bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with antenatal depression among pregnant women in Vietnam: A multisite cross-sectional survey
Authors: Hue Mai Thi , Nguyet Van Nguyen Hang , Nha Phung Phuong , Vu Ngo Tuan , Duc Pham Minh , Van Trang Nguyen Thi , Thinh Phan Thi Ngoc , Anh Le Ngoc , Huyen Le Thanh , Tu Nguyen Huu
Published: March 2020

This study aimed to describe the status of antenatal depression and its associated factors among pregnant women in Vietnam. A cross-sectional study was conducted in four obstetric hospitals in Vietnam from January to September 2019. A total of 1260 pregnant women were interviewed using a structured questionnaire. A Tobit regression model was used to determine factors associated with antenatal depression. Results showed that pregnant women were at high risk of antenatal depression (24.5%). Women with fetus abnormalities and higher education were at higher risk of antenatal depression. We highlighted the need for implementing formal screening programs to early detect antenatal depression.
Gender Parity at Work and Its Association With Workplace Sexual Harassment
Authors: Raj Anita , Johns Nicole E. , Jose Rupa
Published: March 2020

Background: Gender parity in the workplace—and increased representation of women at work—may reduce workplace sexual harassment, but research on this is unclear. This study assessed the associations between gender parity at work and workplace sexual harassment. Methods: We analyzed data from an online sexual harassment survey conducted with a nationally representative sample of U.S. adults in 2018 ( N = 2,009; response rate 29%); current analyses were restricted to employed participants (women n = 610, men n = 690). Data on occupation and industry were each categorized as female-dominant (61%–100% female), male-dominant (0%–39% female), or at parity (40%–60% female). We used sex-stratified logistic regression models to assess associations between gender parity in industry and occupation and workplace sexual harassment. Findings: Our study of employed adults in the U.S. found that 42% women and 15% men had experienced workplace sexual harassment. Logistic regression analyses indicated that women employed in female-dominated industries (adjusted odds ratio [AOR] = 0.52; 95% confidence interval [CI] = [0.33, 0.81]) and men employed in male-dominated occupations (AOR = 0.55; 95% CI = [0.33, 0.91]) were less likely to have experienced workplace sexual harassment. Women in male-dominated occupations were more likely to report harassment or assault by a supervisor (AOR = 2.41, 95% CI = [1.00, 5.80]), and men in male-dominated occupations were less likely to report harassment or assault by a supervisor (AOR = 0.26, 95% CI = [0.08, 0.89]). Conclusion/Application to Practice: Women in female-dominated industries and men in male-dominated occupations, relative to those with workplace gender parity, are at lower risk for harassment. Women in male-dominated occupations are at greater risk for harassment from supervisors. Gender parity at work is not sufficient on its own to address workplace sexual harassment; normative changes are needed.
Time to debridement in open high-grade lower limb fractures and its effect on union and infections: A prospective study in a tropical setting
Authors: Joseph Christina Marie , Jepegnanam Thilak Samuel , Ramasamy Boopalan , Cherian Vinoo Mathew , Nithyananth Manasseh , Sudarsanam Thambu David , Premkumar Prasanna Samuel
Published: March 2020

Purpose:

To prospectively evaluate whether time to debridement has any correlation with union, infection, and quality of life in high-grade lower limb fractures in a tropical setting.

Methods:

A prospective cohort study was conducted at a tertiary care center in South India. Two hundred fifty-four adult skeletally mature patients with 301 grade 3 fractures involving the femur, tibia, or fibula were recruited. The cohort was empirically divided into two groups (early and late) based on the time to debridement (less than or more than 12 h from injury).

Outcome:

The primary outcome was nonunion. Secondary outcomes were deep infection rates and patients’ quality of life. Short form-36 (SF-36) and short musculoskeletal functional assessment (SMFA) questionnaires were also used. Patients were followed up for 9 months.

Results:

The follow-up rate was 93%. The late group had a significantly higher risk of nonunion (odds ratio(OR): 6.5, 95% confidence interval (CI): 2.82–14.95) and infections (OR: 6.05, 95% CI: 2.85–12.82). There was a 4% increase in the infection risk for each hour of delay for the initial 50 h ( p < 0.0001). SF-36 and SMFA scores were superior in the early group ( p < 0.0001).

Conclusion:

The study contradicts findings reported in the literature from the West. Our study was in agreement with our hypothesis and proved that debridement within 12 h resulted in significantly lower rates of nonunion and infections and an overall improved quality of life in high-grade open lower limb fractures in a developing country.

