bluuebunny/crossref_metadata_2025 huggingface dataset:
Anemia and perioperative mortality in Non-cardiac Surgery patients: a secondary analysis based on a single-center retrospective study
Authors: Luo Xueying , Li Feng , Hu Haofei , Liu Baoer , Zheng Sujing , Yang Liping , Gao Rui , Li Ya , Xi Rao , He Jinsong
Published: May 2020

Background : Evidence regarding the relationship between anemia and perioperative prognosis is controversial. The study was conducted to highlight the specific relationship between anemia and perioperative mortality in non-cardiac surgery patients over 18 years of age. Methods: This study was a retrospective analysis of the electronic medical records of 90,784 patients at the Singapore General Hospital from January 1, 2012 to October 31, 2016. Multivariate regression, propensity score analysis, doubly robust estimation, and an inverse probability-weighting model was used to ensure the robustness of our findings. Results : We identified 85,989 patients, of whom75, 163 had none or mild anemia(Hemoglobin>90g/L) and 10,826 had moderate or severe anemia(Hemoglobin≤90g/L). 8,857 patients in each study exposure group had similar propensity scores and were included in the analyses. In the doubly robust model, postoperative 30-day mortality rate was increased by 0.51% (n = 219) in moderate or severe anemia group (Odds Ratio, 1.510; 95% Confidence Interval(CI), 1.049 to 2.174) compared with none or mild anemia group (2.47% vs. 1.22%, P<0.001). Moderate or severe anemia was also associated with increased postoperative blood transfusion rates (OR, 5.608; 95% CI, 4.026 to 7.811, P < 0.001).There was no statistical difference in Intensive Care Unit(ICU) admission rate among different anemia groups within 30 days after surgery (P=0.104). Discussion: In patients undergoing non-cardiac surgery over 18 years old, moderate or severe preoperative anemia would increase the occurrence of postoperative blood transfusion and the risk of death, rather than ICU admission within 30 days after surgery.
“You talk about problems until you feel free”: South African adolescent girls’ and young women’s narratives on the value of HIV prevention peer support clubs
Authors: Baron Deborah , Scorgie Fiona , Ramskin Lethabo , Khoza Nomhle , Schutzman Jennifer , Stangl Anne , Harvey Sheila , Delany-Moretlwe Sinead
Published: May 2020

Background: Daily oral pre-exposure prophylaxis (PrEP) can reduce HIV infection in adolescent girls and young women if used consistently during periods of risk. The EMPOWER study evaluated peer-based clubs incorporating an empowerment curriculum offered to adolescent girls and young women (16-24 years) in South Africa and Tanzania for adherence support. Methods: Using serial in-depth interviews (n=33), we assessed the benefits and challenges of club attendance among 13 EMPOWER participants in the Johannesburg site who were randomised to clubs. We used a summary matrix of coded data to support a narrative, case-based analysis. Four case studies are presented. Results: Club participants reported benefits such as increased self-esteem and self-efficacy, reduced isolation, and greater insight into gender-based violence and strategies to address it. Day-to-day PrEP adherence was not the only topic discussed in clubs; participants also appreciated the safe space for sharing problems (such as relationship conflict and PrEP stigma) and found interactive exercises helpful in improving partner communication.Conclusions: Findings support the use of peer-based clubs using a structured empowerment approach, which may offer valuable PrEP initiation support to adolescent girls and young women in settings with high HIV and gender-based violence prevalence.Trial registration: South African Clinical Trial Register 4353, 15 April 2016
Hospital Admissions Among People Who Inject Opioids Following Syringe Services Program Implementation
Authors: Bornstein Kasha , Coye Austin , Onge Joan St. , Li Hua , Muller Amanda , Bartholomew Tyler , Tookes Hansel
Published: May 2020

Background Syringe service programs (SSPs) are an evidence-based harm reduction strategy that reduce dangerous sequelae of injection drug use among people who inject drugs (PWID) such as overdose. SSP services include safer injection education and community-based naloxone distribution programs. This study evaluates differences in overdose-associated hospital admissions following implementation of the first legal SSP in Florida, based in Miami-Dade County. Methods We performed a retrospective analysis of hospitalizations for injection drug-related sequelae at a county hospital before and after the implementation of the SSP. An algorithm utilizing ICD-10 codes for opioid use and sequelae was used to identify people who inject opioids (PWIO). Florida Department of Law Enforcement Medical Examiners Commission Report data was used to analyze concurrent overdose death trends in Florida counties. Results Over the 25-month study period, 302 PWIO admissions were identified; 146 in the pre-index vs. 156 in post-index. A total of 26 admissions with PWIO overdose were found; 20 pre-index and 6 post-index (p=0.0034). Conclusions Declining overdose-associated admissions among PWIO suggests early impacts following SSP implementation. These results indicate a potential early benefit of SSP that should be further explored for its effects on future hospital admission and mortality.
Risk Perception and Behavior in Egyptian Adolescent Pesticide Applicators: An Intervention Study
Authors: Rohlman Diane S , Davis Jonathan W , Ismail Ahmed , Rasoul Gaafar Abdel , Hendy Olfat , Olson James R , Bonner Matthew R
Published: May 2020

