bluuebunny/crossref_metadata_2025 huggingface dataset:
Digital habits of pulmonary rehabilitation service-users following the COVID-19 pandemic
Authors: Polgar Oliver , Patel Suhani , Walsh Jessica A , Barker Ruth E , Ingram Karen A , Kon Samantha SC , Man William DC , Nolan Claire M
Published: February 2022

Objective

We previously demonstrated low levels of digital literacy amongst pulmonary rehabilitation service-users prior to the COVID-19 pandemic. We aimed to identify whether the pandemic accelerated digital literacy in this population, resulting in greater acceptance of remote web-based pulmonary rehabilitation programme models.

Methods

We surveyed digital access and behaviours and pulmonary rehabilitation delivery preferences of service-users referred to pulmonary rehabilitation in 2021 (cohort 2021) and propensity score-matched them to a cohort who completed the survey in 2020 (cohort 2020).

Results

There were indicators that digital access and confidence were better amongst the Cohort 2021 but no difference was seen in the proportion of patients choosing remote web-based pulmonary rehabilitation as an acceptable method of receiving pulmonary rehabilitation.

Conclusion

In an unselected cohort of service-users, remote web-based pulmonary rehabilitation was considered acceptable in only a minority of patients which has implications on healthcare commissioning and delivery of pulmonary rehabilitation.
Experimental analysis on the effect of ring and rotor spun yarns for comfort characteristics of weft knitted fabric structures
Authors: Gedilu Mekdes , Santhanam Sakthivel , Bogale Meseret , Selvaraj Senthil Kumar
Published: February 2022

This research study experimentally analyzed the effect of ring and rotor yarns which are 100% cotton spun yarn with 30s Ne count on the physical and comfort characteristics of single jersey, rib, and interlock knitted fabrics. The physical characteristics such as fabric Thickness, Tightness factor, Bursting strength, Abrasion resistance, and Pilling behavior were studied according to the ASTM Standard and statistically analyzed using Minitab software with ANOVA analysis. The Comfort characteristics were Thermal Insulation behavior (TIV), Water Vapor Permeability, and Air permeability; they were experimentally studied and reported. The results revealed that rotor spun yarn knitted fabrics demonstrated higher Thermal insulation behavior in the knitted structures when compared to ring spun yarn knitted fabrics. Ring spun yarn has better Abrasion resistance than rotor spun yarn, but the air permeability of the knitted fabric made from rotor spun yarn has better air permeability than ring spun yarn. The low stress mechanical properties are shear and compression behavior of ring and rotor spun yarn knitted fabrics were also critically analyzed. The results show that in a few cases the differences between regular fabric properties and the rotor and ring yarn fabric properties are quite significant, while marginal in other cases. However, the surface roughness values showed some interesting features of the knitted fabric structures.
Enhancement of Acylcarnitine Levels in Small Intestine of Abdominal Irradiation Rats Might Relate to Fatty Acid β-Oxidation Pathway Disequilibration
Authors: Liu Hai-Xiang , Lu Xue , Zhao Hua , Li Shuang , Gao Ling , Tian Mei , Liu Qing-Jie
Published: February 2022

Objective

This study aims to analyze the alteration of carnitine profile in the small intestine of abdominal irradiation-induced intestinal injury rats and explore the possible reason for the altered carnitine profile.

Methods

The abdomens of 15 male Sprague Dawley (SD) rats were irradiated with 0, 10, and 15 Gy of 60Co gamma rays. The carnitine profile in the small intestine and plasma samples of SD rats at 72 h after abdominal irradiated with 0 Gy or 10 Gy of 60Co gamma rays were measured by targeted metabolomics. The changes of fatty acid β-oxidation (FAO), including the expression of carnitine palmitoyltransferase 1 (CPT1) and acyl-CoA dehydrogenases, were analyzed in the small intestine samples of SD rats after exposed to 0, 10, and 15 Gy groups.

Results

There were eleven acylcarnitines in the small intestine and fourteen acylcarnitines in the plasma of the rat model significantly enhanced, respectively (P < .05). The expression level and activity of CPT1 in the small intestine were remarkably increased (P < .05), and the activity of acyl-CoA dehydrogenase in the small intestine was noticeably reduced (P < .01) after abdominal irradiation.

Conclusion

The enhanced acylcarnitine levels in the small intestine of abdominal irradiation rats might relate to the FAO pathway disequilibration.
Understanding paths and options for youth citizenship and social justice
Authors: Odera Erica L , Davis John , Brennan Mark , Dolan Pat
Published: February 2022

Youth-focused researchers and practitioners need conceptual models to consider paths for youth citizenship and social justice which are attenuated to the context, social support, visibility, and structure of engagement opportunities. This article will expand upon the initial conceptual model created by Brennan et al. in this special issue by examining how it can be useful for both research and practice. Specifically, this model can help researchers and practitioners to: (1) remain aware of contextual factors affecting youth engagement; (2) understand how different forms of youth engagement fit within the model; and (3) consider strategies and research to encourage more radical forms of youth engagement. The paper will provide support for the conceptual validity of the model by examining theories which align with it and contextual factors to consider during its application. The paper will then apply the model to differentiate between two forms of youth engagement and conclude with a summary of areas for future research and application.
Feature-specific retrieval of the knowledge of having lied before: Persons and questions independently retrieve truth-related information
Authors: Schreckenbach Franziska , Rothermund Klaus
Published: February 2022

