bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Rise of Diasporas as Adversarial Non-State Actors in Public Diplomacy: The Turkish Case
Authors: Uysal Nur 
Published: July 2019

Summary
The profound changes in communication technology and dramatic increase in global migration have challenged the conventional dyadic conceptualization of ‘domestic’ and ‘foreign’ publics and increased the importance of diaspora publics. Using the four-quadrant model of public diplomacy and cascading activation model of framing, this article analyses the complex role of diasporas in the public diplomacy equation. To illustrate a public-centred and public-based public diplomacy initiative from a non-Western perspective, the article focuses on a Turkish diaspora organization’s attempts to control communication in the aftermath of the 2016 failed coup attempt in Turkey. The analysis reveals how partner publics became adversarial diaspora and transformed into a non-state actor challenging the Turkish state’s legitimacy in the international arena. This case study sheds light on the dynamic transformations of non-Western publics from domestic partners into adversarial diasporas and it questions the dominant Western conceptions of static state-centred, state-initiated public diplomacy.
Impact and cost of the peer-led Students As LifeStyle Activists programme in high schools
Authors: Shrewsbury Vanessa A , Venchiarutti Rebecca L , Hardy Louise L , Foley Bridget C , Bonnefin Amy , Byth Karen , Hayes Alison J , Flood Victoria M , Steinbeck Katharine S , Baur Louise A , Shah Smita 
Published: July 2019

Objective: To determine the impact of a peer-led, school-based programme (Students As LifeStyle Activists; SALSA) on energy balance–related behaviours (EBRBs) in Grade 8 students, and the cost of implementing the programme. Design: Pre–post test Setting: High schools in New South Wales, Australia. Methods: Grade 10 students (15- to 16-year-olds) were trained by university students to deliver four lessons on healthy eating and physical activity to Grade 8 students (13- to 14-year-olds). Students completed an online questionnaire pre–post lessons on EBRBs and intentions to change EBRBs over the next month. Items included fruit, vegetable and sugar-sweetened beverage (SSB) intake, frequency of eating breakfast, participation in moderate-to-vigorous physical activity (MVPA) and school-day recreational screen-time. Pre–post changes were analysed using generalised estimating equations, adjusted for clustering. Standard methods were used to estimate implementation costs. Results: In total, 2,056 Grade 8 students from 23 high schools participated. Significant changes included 5.2% increase in eating >2 fruit serves/day ( p < .001), 2.5% increase in eating >4 vegetable serves/day ( p < .05), a 4.3% increase in drinking <1 cup/day of SSB ( p < .001) but limiting screen-time <2 hours/day decreased by 4.4% ( p < .001). There were significant improvements in students’ intentions to change EBRBs over the next month, with the exception of MVPA. The average actual cost of implementing the SALSA programme in 2014–2015 was AU$1,388 (US$958) per school and AU$9.97 (US$6.88) per student. Conclusion: The SALSA peer education programme had a positive impact on most of the dietary EBRBs examined. The cost evaluation showed that it is a relatively low-cost programme to implement.
Human papillomavirus and health decision-making: Perceptions and accountability in college
Authors: DeLauer Verna , McGill-O’Rourke Andrea , Gordon Carissa , Hamilton Natalie , Desruisseaux Ryan , DuarteCanela Marlene , Heyer Alicia , Macksoud Kathryn 
Published: July 2019

Objective: To identify knowledge and beliefs about the human papillomavirus (HPV) among students in a residential academic institution, including perceptions of safety of the HPV vaccine, perceptions of cancer correlation with HPV, and independence/interdependence in health decision-making. Design: A qualitative study was used. Setting: Participants were recruited from a small private US university. Methods: In-depth, semi-structured interviews. Results: Study findings highlight the need for improved communication about sex and general preventive health care between young adults, their parents and health providers, including the campus health services centre. Findings point to the importance of appropriate health care messaging at the time of the HPV vaccine (if given in adolescence) throughout college. While mothers played a crucial part in helping young adults make sense of health and health care decisions, self-reliance and self-protection were strong drivers of decision-making. Conclusion: As college students progress from dependent child to independent adult, they shift from reliance on others, especially mothers, for health guidance to an emerging self-reliance and self-protective stance. Central to this experience is navigating health decisions by using information from one’s childhood and integrating new knowledge as one emerges into adulthood. College health care providers and related disciplinary faculty have the opportunity to support students during this transition.
Dietary Adequacy Among Young Children in India: Improvement or Stagnation? An Investigation From the National Family Health Survey
Authors: Khan Nizamuddin , Mozumdar Arupendra , Kaur Supreet 
Published: July 2019