Level of evidence:

Level II

Trial registration:

German Clinical Trials Register DRKS00015186
“Yes We Can!” The Mental Health Significance for U.S. Black Adults of Barack Obama’s 2008 Presidential Election
Authors: Brown Tony N. , Solazzo Alexa , Gorman Bridget K.
Published: March 2020

This study examines the mental health significance of Barack Obama’s 2008 presidential election for black adults. His election was a milestone moment. Hence, we expect black adults would experience improved mental health after the first self-identified black person wins election to the most powerful position in the United States. Using nationally representative survey data from the Behavioral Risk Factor Surveillance System (BRFSS), we address this expectation by predicting poor mental health days that black adults report preelection and postelection. We find no overall difference in poor mental health days between the time periods. However, a statistical interaction between gender and time period demonstrates black men report 1.01 fewer poor mental health days after the election, whereas black women report .45 more poor mental health days after the election.
Unrooting Management Education and Entrepreneurial Self From Neoliberal Demands: An Action Research Approach
Authors: Zawadzki Michał , Jałocha Beata , Mazurkiewicz Grzegorz , Pluszyńska Anna , Prawelska-Skrzypek Grażyna
Published: March 2020

This study applies an action research to investigate the possibility of unsettling management education and the entrepreneurial self from neoliberal logic. The reflection takes as its case an action research diploma seminar in a Polish management school based on collaboration among students, employers from public and nongovernmental sectors, and academic teachers in the preparation of master’s theses. The main goal of this article is to illustrate the struggles involved in resisting neoliberal demands, including the ethical reorientation of the entrepreneurial self, in the management classroom. We conclude with a discussion of the emancipatory value of our project and its limitations.
Characteristics of polycystic ovary syndrome throughout life
Authors: Louwers Yvonne V. , Laven Joop S.E.
Published: March 2020

Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age. It is a complex disease in which genetic, endocrine, environmental, and behavioral factors are intertwined, giving rise to a heterogeneous phenotype with reproductive, metabolic, and psychological characteristics. Polycystic ovary syndrome affects women’s health and their quality of life across the life course. During different life stages, the polycystic ovary syndrome phenotype can change, which requires a personalized diagnostic approach and treatment. Polycystic ovary syndrome is a major cause of anovulatory infertility; this disorder is also associated with hirsutism and acne. Diagnosing polycystic ovary syndrome during adolescence is challenging because the polycystic ovary syndrome criteria include normal physiological events that occur during puberty. With increasing age, the syndrome evolves from a reproductive disease to a more metabolic disorder. Along with metabolic disturbances, including insulin resistance and abnormalities of energy expenditure, polycystic ovary syndrome is recognized as a major risk factor for the development of type 2 diabetes and cardiovascular disease in later life. Moreover, there is evidence for familial clustering of endocrine and metabolic features of polycystic ovary syndrome. Environmental factors such as diet and obesity appear to contribute to the phenotype. Treatment should be tailored to the specific concerns and needs of the individual patient and involves restoring fertility, treatment of the metabolic complaints, treatment of androgen excess, and providing endometrial protection. The complexity of the disorder, and the impact on quality of life, requires a timely diagnosis, screening for complications, and management strategies for the long-term health issues associated with polycystic ovary syndrome. The syndrome remains underdiagnosed, and women experience significant delays to diagnosis.
FcRn augments induction of tissue factor activity by IgG-containing immune complexes
Authors: Cines Douglas B. , Zaitsev Sergei , Rauova Lubica , Rux Ann H. , Stepanova Victoria , Krishnaswamy Sriram , Sarkar Amrita , Kowalska M. Anna , Zhao Guohua , Mast Alan E. , Blumberg Laurence J. , McCrae Keith R. , Poncz Mortimer , Hubbard Jonathan J. , Pyzik Michal , Blumberg Richard S.
Published: March 2020

Thromboembolism complicates disorders caused by immunoglobulin G (IgG)–containing immune complexes (ICs), but the underlying mechanisms are incompletely understood. Prior evidence indicates that induction of tissue factor (TF) on monocytes, a pivotal step in the initiation, localization, and propagation of coagulation by ICs, is mediated through Fcγ receptor IIa (FcγRIIa); however, the involvement of other receptors has not been investigated in detail. The neonatal Fc receptor (FcRn) that mediates IgG and albumin recycling also participates in cellular responses to IgG-containing ICs. Here we asked whether FcRn is also involved in the induction of TF-dependent factor Xa (FXa) activity by IgG-containing ICs by THP-1 monocytic cells and human monocytes. Induction of FXa activity by ICs containing IgG antibodies to platelet factor 4 (PF4) involved in heparin-induced thrombocytopenia (HIT), β-2-glycoprotein-1 implicated in antiphospholipid syndrome, or red blood cells coated with anti-(α)-Rh(D) antibodies that mediate hemolysis in vivo was inhibited by a humanized monoclonal antibody (mAb) that blocks IgG binding to human FcRn. IgG-containing ICs that bind to FcγR and FcRn induced FXa activity, whereas IgG-containing ICs with an Fc engineered to be unable to engage FcRn did not. Infusion of an α-FcRn mAb prevented fibrin deposition after microvascular injury in a murine model of HIT in which human FcγRIIa was expressed as a transgene. These data implicate FcRn in TF-dependent FXa activity induced by soluble and cell-associated IgG-containing ICs. Antibodies to FcRn, now in clinical trials in warm autoimmune hemolytic anemia to lower IgG antibodies and IgG containing ICs may also reduce the risk of venous thromboembolism.
TRIM33 prevents pulmonary fibrosis by impairing TGF-β1 signalling
Authors: Boutanquoi Pierre-Marie , Burgy Olivier , Beltramo Guillaume , Bellaye Pierre-Simon , Dondaine Lucile , Marcion Guillaume , Pommerolle Lenny , Vadel Aurélie , Spanjaard Maximilien , Demidov Oleg , Mailleux Arnaud , Crestani Bruno , Kolb Martin , Garrido Carmen , Goirand Françoise , Bonniaud Philippe
Published: March 2020

