bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, causes, and experience of inter-professional conflict and rivalry among healthcare professionals in Nigeria
Authors: Mohammed Elijah N. A.
Published: March 2022

Introduction

The healthcare workforce is regarded as an essential component of any functioning health system, and a lack of optimal collaboration among this group can result to poor quality healthcare services to the population. In Nigerian setting, the health sector is faced with challenges of inter-professional conflict and rivalry. This study aimed at understanding knowledge, causes, and experience of inter-professional conflict and rivalry among healthcare professionals in Nigeria.

Methods

A cross sectional study was undertaken to administer questionnaires to healthcare personnel in various healthcare facilities in Nigeria. Data were analysed using Statistical Package for Social Sciences.

Results

A total of 2207 valid responses were received, and male participants were in majority as indicated by 63.7% of the sample. Collectively, doctors and pharmacists represented two-thirds of the sample, and majority of the participants were in the public sector (82.5%). Disparity in salary structure was the highest source of conflict. Whilst almost all the participants indicated that inter-professional rivalry and conflict are prevalent in health sector, about three-quarters of them (73.2%) disagreed that this practice is productive. A considerable number of the respondents had experienced inter-professional conflict and rivalry.

Conclusion

Evidence from this study can help policymakers in developing framework that can be utilised in addressing rivalry and conflict in the healthcare sector.
Leveraging Mann–Whitney U test on large-scale genetic variation data for analysing malaria genetic markers
Authors: Tai Kah Yee , Dhaliwal Jasbir , Balasubramaniam Vinod
Published: March 2022

Background

The malaria risk analysis of multiple populations is crucial and of great importance whilst compressing limitations. However, the exponential growth in diversity and accumulation of genetic variation data obtained from malaria-infected patients through Genome-Wide Association Studies opens up unprecedented opportunities to explore the significant differences between genetic markers (risk factors), particularly in the resistance or susceptibility of populations to malaria risk. Thus, this study proposes using statistical tests to analyse large-scale genetic variation data, comprising 20,854 samples from 11 populations within three continents: Africa, Oceania, and Asia.

Methods

Even though statistical tests have been utilized to conduct case–control studies since the 1950s to link risk factors to a particular disease, several challenges faced, including the choice of data (ordinal vs. non-ordinal) and test (parametric vs. non-parametric). This study overcomes these challenges by adopting the Mann–Whitney U test to analyse large-scale genetic variation data; to explore the statistical significance of markers between populations; and to further identify the highly differentiated markers.

Results

The findings of this study revealed a significant difference in the genetic markers between populations (p < 0.01) in all the case groups and most control groups. However, for the highly differentiated genetic markers, a significant difference (p < 0.01) was present for most genetic markers with varying p-values between the populations in the case and control groups. Moreover, several genetic markers were observed to have very significant differences (p < 0.001) across all populations, while others exist between certain specific populations. Also, several genetic markers have no significant differences between populations.

Conclusions

These findings further support that the genetic markers contribute differently between populations towards malaria resistance or susceptibility, thus showing differences in the likelihood of malaria infection. In addition, this study demonstrated the robustness of the Mann–Whitney U test in analysing genetic markers in large-scale genetic variation data, thereby indicating an alternative method to explore genetic markers in other complex diseases. The findings hold great promise for genetic markers analysis, and the pipeline emphasized in this study can fully be reproduced to analyse new data.
Diagnosis of malaria in pregnancy: accuracy of CareStart™ malaria Pf/PAN against light microscopy among symptomatic pregnant women at the Central Hospital in Yaoundé, Cameroon
Authors: Ebong Cliford Ebontane , Ali Innocent Mbulli , Fouedjio Hortence Jeanne , Essangui Estelle , Achu Dorothy Fosah , Lawrence Ayong , Sama Dohbit
Published: March 2022

Background

The need to start treatment early for pregnant women who present with clinical features of malaria usually conflicts with the need to confirm diagnosis by microscopy (MP) before treatment, due to delays in obtaining results. Parasite sequestration in the placenta is also a problem. Rapid diagnostic tests (RDT), which detect soluble antigens, are a valuable alternative. The objective of this study was to evaluate pretreatment parasite prevalence by microscopy and by RDT and to assess the accuracy of RDT with MP as reference.

Methods

A prospective cross-sectional study was carried out at the obstetrical unit of the Central Hospital in Yaoundé, during the period January-August 2015. Consenting patients with symptoms of suspected malaria in pregnancy were recruited and a blood sample taken for MP and RDT before treatment was started. The estimates of diagnostic performance (with 95% confidence interval) were calculated in OpenEpi online software using the Wilson’s score. The agreement, as reflected by the Cohen’s kappa, was calculated and interpreted using known intervals.

Results

The results showed that, out of the 104 patients recruited, 69.2% (95%CI: 59.1–77.5) were MP positive while 77.94% (95%CI: 63.1–80.9) were RDT positive. The sensitivity of the malaria RDT was 91.67% (95%CI: 83.69–96.77) while the specificity was 53.13% (95%CI: 31.39–65.57). The diagnostic accuracy of the RDT with MP as reference was 79.81% (95%CI: 70.0–86.1). All cases were due to Plasmodium falciparum. A Cohen’s kappa of 0.45 (95%CI: 0.26–0.64) was obtained, consistent with a moderate agreement between the tests.

