario (with two persons identified respectively as “target face” and “looking face”), we explored how emotional expressions, gaze, and head direction of the looking face affect the observers’ eye movements and judgments of the target face. The target face always displayed a neutral expression, gazing directly at the observer (“direct gaze”). The looking face showed either a direct gaze, looked toward the target face, or averted it. A total of 52 undergraduate students (25 males) freely viewed these scenes for 5 s while their eye movements were recorded, which was followed by collecting ratings of attractiveness and trustworthiness. Dwell times on target faces were longer when accompanied by a looking face with direct gaze, regardless of its emotional expression. However, participants looked longer on faces looking toward the target in the approach condition and fixated more often on target faces that were either next to an angry-looking face directly looking at them or to a happy-looking averted face. We found no gaze effect on faces that were looked at by another face and no significant correlation between observers’ dwell time and attractiveness or trustworthiness ratings of the target and looking face, indicating dissociated perception and judgment processes. Irrespective of the gaze direction, as expected, happy faces were judged as more attractive and trustworthy than angry faces. Future studies will need to examine this dynamic interplay of social cues in triadic scenes.
Stories or Expositive Messages? Comparing Their Effectiveness in Corporate Social Responsibility Communication
Authors: Pérez Andrea , Baraibar-Diez Elisa , García de los Salmones María del Mar
Published: July 2020

In the context of corporate social responsibility (CSR) communication, we explore whether consumer perceptions and responses differ when the message content is based on storytelling or exposition. The conceptual model that we propose in the article includes five attributes of CSR message content (i.e., issue importance, CSR impact, CSR motives, CSR fit, and CSR commitment) and their relationships to two types of consumer responses (i.e., purchase and advocacy). We collected data from 444 participants who evaluated the website of a fictitious restaurant chain that included information about its CSR activities using (a) storytelling or (b) expositive CSR messages. The findings suggest that the use of storytelling notably improves perceptions of issue importance, CSR impact, CSR fit, and CSR commitment. On the contrary, the type of CSR message does not differentiate consumer perceptions of corporate CSR motives. The use of storytelling or an expositive CSR message also has a significant impact on the conceptual model, with consumers responding more or less intensively to each attribute of the CSR message content depending on the type of message they are exposed to.
Plans and situated actions in urban renewal projects: The role of governance devices in realizing projects
Authors: Brorström Sara , Styhre Alexander
Published: July 2020

Municipalities and city administrations have the jurisdiction to determine the use of land and real estate, but must collaborate with various actors, including real estate developers, construction companies, and financial institutions, to realize stated goals. When implementing initiatives such as urban renewal projects, plans and situated actions may be loosely coupled during the early stages, when visions of the future are being articulated; over time, however, the information needed to calculate whether illiquid assets are attractive investment objects must be introduced. As such information is generated, the gap between plans and situated actions closes, having material effects under favourable conditions. This article presents an empirical study of an urban renewal project in a metropolitan area that initially gained external recognition via a prize awarded for visionary planning work. The project eventually encountered considerable difficulties, as a shortage of accurate information hampered production activities. The study underlines the importance of robust governance practices and accompanying governance devices in effectively transforming illiquid assets into, for example, housing.
Comparison of the cytoplastic genomes by resequencing: insights into the genetic diversity and the phylogeny of the agriculturally important genus Brassica
Authors: Qiao Jiangwei , Zhang Xiaojun , Chen Biyun , Huang Fei , Xu Kun , Huang Qian , Huang Yi , Hu Qiong , Wu Xiaoming
Published: July 2020

Background

The genusBrassicamainly comprises three diploid and three recently derived allotetraploid species, most of which are highly important vegetable, oil or ornamental crops cultivated worldwide. Despite being extensively studied, the origination ofB. napusand certain detailed interspecific relationships withinBrassicagenus remains undetermined and somewhere confused. In the current high-throughput sequencing era, a systemic comparative genomic study based on a large population is necessary and would be crucial to resolve these questions.

