bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of 5p15.2 and 15q14 with high myopia in Tujia and Miao Chinese populations
Authors: Wang Junwen , Liu Fang , Song Xiusheng , Li Tuo
Published: June 2020

Background

The polymorphisms rs6885224 and rs634990 have been reported to be associated with high myopia in many populations. As there is still no report on whether these two SNPs are associated with myopia in the Tujia and Miao minority areas of China, we conducted a replication study to evaluate the association of single-nucleotide polymorphisms in the regions 5p15.2 and 15q14 with high myopia in Tujia and Miao Chinese populations.

Methods

We performed a comprehensive meta-analysis of 5831 cases and 7055 controls to assess whether rs6885224 in the 5p15.2 region and rs634990 in the 15q14 region are associated with high myopia. Our replication study enrolled 804 individuals. Genomic DNA was extracted from venous leukocytes, and these two SNPs were genotyped by Sanger sequencing. Allele and genotype frequencies were analysed using χ2 tests, and ORs and 95% CIs were calculated.

Results

According to the results of the meta-analysis, rs6885224 in the CTNND2 gene showed no association with myopia [p = 0.222, OR = 1.154, 95% CI (0.917–1.452)]. Conversely, rs634990 in the 15q14 region did exhibit a significant correlation with myopia [p = 7.270 × 10− 7, OR = 0.817, 95% CI (0.754–0.885)]. In our replication study, no association with high myopia in the Tujia and Miao populations was found for rs634990 or rs6885224. The following were obtained by allele frequency analysis: rs6885224, p = 0.175, OR = 0.845, and 95% CI = 0.662–1.078; rs634990, p = 0.087, OR = 0.84, and the 95% CI = 0.687–1.026. Genotype frequency analysis yielded p = 0.376 for rs6885224 and p = 0.243 for rs634990.

Conclusions

Our meta-analysis results show that rs634990 was significantly associated with myopia but that rs6885224 was not. Nevertheless, in our replication study, these two SNPs showed no association with myopia in the Tujia and Miao Chinese populations. This is the first report involving Tujia and Miao ethnic groups from Enshi minority areas. However, the sample size needs to be expanded and more stringent inclusion and exclusion criteria need to be formulated to verify the findings.
Transient hyponatremia of prematurity caused by mild Bartter syndrome type II: a case report
Authors: Verma Subhrata , Chanchlani Rahul , Siu Victoria Mok , Filler Guido
Published: June 2020

Background

Bartter syndrome subtypes are a group of rare renal tubular diseases characterized by impaired salt reabsorption in the tubule, specifically the thick ascending limb of Henle’s loop. Clinically, they are characterized by the association of hypokalemic metabolic alkalosis, hypercalciuria, nephrocalcinosis, increased levels of plasma renin and aldosterone, low blood pressure and vascular resistance to angiotensin II. Bartter syndrome type II is caused by mutations in the renal outer medullary potassium channel (ROMK) gene (KCNJ1), can present in the newborn period and typically requires lifelong therapy.

Case presentation

We describe a case of a prematurely born female infant presenting with antenatal polyhydramnios, and postnatal dehydration and hyponatremia. After 7 weeks of sodium supplementation, the patient demonstrated complete resolution of her hyponatremia and developed only transient metabolic alkalosis at 2 months of age but continues to be polyuric and exhibits hypercalciuria, without development of nephrocalcinosis. She was found to have two pathogenic variants in the KCNJ1 gene: a frameshift deletion, p.Glu334Glyfs*35 and a missense variant, p. Pro110Leu. While many features of classic ROMK mutations have resolved, the child does have Bartter syndrome type II and needs prolonged pediatric nephrology follow-up.

Conclusion

Transient neonatal hyponatremia warrants a multi-system workup and genetic variants of KCNJ1 should be considered.
Correlates of mental health in occupations at risk for traumatization: a cross-sectional study
Authors: Schäfer Sarah K. , Sopp M. Roxanne , Staginnus Marlene , Lass-Hennemann Johanna , Michael Tanja
Published: June 2020

Background

Hospitals, police stations, and fire departments are highly demanding workplaces. Staff members are regularly exposed to various stressors including traumatic events. Correspondingly, several studies report high rates of mental health issues among these occupations. Nevertheless, despite these challenging circumstances, some staff members manage to sustain their mental health. The current study is the first to investigate three health-promoting factors simultaneously among three different, highly demanding occupations.

Methods

The present cross-sectional survey investigated health-promoting factors (sense of coherence – SOC, trait-resilience, locus of control – LOC) and mental health outcomes (general psychopathological symptom burden, posttraumatic stress, burnout) in medical staff (n = 223), police officers (n = 257), and firefighters (n = 100).

Results

Among all occupations, SOC, trait-resilience, and an internal LOC were negatively associated with general psychopathological symptoms, posttraumatic stress, and burnout symptoms. By contrast, all these outcome measures were positively correlated with an external LOC. Multiple regression models including all health-promoting factors explained 56% of the variance in general psychopathological symptoms and 27% in posttraumatic stress symptoms. Among all occupations, SOC was the strongest predictor of both general psychopathological symptom burden and posttraumatic stress symptoms. Multigroup path analyses revealed minor differences across occupations, mainly driven by a stronger influence of LOC in police officers.