Background: Adolescents are engaged in agricultural work, including pesticide application, around the world. Adolescent pesticide applicators are more likely to be exposed to pesticides than their adult counterparts because of their application practice and hygiene habits surrounding pesticide use. There is a need for low-cost interventions to reduce pesticide exposure. We evaluated a theoretically-based educational intervention to change perceptions about the risk of pesticide use and hygiene habits during and after pesticide application for adolescent and young adult pesticide applicators in Egypt.Methods: Young adult and adolescent male pesticide applicators were given a one-hour educational intervention to inform them about the risk of pesticide use and how to reduce pesticide exposure. The median age of participants was 18 years old. Changes in perceived susceptibility and effectiveness were measured with a survey pre and post-intervention (n=119) on the same day. The same survey (n=95) was given 8-months post-intervention to identify sustained effects. Observational checklists of pesticide application practice were also completed during application seasons before and after the intervention.Results: There was an increase in the proportion of individuals who viewed pesticides as being a long-term health risk (74.7% pre-intervention to 97.9% post-intervention, McNemar test p<0.001). This change remained significant when surveyed at the 8-month follow-up (90.5%, p<0.001). There was also a sustained improvement regarding participants’ views of proper hygiene practice surrounding pesticide application. Applicators were observed wearing goggles, shoes, and masks more frequently post-intervention.Conclusion: This theoretically-based intervention is an example of a low-cost solution that can improve adolescents’ and young adults’ practices regarding pesticide application and personal hygiene practices during and after pesticide application. The intervention can be applied in other countries with similar safety culture surrounding pesticide application.
Testing whether the progression of Alzheimer's disease change with the year of publication, additional design and geographical area: a modeling analysis of literature aggregate data
Authors: zhang ningyuan , Zheng Xijun , Liu Hongxia , Zheng Qingshan , Li Lujin
Published: May 2020

Background Our objective was to develop a disease progression model for cognitive decline in Alzheimer’s disease (AD) and to determine whether disease progression of AD is related to the year of publication, add-on trial design, and geographical regions. Methods Placebo-controlled randomized AD clinical trials were systemically searched in public databases. Longitudinal placebo response (mean change from baseline in the cognitive subscale of the Alzheimer’s Disease Assessment Scale [ADAS-cog]) and the corresponding demographic information were extracted to establish a disease progression model. Covariate screening and subgroup analyses were performed to identify potential factors affecting the disease progression rate. Results A total of 134 publications (140 trials) were included in this model-based meta-analysis. The typical disease progression rate was 5.82 points per year. The baseline ADAS-cog score was included in the final model using an inverse-U type function. Age was found to be negatively correlated with disease progression rate. After correcting the baseline ADAS-cog score and the age effect, no significant difference in disease progression rate was found between trials published before and after 2008, and between trials using add-on design and those that did not use add-on design. However, a significant difference was found among different trial regions. Trials in East Asian countries showed the slowest decline rate and the largest placebo effect. Conclusions Our model successfully quantified AD disease progression by integrating baseline ADAS-cog score and age as important predictors. These factors and geographic location should be considered when optimizing future trial designs and conducting indirect comparisons of clinical outcomes.
Mutation induction of EMS and 60Co γ irradiation in vitro cultured seedlings of red pulp pitaya (Stenocereus) and ISSR analyzing of mutant
Authors: Deng Renju , Fan Jianxin , Wang Yongqing , Liu Tao , Jin Jifen
Published: May 2020

Background

Pitaya is a new type of fruit tree developed vigorously in recent years in China. The current variety characteristics of pitaya can not meet the needs of market development. In order to speed up the breeding process and increase the variation frequency, the red pulp pitaya variety 'Zi Honglong' seedlings in vitro were used as experimental materials, which were treated with different dose of ethyl methanesulfonate (EMS) and 60Co γ irradiation, respectively.
Results

The results indicated that the appropriate concentration for the EMS mutagenesis was 3.71%-3.95%, and the optimum time was 8.26–9.32 h. The feasible irradiation dose range for 60Co γ mutation was 38.5–42.4 Gy. The dose of mutagens was inversely proportional to the survival and differentiation rate of seedlings. By observing the morphological characteristics of mutagenic materials, 14 mutants were screened out. According to the ISSR analysis, a total of 67 bands were amplified from the 9 primers, among which 71.64% polymorphism was obtained. Compared with the control, there was a specific band in No. 5 mutant detected by primer M06, but its functional characteristics needed further research and verification. The genetic distances (GD) among the tested materials were 0.0120 to 0.4169 analyzed by NTSYS pc 2.1. The UPGMA clustering analysis demonstrated that 15 germplasm could be divided into 6 groups at a cutpoint of genetic distance 0.11, and among them No. 5, 6, 10, 12 and 14 warranted separate categorization, which showed that they had more differences in tested germplasm.
Conclusions

It concluded that pitaya mutant might be produced regardless of the mutagenic dose high or low, and a higher dose could increase the frequency of variation. In this study, critical dose and half lethal dose can be used as the appropriate dose for mutation breeding of pitaya. Additional, molecular analysis showed that there was a certain difference between the mutant plants and the control. It needs to be further verified whether this difference was a physiological variation or a real variation due to the randomness of mutation, so as to lay a foundation for better carrying out mutation breeding of pitaya.
Informal learning during the standardized residency training in the context of “Internet plus:" an empirical research
Authors: Lei Li , Jun Ma , Xiaoling Tian , Huixian Cui , Zhifen Yang
Published: May 2020

