bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnitude of peripheral sensory neuropathy and associated factors among HIV/AIDS clients receiving care at public health institutions, Northwest Ethiopia
Authors: Yitbarek Getachew Y , Addis Wondimnew D , Dagnaw Fentaw T , Ayehu Gashaw W , Melese Biruk D , Amare Tadeg J , Mulu Anemut T , Bayih Wubet A , Ashagrie Berhanu K , Zewde Edgeit A , Munye Tigabu , Chanie Ermias S , Ebabu Workneh , Asnakew Sintayehu , Arage Getachew , Teshome Assefa A
Published: March 2022

Background: In the mid-1990s, the development of combination antiretroviral therapy converted HIV infection into a chronic condition, with newly diagnosed patients now living longer than the general population. HIV affects both the central and peripheral nerve systems, resulting in a variety of clinical problems, including peripheral neuropathy, which is a common neurological consequence. Despite this, there is a scarcity of data on the extent of peripheral sensory neuropathy and its underlying factors in Ethiopia, necessitating this study. Objective: The primary goal of this study is to assess the degree of peripheral sensory neuropathy and its related factors among HIV/AIDS clients on follow up at public health institutions in Northwest Ethiopia. Methodology: Institution based cross-sectional study was conducted from November 1 to 30 December 2020 at selected south Gondar zone public health institutions ART clinic. Multistage sampling technique was used to select the study participants. Standardized Questioner adapted from other study was used to collect the data. Moreover, Brief Peripheral Neuropathy Screening tool (BPNS) was used to assess peripheral sensory neuropathy. The data were entered with epi-data manager version 4.4 and analyzed using STATA version 16. Result: A total of 555 adult PLWHIV agreed to participate in the study, resulting in a response rate of 96.8%. The prevalence of Peripheral sensory neuropathy was 32.25, 95% CI (28.28, 36.26). The participant’s age, DM comorbidity, viral load level, and disease clinical stage were all found to have a statistically significant association with peripheral sensory neuropathy. Conclusion: Peripheral sensory neuropathy was incredibly common. Accordingly, peripheral sensory neuropathy was found considerably associated with age, viral load level, stage of the disease, and DM comorbidity. It is vital to integrate routine peripheral sensory neuropathy screening strategies for clients who are on ART follow up for prevention and early identification of the problem.
John Locke, Private Property and the Birth of Achieved Celebrity
Authors: Rojek Chris
Published: March 2022

This article argues that John Locke’s defence of Natural Rights and private property are prerequisites in the rise of Achieved Celebrity. It addresses how the rights of private property are anterior to taking ‘the ordinary citizen’ as an object of attention capital.
Understanding Baseline Concussion Testing: A Resource for School Nurses as Members of Concussion Management Teams
Authors: Miller Dawn , Snyder Renae , Manos Alexa
Published: March 2022

Sports-related concussions (SRCs) are not uncommon among teen athletes. School nurses are in an ideal position to care for athletes affected with SRCs. However, evidence suggests there is a lack of knowledge regarding concussion management, use of baseline concussion testing, and active involvement on concussion management teams among school nurses. This article briefly examines the use of baseline concussion testing as a tool for assessing and managing the student athlete suffering from an SRC. The role of the school nurse on concussion management teams will also be explored. As active members of concussion management teams, working closely with athletic trainers, coaches, school administration, and local medical providers, school nurses have the opportunity to evaluate for return to learn and play, ultimately improving outcomes of student athletes suffering from SRCs.
The Myth of Organizational Change Process: A Study of Uniting Organizational Identity, Promoting Organizational Performance, and Member Behavior
Authors: Chang Tai-Wei , Chen Yu-Shan , Lin Chun-Yu
Published: March 2022

In response to changing circumstances, how organizations actively promote organizational performance and member behavior, and enhance competitiveness have become important issues for enterprises. This research utilized the psychological ownership theory to study how organizational members’ organizational identity, organizational performance, and member behavior to fill the research gaps that organizational psychological ownership only explores at the individual level and extend previous research on its antecedents. Hierarchical linear modeling (HLM) analysis was conducted to test the cross-level hypotheses when organizational identity affects organizational psychological ownership. Participants were volunteers of the Republic of China army with a total of 160 group samples and 630 individual samples. The research resulted that organizational identity could affect organizational performance in team level and organizational psychological ownership in individual level. In the psychology process, organizational psychological ownership could mediate the relationship between work value and member behavior.
Filial Piety and Mental Health Among Older Chinese Immigrants in the Netherlands
Authors: Cheung Sie-Long , Krijnen Wim P. , Fu Yuanyuan , van der Schans Cees P. , Hobbelen Hans
Published: March 2022

Filial piety is important to Chinese adults and is associated with mental health among older Chinese immigrants in the United States. However, it is unclear whether filial piety is linked to the mental health of Chinese immigrants in European countries. Therefore, this study aims to gain insights into the association between mental health and filial piety of first-generation Chinese immigrants in the Netherlands. A random sample of 143 participants took part in the study. A cross-sectional design was used. Data were collected through a postal survey conducted in the Chinese language between January 2021 and March 2021. The survey included a Mental Health Continuum-Short Form (MHC), and expected and perceived filial piety scale. The results indicated that in general, perceived filial piety exceeded expected filial piety (‘filial piety sufficient’). Regression analysis revealed that ‘filial piety sufficient’ is associated with a higher emotional MHC (B =.498, p =.035). This study provided new insights into the wellbeing of older Chinese immigrants in the Netherlands and showed accordance with the literature that filial piety remains an important factor for mental health.
Interest Rate Transmission of Monetary Policy: India Perspective
Authors: Amrutkar Pratik , Joshi Swapnil , Basu Sankarshan
Published: March 2022