Conclusion

Across all occupations, SOC was identified as the most important health-promoting factor. Future longitudinal studies should further examine the causal link between health-promoting factors and mental distress in different workplaces. Such studies will also allow for further development and evaluation of resilience promoting programs.
A spatial-temporal study for the spread of dengue depending on climate factors in Pakistan (2006–2017)
Authors: Shabbir Waqas , Pilz Juergen , Naeem Amna
Published: June 2020

Background

In Pakistan, dengue fever has become a major concerning factor, given that it is a relatively new disease compared to malaria. The number of people affected by dengue fever has increased at least 10-fold in the last 15 years in specific areas of Pakistan. Therefore, it is necessary to analyse this disease to reduce or prevent the effects of dengue fever in the region.

Methods

Geographical information system (GIS) maps are used to identify the intensity of the spread according to the count of affected people in our study area. Generalised linear modelling (GLM) is used to study the significance of factors associated with dengue fever.

Results

The dengue virus is present throughout the year in specific areas of Pakistan. Karachi and Lahore are most significantly affected with cases in these two most populous cities of Pakistan reported every year. In the study period (2006–2017), 2011 was the most devastating year for Pakistan. Lahore recorded more than 17,000 confirmed cases with 290 deaths in a single year. The GLM analysis shows rainfall, the average maximum temperature, and hospitals to be significant factors in the prevalence of dengue fever.

Conclusion

This study finds that Sindh and Khyber Pakhtunkhwa are two of the primarily vulnerable provinces for the spread of dengue fever. Punjab has observed sporadic increases in dengue fever cases. In Pakistan, dengue cases increase in the rainfall season, especially during monsoon season. Lack of proper hospitals and clinics are another major factor, and mobile hospitals are needed in remote hotspot regions often affected by dengue fever. Finally, improved sanitation systems in metropoles would facilitate reducing breeding grounds for Aedes Aegypti larvae.
Prevalence, treatment, control of type 2 diabetes and the risk factors among elderly people in Shenzhen: results from the urban Chinese population
Authors: Sun Yuanying , Ni Wenqing , Yuan Xueli , Chi Hongshan , Xu Jian
Published: June 2020

Background

Type 2 diabetes is regarded as one of the major public health problems worldwide. We aim to investigate the prevalence, treatment, and control rate in the Chinese urban population aged 65 years or older and also identified associated risk factors.

Methods

One hundred twenty-four thousand seven participants aged 65 years old and older were recruited from January 2018 through December 2018 at local community health service centers in Shenzhen. Fasting plasma glucose, as well as other biochemical indicators, were measured by standard methods. The analysis of multivariate logistic regression was applied to assess associated risk factors of type 2 diabetes.

Results

Approximately 22.5% of elderly urban Chinese residents had diabetes. Among people with diabetes, 54.8% received medical treatment. Only 34.4% of those who were treated had their glycemic controlled. The prevalence of T2D increased with increasing age before 80 years old, male, inadequate active physical activity, drinking, previous history of CVD, higher BMI, central obesity, and hypertension.

Conclusions

Our findings suggested that attention should be paid to the prevention and control of T2D in Chinese urban elderly population. The health policy department should develop effective strategies aimed at improving health care management of T2D in elderly adults.
Weight change among repeat participants of an Aboriginal community-based weight loss program
Authors: Bohn-Goldbaum Erika , Cashmore Aaron , Fonua Rose , Milat Andrew , Reid Kate , Shepherd Leah , Bauman Adrian , Grunseit Anne C.
Published: June 2020

Background

Community-based weight loss programs may have potential to address overweight and obesity at the population level. However, participation patterns and individual outcomes from these programs are understudied. This study examined repeat participation patterns and participant weight change between contests over seven years of an Aboriginal Australian team-based program in order to identify (1) predictors of repeat participation and (2) associations with weight change between contests.

Methods

Data for the 12 contests from 2012 to 2018 were merged, with probabilistic record matching. A total of 7510 enrolments were registered for the 12 contests, representing 4438 unique people. Contest lengths varied from 10 to 16 weeks in duration. Non-repeat participants were those who only competed once in the program by the end of 2018, and repeaters were those who competed in at least two contests. Associations between repeat participation and participant baseline (i.e., first participation occasion) characteristics, change in diet and physical activity and percent change in weight during the first participation occasion were examined using crossed random effects (for person and team) regression adjusted for exposure to the program. Weight percentage change between contests was calculated for consecutive participation occasions occurring at least three months apart, converted to percent change per month. Weight change was regressed on number of repeat participation occasions adjusted for age, gender, baseline weight at first participation occasion, and weight percent change in the immediately preceding contest.

Results

One-third of the 4433 participants participated more than once, with women more likely than men to repeat. A 1% reduction in weight during a competition was associated with an increase in weight of 0.05% per month between competition end and subsequent participation. Regain was smaller the heavier participants were at their first participation.