Background

Idiopathic pulmonary fibrosis (IPF) is a devastating disease characterised by myofibroblast proliferation and abnormal extracellular matrix accumulation in the lungs. Transforming growth factor (TGF)-β1 initiates key profibrotic signalling involving the SMAD pathway and the small heat shock protein B5 (HSPB5). Tripartite motif-containing 33 (TRIM33) has been reported to negatively regulate TGF-β/SMAD signalling, but its role in fibrogenesis remains unknown. The objective of this study was to elucidate the role of TRIM33 in IPF.

Methods

TRIM33 expression was assessed in the lungs of IPF patients and rodent fibrosis models. Bone marrow-derived macrophages (BMDM), primary lung fibroblasts and 3D lung tissue slices were isolated fromTrim33-floxed mice and cultured with TGF-β1 or bleomycin (BLM).Trim33expression was then suppressed by adenovirus Cre recombinase (AdCre). Pulmonary fibrosis was evaluated in haematopoietic-specificTrim33knockout mice and inTrim33-floxed mice that received AdCre and BLM intratracheally.

Results

TRIM33 was overexpressed in alveolar macrophages and fibroblasts in IPF patients and rodent fibrotic lungs.Trim33inhibition in BMDM increased TGF-β1 secretion upon BLM treatment. Haematopoietic-specificTrim33knockout sensitised mice to BLM-induced fibrosis. In primary lung fibroblasts and 3D lung tissue slices,Trim33deficiency increased expression of genes downstream of TGF-β1. In mice, AdCre-Trim33inhibition worsened BLM-induced fibrosis.In vitro, HSPB5 was able to bind directly to TRIM33, thereby diminishing its protein level and TRIM33/SMAD4 interaction.

Conclusion

Our results demonstrate a key role of TRIM33 as a negative regulator of lung fibrosis. Since TRIM33 directly associates with HSPB5, which impairs its activity, inhibitors of TRIM33/HSPB5 interaction may be of interest in the treatment of IPF.
Respiratory surveillance in mineral dust-exposed workers
Authors: Wood Clare , Yates Deborah
Published: March 2020

Recently, there has been a worldwide resurgence in pneumoconiosis, or pulmonary fibrosis due to occupational mineral dust exposure. In Queensland, Australia, there has been a re-emergence of coal workers' pneumoconiosis and silicosis. Some coal mining communities have experienced a resurgence of progressive massive fibrosis in the USA and a worldwide epidemic is occurring of accelerated silicosis due to exposure to artificial stone.

These diseases are all preventable and should not be occurring in the 21st century. Best practice prevention includes reduction of exposure to mineral dusts or, ideally, prevention of exposure altogether. However, where dust exposure has occurred, respiratory surveillance can provide a strategy for early disease detection. It is important to identify early signs of occupational lung disease at a stage where intervention may be beneficial, though it must be acknowledged that progression may occur even after cessation of exposure to dusts. Respiratory surveillance should be distinguished from population screening and case finding, which are different methods used for disease investigation and control. Designing an ideal respiratory surveillance programme is challenging, as there is no single test that accurately identifies early disease. Several different respiratory disorders may occur related to the same exposure(s). Physicians organising and interpreting tests used in respiratory surveillance must be aware of the broad range of potential work-related respiratory conditions, complexities in diagnosis, and appropriate interpretation of the exposure history, as well as current management options. A working knowledge of the compensation and medicolegal avenues available to workers in individual jurisdictions is also useful.

Key points

Mineral dust exposure causes a number of conditions, including those specific to dust exposures, such as the pneumoconioses (or pulmonary fibroses due to mineral dust exposure), and others that may additionally be related to other causes, such as COPD.

Identification of multiple conditions using respiratory investigations requires expert interpretation and understanding of the range of potential conditions.

The frequency and content of a respiratory surveillance programme will vary according to the relevant occupational exposures, and be affected by both medical and nonmedical factors, including the background prevalence of local diseases. A programme will also need to consider other factors such as local legislation, availability of resources, worker convenience and cost.

Educational aims

To identify the large range of respiratory diseases caused by exposure to mineral dusts and identify the range of tests that may be used in a surveillance programme for occupational respiratory disorders.

To highlight difficulties that might be experienced by medical practitioners in designing and operating an effective surveillance programme, while incorporating rapidly advancing medical technology and practice.
Screening for obstructive sleep apnoea in professional drivers
Authors: Schiza Sophia E. , Bouloukaki Izolde
Published: March 2020

Professional drivers show a higher prevalence of obstructive sleep apnoea (OSA) compared with the general population. Furthermore, there is concern about the association between OSA and car crash risk given that drivers with OSA show an increased risk for car accidents. Despite this risk, OSA is often underdiagnosed and undertreated in this population, mainly due to lack of appropriate screening and sleep study referrals. Polysomnography (PSG), the gold standard test, is inappropriate for systematic screening because of its high expense, complexity and relative inaccessibility in this population. Therefore, there is a strong demand for good screening tools, including both subjective and objective data that may assist in early identification of possible OSA among professional drivers and, thus, aid in PSG examination referral and OSA management in an accredited sleep centre. However, there is considerable disagreement over screening methods and criteria for triggering a sleep study referral in different countries. There is also a strong need for further research in the area of OSA screening of commercial drivers in order to improve the diagnostic accuracy of screening tools and ensure that patients with OSA are accurately identified.