The workings of monetary policy have often been construed as a “black box.” Not only does the nature of transmission channels vary across the economies, the significance and dominance of one channel over another is also a function of the nature and developmental stage of the economy under consideration. In this article, we attempt to understand the different channels of monetary policy operation and study which is(are) the dominant channel(s) in India. Our primary focus then is to identify the different hurdles that prevent the efficient transmission of monetary policy and assess few policy prescriptions to mitigate them. A simultaneous view from the perspective of business-government-society is also taken.
International expert consensus recommendations for the diagnosis and treatment of Langerhans cell histiocytosis in adults
Authors: Goyal Gaurav , Tazi Abdellatif , Go Ronald S. , Rech Karen L. , Picarsic Jennifer L. , Vassallo Robert , Young Jason R. , Cox Christian W. , Van Laar Jan , Hermiston Michelle L. , Cao Xin-Xin , Makras Polyzois , Kaltsas Gregory , Haroche Julien , Collin Matthew , McClain Kenneth L. , Diamond Eli L. , Girschikofsky Michael
Published: March 2022

Langerhans cell histiocytosis (LCH) can affect children and adults with a wide variety of clinical manifestations, including unifocal, single-system multifocal, single-system pulmonary (smoking-associated), or multisystem disease. The existing paradigms in the management of LCH in adults are mostly derived from the pediatric literature. Over the last decade, the discovery of clonality and MAPK-ERK pathway mutations in most cases led to the recognition of LCH as a hematopoietic neoplasm, opening the doors for treatment with targeted therapies. These advances have necessitated an update of the existing recommendations for the diagnosis and treatment of LCH in adults. This document presents consensus recommendations that resulted from the discussions at the annual Histiocyte Society meeting in 2019, encompassing clinical features, classification, diagnostic criteria, treatment algorithm, and response assessment for adults with LCH. The recommendations favor the use of 18F-Fluorodeoxyglucose positron emission tomography-based imaging for staging and response assessment in the majority of cases. Most adults with unifocal disease may be cured by local therapies, while the first-line treatment for single-system pulmonary LCH remains smoking cessation. Among patients not amenable or unresponsive to these treatments and/or have multifocal and multisystem disease, systemic treatments are recommended. Preferred systemic treatments in adults with LCH include cladribine or cytarabine, with the emerging role of targeted (BRAF and MEK inhibitor) therapies. Despite documented responses to treatments, many patients struggle with a high symptom burden from pain, fatigue, and mood disorders that should be acknowledged and managed appropriately.
LncRNA LINC00461 exacerbates myocardial ischemia–reperfusion injury via microRNA-185-3p/Myd88
Authors: Gao Feng , Wang Xiaochen , Fan Tingting , Luo Zhidan , Ma Mengqing , Hu Guangquan , Li Yue , Liang Yi , Lin Xianhe , Xu Banglong
Published: March 2022

Objective

Long non-coding RNAs (lncRNAs) play critically in the pathogenesis of myocardial ischemia–reperfusion (I/R) injury. Thus, it was proposed to investigate the mechanism of LINC00461 in the disease through mediating microRNA-185-3p (miR-185-3p)/myeloid differentiation primary response gene 88 (Myd88) axis.

Methods

miR-185-3p, LINC00461 and Myd88 expression in mice with I/R injury was measured. Mice with I/R injury were injected with the gene expression-modified vectors, after which cardiac function, hemodynamics, myocardial enzyme, oxidative stress, and cardiomyocyte apoptosis were analyzed.

Results

I/R mice showed LINC00461 and Myd88 up-regulation and miR-185-3p down-regulation. Down-regulating LINC00461 or up-regulating miR-185-3p recovered cardiac function, reduced myocardial enzyme levels, and attenuated oxidative stress and cardiomyocyte apoptosis in mice with I/R. miR-185-3p overexpression rescued the promoting effect of LINC00461 upregulation on myocardial injury in I/R mice.

Conclusion

LINC00461 knockdown attenuates myocardial I/R injury via elevating miR-185-3p expression to suppress Myd88 expression.
Genome-wide identification and characterization of Fusarium circinatum-responsive lncRNAs in Pinus radiata
Authors: Zamora-Ballesteros Cristina , Martín-García Jorge , Suárez-Vega Aroa , Diez Julio Javier
Published: March 2022

Background

One of the most promising strategies of Pine Pitch Canker (PPC) management is the use of reproductive plant material resistant to the disease. Understanding the complexity of plant transcriptome that underlies the defence to the causal agentFusarium circinatum, would greatly facilitate the development of an accurate breeding program. Long non-coding RNAs (lncRNAs) are emerging as important transcriptional regulators under biotic stresses in plants. However, to date, characterization of lncRNAs in conifer trees has not been reported. In this study, transcriptomic identification of lncRNAs was carried out using strand-specific paired-end RNA sequencing, fromPinus radiatasamples inoculated withF. circinatumat an early stage of infection.

