bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of contextualisation in enhancing non-communicable disease programmes and policy implementation to achieve health for all
Authors: Liu Hueiming , Huffman Mark D. , Trieu Kathy
Published: April 2020

The September 2019 United Nations’ High-Level Meeting renewed political commitments to invest in universal health coverage by strengthening health systems, programmes and policies to achieve ‘health for all’. This Political Declaration is relevant to addressing the increasing global burden of non-communicable diseases, but how can evidence-based programmes and policies be meaningfully implemented and integrated into local contexts? In this Commentary, we describe how the process of contextualisation and associated tools, such as ecological frameworks, implementation research frameworks, health system indicators, effective system strengthening strategies and evidence mapping databases with priority-setting, can enhance the implementation and integration of non-communicable disease prevention and control policies and programmes. Examples across health platforms include (1) population approaches to reducing excess sodium intake, (2) fixed-dose combination therapy for cardiovascular disease prevention and control, and (3) health systems strengthening for improving the quality and safety of cardiovascular care. Contextualisation is needed to transfer evidence into locally relevant and impactful policies and programmes. The systematic and comprehensive use of contextualisation tools leverages key implementation research principles to achieve ‘health for all’.
Benchmarking the transparency, comprehensiveness and specificity of population nutrition commitments of major food companies in Malaysia
Authors: Ng SeeHoe , Sacks Gary , Kelly Bridget , Yeatman Heather , Robinson Ella , Swinburn Boyd , Vandevijvere Stefanie , Chinna Karuthan , Ismail Mohd Noor , Karupaiah Tilakavati
Published: April 2020

Background

The aim of this study was to assess the commitments of food companies in Malaysia to improving population nutrition using the Business Impact Assessment on population nutrition and obesity (BIA-Obesity) tool and process, and proposing recommendations for industry action in line with government priorities and international norms.

Methods

BIA-Obesity good practice indicators for food industry commitments across a range of domains (n = 6) were adapted to the Malaysian context. Euromonitor market share data was used to identify major food and non-alcoholic beverage manufacturers (n = 22), quick service restaurants (5), and retailers (6) for inclusion in the assessment. Evidence of commitments, including from national and international entities, were compiled from publicly available information for each company published between 2014 and 2017. Companies were invited to review their gathered evidence and provide further information wherever available. A qualified Expert Panel (≥5 members for each domain) assessed commitments and disclosures collected against the BIA-Obesity scoring criteria. Weighted scores across domains were added and the derived percentage was used to rank companies. A Review Panel, comprising of the Expert Panel and additional government officials (n = 13), then formulated recommendations.

Results

Of the 33 selected companies, 6 participating companies agreed to provide more information. The median overall BIA-Obesity score was 11% across food industry sectors with only 8/33 companies achieving a score of > 25%. Participating (p < 0.001) and global (p = 0.036) companies achieved significantly higher scores than non-participating, and national or regional companies, respectively. Corporate strategy related to population nutrition (median score of 28%) was the highest scoring domain, while product formulation, accessibility, and promotion domains scored the lowest (median scores < 10%). Recommendations included the establishment of clear targets for product formulation, and strong commitments to reduce the exposure of children to promotion of unhealthy foods.

Conclusions

This is the first BIA-Obesity study to benchmark the population nutrition commitments of major food companies in Asia. Commitments of companies were generally vague and non-specific. In the absence of strong government regulation, an accountability framework, such as provided by the BIA-Obesity, is essential to monitor and benchmark company action to improve population nutrition.
The effects of opium on the cardiovascular system: a review of side effects, uses, and potential mechanisms
Authors: Nakhaee Samaneh , Ghasemi Saeedeh , Karimzadeh Kimiya , Zamani Nasim , Alinejad-Mofrad Samaneh , Mehrpour Omid
Published: April 2020

Background

In Iran, as in many other Asian and Middle Eastern countries, some believe that opium has beneficial effects on cardiovascular system. Dependent patients suppose that opium has positive effects on cardiovascular function and can prevent or improve cardiovascular diseases; however, only few comprehensive studies evaluating such effects have been performed.

Objectives

In this study, we sought to clarify the effect of opium on cardiovascular problems by incorporating the previous findings and the current information on the issue and to explain the possible mechanisms of this effect.

Methods

The available human studies published up to October 30, 2019, were searched in different databases. Case-control, cohort, and cross-sectional studies were retrieved. Papers published in English or those with an English abstract were included. The risk of bias for each included study was assessed based on the Newcastle-Ottawa Scale (NOS). We then categorized the effects of opium on cardiovascular problems along with its probable underlying mechanisms of action.

Results

In this study, most of the published articles suggested the adverse effects of opium on the cardiovascular system, including atherosclerosis, myocardial infarction, arrhythmia, low ejection fraction, and cardiovascular mortality; however, some articles reported the beneficial or impartial effects of opium on the cardiovascular system. In this article, we have categorized all the effects of opium on cardiovascular system; also, the proposed mechanisms of action of opium in each of the above-mentioned disorders are summarized.

