bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Information and Communication Technologies in Protecting Health and Transforming the Quality of Employment During the COVID–2019 Pandemic
Authors: Yudina Maria A.
Published: August 2020

The article deals with the study of various aspects of the impact of digitalization on the level and quality of life, manifested in the situation of the COVID-19 pandemic. Information and communication technologies have consolidated their status as the infrastructure that supports socioeconomic interaction in crisis periods. For many Russians, the high spread of ICT in the country has become a significant factor in maintaining the previous standard of living in conditions when it is rapidly falling under the pressure of general isolation. The author reveals that certain forms of digitalization of medicine also cause an ambiguous reaction of society. The impact of ICTs on quality of life in the context of a pandemic has been analyzed based on the data from the World Health Organization. The high importance of trust between society and the state in the fight against COVID-19 has been emphasized, digital monitoring of citizens, in particular. International experience has been systematized: positive and negative examples of such tracking systems in Russia and the world, in general, have been considered. Two management attitudes underlying the social technologies of digital monitoring are identified. The first is based on preventing the spread of the disease by informing and predetermines making decisions by the user. The second is based on self-control of the patient: the citizen must prove compliance with the established rules, violation of which is punishable. It is proved that the application «Social monitoring» used by the authorities of Moscow belongs to the second category. The digital tools, which are already available to the authorities and, when finalized, could be a full-fledged alternative to this application (which received a negative assessment of the city's residents) are mentioned. The impact of COVID-19 on the quality of employment has been manifested not only in a significant increase in remote employment, which contributes to the development of digitalization but also to the growth of risks of unstable employment. The economic situation has deteriorated sharply, but some of the measures taken by the authorities have had the effect of keeping the majority of Russians the same standard of living. ICTs have also played a role in this - the widespread use has allowed most employers to cope with the task of working remotely. However, it is more difficult to guarantee compliance with labour rights remotely, including the balance of working and personal time. In addition, in the conditions of self-isolation, the problems of technostress, and various socio-psychological problems caused by the use of ICT have sharply worsened.
Midline raphe scroti artery flap for penile shaft reconstruction
Authors: Mirastschijski Ursula , Schwenke Carla , Schwab Igor , Buchhorn Andreas , Schmiedl Andreas
Published: August 2020

Aim: To investigate a novel method for penile shaft reconstruction. Methods: Penile tissue loss is caused by injury, infections, obesity or cancer resection. Reconstructive techniques comprise skin grafts with the risk of scarring and tissue rigidity. To develop an alternative reconstructive procedure, the pertinent vascular anatomy was studied on fresh cadavers instilled with red latex, which permitted the design of the midline raphe scrotal artery flap (MiRA). After anatomical proof-of-feasibility, penile reconstruction was performed in adult patients with classic buried penis or after cancer resection. Results: Anatomical studies revealed a novel finding of two scrotal septa, each with the terminal branch of the internal pudendal artery. Pedicled on both arteries, a neurovascular island flap could be harvested. In the presence of excess scrotal tissue, the entire circumference of the penile shaft could be covered by this flap. Patients with penile skin defects and excess scrotal tissue were eligible for flap harvest. The flap was raised either as an extended island flap pedicled on both septal arteries for complete penile shaft coverage, or as a VY-flap for partial reconstruction; the donor site was closed primarily. Post-operative complications included swelling or partial wound dehiscence. There were no flap losses or perfusion problems. Patients reported full sensitivity to the penile shaft skin and sufficient skin elasticity for erection. Conclusion: The MiRA flap is a technically safe neurovascular flap suitable for the reconstruction of partial or full defects of the penile shaft, such as after type III buried penis surgery, and provides sufficiently elastic and sensitive skin for functional penile reconstruction.
Effects of various surgical protocols on maxillofacial growth in patients with unilateral cleft lip and palate: a systematic review
Authors: Corthouts Pasquier , Boels Fien , de Casteele Elke Van , Nadjmi Nasser
Published: August 2020

Aim: The purpose of this study was to ascertain the effect of surgical procedures and their timing on maxillofacial growth in unilateral cleft lip and palate (UCLP) patients through a systematic literature review. Methods: In December 2019, a search was conducted in PubMed and Web of Science on the basis of the keywords: “UCLP”, “maxillofacial growth” and “facial growth”, complemented by a hand search. Results: Eleven articles were included. An important finding was the wide range of treatment protocols. Eight studies performed a multistage procedure, whereas three studies applied a simultaneous repair of cleft lip, palate, and alveolus in a single surgical session. The findings in these articles were based on cephalometric measures. Comparative tables were constructed regarding method of study and time and technique of closure. Conclusion: The results of the articles were conflicting, and it was clear that more research on this subject is necessary. Overall, most studies agreed on the important factor of palatoplasty in maxillofacial growth. The most common finding was a retrusive maxillary growth in comparison to a noncleft control group. This was illustrated by a negative effect on A-point - nasion - B-point. A lot of discussion remains on the effect of lip closure. However, most studies seemed to agree that lip closure results in retro-inclined upper incisors. In conclusion, it is essential that an agreement be reached on the treatment for UCLP, since this is the most common congenital craniofacial condition.
SNRK: a metabolic regulator with multifaceted role in development and disease
Authors: Thirugnanam Karthikeyan , Ramchandran Ramani
Published: August 2020