Results

Overall, 13,312 lncRNAs were predicted through a bioinformatics approach, including long intergenic non-coding RNAs (92.3%), antisense lncRNAs (3.3%) and intronic lncRNAs (2.9%). Compared with protein-coding RNAs, pine lncRNAs are shorter, have lower expression, lower GC content and harbour fewer and shorter exons. A total of 164 differentially expressed (DE) lncRNAs were identified in response toF. circinatuminfection in the inoculated versus mock-inoculatedP. radiataseedlings. The predictedcis-regulated target genes of these pathogen-responsive lncRNAs were related to defence mechanisms such as kinase activity, phytohormone regulation, and cell wall reinforcement. Co-expression network analysis of DE lncRNAs, DE protein-coding RNAs and lncRNA target genes also indicated a potential network regulating pectinesterase activity and cell wall remodelling.

Conclusions

This study presents the first comprehensive genome-wide analysis ofP. radiatalncRNAs and provides the basis for future functional characterizations of lncRNAs in relation to pine defence responses againstF. circinatum.
Reliable detection of Burkholderia pseudomallei using multiple cross displacement amplification label-based biosensor
Authors: Wang Xiaoxia , Wang Licheng , Zhu Huaxiong , Wang Chongzhen , Zhu Xiong
Published: March 2022

Background

Burkholderia pseudomallei (B. pseudomallei), as a highly pathogenic organism, causes melioidosis, which is a disease of public health importance in many tropical developing countries. Here, we present and validate a novel detection technique, termed multiple cross displacement amplification combined with nanoparticles-based lateral flow biosensor (MCDA-NB), for identifying B. pseudomallei and diagnosing melioidosis.

Results

B. pseudomallei-MCDA targets the TTS1 (Type III secretion system gene cluster 1) to specifically design ten MCDA primers. The nanoparticles-based biosensor (NB) can be combined with B. pseudomallei-MCDA for visually, objective, simply and rapidly reporting reaction results. The optimal amplification conditions of B. pseudomallei-MCDA were 66 °C for 30 min. Assay’s sensitivity was 100 fg of genomic DNA in the pure cultures, and the analytical specificity was 100% by the examination of 257 strains, including 228 B. pseudomallei and 29 non-B. pseudomallei. As a result, the whole detection procedure was completed within 50 min, including 15 min for genomic DNA preparation, 30 min for l MCDA reaction, and 2 min for the interpretation of the results visually by biosensor.

Conclusions

B. pseudomallei-MCDA assay is a rapid, sensitive and specific method for the detection of B. pseudomallei, and can be used as a potential tool for melioidosis diagnose in basic, field and clinical laboratories.
Are multimorbidity patterns associated with fear of falling in community-dwelling older adults?
Authors: Canever Jaquelini Betta , de Souza Moreira Bruno , Danielewicz Ana Lúcia , de Avelar Núbia Carelli Pereira
Published: March 2022

Background

Multimorbidity is defined as the co-occurrence of multiple chronic or acute diseases and medical conditions in the same individual and can be grouped into different patterns based on the type of disease. These patterns are associated with poorer quality of life and premature death. It is believed that these patterns entail functional limitations, which may contribute to the fear of falling; however, this association remains unknown. Identifying this possible association is fundamental for developing individual and collective care approaches aimed at preventing the different patterns of chronic diseases in older adults in order to decrease the fear of falling. The objective of this study was to investigate the association between multimorbidity patterns and fear of falling in older adults.

Methods

This was a cross-sectional study including 308 older adults. The exposure variables were the presence of three multimorbidity patterns (cardiopulmonary, musculoskeletal, and vascular-metabolic) and pattern association assessed by self-report of two or more similar coexisting chronic diseases. The outcome was fear of falling assessed by the Brazilian version of Falls Efficacy Scale-International (cut-off point ≥ 23 points). Multivariable logistic regression was used to analyze the association between variables.

Results

Older adults with cardiopulmonary, musculoskeletal, vascular-metabolic patterns and pattern association had 3.49 (95%CI 1.13; 10.78), 2.03 (95%CI 1.13; 3.64), 2.14 (95%CI 1.20; 3.82), and 4.84 (95%CI 2.19; 10.68), respectively, greater chances of presenting fear of falling when compared to older adults without the patterns.

Conclusions

The presence of multimorbidity patterns is associated with higher chances of reporting fear of falling. It is emphasized that the introduction of public health programs aimed at preventing multimorbidity patterns is essential to reduce possible adverse health outcomes, including fear of falling and its negative consequences for older adult health.
Longitudinal social contacts among school-aged children during the COVID-19 pandemic: the Bay Area Contacts among Kids (BACK) study
Authors: Andrejko Kristin L. , Head Jennifer R. , Lewnard Joseph A. , Remais Justin V.
Published: March 2022

Background

The San Francisco Bay Area was the first region in the United States to enact school closures to mitigate SARS-CoV-2 transmission. The effects of closures on contact patterns for schoolchildren and their household members remain poorly understood.