Conclusions

The diagnostic accuracy of the CareStart™ malaria Pf/PAN compared to microscopy was high, but not as desirable, with a false negative RDT at very high parasitaemia. In tertiary facilities, RDTs appear to provide a better diagnostic solution compared to microscopy. However, future studies with larger sample sizes should make this observation more generalizable; as missing a case could have serious consequences on pregnancy outcome.
Low-level plasticizer exposure and all-cause and cardiovascular disease mortality in the general population
Authors: Zeng Guowei , Zhang Qi , Wang Xiaowei , Wu Kai-Hong
Published: March 2022

Background

Plasticizers, also called phthalates, are a group of chemicals widely used in daily life. A previous report showed no significant association between phthalate metabolite concentrations and mortality. We investigated the association of urinary phthalate levels and individual phthalate metabolite levels with all-cause and cardiovascular disease (CVD) mortality after standardizing the phthalate concentration.

Methods

A total of 6,625 participants were recruited from a nationally representative sample of adults aged 40 years or older who were enrolled in the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2014 and were followed up through December 31, 2015. Data were analyzed from January 2021 to June 2021. NHANES-linked updated National Death Index public access files were used to acquire information on mortality status and cause of death. The present study conducted extended follow-up of an earlier analysis. Cox proportional hazard models were performed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of covariate-adjusted creatinine standardization urinary phthalate concentrations with all-cause and CVD mortality after adjusting for demographics, lifestyle factors and comorbidity variables.

Results

The mean ± standard deviation age of all participants in the final study was 59.9±12.6 years old, and 49.6% of the participants were male. The median follow-up time was 73 months (range 1-157 months). At the censoring date of December 31, 2015, 3,023 participants were identified as deceased (13.4%). A fully adjusted Cox model showed that a urinary di(2-ethylhexyl) phthalate (DEHP) concentration >= 83.4 ng/mL was associated with a slight increase in all-cause mortality (HR 1.27, 95% CI 1.03, 1.57, P for trend= 0.014) and CVD mortality (HR 2.19, 95% CI 1.35, 3.54, P for trend= 0.002). Similarly, urinary mono-2-ethyl-5-carboxypentyl phthalate (MECPP) levels >= 39.2 ng/mL were associated with increased CVD mortality (HR 2.33, 95% CI 1.45, 3.73, P for trend < 0.001). Restricted cubic spline analyses suggested linear associations of DEHP and MECPP levels with all-cause and CVD mortality.

Conclusion

In this large nationally representative sample of American adults, high urinary DEHP and MECPP were significantly associated with all-cause and CVD mortality after adjusting for demographics, lifestyle factors and comorbidity variables.
Novel Ti3C2Tx MXene nanozyme with manageable catalytic activity and application to electrochemical biosensor
Authors: Yu Rongjun , Xue Jian , Wang Yang , Qiu Jingfu , Huang Xinyi , Chen Anyi , Xue Jianjiang
Published: March 2022

In this work, Ti3C2Tx MXene was identified as efficient nanozyme with area-dependent electrocatalytic activity in oxidation of phenolic compounds, which originated from the strong adsorption effect between the phenolic hydroxyl group and the oxygen atom on the surface of Ti3C2Tx MXene flake. On the basis of the novel electrocatalytic activity, Ti3C2Tx MXene was combined with alkaline phosphatase to construct a novel cascading catalytic amplification strategy using 1-naphthyl phosphate (1-NPP) as substrate, thereby realizing efficient electrochemical signal amplification. Taking advantage of the novel cascading catalytic amplification strategy, an electrochemical biosensor was fabricated for BCR/ABL fusion gene detection, which achieved excellent sensitivity with linear range from 0.2 fM to 20 nM and limit of detection down to 0.05 fM. This biosensor provided a promising tool for ultrasensitive fusion gene detection in early diagnosis of chronic myelogenous leukemia and acute lymphocytic leukemia. Moreover, the manageable catalytic activity of MXene broke a path for developing nanozymes, which possessed enormous application potential in not only electrochemical analysis but also the extensive fields including organic synthesis, pollutant disposal and so on.

Graphical Abstract
The ketone body β-hydroxybutyrate alleviates CoCrMo alloy particles induced osteolysis by regulating NLRP3 inflammasome and osteoclast differentiation
Authors: Wu Yanglin , Teng Yun , Zhang Chenhui , Pan Ying , Zhang Qin , Zhu Xu , Liu Naicheng , Su Xinlin , Lin Jun
Published: March 2022

Background

Aseptic Loosening (AL) following periprosthetic osteolysis is the main long-term complication after total joint arthroplasty (TJA). However, there is rare effective treatment except for revision surgery, which is costly and painful to the patients. In recent years, the ketone body β-hydroxybutyrate (BHB) has attracted much attention and has been proved to be beneficial in many chronic diseases. With respect to the studies on the ketone body β-hydroxybutyrate (BHB), its anti-inflammatory ability has been widely investigated. Although the ketone body β-hydroxybutyrate has been applied in many inflammatory diseases and has achieved considerable therapeutic efficacy, its effect on wear particles induced osteolysis is still unknown.