Background Informal learning refers to learners-sponsored, monitored and regulated learning method, which lays the foundation for medical life-long education of residents with sustainable self-learning ability and permanent learning behaviors. In this article the authors explore the academic value and significance in informal learning to improve the effectiveness for the standardized residency training in the context of “Internet plus” which combines technology with education to promote reforms for learning patterns. Standardized residency training started relatively late in China and there are less empirical studies targeted for the medical students in this phase. Based on it, this study aims to explore online informal learning behavior of medical students in residency training.Methods An empirical study was performed at the Fourth Hospital of Hebei Medical University in China where postgraduate medical education is being conducted. The study was implemented by questionnaire of the following aspects related to informal learning of residents as learning attitude, motivation, behavior and utilization of learning resources. Learning efficiency before and during COVID-19 is specifically surveyed and analyzed. 451 valid samples were collected to understand the situation of informal learning in the context of “Internet plus” and to find out interconnections among variables. The data from questionnaire has been analyzed through descriptive analysis, difference analysis and correlation regression analysis.Results Informal learning attitudes of residents in standardized training are of high recognition and strong learning belief but need better self-management; The intervention between informal learning motivation and behavior among the levels of self-control, learning target and utilization of online resources resulting in great influence of environmental and individual factors on self-efficacy. Relative weak ability appears in choosing, screening and utilizing effective information online without effective guidance from teachers.Conclusions In this study we innovatively propose appropriate and practical suggestions for researching methods in informal learning of postgraduate medical education in clinical setting during intensive online learning during COVID-19 period. The findings of this research have great significance in guiding learning paths, effects and development for informal learning of residents and put forward effective measures for the development of positive and sustainable informal learning in future career of the doctors-to-be.
A Novel Approach to Objective Validation of YouTube™ Educational Videos for the Instruction of Regional Anesthesia Nerve Blocks
Authors: Tewfik George , Work Adam , Shulman Steven , Discepola Patrick
Published: May 2020

Background
YouTube™ (“YouTube”) is often used as an educational tool to instruct anesthesia providers on regional anesthesia nerve blocks. However, there is no current objective standard to assess the educational quality of these user-uploaded videos. A new approach was used to objectively validate these videos by comparing them to high quality educational sources for the seven most commonly used nerve blocks.
Objective
We sought to evaluate the educational quality of user-uploaded videos when compared to the highest quality anesthesia society websites (NYSORA, ACEP, USRA)
Methods
We first catalogued the characteristics of the instructional material on three of the highest quality anesthesia society websites (NYSORA, ACEP, USRA) into 18 different items. Next, we surveyed the five most popular anesthesia block videos on YouTube for each of the seven peripheral nerve blocks in question. The presence or absence of each category was recorded.
Results
Although there were varying degrees of correlation between the high quality sources and the videos, rarely did YouTube videos contain as high a percentage of these educational characteristics as the well-established sources. Some videos contained very few of these important educational characteristics.
Conclusion
Although YouTube has been used an educational tool, we recommend that only high quality sources be used to teach or illustrate regional anesthesia nerve blocks.
Proposal for a EN 149 Acceptable Reprocessing Method for FFP2 Respirators in Times of Severe Shortage
Authors: Widmer Andreas , Richner Gilles
Published: May 2020

Introduction:Transmission to health care workers (HCW) poses a major burden in the current Covod-19 pandemic. Unprotected exposure to a SARS-CoV-2p patient is a key risk factor for HCWs. Droplet transmission, and high transmission during aerosol-generating procedures are modes of transmission, requiring a respirator such as N95 or FFP2 respirator to protect the HCWs, likely the most important part of personal protection equipment (PPE). However, many HCW were infected due to lack of PPE, or failure to use them. The worldwide shortage of respirators triggered the development of reprocessing used N95 or FFP respirator. Our proposal with H2O2 plasma sterilization for decontamination allows to reprocess a type of FFP2 still meeting filtration effectiveness of EN 149, the European standard for new respirators. The protocol is simple, uses available resources in hospitals and can be rapidly implemented to decrease the shortage of respirators during this crisis. The goal of the study was the evaluate if respirators can be reprocessed without hampering filtration capacity outlined by EN 149MethodsUsed FFP2 respirators – Model 3M AuraTM 1862+ - were sterilized using a low temperature process Hydrogen peroxide (H2O2) V-PRO® maX Low Temperature, a FDA approved method to decontaminate FFP2 respirator. Decontaminated respirators were further checked for residual peroxide by a single-gas detector for H2O2. The Total Inward Leakage of the protective respirators was quantitatively tested with 10 test persons in an atmosphere charged with Paraffin aerosol according to EN 149. The fit factor was calculated as the inverse of the Total Inward Leakage.ResultsTen new and ten decontaminated FFP2 respirators were simultaneously tested for filtration effectiveness. None of the respirators exceeded peroxide maximum acceptable concentration of peroxide before use. More than 4000 respirators have been reprocessed so far, at cost of approximately 0.3 Euro/piece.ConclusionsFFP 2 respirators can be safely reprocessed once after decontamination with plasma peroxid sterilization still meeting EN 149 requirements as new respirators. This allows to almost double the current number of FFP2 respirators that are in serious shortage.
Evaluation of Blended Fertilizer (NPSZnB) Rates on grain yield, nutrient uptake and economic feasibility of maize (Zea mays L.) in Kolla-Temben, Central zone of Tigrai, Ethiopia
Authors: Berhe Hintsa Meresa , Marie Fantaye Belay
Published: May 2020