Conclusions

While individuals benefit from weight loss through program participation, strengthening strategies for weight loss maintenance within or following the program could improve long-term weight outcomes and reduce weight cycling.
Use, adoption, and effectiveness of tippy-tap handwashing station in promoting hand hygiene practices in resource-limited settings: a systematic review
Authors: Mbakaya Balwani Chingatichifwe , Kalembo Fatch Welcome , Zgambo Maggie
Published: June 2020

Background

Tippy-taps are locally made devices for washing hands with running water. They are simple and low-cost, enabling technology that provides adequate water sources, handwashing stations and motivation for people to prioritise handwashing. This systematic review aimed to establish the use, benefits, adoption and effectiveness of enabling technology; tippy-tap handwashing station, in resource-limited settings.

Methods

We systematically searched for articles in the PubMed, EMBASE, PsycINFO, AMED, CINAHL, DOAJ and Google Scholar databases guided by the acceptable best practice developed by the PROSPERO and COCHRANE for systematic search and selection of articles. Search terms such as tippy-taps, enabling technology, hand-washing station, hand-washing behaviour, diarrhoea, respiratory infection, increase handwashing behaviour were used. In addition, a PRISMA flow diagram was used to elaborate on the number of articles retrieved, retained, excluded and reasons for every action. Studies that used tippy-tap hand washing station as a handwashing facility regardless of the design were included in this review. A mixed method appraisal tool was used to appraise studies.

Results

Twenty articles met the eligibility criteria. The use of tippy-taps for handwashing by household members or school children was reported by authors of 16 studies, and it ranged from 2.7 to 80%. The availability of tippy-taps increased handwashing and use of soap among participants. Furthermore, the majority of people who were oriented to tippy-taps or recruited to tippy-tap studies built their tippy-tap stations even after the promotional activities or programs had ended. In one study, tippy-taps were reported by participant to be effective in preventing episodes of stomach pain among participants.

Conclusion

Tippy-tap handwashing station could help in promoting handwashing practice in resource constraint settings. Future studies are needed to evaluate the effectiveness of tippy-tap hand washing station on preventing water and hygiene-related infections.
Initiation and maintenance of lifestyle changes among participants in a healthy life centre: a qualitative study
Authors: Sevild Cille H. , Niemiec Christopher P. , Bru Lars Edvin , Dyrstad Sindre M. , Husebø Anne Marie Lunde
Published: June 2020

Background

Since the early 2000s, Healthy Life Centres have been established in Norway to promote physical and mental health. Yet to date, little is known about the efficacy of Healthy Life Centres in promoting health behaviour change and maintenance or the factors that underlie these processes. Accordingly, the aim of the current study was to examine the factors that participants in a Healthy Life Centre perceive as relevant for the initiation and maintenance of lifestyle changes toward more physical activity and consumption of a healthier diet.

Method

Participants were purposely recruited from among adherers in a 12-month multi-method research project at a Healthy Life Centre. Individual, semi-structured interviews were conducted with 8 women and 6 men who were between the ages of 20 and 61 years old. Data were analysed using Systematic Text Condensation.

Results

Three main themes were derived from this analysis. The first theme focused on the motives behind initiation and maintenance of lifestyle changes along with the importance of a relationally supportive environment to promote perceived competence in pursuing a healthy lifestyle. The second theme focused on strategies for coping with the challenges and potential pitfalls that were associated with various unpleasant experiences and life events. The third theme focused on several specific skills that were helpful to the initiation and maintenance of lifestyle changes.

Conclusion

The current study enhanced an understanding of the initiation and maintenance of lifestyle changes, although these processes were not disentangled in participants’ experiences. In line with self-determination theory, the results suggested that lifestyle change is more likely to be initiated and maintained when goals are not only achievable but also regulated with autonomous motivation and of intrinsic value. Conversely, lifestyle change is difficult to maintain when motives are external to the self. Further, cognitive and behavioural skills were valuable and necessary in coping with unpleasant emotions. Finally, the critical function of self-regulation skills for making realistic plans and prioritizations in order to balance healthy lifestyle behaviours with the routines of “daily life” while monitoring outcomes was readily apparent. Healthy Life Centres can contribute to these processes in meaningful ways.
Work-related physical activity and psychological distress among women in different occupations: a cross-sectional study
Authors: White Rhiannon Lee , Bennie Jason , Abbott Gavin , Teychenne Megan
Published: June 2020

Background

Recent evidence suggests that work-related physical activity may not have the same mental health benefits as leisure-time physical activity. Further, work-related physical activity is likely to include a variety of different behaviours for people with different occupations. As such, the aim of this study was to determine if occupation type moderated the association between work-related physical activity and psychological distress.

Methods

A randomly selected sample of 1080 women from Melbourne, Australia completed the International Physical Activity Questionnaire (IPAQ) and General Health Questionnaire (GHQ-30), and reported their current occupation.