Results

The chloroplast DNA and mitochondrial DNA were synchronously resequenced in a selected set ofBrassicamaterials, which contain 72 accessions and maximally integrated the knownBrassicaspecies. TheBrassicagenomewide cpDNA and mtDNA variations have been identified. Detailed phylogenetic relationships inside and aroundBrassicagenus have been delineated by the cpDNA- and mtDNA- variation derived phylogenies. Different fromB. junceaandB. carinata, the naturalB. napuscontains three major cytoplasmic haplotypes: thecam-type which directly inherited fromB. rapa,polima-type which is close tocam-type as a sister, and the mysterious but predominantnap-type. Certain sparse C-genome wild species might have primarily contributed thenap-type cytoplasm and the corresponding C subgenome toB. napus, implied by their con-clustering in both phylogenies. The strictly concurrent inheritance of mtDNA and cpDNA were dramatically disturbed in theB. napuscytoplasmic male sterile lines (e.g.,moriandnsa). The generaRaphanus, Sinapis,Eruca,Moricandiashow a strong parallel evolutional relationships withBrassica.

Conclusions

The overall variation data and elaborated phylogenetic relationships provide further insights into genetic understanding ofBrassica, which can substantially facilitate the development of novelBrassicagermplasms.
Opportunistic detection of Fusobacterium nucleatum as a marker for the early gut microbial dysbiosis
Authors: Huh Ji-Won , Roh Tae-Young
Published: July 2020

Background

The essential roles of gut microbiome have been emphasized in modulating human health and disease. Fusobacterium nucleatum (F. nucleatum), an obligate Gram-negative microorganism residing in oral cavity, gastrointestinal tract and elsewhere, has been recently considered as a potential oncobacterium associated with human cancers. However, the consequence of its enrichment was not extensively explored in terms of microbial homeostasis and stability at the early stage of disease development.

Result

Our analysis on longitudinal metagenomic data generated by the Integrative Human Microbiome Project (iHMP) showed that F. nucleatum was frequently found in inflammatory bowel diseases (IBD) subjects with reduced microbial diversity. Using non-parametric logarithmic linear discriminant analysis (LDA) effect size (LEfSe) algorithm, 12 IBD- and 14 non-IBD-specific bacterial species were identified in the fecal metagenome and the IBD-specific ones were over-represented in the F. nucleatum-experienced subjects during long-term surveillance. In addition, F. nucleatum experience severely abrogated intra-personal stability of microbiome in IBD patients and induced highly variable gut microbiome between subjects. From the longitudinal comparison between microbial distributions prior and posterior to F. nucleatum detection, 41 species could be proposed as indicative “classifiers” for dysbiotic gut state. By multiple logistic regression models established on these classifiers, the high probability of experiencing F. nucleatum was significantly correlated with decreased alpha-diversity and increased number of biomarker species for IBD and colorectal cancer (CRC). Finally, microbial clustering confirmed that biomarker species for IBD and non-IBD conditions as well as CRC signature markers were well distinguishable and could be utilized for explaining gut symbiosis and dysbiosis.

Conclusion

F. nucleatum opportunistically appeared under early dysbiotic condition in gut, and discriminative classifier species associated with F. nucleatum were successfully applied to predict microbial alterations in both IBD and non-IBD conditions. Our prediction model and microbial classifier biomarkers for estimating gut dysbiosis should provide a novel aspect of microbial homeostasis/dynamics and useful information on non-invasive biomarker screening.
Efficacy of more intensive lipid-lowering therapy on cardiovascular diseases: a systematic review and meta-analysis
Authors: Hsu Hsin-Yin , Lin Chien-Ju , Lee Yu-Shan , Wu Ting-Hui , Chien Kuo-Liong
Published: July 2020

Background

Cardiovascular disease is the leading cause of morbidity and mortality with incidence rates of 5–10 per 1000 person-years, according to primary prevention studies. To control hyperlipidemia—a major risk factor of cardiovascular disease—initiation of lipid-lowering therapy with therapeutic lifestyle modification or lipid-lowering agent is recommended. Few systematic reviews and meta-analyses are available on lipid-lowering therapy for the primary prevention of cardiovascular diseases. In addition, the operational definitions of intensive lipid-lowering therapies are heterogeneous. The aim of our study was to investigate whether intensive lipid-lowering therapies reduce greater cardiovascular disease risks in primary prevention settings.

Methods

MEDLINE, EMBASE, and Cochrane Library databases were searched from inception to March 2019 for randomized controlled trials. We used random effects model for overall pooled risk ratio (RR) estimation with cardiovascular events of interest and all-cause mortality rate for the intensive lipid-lowering group using the standard lipid-lowering group as the reference. The Cochrane Risk of Bias Tool was used for quality assessment.