Methods

We conducted serial cross-sectional surveys (May 2020, September 2020, February 2021) of Bay Area households with children to estimate age-structured daily contact rates for children and their adult household members. We examined changes in contact rates over the course of the COVID-19 pandemic, including after vaccination of household members, and compared contact patterns by household demographics using generalized estimating equations clustered by household.

Results

We captured contact histories for 1,967 households on behalf of 2,674 children, comprising 15,087 non-household contacts over the three waves of data collection. Shortly after the start of shelter-in-place orders in May 2020, daily contact rates were higher among children from Hispanic families (1.52 more contacts per child per day; [95% CI: 1.14–2.04]), households whose parents were unable to work from home (1.82; [1.40–2.40]), and households with income < $150,000 (1.75; [1.33–2.33]), after adjusting for other demographic characteristics and household clustering. Between May and August 2020, non-household contacts of children increased by 145% (ages 5–12) and 172% (ages 13–17), despite few children returning to in-person instruction. Non-household contact rates among children were higher—by 1.75 [1.28–2.40] and 1.42 [0.89–2.24] contacts per child per day in 5–12 and 13–17 age groups, respectively, in households where at least one adult was vaccinated against COVID-19, compared to children’s contact rates in unvaccinated households.

Conclusions

Child contact rates rebounded despite schools remaining closed, as parents obtained childcare, children engaged in contact in non-school settings, and family members were vaccinated. The waning reductions observed in non-household contact rates of schoolchildren and their family members during a prolonged school closure suggests the strategy may be ineffective for long-term SARS-CoV-2 transmission mitigation. Reductions in age-assortative contacts were not as apparent amongst children from lower income households or households where adults could not work from home. Heterogeneous reductions in contact patterns raise concerning racial, ethnic and income-based inequities associated with long-term school closures as a COVID-19 mitigation strategy.
Parental and physician’s point-of-view towards antibiotic prescriptions and discharge conversations in the pediatric emergency department
Authors: Peeters Daphne , van Scheppingen Lars M. A. , Driessen Gertjan J. A. , Verhagen Lilly M.
Published: March 2022

Background

Within Europe, the Netherlands has one of the lowest antibiotic consumption rates. We aimed to gain insight into attitudes of Dutch physicians and parents towards information provided during discharge conversations in the emergency department (ED) and towards antibiotic use in children, in order to obtain information on the assumptions and beliefs that underlie a practice of low prescription rates.

Methods

Discharge conversations of 70 children presenting with an infectious disease at the ED were observed. After 7–10 days, 55 parents were called for a semi-structured interview. In addition, 29 pediatricians and pediatric residents completed a questionnaire on their prescription behaviour.

Results

Concerns about (recognizing) the severity of their child’s infection was parents’ main motivation to seek help. Both pediatricians and parents reported a general reluctance towards antibiotic use. While pediatricians took appropriateness based on indication and the risk of antimicrobial resistance development into account when considering antibiotic treatment, a thorough medical assessment was deemed more important for Dutch parents than any type of therapeutic treatment, including antibiotics. The topic most often discussed during the discharge conversations was safety netting instructions (in 86%), which were discussed more often during discharge conversations with parents of children that did not receive antibiotic treatment (91% versus 69%).

Conclusion

Dutch pediatricians and parents are both reluctant to use antibiotics for uncomplicated infections in children, but for different reasons. The emphasis of discharge conversations was on safety netting instructions, which seems to be an alternative for (early) antibiotic use in our setting and may guide overuse prevention strategies in settings where antibiotic overuse is more common.
Factors associated with blood lead levels in children in Shenyang, China: a cross-sectional study
Authors: Cheng Xiao-Jun , Li Guang-Bo , Zhang Shuang-Shuang , Liu Ying , Dong Yi-Chen , Xue-Ning-Li
Published: March 2022

Background

Although blood lead levels (BLLs) in children are gradually decreasing, low-concentration lead exposure can still exert adverse effects. We studied the factors that affect BLLs in children in Shenyang, China.

Methods

We conducted a cross-sectional study by administering structured questionnaires on family demographics and food intake. The concentrations of lead in venous blood were determined by graphite furnace atomic absorption spectrometry.

Results

A total of 273 children aged 1–6 years were enrolled. The geometric mean (geometric standard deviation) of BLLs was 24.94 (12.70) μg/L in boys and 23.75 (11.34) μg/L in girls. The prevalence of BLLs of ≥35 μg/L was 22.7% and was mainly observed in children aged under 3 years. Often hand washing before meals was protective against BLLs ≥20 μg/L (adjusted OR: 0.427, 95%CI: 0.238–0.767, p = 0.004). Consumption of puffed grains and eggs had an adjusted OR (95%CI) for BLLs ≥20 μg/L of 1.714 (1.012–2.901) (p = 0.045) and 1.787 (1.000–3.192) (p = 0.050), respectively.