Results

Linear regression analyses indicated that occupation significantly moderated the association between work-related walking and psychological distress (F [8, 55] = 2.26, p = .036). Given evidence of moderation, we fitted linear regression models to test the associations between work-related physical activity and psychological distress for three separate groups; professionals, sales and services workers, and tradespersons. Female tradespersons who engaged in a low (B = − 3.81, p = .006) or high amount of work-related walking (B = − 3.23, p = .029), had significantly lower psychological distress symptoms than those who engaged in no work-related walking. There were no significant associations between work-related physical activity of any intensity and psychological distress for professionals, or sales and service workers.

Conclusions

Given the relationship does not exist across all occupations, work-related physical activity should not be promoted above and beyond leisure-time physical activity. However, walking at work may be important in reducing psychological distress for some people and should therefore, not be discounted.
Addressing Vulnerable Population Needs in the Last Mile to the elimination of mother to child transmission of HIV: (Re)Claiming the HIV Response for Female Sex Workers and Their Children
Authors: Hakim Avi J. , Callahan Tegan , Benech Irene , Patel Monita , Adler Michelle , Modi Surbhi , Bateganya Moses , Parris Kae Anne , Bingham Trista
Published: June 2020

As countries strive to eliminate mother-to-child transmission of HIV, female sex workers (FSW) and their children still face barriers to accessing these essential services. Data on FSW uptake of HIV and reproductive health services before, during, and after pregnancy reveal inadequate service utilization. Stigma encountered by FSW in healthcare settings may contribute to low uptake of HIV testing, antiretroviral therapy (ART), and other prevention of mother-to-child HIV transmission (PMTCT) services. Coordination between community-based FSW and facility-based PMTCT programs can facilitate successful linkage of pregnant FSW to antenatal services to support PMTCT efforts. We offer a way forward to reach 90-90-90 targets for FSW and their families and eliminate mother-to-child transmission of HIV.
Social networks and their influences on nutrient intake, nutritional status and physical function in community-dwelling ethnically diverse older adults: a mixed-methods longitudinal study
Authors: Asamane Evans A. , Greig Carolyn A. , Thompson Janice L.
Published: June 2020

Background

The United Kingdom population is ageing and becoming increasingly diverse; thus, it is vital to develop and implement interventions supporting this population shift. Social networks (SN) significantly impact health outcomes in later life, however relatively little is known about SN of community-dwelling ethnically diverse older adults. This study aimed to: 1) profile SN and changes in SN in this population over 8 months; 2) examine associations between SN, dietary intake, nutritional status, and physical function.

Methods

SN were assessed using the Wenger Practitioner Assessment of Network Type. Energy and nutrient intakes were measured using multiple-pass 24-h recalls. The Mini Nutritional Assessment-Short Form (MNA-SF) assessed nutritional status. Physical function was measured using the Short Physical Performance Battery (SPPB) and handgrip strength. Data were collected at baseline and 8-months. Correlation and regression analyses examined relationships between SN, physical function, nutrient intake and nutritional status. Semi-structured interviews were conducted at baseline (n = 92) and follow-up (n = 81) to identify potential influences of SN. Interviews were transcribed verbatim and analysed using directed content analysis.

Results

Quantitative data were obtained from 100 participants at baseline and 81 at follow-up. Mean (SD) age was 70.8 (8.1) years (59% male), comprising African/Caribbean (60%), South Asian (34%), and other ethnicities (6%). Five SN typologies were identified under two broad areas: integrated-SN consisting of locally integrated (44%) and wider community (8%); and non-integrated-SN consisting of family dependent (25%), local self-contained (17%), and private restricted (6%). At follow-up, 37% remained in non-integrated networks, 19% transitioned to non-integrated networks, 11% transitioned to, and 33% remained in, integrated networks. Participants within integrated networks at baseline had higher SPPB scores at follow-up. Compared to the private restricted, local self-contained SN significantly predicted zinc, riboflavin and vitamin B6 intakes. Participants remaining in, or transitioning to, non-integrated networks had low MNA-SF scores. Qualitative findings indicate that participants with reductions in SN perceived it as causing poorer physical function and eating behaviours.

Conclusion

In the present study, integrated SN were associated with higher physical function and nutritional status at 8-month’s follow-up. These results can inform the design of interventions to improve social networks, physical function and healthy nutrition within this population.
Paraspinal back muscles in asymptomatic volunteers: quantitative and qualitative analysis using computed tomography (CT) and magnetic resonance imaging (MRI)
Authors: Khil Eun Kyung , Choi Jung-Ah , Hwang Eunjin , Sidek Sabrilhakim , Choi Il
Published: June 2020

Background

To evaluate paraspinal back muscles of asymptomatic subjects using qualitative and quantitative analysis on CT and MRI and correlate the results with demographic data.

Methods

Twenty-nine asymptomatic subjects were enrolled prospectively (age: mean 34.31, range 23–50; 14 men, 15 women) from August 2016 to April 2017. Qualitative analysis of muscles was done using Goutallier’s system on CT and MRI. Quantitative analysis entailed cross sectional area (CSA) on CT and MRI, Hounsfield unit (HU) on CT, fat fraction using two-point Dixon technique on MRI. Three readers independently analyzed the images; intra- and inter-observer agreements were measured. Linear regression and Spearman’s analyses were used for correlation with demographic data.

