bluuebunny/crossref_metadata_2025_split huggingface dataset:
Forming and implementing community advisory boards in low- and middle-income countries: a scoping review
Authors: Zhao Yang , Fitzpatrick Thomas , Wan Bin , Day Suzanne , Mathews Allison , Tucker Joseph D. 
Published: October 2019

Abstract

Background
Community advisory boards (CABs) have expanded beyond high-income countries (HICs) and play an increasing role in low- and middle-income country (LMIC) research. Much research has examined CABs in HICs, but less is known about CABs in LMICs. The purposes of this scoping review are to examine the creation and implementation of CABs in LMICs, including identifying frequently reported challenges, and to discuss implications for research ethics.

Methods
We searched five databases (PubMed, Embase, Global Health, Scopus, and Google Scholar) for publications describing or evaluating CABs in LMICs. Two researchers independently reviewed articles for inclusion. Data related to the following aspects of CABs were extracted from included publications: time, country, financial support, research focus, responsibilities, and challenges. Thematic analyses were used to summarize textual data describing challenges.

Results
Our search yielded 2005 citations, 83 of which were deemed eligible for inclusion. Most studies (65) were published between 2010 and 2017. Upper-middle-income countries were more likely to have studies describing CABs, with South Africa (17), China (8), and Thailand (7) having the greatest numbers. The United States National Institutes of Health was the main source of financial support for CABs. Many CABs (53/88, 60%) focused on HIV research. Thirty-four studies reported how CABs influenced the informed consent process for clinical trials or other aspects of research ethics. CAB responsibilities were related to clinical trials, including reviewing study protocols, educating local communities about research activities, and promoting the ethical conduct of research. Challenges faced by CABs included the following: incomplete ethical regulations and guidance; limited knowledge of science among members of communities and CABs; unstable and unbalanced power relationships between researchers and local communities; poor CAB management, including lack of formal participation structures and absence of CAB leadership; competing demands for time that limited participation in CAB activities; and language barriers between research staff and community members. Several challenges reflected shortcomings within the research team.

Conclusions
Our findings examine the formation and implementation of CABs in LMICs and identify several ethical challenges. These findings suggest the need for further ethics training among CAB members and researchers in LMICs.
Multimorbidity and healthcare resource utilization in Switzerland: a multicentre cohort study
Authors: Aubert Carole E. , Fankhauser Niklaus , Marques-Vidal Pedro , Stirnemann Jérôme , Aujesky Drahomir , Limacher Andreas , Donzé Jacques 
Published: October 2019

Abstract

Background
Multimorbidity is associated with higher healthcare resource utilization, but we lack data on the association of specific combinations of comorbidities with healthcare resource utilization. We aimed to identify the combinations of comorbidities associated with high healthcare resource utilization among multimorbid medical inpatients.

Methods
We performed a multicentre retrospective cohort study including 33,871 multimorbid (≥2 chronic diseases) medical inpatients discharged from three Swiss hospitals in 2010–2011. Healthcare resource utilization was measured as 30-day potentially avoidable readmission (PAR), prolonged length of stay (LOS) and difference in median LOS. We identified the combinations of chronic comorbidities associated with the highest healthcare resource utilization and quantified this association using regression techniques.

Results
Three-fourths of the combinations with the strongest association with PAR included chronic kidney disease. Acute and unspecified renal failure combined with solid malignancy was most strongly associated with PAR (OR 2.64, 95%CI 1.79;3.90). Miscellaneous mental health disorders combined with mood disorders was the most strongly associated with LOS (difference in median LOS: 17 days) and prolonged LOS (OR 10.77, 95%CI 8.38;13.84). The number of chronic diseases was strongly associated with prolonged LOS (OR 9.07, 95%CI 8.04;10.24 for ≥10 chronic diseases), and to a lesser extent with PAR (OR 2.16, 95%CI 1.75;2.65 for ≥10 chronic diseases).

Conclusions
Multimorbidity appears to have a higher impact on LOS than on PAR. Combinations of comorbidities most strongly associated with healthcare utilization included kidney disorders for PAR, and mental health disorders for LOS.
Tumour heterogeneity revealed by unsupervised decomposition of dynamic contrast-enhanced magnetic resonance imaging is associated with underlying gene expression patterns and poor survival in breast cancer patients
Authors: Fan Ming , Xia Pingping , Liu Bin , Zhang Lin , Wang Yue , Gao Xin , Li Lihua 
Published: October 2019

Abstract

Background
Heterogeneity is a common finding within tumours. We evaluated the imaging features of tumours based on the decomposition of tumoural dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) data to identify their prognostic value for breast cancer survival and to explore their biological importance.