Conclusions

BLLs of children in Shenyang are still higher than in developed countries. Consumption of puffed grains and eggs is associated with higher BLLs. Often hand washing before meals may be protective against high BLLs.
Bayesian multilevel analysis of determinants of acute respiratory infection in children under the age of five years in Ethiopia
Authors: Merera Amanuel , Asena Tilahun , Senbeta Mebratu
Published: March 2022

Background

Acute respiratory tract infection (ARI) is one of the leading causes of illness and mortality in children under the age of five worldwide. Pneumonia, which is caused by a respiratory tract infection, kills about 1.9 million children under the age of 5 years around the world. The majority of these deaths occur in underdeveloped countries. According to the 2016 Ethiopia Demographic and Health Survey (EDHS), the prevalence rate of ARI in Ethiopia was 7%. Prevalence is defined as the number of infectious diseases present at a given period in relation to the total number of children under the age of five who have been exposed to ARI. The goal of this study was to determine the risk factors for acute respiratory infection among children under the age of five in Ethiopia.

Methods

To provide representative samples of the population, a community-based cross-sectional sampling scheme was designed. Bayesian multilevel approach was employed to assess factors associated with the prevalence of ARI among children under age five in Ethiopia. The data was collected from 10,641 children under the age of 5 years out of which 9918 children were considered in this study.

Results

The ARI prevalence rate in children under the age of 5 years was assessed to be 8.4%, somewhat higher than the country’s anticipated prevalence rate. Children whose mothers did not have a high level of education had the highest prevalence of ARI. The key health, environmental, and nutritional factors influencing the proportion of children with ARI differed by area. Tigray (15.3%) and Oromia (14.4%) had the highest prevalence of ARI, while Benishangul Gumuz had the lowest prevalence (2.6%). The use of vitamin A was investigated, and the results revealed that roughly 43.1% of those who received vitamin A had the lowest prevalence of ARI (7.7%) as compared to those who did not receive vitamin A. Diarrhea affected 11.1% of children under the age of five, with the highest frequency of ARI (24.6%) and the highest prevalence of ARI reported in children whose drinking water source was unprotected/unimproved (9.4%).

Conclusions

The prevalence of ARI among children under the age of 5 years was found to be strongly affected by the child’s age, household wealth index, mother’s educational level, vitamin A supplement, history of diarrhea, maternal work, stunting, and drinking water source. The study also found that the incidence of ARI varies significantly between and within Ethiopian areas. When intending to improve the health status of Ethiopian children, those predictive variables should be taken into consideration.
Household-specific physical activity levels and energy intakes according to the presence of metabolic syndrome in Korean young adults: Korean National Health and nutrition examination survey 2016–2018
Authors: Lee Young-Jun , Park Yeon-Hee , Lee Jung-Woo , Sung Eun-Sook , Lee Hyun-Seob , Park Jonghoon
Published: March 2022

Background

Participation in exercise, and dietary and nutritional intakes have an impact on the risk and prevalence of metabolic syndrome (MetS), but these effects may differ according to whether a person lives alone or in a multi-person household. We analyzed differences in physical activity (PA) levels and energy intake according to household-type and MetS presence among young adults, to investigate the relationships among these factors.

Methods

Data of 3974 young adults (aged > 19 years and < 40 years) were obtained from the Korean National Health and Nutrition Examination Survey (2016–2018). We analyzed PA levels (occupational and recreational PA, and transport) and energy intake (total, carbohydrate, protein, and fat).

Results

Logistic regression data showed that low PA levels and higher energy intake were associated with MetS incidence and its components in young adults, after adjusting for body mass index, smoking, household-type, and sex. Overall, there was no significant difference in PA level between the MetS and non-MetS group. The total energy intake was higher in the MetS than in the non-MetS group (p <  0.05). These results were similar to those found in multi-person households. In single-person households, the MetS group had significantly lower PA levels (p <  0.01) and total energy intake (p <  0.05) than the non-MetS group.

Conclusions

We found significant association among low PA levels, high energy intake, and MetS components in young Korean adults, but with patterns differing according to household type. Energy intake was higher in young adults with than those without MetS, who lived in multi-person households, while young adults with MetS who lived alone had lower PA levels and lower energy intake than those without MetS. These findings highlight the need for different approaches of implementing PA and nutrition strategies according to the type of household in order to prevent MetS.
Impact of diabetes group visits on patient clinical and self-reported outcomes in community health centers
Authors: Baig Arshiya A. , Staab Erin M. , Benitez Amanda , Hermans Sarah P. , Ham Sandra A. , Wan Wen , Campbell Amanda , Schaefer Cynthia T. , Quinn Michael T.
Published: March 2022

Background

Diabetes group visits (GVs) are a promising way to deliver high quality care but have been understudied in community health centers (CHCs), across multiple sites, or with a focus on patient-centered outcomes.

Methods

We trained staff and healthcare providers from six CHCs across five Midwestern states to implement a 6-month GV program at their sites. We assessed the impact of diabetes GVs on patient clinical and self-reported outcomes and processes of care compared to patients receiving usual care at these sites during the same period using a prospective controlled study design.

Results

CHCs enrolled 51 adult patients with diabetes with glycosylated hemoglobin (A1C) ≥ 8% for the GV intervention and conducted chart review of 72 patients receiving usual care. We analyzed A1C at baseline, 6, and 12 months, low-density lipoproteins (LDL), blood pressure, and patient-reported outcomes. GV patients had a larger decrease in A1C from baseline to 6 months (-1.04%, 95% CI: -1.64, -0.44) and 12 months (-1.76, 95% CI: -2.44, -1.07) compared to usual care; there was no change in blood pressure or LDL. GV patients had higher odds of receiving a flu vaccination, foot exam, eye exam, and lipid panel in the past year compared to usual care but not a dental exam, urine microalbumin test, or blood pressure check. For GV patients, diabetes distress decreased, diabetes-related quality of life improved, and self-reported frequency of healthy eating and checking blood sugar increased from baseline to 6 months, but there was no change in exercise or medication adherence.