Results

CSA values were significantly higher in men (p < 0.001). Fat fraction was higher (22.53% vs. 14.35%) and HU lower (36.00 vs. 47.43) in women (p < 0.001). Intra- and inter-observer reliabilities of the two methods were greater than 0.8, except for CSA of L5/S1 on MRI; however, regarding quantitative analysis, decreasing HU and increasing fat fraction were correlated with increasing age, female gender and lower lumbar segment (p < 0.001).

Conclusion

MRI and CT can be reliably used for qualitative and quantitative analysis of paraspinal back muscles, regarding fat content. Fat fraction and HU showed highest reliabilities.
A case report of primary upper urinary tract signet-ring cell carcinoma and literature review
Authors: Ye Zhaohua , Mi Qiwu , Luo Daosheng , Li Zhixiong , Luo Jiexin
Published: June 2020

Background

Upper tract urothelial carcinoma with pure non-urothelial histology is an exception but variants are present in ~ 25% of cases. Primary upper urinary tract signet -ring cell carcinoma is extremely rare.

Case presentation

We report the case of a 65-year-old male diagnosed primary upper urinary tract signet-ring cell carcinoma while underwent percutaneous nephrolithotomy. Radical nephroureterectomy and adjuvant chemotherapy were performed sequentially. The patient is now recovering well with a regular follow-up for more than 1 year.

Conclusions

The upper urinary tract malignancy often appears as a high grade, high stage tumor and has a uniformly poor prognosis, but a timely multimodal management can bring a good outcome.
Spatial conservation prioritisation in data-poor countries: a quantitative sensitivity analysis using multiple taxa
Authors: El-Gabbas Ahmed , Gilbert Francis , Dormann Carsten F.
Published: June 2020

Background

Spatial conservation prioritisation (SCP) is a set of computational tools designed to support the efficient spatial allocation of priority areas for conservation actions, but it is subject to many sources of uncertainty which should be accounted for during the prioritisation process. We quantified the sensitivity of an SCP application (using software Zonation) to possible sources of uncertainty in data-poor situations, including the use of different surrogate options; correction for sampling bias; how to integrate connectivity; the choice of species distribution modelling (SDM) algorithm; how cells are removed from the landscape; and two methods of assigning weights to species (red-list status or prediction uncertainty). Further, we evaluated the effectiveness of the Egyptian protected areas for conservation, and spatially allocated the top priority sites for further on-the-ground evaluation as potential areas for protected areas expansion.

Results

Focal taxon (butterflies, reptiles, and mammals), sampling bias, connectivity and the choice of SDM algorithm were the most sensitive parameters; collectively these reflect data quality issues. In contrast, cell removal rule and species weights contributed much less to overall variability. Using currently available species data, we found the current effectiveness of Egypt’s protected areas for conserving fauna was low.

Conclusions

For SCP to be useful, there is a lower limit on data quality, requiring data-poor countries to improve sampling strategies and data quality to obtain unbiased data for as many taxa as possible. Since our sensitivity analysis may not generalise, conservation planners should use sensitivity analyses more routinely, particularly relying on more than one combination of SDM algorithm and surrogate group, consider correction for sampling bias, and compare the spatial patterns of predicted priority sites using a variety of settings. The sensitivity of SCP to connectivity parameters means that the responses of each species to habitat loss are important knowledge gaps.
Evaluation of protective factors in caries free preschool children: a case-control study
Authors: Yazdani Reza , Mohebbi Simin Zahra , Fazli Maryam , Peighoun Maryam
Published: June 2020

Background

Increasing the proportion of caries-free children following the WHO’s global target has led to more desirable welfare and a higher level of quality of life for children. In the present study, we aimed to evaluate the factors contributing to a caries-free condition in preschool children as a basic action towards the global goals of children’s oral health.

Methods

This was a case-control study evaluating the protective factors contributing to dental caries free in 4–6-year-old children in Tehran/Iran in 2017. 500 preschool children and their mothers were selected from 22 randomly selected preschools and were enrolled in the study. The participants were divided into two case (caries-free) and control (with dental caries) groups. The data were collected using two data gathering tools; the child oral examination form and the mother’s valid questionnaire. The latter included three domains; socio-demographic factors, behavioral oral health measures, and feeding practices and dietary habits. The criteria for caries detection were cavities in the enamel and dentine. A logistic regression model was applied to identify caries-free protective factors (P < 0.05).

Results

Among 230 caries-free and 270 non-caries-free children who participated in the study, boys were more caries-free (P = 0.001). The protective factors against dental caries that were identified in the study were dental check-up as the cause of dental visit, being the first child in the family, the fewer sessions night feeding of the child’s, family’s house ownership, and parent’s university education (P < 0.05).