Previous research on event coding has shown that, by default, bindings are binary and elemental, that is, individual objects or single features of these objects can retrieve responses separately and independently. In our study, we applied these findings to the automatic retrieval of former deceptions. Specifically, we investigated whether the person or the question to which one has answered deceptively can retrieve this knowledge independently, or whether there is also evidence for configural retrieval processes that use a combination of person and question information to retrieve the truth status of former episodes. We found evidence for retrieval based on single cues (i.e., person or question), supporting that the elementary retrieval of episodes by independent cues also holds in the context of retrieving knowledge about former lies.
Knowledge and compliance to prevention of central line-associated blood stream infections among registered nurses in Jordan
Authors: Matlab Abd Alrahman , Al-Hussami Mahmoud Ogla , Alkaid Albqoor Maha
Published: February 2022

Background

Central line-associated bloods tream infections (CLABSIs) are among the most common healthcare-associated infections (HAIs).

Aims

To assess the rates of CLABSIs and to investigate predictors of knowledge and compliance of registered nurses to central venous catheters (CVCs) maintenance care bundle in intensive care units (ICUs).

Methods

A cross-sectional correlational design was used. A convenient sample of 114 registered nurses was selected from three hospitals in Jordan. Nurses’ knowledge and compliance were measured by previously established measures and an observational checklist developed according to the Center for Disease Control and Prevention (CDC).

Findings

The rate of CLABSI was the lowest in the hospital that applies the CVC bundle of care. Nurses’ knowledge about CLABSI prevention practices was significantly correlated with their compliance to CVCs maintenance care bundle. Nurses’ knowledge differed bytheirage, income, experience in ICU, and nurse-to-patient ratio, and in multiple regressions, age was the single predictor of knowledge of CLABSI prevention. Significant differences were also found in nurses’ compliance to the CVC care bundle according to the hospital and nurse-to-patient ratio. The nurse-to-patient ratio was the single significant predictor, and it attenuated the effect of age and income on nurse’s compliance to the CVC care bundle.

Conclusion

This study indicated the need to expand the application of the CVC maintenance care bundle in hospitals. Programs that target promoting nurses’ knowledge about CLABSI prevention and compliance to CVC care need to consider some factors, such as nurses’ age and the circumstances of their work (nurse-to-patient ratio).
Comparison of Posterior and Lateral Surface Plating for Type B Weber Lateral Malleoli Fractures
Authors: Hegde Atmananda , Shetty Chethan , Joseph Nitin , Mane Prajwal
Published: February 2022

Purpose

The purpose of this study is to compare the functional outcomes, radiological outcomes, complication rates, and hardware removal between lateral and posterior surface plating in isolated type B Weber lateral malleolus fractures.

Methods

It was a retrospective study that compared the outcomes of type B Weber lateral malleoli fractures treated by either lateral surface or posterior surface plating. Radiological and functional outcomes were assessed at regular intervals. The follow-up details and the complications and need for implant removal were collected from the hospital records.

Results

Our study included 60 patients (male-35 and female-25). The mean age was 41.7 ± 10.5 years. In all, 28 (46.7%) patients received lateral surface plating and 32 (53.3%) patients received posterior surface plating. The mean time gap between the injury and the surgery was significantly more among patients who underwent lateral plate insertion ( P < .001). The mean operative time required for both the procedures was comparable, hence nonsignificant (P = .576). The mean American Orthopaedic Foot and Ankle Society score (AOFAS) after 2 years of operation was significantly higher for posterior plate insertion ( P = .014). The complication rates as well as the implant removal rates were higher in patients with lateral plating ( P < .05).

Conclusion

Posterior surface plating can be considered as the procedure of choice for isolated type B Weber lateral malleolus fractures with respect to better functional outcome, lesser complications rates, and need for implant removal.

Level of Evidence:

Level III: Economic/decision
Clinical Problem Solving: A 56-Year-Old Woman With Right Facial Weakness, Numbness, and Diplopia
Authors: Song Kun-Wei , Budhu Joshua , Isroff Catherine , Siegmund Stephanie , Gonzalez Castro L. Nicolas
Published: February 2022

We discuss a case of a middle-aged woman with a history of urothelial carcinoma, who presented with subacute progression of double vision, right facial numbness, and back pain. Her MRI brain and spine demonstrated multifocal enhancing lesions at the skull base and throughout the spine. Since her initial serum and cerebrospinal fluid (CSF) studies were unrevealing, she underwent a biopsy of her skull base lesion, which was initially concerning for infection. However, her symptoms worsened despite appropriate antibiotic therapy, necessitating a spinal root biopsy that was consistent with leptomeningeal urothelial carcinoma. Her case illustrates the challenge of accurately diagnosing isolated leptomeningeal metastatic disease, which can be difficult to diagnose from CSF analysis and often requires multiple lumbar punctures to improve sensitivity. While genitourinary cancers rarely metastasize to the CNS, clinicians should retain high suspicion for neoplastic etiologies of leptomeningeal disease in patients with a history of cancer and new neurologic deficits.
Experience of dolutegravir-based antiretroviral treatment and risks of diabetes mellitus
Authors: Hirigo Agete Tadewos , Gutema Selamawit , Eifa Aberash , Ketema Worku
Published: February 2022