Conclusions

A diabetes GV intervention improved blood glucose levels, self-care behaviors, diabetes distress, and processes of care among adults with elevated A1Cs compared to patients receiving usual care. Future studies are needed to assess the sustainability of clinical improvements and costs of the GV model in CHCs.
Perception of the image of the nursing profession and its relationship with quality of care
Authors: Grinberg Keren , Sela Yael
Published: March 2022

Background

Good quality of care (QOC) is related to high recovery rates, fewer mistakes, and better outcomes in general. The perception of the nursing profession (NP) among nurses has many social and professional implications, and it is important to understand the implications regarding their QOC. The aim of the study was to examine whether there is a relationship between the self-image of nursing and the nurses’ QOC, and whether men and women differ in their nursing image (NI).

Methods

A cross-sectional study applied among nursing teams employed in various inpatient wards: An online questionnaire was distributed and included (1) Sociodemographic details; (2) Image of the nursing profession; and (3) Nurses’ perception of their nursing care quality.

Results

The results show a significant positive relationship between the NI perception among nurses and their perceptions of the QOC they provide. No sex differences were found between male and female nurses.

Conclusion

This study highlights the correlation between the NP’s self-image and self-reported QOC. Health policy makers should build national programs that improve the image of nursing among nursing teams, and create an empowering and positive working environment, which would most probably improve the quality of nursing care.
Supportive supervision from a roving nurse mentor in a community health worker programme: a process evaluation in South Africa
Authors: Malatji Hlologelo , Griffiths Frances , Goudge Jane
Published: March 2022

Background

Many low and middle- income countries (LMICs) are repositioning community health worker (CHW) programmes to provide a more comprehensive range of promotive and preventive services and referrals to the formal health service. However, insufficient supervision, fragmented programmes, and the low literacy levels of CHWs often result in the under-performance of the programmes. We evaluate the impact of a roving nurse mentor working with CHW teams proving supportive supervision in a semi-rural area of South Africa.

Methods

We conducted a longitudinal process evaluation, using in-depth interviews, focus groups and observations prior to the intervention, during the intervention, and 6 months post-intervention to assess how the effects of the intervention were generated and sustained. Our participants were CHWs, their supervisors, clients and facility staff members and community representatives.

Results

The nurse mentor operated in an environment of resource shortages, conflicts between CHWs and facility staff, and an active CHW labour union. Over 15 months, the mentor was able to (1) support and train CHWs and their supervisors to gain and practice new skills, (2) address their fears of failing and (3) establish operational systems to address inefficiencies in the CHWs’ activities, resulting in improved service provision. Towards the end of the intervention the direct employment of the CHWs by the Department of Health and an increase in their stipend added to their motivation and integration into the local primary care clinic team. However, given the communities’ focus on accessing government housing, rather than better healthcare, and volatile nature of the communities, the nurse mentor was not able to establish a collaboration with local structures.

Conclusions

A roving nurse mentor overseeing several CHW teams within a district healthcare system is a feasible option, particularly in a context where there is a shortage of qualified supervisors to support CHWs activities. A roving nurse mentor can contribute to the knowledge and skills development of the CHWs and enhance the capacity of junior supervisors. However, the long-term sustainability of the effects of intervention is dependent on CHWs’ formal employment by the Department of Health.
The impact of local vaccine coverage and recent incidence on measles transmission in France between 2009 and 2018
Authors: Robert Alexis , Kucharski Adam J. , Funk Sebastian
Published: March 2022

Background

Subnational heterogeneity in immunity to measles can create pockets of susceptibility and result in long-lasting outbreaks despite high levels of national vaccine coverage. The elimination status defined by the World Health Organization aims to identify countries where the virus is no longer circulating and can be verified after 36 months of interrupted transmission. However, since 2018, numerous countries have lost their elimination status soon after reaching it, showing that the indicators defining elimination may not be associated with lower risks of outbreaks.

Methods

We quantified the impact of local vaccine coverage and recent levels of incidence on the dynamics of measles in each French department between 2009 and 2018, using mathematical models based on the “Endemic-Epidemic” regression framework. After fitting the models using daily case counts, we simulated the effect of variations in the vaccine coverage and recent incidence on future transmission.

Results

High values of local vaccine coverage were associated with fewer imported cases and lower risks of local transmissions, but regions that had recently reported high levels of incidence were also at a lower risk of local transmission. This may be due to additional immunity accumulated during recent outbreaks. Therefore, the risk of local transmission was not lower in areas fulfilling the elimination criteria. A decrease of 3% in the 3-year average vaccine uptake led to a fivefold increase in the average annual number of cases in simulated outbreaks.

