bluuebunny/crossref_metadata_2025 huggingface dataset:
The Determinants of Vietnam’s Information and Communication Technologies Exports to the European Union
Authors: Hoan Phan Thanh , My Duong Thi Dieu
Published: January 2022

Vietnam is one of the top information and communication technologies (ICT) exporters globally, and the ICT products constitute nearly one-fifth of Vietnam’s total exports to the European Union (EU). This study empirically investigates the determinants of Vietnam’s ICT exports to the EU by applying the gravity model for trade with panel data from 2000 to 2019. Besides the traditional variables of the gravity model, we added gross capital formation, patent application and exchange rates as explanatory variables. The results show that among factors affecting Vietnam’s ICT export to the EU, market size, patent applications, and exchange rate are the most significant determinants. The article also suggests some policy implications for the development of ICT exports between the two parties.

JEL Codes: F14, C2
Impacts of Reading for Ethiopia’s Achievement Developed Community Outreach Project Intervention on Students’ Oral Reading Fluency, Reading Comprehension, and Academic Achievements
Authors: Tsegaw Sisay Ayalew
Published: January 2022

The aim of this study was to examine the impact of Reading for Ethiopia’s Achievement Developed Community Outreach (READ CO) project intervention on students’ oral reading fluency, reading comprehension, academic achievements, and listening comprehension. It also aimed at identifying the students and teachers’ awareness and practices about the READ CO project interventions. Experimental research—Posttest-only control group—design was employed for the study, which is mainly quantitative, but also uses qualitative techniques (latent content analysis). The results were analyzed using t tests and econometrics analysis mainly. Questionnaires and observations were also developed and employed as other tools among the experimental group principals and language teachers in the school to investigate the overall practice. The results from quantitative data analysis indicated that there were no statistically significant differences between the posttest performance of the study group and the control group for reading comprehension, academic achievements, and listening comprehension, yet oral reading fluency is significant. The result from questionnaire and observation also showed that the project has not been found to have a positive impact on students reading performance or improvement. Finally, it was mainly recommended that practical training and real service should be given for the targeted schools on how to improve and implement reading practices via the project.
Antenatal Care Predicts Neonatal Mortality in Eastern Africa: A Systematic Review and Meta-analysis of Observational Studies
Authors: Tiruye Getahun , Shiferaw Kasiye , Shunu Addisu , Sintayeu Yitagesu , Seid Abdulbasit Musa
Published: January 2022

Background

Sub-Saharan African countries, especially the Eastern region, present the dismal picture of neonatal mortality (NM) in the globe. The majority of these deaths could be avoided if effective health measures are provided throughout pregnancy and childbirth. Although antenatal care (ANC) is assumed as one of the viable interventions that contribute to neonatal survival, the effect of ANC on NM was not systematically analyzed in Eastern Africa. Thus, the study aimed to determine the pooled effect of ANC on NM in Eastern Africa.

Methods

PubMed, EMBASE, CINAHL, and HINARI databases were searched using appropriate keywords from January 1, 1990 to February 12, 2021. Independent authors selected eligible articles and extracted data. The risk of a bias assessment tool for nonrandomized studies was used to assess the quality of the study. Comprehensive meta-analysis version 2 was used for meta-analysis. The random-effect model was employed, and the outcome is expressed as a risk ratio with 95% confidence interval (CI).

Results

In total, 1149 studies were identified through database search, and only 27 studies were included in the meta-analysis. Having at least 1 ANC visit during pregnancy reduced the risk of neonatal death by 42% compared to their counterparts (RR = 0.58, 95% CI [0.47, 0.71]). The pooled prevalence of NM was 8.5% (95% CI [7.3, 9.6]), with NM rate of 46.3/1000 live births.

Conclusion

The study indicated that NM might be decreased even with a single ANC visit when compared to no visits. Scaling up ANC services through ANC promotion and tackling service-related barriers could potentially reduce NM in Eastern Africa.
Seismic performance of a continuous bridge with winding rope device activated by a fluid viscous damper
Authors: Zhang Wenxue , Su Lijun , Zhang Cheng , Zheng Yongrui , Yang Weifeng
Published: January 2022

The seismic requirements of piers with fixed bearings (the fixed pier) for continuous girder bridges are relatively high, while the potential seismic capabilities of piers with sliding bearings (the sliding piers) are not fully utilized. To solve this contradiction, a new type of winding rope shock absorption device activated by a fluid viscous damper (WRD-D) was proposed. The WRD-D was installed on the top of the sliding piers, and the both ends of a fluid viscous damper were connected to the superstructure by winding ropes. During an earthquake, the damping force rises with the increase of relative speed between the sliding piers and the superstructure, activating the WRD-D and producing large frictional resistance, subsequently causing the sliding piers and the fixed pier to bear the seismic load cooperatively. In this study, the working mechanism of the WRD-D was researched. The shaking table test of a scaled continuous girder bridge model employing the WRD-D was conducted. The test results reveal that the WRD-D can effectively reduce the seismic requirements of the fixed pier and the superstructure displacements.
Profile of Patients Availing Marital and Psychosexual Clinic Services During the Pre-COVID and COVID Era: A Study From a Tertiary Care Center
Authors: Sahoo Swapnajeet , Grover Sandeep
Published: January 2022

Aim:

To assess the profile of patients availing the marital and psychosexual clinic (MPC) services through the telemode at a tertiary care center after the imposition of lockdown and compare the same with the profile of the patients attending the outpatient services, in-person MPC services during the prelockdown period.