HIV-infected people have started to live longer since the introduction of antiretroviral therapy, however various co-morbid illnesses have emerged. Three HIV-infected individuals, all at least 43 years old, reported with a new onset of type 2 diabetes after switching to dolutegravir-combined antiretroviral therapy regimen. These three people were switched to integrase strand transfer inhibitor (dolutegravir)-based first-line antiretroviral treatment after receiving non-nucleoside reverse transcriptase inhibitor-combined first-line antiretroviral treatment for at least 6 years, as recommended by the World Health Organization for Sub-Saharan African countries, including Ethiopia.All of the given cases had normal plasma fasting sugar (fasting blood sugar <100 mg/dL) at the time of switching. Polyuria, polydipsia, considerable weight loss, and fatigue were all classified as signs of diabetes mellitus in the two male cases. In addition, their laboratory results demonstrated hyperglycemia (plasma fasting blood sugar > 200 mg/dL and urine glucose level ⩾2+) with no ketonuria after switching to dolutegravir for 4–10 months. A glycemic control was achieved, and metformin medication was continued. After 6 months of dolutegravir treatment, the third female case developed diabetic ketoacidosis and severe hyperglycemia (fasting blood glucose level 600 mg/dL, urine glucose level 3+, and ketonuria 3+). To recover from diabetic ketoacidosis, the patient was given intravenous normal saline and regular insulin. Her glycemic control was then restored, and she was switched to NPH insulin. For all of the cases presented, the dolutegravir-based regimen was maintained. Antiretroviral regimens using dolutegravir have the potential to cause hyperglycemia and other side effects. As a result, blood glucose monitoring is required throughout treatment initiation and regularly throughout treatment follow-up, particularly for those on dolutegravir-combined antiretroviral therapy regimens.
‘Using humanity to change systems’ – understanding the work of online feedback moderation: A case study of Care Opinion Scotland
Authors: Berry Emma , Skea Zoë C , Campbell Marion K , Locock Louise
Published: February 2022

Objective

To gain a deeper understanding of online patient feedback moderation through the organisation of Care Opinion in Scotland.

Methods

An ethnographic study, initially using in-person participant observations, switching to remote methods due to the pandemic. This involved the use of remote observations and interviews. Interviews were carried out with the whole Scottish team ( n = 7).

Results

Our results identify three major themes of work found in online patient feedback moderation. The first is process work, where moderators make decisions on how to edit and publish stories. The second is emotional labour from working with healthcare experiences and with NHS staff. The third is the brokering/mediation role of Care Opinion, where they must manage the relationships between authors, subscribing healthcare providers and Scottish Government. Our results also capture that these different themes are not independent and can at times influence the others.

Conclusion

Our results build on previous literature on Care Opinion and provide novel insights into the emotional and brokering/mediation work they undertake. Care Opinion holds a unique position, where they must balance the interests of the key stakeholders. Care Opinion holds the power to amplify authors’ voices but the power to make changes to services lies with NHS staff and services. Online moderation work is complex, and moderators require support to carry out their work especially given the emotional impact. Further research is planned to understand how patient stories are used by NHS Scotland, and the emotional labour involved with stories, from both the author and NHS staff perspective.
Poverty and Youth Migration Out of Nigeria: Enthronement of Modern Slavery
Authors: Nwosu Innocent A. , Eteng Mary J. , Ekpechu Joseph , Nnam Macpherson U. , Ukah Jonathan A. , Eyisi Emmanuel , Orakwe Emmanuel C.
Published: February 2022

International migration, which is the movement of people across national borders, is a regular occurrence. Many reasons have been adduced for youth migration abroad. These youths are sometimes confronted by severe problems. However, those factors that force youths to risk their lives are persistent. The study therefore sought to determine factors that propel youths to engage in migration in spite of the dangers, as well as the relationship between bad governance, illegal migration and modern slavery. Therefore, the study adopted qualitative research design using in-depth interviews to elicit information from participants. Twenty-five youths from Umuozu community, Isiala-Mbano Imo State, Nigeria were selected through stratified sampling technique. Descriptive statistics was used for data analysis. Findings revealed that youths are aware of the dangers inherent in illegal migration yet, majority of them were willing to risk migrating to foreign countries. This is because of the strength of the push-pull factors. Therefore, youths are likely to make themselves available for voluntary slavery due to increasing rate of poverty. Hence, there is urgent need for governments in Nigeria to institute measures to reduce poverty and educate the youths in order to discourage illegal migration—the foundation for modern-day slavery.
Anatomical and Technical Considerations of Robot-Assisted Cervical Pedicle Screw Placement: A Cadaveric Study
Authors: Mao Jennifer Z. , Soliman Mohamed A.R. , Karamian Brian A. , Khan Asham , Fritz Alexander G. , Avasthi Naval , DiMaria Stephen , Levy Bennett R. , O’Connor Timothy E. , Schroeder Gregory , Pollina John , Vaccaro Alexander R. , Mullin Jeffrey P.
Published: February 2022

Study Design

Cadaver study.