Conclusion

Although the available evidences were incoherent, it was mostly suggested that opium use does not protect against or improve cardiovascular problems.
Brain metastases treated with hypofractionated stereotactic radiotherapy: 8 years experience after Cyberknife installation
Authors: Mengue Laurence , Bertaut Aurélie , Ngo Mbus Louise , Doré Mélanie , Ayadi Myriam , Clément-Colmou Karen , Claude Line , Carrie Christian , Laude Cécile , Tanguy Ronan , Blanc Julie , Sunyach Marie-Pierre
Published: April 2020

Background

Hypofractionated stereotactic radiotherapy (HFSRT) is indicated for large brain metastases (BM) or proximity to critical organs (brainstem, chiasm, optic nerves, hippocampus). The primary aim of this study was to assess factors influencing BM local control after HFSRT.

Then the effect of surgery plus HFSRT was compared with exclusive HFSRT on oncologic outcomes, including overall survival.

Materials and methods

Retrospective study conducted in Léon Bérard Cancer Center, included patients over 18 years-old with BM, secondary to a tumor proven by histology and treated by HFSRT alone or after surgery. Three different dose-fractionation schedules were compared: 27 Gy (3 × 9 Gy), 30 Gy (5 × 6 Gy) and 35 Gy (5 × 7 Gy), prescribed on isodose 80%. Primary endpoint were local control (LC). Secondary endpoints were overall survival (OS) and radionecrosis (RN) rate.

Results

A total of 389 patients and 400 BM with regular MRI follow-up were analyzed. There was no statistical difference between the different dose-fractionations. On multivariate analysis, surgery (p = 0.049) and size (< 2.5 cm) (p = 0.01) were independent factors improving LC. The 12 months LC was 87.02% in the group Surgery plus HFSRT group vs 73.53% at 12 months in the group HFSRT. OS was 61.43% at 12 months in the group Surgery plus HFSRT group vs 50.13% at 12 months in the group HFSRT (p < 0.0085). Prior surgery (OR = 1.86; p = 0.0028) and sex (OR = 1.4; p = 0.0139) control of primary tumor (OR = 0.671, p = 0.0069) and KPS < 70 (OR = 0.769, p = 0.0094) were independently predictive of OS. The RN rate was 5% and all patients concerned were symptomatic.

Conclusions

This study suggests that HFSRT is an efficient and well-tolerated treatment. The optimal dose-fractionation remains difficult to determine. Smaller size and surgery are correlated to LC. These results evidence the importance of surgery for larger BM (> 2.5 cm) with a poorer prognosis. Multidisciplinary committees and prospective studies are necessary to validate these observations.
A model for evaluation of the electric activity and oxygenation in the erector spinae muscle during isometric loading adapted for spine patients
Authors: Ekström Lars , Zhang Qiuxia , Abrahamson Josefin , Beck Joel , Johansson Christer , Westin Olof , Todd Carl , Baranto Adad
Published: April 2020

Background

Simultaneous measurement of electromyography (EMG) and local muscle oxygenation is proposed in an isometric loading model adjusted for patients that have undergone spinal surgery.

Methods

Twelve patients with degenerative lumbar spinal stenosis (DLSS) were included. They were subjected to a test protocol before and after surgery. The protocol consisted of two parts, a dynamic and an isometric Ito loading with a time frame of 60 s and accompanying rest of 120 s. The Ito test was repeated three times. EMG was measured bilaterally at the L4 level and L2 and was recorded using surface electrodes and collected (Biopac Systems Inc.). EMG signal was expressed as RMS and median frequency (MF). Muscle tissue oxygen saturation (MrSO2) was monitored using a near-infrared spectroscopy (NIRS) device (INVOS® 5100C Oxymeter). Two NIRS sensors were positioned bilaterally at the L4 level.

The intensity of the leg and back pain and perceived exertion before, during, and after the test was evaluated with a visual analogue scale (VAS) and Borg RPE-scale, respectively.

Results

All patients were able to perform and complete the test protocol pre- and postoperatively. A consistency of lower median and range values was noted in the sensors of EMG1 (15.3 μV, range 4.5–30.7 μV) and EMG2 (13.6 μV, range 4.0–46.5 μV) that were positioned lateral to NIRS sensors at L4 compared with EMG3 (18.9 μV, range 6.5–50.0 μV) and EMG4 (20.4 μV, range 7.5–49.0 μV) at L2. Right and left side of the erector spinae exhibited a similar electrical activity behaviour over time during Ito test (60 s). Regional MrSO2 decreased over time during loading and returned to the baseline level during recovery on both left and right side. Both low back and leg pain was significantly reduced postoperatively.

Conclusion

Simultaneous measurement of surface EMG and NIRS seems to be a promising tool for objective assessment of paraspinal muscle function in terms of muscular activity and local muscle oxygenation changes in response to isometric trunk extension in patients that have undergone laminectomy for spinal stenosis.
Deep learning methods improve linear B-cell epitope prediction
Authors: Liu Tao , Shi Kaiwen , Li Wuju
Published: April 2020

Background

B-cell epitopes play important roles in vaccine design, clinical diagnosis, and antibody production. Although some models have been developed to predict linear or conformational B-cell epitopes, their performance is still unsatisfactory. Hundreds of thousands of linear B-cell epitope data have accumulated in the Immune Epitope Database (IEDB). These data can be explored using the deep learning methods, in order to create better predictive models for linear B-cell epitopes.