Materials and Methods:

It was a retrospective study in which comparisons were made between patients availing the MPC services from March 24, 2020 to March 23, 2021 with the profile of patients during the period of March 24, 2019 to March 23, 2020 (ie, COVID period—lockdown).

Results:

A total of 112 patients availed the MPC services during the COVID study period compared to 307 patients in the pre-COVID period. However, when the proportion of MPC cases among the total walk-ins was compared, during the COVID period the proportion of MPC cases increased by almost 1.75 times. During the COVID time period, there was an increase in the patients who were significantly younger ( P = .002), females ( P = .003), more from urban locality ( P = .035), and being referred by self or caregiver ( P = .001). In terms of specific diagnosis, as compared to the pre-COVID timeframe, significantly higher numbers of patients were diagnosed with premature ejaculation (PME) and PME + erectile dysfunction while the services were being provided through the telemode.

Conclusion:

The present study suggests an increase in the proportion of patients seeking help for marital and sexual issues while the services are being provided by telemode.
Analysis of the transcriptome of the needles and bark of Pinus radiata induced by bark stripping and methyl jasmonate
Authors: Nantongo J. S. , Potts B. M. , Frickey T. , Telfer E. , Dungey H. , Fitzgerald H. , O’Reilly-Wapstra J. M.
Published: January 2022

Background

Plants are attacked by diverse insect and mammalian herbivores and respond with different physical and chemical defences. Transcriptional changes underlie these phenotypic changes. Simulated herbivory has been used to study the transcriptional and other early regulation events of these plant responses. In this study, constitutive and induced transcriptional responses to artificial bark stripping are compared in the needles and the bark of Pinus radiata to the responses from application of the plant stressor, methyl jasmonate. The time progression of the responses was assessed over a 4-week period.

Results

Of the 6312 unique transcripts studied, 86.6% were differentially expressed between the needles and the bark prior to treatment. The most abundant constitutive transcripts were related to defence and photosynthesis and their expression did not differ between the needles and the bark. While no differential expression of transcripts were detected in the needles following bark stripping, in the bark this treatment caused an up-regulation and down-regulation of genes associated with primary and secondary metabolism. Methyl jasmonate treatment caused differential expression of transcripts in both the bark and the needles, with individual genes related to primary metabolism more responsive than those associated with secondary metabolism. The up-regulation of genes related to sugar break-down and the repression of genes related with photosynthesis, following both treatments was consistent with the strong down-regulation of sugars that has been observed in the same population. Relative to the control, the treatments caused a differential expression of genes involved in signalling, photosynthesis, carbohydrate and lipid metabolism as well as defence and water stress. However, non-overlapping transcripts were detected between the needles and the bark, between treatments and at different times of assessment. Methyl jasmonate induced more transcriptional responses in the bark than bark stripping, although the peak of expression following both treatments was detected 7 days post treatment application. The effects of bark stripping were localised, and no systemic changes were detected in the needles.

Conclusion

There are constitutive and induced differences in the needle and bark transcriptome of Pinus radiata. Some expression responses to bark stripping may differ from other biotic and abiotic stresses, which contributes to the understanding of plant molecular responses to diverse stresses. Whether the gene expression changes are heritable and how they differ between resistant and susceptible families identified in earlier studies needs further investigation.
What do patients experience? Interprofessional collaborative practice for chronic conditions in primary care: an integrative review
Authors: Davidson Alexandra R. , Kelly Jaimon , Ball Lauren , Morgan Mark , Reidlinger Dianne P.
Published: January 2022

Background

Improving the patient experience is one of the quadruple aims of healthcare. Therefore, understanding patient experiences and perceptions of healthcare interactions is paramount to quality improvement. This integrative review aimed to explore how patients with chronic conditions experience Interprofessional Collaborative Practice in primary care.

Methods

An integrative review was conducted to comprehensively synthesize primary studies that used qualitative, quantitative, and mixed methods. Databases searched were Medline, Embase, CINAHL and Web of Science on June 1st, 2021. Eligible studies were empirical full-text studies in primary care that reported experiences or perceptions of Interprofessional Collaborative Practice by adult patients with a chronic condition, in any language published in any year. Quality appraisal was conducted on included studies using the Mixed Method Appraisal Tool. Data on patients’ experiences and perceptions of Interprofessional Collaborative Practice in primary care were extracted, and findings were thematically analyzed through a meta-synthesis.

Results

Forty-eight (n = 48) studies met the inclusion criteria with a total ofn = 3803 participants. Study quality of individual studies was limited by study design, incomplete reporting, and the potential for positive publication bias. Three themes and their sub-themes were developed inductively: (1) Interacting with Healthcare Teams, subthemes: widening the network, connecting with professionals, looking beyond the condition, and overcoming chronic condition collectively; (2) Valuing Convenient Healthcare, subthemes: sharing space and time, care planning creates structure, coordinating care, valuing the general practitioner role, and affording healthcare; (3) Engaging Self-care, subthemes: engaging passively is circumstantial, and, engaging actively and leading care.