Objectives

Assess the feasibility of robot-assisted cervical pedicle screw (RA-CPS) placement and understand the anatomical considerations of this technique.

Methods

Four cadaver specimens free from bony pathology were acquired. Anatomical considerations, such as pedicle width (PW) and height (PH), transverse pedicle angle (TPA), and maximal screw length (MSL), were recorded from preoperative computational tomography (CT) scans. Intraoperative cone-beam CT was acquired and registered to the robotic system. After cervical levels were segmented, screw sizes and trajectories were planned, and RA-CPS were placed. Accuracy was assessed using Gertzbein and Robbin’s classification on postoperative CT scans.

Results

Thirty-five RA-CPS were placed. Major breaches (≥Grade C) occurred in 28.57% screws. Grade A or B accuracy was found in 71.43% of screws, with the most common direction of breach being medial (81.3%). The greatest proportion of breach per level occurred in the upper subaxial levels, (C3:71.4%, C4 66.6%, C5:50%) which had the smallest PW (C3: 4.34 ± .96 mm, C4: 4.48 ± .60, C5: 5.76 ± 1.11). PH was greatest at C2 (8.14 ± 1.89 mm) and ranged subaxial from 6.36 mm (C3) to 7.48 mm (C7). The mean PW was 5.37 mm and increased caudally from 4.34 mm (C3) to 6.31 mm (C7). The mean TPA was 39.9° and decreased moving caudally 46.9°) to C7 (34.4°). The MSL was 37.1 mm and increased from C2 (26.3 mm) to C7 (41.0 mm).

Conclusion

RA-CPS has the potential to be feasible, but technological and instrument modifications are necessary to increase the accuracy in the cervical region.
A case of candida parapsilosis periprosthetic joint infection: Case report and literature review
Authors: Chong Yau Chun , Tse Tao Sun Tycus
Published: February 2022

A 76 year old female, with a background history of eczema and iatrogenic Cushing syndrome, received a right total knee replacement for her knee osteoarthritis. In the early post-operative period, a small amount of discharge was noted from the surgical wound. The wound swab culture of the discharge yielded candida species. It was regarded as contamination initially. Half year later, she presented with a subcutaneous abscess around the right knee. Aspiration and culture confirmed infection of Candida parapsilosis. The patient was treated conservatively with fluconazole because she had initially refused operative treatment. The infection progressed to abscess formation afterward. A two-stage revision arthroplasty with cement spacer was performed subsequently. In addition, we have reviewed the literature regarding fungal periprosthetic joint infection.
Reducing Youth In-Group Favoritism to Address Social Injustice
Authors: Carlo Gustavo , Davis Alexandra N. , Taylor Laura K.
Published: February 2022

Social injustices toward minority groups are pervasive around the world, and further exacerbated by global threats such as COVID-19 and climate change. Prosocial tendencies, such as empathy, moral reasoning, and helping behaviors directed only toward members of one's own social groups, discriminate against outgroups, and can perpetuate an unjust status quo. Yet, recent meta-analyses point to effective intervention programs that can foster prosocial responses across group lines. Developmental science has identified evidence-based interventions, policies, and programs to foster inclusive prosocial tendencies (toward both in-group and out-group members) to redress social injustices and inequities, and ultimately, lead to more just and peaceful societies. The recent developmental science informs five policy principles (e.g., developmental science, resilience, culture, collaboration, and sustainability) that can advance the United Nations Sustainable Development Goals (SDGs) around inclusion and peace.
Undergraduate Medical Students’ Perceptions of an Online Audio-Visual-Based Module for Teaching Musculoskeletal Physical Examination Skills
Authors: Alomar Abdulaziz Z
Published: February 2022

Introduction

Video-based learning has gained prominence in medical education and, more recently, in musculoskeletal teaching. This study investigated medical students’ perceptions of the effectiveness of online video-based learning for musculoskeletal physical examination skills.

Methods

For one academic year, undergraduate medical students were instructed online through video-based learning before bedside teaching about the physical examination of knee and shoulder joints. At the end of the course, the students participated in a survey to assess their perceptions of the online video-based learning module using a pre-validated questionnaire. The questionnaire consisted of closed-ended and open-ended questions. The closed-ended question responses were assessed using a Likert scale; the open-ended responses were analyzed qualitatively.

Results

In total, 242 out of 310 students who participated in the online video-based learning responded to the survey. Most students found the teaching approach to be satisfactory and preferable to traditional teaching methods. However, they also felt that these modules could not replace hands-on practice. The most helpful aspects of the training modules were a better understanding of the specific tests, technique, and sequence of administering the physical examination. Perceived limitations included the inadequately addressed theoretical basis of the physical examination and the special tests, the need for more time to explain clinical anatomy, and the practical implications of the positive special tests.