Background: This study assessed the trend of minimum acceptable dietary practices among children aged 6 to 23 months in India in the past decade. Methods: Data collected in the National Family Health Survey during 2005 to 2006 (NFHS-3) and 2015 to 2016 (NFHS-4) were used. The sample size for this study was 11 727 children for NFHS-3 and 61 158 children for NFHS-4. Bivariate and multivariate analyses were done to identify the predictors of feeding practices. We analyzed data of last-born singleton children aged 6 to 23 months who were living with their mother (ever-married women aged 15-49 years). Results: In India, a low proportion (10%) of children aged 6 to 23 months received a minimum acceptable diet, and its estimate remained the same in the past 10 years. Older mothers, educated mothers, antenatal care, high economic status, and place of residence were the most consistent predictors of minimum acceptable dietary intake. Over the past decade, however, the minimum acceptable dietary intake has declined among older children (odds ratio [OR] = 0.57, 95% confidence interval [CI], 0.47-0.70; P < .001), children with overweight mothers (OR = 0.40, 95% CI, 0.31-0·50; P <.001), and children of well-off families (OR = 0.29, 95% CI, 0.23-0.37; P < .001). The odds for minimum acceptable dietary intake were significantly higher among children of high (4+) birth order (OR = 1.74, 95% CI, 1.41-2.15; P < .001), rural areas, and children living in the central, eastern, and north-eastern region. Conclusion: Results indicate the need for further investigations of poor dietary intake among children living in well-off families and in the northern region. This study suggests policymakers and program managers to address contextual barriers against minimum acceptable dietary intake among children and to reconsider existing strategies in India.
Evaluation of thiamine for the prevention of ifosfamide-induced encephalopathy
Authors: Lentz Katie L , Clark Stephen M , Ayarza Melanie , Liu Beiyu , Morgan Katherine P , Wind Lucas S , Hairston Alicia 
Published: July 2019

Study objective To determine whether thiamine prophylaxis decreases the incidence of ifosfamide-induced encephalopathy in patients receiving ifosfamide for the treatment of lymphoma. Design Retrospective, multi-center, cohort study. Patients A total of 73 patients who received 187 total cycles of ifosfamide, carboplatin, and etoposide chemotherapy for the treatment of lymphoma were included in this study. Forty-four of these patients (114 cycles) were included in the no-thiamine group and 29 (65 cycles) in the thiamine group. Measurements and main results The incidence of ifosfamide-induced encephalopathy was measured using the Common Terminology Criteria for Adverse Events and documentation in the patient chart. Regarding the primary endpoint of ifosfamide-induced encephalopathy, eight patients (18.2%) in the no-thiamine group and three patients (10.3%) in the thiamine group experienced an event ( p = 0.5087). No patient experienced more than one neurotoxic event. Conclusion There was no significant difference found in the incidence of ifosfamide-induced encephalopathy with the addition of thiamine prophylaxis in patients receiving ifosfamide, carboplatin, and etoposide–based chemotherapy regimens for lymphoma. Larger, prospective studies assessing the use of thiamine prophylaxis in this patient population are warranted to better assess its impact on the incidence of ifosfamide-induced encephalopathy.
Immediate Benefit of Art on Pain and Well-Being in Community-Dwelling Patients with Mild Alzheimer's
Authors: Pongan Elodie , Delphin-Combe Floriane , Krolak-Salmon Pierre , Leveque Yohana , Tillmann Barbara , Bachelet Romain , Getenet Jean-Claude , Auguste Nicolas , Trombert Béatrice , Dorey Jean-Michel , Laurent Bernard , Rouch Isabelle 
Published: July 2019