Methods
Imaging features (n = 14), such as texture, histogram distribution and morphological features, were extracted to determine their associations with recurrence-free survival (RFS) in patients in the training cohort (n = 61) from The Cancer Imaging Archive (TCIA). The prognostic value of the features was evaluated in an independent dataset of 173 patients (i.e. the reproducibility cohort) from the TCIA I-SPY 1 TRIAL dataset. Radiogenomic analysis was performed in an additional cohort, the radiogenomic cohort (n = 87), using DCE-MRI from TCGA-BRCA and corresponding gene expression data from The Cancer Genome Atlas (TCGA). The MRI tumour area was decomposed by convex analysis of mixtures (CAM), resulting in 3 components that represent plasma input, fast-flow kinetics and slow-flow kinetics. The prognostic MRI features were associated with the gene expression module in which the pathway was analysed. Furthermore, a multigene signature for each prognostic imaging feature was built, and the prognostic value for RFS and overall survival (OS) was confirmed in an additional cohort from TCGA.

Results
Three image features (i.e. the maximum probability from the precontrast MR series, the median value from the second postcontrast series and the overall tumour volume) were independently correlated with RFS (p values of 0.0018, 0.0036 and 0.0032, respectively). The maximum probability feature from the fast-flow kinetics subregion was also significantly associated with RFS and OS in the reproducibility cohort. Additionally, this feature had a high correlation with the gene expression module (r = 0.59), and the pathway analysis showed that Ras signalling, a breast cancer-related pathway, was significantly enriched (corrected p value = 0.0044). Gene signatures (n = 43) associated with the maximum probability feature were assessed for associations with RFS (p = 0.035) and OS (p = 0.027) in an independent dataset containing 1010 gene expression samples. Among the 43 gene signatures, Ras signalling was also significantly enriched.

Conclusions
Dynamic pattern deconvolution revealed that tumour heterogeneity was associated with poor survival and cancer-related pathways in breast cancer.
Growth differentiation factor 15 and early prognosis after out-of-hospital cardiac arrest
Authors: Rueda Ferran , Cediel Germán , García-García Cosme , Aranyó Júlia , González-Lopera Marta , Aranda Nevado M. Cruz , Serra Gregori Judith , Oliveras Teresa , Labata Carlos , Ferrer Marc , El Ouaddi Nabil , Bayés-Genís Antoni 
Published: October 2019

Abstract

Background
Growth differentiation factor 15 (GDF-15) is an inflammatory cytokine released in response to tissue injury. It has prognostic value in cardiovascular diseases and other acute and chronic conditions. Here, we explored the value of GDF-15 as an early predictor of neurologic outcome after an out-of-hospital cardiac arrest (OHCA).

Methods
Prospective registry study of patients in coma after an OHCA, admitted in the intensive cardiac care unit from a single university center. Serum levels of GDF-15 were measured on admission. Neurologic status was evaluated according to the cerebral performance category (CPC) scale. The relationship between GDF-15 levels and poor neurologic outcome at 6 months was analyzed.

Results
Among 62 patients included, 32 (51.6%) presented poor outcome (CPC 3–5). Patients with CPC 3–5 exhibited significantly higher GDF-15 levels (median, 17.1 [IQR, 11.1–20.4] ng/mL) compared to those with CPC 1–2 (7.6 [IQR, 4.1–13.1] ng/mL; p = 0.004). Multivariable logistic regression analyses showed that age (OR, 1.09; 95% CI 1.01–1.17; p = 0.020), home setting arrest (OR, 8.07; 95% CI 1.61–40.42; p = 0.011), no bystander cardiopulmonary resuscitation (OR, 7.91; 95% CI 1.84–34.01; p = 0.005), and GDF-15 levels (OR, 3.74; 95% CI 1.32–10.60; p = 0.013) were independent predictors of poor outcome. The addition of GDF-15 in a dichotomous manner (≥ 10.8 vs. < 10.8 ng/mL) to the resulting clinical model improved discrimination; it increased the area under the curve from 0.867 to 0.917, and the associated continuous net reclassification improvement was 0.90 (95% CI 0.48–1.44), which allowed reclassification of 37.1% of patients.