Results

After data cleaning, we obtained 240,563 peptide samples with experimental evidence from the IEDB database, including 25,884 linear B-cell epitopes and 214,679 non-epitopes. Based on the peptide center, we adapted each peptide to the same length by trimming or extending. A random portion of the data, with the same amount of epitopes and non-epitopes, were set aside as test dataset. Then a same number of epitopes and non-epitopes were randomly selected from the remaining data to build a classifier with the feedforward deep neural network. We built eleven classifiers to form an ensemble prediction model. The model will report a peptide as an epitope if it was classified as epitope by all eleven classifiers. Then we used the test data set to evaluate the performance of the model using the area value under the receiver operating characteristic (ROC) curve (AUC) as an indicator. We established 40 models to predict linear B-cell epitopes of length from 11 to 50 separately, and found that the AUC value increased with the length and tended to be stable when the length was 38. Repeated results showed that the models constructed by this method were robust. Tested on our and two public test datasets, our models outperformed current major models available.

Conclusions

We applied the feedforward deep neural network to the large amount of linear B-cell epitope data with experimental evidence in the IEDB database, and constructed ensemble prediction models with better performance than the current major models available. We named the models as DLBEpitope and provided web services using the models at http://ccb1.bmi.ac.cn:81/dlbepitope/.
Physical activity reduces anxiety and regulates brain fatty acid synthesis
Authors: Liśkiewicz Arkadiusz , Przybyła Marta , Wojakowska Anna , Marczak Łukasz , Bogus Katarzyna , Nowacka-Chmielewska Marta , Liśkiewicz Daniela , Małecki Andrzej , Barski Jarosław , Lewin-Kowalik Joanna , Toborek Michal
Published: April 2020

Physical activity impacts brain functions, but the direct mechanisms of this effect are not fully recognized or understood. Among multidimensional changes induced by physical activity, brain fatty acids (FA) appear to play an important role; however, the knowledge in this area is particularly scarce. Here we performed global metabolomics profiling of the hippocampus and the frontal cortex (FC) in a model of voluntary running in mice. Examined brain structures responded differentially to physical activity. Specifically, the markers of the tricarboxylic acid (TCA) cycle were downregulated in the FC, whereas glycolysis was enhanced in the hippocampus. Physical activity stimulated production of myristic, palmitic and stearic FA; i.e., the primary end products of de novo lipogenesis in the brain, which was accompanied by increased expression of hippocampal fatty acid synthase (FASN), suggesting stimulation of lipid synthesis. The changes in the brain fatty acid profile were associated with reduced anxiety level in the running mice. Overall, the study examines exercise-related metabolic changes in the brain and links them to behavioral outcomes.
Urinary expression of let-7c cluster as non-invasive tool to assess the risk of disease progression in patients with high grade non-muscle invasive bladder Cancer: a pilot study
Authors: Spagnuolo Manuela , Costantini Manuela , Ferriero Mariaconsiglia , Varmi Marco , Sperduti Isabella , Regazzo Giulia , Cicchillitti Lucia , Díaz Méndez Ana Belén , Cigliana Giovanni , Pompeo Vincenzo , Russo Andrea , Laquintana Valentina , Mastroianni Riccardo , Piaggio Giulia , Anceschi Umberto , Brassetti Aldo , Bove Alfredo , Tuderti Gabriele , Flammia Rocco Simone , Gallucci Michele , Simone Giuseppe , Rizzo Maria Giulia
Published: April 2020

Background

High grade non-muscle-invasive bladder cancer (HG-NMIBC) is a heterogeneous disease with variable risk of progression. Urinary microRNAs are promising biomarkers for BC detection and surveillance. Let-7c-5p miRNA, clustered with miR-99a-5p and -125b-5p, is deregulated in cancer, including BC. The aim of this study is to evaluate urinary let-7c cluster expression in Ta/T1 HG-NMIBC patients and its impact on progression-free survival (PFS).

Methods

Quantitative Real-Time-Polymerase-Chain-Reaction (qRT-PCR) was used to analyze the let-7c cluster expression in 57 urine and 49 neoplastic paired tissue samples prospectively collected from transurethral resection (TUR) HG-NMIBC patients. Twenty urine and 10 bladder tissue samples were collected and analyzed as normal controls. QRT-PCR was also used to detect intra−/extra-cellular let-7c cluster in BC cells. Receiver Operating Characteristic (ROC) curves were used to identify urinary miRNAs cut-off values predicting T-stage and PFS. Uni/multivariable Cox regression was performed to identify predictors of PFS. A nomogram predicting progression risk and a decision curve analysis (DCA) were performed.

Results

Urinary let-7c was significantly up-regulated in patients compared with controls, while the whole cluster was down-regulated in tumor tissues. Supporting these findings, in vitro comparison of extra−/intra-cellular ratios of cluster levels between BC cells, showed a higher ratio for let-7c in HG-NMIBC versus low-grade cells. Urinary let-7c cluster expression was increased in higher T-stage and was an independent predictor of progression. Lower EORTC-score and downregulation of urinary cluster were predictors of higher PFS on univariable Cox regression, while on multivariable analysis only cluster expression was an independent progression predictor. On DCA, a benefit was evident for patients with a PFS probability > 20%.