Objective: The present report aims to evaluate whether singing intervention can bring an immediate benefit that is greater than the one provided by painting intervention on pain and well-being. Methods: Fifty-nine mild patients with Alzheimer disease were randomized to a 12-week singing (n = 31) or painting group (n = 28). In the present analysis, the immediate evolution of pain and well-being was compared across sessions between the 2 groups using mixed-effects models. Results: We observed a significant improvement in well-being for both singing and painting groups immediately after sessions, compared to the assessment before the sessions. We did not observe this improvement across the sessions for pain intensity measurement. Discussion: Our results revealed that both painting and singing interventions provide an immediate benefit on the patients’ well-being.
In Silico Examination of Initiation of Long-Acting Insulin Analogs Toujeo Compared to Lantus Under 3 Dosing Titration Rules in Virtual Type 2 Diabetes Subjects
Authors: Sieber Jochen , Weinheimer Mark , Kongable Gail , Riddle Susan , Chang Yung-Yeh , Flacke Frank 
Published: July 2019

Background: Despite the benefits and clinical necessity of insulin treatment in type 2 diabetes (T2D), healthcare providers are reluctant to initiate insulin, and patients are reluctant to start it for several reasons, one of these being the complexity of insulin treatment. Patients and their healthcare providers can benefit from titration algorithms (TAs) or rules that assist with the initiation and titration of insulin, performing the calculations that are needed to safely initiate and conservatively adjust. Methods: The primary objective for this in silico study was to examine the effectiveness of 3 dose TAs (1-3) for optimization of basal insulin glargine (Gla-100 and Gla-300). In the simulations, 100 virtual subjects with T2D were included (50% men, age 62 ± 3 years, HbA1c 8.1% ± 2.9%, body weight 94 ± 16 kg). Subjects were studied under each TA (TA1 and TA2 fasting blood glucose [FBG] targets 90-130 mg/dL, TA3 FBG target 110-150 mg/dL). Initial dose of both insulins was based on 0.2 U/kg body weight. During 3 months, subjects reported their FBG to the LTHome web-based dose guidance system with a rules engine to safely guide long-acting insulin titration and maintenance. Subjects followed dose recommendations to reach designated FBG target ranges. Results: All subjects reached stable doses under all TAs with both Gla-100 and Gla-300 insulin, and 93 or more of the 100 subjects, depending on the assigned TA, achieved the target FBG range within the 3-month simulation for all TAs. Mean FBG was lowered (Gla-100: 155 ± 40 to 118 ± 11 mg/dL with TA1 and TA2 and 132 ± 12 mg/dL for TA3; Gla-300: 125 ± 14 with TA1 and TA2 and 134 ± 15 mg/dL with TA3). Calculated HbA1c improved from 8.1% ± 2.9% to 7.1% ± 2.5% for TA1 and TA2 and 7.5% ± 2.5% for TA3, a reduction of 0.9% and 0.6% over 3 months for both insulins. Three subjects on Gla-100 and one subject on Gla-300 experienced mild hypoglycemia. Conclusion: All TAs delivered safe dose recommendations with minimal hypoglycemia, leading to a stable glucose control in the majority of subjects.
Associations of blood pressure categories defined by 2017 ACC/AHA guidelines with mortality in China: Pooled results from three prospective cohorts
Authors: Liu Na , Yang Jae Jeong , Meng Ruiwei , Pan Xiong-Fei , Zhang Xiaomin , He Meian , Li Honglan , Gao Yu-Tang , Xiang Yong-Bing , Shu Xiao-Ou , Zheng Wei , Wu Tangchun , Yu Danxia , Pan An 
Published: July 2019