Conclusions
After an OHCA, increased GDF-15 levels were an independent, early predictor of poor neurologic outcome. Furthermore, when added to the most common clinical factors, GDF-15 improved discrimination and allowed patient reclassification.
A new application of Schrödinger-type identity to singular boundary value problem for the Schrödinger equation
Authors: Meng Bo 
Published: October 2019

Abstract
In this paper, we present a modified Schrödinger-type identity related to the Schrödinger-type boundary value problem with mixed boundary conditions and spatial heterogeneities. This identity can be regarded as an $L^{1}$

L
1

-version of Fisher–Riesz’s theorem and has a broad range of applications. Using it and fixed point theory in $L^{1}$

L
1

-metric spaces, we prove that there exists a unique solution for the singular boundary value problem with mixed boundary conditions and spatial heterogeneities. We finally provide two examples, which show the effectiveness of the Schrödinger-type identity method.
Risk factors for Blastocystis infection in HIV/AIDS patients with highly active antiretroviral therapy in Southwest China
Authors: Zhang Shun-Xian , Kang Fen-Yan , Chen Jia-Xu , Tian Li-Guang , Geng Lan-Lan 
Published: October 2019

Abstract

Background
Blastocystis is a widespread zoonotic protozoan of mammalian species, especially in HIV/AIDS individuals. The aim of this study was to analyze the prevalence and risk factors related with Blastocystis infection among HIV/AIDS patients in Southwest China.

Methods
The cross-sectional study was performed in 311 HIV/AIDS cases in Tengchong City, Yunnan Province from July 2016 to March 2017. For each subject, stool specimen was collected to detect the Blastocystis, and the blood sample was used to detect HIV virus load and CD4+ T cell count, in addition, structured questionnaire was used to collect the basic information and risk factors.

Findings
The result showed that the detection rate of Blastocystis was 3.86% (95% CI: 2.22–6.62) among HIV/AIDS patients. Both raising animal (OR = 12.93, 95% CI: 1.54–108.36) and drinking un-boiled water (OR = 8.17, 95% CI: 1.76–37.90) were risk factors for Blastocystis infection in HIV/AIDS individuals. In addition, the interaction of CD4+ T cell count and HIV virus load was also contribution to Blastocystis infection (P = 0.007).

Conclusions
A high prevalence of Blastocystis infection was found in HIV/AIDS patients in Tengchong. Poor hygienic habits, the interaction of HIV virus load and CD4+ T cell count were identified as main risk factors for infection. These results will help us to develop efficient control strategies to intervene with and prevent the occurrence of Blastocystis among HIV-infected individuals.
Chitosan enhances rosmarinic acid production in shoot cultures of Melissa officinalis L. through the induction of methyl jasmonate
Authors: Fooladi vanda Ghazaleh , Shabani Leila , Razavizadeh Roya 
Published: October 2019

AbstractBackgroundChitosan is a polycationic polysaccharide derived from chitin that has been recognized as an effective elicitor in the production of secondary metabolites of many medicinal plants. In this study, the effect of abiotic elicitor (chitosan) at various concentrations on rosmarinic acid (RA) and total phenolic accumulation in shoot cultures of lemon balm was investigated.ResultsTreatment of shoots by chitosan led to a noticeable induction of phenylalanine ammonia-lyase (PAL), catalase (CAT), guaiacol peroxidase (GPX) and lipoxygenase (LOX) activities. Besides, the expression ofPAL1,TATandRASgenes and accumulation of RA and phenolic compound increased in chitosan-treated lemon balm shoots. Chitosan treatment also increased H2O2accumulation and the expression ofRBOH, an essential gene implicated in ROS production. Also, the up-regulation of theOPRgene by exogenous chitosan was associated with the induction of endogenous JA determined by GC-MASS.ConclusionThe present study showed that the induced production of rosmarinic acid by chitosan involves the trigger of defense-related enzymes, up-regulated expression ofTATandRASgenes, and stimulation of JA biosynthesis.
Surgical outcomes in adults with purpura fulminans: a systematic review and patient-level meta-synthesis
Authors: Klifto Kevin M. , Gurno Caresse F. , Grzelak Michael J. , Seal Stella M. , Asif Mohammed , Hultman C. Scott , Caffrey Julie A. 
Published: October 2019

Abstract

Background
Cutaneous manifestations of purpura fulminans (PF) present many challenges for clinicians and surgeons. In a state of septic shock complicated by limb ischemia, surgical interventions are necessary to control the pathological cascade and improve patient outcomes. The objective of this article was to report etiologies and surgical outcomes associated with cutaneous manifestations in adults.