Conclusions

Dental health can be achieved by considering protective factors like the regular dental check-up and socio-economic factors. Communities are invited to pay close attention to these important protective factors as far as they can increase the proportion of caries-free among preschool children especially in countries with developing oral health care systems.
Negotiating the turning point in the transition from curative to palliative treatment: a linguistic analysis of medical records of dying patients
Authors: Hov Laila , Synnes Oddgeir , Aarseth Guri
Published: June 2020

Background

Many deaths in Norway occur in medical wards organized to provide curative treatment. Still, medical departments are obliged to meet the needs of patients at the end of life. Here, we analyse the electronic patient record regarding documentation of the transition from curative to palliative care (i.e. the ‘turning point’). Considering the consequences of these decisions for patients, they have received surprisingly little attention from researchers. This study aims to investigate how the patient record denotes reasons for the shift from curative treatment to palliation and how texts involve voices of the patient and their families.

Methods

The study comprised excerpts from electronic patient records retrieved from medical wards in three urban hospitals in Norway. We executed a retrospective analysis of anonymized extracts from 16 electronic patient records, searching for documentation on the transition from curative to palliative care.

Results

In the development of the turning point, the texts usually shift from statements about the patient’s clinical status and technical findings to displaying uncertainty and openness to negotiation with different textual voices. This shift may represent a need to align or harmonize the attitudes of colleagues, family, and patient towards the turning-point decision. The patient’s voice is mostly absent or reported only briefly when, in their notes, nurses gave an account of the patient’s opinion. None of the physicians’ notes provided a detailed account of patient attitudes, wishes, and experiences.

Conclusion

In this article, we have analysed textual representations of patient transitions from curative to end-of-life care. The ‘reality’ behind the text has not been our concern. As the only documentation left, the patient record is an adequate basis for considering how patients are estimated and cared for in their last days of life.
Methodological and reporting quality evaluation of meta-analyses on the Chinese herbal preparation Zheng Qing Feng Tong Ning for the treatment of rheumatoid arthritis
Authors: Liang Mingge , Yan Lan , Mei Zhigang , Luo Yanan , Hou Xiaoqiang , Feng Zhitao
Published: June 2020

Background

Zheng Qing Feng Tong Ning (ZQFTN) is a sinomenine (SIN) preparation that has been used in clinical practice. Our study aimed to assess the methodological and reporting quality of meta-analyses on the Chinese herbal formula ZQFTN for the treatment of rheumatoid arthritis (RA).

Methods

Systematic searches were carried out with the 5 following electronic databases from inception to July 2019: China National Knowledge Infrastructure (CNKI), Wanfang, VIP database for Chinese technical periodicals (VIP), Cochrane Library and PubMed. The quality of the methodology and reporting was measured with the assessment of multiple systematic reviews 2 (AMSTAR 2) scale, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).

Results

Eight studies were identified. Among the 16 items of the AMSTAR 2 scale, four items were optimally reported (“Y” =100% of the items), and another four items were poorly reported (“Y” =0% of the items). Only 2 studies received a good overall score (“Y” ≥50% of the items). Regarding the PRISMA statement, the scores of 5 studies were lower than the average score (17.69), indicating that the quality of the reports was very low. In terms of the GRADE, none of the 61 results were of high quality (0.0%). Fifteen results were of medium quality (25%), 34 were of low quality (55%), and 12 were of very low quality (20%). Among the five downgrading factors, deviation risk (n = 61, 100%) was the most common downgrading factor, followed by inconsistency (n = 30, 50%), publication bias (n = 17, 28%), inaccuracy (n = 11, 18%) and indirectness (n = 0, 0%).

Conclusions

The methodological and reporting quality of the meta-analyses and systematic reviews in the included studies are less than optimal, and researchers should undergo additional training and follow the AMSTAR 2 scale, PRISMA statement and GRADE to design high-quality studies in the future.
Jianpi-yangwei decoction inhibits DNA damage repair in the drug resistance of gastric cancer by reducing FEN1 expression
Authors: Huang Wenjie , Tang Huijuan , Wen Fang , Lu Xiaona , Li Qingpei , Shu Peng
Published: June 2020

Background

Flap Endonuclease 1(FEN1) has been considered as a new tumor marker in recent years and Jianpi Yangwei Decoction (JPYW) is a basic Traditional Chinese Medicine (TCM) for the treatment of gastric cancer. This study aimed to explore the role of FEN1-mediated DNA damage repair in the drug resistance of gastric cancer and the effect of JPYW on it by employing BGC823/5-Fu drug-resistant cell model.

Methods

The DNA repair efficiency of BGC823 and BGC823/5-Fu was compared intracellularly and extracellularly using an extrachromosomal assay system and the reconstituted base excision repair assay. By comparing gene and protein expression and identifying cell survival rates after knockdown or high expression of FEN1, the correlation between FEN1 high expression and 5-Fluorouracil (5-Fu) drug resistance was revealed. The effect of JPYW on DNA damage repair and FEN1 expression was observed by the degree of γ-H2AX phosphorylation in the cells, DNA repair efficiency and enzyme activity, et al.