Conclusion

Undergraduate medical students perceive VBL as helpful for MPES learning. The positive aspects of the VBL approach in teaching MPES are that it is comprehensive, easily accessible, offers standardized teaching, save times, and it includes demonstrations of special tests, examination techniques, and the sequence and organization of the clinical examination. The main perceived limitations were lack of content regarding clinical reasoning and the anatomical basis of the clinical tests.
Seminal fluid gene expression and reproductive fitness in Drosophila melanogaster
Authors: Patlar Bahar , Civetta Alberto
Published: February 2022

Background

The rapid evolution of seminal fluid proteins (SFPs) has been suggested to be driven by adaptations to postcopulatory sexual selection (e.g. sperm competition). However, we have recently shown that most SFPs evolve rapidly under relaxed selective pressures. Given the role of SFPs in competition for fertilization phenotypes, like the ability to transfer and store sperm and the modulation of female receptivity and ovulation, the prevalence of selectively relaxed SFPs appears as a conundrum. One possible explanation is that selection on SFPs might be relaxed in terms of protein amino acid content, but adjustments of expression are essential for post-mating function. Interestingly, there is a general lack of systematic implementation of gene expression perturbation assays to monitor their effect on phenotypes related to sperm competition.

Results

We successfully manipulated the expression of 16 SFP encoding genes using tissue-specific knockdowns (KDs) and determined the effect of these genes’ perturbation on three important post-mating phenotypes: female refractoriness to remating, defensive (P1), and offensive (P2) sperm competitive abilities in Drosophila melanogaster. Our analyses show that KDs of tested SFP genes do not affect female refractoriness to remating and P2, however, most gene KDs significantly decreased P1. Moreover, KDs of SFP genes that are selectively constrained in terms of protein-coding sequence evolution have lower P1 than KDs of genes evolving under relaxed selection.

Conclusions

Our results suggest a more predominant role, than previously acknowledged, of variation in gene expression than coding sequence changes on sperm competitive ability in D. melanogaster.
Models to predict the short-term survival of acute-on-chronic liver failure patients following liver transplantation
Authors: Yang Min , Peng Bo , Zhuang Quan , Li Junhui , Liu Hong , Cheng Ke , Ming Yingzi
Published: February 2022

Background

Acute-on-chronic liver failure (ACLF) is featured with rapid deterioration of chronic liver disease and poor short-term prognosis. Liver transplantation (LT) is recognized as the curative option for ACLF. However, there is no standard in the prediction of the short-term survival among ACLF patients following LT.

Method

Preoperative data of 132 ACLF patients receiving LT at our center were investigated retrospectively. Cox regression was performed to determine the risk factors for short-term survival among ACLF patients following LT. Five conventional score systems (the MELD score, ABIC, CLIF-C OFs, CLIF-SOFAs and CLIF-C ACLFs) in forecasting short-term survival were estimated through the receiver operating characteristic (ROC). Four machine-learning (ML) models, including support vector machine (SVM), logistic regression (LR), multi-layer perceptron (MLP) and random forest (RF), were also established for short-term survival prediction.

Results

Cox regression analysis demonstrated that creatinine (Cr) and international normalized ratio (INR) were the two independent predictors for short-term survival among ACLF patients following LT. The ROC curves showed that the area under the curve (AUC) ML models was much larger than that of conventional models in predicting short-term survival. Among conventional models the model for end stage liver disease (MELD) score had the highest AUC (0.704), while among ML models the RF model yielded the largest AUC (0.940).

Conclusion

Compared with the traditional methods, the ML models showed good performance in the prediction of short-term prognosis among ACLF patients following LT and the RF model perform the best. It is promising to optimize organ allocation and promote transplant survival based on the prediction of ML models.
Bloodstream infection and pneumonia caused by Chlamydia abortus infection in China: a case report
Authors: Zhu Changjun , Lv Minjie , Huang Jianling , Zhang Changwen , Xie Lixu , Gao Tianming , Han Bo , Wang Wenjing , Feng Ganzhu
Published: February 2022

Background

Chlamydia abortus is generally considered to cause abortion, stillbirth, and gestational sepsis in pregnant women, but it’s rare in bloodstream infection and pneumonia.

Case presentation

We present details of a patient with bloodstream infection and pneumonia caused by Chlamydia abortus. Both blood next-generation sequencing (NGS) and sputum NGS indicate Chlamydia abortus infection. The patient received intravenous infusion of piperacillin sodium and tazobactam sodium (4.5 g/8 h) and moxifloxacin (0.4 g/d) and oral oseltamivir (75 mg/day). Within one month of follow-up, the patient's clinical symptoms were significantly improved, and all laboratory parameters showed no marked abnormality. However, chest computer tomography (CT) showed the inflammation wasn’t completely absorbed. And we are still following up.