Methods
This systematic review and meta-analysis compared 190 adult patients with etiologies, signs and symptoms, and surgical outcomes associated with cutaneous manifestations of PF. The PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus databases were systematically and independently searched. Patient and clinical characteristics, surgical interventions, outcomes, and complications were recorded.

Results
Seventy-nine studies were eligible for the systematic review, and 77 were eligible for meta-analysis using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) and Cochrane guidelines. A total of 71/190 (38%) cases reported surgical debridement. Fasciotomies were reported in 12/190 (6%) cases and 20 procedures. Amputations were reported in 154/190 (81%) cases. Reconstruction was reported in 45 cases. Skin grafts were applied in 31 cases. Flaps were used for reconstruction in 28 cases. Median (IQR) surgical procedures per patient were 4 (4, 5) procedures. Infectious organisms causing PF were 32% Neisseria meningitidis (n = 55) and 32% Streptococcus pneumonia (n = 55). Coagulase-negative Staphylococcus (95% confidence interval (CI)(8.2–177.9), p = 0.032), Haemophilus influenza (95%CI (7.2–133), p = 0.029), Streptococcus pneumonia (95% CI (13.3–75.9), p = 0.006), and West Nile Virus (95%CI (8.2–177.9), p = 0.032) were associated with significantly more extensive amputations compared to other organisms.

Conclusion
This systematic review and patient-level meta-analysis found the most common presentation of PF was septic shock from an infectious organism. Neisseria meningitidis and Streptococcus pneumonia were equally the most common organisms associated with PF. The majority of cases were not treated in a burn center. The most common surgeries were amputations, with below-the-knee-amputations being the most common procedure. Skin grafting was the most commonly performed reconstructive procedure. The most common complications were secondary infections. Organisms with significantly more extensive amputations were coagulase-negative Staphylococcus, Haemophilus influenza, Streptococcus pneumonia, and West Nile Virus. Interpretation of findings should be cautioned due to limited sample data.
Natural Education in Wollstonecraft’s Wrongs of Woman and Rousseau’s Emile
Authors: Engh Catherine 
Published: October 2019

Abstract
This essay places Wollstonecraft’s late novel Maria; or, The Wrongs of Woman (1798) in conversation with Rousseau’s thought on natural education in Emile (1762). In both texts, aesthetic sensibility is a foundation of religious belief and a crucial feature of a program of natural education that aims at freedom. Education falters, however, as Rousseau’s student and Wollstonecraft’s heroine are consigned to exile by a prejudiced society. Though Rousseau and Wollstonecraft make strong claims for the moral and liberating possibilities of aesthetic sensibility, they differ in their interpretation of exile. Wollstonecraft rewrites Rousseau’s portrait of the self-sufficient exile to highlight her outcast heroine’s estrangement from the vital forces that animate life and the mind. Natural education fails in Wrongs of Woman because the cultivation of sensibility remains separate from the work of reforming the social structures that discredit women’s reason.
Memory Thieves?
Authors: Vice Sue 
Published: October 2019

AbstractThis article examines the contemporary phenomenon of fiction and film about Holocaust survivors suffering from dementia. Earlier examples of this kind use dementia to explore the interior states of survivor guilt and the suppression of painful memories. By contrast, twenty-first-century representations convey the passing on of Holocaust memory to the next generation. These individuals, in the role of offspring or carers, act as the investigators and inheritors of a history that either has vanished from the survivor’s memory or appears in the present as if it were still taking place. Such works are expressive of cultural anxiety at the vanishing of the generation of eyewitnesses to the events of the Holocaust yet also act to defuse the unwelcome lessons such witnesses might impart.
A concept analysis of postpartum contraception
Authors: Kapito Esnath , Chirwa Ellen , Haruzivishe Clara , Sakala Betty , Mwale Ruth , Gwaza Elizabeth , Maluwa Veronica 
Published: October 2019