Conclusions

Urinary let-7c cluster evaluation may improve prognosis, identifying patients at risk of progression and addressing early radical treatment.
Ovary does harbor stem cells - size of the cells matter!
Authors: Bhartiya Deepa , Sharma Diksha
Published: April 2020

A recent study published in the journal Nature Communications from Karolinska Institute, Sweden was unable to detect stem cells in adult human ovarian cortex by single-cell RNAseq and by studying cell surface antigen profiles by flow cytometry studies. Their findings are startling since stem cells have been well characterized in the adult mammalian ovary of several species including mouse, rabbit, monkey, sheep, pig and humans. Ovarian stem cells include pluripotent, very small embryonic-like stem cells (VSELs) and slightly bigger ovarian stem cells (OSCs) which are easily visualized in smears obtained by gently scraping the ovary surface. The potential of ovarian stem cells to differentiate into oocyte-like structures in vitro and also resulting in the birth of mouse pups has been reported. A possible role of ovarian VSELs in initiation of ovarian cancers has also been delineated. The ovarian stem cells can also be collected by enzymatic digestion of ovarian tissue for various studies, taking care to always pellet the cells suspension at 1000 g since this high speed is required to collect the small-sized stem cell populations (VSELs & OSCs) with high nucleo-cytoplasmic ratio. These stem cells invariably get discarded when cells suspension is spun at lower speed. The cells were spun at 300 g for various experiments in the Karolinska study and this is the underlying reason for their negative results. Stem cells were inadvertently and unknowingly discarded and never got analyzed by single-cell RNAseq and flow cytometry experiments. To conclude, stem cells surely exist in adult mammalian ovary and their role during neo-oogenesis and primordial follicle assembly under physiological conditions is currently being investigated.
VENTILatOry strategies in patients with severe traumatic brain injury: the VENTILO Survey of the European Society of Intensive Care Medicine (ESICM)
Authors:   on the behalf of the ESICM NIC/ARF sections, Picetti Edoardo , Pelosi Paolo , Taccone Fabio Silvio , Citerio Giuseppe , Mancebo Jordi , Robba Chiara
Published: April 2020

Background

Severe traumatic brain injury (TBI) patients often develop acute respiratory failure. Optimal ventilator strategies in this setting are not well established. We performed an international survey to investigate the practice in the ventilatory management of TBI patients with and without respiratory failure.

Methods

An electronic questionnaire, including 38 items and 3 different clinical scenarios [arterial partial pressure of oxygen (PaO2)/inspired fraction of oxygen (FiO2) > 300 (scenario 1), 150–300 (scenario 2), < 150 (scenario 3)], was available on the European Society of Intensive Care Medicine (ESICM) website between November 2018 and March 2019. The survey was endorsed by ESICM.

Results

There were 687 respondents [472 (69%) from Europe], mainly intensivists [328 (48%)] and anesthesiologists [206 (30%)]. A standard protocol for mechanical ventilation in TBI patients was utilized by 277 (40%) respondents and a specific weaning protocol by 198 (30%). The most common tidal volume (TV) applied was 6–8 ml/kg of predicted body weight (PBW) in scenarios 1–2 (72% PaO2/FIO2 > 300 and 61% PaO2/FiO2 150–300) and 4–6 ml/kg/PBW in scenario 3 (53% PaO2/FiO2 < 150). The most common level of highest positive end-expiratory pressure (PEEP) used was 15 cmH2O in patients with a PaO2/FiO2 ≤ 300 without intracranial hypertension (41% if PaO2/FiO2 150–300 and 50% if PaO2/FiO2 < 150) and 10 cmH2O in patients with intracranial hypertension (32% if PaO2/FiO2 150–300 and 33% if PaO2/FiO2 < 150). Regardless of the presence of intracranial hypertension, the most common carbon dioxide target remained 36–40 mmHg whereas the most common PaO2 target was 81–100 mmHg in all the 3 scenarios. The most frequent rescue strategies utilized in case of refractory respiratory failure despite conventional ventilator settings were neuromuscular blocking agents [406 (88%)], recruitment manoeuvres [319 (69%)] and prone position [292 (63%)].

Conclusions

Ventilatory management, targets and practice of adult severe TBI patients with and without respiratory failure are widely different among centres. These findings may be helpful to define future investigations in this topic.
The role of oxygen depletion and subsequent radioprotective effects during irradiation of mosquito pupae in water
Authors: Yamada Hanano , Maiga Hamidou , Bimbile-Somda Nanwintoum Severin , Carvalho Danilo O. , Mamai Wadaka , Kraupa Carina , Parker Andrew G. , Abrahim Aiman , Weltin Georg , Wallner Thomas , Schetelig Marc F. , Caceres Carlos , Bouyer Jeremy
Published: April 2020

Background

Radiation induced sterility is the basis of the Sterile Insect Technique, by which a target insect pest population is suppressed by releasing artificially reared sterile males of the pest species in overflooding numbers over a target site. In order for the sterile males to be of high biological quality, effective standard irradiation protocols are required. Following studies investigating the effects of mosquito pupae irradiation in waterversusin air, there is a need to investigate the oxy-regulatory behavior of mosquito pupae in water to better understand the consequences of irradiation in hypoxic versus normoxic conditions.

Methods

Pupae ofAedes aegypti,Ae. albopictus, andAnopheles arabiensiswere submerged in water inside air-tight 2 ml glass vials at a density of 100 pupae/ml and the dissolved oxygen (DO) levels in the water were measured and plotted over time. In addition, male pupae ofAe. aegypti(aged 40–44 h),Ae. albopictus(aged 40–44 h) andAn. arabiensis(aged 20–24 h) were irradiated in a gammacell220 at increasing doses in either hypoxic (water with < 0.5% O2content) or normoxic (in air) conditions. The males were then mated to virgin females and resulting eggs were checked for induced sterility.