Conclusions

Local vaccine uptake was a reliable indicator of the intensity of transmission in France, even if it only describes yearly coverage in a given age group, and ignores population movements. Therefore, spatiotemporal variations in vaccine coverage, caused by disruptions in routine immunisation programmes, or lower trust in vaccines, can lead to large increases in both local and cross-regional transmission. The incidence indicator used to define the elimination status was not associated with a lower number of local transmissions in France, and may not illustrate the risks of imminent outbreaks. More detailed models of local immunity levels or subnational seroprevalence studies may yield better estimates of local risk of measles outbreaks.
The impact of the surgical Apgar score on oncological outcomes in patients with colorectal cancer: a propensity score-matched study
Authors: Sugimoto Atsushi , Fukuoka Tatsunari , Nagahara Hisashi , Shibutani Masatsune , Iseki Yasuhito , Sasaki Maho , Okazaki Yuki , Maeda Kiyoshi , Ohira Masaichi
Published: March 2022

Background

The surgical Apgar score (SAS) predicts postoperative complications (POCs) following gastrointestinal surgery. Recently, the SAS was reported to be a predictor of not only POCs but also prognosis. However, the impact of the SAS on oncological outcomes in patients with colorectal cancer (CRC) has not been fully examined. The present study therefore explored the oncological significance of the SAS in patients with CRC, using a propensity score matching (PSM) method.

Methods

We retrospectively analyzed 639 patients who underwent radical surgery for CRC. The SAS was calculated based on three intraoperative parameters: estimated blood loss, lowest mean arterial pressure, and lowest heart rate. All patients were classified into 2 groups based on the SAS (≤6 and >6). The association of the SAS with the recurrence-free survival (RFS), overall survival (OS), and cancer-specific survival (CSS) was analyzed.

Results

After PSM, each group included 156 patients. Univariate analyses revealed that a lower SAS (≤6) was significantly associated with a worse OS and CSS. A multivariate analysis revealed that the age ≥75 years old, ASA-Physical Status ≥3, SAS ≤6, histologically undifferentiated tumor type, and an advanced pStage were independent factors for the OS, and open surgery, a SAS ≤6, histologically undifferentiated tumor type and advanced pStage were independent factors for the CSS.

Conclusions

A lower SAS (≤6) was an independent prognostic factor for not only the OS but also the CSS in patients with CRC, suggesting that the SAS might be a useful biomarker predicting oncological outcomes in patients with CRC.
Subtypes in pancreatic ductal adenocarcinoma based on niche factor dependency show distinct drug treatment responses
Authors: Shinkawa Tomohiko , Ohuchida Kenoki , Mochida Yuki , Sakihama Kukiko , Iwamoto Chika , Abe Toshiya , Ideno Noboru , Mizuuchi Yusuke , Shindo Koji , Ikenaga Naoki , Moriyama Taiki , Nakata Kohei , Oda Yoshinao , Nakamura Masafumi
Published: March 2022

Background

Pancreatic ductal adenocarcinoma (PDAC) is characterized by abundant stroma in which microenvironmental (niche) factors promote PDAC progression. In mouse models, reduction of the stroma increased the proportion of poorly differentiated PDAC with a worse prognosis. Here, we aimed to clarify the effects of stroma on PDAC that may define the PDAC phenotype and induce distinct therapeutic responses.

Methods

The molecular features of PDAC based on differentiation grade were clarified by genome and transcriptome analysis using PDAC organoids (PDOs). We identified the dependency on niche factors that might regulate the differentiation grade. A three-dimensional co-culture model with cancer-associated fibroblasts (CAFs) was generated to determine whether CAFs provide niche factors essential for differentiated PDAC. PDOs were subtyped based on niche factor dependency, and the therapeutic responses for each subtype were compared.

Results

The expression profiles of PDOs differed depending on the differentiation grade. Consistent with the distinct profiles, well differentiated types showed high niche dependency, while poorly differentiated types showed low niche dependency. The three-dimensional co-culture model revealed that well differentiated PDOs were strongly dependent on CAFs for growth, and moderately differentiated PDOs showed plasticity to change morphology depending on CAFs. Differentiated PDOs upregulated the expression of mevalonate pathway-related genes correlated with the niche dependency and were more sensitive to simvastatin than poorly differentiated PDOs.

Conclusions

Our findings suggest that CAFs maintain the differentiated PDAC phenotype through secreting niche factors and induce distinct drug responses. These results may lead to the development of novel subtype-based therapeutic strategies.
The effects of the Green-Mediterranean diet on cardiometabolic health are linked to gut microbiome modifications: a randomized controlled trial
Authors: Rinott Ehud , Meir Anat Yaskolka , Tsaban Gal , Zelicha Hila , Kaplan Alon , Knights Dan , Tuohy Kieran , Scholz Matthias Uwe , Koren Omry , Stampfer Meir J. , Wang Dong D. , Shai Iris , Youngster Ilan
Published: March 2022

Background

Previous studies have linked the Mediterranean diet (MED) with improved cardiometabolic health, showing preliminary evidence for a mediating role of the gut microbiome. We recently suggested the Green-Mediterranean (Green-MED) diet as an improved version of the healthy MED diet, with increased consumption of plant-based foods and reduced meat intake. Here, we investigated the effects of MED interventions on the gut microbiota and cardiometabolic markers, and the interplay between the two, during the initial weight loss phase of the DIRECT-PLUS trial.