Background: Maize is an important cereal crop grown and consumed in Ethiopia. However, its yield is constrained by low soil fertility and improper utilization of fertilizer. Therefore the objective of this finds was to study the effect of NPSZNb fertilizer rates on grain yield, nutrient uptake and economic feasibility of maize. Methods: A field experiment was conducted at Bega-Sheka in 2018/19 & 2019/2020 cropping season. The treatments were consisted of six blended fertilizer rates (0, 50, 100, 150, 200 and 250 kg NPSZnB ha -1 ) and recommended p (40 kg ha -1 ). Treatments were arranged in RCBD design with three replications. Result: Analysis of variance indicated that blended fertilizer rate had statistically significant (p < 0.005) effect on plant height, ear length, number of seeds per row, grain and biomass yield. However, it did not have a significant effect on phonological traits, number of grain rows and 1000-grains weight. Application of NPSZnB fertilizer ranging from 150 to 250 kg ha-1 and 200 kg ha-1 of DAP gives the highest grain and biomass yields. Hence the higher nutrient uptake of N and P was recorded from the maximum rate of NPSZnB and P fertilizer, respectively. The MRR value showed that the highest MRR of 529% was obtains from 150 kg NPSZnB ha -1 . Conclusions: From the result of the study, application of 150 kg NPSZnB ha -1 increases yield and yield component of maize and give maximum return from unit investment which can be recommended for the study area.
Identification of Specific Selection Criteria in Young Ball Sport Players
Authors: Pucsok József Márton , Ráthonyi Gergely , Varga Katalin , Perényi Gabriella , Puskás Andrea Lenténé , Bács Zoltán , Balogh László
Published: May 2020

Background: The purpose of our study was to analyze body composition and spiroergometric data of young (14-15 years) elite level ball sport players. We suggested that three-ball sports (handball, soccer, and basketball) share common performance indicators, as each ball sport is primarily characterized by rapid intermittent movements. Methods: We selected one-hundred and ten, handball (n=30), basketball (n=40) and soccer (n=40) players male and female from local clubs in Hungary. To measure their performance to develop high-quality training programs adequately age was differing from 14 to 15, they represented the elite level of their sports. They participated in performance analysis, the protocol included a body composition analysis and spiroergometric tests. We measured body composition and physiological parameters utilizing an In Body 720 device, and a standard Bruce treadmill protocol. Although we were aware of the limitations of the Bruce protocol in elite athletes, we choose this protocol as a safer alternative for younger inexperienced athletes. Results and conclusions: We concluded that in young male soccer and basketball players mean peak /load (W), peak/VE (l), peak/Vtex (l), peak/VO2 (ml/min), peak/VCO2 (ml/min), and peak/ O2 pulse (ml) data is a reliable indicator of the sport-specific performance. We may also suggest, that in our population of male basketball and handball players peak/Vtex (l) is the only variable, which is significantly different. Between groups of male handball and soccer players, peak/VO2/kg (ml/min) may be a valid performance indicator too. Among female basketball and handball players we found a significant difference in three performance variables: peak/Vtex (l), peak/VO2 (ml/min) and peak/ O2 pulse (ml). Although we must be careful when interpreting results, prior experiences with exercise testing, biological maturation differences must be considered. Trial registration: All examinations involving human subjects were approved by the Hungarian Ethical Committee ETT TUKEB:15117-4/2018/EÜIG.
Career aspirations among specialty residents: a gender-based comparison
Authors: Cathelain Alice , Jourdain Mercedes , Cordonnier Charlotte , Jonard Sophie Catteau , Sebbane Deborah , Copin Marie-Christine , Berlingo Laura , Rubod Chrystele , Garabedian Charles
Published: May 2020

Background - Two recent studies looked at the career choice of residents in obstetrics & gynecology. It seemed useful to us to broaden this questioning to other specialties, by proposing a study to all residents in the same Faculty. The objective of our study was to describe residents career aspirations and possible barriers according to gender.Methods – Declarative cross-sectional survey, using questionnaires sent by email to the specialty residents of the Faculty of Medicine of Lille (France). An analysis by specialty group (i.e. medicine, surgery, obstetrics & gynecology and anesthesia & resuscitation) and a comparison of the results according to gender were performed. Results – Of the 1,384 specialty residents currently in training, 462 answered the questionnaires (33.38%), among whom 289 women and 173 men (average age = 27.08 years +/- 0.091). 17 women (5.9%) were currently considering a university hospital career versus 37 men (21.4%) (p = 0.001). Gender analysis made it possible to identify obstacles to engaging in a university career: lacking female model, more frequent doubting in the ability to lead this type of career among women (61.6%) than men (35.3%) (p <0.001), and gender discrimination felt in the workplace for 51.6% of women (versus 7.5% of men, p <0.001). Subgroup analysis showed specificities related to each specialty. Conclusions – Few residents plan to embark upon a university hospital career, let alone female residents. There are specificities specific to each specialty and marked gender differences regarding career aspirations. Many obstacles have been identified as obstacles to access to university hospital positions for women. It is important to develop strategies to remove these barriers and enable women to pursue such university careers.
Mothers’ Competence in Child Feeding Recommendations, Complementary Feeding Practices and Determinants of Adequate Diet
Authors: MOGRE VICTOR , Appiah Kingsley B , Cheyuo Ernest K , Alhassan Abdul-Mumin , Ayanore Martin A , Kubuga Clement K
Published: May 2020