Key points

Obstructive sleep apnoea (OSA) is often undiagnosed and undertreated in professional drivers.

Professional drivers often under-report and are reluctant to report OSA symptoms.

Barriers to OSA diagnosis include appropriate screening and sleep study referrals.

Screening tools including both subjective and objective data may assist in early identification of possible OSA among professional drivers.

Educational aims

To evaluate screening instruments currently used to identify OSA risk in professional drivers.

To provide guidance for developing an assessment strategy for OSA by professional driver medical examiners.
Revealing hidden information in osteoblast’s mechanotransduction through analysis of time patterns of critical events
Authors: Ascolani Gianluca , Skerry Timothy M. , Lacroix Damien , Dall’Ara Enrico , Shuaib Aban
Published: March 2020

Background

Mechanotransduction in bone cells plays a pivotal role in osteoblast differentiation and bone remodelling. Mechanotransduction provides the link between modulation of the extracellular matrix by mechanical load and intracellular activity. By controlling the balance between the intracellular and extracellular domains, mechanotransduction determines the optimum functionality of skeletal dynamics. Failure of this relationship was suggested to contribute to bone-related diseases such as osteoporosis.

Results

A hybrid mechanical and agent-based model (Mech-ABM), simulating mechanotransduction in a single osteoblast under external mechanical perturbations, was utilised to simulate and examine modulation of the activation dynamics of molecules within mechanotransduction on the cellular response to mechanical stimulation. The number of molecules and their fluctuations have been analysed in terms of recurrences of critical events. A numerical approach has been developed to invert subordination processes and to extract the direction processes from the molecular signals in order to derive the distribution of recurring events. These predict that there are large fluctuations enclosing information hidden in the noise which is beyond the dynamic variations of molecular baselines. Moreover, studying the system under different mechanical load regimes and altered dynamics of feedback loops, illustrate that the waiting time distributions of each molecule are a signature of the system’s state.

Conclusions

The behaviours of the molecular waiting times change with the changing of mechanical load regimes and altered dynamics of feedback loops, presenting the same variation of patterns for similar interacting molecules and identifying specific alterations for key molecules in mechanotransduction. This methodology could be used to provide a new tool to identify potent molecular candidates to modulate mechanotransduction, hence accelerate drug discovery towards therapeutic targets for bone mass upregulation.
Cathepsin K regulates localization and secretion of Tartrate-Resistant Acid Phosphatase (TRAP) in TRAP-overexpressing MDA-MB-231 breast cancer cells
Authors: Reithmeier Anja , Norgård Maria , Ek-Rylander Barbro , Näreoja Tuomas , Andersson Göran
Published: March 2020

Background

Tartrate–resistant acid phosphatase (TRAP/ ACP5) belongs to the binuclear metallophosphatase family and is present in two isoforms. The primary translation product is an uncleaved TRAP 5a isoform with low phosphatase activity. TRAP 5a can be post-translationally processed to a cleaved TRAP 5b isoform with high phosphatase activity by e.g. cysteine proteinases, such as Cathepsin K (CtsK). The relevance of the phosphatase activity of TRAP 5b has been demonstrated for proliferation, migration and invasion of cancer cells. TRAP-overexpressing MDA-MB-231 breast cancer cells displayed higher levels of TRAP 5a and efficient processing of TRAP 5a to TRAP 5b protein, but no changes in levels of CtsK when compared to mock-transfected cells. In TRAP-overexpressing cells colocalization of TRAP 5a and proCtsK was augmented, providing a plausible mechanism for generation of TRAP 5b. CtsK expression has been associated with cancer progression and has been pharmacologically targeted in several clinical studies.

Results

In the current study, CtsK inhibition with MK-0822/Odanacatib did not abrogate the formation of TRAP 5b, but reversibly increased the intracellular levels of a N-terminal fragment of TRAP 5b and reduced secretion of TRAP 5a reversibly. However, MK-0822 treatment neither altered intracellular TRAP activity nor TRAP-dependent cell migration, suggesting involvement of additional proteases in proteolytic processing of TRAP 5a. Notwithstanding, CtsK was shown to be colocalized with TRAP and to be involved in the regulation of secretion of TRAP 5a in a breast cancer cell line, while it still was not essential for processing of TRAP 5a to TRAP 5b isoform.