Results

All three species depleted the water of DO to levels under 0.5% within 30 minutes, withAn. arabiensisconsuming oxygen the fastest at under 10 minutes. Following irradiation, the protective effect of hypoxia was observed across species and doses (P < 0.0001), increasing at higher doses. This effect was most pronounced inAn. arabiensis.

Conclusions

The consumption of dissolved oxygen by pupae submerged in water was significantly different between species, indicating that their oxy-regulatory capacity seems to have possibly evolved according to their preferred breeding site characteristics. This needs to be considered when sterilizing male mosquitoes at pupal stage in water. Depending on species, their DO consumption rates and their density, irradiation doses needed to achieve full sterility may vary significantly. Further assessments are required to ascertain optimal conditions in terms of ambient atmosphere during pupal irradiation to produce competitive sterile males, and temperature and density dependent effects are expected.
Hermite–Hadamard and Hermite–Hadamard–Fejer type inequalities for p-convex functions via conformable fractional integrals
Authors: Mehreen Naila , Anwar Matloob
Published: April 2020

In this paper, we obtain the Hermite–Hadamard and Hermite–Hadamard–Fejer type inequalities forp-convex functions via conformable fractional integrals. We also discuss some special cases.
A high–throughput digital script for multiplexed immunofluorescent analysis and quantification of sarcolemmal and sarcomeric proteins in muscular dystrophies
Authors: Scaglioni Dominic , Ellis Matthew , Catapano Francesco , Torelli Silvia , Chambers Darren , Feng Lucy , Sewry Caroline , Morgan Jennifer , Muntoni Francesco , Phadke Rahul
Published: April 2020

The primary molecular endpoint for many Duchenne muscular dystrophy (DMD) clinical trials is the induction, or increase in production, of dystrophin protein in striated muscle. For accurate endpoint analysis, it is essential to have reliable, robust and objective quantification methodologies capable of detecting subtle changes in dystrophin expression. In this work, we present further development and optimisation of an automated, digital, high-throughput script for quantitative analysis of multiplexed immunofluorescent (IF) whole slide images (WSI) of dystrophin, dystrophin associated proteins (DAPs) and regenerating myofibres (fetal/developmental myosin-positive) in transverse sections of DMD, Becker muscular dystrophy (BMD) and control skeletal muscle biopsies. The script enables extensive automated assessment of myofibre morphometrics, protein quantification by fluorescence intensity and sarcolemmal circumference coverage, colocalisation data for dystrophin and DAPs and regeneration at the single myofibre and whole section level. Analysis revealed significant variation in dystrophin intensity, percentage coverage and amounts of DAPs between differing DMD and BMD samples. Accurate identification of dystrophin via a novel background subtraction method allowed differential assessment of DAP fluorescence intensity within dystrophin positive compared to dystrophin negative sarcolemma regions. This enabled surrogate quantification of molecular functionality of dystrophin in the assembly of the DAP complex. Overall, the digital script is capable of multiparametric and unbiased analysis of markers of myofibre regeneration and dystrophin in relation to key DAPs and enabled better characterisation of the heterogeneity in dystrophin expression patterns seen in BMD and DMD alongside the surrogate assessment of molecular functionality of dystrophin. Both these aspects will be of significant relevance to ongoing and future DMD and other muscular dystrophies clinical trials to help benchmark therapeutic efficacy.
ICT Engagement: a new construct and its assessment in PISA 2015
Authors: Kunina-Habenicht Olga , Goldhammer Frank
Published: April 2020

As a relevant cognitive-motivational aspect of ICT literacy, a new construct ICT Engagement is theoretically based on self-determination theory and involves the factors ICT interest, Perceived ICT competence, Perceived autonomy related to ICT use, and ICT as a topic in social interaction. In this manuscript, we present different sources of validity supporting the construct interpretation of test scores in the ICT Engagement scale, which was used in PISA 2015. Specifically, we investigated the internal structure by dimensional analyses and investigated the relation of ICT Engagement aspects to other variables. The analyses are based on public data from PISA 2015 main study from Switzerland (n = 5860) and Germany (n = 6504). First, we could confirm the four-dimensional structure of ICT Engagement for the Swiss sample using a structural equation modelling approach. Second, ICT Engagement scales explained the highest amount of variance in ICT Use for Entertainment, followed by Practical use. Third, we found significantly lower values for girls in all ICT Engagement scales except ICT Interest. Fourth, we found a small negative correlation between the scores in the subscale “ICT as a topic in social interaction” and reading performance in PISA 2015. We could replicate most results for the German sample. Overall, the obtained results support the construct interpretation of the four ICT Engagement subscales.
Non-invasive computer navigation can quantify the pivot shift maneuver with good to excellent reliability in healthy volunteers
Authors: Monaco Edoardo , Bruni Giorgio , Lo Torto Sara , Carrozzo Alessandro , Daggett Matthew , Annibaldi Alessandro , Saithna Adnan , Ferretti Andrea
Published: April 2020

Purpose

The aim of this study was to determine the inter- and intra-observer reliability of knee laxity assessment using a non-invasive navigation system in a population of healthy young athletes. It was hypothesized that knee laxity parameters recorded using non-invasive computer navigation would demonstrate good inter- and intra-observer reliability.