Sucrose nonfermenting 1-related kinase (SNRK) is a serine/threonine kinase and a member of the adenosine monophosphate (AMP)-activated protein kinase (AMPK) family that is involved in the metabolic regulatory mechanisms in various cell types. SNRK is an important mediator in maintaining cellular metabolic homeostasis. In this review, we discuss the role of SNRK in metabolic tissues where it is expressed, including heart and adipose tissue. We discuss its role in regulating inflammation in these tissues and the pathways associated with regulating inflammation. We also discuss SNRK’s role in vascular development and the processes associated with it. Finally, we review SNRK’s potential as a target in various metabolic dysfunction-associated diseases such as cardiovascular diseases, diabetes, obesity, and cancer. This comprehensive review on SNRK suggests that it has therapeutic value in the suppression of inflammation in cardiac and adipose tissue.
Deflation Troughs, Water, and Prehistoric Occupation on the Margins of the South Texas Sand Sheet
Authors: González Juan , Skrowronek Russell , Lovett Bobbie
Published: August 2020

Within the South Texas Plains, the area broadly defined by the Rio Grande to the south and the Nueces River to the north, a distance of ca. 175 km, evidence of open human occupation is remarkably abundant. Because it is predominantly a region of loose, sandy soils and active and relict sand dunes where wind processes dominate, the area is known as the South Texas Sand Sheet (STSS). There is no running water within the STSS and all streams are ephemeral. Existing drainage systems are small, localized, and not integrated, carrying water for a few days and up to two weeks after the passage of a storm. The lack of running water makes human occupation on this semi-arid area even more remarkable. The STSS and the adjacent wind deflated areas have hundreds of small and shallow elongated deflation troughs. Most of these poorly drained swales retain seasonal fresh water that sustain high moisture plants and are ephemeral wetlands; a small percentage of them hold water year round. As a result, the long history of human occupation of the STSS was possible due to the presence of the deflation troughs. This study explores the connection between human occupation of the STSS and deflation troughs at four previously unreported archeological sites in northern Hidalgo County using a combination of intensive archeological and geological survey, oral history, GIS technology, and existing soil maps.
Geographical variation in determinants of high-risk fertility behavior among reproductive age women in Ethiopia using the 2016 Demographic and Health Survey: a geographically weighted regression analysis.
Authors: Tadesse Zemenu Tessema , Azanaw Melkalem Mamuye , Asmare Yeaynmarnesh , Gelaye Kassahun Alemu
Published: August 2020

Background: Maternal and child mortalities are the main public health problems worldwide and both are the major health concern in developing countries such as Africa and Asia. The fertility behavior of women characterized by maternal age, birth spacing, and order, impacts the health of women and children. The aim of this study was to assess the geographically variation in risk factors of high-risk fertility behavior (HRFB) among reproductive-age women in Ethiopia using the 2016 Demographic and Health Survey.Methods: A total of 11,022 reproductive-age women were included in this study. The data were cleaned and weighted by STATA 14.1 software. Bernoulli based spatial scan statistics was used to identify the presence of pure high-risk fertility behavior spatial clusters using Kulldorff’s SaTScan version 9.6 software. ArcGIS 10.7 was used to visualize the spatial distribution of high-risk fertility behavior. Geographically weighted regression analysis was employed by multiscale geographical using Multiscale geographical weighted regression version 2.0 software. A p-value of less than 0.05 was used to declare statistically significant predictors (at a local level). Results: Overall, 76 % with 95 % confidence interval of 75.60 to 77.20 of reproductive age women were faced with high-risk fertility problems in Ethiopia. High-risk fertility behavior was highly clustered in the Somali and Afar regions of Ethiopia. SaTScan identified 385 primary spatial clusters (RR= 1.13, P < 0.001) located at Somali, Afar, and some parts of Oromia Regional Stateregional state of Ethiopia. Women who are living in primary clusters were 13% more likely venerable to high-risk fertility behavior than outside the cluster. In geographically weighted regression, not using contraceptives and home delivery were statistically significant vary risk factors affecting high- risk fertility behavior spatially. No contraceptive use and home delivery were statistically significant predictors ( at the local level) in different regions of Ethiopia.Conclusion: In Ethiopia, HRFB varies across regions. Statistically, a significant-high hot spot high-risk fertility behavior was identified at Somali and Afar. No contraceptive use and home delivery were statistically significant predictors (at a local level) in different regions of Ethiopia. Therefore, policymakers and health planners better to design an effective intervention program at Somali, and Afar to reduce high-risk fertility behavior and Special attention needs about health education on the advantage of contraceptive utilization and health facility delivery to reduce high-risk fertility behavior.
Insecticide resistance in indoor and outdoor-resting Anopheles gambiae in Northern Ghana
Authors: Hamid-Adiamoh Majidah , Amambua-Ngwa Alfred , Nwakanma Davis , D’Alessandro Umberto , Awandare Gordon A. , Afrane Yaw A.
Published: August 2020