Conclusions

Chlamydia abortus can cause pneumonia in humans. NGS has the particular advantage of quickly and accurately identifying the infection of such rare pathogens. Pneumonia is generally not life-threatening, and has a good prognosis with appropriate treatment. However, Chlamydia infection can lead to serious visceral complications which clinicians should pay attention to.
Epidemiological and clinical risk factors related to severe COVID-19 in Iran: a multi-center study
Authors: Hashemi-Shahri Seyed Mohammad , Tabatabaei Seyed Mohammad Nasiraldin , Ansari-Moghaddam Alireza , Mohammadi Mahdi , Okati-Aliabad Hassan , Tabatabaei Seyed Mehdi , Ansari Hossein , Abbasi Mohammadhadi , Sheikhzadeh Khodadad , Baygi Mehdi Zanganeh , Sartipi Majid , Sanei-Sistani Sharareh , Khorashad Ali Reza Salimi , Ansari-Moghadam Fatemeh , Torab Neda , Khalili Tahereh , Miri-Aliabad Ghasem
Published: February 2022

Background

Iran was one of the first countries to be affected by COVID-19. Identifying factors associated with the severity of COVID-19 is effective in disease management. This study investigated the epidemiological and clinical features and factors related to the severity of COVID-19 in one of the less privileged areas in Iran.

Methods

In a multi-center study, all patients admitted to Zahedan University of Medical Sciences hospitals in southeastern Iran were investigated from February 29 to April 31, 2020. Demographic, epidemiological, and clinical data of patients were extracted from medical records. Bivariate and multivariate logistic regression models were used to explore the risk factors associated with the severity of COVID-19.

Results

Among the 413 patients, 55.5% were male, and 145 (35.10%) were in a severe condition at admission time. Multivariate analysis showed that the adjusted odds of the disease severity increased in patients with older age (OR 2.27; 95% CI 1.41–3.65), substance abuse (OR 2.49; 95% CI 1.14–5.43), having one underlying disease (OR 1.52; 95% CI 0.90–2.55), having two underlying disease (OR 2.31; 95% CI 1.19–4.50), and having three or more underlying disease (OR 2.60; 95% CI 1.19–5.66).

Conclusions

COVID-19 was more severe in older patients, patients with a history of substance abuse, and patients with the underlying disease. Understanding the factors affecting the disease severity can help the clinical management of COVID-19, especially in less privileged areas where fewer resources are available.
Mental health and life satisfaction among 10–11-year-olds in Wales, before and one year after onset of the COVID-19 pandemic
Authors: Moore Graham , Anthony Rebecca , Angel Lianna , Hawkins Jemma , Morgan Kelly , Copeland Lauren , Murphy Simon , Van Godwin Jordan , Shenderovich Yulia
Published: February 2022

Background

In many countries, including in the United Kingdom (UK), COVID-19 social distancing measures placed substantial restrictions on children’s lives in 2020 and 2021, including closure of schools and limitations on play. Many children faced milestones such as transition to secondary school having missed several months of face-to-face schooling in the previous academic years.

Methods

This paper examines change in mental health difficulties, life satisfaction, school connectedness, and feelings about transition to secondary school among 10–11-year-olds in Wales, UK, using data from repeat cross-sectional surveys before and after the onset of the COVID-19 pandemic. Participants were 4032 10–11-year-old schoolchildren. The first cohort completed a school-based survey in 2019 (prior to introduction of social distancing measures), and the second in 2021 (following full return to school after two rounds of school closure).

Results

The percentage of children reporting elevated emotional difficulties rose from 17% in 2019 to 27% in 2021 (Odds Ratio = 1.65; 95%CI = 1.23 to 2.20). There was no evidence of increased behavioural difficulties (OR = 1.04; 95%CI = 0.73 to 1.46). There was a tendency toward declines in life satisfaction in all analyses, but this intersected the null (OR = 0.86; 95%CI = 0.70 to 1.07). Children reported a high degree of school connectedness before and after the pandemic, with no evidence of change in ratings of teacher relationships, pupil relationships or pupil involvement in school life. There was no evidence of impacts of the pandemic on children’s feelings about the transition to secondary school, with feelings becoming more positive as transition neared. Most findings were robust to a range of sensitivity analyses.

Conclusions

Supporting children’s emotional recovery from the COVID-19 pandemic is a public health priority requiring urgent and effective action at multiple levels of society. Maintaining connectedness to school through the pandemic may have played a role in preventing a steeper increase in child mental health difficulties.
Association between physical activity, sedentary time, participation in organized activities, social support, sleep problems and mental distress among adults in Southern Norway: a cross-sectional study among 28,047 adults from the general population
Authors: Stea Tonje Holte , Solaas Susanne Aune , Kleppang Annette Løvheim
Published: February 2022

Background

Identification of modifiable factors associated with poor mental health is crucial to develop targeted and effective intervention strategies for prevention of mental distress and illness in the general population. Thus, the aim of the present study was to examine the association between low level of leisure-time physical activity, high sedentary time, low participation in organized activities, low social support, sleep problems, and mental distress in a large sample of Norwegian adults.

Methods

A cross-sectional study was completed by 28,047 adults (≥18 years old) in southern Norway by filling out an online self-report questionnaire. Multivariable binary logistic regression models, stratified according to gender and adjusted for age and perceived financial situation, were used to examine possible associations between unhealthy lifestyle behaviors, participation in organized activities, social support, and mental distress.