Methods

Healthy volunteers aged between 18 to 30 years were recruited to the study. Static and dynamic knee laxity parameters including anterior tibial translation and tibial rotation during the pivot shift test were recorded on awake patients using non-invasive computer navigation by two independent observers: at the first visit each athlete was evaluated by the consultant and resident surgeons independently; 6 weeks after the first visit all the participants were re-tested only by the resident surgeon. Inter- and intra-observer reliability was calculated and then interpreted according to Cicchetti’s criteria.

Results

One hundred healthy volunteers were recruited to the study, of these 38 were women (38%), and the average age was 25.5 ± 2.4 years. According to Cicchetti’s criteria the intra- and inter-observer reliability for static measurements were fair for anterior tibial translation (0.572 and 0.529, respectively) and excellent for total passive tibial rotation (0.859 and 0.883, respectively). For the dynamic measurements of translation and rotation during the pivot shift maneuver both measurements demonstrated good to excellent reliability with intra and inter observer reliability ranging from 0.684 to 0.936.

Conclusion

Non-invasive navigation for the assessment of knee laxity is associated with fair to excellent inter- and intra-observer reliability in a population of healthy volunteers.
Male partner approval on the use of modern contraceptive methods: factors determining usage among couples in Kibaha district, Tanzania
Authors: Msovela Judith , Tengia–Kessy Anna , Rumisha Susan F. , Simba Daudi O. , Urassa David P. , Msamanga Gernard
Published: April 2020

Background

Men in developing countries play an important role in the adoption of family planning (FP), either as actual users or supporters of their partners. Notwithstanding the universal knowledge on the contraceptive methods, their approval and use have been low among men in Tanzania. This study determined the magnitude and factors that influence men to use or approve the use of modern contraceptive methods with their spouses.

Methods

A cross sectional, community-based study was conducted in Kibaha, Pwani region in 2014. A total of 365 randomly selected married and cohabiting men; aged 18 to 60 years who had at least a child below the age of 5 years were interviewed using a structured questionnaire. Descriptive statistics were performed and associations between status of men using modern FP with their partners and potential factors were tested using Chi-square and Fisher’s exact tests as appropriate. Logistic regression model was fitted to determine significant factors associated with male use of the methods with their partners.

Results

About 60 % of men (59.7%) reported to use modern FP methods. In the bivariate analysis, education level (odds ratio (OR) = 2.6, CI = 1.4–4.8; p = 0.002); men knowledge on any contraceptive method (OR = 24.1, CI = 7.3–79.9; p < 0.001); awareness of a nearby FP clinic (OR = 6.2, CI = 3.1–12.3; p < 0.001); number of children (OR = 2, CI = 1.1–3.6; p < 0.025) and presence of a provider during clinic visit (OR = 12.0, CI = 2.26–63.7; p < 0.004) were significantly associated with the use of FP. However, in the multivariable analysis, only knowledge on FP methods (adjusted odds ratios (AOR) =26.4; CI = 7.9–88.4, p < 0.001) and number of children a man had (AOR = 1.9; CI = 1.0–3.6, p = 0.039) remained significantly associated with the use of modern FP methods.

Conclusion

This study has shown that for men to use family planning methods with their partners, knowledge of FP methods and number of children are critical factors. Visiting a FP center alone or with a spouse, and availability of FP provider (during visit) also influence this practice. These findings emphasize a need to increase knowledge on contraception and family planning services access among men.
Megestrol acetate increases the incidence of deep venous thrombosis in patients with non small cell lung cancer
Authors: Hussain S. , Singh M. , Shi R. , Mansour R. , Mills G. , Marion J.
Published: April 2020

18510

Background: To evaluate the incidence of deep venous thrombosis (DVT) in patients with non small cell lung cancer who take megestrol acetate as an appetite stimulant. Methods: A retrospective study of patients with non small cell lung cancer (NSCLC) was performed to determine the incidence of deep venous thrombosis. We reviewed medical records of patients with NSCLC who were treated with and without megestrol acetate as an appetite stimulant during the course of their treatment or follow up. Cochran-Mantel-Hansel statistics was performed. Results: We reviewed the charts of 179 patients with NSCLC. 86 patients received megestrol acetate during the course of treatment or follow up whereas 93 did not. Within the treatment group, 28 patients were female and 58 were male. In the control group 43 patients were female and 50 were male. There was no significant difference in the ECOG performance status of those in the treatment group from those in the control group. The frequency of DVT was 3.4 times higher in the treatment group as compared to the control group adjusting for gender (p < 0.02). Similarly, the frequency of DVT was 2.8 times higher in the treatment group as compared to the control group adjusting for stage (P < 0.045). Conclusions: After adjusting for gender or stage, the incidence of DVT appears to be higher for patients with NSCLC who took megestrol acetate as compared to those who did not. Even though megestrol acetate was being used as an appetite stimulant, the observed differences were not due to differences in the performance status of the two groups. Further prospective study of the risks and benefits of megestrol acetate as an appetite stimulant in patients with advanced NSCLC and other malignancies is warranted.