Background Selection pressure from continued exposure to insecticides drives development of insecticide resistance and changes in resting behaviour of malaria vectors. There is need to understand how resistance drives changes in resting behaviour within vector species. The association between insecticide resistance and resting behaviour of Anopheles gambiae sensu lato (s.l.) in Northern Ghana was examined. Methods F1 progenies from adult mosquitoes collected indoors and outdoors were exposed to DDT, deltamethrin, malathion and bendiocarb using WHO insecticide susceptibility tests. Insecticide resistance markers including voltage-gated sodium channel (Vgsc)- 1014F, Vgsc-1014S, Vgsc-1575Y, glutathione-S-transferase epsilon 2 (GSTe2)-114T and acetylcholinesterase (Ace1)-119S, as well as blood meal sources were investigated using PCR methods. Activities of metabolic enzymes, acetylcholine esterase (AChE), non-specific β-esterases, glutathione-S-transferase (GST) and monooxygenases were measured from unexposed F1 progenies using microplate assays. Results Susceptibility of Anopheles coluzzii to deltamethrin 24hr post-exposure was significantly higher in indoor (mortality=5%) than outdoor (mortality=2.5%) populations (P=0.02). Mosquitoes were fully susceptible to malathion (mortality: indoor=98%, outdoor=100%). Susceptibility to DDT was significantly higher in outdoor (mortality=9%) than indoor (mortality=0%) mosquitoes (P=0.006). Mosquitoes were also found with suspected resistance to bendiocarb but mortality was not statistically different (mortality: indoor=90%, outdoor=95%. P=0.30). Frequencies of all resistance alleles were higher in F1 outdoor (0.11-0.85) than indoor (0.04-0.65) mosquito populations, while Vgsc-1014F in F0 An. gambiae sensu stricto (s.s) was significantly associated with outdoor-resting behaviour (P=0.01). Activities of non-specific β-esterase enzymes were significantly higher in outdoor than indoor mosquitoes (Mean enzyme activity: Outdoor=: 1.70/mg protein; Indoor=1.35/mg protein. P<0.0001). AChE activity was also more elevated in outdoor (0.62/mg protein) than indoor (0.57/mg protein) mosquitoes but this was not significant (P=0.08). Human blood index (HBI) was predominantly detected in indoor (18%) than outdoor mosquito populations (3%). Conclusions The overall results did not establish that there was a significant preference of resistant malaria vectors to solely rest indoors or outdoors, but varied depending on the resistant alleles present. Phenotypic resistance was higher in indoor than outdoor-resting mosquitoes, but genotypic and metabolic resistance levels were higher in outdoor than the indoor populations. Continued monitoring of changes in resting behaviour within An. gambiae s.l. populations is recommended.
Administration of Saccharomyces boulardii mafic-1701 improves feed conversion ratio, promotes antioxidant capacity, alleviates intestinal inflammation and modulates gut microbiota in weaned piglets
Authors: Zhang Wenxiu , Bao Chengling , Wang Jian , Zang Jianjun , Cao Yunhe
Published: August 2020

Background: Probiotics are used as a means to improve animal health and intestinal development. Saccharomyces boulardii ( S. boulardii ) is a well-known probiotic, however, few studies have examined the effects of S. boulardii on weaned pig let performance. Therefore, this 28-day study compared the effects of S. boulardii mafic-1701 and aureomycin in weaned piglet diets on growth performance, antioxidant parameters, inflammation and intestinal microbiota. One hundred and eight weaned piglets were randomly divided into three dietary treatment groups: (1) basal diet (CON); (2) basal diet supplemented with 75 mg/kg aureomycin (ANT); (3) basal diet supplemented with 1 × 10 8 CFU/kg S. boulardii mafic-1701 (SB). Results: Compared to CON group, SB group had higher feed efficiency ( P < 0.01) and lower diarrhea rate ( P < 0.05) over the entire 28 days. Total superoxide dismutase concentration in serum was markedly increased in SB group ( P < 0.05). Moreover, compared with CON group, SB group decreased the level of pro-inflammatory cytokines interleukin-6 ( P < 0.01) and tumor necrosis factor ( P < 0.05) in jejunum. Supplementation with S. boulardii mafic-1701 increased abundance of Bacillus and Ruminococcaceae_UCG_009 ( P < 0.05), whereas abundance of unclassified _Clostridiaceae_4 was decreased ( P < 0.05). Furthermore, S. boulardii mafic-1701 administration increased cecal concentration of microbial metabolites , isobutyrate and valerate ( P < 0.05). Conclusions: The improvement in feed conversion ratio, reduction in diarrhea rate in weaned piglets provided diets supplemented with S. boulardii mafic-1701 may be associated with enhanced antioxidant activity, anti-inflammatory responses and improved intestinal microbial ecology.
COVID-19: A scoping review
Authors: Berhe Brhane , Legese Haftom , Degefa Hagos , Adhanom Gebre , Gebrewahd Aderajew , Mardu Fitsum , Tesfay Kebede , Kahsu Getachew , Welay Miglas , Negash Hadush
Published: August 2020

Background: Globally, the novel coronavirus, SARS-CoV-2, has led to a pandemic in which individuals may experience severe and life-threatening complications. Methods: A scoping review was conducted following the methodological framework. In this scoping review, 70 records as of May 21, 2020, were included and discussed to better understand the current updates of the virus. PubMed, BioRxiv, MedRxiv, Global Health and google scholars were searched comprehensively for articles, preprints, grey literature, reports, conference proceedings and expert information. Studies conducted in human and published in the English language were included in the review. All the findings and statements of the review regarding the outbreak are based on published data.Results: We identified 624 records, of which 70 studies met the inclusion criteria. We synthesized the data from the included records and deep insights were extracted. It was observed that the impact of the outbreak is worsening due to overcrowding, presence of asymptomatic carriers, scarcity of test kits, the immune escaping ability of the virus and lack of community awareness.Conclusions and recommendations: Due to the fast-spreading nature of the SARS-CoV-2 the prevention and control strategies become challenging. It is imposing social, psychological, and socio-economic impacts. Adherence to physical distancing, quarantining suspects, using personal protective equipment, health education and introducing appropriate handwashing practices, avoiding contact with animals, improved control, and prevention strategies are recommended.
Distraction by a cognitive task has a higher impact on electrophysiological measures compared with conditioned pain modulation
Authors: Do A. T. Lisa , Enax-Krumova Elena , Özgül Özüm , Eitner Lynn B. , Heba Stefanie , Tegenthoff Martin , Maier Christoph , Höffken Oliver
Published: August 2020