Methods

In the DIRECT-PLUS study, 294 participants with abdominal obesity/dyslipidemia were prospectively randomized to one of three intervention groups: healthy dietary guidelines (standard science-based nutritional counseling), MED, and Green-MED. Both isocaloric MED and Green-MED groups were supplemented with 28g/day walnuts. The Green-MED group was further provided with daily polyphenol-rich green tea and Mankai aquatic plant (new plant introduced to a western population). Gut microbiota was profiled by 16S rRNA for all stool samples and shotgun sequencing for a select subset of samples.

Results

Both MED diets induced substantial changes in the community structure of the gut microbiome, with the Green-MED diet leading to more prominent compositional changes, largely driven by the low abundant, “non-core,” microorganisms. The Green-MED diet was associated with specific microbial changes, including enrichments in the genus Prevotella and enzymatic functions involved in branched-chain amino acid degradation, and reductions in the genus Bifidobacterium and enzymatic functions responsible for branched-chain amino acid biosynthesis. The MED and Green-MED diets were also associated with stepwise beneficial changes in body weight and cardiometabolic biomarkers, concomitantly with the increased plant intake and reduced meat intake.

Furthermore, while the level of adherence to the Green-MED diet and its specific green dietary components was associated with the magnitude of changes in microbiome composition, changes in gut microbial features appeared to mediate the association between adherence to the Green-MED and body weight and cardiometabolic risk reduction.

Conclusions

Our findings support a mediating role of the gut microbiome in the beneficial effects of the Green-MED diet enriched with Mankai and green tea on cardiometabolic risk factors.

Trial registration

The study was registered on ClinicalTrial.gov (NCT03020186) on January 13, 2017.
Depressive symptoms among Olympic athletes during the Covid-19 pandemic
Authors: Lambert Christophe , Schuetz Lisa-Marie , Rice Simon , Purcell Rosemary , Stoll Theresa , Trajdos Martyna , Ritzmann Ramona , Böhm Anna-Lena , Walz Martin
Published: March 2022

Objectives

The aim of this study was to analyze athlete-specific psychological strain among Olympic athletes following the postponement of the Tokyo 2020 Olympic games due to the COVID-19 pandemic.

Methods

A survey that comprised three sub-sections (Psychological Strain Questionnaire (APSQ), Patient Health Questionnaire—Depression Module (PHQ-8) and Participant characteristic) concerning mental health, performance issues and concerns about the postponement of the Tokyo Olympics, was distributed online and sent to 102 Olympic athletes.

Results

A total of 85 participants from 11 Olympic sports were enrolled. Results indicated that most athletes showed psychological strain related to concerns regarding the postponement of the Tokyo Olympics. Depression severity was positively associated with maladaptive avoidance coping patterns, negative effects in training, worries and fear. Depression severity was also negatively associated with motivation and adaptive factors such as chances and opportunities that can be drawn from the pandemic.

Conclusion

The present sample of Olympic athletes reported suffering from psychological uncertainty associated with the postponement of the Olympic games. Sports federations should therefore, provide ongoing wellbeing support to athletes and offer them, for example, sports psychological support in order to be able to better deal with pandemic-related uncertainties and changes.
SEEMLIS: a flexible semi-automated method for enrichment of methylated DNA from low-input samples
Authors: Rodems Tamara S. , Juang Duane S. , Stahlfeld Charlotte N. , Gilsdorf Cole S. , Krueger Tim E. G. , Heninger Erika , Zhao Shuang G. , Sperger Jamie M. , Beebe David J. , Haffner Michael C. , Lang Joshua M.
Published: March 2022

Background

DNA methylation alterations have emerged as hallmarks of cancer and have been proposed as screening, prognostic, and predictive biomarkers. Traditional approaches for methylation analysis have relied on bisulfite conversion of DNA, which can damage DNA and is not suitable for targeted gene analysis in low-input samples. Here, we have adapted methyl-CpG-binding domain protein 2 (MBD2)-based DNA enrichment for use on a semi-automated exclusion-based sample preparation (ESP) platform for robust and scalable enrichment of methylated DNA from low-input samples, called SEEMLIS.

Results

We show that combining methylation-sensitive enzyme digestion with ESP-based MBD2 enrichment allows for single gene analysis with high sensitivity for GSTP1 in highly impure, heterogenous samples. We also show that ESP-based MBD2 enrichment coupled with targeted pre-amplification allows for analysis of multiple genes with sensitivities approaching the single cell level in pure samples for GSTP1 and RASSF1 and sensitivity down to 14 cells for these genes in highly impure samples. Finally, we demonstrate the potential clinical utility of SEEMLIS by successful detection of methylated gene signatures in circulating tumor cells (CTCs) from patients with prostate cancer with varying CTC number and sample purity.

Conclusions

SEEMLIS is a robust assay for targeted DNA methylation analysis in low-input samples, with flexibility at multiple steps. We demonstrate the feasibility of this assay to analyze DNA methylation in prostate cancer cells using CTCs from patients with prostate cancer as a real-world example of a low-input analyte of clinical importance. In summary, this novel assay provides a platform for determining methylation signatures in rare cell populations with broad implications for research as well as clinical applications.