Results

A total of 18 randomized controlled trials were included. The risk reductions in cardiovascular outcomes and all-cause mortality associated with more intensive vs. standard lipid-lowering therapy across all trials were 24 and 10%, respectively (RR 0.76, 95% confidence interval 0.68–0.85; RR 0.90, 95% confidence interval 0.83–0.97); however, the risk reduction varied by baseline LDL-C level in the trial. A greater risk reduction was noted with higher LDL-C level. Intensive lipid-lowering for coronary heart disease protection was more pronounced in the non-diabetic populations than in the diabetic populations.

Conclusions

More intensive LDL-C lowering was associated with a greater reduction in risk of total and cardiovascular mortality in trials of patients with higher baseline LDL-C levels than less intensive LDL-C lowering. Intensive lipid-lowering was associated with a significant risk reduction of coronary heart disease and must be considered even in the non-diabetic populations.
A pay for performance scheme in primary care: Meta-synthesis of qualitative studies on the provider experiences of the quality and outcomes framework in the UK
Authors: Khan Nagina , Rudoler David , McDiarmid Mary , Peckham Stephen
Published: July 2020

Background

The Quality and Outcomes Framework (QOF) is an incentive scheme for general practice, which was introduced across the UK in 2004. The Quality and Outcomes Framework is one of the biggest pay for performance (P4P) scheme in the world, worth £691 million in 2016/17. We now know that P4P is good at driving some kinds of improvement but not others. In some areas, it also generated moral controversy, which in turn created conflicts of interest for providers. We aimed to undertake a meta-synthesis of 18 qualitative studies of the QOF to identify themes on the impact of the QOF on individual practitioners and other staff.

Methods

We searched 5 electronic databases, Medline, Embase, Healthstar, CINAHL and Web of Science, for qualitative studies of the QOF from the providers’ perspective in primary care, published in UK between 2004 and 2018. Data was analysed using the Schwartz Value Theory as a theoretical framework to analyse the published papers through the conceptual lens of Professionalism. A line of argument synthesis was undertaken to express the synthesis.

Results

We included 18 qualitative studies that where on the providers’ perspective. Four themes were identified; 1) Loss of autonomy, control and ownership; 2) Incentivised conformity; 3) Continuity of care, holism and the caring role of practitioners’ in primary care; and 4) Structural and organisational changes.Our synthesis found, the Values that were enhanced by the QOF were power, achievement, conformity, security, and tradition. The findings indicated that P4P schemes should aim to support Values such as benevolence, self-direction, stimulation, hedonism and universalism, which professionals ranked highly and have shown to have positive implications for Professionalism and efficiency of health systems.

Conclusions

Understanding how practitioners experience the complexities of P4P is crucial to designing and delivering schemes to enhance and not compromise the values of professionals. Future P4P schemes should aim to permit professionals with competing high priority values to be part of P4P or other quality improvement initiatives and for them to take on an ‘influencer role’ rather than being ‘responsive agents’. Through understanding the underlying Values and not just explicit concerns of professionals, may ensure higher levels of acceptance and enduring success for P4P schemes.
Hepatitis B virus-associated hepatocellular carcinoma in South Africa in the era of HIV
Authors: Maponga Tongai Gibson , Glashoff Richard H. , Vermeulen Hannali , Robertson Barbara , Burmeister Sean , Bernon Marc , Omoshoro-Jones Jones , Ruff Paul , Neugut Alfred I. , Jacobson Judith S. , Preiser Wolfgang , Andersson Monique I.
Published: July 2020

Background

Patients co-infected with hepatitis B virus (HBV) and the human immunodeficiency virus (HIV) are at risk of developing hepatocellular carcinoma (HCC). In sub-Saharan Africa, the overlap between high HIV and HBV prevalence may increase the incidence of HCC. This study investigated the impact of HBV/HIV co-infection on age at presentation and survival of HCC.

Methods

Ethical approval was obtained to recruit, following informed written consent, patients diagnosed with HCC at oncology units at four South African hospitals. Between December 2012 and August 2015, patients newly diagnosed with HCC were recruited and provided demographic and clinical data and blood specimens. Patients were tested for HBV, hepatitis C virus (HCV) and HIV. Survival data was available for a subset of patients.