Results

In this work, we confirmed that the anti-inflammatory action of β-hydroxybutyrate (BHB) could be reappeared in CoCrMo alloy particles induced osteolysis. Mechanistically, the ketone body β-hydroxybutyrate (BHB) deactivated the activation of NLRP3 inflammasome triggered by CoCrMo alloy particles. Of note, this inhibitory action was independent of Gpr109a receptor as well as histone deacetylase (HDAC) suppression. Furthermore, given that butyrate, one kind of short chain fatty acid (SCFA) structurally related to β-hydroxybutyrate (BHB), has been reported to be an inhibitor of osteoclast, thus we also investigate the effect of β-hydroxybutyrate (BHB) on osteoclast, which was contributed to bone resorption. It was found that β-hydroxybutyrate (BHB) did not only affect osteoclast differentiation, but also inhibit its function. Unlike the inflammasome, the effect of β-hydroxybutyrate (BHB) on osteoclast may mainly rely on histone deacetylase (HDAC) suppression.

Conclusions

In general, our study showed that the alleviation of osteolysis may owe to the effect of β-hydroxybutyrate (BHB) on inflammasome deactivation and osteoclast.

Graphical Abstract
Cur@SF NPs alleviate Friedreich’s ataxia in a mouse model through synergistic iron chelation and antioxidation
Authors: Xu Li , Sun Zichen , Xing Zhiyao , Liu Yutong , Zhao Hongting , Tang Zhongmin , Luo Yu , Hao Shuangying , Li Kuanyu
Published: March 2022

Abnormal iron metabolism, mitochondrial dysfunction and the derived oxidative damage are the main pathogeneses of Friedrich's ataxia (FRDA), a single-gene inherited recessive neurodegenerative disease characterized by progressive cerebellar and sensory ataxia. This disease is caused by frataxin (FXN) mutation, which reduces FXN expression and impairs iron sulfur cluster biogenesis. To date, there is no effective therapy to treat this condition. Curcumin is proposed harboring excellent ability to resist oxidative stress through Nrf2 activation and its newly found ability to chelate iron. However, its limitation is its poor water solubility and permeability. Here, we synthesized slow-release nanoparticles (NPs) by loading curcumin (Cur) into silk fibroin (SF) to form NPs with an average size of 150 nm (Cur@SF NPs), which exhibited satisfactory therapeutic effects on the improvement of FRDA manifestation in lymphoblasts (1 μM) derived from FRDA patients and in YG8R mice (150 mg/kg/5 days). Cur@SF NPs not only removed iron from the heart and diminished oxidative stress in general but also potentiate iron-sulfur cluster biogenesis, which compensates FXN deficiency to improve the morphology and function of mitochondria. Cur@SF NPs showed a significant advantage in neuron and myocardial function, thereby improving FRDA mouse behavior scores. These data encourage us to propose that Cur@SF NPs are a promising therapeutic compound in the application of FRDA disease.

Graphical Abstract
Tailoring conductive inverse opal films with anisotropic elliptical porous patterns for nerve cell orientation
Authors: Zhang Zeyou , Wang Yu , Chen Zhuoyue , Xu Dongyu , Zhang Dagan , Wang Fengyuan , Zhao Yuanjin
Published: March 2022

Background

The nervous system is critical to the operation of various organs and systems, while novel methods with designable neural induction remain to exploit.

Results

Here, we present a conductive inverse opal film with anisotropic elliptical porous patterns for nerve orientation induction. The films are fabricated based on polystyrene (PS) inverse opal scaffolds with periodical elliptical porous structure and poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) mixed polyacrylamide (PAAm) polymers fillers. It is demonstrated that the anisotropic elliptical surface topography allows the nerve cells to be induced into orientation connected with the stretching direction. Because of the anisotropic features of the film which can be stretched into different directions, nerve cells can be induced to grow in one or two directions, forming a neural network and promoting the connection of nerve cells. It is worth mentioning that the PEDOT:PSS-doped PAAm hydrogels endow the film with conductive properties, which makes the composite films be a suitable candidate for neurites growth and differentiation.

Conclusions

All these features of the conductive and anisotropic inverse opal films imply their great prospects in biomedical applications.

Graphical Abstract
Prevalence of stress and depression and associated factors among women seeking a first-trimester induced abortion in China: a cross-sectional study
Authors: Zhang Qiuxiang , Wang Na , Hu Yinchu , Creedy Debra K.
Published: March 2022

Objectives

To determine the prevalence of stress and depression and associated factors among women seeking a first-trimester induced abortion in China.

Methods

A cross-sectional study was conducted in a tertiary hospital in Beijing, from April 1st to Oct 31st, 2021. Women seeking termination of an intrauterine first-trimester pregnancy were invited to participate and complete a digital self-administered questionnaire. The survey included socio-demographic and health questions, Perceived Stress Scale-10 (PSS-10), and Patient Health Questionnaire-9 (PHQ-9). Descriptive analyses and binary logistic regression analyses were performed using SPSS 23.0.