Background Conditioned pain modulation (CPM) evaluates the effect of a painful conditioning stimulus (CS) on a painful test stimulus (TS). Using painful cutaneous electrical stimulation (PCES) as TS and painful cold water as CS, the pain relief was paralleled by a decrease in evoked potentials (PCES-EPs). We now aimed to compare the effect of CPM with cognitive distraction on PCES-induced pain and PCES-EP amplitudes. Methods PCES was performed using surface electrodes inducing a painful sensation of 60 (NRS 0-100) on one hand. In a crossover design healthy subjects (included: n=38, analyzed: n=23) immersed the contralateral hand into 10°C cold water (CS) for CPM evaluation and performed the 1-back task for cognitive distraction. Before and during the CS and 1-back task, respectively, subjects rated the pain intensity of PCES and simultaneously cortical evoked potentials were recorded. Results Both CPM and cognitive distraction significantly reduced PCES-EP amplitudes (CPM: 27.6±12.0μV to 20.2±9.5μV, cognitive distraction: 30.3±14.2µV to 13.6±5.2μV, p<0.001) and PCES-induced pain (on a 0–100 numerical rating scale: CPM: 58±4 to 41.1±12.3, cognitive distraction: 58.3±4.4 to 38.0±13.0, p<0.001), though the changes in pain intensity and PCES-amplitude did not correlate. The changes of the PCES-EP amplitudes during cognitive distraction were more pronounced than during CPM (p=0.001). Conclusions CPM and cognitive distraction reduced the PCES-induced pain to a similar extent. The more pronounced decrease of PCES-EP amplitudes after distraction by a cognitive task implies that both conditions might not represent the general pain modulatory capacity of individuals, but may underlie different neuronal mechanisms with the final common pathway of perceived pain reduction.
What mechanisms drive uptake of family planning when integrated with childhood immunisation in Ethiopia? A realist evaluation
Authors: Krishnaratne Shari , Hamon Jessie K. , Hoyt Jenna , Chantler Tracey , Landegger Justine , Spilotros Nathaly , Demissie Shiferaw Dechasa , Mohammed Siraj , Webster Jayne
Published: August 2020

Background: Maternal and child health are key priorities among the Sustainable Development Goals , which include a particular focus on reducing morbidity and mortality among women of reproductive age, newborns, and children under the age of five. Two key components of maternal and child health are family planning (FP) and immunisation. Providing these services through an integrated delivery system could increase the uptake of vaccines and modern contraceptive methods (MCMs) particularly during the post-partum period. Methods: A realist evaluation was conducted in two woredas in Ethiopia to determine the key mechanisms and their triggers that drive successful implementation and service uptake of an intervention of integrated delivery of immunisations and FP. This evaluation included the: 1) development of an initial programme theory; 2) review of relevant published theories; 3) analysis of project monitoring data; 4) analysis of qualitative data from 23 semi-structured interviews to determine key mechanisms and drivers; and 5) development of a revised programme theory comprised of context-mechanism-actor-outcome and context-mechanism-intervention-actor-outcome configurations based on empirical findings. Results: The proportion of women who brought their children for immunisation and received MCMs was 63.0% (4,260/6,764) overall [74.3% (2,944/3,961) in Assosa woreda and 46.9% (1,316/2,803) in Bambasi woreda]. Key contextual factors identified were: a strong belief in values among religious leaders and community members that challenged FP; a lack of support for FP from male partners based on religious values; and the use of trained Health Extension Workers (HEWs) to deliver FP services. Within these contexts, intervention components that focused on the alignment of religious texts with FP, the promotion of FP by religious leaders, and the training of HEWs and health care workers on FP counselling and service delivery, influenced the implementation of the intervention and triggered several mechanisms of acceptability, access, and adoption of innovations. Conclusions: Linking context and intervention components to the mechanisms they triggered helped explain the intervention outcomes, and more broadly how and for who the intervention worked. This enabled the development of a programme theory that could be used to inform the integrated delivery of FP services in similar contexts.
Acute effects of the Prevent injury and Enhance Performance warm-up on potential reinjury risk factors associated with unanticipated jump landings: Study protocol for a crossover randomized controlled trial in individuals cleared for return to sports after anterior cruciate ligament reconstruction.
Authors: Ashigbi Evans Y. K. , Giesche Florian , Banzer Winfried , Groneberg David A. , Niederer Daniel
Published: August 2020