No significant financial relationships to disclose.
The impact of physician’s sequence [1st vs 2nd] and posture [sitting vs standing] on cancer patients’ physician preference and perception of compassion
Authors: Bruera E. , Strasser F. , Kaur G. , Zhang T. K. , Cohen L. , Pace E. , Palmer J.
Published: April 2020

18513

Background: Our group previously found in a cross-over RCT in 69 advanced cancer patients [P] that the sitting posture was preferred; we also found that patients consistently chose the physician [MD] they observed in 2nd order [ASCO 2003:2958]. The effect of sequence on MD preference and perception of compassion had not been reported before. The purpose of this study was to assess if P preferred MD seen in 2nd order after controlling for posture. Methods: Advanced cancer P were randomized to observe 2 9-minute videos of a P/MD interaction. Both videos were identical except for the posture of the MD [sitting versus standing]. After a 2–3 minute assessment P were crossed-over into viewing the opposite video. Investigators were blinded to the type of video observed. P were blinded to the purpose of the study and difference between videos. Results: 168 P [98%] were evaluable. The mean perception of compassion [0 = worst, 50 = best] was 29 ± 13 for the 1st MD versus 33 ± 11 for the 2nd MD [p < 0.001]. P also preferred sitting [33 ± 11] versus standing [29 ± 12, p < 0.001]. The overall impression [0 = worst, 10 = best] for the MD seen 2nd versus 1st was 6.5 ± 2.3 versus 5.7 ± 2.7 [p ≤ 0.001]. All differences in response were independent on posture. 119/168 P [71%] perceived a difference between the 2 MDs and this difference was considered ≥ moderately important in 95 P [80%]. 76/168 P preferred the 2nd MD [45%, 95% CI, 38–53], 38/168 P preferred the 1st MD [23%, 95% CI, 16–29], and 54/168 P had no preference [32%, 95% CI, 25–39]. 49/114 P who expressed a preference perceived their preferred MD had spent more time with the P [43%]. 87/168 P preferred their MD to sit [52%] but they considered posture more important than time in 23 cases [20%], friendliness in 18 [15%], patience in 16 [14%], caring in 15 [14%], and respect in 18 [16%]. Conclusions: P prefer MDs they see in 2nd order, they have an overall better impression of them and consider them more compassionate, and they perceive that they spent more time with their P, independently on the MD’s chosen posture. Most P also prefer MDs to sit but posture is rated as a relatively low priority in P/MD communication. These findings are important for clinical care and trial participation.

No significant financial relationships to disclose.
Retrospective study of locally advanced bladder cancer in elderly patients
Authors: El Karak F. , Bringeon G. , Kepenekian G. , Flechon A. , Ghosn M. , Droz J. , Terret C.
Published: April 2020

18523

Background: Bladder cancer is one of the most frequent tumors in elderly patients (pts). However, guidelines have not been established yet in this age group. Methods: We analyzed retrospectively pts aged 75 years or more, with muscle invasive or metastatic bladder cancer treated between January 2000 and June 2005, in three institutions in Lyon-France: Léon Bérard Center, Saint Luc Saint Joseph Hospital and Protestant Infirmary. Results: Data from 126 pts (81% male) were available: median age was 80 years (75–94). 99 pts had disease confined to the bladder, 19 confirmed metastatic cancer and 8 at least T2aM0 disease. 42% of pts had a history of superficial bladder cancer; 96% an urothelial carcinoma, 19% an associated in situ carcinoma. Of note, 33% of male pts had a concomitant prostate cancer. Median Performance Status, American Society of Anesthesia score and Charlson Comorbidity index were 1, 2 and 2.14 respectively. Cardiovascular comorbidities were the most common (42.8%). 87% of pts were taking medications; median number of drug intake was 4. We focused on pts with muscle invasive, non metastatic bladder cancer: 55 of 99 pts underwent surgery; 48 of them had external urinary diversion. Postoperative complications occurred in 34% of pts: evisceration (15%), sepsis, hemorrhage, acute cardiac failure, acute renal failure, pulmonary embolism (3.7% each), bowel obstruction and acute arterial thrombosis of lower limbs (1.8% each), and 2 immediate postoperative deaths. 16 pts received radiotherapy with a curative intent, 6 of them had chemoradiation. Mean irradiation dose and duration were respectively 56.4 Gy and 6.5 weeks. Toxicity occurred in 5 pts: 2 discontinuations for intolerance, 1 acute cardiac failure, 1 grade 3 thrombopenia, and 1 toxic death (intestinal perforation). The last 28 pts received palliative care. After a median follow up of 14 months, 33 operated pts and 3 pts treated by radiotherapy were still alive in complete remission. Disease free survival and median survival were 11.5 and 42 months in the surgical group respectively and 12 and 12 months in the radiotherapy group respectively. Conclusions: Treatment of locally advanced bladder cancer in the elderly carries significant morbidity and mortality. Oncogeriatric assessment benefit for individual management must be studied.

No significant financial relationships to disclose.
An Internet-based survey evaluating attitudes of cancer patients towards pain intervention
Authors: Simone C. B. , Vapiwala N. , Hampshire M. K. , Metz J. M.
Published: April 2020