Results

A total of 253 women participated. Prevalence of high perceived stress (cut-off ≥ 20) and depressive symptoms (cut-off ≥ 10) was 25.3% and 22.5%, respectively. Women were more likely to suffer high stress if they reported low resilience (aOR = 16.84, 95% CI 5.18–54.79), were not-using contraceptives (aOR = 3.27, 95% CI 1.39–6.29), had low social support (aOR = 2.95, 95% CI 1.39–6.29), were non-local residents (aOR = 2.51, 95% CI 1.15–5.92), were dissatisfied with their intimate relationship (aOR = 2.44, 95% CI 1.15–5.16), or held pro-life attitudes towards abortion (aOR = 1.04, 95% CI 1.18–3.53). Odds of experiencing depression were higher among women who also reported high perceived stress (aOR = 19.00, 95% CI 7.67–47.09), had completed higher education (aOR = 12.28, 95% CI 1.24–121.20), and were non-local residents (aOR = 3.38, 95% CI 1.37–8.32).

Conclusions

The magnitude of perceived stress and depression was high among Chinese women seeking a first-trimester induced abortion. It is necessary to comprehensively evaluate the mental health of women seeking an abortion, especially those with high risk. Interventions to mitigate relevant associated factors could improve the psychological wellbeing of women.
The active knee extension after extensor mechanism reconstruction using allograft is not influenced by “early mobilization”: a systematic review and meta-analysis
Authors: De Franco Cristiano , de Matteo Vincenzo , Lenzi Marco , Marano Ernesto , Festa Enrico , Bernasconi Alessio , Smeraglia Francesco , Balato Giovanni
Published: March 2022

Background

Postoperative rehabilitation after extensor mechanism reconstruction (EMR) with allograft following total knee arthroplasty (TKA) is not standardized. This meta-analysis aimed to evaluate the effectiveness of early and late knee mobilization after EMR. The range of motion (ROM) and extensor lag in both groups were also assessed as the secondary endpoint.

Methods

Following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, a systematic review of the literature was performed, including studies dealing with the use of allograft for EMR following TKA. Failure was defined as the persistence of extensor lag > 20°. Coleman Methodology Score and Methodological Index for Non-Randomized Studies (MINORS) score were used to assess the quality of studies included. The failure rate was set as the primary outcome in early (4 weeks) and late (8 weeks) mobilization groups after EMR with allograft. Secondary outcomes were postoperative extensor lag and ROM.

Results

Twelve articles (129 knees) were finally selected for this meta-analysis. Late and early knee mobilization was described in five and seven studies, respectively. No difference was noted between both groups' failure rates (11/84 vs. 4/38, respectively; p = 0.69). The mean extensor lag at last follow-up was 9.1° ± 8.6 in the early mobilization group, and 6.5° ± 6.1 in the late mobilization group is not significantly different (p > 0.05). The mean postoperative knee flexion was 107.6° ± 6.5 and 104.8° ± 7 in the early and late mobilization group, respectively.

Conclusion

While immobilization after EMR in TKA is mandatory to allow tissue healing, early knee mobilization after four weeks can be recommended with no additional risk of failure and increased extensor lag compared to a late mobilization protocol.

Level of evidence

IV, therapeutic study.

Registration

PROSPERO (International Prospective Register of Systematic Reviews): CRD42019141574.
Advising and limiting medical treatment during phone consultation: a prospective multicentre study in HEMS settings
Authors: Kangasniemi Heidi , Setälä Piritta , Huhtala Heini , Olkinuora Anna , Kämäräinen Antti , Virkkunen Ilkka , Tirkkonen Joonas , Yli-Hankala Arvi , Jämsen Esa , Hoppu Sanna
Published: March 2022

Background

We investigated paramedic-initiated consultation calls and advice given via telephone by Helicopter Emergency Medical Service (HEMS) physicians focusing on limitations of medical treatment (LOMT).

Methods

A prospective multicentre study was conducted on four physician-staffed HEMS bases in Finland during a 6-month period.

Results

Of all 6115 (mean 8.4/base/day) paramedic-initiated consultation calls, 478 (7.8%) consultation calls involving LOMTs were included: 268 (4.4%) cases with a pre-existing LOMT, 165 (2.7%) cases where the HEMS physician issued a new LOMT and 45 (0.7%) cases where the patient already had an LOMT and the physician further issued another LOMT. The most common new limitation was a do-not-attempt cardiopulmonary resuscitation (DNACPR) order (n = 122/210, 58%) and/or ‘not eligible for intensive care’ (n = 96/210, 46%). In 49 (23%) calls involving a new LOMT, termination of an initiated resuscitation attempt was the only newly issued LOMT. The most frequent reasons for issuing an LOMT during consultations were futility of the overall situation (71%), poor baseline functional status (56%), multiple/severe comorbidities (56%) and old age (49%). In the majority of cases (65%) in which the HEMS physician issued a new LOMT for a patient without any pre-existing LOMT, the physician felt that the patient should have already had an LOMT. The patient was in a health care facility or a nursing home in half (49%) of the calls that involved issuing a new LOMT. Access to medical records was reported in 29% of the calls in which a new LOMT was issued by an HEMS physician.