Background Appropriate complementary feeding is critical for optimal nutrition in infant and young children as it ensures their growth, health and development to attain their full potential. However, evidence shows children from developing countries do not meet the core indicators for appropriate complementary feeding. We evaluated mothers’ competency in infant and young child feeding recommendations and their association to complementary feeding practices among children aged 6–23 months.Methods This cross-sectional study included 200 children aged 6–23 months and their mothers/care givers recruited during the child welfare clinics of two health facilities in Ghana. Data was collected using a structured questionnaire. Multivariate logistic regression was used to assess determinants of appropriate diet.Results Sixty-eight percent of the mothers knew the recommended duration of continued breastfeeding, 56.5% how to ensure dietary diversity and enrich their children’s diets and 94% (n = 188) had positive attitude towards recommended infant and young child feeding practices. Majority of the mothers (92%, n = 183) practiced continued breastfeeding, 10.5% of the children met minimum diet diversity score, 39.5% minimum meal frequency and 8.5% received minimum acceptable diet. Determinants of receipt of minimum adequate diet were: having high knowledge in child feeding recommendations (100% vs. 0.0; p < 0.001) and child’s father reportedly earning enough financially (AOR = 12.1 (1.32–109.72; p = 0.027).Conclusion Poor complementary feeding practices were common and mother’s knowledge levels regarding infant and young child feeding recommendations as well as the income levels of the child’s father were important determinants of appropriate diet. Nutrition education should emphasis on improving mothers’ nutrition knowledge regarding infant and young child feeding and supporting mothers to overcome barriers to feed their children with appropriate complementary foods.
Clinically Significant Shared and Distinct Genomic Alterations in Chinese and Western Patients with Intrahepatic Cholangiocarcinoma
Authors: Xu Shifeng , Guo Yuan , Zeng Yanwu , Song Zhijian , Zhu Xiaodan , Fan Ning , Zhang Zhilei , Ren Guibing , Zang Yunjin , Rao Wei
Published: May 2020

Background The goal of this study is to disclose the clinically significant genomic alterations in patients with intrahepatic cholangiocarcinoma of the Chinese and Western populations.Methods A total of 86 Chinese patients were enrolled in this study. Samples from those patients were sequenced for a panel of pan-cancer genes. Results were compared to a public dataset from a cohort of Western patients. The comparison between the two populations was conducted in the driver genes, actionability, and TMB.Results The Chinese and Western cohorts had 38 and 12 driver genes, respectively. Seven driver genes (IDH1, KRAS, TP53, BAP1, PBRM1, ARID1A, and NRAS) were shared by the two cohorts. For both cohorts, half of the patients had actionable mutations. The two cohorts shared most of the actionable genes but differed much in the frequency. Though KRAS mutations were at the first and second actionable rank respectively for Chinese and Western populations, they were still at a relatively low level of actionable evidence. Four driver genes (SPTA1, ARID2, TP53, and GATA1) were found significantly correlated with the tumor mutation burden.Conclusions The revealed genomic alterations with clinical significance could help to improve the treatment of intrahepatic cholangiocarcinoma.
WITHDRAWN: Effective Learning, Leadership and Professionalism Series (ELLPS) nurturing early clinical year development: Transformation based on medical students’ feedbacks.
Authors: Nor Fadzilah Mohd , Ismail Nurhuda , Rahman Thuhairah Hasrah Abdul , Aziz Mardiana Abdul , Houssaini Jamal , Wang Seok Mui , Abdullah Bahiyah , Heo Chong Chin , Zohdi Wan Najwa Wan Ahmad
Published: May 2020

Objective To develop an improved early clinical year development programme based on undergraduate medical students’ feedback on the existing programme. Design A one-day evaluation workshop on existing early clinical year development programme was conducted in September 2018 based on a semi-structured qualitative feedback comprising four domains which were the 1) organisation 2) overall programme content 3) comments on each topic content and 4) suggestions on the improvement for future programmes. The domain on comments and suggestions examine the attitudes on 1) what should be learnt 2) when learning should occur 3) what methods should be used 4) how learning should be assessed and 5) what kind of students’ barriers are in such development programme throughout their early clinical years. Participants A total of 220 first-year undergraduate medical students in Year 1 MBBS programme attended the workshop. Results A total of 211 (95.9%) medical students have participated in the feedback survey. Majority of students (more than 80%) were satisfied with the overall programme. Fifty students (23.7%) have provided their comments and suggestions for future improvement. Three domains emerged: 1) effective learning 2) leadership and 3) professionalism encompass eight inter-related themes: 1) packed sessions 2) interactive session 3) learning style 4) critical thinking 5) student-centred learning 6) innovative learning 7) mental fitness and 8) sharing session. Conclusions An improved early clinical year development programme is proposed based on the first-year undergraduate medical students’ feedbacks. It is a transformation to a student-based curriculum with the integration of advanced use of information technology and management education. These findings offer insights into the students’ view of future doctors’ development in effective learning, leadership and professionalism in the clinical context.
Near-source characteristics of two-phase gas-solid outbursts in roadways
Authors: Zhou Aitao , Zhang Meng , Wang Kai , Elsworth Derek
Published: May 2020