Results

Our results showed an increased odds of having mental distress among men reporting low leisure-time physical activity (OR: 1.18; 95%CI: 1.03–1.37), high sedentary time (1.32; 1.16–1.51), low involvement in organized activities (1.43; 1.25–1.64), low social support (2.55; 2.18–2.99), and sleep problems (7.29; 6.35–8.37) compared to the rest of the male population. For women, the results showed increased odds of mental distress among those reporting high sedentary time (1.25; 1.11–1.39), low involvement in organized activities (1.60; 1.42–1.80), low social support (2.71; 2.39–3.06), and sleep problems (5.78; 5.15–6.50) compared to the rest of the female population. For both men and women, results also indicated that mental distress was increased among younger adults and among those reporting financial difficulties compared to the rest of the population.

Conclusion

Our results showed an association between unhealthy lifestyle behaviors, low participation in organized activities, low social support and mental distress, and that the strength of the association varied substantially. These findings provide increased knowledge about the relationship between modifiable lifestyle factors and mental health which should have implications for future public health efforts.
Multiple vas deferens with polyorchidism and many congenital malformations in a symptomatic 11-year-old male patient: a rare case report
Authors: Mansour Marah , Ismail Mohammad Adel , Dashan Mohammad Ali , Kheat Ahmad , Alsuliman Tamim , Alrebdawi Khaled
Published: February 2022

Background

Ductus deferens may manifest in a variety of anomalies such as its absence, duplication, ectopy, or diverticulum. Ectopic seminal tract opening has two main types, ectopic ejaculatory duct opening, and ectopic vas deferens opening. Generally, ductus deferens anomalies affect approximately 0.05% of the population. Patients may be asymptomatic or complaining of urinary tract infections and/or epididymitis. Most of these cases are associated with renal dysplasia. To confirm the diagnosis Cystourethroscopy catheterization and retrograde urethrogram should be performed, but the definitive diagnosis is done by vasography. The definitive treatment is complete surgical resection of the pathological urogenital connection. This case is commonly discovered while exploring other findings such as testicular torsion and inguinal hernia.

Case presentation

We report a rare case of an 11-year-old male who presented with gross hematuria and numerous congenital malformations including a left polydactyly clubfoot, polyorchidism, with several surgical procedures, and left kidney dysgenesis. Surgery was performed for a left inguinal hernia, during which a third undescended testicle was discovered incidentally and was eradicated. A retrograde urethrogram was performed to establish the diagnosis. A fistula- that is connected with the left ureter- was resected. The histopathologic findings confirmed the diagnosis of true duplication of the Vas deferens, with communication between the ureter and the vas deferens. By follow-up, the kidney function tests were within normal limits.

Conclusions

This case report aims to highlight the early diagnosis and management of the duplicated vas deferens and the associated congenital malformations to improve the prognosis and kidney function and to avoid long-term complications.
A rare case of male Fournier’s gangrene with mixed Actinomyces turicensis infection
Authors: Mao Tong-chun , Zhou Xuan , Tian Meng-nan , Zhang Yi-ming , Wang Shao-liang
Published: February 2022

Background

Fournier's gangrene (FG), a urological emergency with high mortality, is an infectious necrotizing fasciitis of the perineal and genital regions. The majority of FG is caused by polymicrobial organisms involving mixed aerobes and anaerobes but rarely reveals Actinomyces species.

Case presentation

We report a healthy 67-year-old Asian male who presented with rapidly progressive painful swelling of the scrotum. Clinically diagnosed with FG, the patient underwent an emergency radical debridement, followed by broad-spectrum antibiotics and negative pressure wound therapy. The identification of the causative microorganisms showed Actinomyces turicensis and the antibiotic treatment was adjusted accordingly. After wound bed preparation, we took split-thickness skin grafts to cover the scrotal wound. Active management to minimize faecal contamination was applied throughout the whole course of treatment and repair. The patient was satisfied with the outcome. This was an extremely rare case of A. turicensis as the main causative pathogen of FG.

Conclusions

FG due to Actinomyces species is rarely reported, but we should still consider this pathogenic microorganism that has long been neglected.
Investigating the knowledge, perception, and practice of healthcare practitioners toward rational use of compounded medications and its contribution to antimicrobial resistance: a cross-sectional study
Authors: Assefa Desta , Paulos Getahun , Kebebe Dereje , Alemu Sintayehu , Reta Wondu , Mulugeta Temesgen , Gashe Fanta
Published: February 2022

Background

Pharmaceutical compounding ensures access of individuals with specific requirements to individualized therapy. However, there is an inconsistency of compounded medication quality. Therefore, advancing the rational use of compounded medication is essential for patient safety and medication effectiveness.

Objective

The presented study was aimed to investigate the healthcare practitioners’ knowledge, perception, and practice of extemporaneous compounding and its contribution to the prevalence of antimicrobial resistance.

Method

A descriptive cross-sectional survey using a structured questionnaire was conducted. The study participants were 300 healthcare practitioners working in Jimma University Medical Center, hospital pharmacies, and community pharmacies in Jimma and Mettu Town, Southwest Ethiopia.

Results

Most respondents were pharmacists (62.7%) and first-degree holders (48.3%). The majority of them had experience in administering (57.7%), preparing (38%), prescribing (21%), and repackaging and labeling (14%) compounded medications. Commonly they request compounded medications when prepackaged products (77.7%) and needed dosage regimens (72.3%) were not available in the market. However, most of them believed that compounded medications might lack quality (49%) and had poor patient compliance (40.7%). Moreover, they fear that inappropriate preparation processes (75%) and under-dose administration (59%) of compounded medication might contribute to the development and prevalence of antimicrobial resistance.