Background The recent American College of Cardiology/American Heart Association guidelines for high blood pressure lowered the hypertension criteria from systolic/diastolic blood pressure (SBP/DBP) of 140/90 mmHg or greater to 130/80 mmHg or greater, while the potential impact of the change on Chinese adults remains unclear. Design A pooled prospective cohort analysis. Methods Included were 154,407 Chinese adults from three prospective cohorts, which measured blood pressure at baseline and follow-up visits, and tracked death events by linkages to medical insurance system or vital statistics registries. Cox regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Results During a total follow-up of 1,718,089 person-years, 14,692 deaths were documented including 5086 cardiovascular deaths (1277 ischaemic heart disease and 2509 cerebrovascular disease deaths). Compared to normal blood pressure (SBP/DBP < 120/80 mmHg), newly defined stage 1 hypertension (SBP/DBP 130–139/80–89 mmHg) was associated with increased cardiovascular mortality (HR 1.40, 95% CI 1.16–1.69; HR 1.36, 95% CI 1.12–1.65 for ischaemic heart disease mortality; HR 1.53, 95% CI 1.18–2.00 for cerebrovascular mortality), but not with all-cause mortality (HR 1.04, 95% CI 0.89–1.21). Stage 2 hypertension (SBP/DBP ≥ 140/90 mmHg) showed significant associations with cardiovascular disease and all-cause mortality, while elevated blood pressure (SBP 120–129 mmHg and DBP < 80 mmHg) showed null associations. The associations were stronger in adults younger than 65 years and adults without pre-existing cardiovascular disease compared with their counterparts ( P for heterogeneity < 0.05). Conclusions The newly defined stage 1 hypertension is associated with an increased risk of cardiovascular disease mortality in the Chinese population, particularly among younger adults and those without a history of cardiovascular disease.
Dual-action CXCR4-targeting liposomes in leukemia: function blocking and drug delivery
Authors: McCallion Catriona , Peters Anna D. , Booth Andrew , Rees-Unwin Karen , Adams Julie , Rahi Raisa , Pluen Alain , Hutchinson Claire V. , Webb Simon J. , Burthem John 
Published: July 2019

Abstract
CXC chemokine receptor 4 (CXCR4) is overexpressed by a broad range of hematological disorders, and its interaction with CXC chemokine ligand 12 (CXCL12) is of central importance in the retention and chemoprotection of neoplastic cells in the bone marrow and lymphoid organs. In this article, we describe the biological evaluation of a new CXCR4-targeting and -antagonizing molecule (BAT1) that we designed and show that, when incorporated into a liposomal drug delivery system, it can be used to deliver cancer therapeutics at high levels to chronic lymphocytic leukemia (CLL) cells. CXCR4 targeting and antagonism by BAT1 were demonstrated alone and following its incorporation into liposomes (BAT1-liposomes). Antagonism of BAT1 against the CXCR4/CXCL12 interaction was demonstrated through signaling inhibition and function blocking: BAT1 reduced ERK phosphorylation and cell migration to levels equivalent to those seen in the absence of CXCL12 stimulation (P &lt; .001). Specific uptake of BAT1-liposomes and delivery of a therapeutic cargo to the cell nucleus was seen within 3 hours of incubation and induced significantly more CLL cell death after 24 hours than control liposomes (P = .004). The BAT1 drug-delivery system is modular, versatile, and highly clinically relevant, incorporating elements of proven clinical efficacy. The combined capabilities to block CXCL12-induced migration and intracellular signaling while simultaneously delivering therapeutic cargo mean that the BAT1-liposome drug-delivery system could be a timely and relevant treatment of a range of hematological disorders, particularly because the therapeutic cargo can be tailored to the disease being treated.
Shearing overbite and asymmetrical jaw motions facilitate food breakdown in a freshwater stingray, Potamotrygon motoro
Authors: Laurence-Chasen J. D. , Ramsay Jason B. , Brainerd Elizabeth L. 
Published: July 2019

ABSTRACT
Many species of fish process their prey with cyclic jaw motions that grossly resemble those seen in mammalian mastication, despite starkly different tooth and jaw morphologies. The degree of similarity between the processing behaviors of these disparate taxa has implications for our understanding of convergence in vertebrate feeding systems. Here, we used XROMM (X-ray reconstruction of moving morphology) to investigate prey processing behavior of Potamotrygon motoro, the ocellate river stingray, which has recently been found to employ asymmetrical, shearing jaw motions to break down its prey. We found that P. motoro modulates its feeding kinematics to produce two distinct types of chew cycles: compressive cycles and overbite cycles. The latter are characterized by over-rotation of the upper jaw relative to the lower jaw, past the expected occlusal limit, and higher levels of bilateral asymmetry as compared with compressive chews. We did not find evidence of the mediolateral shearing motions typical of mammalian mastication, but overbite cycles appear to shear the prey item between the upper and lower toothplates in a propalinal fashion. Additionally, comparison of hyomandibular and jaw motions demonstrates that the angular cartilages decouple jaw displacement from hyomandibular displacement in rostrocaudal and mediolateral directions. The multiple similarities between mammalian mastication and the dynamic processing behavior of P. motoro support the use of sub-family Potamotrygoninae as a model for studying evolutionary convergence of mastication-like processing.
Prevalence of extensive drug resistance in bacterial isolates harboring blaNDM-1 in Quetta Pakistan
Authors: Ahmed Nazeer , Din Mohammad , Babar Khan Muhammad , Ahmed Shabir , Aleem Abdul , Shah Dawood , Ghilzai Daud 
Published: July 2019