Conclusion

Consultation calls with HEMS physicians involving patients with LOMT decisions were common. HEMS physicians considered end-of-life questions on the phone and issued a new LOMT in 3.4% of consultations calls. These decisions mainly concerned termination of resuscitation, DNACPR, intubation and initiation of intensive care.
A machine learning-assisted model for renal urate underexcretion with genetic and clinical variables among Chinese men with gout
Authors: Sun Mingshu , Sun Wenyan , Zhao Xuetong , Li Zhiqiang , Dalbeth Nicola , Ji Aichang , He Yuwei , Qu Hongzhu , Zheng Guangmin , Ma Lidan , Wang Jiayi , Shi Yongyong , Fang Xiangdong , Chen Haibing , Merriman Tony R. , Li Changgui
Published: March 2022

Objectives

The objective of this study was to develop and validate a prediction model for renal urate underexcretion (RUE) in male gout patients.

Methods

Men with gout enrolled from multicenter cohorts in China were analyzed as the development and validation data sets. The RUE phenotype was defined as fractional excretion of uric acid (FEUA) <5.5%. Candidate genetic and clinical features were screened by the least absolute shrinkage and selection operator (LASSO) with 10-fold cross-validation. Machine learning algorithms (stochastic gradient descent (SGD), logistic regression, support vector machine) were performed to construct a predictive classifier of RUE. Models were assessed by the area under the receiver operating characteristic curve (AUC) and the precision-recall curve (PRC).

Results

One thousand two hundred thirty-eight and two thousand twenty-three patients were enrolled as the development and validation cohorts, with 1220 and 754 randomly chosen patients genotyped, respectively. Rs3775948.GG of SLC2A9/GLUT9, rs504915.AA of NRXN2/URAT1, and 7 clinical features (age, hypertension, nephrolithiasis, blood glucose, serum urate, urea nitrogen, and creatinine) were generated by LASSO. Two additional SNP variants (rs2231142.GG of ABCG2 and rs11231463.GG of SLC22A9/OAT7) were selected based on their contributions to gout in the development cohort and their reported effects on renal urate handling. The optimized classifiers yielded AUCs of ~0.914 and PRCs of ~0.980 using these 11 variables. The SGD model was conducted in the validation cohort with an AUC of 0.899 and the PRC of 0.957.

Conclusions

A prediction model for RUE composed of four SNPs and readily accessible clinical features was established with acceptable accuracy for men with gout.
Overestimation and underestimation of youths’ health-related quality of life are associated with youth and caregiver positive screens for depression: results of a population-based study among youths with longstanding type 1 diabetes
Authors: Stahl-Pehe Anna , Selinski Silvia , Bächle Christina , Castillo Katty , Lange Karin , Holl Reinhard W. , Rosenbauer Joachim
Published: March 2022

Background

This study aimed to analyze the extent and direction of disagreement between self- and proxy-reported quality of life (QoL) and the factors associated with QoL overestimation and underestimation by caregivers compared with self-reports.

Methods

This study used data from population-based questionnaire surveys conducted in 2012–2013 and 2015–2016 with 11- to 17-year-olds with a duration of type 1 diabetes of 10 years or longer and their caregivers (n = 1058). QoL in youth was assessed via 10-item KIDSCREEN (KIDSCREEN-10) self- and proxy-reported questionnaires. The scores ranged from 0 to 100, with higher scores indicating better QoL. Depression screening was performed via the Center for Epidemiological Studies Depression Scale for Children for youths (CES-DC screen positive: score > 15) and WHO-5 Well-being Index for parents/caregivers (WHO-5 screen positive: score ≤ 50).

Results

The mean self- and proxy-reported normalized KIDSCREEN-10 scores were 64.2 (standard deviation [SD] 11.4) and 66.1 (11.5), respectively. More caregivers overestimated (self-reported minus proxy-reported score < − 0.5*SD self-reported score) than underestimated (self-reported minus proxy-reported score > 0.5*SD self-reported score) youths’ QoL (37% versus 23%, p < 0.001). Youths who screened positive for depression (18%) were at higher risk of their QoL being overestimated and lower risk of their QoL being underestimated by caregivers than youths who screened negative for depression (RROverestimation1.30 [95% CI 1.10–1.52], RRUnderestimation0.27 [0.15–0.50]). Caregivers who screened positive for depression (28%) overestimated the QoL of their children less often and underestimated the QoL of their children more often than caregivers who screened negative for depression (RROverestimation0.73 [0.60–0.89], RRUnderestimation1.41 [1.14–1.75]).

Conclusions

Caregivers often over- or underestimated their children’s QoL. Positive screens for depression among both youths and caregivers contributed to the observed differences between self- and caregiver-reported QoL.
Performance analysis of 6LoWPAN protocol for a flood monitoring system
Authors: Gabriel Piñeres-Espitia , Butt Shariq Aziz , Francisco Estévez-Ortiz , Alejandro Cama-Pinto , Maleh Yassine
Published: March 2022