Coal and gas outbursts compromise two-phase gas-solid mixtures as they propagate as shock waves and flows from their sources. Propagation is influenced by the form of the outburst, proximity to source, the structure and form of the transmitting roadways and the influence of obstacles. The following characterizes the propagation of coal and gas outbursts as two-phase gas-solid flows proximal to source where the coupled effects of pulverized coal and gas flows dominate behavior. The characteristics of shock wave propagation and attenuation are systematically examined for varied roadway geometries using experiments and numerical models. The results demonstrate that the geometry of roadway obstructions is significant and may result in partial compression and sometimes secondary overpressurization in blocked and small corner roadways leading to significant attenuation of outburst shock waves. The shock waves attenuate slowly in both straight and abruptly expanding roadways and more significantly in T-shaped roadways. The most significant attenuation appears in small angle corners and bifurcations in roadways with the largest attenuation occurring in blocked roadways. These results provide basic parameters for simplifying transport in complex roadway networks in the far-field, and guidance for the design of coal and gas outburst prevention facilities and disaster ventilation.
Association between Depression and HIV Treatment Outcomes in a US Military Population with HIV Infection
Authors: Carney Brandon , Daniel Colton , Xu Xiaohe , Sunil Thankam , Ganesan Anuradha , Blaylock Jason , Kronmann Karl , Schofield Christina , Lalani Tahaniyat , Agan Brian , Okulicz Jason
Published: May 2020

Background: Depression is common among HIV-infected individuals and may contribute to suboptimal adherence to antiretroviral therapy (ART) and subsequent inability to attain viral load (VL) suppression. We evaluated longitudinal HIV treatment outcomes in US Military HIV Natural History Study (NHS) participants with depression. Methods: Male NHS participants with available ICD-9 data for mental health diagnoses, Center for Epidemiological Studies Depression (CES-D) measures, and self-reported adherence (SRA) were included. ART use was defined as ART initiation between 2006-2010, with follow-up through 2015. SRA was defined as taking ³95% of ART doses and continuous ART was defined as longitudinal ART use with gaps <30 days. Continuous VL suppression was defined as maintaining VLs <200 c/mL on ART. To analyze the association between depression and HIV treatment outcomes, latent class analysis was used to create classes of depression trajectories: low depression (LD), recent onset depression (ROD) and high Depression (HD). Results: Participants had a mean age of 32 (±8.3) years at HIV diagnosis, and similar proportions were Caucasian (44.3%) or African American (40.8%). Overall, older participants at HIV diagnosis had greater odds of having 95% SRA (OR 1.06, 95% CI 1.02-1.12), and African Americans had lower odds (OR 0.41, 95% CI 0.22-0.76) compared to Caucasians (OR 1.49, 95% CI 0.52-4.28). However, there was no difference in SRA by depression trajectory. Participants with HD had a trend towards taking ART continuously (OR 1.75, 95% CI 0.99-3.09), and those with ROD had significantly higher odds of virologic failure (OR 0.58, 95% CI 0.38-0.91). Conclusions: Although there was no observed association between depression and SRA, participants with ROD had lower odds of attaining the HIV treatment goal of VL suppression. Continued efforts to identify and aggressively manage mental health disorders is important to success along the HIV care continuum.
Relationship between the non-HDLc-to-HDLc ratio and carotid plaques in a high stroke risk population: a cross-sectional study in China
Authors: Liu Yan , Zhang Zhenwen , Xia Binlan , Wang Liping , Zhang Hengzhong , Zhu Yan , Liu Chao , Song Bin
Published: May 2020