Conclusions

Patients overwhelmingly had positive experiences of Interprofessional Collaborative Practice, signaling it is appropriate for chronic condition management in primary care. The patient role in managing their chronic condition was closely linked to their experience. Future studies should investigate how the patient role impacts the experience of patients, carers, and health professionals in this context.

Systematic review registration

PROSPERO: CRD42020156536.
The influence of primary care quality on nursing home admissions in a multimorbid population with and without dementia in Germany: a retrospective cohort study using health insurance claims data
Authors: Seibert Kathrin , Stiefler Susanne , Domhoff Dominik , Wolf-Ostermann Karin , Peschke Dirk
Published: January 2022

Background

Multimorbidity poses a challenge for high quality primary care provision for nursing care-dependent people with (PWD) and without (PWOD) dementia. Evidence on the association of primary care quality of multimorbid PWD and PWOD with the event of a nursing home admission (NHA) is missing. This study aimed to investigate the contribution of individual quality of primary care for chronic diseases in multimorbid care-dependent PWD and PWOD on the duration of ongoing residence at home before the occurrence of NHA.

Methods

We conducted a retrospective cohort study among elderly care-dependent PWD and PWOD in Germany for six combinations of chronic diseases using statutory health insurance claims data (2007–2016). Primary care quality was measured by 21 process and outcome indicators for hypertension, diabetes, depression, chronic obstructive pulmonary disease and heart failure. The primary outcome was time to NHA after initial onset of care-dependency. Multivariable Cox proportional hazard models were used to compare the time-to-event between PWD and PWOD.

Results

Among 5876 PWD and 12,837 PWOD 5130 NHA occurred. With the highest proportion of NHA for PWD with hypertension and depression and for PWOD with hypertension, diabetes and depression. Average duration until NHA ranged from 6.5 to 8.9 quarters for PWD and from 9.6 to 13.5 quarters for PWOD. Adjusted analyses show consistent associations of the quality of diabetes care with the duration of remaining in one’s own home regardless of the presence of dementia. Process indicators assessing guideline-fidelity are associated with remaining in one’s home longer, while indicators assessing complications, such as emergency inpatient treatment (HR = 2.67, 95% CI 1.99–3.60 PWD; HR = 2.81, 95% CI 2.28–3.47 PWOD) or lower-limb amputation (HR = 3.10, 95% CI 1.78–5.55 PWD; HR = 2.81, 95% CI 1.94–4.08 PWOD) in PWD and PWOD with hypertension and diabetes, increase the risk of NHA.

Conclusions

The quality of primary care provided to care-dependent multimorbid PWD and POWD, influences the time individuals spend living in their own homes after onset of care-dependency before a NHA. Health care professionals should consider possibilities and barriers of guideline-based, coordinated care for multimorbid care-dependent people. Further research on quality indicator sets that acknowledge the complexity of care for multimorbid elderly populations is needed.
Planning and designing a self-compassion intervention for family carers of people living with dementia: a person-based and co-design approach
Authors: Murfield Jenny , Moyle Wendy , O’Donovan Analise
Published: January 2022

Background

This article describes the research activities undertaken to plan and design a self-compassion intervention for family carers of people living with dementia using a person-based and co-design approach. In providing this example, our aim is two-fold: to highlight the value of using qualitative research and co-design processes within intervention development; and to showcase systematic reporting of an intervention’s early planning and design stages.

Methods

A person-based and co-design approach informed the planning and design of the self-compassion intervention. In Stage 1, qualitative interviews were undertaken with 14 family carers of people living with dementia and 14 professional stakeholders. In Stage 2, intervention guiding principles were developed, psychological theory was incorporated, and six family carers of people living with dementia were engaged as co-designers.

Results

Knowledge generated during intervention planning identified that the intervention should be situated within the concept of compassion more broadly; address misperceptions, fears, blocks, and resistances to self-compassion; and target feelings of shame, guilt, and self-criticism. Subsequent intervention design activities determined that the needs of family carers of people living with dementia were best met by tailoring an existing intervention, namely group-based Compassion-Focused Therapy.

Conclusions

Our systematic approach highlights the value of incorporating in-depth qualitative research and co-design within the intervention development process to prioritise the perspectives and lived experiences of family carers of people living with dementia. The planning and design process outlined provides insight that is applicable to the development of our intervention and complex health interventions within gerontology and beyond.
Neutrophil-to-lymphocyte ratio as a prognostic factor for patients with metastatic or recurrent breast cancer treated using capecitabine: a retrospective study
Authors: Takamizawa Shigemasa , Shimoi Tatsunori , Satomi-Tsushita Natsuko , Yazaki Shu , Okuya Toshihiro , Kojima Yuki , Sumiyoshi-Okuma Hitomi , Nishikawa Tadaaki , Tanioka Maki , Sudo Kazuki , Noguchi Emi , Yonemori Kan
Published: January 2022

Background

Eribulin or capecitabine monotherapy is the next cytotoxic chemotherapy option for patients with metastatic or recurrent breast cancer who have previously received an anthracycline or a taxane. However, it is unclear what factors can guide the selection of eribulin or capecitabine in this setting, and prognostic factors are needed to guide appropriate treatment selection. The neutrophil-to-lymphocyte ratio (NLR) is a prognostic factor for eribulin-treated patients, although it is unclear whether it is a prognostic factor for capecitabine-treated patients. Therefore, we analysed the ability of the NLR to predict oncological outcomes among patients who received capecitabine after previous anthracycline or taxane treatment for breast cancer.