18540

Background: Pain is a common symptom among cancer patients (pts), but many pts experience inadequate medical management for pain. There are little data quantifying reasons that cancer pts fail to receive optimal analgesic treatment. This study evaluated those reasons and investigated the causes of pain in cancer pts. Methods: An Internet-based questionnaire assessing pt demographics and pain symptoms was piloted with pts and healthcare providers and posted on the OncoLink (http://www.oncolink.org) website. The questionnaire included 22 queries evaluating medication utilization, pain control and attitudes regarding pain medications. The questionnaire was IRB approved and held on a secure server. Between 11/05–1/06, 99 pts responded to the questionnaire. They were predominantly Caucasian (76%), female (78%) and pursued education beyond high school (66%). The most common diseases included cancer of the breast (51%), lung (8%) and brain (6%). Cancer treatment included surgery (75%), chemotherapy (63%) and radiation (45%). Results: Half (49%) of the respondents reported pain directly from their cancer and 42% complained of pain due to cancer treatment. This pain was primarily intermittent (42%) or chronic (35%). Most (77%) pts did not use medication specifically to help manage their pain. Analgesic usage trended less in women (19% vs. 36%, p = 0.10), Caucasians (19% vs. 38%, p = 0.06), and pts with higher education levels (17% vs. 26%, p = 0.29) but did not reach statistical significance. Reasons most commonly cited for not taking analgesics included the healthcare provider not recommending medications (86%), fear of becoming addicted or dependent (80%) and an inability to pay for medication (75%). Participants experiencing pain, but not taking analgesics, sought alternative measures for pain control such as physical therapy (84%), massage (7%) and acupuncture (4%). Conclusions: Although many cancer pts experience pain regularly, both from their cancer and cancer treatment, most pts in this study did not seek out analgesics. Pts do seek complementary therapies for pain control. Healthcare providers should regularly have open discussions with pts regarding pain symptoms. Further study will be needed to evaluate attitudes of pts towards pain based on disease condition.

No significant financial relationships to disclose.
A randomized comparison of darbepoetin alfa with epoetin for chemotherapy induced anemia in nonhematological tumors
Authors: Kotsori A. A. , Alexopoulos C. G.
Published: April 2020

18554

Background: Although once weekly (QW) Darbepoetin is nowadays used for chemotherapy induced anemia by many oncologists, a head to head comparison with thrice weekly (TIW) Epoetin regimen has not been published so far. Methods: We randomly compared QW Darbepoetin alfa with TIW Epoetin in 110 cancer patients with chemotherapy induced anemia (Hb ≤ 11 gr%). Epoetin was administered at 10.000 U TIW (20.000 U in nonresponders after 4 weeks, Group A). Darbepoetin was administered at 150 mcg QW (300 mcg as above, Group B). Evaluation was performed on week 4 and 8 including QoL assessment using FACT- An scale. Results: In group A, Hb increased from 10.11 ± 0.94 at baseline to 11.02 ± 1.39 at 4 weeks (p = .000) and to 12.09 ± 1.78 at 8 weeks (p = .000). It also increased between week 4 and 8 (p = .000). In group B, Hb increased from 10.26 ± 0.81 at baseline to 10.91 ± 1.89 at 4 weeks (p = .003) and to 11.66 ± 2.25 at 8 weeks (p = .000). It also increased between week 4 and 8 (p = .001). In all 110 patients, Hb increased from 10.2 ± 0.87 at baseline to 10.95 ± 1.71 at 4 weeks (p= .000) and to 11.82 ± 2.08 at 8 weeks (p = .000). It also increased between week 4 and 8 (p = .000). Fifteen of 27 (55.6%) responding patients in group A had to double Epoetin dose versus 18 of 39 (46.2%) in group B (P = .61). Three patients in group A required transfusions compared with 9 in group B (p= .35). On an intent to treat analysis, RR, at 4 weeks, was 46.7% for Epoetin versus 40% for Darbepoetin (p =.56). At 8 weeks, it was 55.6% and 56.9%, respectively (p = NS). QoL analysis showed that mean physical, social, functional and emotional well-being scores as well as mean fatigue and non-fatigue subscale scores were not significantly different between the two groups. Conclusions: Once weekly Darbepoetin is equally effective and more convenient therapy than thrice weekly Epoetin.

No significant financial relationships to disclose.
The impact of ”laying on of hands” on well being in patients with advanced cancer
Authors: Pohl G. , Seemann H. , Zojer N. , Ochsner C. , Luhan C. , Schemper M. , Heinzl H. , Ludwig H.
Published: April 2020

18566

Background: To determine whether the impact of “laying on of hands” on well being of patients with advanced cancer is more efficient when performed by a person with “healing powers” as compared to an actor. Methods: A total of 80 patients was registered to participate in a randomized, single-blind phase III trial to evaluate the difference in efficacy of “laying on of hands” by either a “healer” or a sham person (actor). Both arms were designed to consist of a total of 40 patients, divided into 5 groups including 8 patients each. Each patient should receive treatment for 5 minutes, 3 times a week. A “Well-being scale” was used to measure differences in treatment outcomes. The primary and secondary endpoint evaluated the difference in the total sum score of the “Well-being scale” between the two arms on day 10 or day 5, respectively. Results: The first run was unblinded by the “healer”. Hence, only the second run was available for comparison. There was no significant difference in sum-score values between the “healer” and the actor (p = 0.34) with regard to the primary endpoint or the secondary endpoint (p = 0.94). After the second run, the “healer” quit and a major protocol violation occurred. Despite this major obstacle, the study was completed by the actor as a descriptive, explorative study. There was a significant decrease in total sum score values after each single treatment (day 1, 3 and 5, p < 0.0001, respectively) for all patients. In addition, a significant improvement in symptoms could be found on day 5 (p < 0.001) after treatment and day 10 (p = 0.0002) as compared to day 1 before treatment. Conclusions: “Laying on of hands” resulted in a significant improvement of cancer or cancer-therapy associated symptoms. The magnitude of improvement obtained was similar when “treatment” was provided by a self declared “healer” or an actor, although the comparison was hampered by protocol vialotions by the “healer”.

No significant financial relationships to disclose.