Background
Evidence on the association between the non-high-density lipoprotein cholesterol (non-HDLc)-to-high-density lipoprotein cholesterol (HDLc) ratio (non-HDLc/HDLc) and carotid plaques is still limited. We aimed to assess the relationship between the non-HDLc/HDLc and carotid plaques in a population with a high risk of stroke.
Methods
A cross-sectional study based on the community was conducted in Yangzhou, China. Residents (no younger than 40 years old) underwent questionnaire interviews, physical examinations, and laboratory testing during 2013–2014. The subjects with a high risk of stroke were further selected (at least three of eight risk factors including hypertension, atrial fibrillation, type 2 diabetes mellitus, dyslipidaemia, smoking, lack of exercise, overweight, and family history of stroke) or a transient ischaemic attack (TIA) or stroke history. Carotid ultrasonography was then performed on the high stroke risk participants. Logistic regression was employed to evaluate the relationship between the non-HDLc/HDLc and carotid plaques.
Results
Overall, 839 subjects with a high risk of stroke were ultimately included in the analysis, and carotid plaques were identified in 341 (40.6%) of them. Participants in the highest non-HDLc/HDLc tertile group presented a higher proportion of carotid plaques than did those in the other two groups. After adjustment for other confounders, each unit increase in the non-HDLc/HDLc was significantly associated with carotid plaques (OR 1.55, 95%CI 1.28–1.88). In the subgroup analysis, the non-HDLc/HDLc was positively and significantly associated with the presence of carotid plaques in most subgroups. Additionally, the non-HDLc/HDLc interacted significantly with three stratification variables, including sex (OR 1.31 for males versus OR 2.37 for females, P interaction = 0.016), exercise (OR 1.18 for subjects without lack of exercise versus OR 1.99 for subjects with lack of exercise, P interaction = 0.004) and heart diseases (OR 1.40 for subjects without heart diseases versus OR 3.12 for subjects with heart diseases, P interaction = 0.033).
Conclusion
The non-HDLc/HDLc was positively and consistently associated with the presence of carotid plaques in a Chinese high stroke risk population.
Rapid review of the existing COVID-19 Case Definitions: A Bayesian Approach model to COVID-19 Case Definitions: A Research Article
Authors: Rad Emad Karimian , Yazdani Shahram , Foroughi Zeynab , Haghdoost Ali-Akbar , Jabali Hadi , Hajikhani Alireza , Abardeh Maryam Hoseini
Published: May 2020

Background Since December 2019, the novel coronavirus disease (COVID-19) has rapidly spread around the world leading to a pandemic with more than 3,000,000 infected people and more than 200,000 death. Several case definitions have been released and revised by countries and organizations. However, collectivization of case definitions has not been fully investigated.Methods In this study, we rapidly reviewed existing COVID-19 case definitions, finally a dynamic case definition algorithm was provided by using Bayesian theorem models of diagnosis.Results Our results showed categorization as suspected, probable, and confirmed cases, is used in majority of case definitions. Furthermore, the criteria for suspected cases and laboratory testing priority was a point of argument. Due to pandemic situation and resource limitation, diagnostic tests were rationed and mainly administered to a selected population, thus it was shown that the fraction of positive test results does not reflect the total infection rate of the population. Case definitions for COVID-19 is changing as we learn more about the disease. RT-PCR and CT Scan of lung seem to be beneficial in COVID-19 diagnosis and combing them with epidemiological criteria helps us in better understanding of the disease.Conclusion Based on our results, in the current case definitions, only symptomatic patients categorized and tested as a susceptible case. While the majority of COVID-19 cases are asymptomatic carriers of the disease, thus making the prevention more challenging. Dynamic statistical models can provide new insights into surveillance systems.
Loss of 908 Second Molars in Chinese adults: Consequences of the Presence of Their Neighboring Third Molars?
Authors: Sun Li-Juan , Tian Yi , Qu Hong-Lei , Yang Yang , Chen Fa-Ming
Published: May 2020

Background Many studies have reported that the presence of third molars (M3s) can increase the risk of pathology in neighboring second molars (M2s). However, whether the presence of M3s can effect the mortality of M2s remains unknown. The main aim of this study was to reveal the reasons for M2 loss and how the M2 loss were related to their neighboring M3s. Methods This was a retrospective cross-sectional study. A review of the medical records and radiographic imagines of patients who had their M2(s) removed was undertaken to analyze the reasons for tooth extraction and how those reasons were related to the presence of M3s situated adjacent to the removed M2s. Results Clinical material (from January to March 2019) of 800 patients met the inclusion criteria were involved into this study. M2s in 908 quadrants (i.e. 908 M2s) were removed from these enrolled patients, wherein 382 quadrants were with the absence of M3s and the other 526 quadrants were with the presence of M3s. The average age of patients whose missing M2s had or had no neighboring M3s was 52.4 ± 14.8 years and 56.7 ± 14.9 years respectively (Mann-Whitney U test, p < 0.001). When the reasons for the 908 extracted M2s were traced, it was found that 433 teeth (47.7%) were removed due to caries and sequelae, while 300 teeth (33.0%) were lost for periodontal diseases. In addition, substantial evidence confirmed that 14.4% of the M2s with adjacent M3s were removed due to diseases mainly in the distal surface which were closely related to their neighboring M3s, and it was much higher than that was identified from removed M2s without adjacent M3s (1.8%). Except for residual roots, 42.2% M3s were removed along with neighboring M2s simultaneously. Conclusions The presence of M3s, no matter impacted or erupted M3s, was associated with an earlier loss of their neighboring M2s.
Impact of Coronavirus Disease 2019 on Pulmonary Function in Early Convalescence Phase
Authors: Huang Yiying , Tan Cui yan , Wu Jian , Chen Mei zhu , Wang Zhen guo , Luo Li yun , Zhou Xiao rong , Liu Xin ran , Huang Xiao ling , Yuan Chi can , Chen Chao lin , Gao Fen , Huang Jin , Shan Hong , Liu Jing
Published: May 2020