Methods

We retrospectively reviewed the medical records of patients with metastatic or recurrent breast cancer who had previously received anthracycline or taxane treatment at the National Cancer Center Hospital between 2007 and 2015. Patients were included if they received eribulin or capecitabine monotherapy as first-line, second-line, or third-line chemotherapy. Analyses of overall survival (OS) and progression-free survival (PFS) were performed according to various factors.

Results

Between 2007 and 2015, we identified 125 eligible patients, including 46 patients who received only eribulin, 34 patients who received only capecitabine, and 45 patients who received eribulin and capecitabine. The median follow-up period was 19.1 months. Among eribulin-treated patients, an NLR of <3 independently predicted better OS. Among capecitabine-treated patients, an NLR of <3 independently predicted better PFS but not better OS. In addition, a lymphocyte-to-monocyte ratio of ≥5 was associated with better PFS and OS.

Conclusions

To the best of our knowledge, this is the first study to evaluate whether the NLR is a prognostic factor for capecitabine-treated patients with metastatic or recurrent breast cancer. However, the NLR only independently predicted PFS in this setting, despite it being a useful prognostic factor for other chemotherapies.
An embedded multiple case study: using CFIR to map clinical food security screening constructs for the development of primary care practice guidelines
Authors: Taher Sabira , Muramatsu Naoko , Odoms-Young Angela , Peacock Nadine , Michael C. Fagen , Courtney K. Suh
Published: January 2022

Background

Food insecurity (FI), the limited access to healthy food to live an active and healthy life, is a social determinant of health linked to poor dietary health and difficulty with disease management in the United States (U.S.). Healthcare experts support the adoption of validated screening tools within primary care practice to identify and connect FI patients to healthy and affordable food resources. Yet, a lack of standard practices limits uptake. The purpose of this study was to understand program processes and outcomes of primary care focused FI screening initiatives that may guide wide-scale program implementation.

Methods

This was an embedded multiple case study of two primary care-focused initiatives implemented in two diverse health systems in Chicago and Suburban Cook County that routinely screened patients for FI and referred them to onsite food assistance programs. The Consolidated Framework for Implementation Research and an iterative process were used to collect/analyze qualitative data through semi-structured interviews withN = 19 healthcare staff. Intended program activities, outcomes, actors, implementation barriers/facilitators and overarching implementation themes were identified as a part of a cross-case analysis.

Results

Programs outcomes included: the number of patients screened, identified as FI and that participated in the onsite food assistance program. Study participants reported limited internal resources as implementation barriers for program activities. The implementation climate that leveraged the strength of community collaborations and aligned internal, implementation climate were critical facilitators that contributed to the flexibility of program activities that were tailored to fill gaps in resources and meet patient and clinician needs.

Conclusion

Highly adaptable programs and the healthcare context enhanced implementation feasibility across settings. These characteristics can support program uptake in other settings, but should be used with caution to preserve program fidelity. A foundational model for the development and testing of standard clinical practice was the product of this study.
COVID-19 infections in day care centres in Germany: social and organisational determinants of infections in children and staff in the second and third wave of the pandemic
Authors: Neuberger Franz , Grgic Mariana , Diefenbacher Svenja , Spensberger Florian , Lehfeld Ann-Sophie , Buchholz Udo , Haas Walter , Kalicki Bernhard , Kuger Susanne
Published: January 2022

Background

During the SARS-CoV-2 pandemic, German early childhood education and care (ECEC) centres organised children’s attendance in different ways, they reduced opening hours, provided emergency support for a few children, or closed completely. Further, protection and hygiene measures like fixed children-staff groups, ventilation and surface disinfection were introduced in ECEC centres. To inform or modify public health measures in ECEC, we investigate the occurrence of SARS-CoV-2 infections among children and staff in ECEC centres in light of social determinants (i.e. the socioeconomic status of the children) and recommended structural and hygiene measures. We focus on the question if the relevant factors differ between the 2nd (when no variant of concern (VOC) circulated) and the 3rd wave (when VOC B.1.1.7 (Alpha) predominated).

Methods

Based on panel data from a weekly online survey of ECEC centre managers (calendar week 36/2020 to 22/2021, ongoing) including approx. 8500 centres, we estimate the number of SARS-CoV-2 infections in children and staff using random-effect-within-between (REWB) panel models for count data in the 2nd and 3rd wave.

Results

ECEC centres with a high proportion of children with low socioeconomic status (SES) have a higher risk of infections in staff and children. Strict contact restrictions between groups like fixed group assignments for children and fixed staff assignments to groups prevent infections. Both effects tend to be stronger in the 3rd wave.