BackgroundIn team-sports such as football or basketball, athletes need to rapidly adapt their motor plans and actions to unanticipated changes in the environment. Unanticipated jump-landing tasks have been found to elevate the risk of non-contact anterior cruciate ligament (ACL) injuries compared to an anticipated condition. ACL-reconstructed individuals may have greater difficulties to maintain neuromuscular control under unanticipated conditions exposing them to a higher reinjury risk during the game. The planned trial aims to investigate the acute effects of a team-sport specific injury prevention programme on potential ACL reinjury risk factors under anticipated and unanticipated jump-landings.Methods and design:Single center randomized controlled crossover trial. Female and male ACL-reconstructed participants cleared for return to sports (≥ 6 months and ≤ 24 months post-reconstruction) will be included. In a randomized sequence and with a washout phase of one week in between, the participants will perform an injury preventive warm-up protocol (PEP; strengthening, flexibility, plyometry and agility) and a standard warm-up program (bicycle ergometer). Both interventions will last for 12 minutes and will be conducted at moderate intensity (BORG scale: 12 to 14). After each warm-up, participants will perform counter movement jumps with single-leg landings on a force plate. Prior to the jump, a left or right footprint (equally distributed) will be indicated on a screen. Under the anticipated condition, the participants will be informed before the jump that the displayed footprint will not change after take-off. Under the unanticipated condition, the participants will not know whether the target landing side will remain the same (consistent with pre-movement expectations) or change (inconsistent). Under both unanticipated conditions, this information will be displayed 0.1 second after take-off and thus approximately 0.3 seconds before landing.Parametric/non-parametric crossover-analyses (carryover-tests and crossover test) for between-conditions comparisons will be applied. Trial registration: German Clinical Trials Register, identification number DRKS00016942. Registered on May 24, 2019.
Care Integration Decreases Hospitalization Costs: Retrospective Cohort Study of Palliative Care Consult Service for Hospital Patients With Metastatic Cancer
Authors: Zemplenyi Antal Tamás , Csikós Ágnes , Fadgyas-Freyler Petra , Csanádi Marcell , Kaló Zoltán , Pozsgai Éva , Mölken Maureen Rutten-van , Pitter János György
Published: August 2020

The authors have withdrawn this preprint due to author disagreement.
Equity and Elderly Health in India: Reflections from 75th Round National Sample Survey, 2017-18, amidst the COVID-19 Pandemic
Authors: Ranjan Alok , R Muraleedharan V
Published: August 2020

Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak, called coronavirus disease - 2019 (COVID-19), has affected more than 200 countries across the globe with a higher fatality rate in the elderly population. Historical experience shows that the pandemic disproportionately afflicts the socioeconomically disadvantaged population. Aim of the study is to highlight the vulnerability of the aged amidst the current pandemic, in the light of the recent international evidence, and what government could do to mitigate their vulnerability. Methods: Data from the recently released (November 2019) 75 th Round National Sample Survey (NSS), which was conducted from July 2017 to June 2018, across 8077 rural villages and 6181 urban wards was used for this study. Data collected from 555115 individuals (rural: 325232; urban: 229232) included that of 42762 elderly individuals (60 years or above). Bivariate and multivariate analysis was used for the calculation. Results: 27.7 % of elderly reported suffering from any ailment in the last 15 days, whereas 8.5% had hospitalization during the last 365 days. Hospitalization rate was higher in the urban areas (OR: 1.21), general category (OR: 1.18), richest economic quintile (OR: 1.68), and among elderly living alone (OR: 2.05), which was statistically significant. 64% of the scheduled tribe and 51.0% of the poorest income quintile elderly utilized public facilities during hospitalization. Cardiovascular ailments were major cause for hospitalization (18.1%) and outpatient visit (32.0%) in the elderly. Diabetes and hypertension together constituted 55% of outpatient visit for the elderly. 18.9% of the elderly has health insurance though chances of facing catastrophic health expenditure was high in the elderly. 6.6% of elderly female and 1.6% male live alone, and 27.5% of elderly of age 80 years or above are immobile. 50% of male and 90% of female are financially dependent on others and more so in poorer economic quintiles. Conclusions: The vulnerability of India’s elderly increases across various equity dimensions which include the place of residence, gender, caste, marital status, economic quintile, living arrangements, surviving children, and economic dependence. The current COVID-19 pandemic poses a greater risk of social isolation among the elderly, which may lead to detrimental health impact.
Understanding What Influences Community-Based Care Coordination Improvement: Interpreting Variation in a Medicare Hospital Readmissions Reduction Program Using the Consolidated Framework for Implementation Research (CFIR)
Authors: Brock Jane , Gass Brianna , Brothersen Alaina , McFall Lacey , Walsh Kati , Goatee Christina , Huebschmann Amy G , Holtrop Jodi Summers
Published: August 2020

Background Quality Improvement Networks Quality Improvement Organizations (QIN-QIOs) developed community coalitions to align care coordination efforts for Medicare beneficiaries in order to reduce readmission rates within geographically defined communities. This CMS (Centers for Medicare & Medicaid Services) funded national quality improvement program worked with 380 coalitions from 2014-2019, facilitating a variety of interventions within each community. Baseline readmission rates among communities, calculated from claims data, varied from 17.7 to 112 readmissions/1000 beneficiaries. Program results ranged from +40.7% (high performance) to -35.8% (low performance) relative improvement.We applied an implementation framework (CFIR) to the QIN-QIO efforts to define common characteristics of interventions, implementation strategies, and contexts in which improvement efforts took place. We identify features associated with successful and unsuccessful intervention implementation, and with changes in readmission rates.Methods We selected 22 communities representing a range of relative improvement, geographic characteristics and baseline readmissions rates. We measured the QIN-QIO’s perception of influence of individual CFIR constructs on community readmission rates over time using a written assessment and elicited details and mechanisms through structured interviews. Two independent reviewers qualitatively coded transcribed interviews. Final ratings for the influence of each CFIR construct on community performance were assigned by consensus, ranging from -2 (strong negative influence) to +2 (strong positive influence).Results Some adaptation of the CFIR, such including codes in a coalition domain, and adding constructs to the outer setting domain, such as healthcare market characteristics, helped fit the framework to the QIN-QIO work. The characteristics of individuals domain was less applicable to this study. Several constructs were found to be associated with improvement, or lack of, in readmission rates in communities.Conclusions The CFIR is an appropriate taxonomy for understanding implementation of care coordination interventions in the QIN-QIO communities, with constructs from the Outer Setting and Process domains having the most influence on successful implementation. Communities effectively reducing readmissions had coalitions with favorable implementation climates, robust stakeholder engagement strategies, and interventions aligned with local concerns and capabilities. The CFIR can help guide, monitor and evaluate community-based improvement initiatives, although further development some constructs is needed.
Interventions to Improve Infant and Young Child Feeding Practices in Ethiopia: A Systematic Review  
Authors: Ahmed Kedir Yimam , Agho Kingsley E. , Page Andrew , Arora Amit , Ogbo Felix
Published: August 2020