The internet of things is a disruptive technology that has been applied as a solution to problems in many fields of monitoring environmental variables. It is supported by technologies such as wireless sensor networks, which offer many protocols and hardware platforms in the market today. Protocols such as 6LoWPAN are novel, so this work focuses on determining whether its implementation on TelosB mote is feasible; these would be placed on an experimental deployment for a particular scenario of flash floods in a sector known as “La Brigada”, in the city of Barranquilla. This proposal has not been evaluated in Colombia for this type of application, and no similar work has been done for this type of scenario. For the evaluation of 6LoWPAN, a deployment with two end nodes and a sink node has been designed, due to the monitoring section under study; 5-min tests are proposed where through round trip time traffic PINGv6 packets are generated back and forth (Echo) between a sink node and two end nodes. The results are based on the evaluation of metrics such as delay and ping packet request/response rate. The performance of these metrics is subject to test scenarios that vary according to distance, packet size, and channel scan time. Two routing options, static or dynamic, are also proposed for this application case. The tests performed yielded results in terms of better performance in the test scenarios for packets with an average size of 120 B and channel monitoring times of 1024 ms. Likewise, the use of the TelosB platform was validated as a viable and innovative option for a monitoring scenario to flash floods in short stretches of the city of Barranquilla—Colombia. This study is important because it can provide information on the use of the TelosB platform as a valid solution for similar application scenarios; furthermore, the tests performed can be replicated in similar studies to evaluate congestion, power consumption, routing, topologies, and other metrics. This study is providing a road map for the research community to follow the simulation scenario to apply the test to their own studies. This work also provides the guidelines for similar researchers to monitor the flood in their own regions and then compare their results with this study.
Hyers–Ulam stability and hyperstability of a Jensen-type functional equation on 2-Banach spaces
Authors: Selvan Arumugam Ponmana , Najati Abbas
Published: March 2022

The main aim of this paper is to establish the Hyers–Ulam stability and hyperstability of a Jensen-type quadratic mapping in 2-Banach spaces. That is, we prove the various types of Hyers–Ulam stability and hyperstability of the Jensen-type quadratic functional equation of the form $$ g \biggl( \frac{x+y}{2} + z \biggr) + g \biggl( \frac{x+y}{2} - z \biggr) + g \biggl( \frac{x-y}{2} + z \biggr) + g \biggl( \frac{x-y}{2} - z \biggr) = g(x) + g(y) + 4 g(z), $$
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Regularity and uniqueness for the 3D compressible magnetohydrodynamic equations
Authors: Zhang Mingyu
Published: March 2022

In this paper, some new $L^{p}$

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gradient estimates are justified for the three-dimensional compressible magnetohydrodynamic equations in the whole space $\mathbb{R}^{3}$

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. The key to derive the estimate $\|\nabla \textbf {u}\|_{L^{3}}$

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is the “div-curl” decomposition technique. For regular initial data with small energy, we prove the existence of global solutions belonging to a new class of functions in which the uniqueness can be shown to hold.
Nutrition-sensitive chicken production in Ethiopia: a qualitative evaluation
Authors: Passarelli Simone , Abdelmenan Semira , Tewahido Dagmawit , Demmu Yohannes Mulugeta , Abreham Helen , Ambikapathi Ramya , Gunaratna Nilupa S. , Berhane Yemane , Fawzi Wafaie
Published: March 2022

Small-scale chicken production holds great potential as a nutrition-sensitive strategy in low-income settings, due to its potential for improving income, increasing the consumption of nutritious foods (including eggs and meat), and empowering women. This study sought to evaluate the impacts of and to identify challenges and solutions for a nutrition-sensitive chicken production intervention in rural Ethiopia. We conducted a qualitative study following the endline evaluation of the African Chicken Genetic Gains and Agriculture to Nutrition project in the Amhara and Oromia regions of Ethiopia. Using semi-structured interviews, we held twelve Focus Group Discussions with woman project participants and six Key Informant Interviews with project staff. Data were analyzed using thematic analysis. Six Focus Group Discussions were with participants in the African Chicken Genetic Gains intervention, through which women received 25 high-yielding chickens. The other six Focus Group Discussions were held with participants who (in addition to the African Chicken Genetic Gains intervention) also received the Agriculture to Nutrition intervention, which focused on nutrition-sensitive behavior change communication related to child feeding, water, sanitation and hygiene, and home gardening. The African Chicken Genetic Gains and the Agriculture to Nutrition interventions benefited participants through improved income, nutrition, and child caregiving knowledge. Nutrition and child feeding benefits were emphasized more in the nutrition-sensitive behavior change arm, while income benefits were emphasized more in the arm that did not receive behavior change. The primary challenges of the project included death and disease of chickens and implementation issues at both the project and household levels. Recommendations to address these challenges included improved chicken housing designs, access to inputs, access to veterinary care (including vaccines and medication), and project logistics. The nutrition-sensitive and chicken production interventions were largely well-received by participants. Most participants agreed that the benefits of the project outweighed the challenges. Future projects would benefit from logistical and infrastructural improvements to improve implementation and impacts on nutrition, health, and livelihoods.
Global DNA methylation profiling reveals chromosomal instability in IDH-mutant astrocytomas
Authors: Liu Yan , Sathe Adwait Amod , Abdullah Kalil G. , McBrayer Samuel K. , Adams Steven H. , Brenner Andrew J. , Hatanpaa Kimmo J. , Viapiano Mariano S. , Xing Chao , Walker Jamie M. , Richardson Timothy E.
Published: March 2022