Results

Of 107 HCC cases, 83 (78%) were male. Median age was 46 years (range 18 to 90 years), 68/106 (64%) were HBsAg-positive, and 22/100 (22%) were HIV infected. Among HBV surface antigen (HBsAg)-positive HCC cases, 18/66 (27%) were HIV-infected compared to 3/34 (9%) among those that were HBsAg-negative (p = 0.04). A greater proportion of HBV/HIV co-infected cases were female than HBV mono-infected (6/18, 33% vs 6/47, 13%; p = 0.005). In addition, HBV/HIV co-infected females presented at a younger mean age (36.8 years) than HBV mono-infected women (50.5 years) (p = 0.09). Median survival was 82 days among the HIV-infected HCC patients compared to 181 days among those without HIV (p = 0.15).

Conclusions

HCC is an important complication in the HIV/HBV infected patient. HIV-positive patients presented with HCC at a younger age than HIV-negative patients, this effect appears to be greater in women. These data provide more evidence supporting the call to address. HCC as a cause of morbidity and mortality in the HBV/HIV co-infected patient population. (281 words).
The age-specific incidence of hospitalized paediatric malaria in Uganda
Authors: Mpimbaza Arthur , Walemwa Richard , Kapisi James , Sserwanga Asadu , Namuganga Jane Frances , Kisambira Yasin , Tagoola Abner , Nanteza Jane Frances , Rutazaana Damain , Staedke Sarah G. , Dorsey Grant , Opigo Jimmy , Kamau Alice , Snow Robert W.
Published: July 2020

Background

Understanding the relationship between malaria infection risk and disease outcomes represents a fundamental component of morbidity and mortality burden estimations. Contemporary data on severe malaria risks among populations of different parasite exposures are scarce. Using surveillance data, we compared rates of paediatric malaria hospitalisation in areas of varying parasite exposure levels.

Methods

Surveillance data at five public hospitals; Jinja, Mubende, Kabale, Tororo, and Apac were assembled among admissions aged 1 month to 14 years between 2017 and 2018. The address of each admission was used to define a local catchment population where national census data was used to define person-year-exposure to risk. Within each catchment, historical infection prevalence was assembled from previously published data and current infection prevalence defined using 33 population-based school surveys among 3400 children. Poisson regression was used to compute the overall and site-specific incidences with 95% confidence intervals.

Results

Both current and historicalPlasmodium falciparumprevalence varied across the five sites. Current prevalence ranged from < 1% in Kabale to 54% in Apac. Overall, the malaria admission incidence rate (IR) was 7.3 per 1000 person years among children aged 1 month to 14 years of age (95% CI: 7.0, 7.7). The lowest rate was described at Kabale (IR = 0.3; 95 CI: 0.1, 0.6) and highest at Apac (IR = 20.3; 95 CI: 18.9, 21.8). There was a correlation between IR across the five sites and the current parasite prevalence in school children, though findings were not statistically significant. Across all sites, except Kabale, malaria admissions were concentrated among young children, 74% were under 5 years. The median age of malaria admissions at Kabale hospital was 40 months (IQR 20, 72), and at Apac hospital was 36 months (IQR 18, 69). Overall, severe anaemia (7.6%) was the most common presentation and unconsciousness (1.8%) the least common.

Conclusion

Malaria hospitalisation rates remain high in Uganda particularly among young children. The incidence of hospitalized malaria in different locations in Uganda appears to be influenced by past parasite exposure, immune acquisition, and current risks of infection. Interruption of transmission through vector control could influence age-specific severe malaria risk.
Discriminative pattern of reduced cerebral blood flow in Parkinson’s disease and Parkinsonism-Plus syndrome: an ASL-MRI study
Authors: Cheng Lina , Wu Xiaoyan , Guo Ruomi , Wang Yuzhou , Wang Wensheng , He Peng , Lin Hanbo , Shen Jun
Published: July 2020

Background

Accurate identification of Parkinson’s disease (PD) and Parkinsonism-Plus syndrome (PPS), especially in the early stage of the disease, is very important. The purpose of this study was to investigate the discriminative spatial pattern of cerebral blood flow (CBF) between patients with PD and PPS.