Background: Detailed understanding of the specific types of interventions that can be implemented to increase infant and young child feeding (IYCF) is essential to improve child health and development. In Ethiopia, despite the implementation of several interventions to improve IYCF practices, no published studies have highlighted the most effective IYCF interventions in the country. This systematic review investigated the impacts of various interventions on IYCF in Ethiopia.Methods: A systematic search was conducted on seven computerized bibliographic databases (Embase, ProQuest Central, Scopus, PsycINFO, Web of Science, MEDLINE/PubMed and CINAHL) to locate experimental or quasi-experimental studies. Interventional studies that measured IYCF indicators (early initiation of breastfeeding [EIBF], exclusive breastfeeding [EBF], the introduction of complementary foods, minimum dietary diversity [MDD], minimum meal frequency [MMF] and minimum acceptable diet [MAD]) as outcome variables were included.Results: Of the thirteen eligible studies, ten studies were quasi-experimental and three studies were cluster randomised trials. Five studies showed that interventions in the form of policy advocacy, health service strengthening, interpersonal communication, community mobilisation, and mass media campaigns improved EBF. Four studies indicated that community-level and health facility breastfeeding promotions increased EIBF. Three studies for MDD and two studies for MMF indicated significant effects of policy advocacy, interpersonal communication, community mobilisation, and mass media campaigns on infants and young children. Interventions that were delivered in combination increased the impacts in improving EIBF, MDD and MMF compared to single intervention.Conclusion: Our review showed that a combination of community-level interventions improved EIBF, EBF, MDD, and MMF in Ethiopia. The improvement in IYCF in Ethiopia would require multi-prong approaches at the household and community levels along the continuum of care from conception until a child’s second birthday.
School Bullying Victimization and Emotional Problems in Relation to Sexual Orientation Among High School Students in China：A Cross-Sectional Study
Authors: Yang Mengsi , Wu Fang , Liu Qianwen , Yang Zhengmin , Lai Xin , Liu Xiaoqun
Published: August 2020

Background：School bullying has become a global concern for the public as well as a fierce battlefield for educational psychologists. And sexual minority youth (SMY) may experience minority stress, a chronic form of stress engendered by negative social experiences such as stigmatization, that is known to impact adversely mental health and well-being. Under the specific cultural background of China, few scholars associate sexual orientation with campus bullying, as well as depression and anxiety symptoms. But in fact, China's sexual minority adolescences face no less difficulties than any sexual minority in the world.Methods：From April to July 2018, a cross-sectional survey was conducted among senior high school students in Hunan Province, China. A total of 3934 subjects were investigated by multi-stage cluster random sampling. Traditional bullying victimization was surveyed via the suffering subscale of Chinese version of Olweus Bully/Victim Questionnaire (OBVQ). Cyber school bullying was surveyed via a question. The Chinese version of the 9-item Patient Health Questionnaire (PHQ-9) and the Chinese version of the 7-item Generalized Anxiety Disorder Scale (GAD-7) were used to screen depression and anxiety symptoms of participants. Logistic regression model was used to analyze the relationship between sexual orientation and types of bullying victimization , depression and anxiety symptoms.Results：Bisexuality accounted for the highest proportion of victims of traditional bullying only and cyber bullying only, at 10.2% and 4.8%, respectively. Homosexuality accounts for the highest proportion of combined bullying, at 18.2%. Homosexuality(OR: 5.833; 95% CI: 3.045 to 11.176), bisexuality(OR: 2.831; 95% CI: 1.354 to 5.923)and uncertainty of sexual orientation(OR: 2.206; 95% CI: 1.435 to 3.392) were significantly associated with combined bullying. The bisexual group has the highest rate of depression(40.1%) and anxiety(38.1%) symptoms. Compared to heterosexual group, bisexual group has the highest risk of depression(OR: 2.349; 95% CI: 1.664 to 3.316) and anxiety(OR: 3.049; 95% CI: 2.150 to 4.324) symptoms.Conclusions: Homosexuals are at the greatest risk of becoming victims of double bullying(traditional bullying and cyberbullying)and bisexuals are at the greatest risk of depression and anxiety symptoms.
Impact of Behavioural Changes in Mosquito Feeding on Malaria Invasion: A Model-Based Approach
Authors: Kim Sungchan , Kim Yongkuk , Kim Byul Nim , Masud M A , Jung Il Hyo
Published: August 2020

