bluuebunny/crossref_metadata_2025 huggingface dataset:
Human microbiota modulation via QseC sensor kinase mediated in the Escherichia coli O104:H4 outbreak strain infection in microbiome model
Authors: Machado Ribeiro Tamara Renata , Salgaço Mateus Kawata , Adorno Maria Angela Tallarico , da Silva Miriam Aparecida , Piazza Roxane Maria Fontes , Sivieri Katia , Moreira Cristiano Gallina
Published: June 2021

Background

The intestinal microbiota plays a crucial role in human health, adjusting its composition and the microbial metabolites protects the gut against invading microorganisms. Enteroaggregative E. coli (EAEC) is an important diarrheagenic pathogen, which may cause acute or persistent diarrhea (≥14 days). The outbreak strain has the potent Shiga toxin, forms a dense biofilm and communicate via QseBC two-component system regulating the expression of many important virulence factors.

Results

Herein, we investigated the QseC histidine sensor kinase role in the microbiota shift during O104:H4 C227–11 infection in the colonic model SHIME® (Simulator of the Human Intestinal Microbial Ecosystem) and in vivo mice model. The microbiota imbalance caused by C227–11 infection affected ỿ-Proteobacteria and Lactobacillus spp. predominance, with direct alteration in intestinal metabolites driven by microbiota change, such as Short-chain fatty acids (SCFA). However, in the absence of QseC sensor kinase, the microbiota recovery was delayed on day 3 p.i., with change in the intestinal production of SCFA, like an increase in acetate production. The higher predominance of Lactobacillus spp. in the microbiota and significant augmented qseC gene expression levels were also observed during C227–11 mice infection upon intestinal depletion. Novel insights during pathogenic bacteria infection with the intestinal microbiota were observed. The QseC kinase sensor seems to have a role in the microbiota shift during the infectious process by Shiga toxin-producing EAEC C227–11.

Conclusions

The QseC role in C227–11 infection helps to unravel the intestine microbiota modulation and its metabolites during SHIME® and in vivo models, besides they contribute to elucidate bacterial intestinal pathogenesis and the microbiota relationships.
Diabetic microvascular complications are associated with reduced global longitudinal strain independent of atherosclerotic coronary artery disease in asymptomatic patients with diabetes mellitus: a cross-sectional study
Authors: Pararajasingam Gokulan , Heinsen Laurits Juhl , Larsson Johanna , Andersen Thomas Rueskov , Løgstrup Brian Bridal , Auscher Søren , Hangaard Jørgen , Møgelvang Rasmus , Egstrup Kenneth
Published: June 2021

Background

Reduced left ventricular function, assessed by global longitudinal strain (GLS), is sometimes observed in asymptomatic patients with diabetes mellitus (DM) and is often present in patients with diabetes-related microvascular complications. Our aim was to assess the association between microvascular complications, coronary artery plaque burden (PB) and GLS in asymptomatic patients with DM and non-obstructive coronary artery disease (CAD).

Methods

This cross-sectional study included patients with DM without any history, symptoms or objective evidence of obstructive CAD. All patients were identified in the outpatient Clinic of Endocrinology at Odense University Hospital Svendborg. An echocardiography and a coronary computed tomography angiography were performed to assess GLS and the degree of CAD, respectively. A coronary artery stenosis < 50% was considered non-obstructive. A linear regression model was used to evaluate the impact of potential confounders on GLS with adjustment of body mass index (BMI), mean arterial pressure (MAP), microvascular complications, type of diabetes, tissue Doppler average early diastolic mitral annulus velocity (e’) and PB.

Results

Two hundred and twenty-two patients were included, of whom 172 (77%) had type 2 DM and 50 (23%) had type 1 diabetes. One hundred and eleven (50%) patients had microvascular complications. GLS decreased as the burden of microvascular complications increased (P-trend = 0.01): no microvascular complications, GLS (− 16.4 ± 2.5%), 1 microvascular complication (− 16.0 ± 2.5%) and 2–3 microvascular complications (− 14.9 ± 2.8%). The reduction in GLS remained significant after multivariable adjustment (β 0.50 [95% CI 0.11–0.88], p = 0.01). BMI (β 0.12 [95% CI 0.05–0.19]) and MAP (β 0.05 [95% CI 0.01–0.08]) were associated with reduced GLS. In addition, an increased number of microvascular complications was associated with increased PB (β 2.97 [95% CI 0.42–5.51], p = 0.02) in a univariable linear regression model, whereas there was no significant association between PB and GLS.