Conclusion

ECEC centres with a large proportion of children with a low SES background and lack of using fixed child/staff cohorts experience higher COVID-19 rates. Over the long run, centres should be supported in maintaining recommended measures. Preventive measures such as the vaccination of staff should be prioritised in centres with large proportions of low SES children.
Acute and sub-acute oral toxicity of aqueous whole leaf and green rind extracts of Aloe vera in Wistar rats
Authors: Nalimu Florence , Oloro Joseph , Peter Emanuel L. , Ogwang Patrick Engeu
Published: January 2022

Background

Several local communities in Central, Western, Eastern, and Northern regions of Uganda have been using the whole leaf extracts of Aloe vera (L.) Burm. f. (Asphodelaceae) in the treatment of various ailments. Also, several commercial companies sell A. vera as soft drinks in Uganda. However, there are inadequate reports on the toxicities of such preparations. This paper reports the acute and sub-acute oral toxicity of aqueous extracts of whole leaf and green rind of A. vera in Wistar rats.

Methods

Acute oral toxicity test was carried out in female Wistar rats at doses of 175, 550, 1750, and 5000 mg/kg, p.o. The animals were observed for signs of toxicity for 14 days. Similarly, a sub-acute oral toxicity test was performed in both sexes of rats at doses of 200, 400, and 800 mg/kg, p.o. daily for 28 days. All the groups of animals were monitored for behavioral, morphological, biochemical, and physiological changes, including mortality and compared with respective controls. Body weights were measured weekly while the animals’ relative organ weights, hematological, biochemical, gross, and microscopic pathology were examined on day 29.

Results

There was no mortality or apparent behavioral changes at the doses tested in acute and sub-acute oral toxicity tests. Thus, the Median Lethal Dose (LD50) of green rind and whole leaf aqueous extracts was above 5000 mg/kg. Gross anatomy revealed that the rats’ relative spleen weight in green rind extract at 200 mg/kg significantly decreased compared to the control group. The creatinine levels in female rats that received green rind extract and the chloride ion levels in male rats administered whole leaf extract were significantly elevated. Conversely, Mean Corpuscular Hemoglobin Concentration (MCHC) levels significantly decreased at lower doses of the green rind extract compared to the control. Histopathology of the kidney revealed the renal interstitium’s inflammation at doses of 200 and 800 mg/kg of the whole leaf extract.

Conclusion

The findings demonstrated that A. vera green rind and whole leaf extracts are non-toxic at relatively high doses when used for a short duration. Prolonged use of the aqueous whole leaf extract might be associated with kidney toxicity.
Do pharmacy practice standards effectively describe behaviour? Reviewing practice standards using a behavioural specificity framework
Authors: Mill Deanna , Page Amy , Johnson Jacinta , Lee Kenneth , Salter Sandra M. , Seubert Liza , Clifford Rhonda , D’Lima Danielle
Published: January 2022

Background

Guidelines and practice standards exist to communicate the conduct and behaviour expected of health care professionals and ensure consistent quality practice. It is important that they describe behaviours explicitly so they can be interpreted, enacted and measured with ease. The AACTT framework specifies behaviour in terms of the: Action to be performed, Actor who performs the action, Context where the action occurs, Target who the action is performed with/for and Time when the action is performed (AACTT). It provides the most up to date framework for specifying behaviours and is particularly relevant to complex behavioural problems that involve sequences of behaviours performed by different people. Behavioural specificity within pharmacy practice standards has not been explored.

Aim

To determine if behaviours described in the Professional Practice Standards for Australian Pharmacists specify Action, Actor, Context, Target and Time.

Methods

Two researchers independently reviewed the scope and structure of the practice standards and one extracted action statements (behaviours) verbatim. Through an iterative process, the researchers modified and developed the existing AACTT definitions to operationalise them for application to review of the action statements in the practice standards. The operational definitions, decision criteria and curated examples were combined in a codebook. The definitions were consistently applied through a directed content analysis approach to evaluate all extracted action statements by one researcher. For consistency 20% was independently checked for agreement by a second researcher.

Results

A novel codebook to apply AACTT criteria to evaluate practice standards was developed. Application of this codebook identified 768 independent behaviours. Of these, 300 (39%) described at least one discrete observable action, none specified an actor, 25 (3%) specified context, 131 (17%) specified target and 88 (11%) specified time.

Conclusion(s)

The behaviours detailed in practice standards for Australian pharmacists do not consistently specify behaviours in terms of Action, Actor, Context, Target and Time. Developers in the pharmacy profession, and beyond, should consider the behavioural specificity of their documents to improve interpretability, usability and adherence to the behaviours detailed. This also has implications for the development and evaluation of interventions to change such behaviours and improve quality of care.
Meta-analysis links dietary branched-chain amino acids to metabolic health in rodents
Authors: Solon-Biet Samantha M. , Griffiths Lucy , Fosh Sophie , Le Couteur David G. , Simpson Stephen J. , Senior Alistair M.
Published: January 2022

Background

The role of dietary branched chain amino acids (BCAAs) and their effect on metabolic health is complex. How dietary BCAA levels and their interaction with background nutrition affect health is unclear. Here, we used meta-analysis and meta-regression, together with the nutritional modelling, to analyse the results of rodent studies that increased the level of dietary BCAAs and measured circulating levels, outcomes related to metabolic health, body mass and food intake.