Background: Malaria hosts are known to manipulate the feeding behaviour of mosquitoes to protect them from external threats and control. In particular, the phenomenon in which a mosquito's feeding target is biased toward an infectious host is called a vector-bias, and it can be a threat to malaria eradication if not considered. Aim of the study is to understand the problems that may arise when vector-bias is not considered in early invasion scenarios.Methods: Stochastic formulations of malaria transmission, including the vector-bias effect, ware constructed. Invasive dynamics were investigated using an individual-based continuous time Markov chain model and the offspring distributions of secondary infections. In addition, the extinction probability was derived using the negative binomial count model. Results: Invasions will occur quickly, and once the disease spreads, extinction will become difficult compared to when the vector-bias effect is not considered. In a highly heterogeneous environment, vector-bias has rare effect on decreasing the extinction probability. Conclusion: The early detection of a malaria invasion and the early control beginning are more important due to vector-bias for the malaria eradication in early invasion scenarios. In addition, some possible mosquito-biased behaviours were discussed in terms of adaptive dynamics.
Primary Tumor Resection is a Powerful Predictor of Long-term Outcome of Left-side Obstructive Colorectal Cancer
Authors: Kawahara Hidejiro , Omura Nobuo , Akiba Tadashi
Published: August 2020

AimThis study aimed to evaluate a long-term outcome predictor of left-side obstructive colorectal cancer. MethodsBetween 2001 and 2017, 40 patients with left-side obstructive colorectal cancer, 80 years of age or younger, who underwent emergency surgery at Kashiwa Hospital, Jikei University, were enrolled into this retrospective study. We compared 24 patients undergoing primary tumor resection with temporary colostomy with 16 patients undergoing only the creation of the decompression colostomy without primary tumor resection as the first operation. ResultsThree of 16 patients (19%) who underwent only the creation of colostomy as the first operation could undergo the primary tumor resection as the secondary operation a month after the first operation. The other 13 patients who could not undergo the primary tumor resection received intensive chemotherapy consecutively. The 5-year survival rate of the patients with primary tumor resection as the first operation was 56.5%, whereas that of patients with only the creation of colostomy as the first operation was 18.8% (p<0.001). The fact that the primary tumor resection could not be performed was an independent risk factor by multivariate analyses (p=0.002). ConclusionPrimary tumor resection is a powerful predictor of long-term outcome of left-side obstructive colorectal cancer.
Vitamin C administration by intravenous infusion increases tumour ascorbate content in patients with colon cancer: a clinical intervention study
Authors: Dachs Gabi U , Gandhi Jamish , Wohlrab Christina , Carr Anitra C , Morrin Helen , Pullar Juliet M , Bayer Simone B , Eglinton Tim W , Robinson Bridget A , Vissers Margreet C M
Published: August 2020

Background: The use of high dose ascorbate infusions in cancer patients is widespread, but without evidence of efficacy. Several mechanisms whereby ascorbate could affect tumour progression have been proposed, including (i) the localised generation of cytotoxic quantities of H2O2, (ii) ascorbate-dependent activation of the 2-oxoglutarate-dependent dioxygenases that control the hypoxia-inducible factors (HIFs) and that are responsible for the demethylation of DNA and histones and (iii) increased oxidative stress induced by dehydroascorbic acid. We hypothesise that the dysfunctional vasculature of solid tumours results in compromised delivery of ascorbate to poorly perfused regions of the tumour and that this ascorbate deficit acts as an additional driver of the hypoxic response via upregulation of HIFs. Using a randomised ‘therapeutic window of opportunity’ clinical study we aimed to determine whether ascorbate infusions affected tumour ascorbate content and tumour biology.Methods: Patients with colon cancer were randomised to receive infusions of up to 1 g/kg ascorbate for four days before surgical resection (n=9) or to not receive infusions (n=6). Ascorbate was measured in plasma, erythrocytes, tumour and histologically normal mucosa at diagnostic colonoscopy and at surgery. Protein markers of tumour hypoxia or DNA damage were monitored in resected tissue.Results: Plasma ascorbate reached millimolar levels following infusion and returned to micromolar levels over 24 h. Pre-infusion plasma ascorbate increased from 38 ± 10 mM to 241 ± 33 mM (p<0.0001) over four days and erythrocyte ascorbate from 14 ± 15 mM to 2004 ± 814 mM (p<0.005). Tumour ascorbate increased from 15 ± 6 to 28 ± 6 mg/100g tissue (p<0.0001) and normal tissue from 14 ± 6 to 21 ± 4 mg/100g (p<0.001). A gradient of lower ascorbate was evident towards the tumour centre in both control and infusion samples. Lower expression of hypoxia-associated proteins was seen in post-infusion tumours compared with controls. There were no significant adverse events and quality of life was unaffected by ascorbate infusion.Conclusions: This is the first clinical study to demonstrate that tumour ascorbate levels increase following infusion, even in regions of poor diffusion, and that this could modify tumour biology. Trial registration: ANZCTR Trail ID ACTRN12615001277538
COVID-19 Salgını Süresince Aile İçi İlişkilerin Doğrulayıcı Faktör Analizi ile İncelenmesi
Authors: Ergül Barış , Yılmaz Veysel
Published: August 2020