Conclusion

In cancer cells multiple proteases are involved in cleaving TRAP 5a to high-activity phosphatase TRAP 5b. However, CtsK-inhibiting treatment was able to reduce secretion TRAP 5a from TRAP-overexpressing cancer cells.
Genome of the webworm Hyphantria cunea unveils genetic adaptations supporting its rapid invasion and spread
Authors: Chen Qi , Zhao Hanbo , Wen Ming , Li Jiaxin , Zhou Haifeng , Wang Jiatong , Zhou Yuxin , Liu Yulin , Du Lixin , Kang Hui , Zhang Jian , Cao Rui , Xu Xiaoming , Zhou Jing-Jiang , Ren Bingzhong , Wang Yinliang
Published: March 2020

Background

The fall webwormHyphantria cuneais an invasive and polyphagous defoliator pest that feeds on nearly any type of deciduous tree worldwide. The silk web ofH. cuneaaids its aggregating behavior, provides thermal regulation and is regarded as one of causes for its rapid spread. In addition, both chemosensory and detoxification genes are vital for host adaptation in insects.

Results

Here, a high-quality genome ofH. cuneawas obtained. Silk-web-related genes were identified from the genome, and successful silencing of the silk protein geneHcunFib-Hresulted in a significant decrease in silk web shelter production. The CAFE analysis showed that some chemosensory and detoxification gene families, such asCSPs,CCEs,GSTsandUGTs, were expanded. A transcriptome analysis using the newly sequencedH. cuneagenome showed that most chemosensory genes were specifically expressed in the antennae, while most detoxification genes were highly expressed during the feeding peak. Moreover, we found that many nutrient-related genes and one detoxification gene,HcunP450(CYP306A1), were under significant positive selection, suggesting a crucial role of these genes in host adaptation inH. cunea. At the metagenomic level, several microbial communities inH. cuneagut and their metabolic pathways might be beneficial toH. cuneafor nutrient metabolism and detoxification, and might also contribute to its host adaptation.

Conclusions

These findings explain the host and environmental adaptations ofH. cuneaat the genetic level and provide partial evidence for the cause of its rapid invasion and potential gene targets for innovative pest management strategies.
CuAS: a database of annotated transcripts generated by alternative splicing in cucumbers
Authors: Sun Ying , Zhang Quanbao , Liu Bing , Lin Kui , Zhang Zhonghua , Pang Erli
Published: March 2020

Background

Alternative splicing (AS) plays a critical regulatory role in modulating transcriptome and proteome diversity. In particular, it increases the functional diversity of proteins. Recent genome-wide analysis of AS using RNA-Seq has revealed that AS is highly pervasive in plants. Furthermore, it has been suggested that most AS events are subject to tissue-specific regulation.

Description

To reveal the functional characteristics induced by AS and tissue-specific splicing events, a database for exploring these characteristics is needed, especially in plants. To address these goals, we constructed a database of annotated transcripts generated by alternative splicing in cucumbers (CuAS: http://cmb.bnu.edu.cn/alt_iso/index.php) that integrates genomic annotations, isoform-level functions, isoform-level features, and tissue-specific AS events among multiple tissues. CuAS supports a retrieval system that identifies unique IDs (gene ID, isoform ID, UniProt ID, and gene name), chromosomal positions, and gene families, and a browser for visualization of each gene.

Conclusion

We believe that CuAS could be helpful for revealing the novel functional characteristics induced by AS and tissue-specific AS events in cucumbers. CuAS is freely available at http://cmb.bnu.edu.cn/alt_iso/index.php.
Description of the targeted water supply and hygiene response strategy implemented during the cholera outbreak of 2017–2018 in Kinshasa, DRC
Authors: Bompangue Didier , Moore Sandra , Taty Nadège , Impouma Benido , Sudre Bertrand , Manda Richard , Balde Thierno , Mboussou Franck , Vandevelde Thierry
Published: March 2020

Background

Rapid control of cholera outbreaks is a significant challenge in overpopulated urban areas. During late-2017, Kinshasa, the capital of the Democratic Republic of the Congo, experienced a cholera outbreak that showed potential to spread throughout the city. A novel targeted water and hygiene response strategy was implemented to quickly stem the outbreak.

Methods

We describe the first implementation of the cluster grid response strategy carried out in the community during the cholera outbreak in Kinshasa, in which response activities targeted cholera case clusters using a grid approach. Interventions focused on emergency water supply, household water treatment and safe storage, home disinfection and hygiene promotion. We also performed a preliminary community trial study to assess the temporal pattern of the outbreak before and after response interventions were implemented. Cholera surveillance databases from the Ministry of Health were analyzed to assess the spatiotemporal dynamics of the outbreak using epidemic curves and maps.

Results

From January 2017 to November 2018, a total of 1712 suspected cholera cases were reported in Kinshasa. During this period, the most affected health zones included Binza Météo, Limeté, Kokolo, Kintambo and Kingabwa. Following implementation of the response strategy, the weekly cholera case numbers in Binza Météo, Kintambo and Limeté decreased by an average of 57% after 2 weeks and 86% after 4 weeks. The total weekly case numbers throughout Kinshasa Province dropped by 71% 4 weeks after the peak of the outbreak.