Results

Across all studies, increasing dietary BCAAs resulted in increased levels of circulating BCAAs. These effects, however, were heavily moderated by background dietary levels whereby on high BCAA diets, further increases were not reflected in the blood. Impaired glucose tolerance was associated with elevated dietary BCAAs, with the greatest effect occurring with a simultaneous increase in total protein intake. Effects of dietary BCAAs on plasma glucose, insulin, or HOMA emerged only when dietary macronutrient background was considered. We found that elevated dietary BCAAs increases % body fat, with largest increases in adiposity occurring when BCAAs are increased on a high protein, low carbohydrate dietary background. Finally, we found that increased dietary BCAAs were associated with increased food intake when the background diet was low in BCAAs.

Conclusion

Our data highlights the interaction between BCAAs and background nutrition. We show that the effects of BCAAs on metabolic health cannot be studied in isolation but must be considered as part of complex mixture of dietary components.
SAG3 Toxoplasma gondii cloning reveals unexpected fivefold infection in the blood of feral cats in the Mexican Caribbean
Authors: Valenzuela-Moreno Luis Fernando , Méndez-Cruz Sara Teresa , Rico-Torres Claudia Patricia , Cedillo-Peláez Carlos , Correa Dolores , Caballero-Ortega Heriberto
Published: January 2022

Background

Currently, more than 300 genotypes ofToxoplasma gondii(T. gondii)have been described throughout the world, demonstrating its wide genetic diversity. TheSAG3locus is one of the genes included in the genotyping panel of this parasite. It is associated with its virulence since it participates during the invasion process of the host cells. Therefore, cloning, sequencing, and bioinformatic analysis were used to deepen the understanding of theSAG3locus genetic diversity ofT. gondiiin blood samples from feral cats.

Results

Six differentSAG3sequences were detected, five of which were detected in one feline. Three sequences were first reported here; one of them was an intragenic recombinant. In the cladogram, four out of tenSAG3sequences did not share nodes with others reported worldwide.

Conclusions

Cloning and sequencing of samples with more than one restriction pattern by PCR-RFLP were very helpful tools to demonstrate the presence of more than three genotypes ofT. gondiiin the blood of feral cats from southeastern Mexico. This suggests a potential mixed infection of multipleT. gondiistrains and high genetic diversity of the parasites in felines in this tropical region of Mexico.
Pandemic inequalities: emerging infectious diseases and health equity
Authors: Bambra Clare
Published: January 2022

The frequency and scale of Emerging Infectious Diseases (EIDs) with pandemic potential has been increasing over the last two decades and, as COVID-19 has shown, such zoonotic spill-over events are an increasing threat to public health globally. There has been considerable research into EIDs – especially in the case of COVID-19. However, most of this has focused on disease emergence, symptom identification, chains of transmission, case prevalence and mortality as well as prevention and treatment. Much less attention has been paid to health equity concerns and the relationship between socio-economic inequalities and the spread, scale and resolution of EID pandemics. This commentary article therefore explores socio-economic inequalities in the nature of EID pandemics. Drawing on three diverse case studies (Zika, Ebola, COVID-19), it hypothesises the four main pathways linking inequality and infectious disease (unequal exposure, unequal transmission, unequal susceptibility, unequal treatment) – setting out a new model for understanding EIDs and health inequalities. It concludes by considering the research directions and policy actions needed to reduce inequalities in future EID outbreaks.
Comparison of RNAscope and immunohistochemistry for evaluation of the UPK2 status in urothelial carcinoma tissues
Authors: Lu Jiangli , Zhao Ming , Wu Chenyan , Chu Chengbiao , Zhang Chris Zhiyi , Cao Yun
Published: January 2022

Background

UPK2 exhibits excellent specificity for urothelial carcinoma (UC). UPK2 evaluation can be useful in making the correct diagnosis of UC. However, UPK2 detection by immunohistochemistry (IHC) has relatively low sensitivity. This paper aimed to compare the diagnostic sensitivity of RNAscope and IHC for evaluation of the UPK2 status in UC.

Methods

Tissue blocks from 127 conventional bladder UCs, 45 variant bladder UCs, 24 upper tract UCs and 23 metastatic UCs were selected for this study. IHC and RNAscope were used to detect the UPK2 status in UCs. Then, comparisons of the two methods were undertaken.

Results

There was no significant difference between RNAscope and IHC for the evaluation of the UPK2 positivity rate in UC (68.0% vs. 62.6%, P = 0.141). Correlation analysis revealed a moderate positive correlation for detection of UPK2: RNAscope vs. IHC (P < 0.001, R = 0.441). Our results showed a trend toward a higher positive UPK2 rate detected by RNAscope (53.3%) than by IHC (35.6%) in variant bladder UCs. Disappointingly, the P value did not indicate a significant difference (P = 0.057).

Conclusions

RNAscope for UPK2 appeared to perform similarly to IHC, with a marginally higher positive rate, suggesting it could be used as an alternative or adjunct to UPK2 IHC.
Cytomegalovirus cell tropism and clinicopathological characteristics in gastrointestinal tract of patients with HIV/AIDS
Authors: Sun Lei , Chen Jia-min , Yang Kun , Zhang Liang , Ma Zhi-yuan , Chen Xiang-mei , Li Man , Zhou Xingang , Li Ping , Zhao Hong-xin , Xiao Jiang , Qi Li-ming , Wang Peng
Published: January 2022

Background

Cytomegalovirus (CMV) has been recognized as one of the frequently occurring opportunistic infections (OIs) reported in the patients having human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). In addition, it has been identified as the factor leading to gastrointestinal (GI) tract disorder among HIV/AIDS population. CMV exhibits broad cell tropism in different organs. This study evaluated the CMV cell tropism and clinicopathological characteristics of CMV infection in the different GI regions in HIV/AIDS cases.