Methods

Arterial spin labeling (ASL) perfusion-weighted imaging was performed in 20 patients with PD (mean age 56.35 ± 7.56 years), 16 patients with PPS (mean age 59.62 ± 6.89 years), and 17 healthy controls (HCs, mean age 54.17 ± 6.58 years). Voxel-wise comparison of the CBF was performed among PD, PPS, and HC groups. The receiver operating characteristic (ROC) curve was used to evaluate the performance of CBF in discriminating between PD and PPS. The relationship between CBF and non-motor neuropsychological scores was assessed by correlation analysis.

Results

PD group showed a significantly decreased CBF in the right cerebelum_crus2, the left middle frontal gyrus (MFG), the triangle inferior frontal gyrus (IFG_Tri), the left frontal medial orbital gyrus (FG_Med_Orb) and the left caudate nucleus (CN) compared with the HC group (P < 0.05). Besides the above regions, the left supplementary motor area (SMA), the right thalamus had decreased CBF in the PPS group compared with the HC group (P < 0.05). PPS group had lower CBF value in the left MFG, the left IFG_Tri, the left CN, the left SMA, and the right thalamus compared with the PD group (P < 0.05). CBFs in left IFG_Tri, the left CN, the left SMA, and the right thalamus had moderate to high capacity in discriminating between PD and PPS patients (AUC 0.719–0.831). The CBF was positively correlated with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores in PD patients, while positively correlated with the MMSE, Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) scores in PPS patients (P < 0.05).

Conclusion

PD and PPS patients have certain discriminative patterns of reduced CBFs, which can be used as a surrogate marker for differential diagnosis.
Association of MUC1 5640G>A and PSCA 5057C>T polymorphisms with the risk of gastric cancer in Northern Iran
Authors: Alikhani Reza , Taravati Ali , Hashemi-Soteh Mohammad Bagher
Published: July 2020

Background

Gastric cancer is one of the four most common cancer that causing death worldwide. Genome-Wide Association Studies (GWAS) have shown that genetic diversities MUC1 (Mucin 1) and PSCA (Prostate Stem Cell Antigen) genes are involved in gastric cancer. The aim of this study was avaluating the association of rs4072037G > A polymorphism in MUC1 and rs2294008 C > T in PSCA gene with risk of gastric cancer in northern Iran.

Methods

DNA was extracted from 99 formalin fixed paraffin-embedded (FFPE) tissue samples of gastric cancer and 96 peripheral blood samples from healthy individuals (sex matched) as controls. Two desired polymorphisms, 5640G > A and 5057C > T for MUC1 and PSCA genes were genotyped using PCR-RFLP method.

Results

The G allele at rs4072037 of MUC1 gene was associated with a significant decreased gastric cancer risk (OR = 0.507, 95% CI: 0.322–0.799, p = 0.003). A significant decreased risk of gastric cancer was observed in people with either AG vs. AA, AG + AA vs. GG and AA+GG vs. AG genotypes of MUC1 polymorphism (OR = 4.296, 95% CI: 1.190–15.517, p = 0.026), (OR = 3.726, 95% CI: 2.033–6.830, p = 0.0001) and (OR = 0.223, 95% CI: 0.120–0.413, p = 0.0001) respectively. Finally, there was no significant association between the PSCA 5057C > T polymorphism and risk of gastric cancer in all genetic models.

Conclusion

Results indicated that the MUC1 5640G > A polymorphism may have protective effect for gastric cancer in the Northern Iran population and could be considered as a potential molecular marker in gastric cancer.
Macrophage polarization in innate immune responses contributing to pathogenesis of chronic kidney disease
Authors: Lee Hewang , Fessler Michael B. , Qu Peng , Heymann Jurgen , Kopp Jeffrey B.
Published: July 2020