Bu çalışmada, COVID-19 süresince aile içi iletişimi etkileyen faktörler hakkında bir model önerilmiştir. Önerilen modelde, aile etkileşimi, ebeveynlik, duygusal/finansal yeterlilikler ve fiziksel yeterlilikler boyutları ele alınmıştır. İlk aşamada, açıklayıcı faktör analizi ile (AFA) faktör yapısı araştırılmış, daha sonra doğrulayıcı faktör analiziyle (DFA), AFA’da bulunan faktör yapısı doğrulanmaya çalışılmıştır. Özellikle COVID-19 süresince aile içi iletişimi etkileyen faktörler arasındaki ilişki birinci ve ikinci düzey doğrulayıcı faktör analizi ile değerlendirilmeye çalışılmıştır. İkinci düzey doğrulayıcı faktör analizi sonucunda aile iletişimi olarak tanımlanan üst boyutun varlığı ortaya konmuştur. İkinci düzey DFA analizi sonucunda, aile içi iletişim üst boyutu ile diğer faktörler arasında pozitif yönde kuvvetli bir ilişki olduğu görülmüştür. Özellikle duygusal/finansal ve fiziksel yeterlilikler arttıkça aile içi iletişimin de artacağı değerlendirilmiştir.
Evde Yaşayan Yaşlılarda Yalnızlık, Yaşam Doyumu ve Ölüm Kaygısının Belirlenmesi
Authors: Tel Havva , Koç Medine , Tel Aydın Hatice
Published: August 2020

Araştırma evde yaşayan yaşlı bireylerde yalnızlık, yaşam doyumu ve ölüm kaygısını belirlemek amacı ile yapılmıştır. Tanımlayıcı ve kesitsel tipteki bu araştırmanın örneklemini 27 Mayıs - 27 Haziran 2016 tarihleri arasında bir aile sağlığı merkezine kayıtlı, evde yaşayan 65 yaş ve üzeri 545 birey oluşturmuştur. Araştırma verileri yaşlı bilgi formu, yaşlılar için yalnızlık ölçeği, yaşam doyumu ölçeği ve ölüm kaygısı ölçeği kullanılarak toplanmıştır. Çalışmaya katılan yaşlı bireylerin yaş ortalaması 72,95 ± 6,18 olup, %53,0’ü erkek, %56,7’si evli, %33,9’u okur-yazar, %51,6’sı eşi ile birlikte yaşamaktadır. Yaşlı bireylerde medeni durum, eğitim durumu ve birlikte yaşadığı kişiye göre yalnızlık, yaşam doyumu ve ölüm kaygısı puanları arasında istatistiksel olarak anlamlı bir fark olduğu saptanmıştır (p
İşsizlik ve Enflasyonun Ekonomik Büyüme Üzerine Etkisi: 1988-2019 Dönemi Türkiye İncelemesi
Authors: Kopuk Ezgi
Published: August 2020

Bu çalışmada, ülkelerin ekonomilerine yön veren enflasyon ve işsizliğin, Türkiye ekonomisi üzerindeki etkisini tespit etmek amaçlanmıştır. 1988 ve 2019 yıllarını içeren çalışmada, öncelikle değişkenler arasında koentegrasyonun olup olmadığını belirlemek için Johansen Eşbütünleşme Testi yapılmıştır. Johansen Eşbütünleşme testi ile seriler arasında bir tane koentegrasyon denklemi olduğu saptanmıştır. Bu ilişkinin belirlenmesinden sonra değişkenler arasındaki ilişkininin yönü Granger Nedensellik testi ile belirlenmiş ve enflasyon-GSYİH ile enflasyon-işsizlik arasında tek yönlü Granger nedensellik olduğu gözlemlenmiştir. Son olarak FMOLS, CCR ve DOLS yöntemleri ile uzun dönem katsayıları, hata düzeltme modeli ile kısa dönem katsayıları hesaplanarak, işsizlik ve enflasyonun, uzun ve kısa dönemde GSYH’ yı azalttığı tespit edilmiştir. Test sonuçlarına göre enflasyonun işsizliği tetiklediği ve her iki değişkenin de GSYİH üzerinde azaltıcı bir etkisinin olduğu belirlenmiştir. Artan enflasyon ve işsizlik ise ülke ekonomilerinde durgunluk ve gerilemeye sebebiyet verir. Bu olumsuz sonucun yaşanmaması için politika yapıcıların enflasyonu düşürücü hamlelerde bulunması gerekir. Özellikle üretim arttırılmalı, yeni istihdam olanakları sağlanmalı ve piyasa yapılarına uygun para politikaları geliştirilmelidir.
What is the Impact of Bisphenol A on Sperm Function and Related Signaling Pathways: A Mini-review?
Authors: Zhou Yian , Xu Wenqing , Yuan Yuan , Luo Tao
Published: August 2020

Bisphenol A (BPA) is an organic synthetic compound that is ubiquitously present in daily life. It is a
typical environmental endocrine disruptor that affects the functions of endogenous hormones. There is a significant
negative correlation between BPA and male reproduction. This mini-review describes current research data
on the negative effects of BPA on sperm functions in humans and animal models, as well as on its supposed
mechanisms of action, such as CATSPER-Ca2+ signaling, cAMP-protein kinase A signaling, and epigenetic
changes. The published evidence showed an adverse impact of BPA on sperm tail morphology, counts, motility,
and acrosome reaction action. Sperm function related signaling pathways, such as CATSPER-Ca2+ signaling,
cAMP-protein kinase A signaling, and phosphorylation signaling, as well as epigenetic changes and sperm aging,
are associated with BPA exposure in human and animal models. The clear risks of BPA exposure can provide
greater awareness of the potential threat of environmental contaminants on male fertility.
World Chagas Disease Day and the New Road Map for Neglected Tropical Diseases
Authors: Ferreira Leonardo L.G. , Andricopulo Adriano D.
Published: August 2020

The first-ever World Chagas Disease Day, celebrated in April 14, 2020, is a key initiative to
raise awareness of the impact of this neglected tropical disease (NTD). This landmark comes along
with the first World NTD Day and the new WHO Road Map on NTDs for 2021-2030.