Objective: Extensive drug resistant Gram-negative bacilli, harboring New Delhi metallo-β-lactamase-1 (blaNDM-1) having the ability to hydrolyze β-lactams, have become a vital global clinical threat. The present study was, therefore, designed to investigate the prevalence and epidemiology of NDM-1 producers in Quetta, Pakistan.
Methods: This study was carried out in Microbiology Laboratory, Bolan Medical Complex Hospital Quetta, Biotechnology laboratory, BUITEMS Quetta and Hi-tech laboratory, CASVAB, University of Balochistan, Quetta, from March to June 2018, during the hot season. Biochemical and molecular approaches were applied for the identification of bacterial isolates. Minimum Inhibitory Concentrations (MICs) were determined using E-test method. Carbapenemase activity was ascertained by Modified Hodge Test (MHT) and the presence of blaNDM-1 gene was recognized by Polymerase Chain Reaction (PCR).
Results: We isolated five blaNDM-1 harboring isolates of three different species namely Morganella morganii (n=2) Enterobacter cloacae (n=2) and Citrobacter freundii (n=1), from 300 pus samples. These isolates were found extensive drug resistant (XDR). Strikingly, two isolates of M. morganii were displaying resistance against 23 antibiotics of sulphonamides, aminoglycosides, polypeptide, monobactams, tetracyclines, quinolones, macrolides, cephalosporins, phosphonic acid and β-lactams groups, suggesting Pan Drug Resistance (PDR).
Conclusion: This is the first report on emergence of PDR strain of M. morganii producing NDM1 in the province of Balochistan, Pakistan. The presence of blaNDM-1 in different bacterial species and their extensive rather pan drug resistance pattern poses a momentous clinical threat.
doi: https://doi.org/10.12669/pjms.35.4.372
How to cite this:Din M, Babar KM, Ahmed S, Aleem A, Shah D, Ghilzai D, et al. Prevalence of extensive drug resistance in bacterial isolates harboring blaNDM-1 in Quetta Pakistan. Pak J Med Sci. 2019;35(4):1155-1160. doi: https://doi.org/10.12669/pjms.35.4.372
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The quality of public sources of drinking water in oil-bearing communities in the Niger Delta region of Nigeria
Authors: Maduka Omosivie , Ephraim-Emmanuel Benson 
Published: July 2019

Background: Studies carried out in the Niger Delta region of Nigeria have demonstrated a link between oil exploration and poor-quality drinking water. However, many of these studies have been limited by small coverage and focus on few parameters. This study thus aimed at a comprehensive assessment of the quality of public sources of drinking water in three gas flaring and three non-gas flaring communities in the Niger Delta region of Nigeria. Methods: A total of 13 samples were collected from the major sources of drinking water in six communities in Rivers, Bayelsa and Delta States, Nigeria. These were stored and transported in line with International standards to a certified environmental laboratory where physical, chemical, bacteriological and petro-chemical assessments were conducted for 27 parameters. Results: Some samples had a pH below the normal range for drinking water, with median pH value of 4.63. All chemical parameters assessed fell below the normal acceptable range with exception of magnesium which exceeded the acceptable range. There were11 samples (91.7%) with microbial contamination; total and faecal coliform demonstrated at values ranging between 15 and 90 most probably number (MPN)/100 ml for total coliform and 9 to 23 MPN/100 ml for faecal coliforms. Oil, grease and total petroleum hydrocarbons (TPH) were identified in water samples from all communities. Values for oil and grease ranged between <0.001 and 0.015 mg/l, while TPH values were between <0.001 and 0.046 mg/l. There was no significant difference between median values in gas flaring and non-gas flaring communities. Conclusion: Distortion of physico-chemical properties, and hydrocarbon and faecal contamination of drinking water are a major challenge in oil-bearing communities in the Niger Delta region of Nigeria irrespective of gas flaring status. This calls for urgent interventions to improve the quality of drinking water for the people of the Niger Delta.