Conclusion

Most healthcare practitioners practice rational use of compounded medications and strongly agree that inappropriate compounding of antimicrobials contributes to antimicrobial resistance development.
METTL3/IGF2BP3 axis inhibits tumor immune surveillance by upregulating N6-methyladenosine modification of PD-L1 mRNA in breast cancer
Authors: Wan Weijun , Ao Xiang , Chen Quan , Yu Yang , Ao Luoquan , Xing Wei , Guo Wei , Wu Xiaofeng , Pu Chengxiu , Hu Xueting , Li Zhan , Yao Mengwei , Luo Donglin , Xu Xiang
Published: February 2022

Background

Continual expression of PD-L1 in tumor cells is critical for tumor immune escape and host T cell exhaustion, however, knowledge on its clinical benefits through inhibition is limited in breast cancer. N6-methyladenosine (m6A) plays a crucial role in multiple biological activities. Our study aimed to investigate the regulatory role of the m6A modification in PD-L1 expression and immune surveillance in breast cancer.

Methods

MeRIP-seq and epitranscriptomic microarray identified that PD-L1 is the downstream target of METTL3. MeRIP-qPCR, absolute quantification of m6A modification assay, and RIP-qPCR were used to examine the molecular mechanism underlying METTL3/m6A/IGF2BP3 signaling axis in PD-L1 expression. B-NDG and BALB/c mice were used to construct xenograft tumor models to verify the phenotypes upon METTL3 and IGF2BP3 silencing. In addition, breast cancer tissue microarray was used to analyze the correlation between PD-L1 and METTL3 or IGF2BP3 expression.

Results

We identified that PD-L1 was a downstream target of METTL3-mediated m6A modification in breast cancer cells. METTL3 knockdown significantly abolished m6A modification and reduced stabilization of PD-L1 mRNA. Additionally, METTL3-mediated PD-L1 mRNA activation was m6A-IGF2BP3-dependent. Moreover, inhibition of METTL3 or IGF2BP3 enhanced anti-tumor immunity through PD-L1-mediated T cell activation, exhaustion, and infiltration both in vitro and in vivo. PD-L1 expression was also positively correlated with METTL3 and IGF2BP3 expression in breast cancer tissues.

Conclusion

Our study suggested that METTL3 could post-transcriptionally upregulate PD-L1 expression in an m6A-IGF2BP3-dependent manner to further promote stabilization of PD-L1 mRNA, which may have important implications for new and efficient therapeutic strategies in the tumor immunotherapy.
Impact of prehabilitation during neoadjuvant chemotherapy and interval cytoreductive surgery on ovarian cancer patients: a pilot study
Authors: Miralpeix Ester , Sole-Sedeno Josep-Maria , Rodriguez-Cosmen Cristina , Taus Alvaro , Muns Maria-Dolors , Fabregó Berta , Mancebo Gemma
Published: February 2022

Background

Cytoreductive surgery followed by systemic chemotherapy is the standard of treatment in advanced ovarian cancer where feasible. Neoadjuvant chemotherapy (NACT) followed by surgery is applicable where upfront cytoreductive surgery is not feasible because of few certain reasons. Nevertheless, surgical interventions and the chemotherapy itself may be associated with postoperative complications usually entailing slow postoperative recovery. Prehabilitation programs consist of the patient’s preparation before surgery to improve the patient’s functional capacity. The aim of this study was to evaluate the impact of a prehabilitation program during neoadjuvant treatment and interval cytoreductive surgery for ovarian cancer patients.

Methods

A retrospective observational pilot study of patients with advanced ovarian cancer treated with NACT and interval cytoreductive surgery was conducted. The prehabilitation group received a structured intervention based on physical exercise, nutritional counseling, and psychological support. Nutritional parameters were assessed preoperatively and postoperatively, and functional parameters and perioperative and postoperative complications were also recorded.

Results

A total of 29 patients were included in the study: 14 in the prehabilitation group and 15 in the control group. The patients in the prehabilitation program showed higher mean total protein levels in both preoperative (7.4 vs. 6.8, p = 0.004) and postoperative (4.9 vs. 4.3, p = 0.005) assessments. Up to 40% of controls showed intraoperative complications vs. 14.3% of patients in the prehabilitation group, and the requirement of intraoperative blood transfusion was significantly lower in the prehabilitation group (14.3% vs. 53.3%, p = 0.027). The day of the first ambulation, rate of postoperative complications, and length of hospital stay were similar between the groups. Finally, trends towards shorter time between diagnosis and interval cytoreductive surgery (p = 0.097) and earlier postoperative diet restart (p = 0.169) were observed in the prehabilitation group.

Conclusion

Prehabilitation during NACT in women with ovarian cancer candidates to interval cytoreductive surgery may improve nutritional parameters and thereby increase postoperative recovery. Nevertheless, the results of this pilot study are preliminary, and further studies are needed to determine the clinical impact of prehabilitation programs.