Postpartum contraception has some ambiguities in terms of its definition and period. The purpose of this concept analysis is to clarify postpartum contraception in terms of its attributes, antecedents, consequences and empirical referents. This can be used in the development of a model for care that promotes the use of postpartum contraception Walker and Avant's (2011) traditional method of concept analysis was used here. A theoretical definition of postpartum contraception was formulated and six defining attributes of postpartum contraception were identified through the process of induction. The antecedents and consequences of postpartum contraception are presented Defining postpartum contraception helps highlight important elements that can be applied in client care in order to improve maternal and neonatal outcomes. Further insights to this concept are required for the development of a model, which can be used to improve midwifery practice and maternal and neonatal health.
Understanding the Role of the Brick-and-Mortar Classroom in Course Design and Implementation of the “Flipped” Classroom: An Exploratory Case Study
Authors: Counselman Carpenter Elisabeth , Redcay Alex 
Published: October 2019

This article shares the results of a two-year exploratory case study on the impact of flipped classroom design on generalist and advanced practice social work skills in a large urban graduate university setting. The flipped classroom was chosen due to its’ emphasis on physical space as an active learning, skills-oriented, activity-based environment, rather than traditional lecture-based learning. This two-year study gathered quantitative data on the flipped classroom format, which featured weekly lectures recorded and posted through the Canvas learning platform, with information outcome and learning retention quizzes also taken in Canvas, followed by in-class live experiential lab sessions in which students were paired up or placed into small groups to develop and strengthen their clinical skills. Students then completed reflection journals following these activities, which were compared to Educational Policy and Accreditation Standards to further assess for additional data and learning outcomes.
This article will present the findings of the study, which revealed statistical significance in overall general practice skills scores and in specific advanced practice clinical skills. Additionally, the article will discuss student-generated feedback on the physical learning environment, instructor workload demands, and required preparatory work. Further discussion will include expected and unexpected limitations of the space, expansion of the classroom through digital platforms, inclusion of differently-abled students in the flipped laboratory space, as well as recommendations for future research and iterations of the course. This study is the first to use the Play Therapy Attitude Knowledge Skills Survey (PTAKSS) and Practice Skills Inventory (PSI) to measure the outcome of play therapy classes for MSW students and to specifically measure the effectiveness of the flipped classroom model to teach play therapy skills. This study shows promising outcomes for the use of the flipped model as a way of delivering practice content to students and explores the role and specific impact that weekly sessions in the physical learning environment had on student outcomes.
Validation of a rapid, comprehensive and clinically relevant amino acid profile by underivatised liquid chromatography tandem mass spectrometry
Authors: Carling Rachel S. , John Kate , Churchus Richard , Turner Charles , Dalton R. Neil 
Published: October 2019

Abstract

Background
Quantification of plasma amino acids is key to the diagnosis of inherited defects of amino acid synthesis, catabolism and transport, many of which present as clinical emergencies. The utility of this test is limited by the long analysis time and subsequent inability of laboratories to provide results in real-time. Traditionally, analysis has been performed by ion exchange chromatography (IEC) but recently there has been a move towards liquid chromatography tandem mass spectrometry (LC-MS/MS) which provides the potential for faster analysis. However, the necessity to derivatise the sample and/or utilise an ion-pair reagent, combined with lack of commercially available stable isotope internal standards (IS) has prevented laboratories fully exploiting the benefits of this methodology. We describe an underivatised LC-MS/MS method enabling patient results to be reported with an improved turnaround time (<1 h).

Methods
Methanolic IS was added to plasma (10 μL) to precipitate protein. Following centrifugation amino acids were analysed by LC-MS/MS using selected reaction monitoring (SRM) for each analyte and corresponding IS.

Results
Patient samples (n = 57) and external quality assessment (EQA) material (n = 11) were analysed and results compared with IEC. Comparable accuracy and precision were obtained with 15-min analysis time.

Conclusions
This method enables the analysis of a clinically comprehensive amino acid profile without the need for derivatisation/ion-pair reagents and benefitting from improved analytical quantitation through multipoint calibration and use of stable isotope IS. The analysis time is fast in comparison to IEC, improves efficiency of laboratory workflow and enables stat analysis of clinically urgent samples.