Diffusely infiltrating gliomas are among the most common central nervous system tumors in adults. Over the past decade, the subcategorization of these tumors has changed to include both traditional histologic features and more recently identified molecular factors. However, one molecular feature that has yet to be integrated is the presence/absence of chromosomal instability (CIN). Herein, we use global methylation profiling to evaluate a reference cohort of IDH-mutant astrocytomas with and without prior evidence of CIN (n = 42), and apply the resulting methylation-based characteristics to a larger test cohort of publicly-available IDH-mutant astrocytomas (n = 245). We demonstrate that IDH-mutant astrocytomas with evidence of CIN cluster separately from their chromosomally-stable counterparts. CIN cases were associated with higher initial histologic grade, altered expression patterns of genes related to CIN in other cancers, elevated initial total copy number burden, and significantly worse progression-free and overall survival. In addition, in a grade-for-grade analysis, patients with CIN-positive WHO grade 2 and 3 tumors had significantly worse survival. These results suggest that global methylation profiling can be used to discriminate between chromosomally stable and unstable IDH-mutant astrocytomas, and may therefore provide a reliable and cost-effective method for identifying gliomas with chromosomal instability and resultant poor clinical outcome.
Diabetes emergency cases identification based on a statistical predictive model
Authors: Azbeg Kebira , Boudhane Mohcine , Ouchetto Ouail , Jai Andaloussi Said
Published: March 2022

Diabetes is a chronic metabolic disease which is characterized by a permanently high blood sugar level. A distinction is made between two forms: Type 1 diabetes and Type 2 diabetes. It is believed that there are around 415 million people between the ages of 20 and 79 worldwide who have some form of diabetes illness today. In Europe, over 60 million people are diabetic, a diabetes incidence of 10.3% of men and 9.6% of women is estimated. The prevalence of diabetes is increasing among all ages in the European Region, mainly due to increases in overweight and obesity, unhealthy diet, and physical inactivity. A huge people in this population have type 2 diabetes, and the numbers will continue to rise over the next few years. So one can speak of a real widespread disease. The problem is not only the increased blood sugar, but also complications and accompanying diseases such as heart attack, stroke, or diabetic foot. However, as a type 2 diabetic, we can significantly influence the course of the disease and the success of therapy. To do this, it is important that we early detect the person that have (or likely have) a serious problem or an emergent case, and know about it as fast as possible. Early detection and treatment of this disease are very important to help diabetics live a healthy and near normal life. It can also help to avoid several serious complications. In addition, the evolution of wearable and Internet of Things medical devices can help to collect various health data for diagnosis using machine learning algorithms. In this paper, we present an IoT-based system architecture which ensures the collection of patient data in order to predict serious cases of diabetes. To secure data, Blockchain and IPFS are used, and to analyze data, we propose a statistical-based method for predictions. The process is as follows. First, data were collected from IoT devices, and a dataset was constructed and stored using IPFS. Then, the data will be scaled and filtered using noise-invariant data expansion. Next, an adaptive random forest algorithm is made in order to train data on the training dataset, and people with diabetes were classified using the proposed model. Three datasets were used, namely, the Pima Indian diabetes dataset, the Frankfurt Hospital diabetes dataset, and the last is the fusion of these two datasets. Finally, the performance of the method was evaluated and compared with other recent prediction methods. Based on the experiment result, an accuracy of 85.9%, 99.5%, and 99.8% has been achieved based on the three datasets, respectively. Thus, the model can be used to predict and alert physicians or hospitals serious cases that need urgent reactions.
Recombinant human soluble thrombomodulin for acute exacerbation of idiopathic pulmonary fibrosis: a nationwide observational study
Authors: Awano Nobuyasu , Jo Taisuke , Izumo Takehiro , Inomata Minoru , Morita Kojiro , Matsui Hiroki , Fushimi Kiyohide , Urushiyama Hirokazu , Nagase Takahide , Yasunaga Hideo
Published: March 2022

Background

Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is the leading cause of death among patients with IPF. However, there is no established treatment for this condition. Hence, we aimed to investigate the effectiveness and safety of recombinant human soluble thrombomodulin (rTM) for the treatment of AE-IPF.

Methods

Data were retrospectively collected from the Japanese Diagnosis Procedure Combination database from 1 January 2014 to 31 March 2018. We identified adult patients with IPF who received high-dose methylprednisolone (mPSL) therapy and mechanical ventilation upon admission. Eligible patients (n = 2814) were divided into those receiving high-dose mPSL alone (mPSL alone group, n = 2602) and rTM combined with high-dose mPSL (rTM group, n = 212). A stabilised inverse probability of treatment weighting (IPTW) using propensity scores was performed to compare outcomes between the two groups. The primary outcome was in-hospital mortality, and the secondary outcomes were 14- and 28-day mortality, bleeding events and length of hospital stay.

Results

The in-hospital mortality rates of the mPSL alone and rTM groups were 75.9% and 76.9%, respectively. The results did not significantly differ between the two groups after performing a stabilised IPTW. The odds ratio of the rTM group compared to the mPSL alone group was 1.15 (95% confidence interval: 0.71–1.84; p = 0.57). Moreover, the secondary outcomes did not differ significantly between the two groups.