Conclusion

During the 2017–2018 period, Kinshasa experienced a sharp increase in cholera case numbers. To contain the outbreak, water supply and hygiene response interventions targeted case households, nearby neighbors and public areas in case clusters using a grid approach. Following implementation of the response, the outbreak in Kinshasa was quickly brought under control. A similar approach may be adapted to quickly interrupt cholera transmission in other urban settings.
Maternal and neonatal outcomes and determinants of iodine deficiency in third trimester of pregnancy in an iodine sufficient area
Authors: Gargari Soraya Saleh , Fateh Reyhaneh , Bakhshali-bakhtiari Mina , Saleh Masoumeh , Mirzamoradi Masoumeh , Bakhtiyari Mahmood
Published: March 2020

Background

Mild to moderate iodine deficiency in pregnant women may expose them to the increased risk of the development of goiter and thyroid disorder. There is a relationship between low maternal UIC (Urinary iodine concentration) in pregnancy and diminished placental weight and neonatal head circumference. The current study was an attempt to assess iodine nutritional status, its determinants and relationship with maternal and neonatal outcomes.

Methods

In this population based cross-sectional study, which was conducted from April 2017 to September 2018, information was collected from 884 women of 20–45 years old who referred for periodic pregnancy visits. UIC was measured in random urine samples by applying a manual method which was based on the Sandell–Kolthoff technique. Information related to neonatal and maternal complications was collected from the individuals enrolled in the study through systematic follow-ups of the research team in each hospitals and the referral of trained midwives to the place of delivery and the retrieval of the case files.

Results

The results showed that out of 884 participants 838 (94.8%) had a urinary iodine concentration of more than 150 micrograms/litre and 46 (5.2%) showed urinary iodine concentrations less than 150 micrograms/litre. The median (IQR) urinary iodine concentration in the third trimester was 176 (165–196) μg/l. According to the WHO criteria 46 of the participants (5.2%) had insufficient urinary iodine concentrations, 805 (91.06%) had adequate urinary iodine concentrations while 33 (3.73%) showed more than adequate levels. There were no participants with urinary iodine concentrations higher than 500 micrograms/litre. The main influencing factors on maternal iodine deficiency in this study were weight gain during pregnancy (Odds Ratio (OR) =0.88, 95% CI: 0.82–0.95), number of previous pregnancy (OR = 0.59, 95% CI: 0.39–0.89) the interval between the most recent pregnancies (OR = 0.78, 95% CI: 0.64–0.95), whether or not the pregnancy has been Planned (OR = 2.92, 95% CI: 1.29–6.58) and nutritional complement consumption (OR = 3.64, 95% CI: 1.44–9.1). The need for a neonatal intensive care unit (NICU) admission (OR = 4.64, 95% CI: 1.81–11.9) and preterm birth (OR = 3.29, 95% CI: 1.51–7.1) were significantly related with maternal iodine deficiency before delivery. Also there is no significant differences regarding the mean maternal urinary iodine concentration between the normal and different maternal complications groups (p = 0.47).

Conclusion

Iodine deficiency in pregnant women can be improved by appreciate planning for pregnancy, proper inter-pregnancy time interval (> 12 months to < 5 years), appropriate nutrition during pregnancy. Besides, controlling maternal urinary iodine concentrations is important to prevent neonatal complications such as preterm delivery and NICU admission.
Systematic review of the measurement properties of indices of prenatal care utilization
Authors: Rowe Stewart , Karkhaneh Zahra , MacDonald Isaiah , Chambers Thane , Amjad Sana , Osornio-Vargas Alvaro , Chari Radha , Kumar Manoj , Ospina Maria B.
Published: March 2020

Background

An accurate assessment of the adequacy of prenatal care utilization is critical to inform the relationship between prenatal care and pregnancy outcomes. This systematic review critically appraises the evidence on measurement properties of prenatal care utilization indices and provides recommendations about which index is the most useful for this purpose.

Methods

MEDLINE, EMBASE, CINAHL, and Web of Science were systematically searched from database inception to October 2018 using keywords related to indices of prenatal care utilization. No language restrictions were imposed. Studies were included if they evaluated the reliability, validity, or responsiveness of at least one index of adequacy of prenatal care utilization. We used the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. We conducted an evidence synthesis using predefined criteria to appraise the measurement properties of the indices.

Results

From 2664 studies initially screened, 13 unique studies evaluated the measurement properties of at least one index of prenatal care utilization. Most of the indices of adequacy of prenatal care currently used in research and clinical practice have been evaluated for at least some form of reliability and/or validity. Evidence about the responsiveness to change of these indices is absent from these evaluations. The Adequacy Perinatal Care Utilization Index (APNCUI) and the Kessner Index are supported by moderate evidence regarding their reliability, predictive and concurrent validity.

Conclusion

The scientific literature has not comprehensively reported the measurement properties of commonly used indices of prenatal care utilization, and there is insufficient research to inform the choice of the best index. Lack of strong evidence about which index is the best to measure prenatal care utilization has important implications for tracking health care utilization and for formulating prenatal care recommendations.
Maternal and health service predictors of postpartum hemorrhage across 14 district, general and regional hospitals in Thailand
Authors: Prapawichar Phat , Ratinthorn Ameporn , Utriyaprasit Ketsarin , Viwatwongkasem Chukiat
Published: March 2020

Background

Postpartum hemorrhage (PPH) is a preventable complication, however, it remains being the leading cause of maternal mortality and morbidity worldwide including Thailand.