Results

BGC823/5-Fu had a higher DNA repair efficiency than BGC823(P < 0.001), which proved to be both intracellular and extracellular. FEN1 was highly expressed in BGC823/5-Fu regardless of gene level(P < 0.001) or protein level. Furthermore, manipulating FEN1 altered the sensitivity of cancer cells to chemotherapeutic drug 5-Fu. Different concentrations of JPYW were used to investigate the inhibitory effect on the expression of FEN1 and DNA damage repair. JPYW inhibited DNA damage repair both intracellularly and extracellularly: the phosphorylation of γ-H2AX increased, with more DNA damage in the cells; the synthetic 8-oxo dG damage repair was reduced; and the ability of cell lysates to repair DNA damage decreased. The decrease of FEN1 expression in BGC823/5-Fu had a concentration dependent relationship with JYPW. In addition, JPYW inhibited the activity of FEN1 at the enzymatic level, as the amount of cut-off synthetic 32p labeled DNA substrates were decreased.

Conclusion

FEN1 was highly expressed in drug-resistance gastric cancer cells BGC823/5-Fu, which leading to BGC823 resistant to (5-Fu) by acting on DNA damage repair. JPYW inhibited DNA damage repair and reversed 5-Fu drug resistance by reducing FEN1 expression and inhibiting FEN1 functional activity.
Resident attitudes and benefits of mock oral board examinations in radiation oncology
Authors: Peters Gabrielle W. , Decker Roy H. , Park Henry S. , Yu James B. , Evans Suzanne B.
Published: June 2020

Background

Presently, educational programming is not standardized across radiation oncology (RO) training programs. Specifically, there are limited materials through national organizations or structured practice exams for residents preparing for the American Board of Radiology (ABR) oral board examination. We present our 2019 experience implementing a formalized program of early mock oral board examinations (MOBE) for residents in post-graduate years (PGY) 3–5.

Methods

A mixed-methods survey regarding MOBE perception and self-reported comfort across five clinical domains were administered to PGY2–5 residents. MOBEs and a post-intervention survey were implemented for the PGY3–5. The pre and post-intervention score across clinical domains were compared using t-tests. Faculty and residents were asked for post-intervention comments.

Results

A total of 14 PGY2–5 residents completed the pre-intervention survey; 9 residents participated in the MOBE (5/14 residents were PGY2s) and post-intervention survey. This was the first mock oral radiation oncology examination experience for 65% of residents. 100% of residents felt the MOBE increased their clinical knowledge and comfort with clinical reasoning. Overall, there was a trend towards improved resident confidence giving planning dose parameters and (p = 0.08). There was also unanimous request for more MOBE experiences from residents and faculty, but time was identified as a significant barrier.

Conclusions

Future directions for this MOBE program are inclusion of more disease sites, better emulation of the exam, the creation of a more rigorous consolidated format testing all sites at once, and consideration for grading of these sessions for future correlation with certifying oral board examination (OBE) performance.
How is self-regulated learning documented in e-portfolios of trainees? A content analysis
Authors: van der Gulden R. , Heeneman S. , Kramer A. W. M. , Laan R. F. J. M. , Scherpbier-de Haan N. D. , Thoonen B. P. A.
Published: June 2020

Background

It is assumed that portfolios contribute to self-regulated learning (SRL). Presence of these SRL processes within the documentation kept in portfolios is presupposed in common educational practices, such as the assessment of reflective entries. However, questions can be asked considering the presence of SRL within portfolios. The aim of this study was to gain insight into the documentation of SRL processes within the electronic (e)-portfolio content of medical trainees. SRL consists of numerous processes, for this study the focus was on self-assessment via reflection and feedback, goal-setting and planning, and monitoring, as these are the processes that health professions education research mentions to be supported by portfolios.

Methods

A database containing 1022 anonymous e-portfolios from General Practitioner trainees was used to provide descriptive statistics of the various available e-portfolio forms. This was followed by a quantitative content analysis of 90 e-portfolios, for which, a codebook was constructed to rate the documentation of the included SRL processes.

Results

The numbers of forms in the e-portfolios varied to a great extent. Content analysis showed a limited documentation of reflective entries, and available entries mainly described events and experiences without explanations and context. Feedback was generally limited to comments on what went well and lacked specificity, context and suggestions for future action. Learning goals and plans were short of specificity, but did contain challenging topics and different goals were compatible with each other. 75% of the e-portfolios showed (limited) signs of monitoring.

Conclusions

The e-portfolio content showed limited documentation of SRL processes. As documentation of SRL requires time and asks for a high level of introspection and writing skills, one cannot expect documentation of SRL processes to appear in e-portfolio content without efforts.
Health staff experiences with the implementation of early essential newborn care guidelines in Da Nang municipality and Quang Nam province in Viet Nam
Authors: Morseth Marianne S. , Nguyen Tuan T. , Skui Malene , Terragni Laura , Ngo Quang V. , Vu Ha T. T. , Mathisen Roger , Henjum Sigrun
Published: June 2020

Background

The World Health Organization (WHO) recommends early essential newborn care (EENC) – The First Embrace – as a simple lifesaving procedure for newborns. The successful implementation of EENC at scale requires an understanding of health staff experiences, including facilitators, barriers, and local adaptations of EENC. This study aims to gain insight into health staff experiences with implementation of EENC guidelines after participation in training and coaching initiatives in Da Nang municipality and Quang Nam province in Viet Nam.