Conclusions

In patients with AE-IPF who developed severe respiratory failure, rTM in addition to high-dose mPSL was not associated with a better outcome.
Hypnotherapy for procedural pain, itch, and state anxiety in children with acute burns: a feasibility and acceptability study protocol
Authors: Geagea Dali , Griffin Bronwyn , Kimble Roy , Polito Vince , Terhune Devin B. , Tyack Zephanie
Published: March 2022

Background

Burns and related procedures are painful and distressing for children, exposing them to acute and chronic sequelae that can negatively affect their physiological, psychological, and social functions. Non-pharmacological interventions such as distraction techniques are beneficial adjuncts to pharmacological agents for procedural pain, state anxiety, and itch in children with burns but have limitations (e.g. lack of research on burn-related itch, tailoring, and consensus on optimal treatment). Hypnotherapy is a non-pharmacological intervention that can be tailored for varied settings and populations with evidence of benefit for itch and superior effectiveness in comparison to other non-pharmacological interventions for children’s procedural pain and state anxiety. Thus, children with burns can benefit from hypnotherapy as an adjunct to pharmacological agents. Yet, in paediatric burns, rigorous studies of effectiveness are limited and no studies have been identified that screen for hypnotic suggestibility, an important predictor of hypnotherapy outcomes. Considering potential barriers to the delivery of hypnotherapy in paediatric burns, the proposed study will examine the feasibility and acceptability of hypnotic suggestibility screening followed by hypnotherapy for procedural pain, state anxiety, and itch in children with acute burns.

Methods

An observational mixed-methods feasibility and acceptability study will be conducted over 15 weeks. Eligible children (N = 30) aged 4 to 16 years presenting to a paediatric burns outpatient centre in a metropolitan children’s hospital in Australia with acute burns requiring dressing changes will be included. Eligible parents of children (N = up to 30) and clinicians who perform dressing changes (N = up to 20) will also be included. Child participants screened as having medium to high suggestibility as assessed by behavioural measures will receive hypnotherapy during dressing changes. A process evaluation will target feasibility and acceptability as primary outcomes and implementation (i.e. fidelity in delivery), reach, potential effectiveness, and adoption of evaluation procedures and intervention as secondary outcomes.

Discussion

Ethical approval was obtained from the Queensland Children’s Hospital and Health Service ethics committee. Results will be published in peer-reviewed publications and conference proceedings.

The findings will guide the design of future trials on the effectiveness of hypnotherapy and inform the development of child-centred hypnotic interventions in children with burns.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12620000988954
A study of the genotyping and vascular endothelial growth factor polymorphism differences in diabetic and diabetic retinopathy patients
Authors: Wagih Sara , Hussein Manal M. , Rizk Kareem A. , Abdel Azeem Amira A. , El-Habit Ola H.
Published: March 2022

Background

Retinopathy is one of the major causes of visual impairment which is the most severe microvascular complication of diabetes mellitus (DM). The aim of this study was to evaluate the association between diabetic retinopathy (DR) and two SNPs (− 152G > A and − 165C > T) located in the promoter region of the vascular endothelial growth factor (VEGF) gene in a small sample from Egyptian population. One hundred diabetic patients without retinopathy (DWR) and two hundred diabetic patients with retinopathy were included in this study. Genotype analysis for the two SNPs (− 152G > A and − 165C > T) was assessed by using the PCR–RFLP technique. In addition, the serum protein level of VEGF was measured by ELISA assay.

Results

The results showed a significant relationship between − 152G > A (rs13207351) polymorphism and both proliferative and non-proliferative retinopathy in genotypes (GG, GA, AA). The risk factor increment in the mutant heterozygous genotype (GA) was significantly increased in NPDR compared to PDR (OR = 16.3, 95%CI = 0.80–331.7); (OR = 20.4, 95%CI = 1.08–385.3), respectively. There was no significance between VEGF − 165C > T (rs79469752) gene polymorphism and retinopathy. Moreover, the serum protein level of VEGF showed a highly significant increase (P = 0.0001) in PDR (Mean ± SD = 3691 ± 124.9) when compared to both DWR (Mean ± SD = 497.3 ± 18.51) and NPDR (Mean ± SD = 1674.5 ± 771.7). These results were supported by the increased level of VEGF in serum protein which is positively correlated with the severity of retinopathy. Measuring VEGF protein level in DR patients would help as a biomarker in early diagnosis.

Conclusion

The increase in the mutant heterogeneous GA genotype in VEGF − 152G > A SNP could be a risk factor for the progression of severe retinopathy in diabetic patients.
Treatment options for entrapment neuropathy of infrapatellar branch of saphenous nerve post knee arthroplasty: a case report
Authors: Singh Tejinder , Kumar Parijat
Published: March 2022

Background

The infrapatellar branch of the saphenous nerve is highly prone to form a neuroma or undergo transaction after midline incision of knee arthroplasty. The presence of neuroma and entrapment of these fibers can cause pain and numbness/tingling in the knee. The presence of these symptoms can significantly impact rehabilitation outcomes and long-term outcomes.

Case presentation

The patient is a 63-year-old Caucasian female reported to an outpatient orthopedic physical therapy clinic post left knee arthroplasty. The patient reported severe pain (VAS-9/10) with knee range of motion from 5 to 64° flexion. The lower extremity functional score was 42/80 with moderate deficits in function.

Conclusion

The anterior inferior knee pain with saphenous nerve entrapment can cause severe symptoms. Soft tissue mobilizations followed by neurodynamic techniques can improve neural mobility and functional outcomes (LEFS-52/80).