Methods

A case-control study to examine the risk factors associated with PPH across the hospitals under the Ministry of Public Health in Thailand, was conducted. A total of 1833 patient birth records and hospital profiles including human and physical resources from 14 hospitals were obtained. A multiple logistic regression was used identifing the factors that are significantly associated with PPH.

Results

The results show that the rate of PPH varied across the hospitals ranging from 1.4 to 10.6%. Women with past history of PPH were more likely to have increased risk of having PPH by 10.97 times (95% CI 2.27,53.05) compared to those who did not. The odds of PPH was higher in district and general hospitals by 14 (95% CI 3.95,50.04) and 7 (95% CI 2.27,23.27) times respectively, compared to regional hospitals. The hospitals which had inadequate nurse midwife to patient ratio (OR 2.31,95% CI 1.08,4.92), lacked nurse midwives with working experience of 6–10 years (OR 2.35, 95% CI 1.41,3.92), as well as inadequate equipment and supplies for emergency obstetric care (OR 6.47, 95% CI 1.93,21.63), had significantly higher incidence of having PPH, respectively.

Conclusions

This study provides interesting information that the rate of PPH varies across the hospitals in Thailand, in particular where essential nurse midwives, equipment, and supplies are limited. Therefore, improving health care services by allocating sufficient human and physical resources would contribute to significantly reduce this complication.
Therapeutic implications of PD-L1 expression in bladder cancer with squamous differentiation
Authors:   on behalf of the German Study Group of Bladder Cancer (DFBK e.V.), Morsch Ronja , Rose Michael , Maurer Angela , Cassataro Maria Angela , Braunschweig Till , Knüchel Ruth , Vögeli Thomas-Alexander , Ecke Thorsten , Eckstein Markus , Weyerer Veronika , Esposito Irene , Ackermann Maximilian , Niegisch Günter , Gaisa Nadine T.
Published: March 2020

Background

Immune checkpoint inhibitors (ICI) are an integral part of bladder cancer therapy, however, the relevance of ICI treatment for mixed and pure squamous cell carcinoma of the bladder remains poorly studied. Therefore, we analysed the expression of programmed death-ligand 1 (PD-L1) in urothelial carcinomas with squamous differentiation (UC/SCC) and pure squamous cell carcinoma (SCC) of the bladder and studied a UC/SCC patient with ICI therapy.

Methods

Tissue microarrays of 45 UC/SCC and 63 SCC samples were immunohistochemically stained with four anti-PD-L1 antibodies (28–8, 22C3, SP142 and SP263). PD-L1 expression was determined for tumour cells (TP-Score), immune cells (IC-Score) and combined (CPS, combined positive score). In addition, we present clinical and histological data of an UC/SCC patient with nivolumab therapy.

Results

Overall, positive PD-L1 staining ranged between 4.8 and 61.9% for IC and 0 and 51.2% for TC depending on the used antibody. There were no significant differences between UC/SCC and SCC. According to current FDA guidelines for example for first line therapy of urothelial cancer with pembrolizumab (CPS ≥ 10), a subset of SCC patients up to 20% would be eligible. Finally, our UC/SCC index patient revealed excellent therapy response regarding his lung metastasis.

Conclusions

Our data reveal a PD-L1 expression in squamous differentiated carcinomas comparable with current data shown for urothelial tumours. In accordance with the encouraging clinical data of the index patient we suggest ICI treatment also for mixed and pure SCC of the urinary bladder.
Screening and care for alcohol use disorder in France: expectations, barriers and levers using a mixed-methods approach
Authors: Costa Marie , Barré Tangui , Coste Marion , Yaya Issifou , Berenger Cyril , Tanti Marc , Cutarella Christophe , Mora Marion , Poloméni Pierre , Maynard Marianne , Teuma Danielle , Bazin Michaël , Maradan Gwenaelle , Roux Perrine , Carrieri Patrizia Maria
Published: March 2020

Background

The widespread under-screening and under-treatment of alcohol use disorder (AUD) contributes to its health and socioeconomic burden. We conducted a mixed-methods (qualitative and qualitative) study in people with alcohol use disorder (PWAUD) to explore their expectations, as well as barriers and levers to AUD care.

Methods

Individuals with AUDIT > 15 (N = 179) were interviewed using computer-assisted interviews in several medical and non-medical sites (e.g., bars) (quantitative substudy). We also conducted semi-structured face-to-face interviews with 36 PWAUD (qualitative substudy). Using logistic regression, we explored factors associated with having previously received/sought care for AUD. Three major themes were identified in the qualitative textual analysis using a descending hierarchical classification.

Results

Not socializing with heavy drinkers (AOR [95%CI]:3.84[1.66–8.85]), regular smoking (9.72[3.91–24.15]) and feeling discriminated against (2.35[1.10–5.05]) were independent levers to having sought/received care for AUD, while being aged < 50 and employment were independent barriers. The five predominant themes in PWAUD discourses emerging from the textual analysis were: drinking context, medical care, alcohol treatment, tobacco/addiction and family. When triangulating results from the logistic regression and the textual analysis, two barriers (social drinking and difficulties with the medical care system), and two levers (family influence and tobacco addiction), emerged.