Methods

Using nucleic acid in situ hybridization (ISH), CMV was detected in the gastrointestinal mucosal biopsy samples. The paraffin-embedded samples were stained with hematoxylin and eosin (HE) and immunohistochemistry (IHC), respectively.

Results

A total of 32 HIV/AIDS patients were enrolled in this study. Fourteen of these patients underwent gastroscopy, while the remaining eighteen received colonoscopy. CMV-infected cells were observed at 46 GI sites. Among them, the colon was the region with the highest susceptibility to GI CMV infection (n = 12, 26.1%). The CMV giant cell inclusion bodies were detected in epithelial cells and mesenchymal cells, including histiocytes, smooth muscle cells, fibroblasts, and endothelial cells. In the duodenum, there were markedly more positive epithelial cells than mesenchymal cells (p = 0.033). In contrast, in the esophagus (p = 0.030), cardia (p = 0.003), rectum (p = 0.019), colon (p < 0.001), and cecum (p < 0.001), there were notably less positive epithelial cells than mesenchymal cells. The expression levels of PDGFRα and Nrp2 in the mesenchymal cells were higher than the epithelial cells in cardia, cecum, colon, sigmoid, and rectum, especially in the areas with ulcers. However, Nrp2 in the epithelial cells was higher than that in the duodenum. Moreover, the positive CMV DNA in peripheral blood was related to the CMV-positive cell count, as well as the ulceration in GI tract (p = 0.035 and 0.036, respectively).

Conclusions

The colon has been identified as the GI site with the highest susceptibility to CMV infection. There are different CMV-infected cells in the different sites of the GI that relate to the expression level of PDGFRα and Nrp2. CMV DNA positive in the blood is related to the positive CMV cell count, as well as ulceration in the GI tract.
Knowledge and practice of tracheal tube cuff pressure monitoring: a multicenter survey of anaesthesia and critical care providers in a developing country
Authors: Nwosu Arinze Duke George , Ossai Edmund Ndudi , Onyekwulu Fidelis Anayo , Amucheazi Adaobi Obianuju , Ewah Richard , Onwuasoigwe Okechukwu , Akhideno Irene
Published: January 2022

Background

Tracheal tubes are routinely used during anaesthesia and in the intensive care unit. Subjective monitoring of cuff pressures have been reported to produce consistently inappropriate cuffs pressures, with attendant morbidity. But this practice of unsafe care remains widespread. With the proliferation of intensive care units in Nigeria and increasing access to surgery, morbidity relating to improper tracheal cuff pressure may assume a greater toll. We aimed to evaluate current knowledge and practice of tracheal cuff pressure monitoring among anaesthesia and critical care providers in Nigeria.

Methods

This was a multicenter cross-sectional study conducted from March 18 to April 30, 2021. The first part (A) was conducted at 4 tertiary referral hospitals in Nigeria by means of a self-administered questionnaire on the various cadre of anaesthesia and critical care providers. The second part (B) was a nation-wide telephone survey of anaesthesia faculty fellows affiliated to 13 tertiary hospitals in Nigeria, selected by stratified random sampling.

Results

Only 3.1% (6/196) of the care providers admitted having ever used a tracheal cuff manometer, while 31.1% knew the recommended tracheal cuff pressure. The nationwide telephone survey of anaesthesia faculty fellows revealed that tracheal cuff manometer is neither available, nor has it ever been used in any of the 13 tertiary hospitals surveyed. The ‘Pilot balloon palpation method’ and ‘fixed volume of air from a syringe’ were the most commonly utilized method of cuff pressure estimation by the care providers, at 64.3% and 28.1% respectively in part A survey (84.6% and 15.4% respectively, in the part B survey).

Conclusion

The use of tracheal cuff manometer is very limited among the care providers surveyed in this study. Knowledge regarding tracheal cuff management among the providers is adjudged to be fair, despite the poor practice and unsafe care.
The prognostic utility of protein C as a biomarker for adult sepsis: a systematic review and meta-analysis
Authors: Catenacci Vanessa , Sheikh Fatima , Patel Kush , Fox-Robichaud Alison E.
Published: January 2022

Background

Sepsis, the dysregulated host response to infection, triggers abnormal pro-coagulant and pro-inflammatory host responses. Limitations in early disease intervention highlight the need for effective diagnostic and prognostic biomarkers. Protein C’s role as an anticoagulant and anti-inflammatory molecule makes it an appealing target for sepsis biomarker studies. This meta-analysis aims to assess the diagnostic and prognostic value of protein C (PC) as a biomarker for adult sepsis.