Methods

In each province/municipality, we randomly selected one hospital from the following categories: public provincial/municipal hospital, public district hospital, and private hospital. We conducted in-depth interviews with 19 hospital staff (11 midwives, 5 doctors and 3 health managers) and two trainers during 7 days between September and October 2017. We used deductive/inductive thematic analysis to generate themes.

Results

The health staff reported improved staff and mother satisfaction, and health benefits for both mothers and newborns after implementing EENC. Facilitators to successful implementation were management support for resource allocation and collaboration across departments, and creative demand generation. Barriers included staff shortage, skepticism about the new protocols and practices and challenges translating knowledge and skills from trainings and coaching into practice.

Conclusions

After implementing EENC, through training and coaching using the WHO approach, health staff reported improved staff and mother satisfaction as well as health benefits for both mothers and newborns. An approach to develop competencies, with a focus on practical training and coaching, should be promoted to form, reinforce and sustain recommended EENC practices among health staff.
Addressing challenges for clinical research responses to emerging epidemics and pandemics: a scoping review
Authors: Sigfrid Louise , Maskell Katherine , Bannister Peter G. , Ismail Sharif A. , Collinson Shelui , Regmi Sadie , Blackmore Claire , Harriss Eli , Longuere Kajsa-Stina , Gobat Nina , Horby Peter , Clarke Mike , Carson Gail
Published: June 2020

Background

Major infectious disease outbreaks are a constant threat to human health. Clinical research responses to outbreaks generate evidence to improve outcomes and outbreak control. Experiences from previous epidemics have identified multiple challenges to undertaking timely clinical research responses. This scoping review is a systematic appraisal of political, economic, administrative, regulatory, logistical, ethical and social (PEARLES) challenges to clinical research responses to emergency epidemics and solutions identified to address these.

Methods

A scoping review. We searched six databases (MEDLINE, Embase, Global Health, PsycINFO, Scopus and Epistemonikos) for articles published from 2008 to July 2018. We included publications reporting PEARLES challenges to clinical research responses to emerging epidemics and pandemics and solutions identified to address these. Two reviewers screened articles for inclusion, extracted and analysed the data.

Results

Of 2678 articles screened, 76 were included. Most presented data relating to the 2014–2016 Ebola virus outbreak or the H1N1 outbreak in 2009. The articles related to clinical research responses in Africa (n = 37), Europe (n = 8), North America (n = 5), Latin America and the Caribbean (n = 3) and Asia (n = 1) and/or globally (n = 22). A wide range of solutions to PEARLES challenges was presented, including a need to strengthen global collaborations and coordination at all levels and develop pre-approved protocols and equitable frameworks, protocols and standards for emergencies. Clinical trial networks and expedited funding and approvals were some solutions implemented. National ownership and community engagement from the outset were a key enabler for delivery. Despite the wide range of recommended solutions, none had been formally evaluated.

Conclusions

To strengthen global preparedness and response to the COVID-19 pandemic and future epidemics, identified solutions for rapid clinical research deployment, delivery, and dissemination must be implemented. Improvements are urgently needed to strengthen collaborations, funding mechanisms, global and national research capacity and capability, targeting regions vulnerable to epidemics and pandemics. Solutions need to be flexible to allow timely adaptations to context, and research led by governments of affected regions. Research communities globally need to evaluate their activities and incorporate lessons learnt to refine and rehearse collaborative outbreak response plans in between epidemics.
Long non-coding RNA profiling of pediatric Medulloblastoma
Authors: Kesherwani Varun , Shukla Mamta , Coulter Don W. , Sharp J. Graham , Joshi Shantaram S. , Chaturvedi Nagendra K.
Published: June 2020

Background

Medulloblastoma (MB) is one of the most common malignant cancers in children. MB is primarily classified into four subgroups based on molecular and clinical characteristics as (1) WNT (2) Sonic-hedgehog (SHH) (3) Group 3 (4) Group 4. Molecular characteristics used for MB classification are based on genomic and mRNAs profiles. MB subgroups share genomic and mRNA profiles and require multiple molecular markers for differentiation from each other. Long non-coding RNAs (lncRNAs) are more than 200 nucleotide long RNAs and primarily involve in gene regulation at epigenetic and post-transcriptional levels. LncRNAs have been recognized as diagnostic and prognostic markers in several cancers. However, the lncRNA expression profile of MB is unknown.

Methods

We used the publicly available gene expression datasets for the profiling of lncRNA expression across MB subgroups. Functional analysis of differentially expressed lncRNAs was accomplished by Ingenuity pathway analysis (IPA).

Results

In the current study, we have identified and validated the lncRNA expression profile across pediatric MB subgroups and associated molecular pathways. We have also identified the prognostic significance of lncRNAs and unique lncRNAs associated with each MB subgroup.

Conclusions

Identified lncRNAs can be used as single biomarkers for molecular identification of MB subgroups that warrant further investigation and functional validation.