Chronic kidney disease (CKD) is characterized by inflammation, injury and fibrosis. Dysregulated innate immune responses mediated by macrophages play critical roles in progressive renal injury. The differentiation and polarization of macrophages into pro-inflammatory ‘M1’ and anti-inflammatory ‘M2’ states represent the two extreme maturation programs of macrophages during tissue injury. However, the effects of macrophage polarization on the pathogenesis of CKD are not fully understood. In this review, we discuss the innate immune mechanisms underlying macrophage polarization and the role of macrophage polarization in the initiation, progression, resolution and recurrence of CKD. Macrophage activation and polarization are initiated through recognition of conserved endogenous and exogenous molecular motifs by pattern recognition receptors, chiefly, Toll-like receptors (TLRs), which are located on the cell surface and in endosomes, and NLR inflammasomes, which are positioned in the cytosol. Recent data suggest that genetic variants of the innate immune molecule apolipoprotein L1 (APOL1) that are associated with increased CKD prevalence in people of African descent, mediate an atypical M1 macrophage polarization. Manipulation of macrophage polarization may offer novel strategies to address dysregulated immunometabolism and may provide a complementary approach along with current podocentric treatment for glomerular diseases.
Defective migration and dysmorphology of neutrophil granulocytes in atypical chronic myeloid leukemia treated with ruxolitinib
Authors: Bornemann Lea , Schuster Marc , Schmitz Saskia , Sobczak Charlyn , Bessen Clara , Merz Simon F. , Jöckel Karl-Heinz , Haverkamp Thomas , Gunzer Matthias , Göthert Joachim R.
Published: July 2020

Background

The identification of pathologically altered neutrophil granulocyte migration patterns bears strong potential for surveillance and prognostic scoring of diseases. We recently identified a strong correlation between impaired neutrophil motility and the disease stage of myelodysplastic syndrome (MDS). Here, we apply this assay to study quantitively increased neutrophils of a patient suffering from a rare leukemia subtype, atypical chronic myeloid leukemia (aCML).

Methods

A 69-year-old male was analyzed in this study. Besides routine analyses, we purified the patient’s neutrophils from peripheral whole blood and studied their migration behavior using time-lapse video microscopy in a standardized assay. These live cell migration analyses also allowed for the quantification of cell morphology. Furthermore, the cells were stained for the markers CD15, CD16, fMLPR, CXCR1 and CXCR2.

Results

Despite cytoreductive therapy with hydroxyurea, the patient’s WBC and ANC were poorly controlled and severe dysgranulopoiesis with hypogranularity was observed. Neutrophils displayed strongly impaired migration when compared to healthy controls and migrating cells exhibited a more flattened-out morphology than control neutrophils. Because of a detected CSF3R (p.T618I) mutation and constitutional symptoms treatment with ruxolitinib was initiated. Within 1 week of ruxolitinib treatment, the cell shape normalized and remained indistinguishable from healthy control neutrophils. However, neutrophil migration did not improve over the course of ruxolitinib therapy but was strikingly altered shortly before a sinusitis with fever and bleeding from a gastric ulcer. Molecular work-up revealed that under ruxolitinib treatment, the CSF3R clone was depleted, yet the expansion of a NRAS mutated subclone was promoted.

Conclusion

These results demonstrate the usefulness of neutrophil migration analyses to uncover corresponding alterations of neutrophil migration in rare myeloid neoplasms. Furthermore, in addition to monitoring migration the determination of morphological features of live neutrophils might represent a useful tool to monitor the effectiveness of therapeutic approaches.
Ophthalmic manifestations of congenital protein C deficiency: a case report and mini review
Authors: Ghassemi Fariba , Abdi Fatemeh , Esfahani Mandana
Published: July 2020

Background

Homozygous protein C (PC) deficiency is a potentially fatal disease with ocular blinding presentation or sequela.

Case presentation

A 5 month-old boy was presented for evaluation of leukocoria. He had a history of frequent bruises and PC deficiency, treated with warfarin.

His intraocular pressure was normal. In the left eye leukoma with anterior segment dysgenesis, shallow anterior chamber, and cataract were observed. Fundus was not visible. B-scan revealed a closed funnel retinal detachment. His right eye had a normal anterior segment and a thin retina with anomalous retinal vascular branching at equator and peripheral retina. A fibrovascular tuft on the optic nerve head with induced traction on superior arcade was visible. Total loss of a and b wave of both were appreciated in electroretinography (ERG). Fluorescein angiography (FA) showed very severe leakage at the junction of the vascularized and non-vascularized retina and optic nerve head. Favorable outcome was achieved with lasering of avascular retina in the right eye.

Conclusion

The potential for protein C deficiency should be assessed in all infants with leukocoria, anterior segment dysgenesis, retinal detachment and retinal dysplasia. Early diagnosis could save the child’s life and vision.