Conclusion

These results underline the need for interventions targeting families and the social network to increase awareness about AUD and related care. Simplified and novel comprehensive care trajectories are urgently needed to reduce the clinical and public health burden of AUD.
Determinants of life expectancy and clustering of provinces to improve life expectancy: an ecological study in Indonesia
Authors: Paramita Sekar Ayu , Yamazaki Chiho , Koyama Hiroshi
Published: March 2020

Background

Life expectancy acts as a population measure of the performance of healthcare systems. Regional disparities on life expectancy in Indonesia has been persisted and become a public health policy challenge. A systematic clustering of provinces can be a valuable alternative for organizing cooperation that aimed to increase life expectancy and reduce disparities. This study aimed to identify determinants of life expectancy and designate clusters of Indonesian provinces with similar characteristics. This approach can be useful in generating alternative cooperation strategies to improve life expectancy.

Methods

We carefully selected variables that have been shown to impact life expectancy and gathered 2015 data from Indonesia’s Ministry of Health. All 34 Indonesian provinces were included as analysis units. We performed structural equation modeling (SEM) to select domains that needed to work on from theoretical models. Based on SEM results, we performed cluster analysis to arrange cooperation groups.

Results

Life expectancy showed correlations with mean years of schooling, expenditure per capita, health workforce, healthcare facilities, and environment. Expenditure per capita also was the strongest of all constructs. Based on SEM results, we performed cluster analysis to arrange cooperation groups of total 34 provinces and generated five clusters of provinces.

Conclusions

Enhancing the economy is the most effective approach for improving life expectancy and other constructs. These clusters can build cooperation that is new, within, and across clusters. These results may be useful in formulating cooperation strategies aimed at increasing life expectancy.
Impact of sugar-sweetened beverage tax on dental caries: a simulation analysis
Authors: Urwannachotima Nipaporn , Hanvoravongchai Piya , Ansah John Pastor , Prasertsom Piyada , Koh Victoria Rui Ying
Published: March 2020

Background

The tiered sugar-sweetened beverage (SSB) tax was implemented in Thailand to encourage industries to reduce sugar content in beverages, and consequently reduce sugar consumption in the population. The aim of the study is to explore the expected impact of the new SSB tax policy in Thailand, a middle-income country in Asia, and other alternative policies on oral health outcomes as measured by the prevalence and severity of dental caries among the Thai population.

Methods

A qualitative system dynamics model that captures the complex interrelationships among SSB tax, sugar consumption and dental caries, was elicited through participatory stakeholder engagement. Based on the qualitative model, a quantitative system dynamics model was developed to simulate the SSB tax policy and other alternative scenarios in order to evaluate their impact on dental caries among Thai adults from 2010 to 2040.

Results

Under the base-case scenario, the dental caries prevalence among the Thai population 15 years and older, is projected to increase from 61.3% in 2010 to 74.9% by 2040. Implementation of SSB tax policy is expected to decrease the prevalence of dental caries by only 1% by 2040, whereas the aggressive policy is projected to decrease prevalence of dental caries by 21% by 2040.

Conclusions

In countries where a majority of the sugar consumed is from non-tax sugary food and beverages, especially Asian countries where street food culture is ubiquitous and contributes disproportionately to sugar intake, SSB tax alone is unlikely to have meaningful impact on oral health unless it is accompanied with a comprehensive public health policy that aims to reduce total sugar intake from non-SSB sources.
Stress, stressors and related factors in clinical learning of midwifery students in Iran: a cross sectional study
Authors: Rezaei Behrooz , Falahati Juliana , Beheshtizadeh Raziyeh
Published: March 2020

Background

Midwifery is an emotionally challenging profession, and academic education of midwifery especially clinical learning has its own specific challenges. Midwifery students face with stressful experiences, especially related to instructor and characteristics of clinical environment, which can affect their theoretical and practical abilities. There is insufficient evidence in this field. This study aimed to explore (1) the perceived stress and stressors of midwifery students and (2) the relationships between students’ stress and related factors in clinical learning environment.

Methods

A cross sectional, survey design was conducted at one university in Iran. A sample of 108 students was selected using Krejcie and Morgan table in 2016. Data was collected using Persian version of Cohen’s perceived stress scale, Persian questionnaire of sources of stress and demographic form. Data was analyzed using independent t, ANOVA and correlation coefficient test (α < 0.05).

Results

Participants returned 70 surveys (response rate, 64.8%). Approximately 56% of the students perceived a high level of stress. The most common dimensions of stressors were “unpleasant emotions” and “humiliating experiences”. The highest stressors were included “feeling suffering due to seeing for patients with critical situation”, “instructor’s admonition in the presence of clinical staff” and “communication with instructor”. The “interest in the field of study” had a negative impact on perception of stressors in dimensions of “clinical practices” and “interpersonal communication”.

Conclusions

The midwifery students reported their stress in severe level, especially in dimensions of “unpleasant emotions” and “humiliating experiences”. The factors associated with the instructors have caused more stress in students. These findings will highlight need for supportive strategies by the clinical instructors. In this regard, the use of experienced instructors, the development of communication skills of the instructors, increasing coping skills of the students and the creation of a supportive environment may be helpful.