Objective: This study investigated the influence of Coronavirus Disease 2019 (COVID-19) on lung function in early convalescence phase. Methods: A prospective study of COVID-19 patients at the Fifth Affiliated Hospital of Sun Yat-sen University were conducted, with serial assessments including lung volumes (TLC), spirometry (FVC, FEV1), lung diffusing capacity for carbon monoxide (DLCO),respiratory muscle strength, 6-minute walking distance (6MWD) and high resolution CT being collected at 30 days after discharged. Results: 57 patients completed the serial assessments. There were 40 non-severe cases and 17 severe cases. Thirty-one patients (54.3%) had abnormal CT findings. Abnormalities were detected in the pulmonary function tests in 43 (75.4%) of the patients. Six (10.5%), 5(8.7%), 25(43.8%) 7(12.3%), and 30 (52.6%) patients had FVC, FEV1, FEV1/FVC ratio, TLC, and DLCO values less than 80% of predicted values, respectively. 28 (49.1%) and 13 (22.8%) patients had PImax and PEmax values less than 80% of the corresponding predicted values. Compared with non-severe cases, severe patients showed higher incidence of DLCO impairment (75.6%vs42.5%, p=0.019), higher lung total severity score（TSS）and R20, and significantly lower percentage of predicted TLC and 6MWD. No significant correlation between TSS and pulmonary function parameters was found during follow-up visit. Conclusion: Declining DLCO, lower respiratory muscle strength, and lung imaging abnormalities were detected in more than half of the COVID-19 patients in early convalescence phase. Compared with non-severe cases, severe patients had a higher incidence of DLCO impairment and encountered more TLC decrease and 6MWD decline.
Exploring the clinical association between neurological symptoms and COVID-19 pandemic outbreak: A systematic review of current Literature
Authors: Carlo Davide Tiziano Di , Montemurro Nicola , Petrella Giandomenico , Gabriele  , Ceravolo Roberto , Perrini Paolo
Published: May 2020

Object: The novel severe acute respiratory syndrome (SARS)-CoV-2 outbreak has been declared a pandemic in March, 2020. An increasing body of evidence suggests that patients with the coronavirus disease (COVID-19) might have a heterogeneous spectrum of neurological symptomsMethods. A systematic search of two databases was performed for studies published up to April 17th, 2020. PRISMA guidelines were followed.Results: We included 13 studies evaluating 2499 patients with laboratory-confirmed COVID-19 infections. The median age of patients was 50.3 (IQR 9.6), and the rate of male patients was 50% (95% CI 47.9-52%). The most common reported comorbidities were hypertension and diabetes (18.7%, 95% CI 16.9-20.7% and 9%, 95% CI 7.4-11.3%, respectively). Headache was reported in 17.9% of patients (95% CI 16.1-19.8%), and dizziness in 13.9% (95% CI 10.7-18%). Fatigue or myalgia, hypo/anosmia, and gustatory dysfunction were reported in 24%, 55.2%, and 55.4%, of patients, respectively.Conclusions: These data support accumulating evidence that a significant proportion of patients with COVID-19 infection develop neurological manifestations, especially olfactory and gustatory dysfunction. The pathophysiology of this association is under investigation and warrants additional studies, Physicians should be aware of this possible association because during the epidemic period of COVID-19, early recognition of neurologic manifestations otherwise not explained would raise the suspect of acute respiratory syndrome coronavirus 2 infection.
O DIREITO À BUSCA DA FELICIDADE: A SUA POSSÍVEL APLICAÇÃO COMO UM DIREITO FUNDAMENTAL NO BRASIL
Authors: SCARPELLINI Giulia , GIOLO JÚNIOR Cildo
Published: May 2020

O objetivo geral do presente artigo é investigar se a busca da felicidade pode ser caracterizada como um direito fundamental no ordenamento jurídico brasileiro. Para isso, reflete-se o conceito de felicidade, tanto no âmbito da Filosofia, quanto no da Ciência, permeando, ainda, os ordenamentos jurídicos estrangeiros, a fim de encontrar uma conclusão sobre a situação da felicidade no direito comparado. Faz-se, ainda, uma análise dos direitos fundamentais, dos direitos humanos e da dignidade da pessoa humana, com o propósito de melhor entendimento do tema. Por fim, explora-se a felicidade no contexto do direito brasileiro e conclui-se que não é possível caracterizar a busca da felicidade como um direito fundamental, em razão da difícil conceituação do bem-estar subjetivo.
The role of inflammation mechanisms in the development of predisposition to thrombosis and thromboembolism in patients with chronic obstructive pulmonary disease and concurrent obstructive sleep apnea
Authors: Tseymakh I. Ya. , Shoykhet Ya. N. , Tseymakh A. E.
Published: May 2020

The objective: to study the effect of sleep-related breathing disorders on the activation of blood coagulation reactions associated with systemic inflammation in patients with chronic obstructive pulmonary disease and concurrent obstructive sleep apnea.

Subjects and methods. An open prospective comparative study analyzed thrombogenic risk factors, markers of inflammation and insulin resistance in 65 patients with chronic obstructive pulmonary disease and concurrent obstructive sleep apnea, 26 of them received non-invasive ventilation as a part of their therapy (main group).

Results. The blood levels of homocysteine and prothrombin fragments 1+2 are closely associated with the duration of nocturnal hypoxemia, concentrations of C-reactive protein, C-peptide, and endothelial vascular growth factor and can be managed with CPAP therapy.

The authors state that they have no conflict of interests.