Methods

We searched MEDLINE, PubMed, EMBASE, CINAHL and Cochrane Library from database inception to September 12, 2021. We included prospective observational studies of (1) adult patients (> 17) with sepsis or suspicion of sepsis that; (2) measured PC levels with 24 h of study admission with; and (3) the goal of examining PC as a diagnostic or prognostic biomarker. Two authors screened articles and conducted risk of bias (RoB) assessment, using the Quality in Prognosis Studies (QUIPS) and the Quality Assessment in Diagnostic Studies-2 (QUADAS-2) tools. If sufficient data were available, meta-analysis was conducted to estimate the standardized mean difference (SMD) between patient populations.

Results

Twelve studies were included, and 8 were synthesized for meta-analysis. Pooled analysis demonstrated moderate certainty of evidence that PC levels were less reduced in sepsis survivors compared to non-survivors (6 studies, 741 patients, SMD = 0.52, 95% CI 0.24–0.81, p = 0.0003, I2 = 55%), and low certainty of evidence that PC levels were less reduced in septic patients without disseminated intravascular coagulation (DIC) compared to those with DIC (3 studies, 644 patients, SMD = 0.97, 95% CI 0.62–1.32, p < 0.00001, I2 = 67%). PC could not be evaluated as a diagnostic tool due to heterogeneous control populations between studies.

Conclusion and relevance

Our review demonstrates that PC levels were significantly higher in sepsis survivors compared to non-survivors and patients with sepsis but not disseminated intravascular coagulation (DIC). Our evaluation is limited by high RoB in included studies and poor reporting of the sensitivity and specificity of PC as a sepsis biomarker. Future studies are needed to determine the sensitivity and specificity of PC to identify its clinical significance as a biomarker for early sepsis recognition.

Trial Registration PROSPERO registration number: CRD42021229786. The study protocol was published in BMJ Open.
Limited evidence for graft selection in pediatric ACL reconstruction: a narrative review
Authors: De Petrillo Gianni , Pauyo Thierry , Franklin Corinna C. , Chafetz Ross S. , Nault Marie-Lyne , Veilleux Louis-Nicolas
Published: January 2022

Anterior cruciate ligament reconstruction is the preferred treatment to anterior cruciate ligament injury. With the increase in anterior cruciate ligament injuries in both adults and skeletally immature patients comes the need for individualized anterior cruciate ligament reconstruction graft selection whether it is the type of graft (auto vs. allograft) or the harvesting site (hamstrings, iliotibial band, quadriceps, patella). Several factors need to be considered preoperatively in order to optimize the patients’ recovery and restore anterior cruciate ligament strength and function. These include age and bone maturity, preoperative knee flexor/extensor strength, sport participation, patient’s needs and anatomical characteristics. This paper aims at bringing evidence supporting the use of a personalized approach in graft selection for faster and more efficient return to sport and propose a theoretical framework to support the approach.
The role of R&D and economic policy uncertainty in Sri Lanka’s economic growth
Authors: Amarasekara Chandranath , Iyke Bernard Njindan , Narayan Paresh Kumar
Published: January 2022

In this paper, we assess the role of investment in research and development (R&D) and economic policy uncertainty (EPU) in Sri Lanka’s economic growth experience. We do this by first determining which endogenous growth theories best explain the evolution of total factor productivity (TFP) in the country. Using historical time series data (1980–2018), we find that semi-endogenous growth theories best explain the evolution of TFP in Sri Lanka. This evidence suggests that R&D is critical to the country’s TFP expansion. We find that, through R&D, EPU has a crucial detrimental impact on TFP growth, although it is short-lived. Our findings are robust and have important implications for R&D investment and for moderating EPU.
Pelvic pain in Maigne’s syndrome—a multi-segmental approach
Authors: Singh Tejinder , Kumar Parijat
Published: January 2022

Background

Maigne’s syndrome is a poorly understood condition that affects the thoracolumbar junction. The symptoms can range from pain in the low back, pelvis, hip, lower abdomen, and groin. These symptoms can have bio-mechanical and neurophysiological attributions due to the complexity of spinal mechanics. Thoraco-lumbar junction (T12-L1) is a transitional zone with a higher degree of mean angular motion and a mean translation motion than T10-T11 and T11-T12. This higher degree of translational and rotation mobility predisposes these segments to a higher degree of stress, making them more prone to biomechanical faults such as dysfunctions and positional faults. These altered static and dynamic mechanics can create a cascade of problems along the biomechanical chain. The co-existence of thoracolumbar junction problems with pelvic pain and dysfunctions strengthens the idea of regional interdependence.

Case presentation

The patient is a 44-year-old Caucasian male who reported pain in the low back with symptoms radiating to the right hip, iliac region, lower abdomen, and gluteal region. The patient tested positive for Sacroiliac joint dysfunction with both Laslett’s cluster testing and palpatory sacroiliac examination. In addition, the segmental examination showed restriction in thoracolumbar junction with positive skin rolling test and hypomobility in manual segmental testing. Thus, the manual therapy treatment targeted the thoracolumbar junction and sacroiliac joint to address the underlying biomechanical dysfunctions.

Conclusions

The manual therapy targeting both sacroiliac and thoracolumbar spine can improve pelvic and thoracic spine mobility. In addition, therapeutic exercises can focus on enhancing anterior and posterior chain force generation capacity. This combined approach helped improve functional outcomes with a significant decrease in the Modified Oswestry Disability index and significant improvement on Visual analog scale.