Conclusions

The burden of microvascular complications was associated with reduced GLS independent of other cardiovascular risk factors in asymptomatic patients with DM and non-obstructive CAD. In addition, the burden of microvascular complications was associated with increasing PB, whereas PB was not associated with GLS.
Experiences of community-dwelling older people with dementia participating in a person-centred multidimensional interdisciplinary rehabilitation program
Authors: Sondell Anna , Lampinen Josefine , Conradsson Mia , Littbrand Håkan , Englund Undis , Nilsson Ingeborg , Lindelöf Nina
Published: June 2021

Background

There is great need for development of feasible rehabilitation for older people with dementia. Increased understanding of this population’s experiences of rehabilitation participation is therefore important. The aim of this study was to explore the experiences of community-dwelling older people with dementia participating in a person-centred multidimensional interdisciplinary rehabilitation program.

Methods

Sixteen older people with dementia were interviewed about their experiences of participation in a person-centred multidimensional interdisciplinary rehabilitation program. The program comprised assessments by a comprehensive team of rehabilitation professionals followed by a rehabilitation period of 16 weeks, including interventions based on individualized rehabilitation goals conducted with the support of the rehabilitation team. The rehabilitation was performed in the participants’ homes, in the community and at an outpatient clinic, including exercise with social interaction in small groups offered twice a week to all participants. The interviews were conducted at the end of the rehabilitation period and analysed with qualitative content analysis.

Results

The analysis resulted in one overarching theme: Empowered through participation and togetherness and four sub-themes: Being strengthened through challenges; Gaining insights, motives, and raising concerns about the future; Being seen makes participation worthwhile; and Feelings of togetherness in prosperity and adversity. The participants increased their self-esteem by daring and coping in the rehabilitation. The insights about themselves and their condition motivated them to continue with their prioritized activities, but also raised concerns about how the future would play out. Collaboration in the group and being seen and acknowledged by staff strengthened their own motivation and self-efficacy.

Conclusion

According to community-dwelling older people with dementia, a person-centred multidimensional interdisciplinary rehabilitation program was experienced as viable and beneficial. The participants seemed empowered through the rehabilitation and expressed mostly positive experiences and perceived improvements. Providers of interdisciplinary rehabilitation programs for this group should consider aspects raised by the participants e.g. the positive experience of being challenged in both exercise and daily activities; the importance of being seen and feeling secure; the benefits and challenges of collaboration with others in the same situation; and the generation of new perspectives of current and future situation.
Antimicrobial resistance in Neisseria gonorrhoeae isolates and gonorrhoea treatment in the Republic of Belarus, Eastern Europe, 2009–2019
Authors: Aniskevich Aliaksandra , Shimanskaya Iryna , Boiko Iryna , Golubovskaya Tatyana , Golparian Daniel , Stanislavova Iryna , Jacobsson Susanne , Adaskevich Aliaksandr , Unemo Magnus
Published: June 2021

Background

Limited antimicrobial resistance (AMR) data for Neisseria gonorrhoeae are available in Eastern Europe. We investigated AMR in N. gonorrhoeae isolates in the Republic of Belarus from 2009 to 2019, antimicrobial treatment recommended nationally, and treatment given to patients with gonorrhoea.

Methods

N. gonorrhoeae isolates (n = 522) cultured in three regions of Belarus in 2009–2019 were examined. Determination of minimum inhibitory concentrations (MICs) of eight antimicrobials was performed using Etest. Resistance breakpoints from the European Committee on Antimicrobial Susceptibility Testing were applied where available. A Nitrocefin test identified β-lactamase production. Gonorrhoea treatment for 1652 patients was also analysed. Statistical significance was determined by the Z-test, Fisher’s exact test, or Mann-Whitney U test with p-values of < 0.05 indicating significance.

Results

In total, 27.8% of the N. gonorrhoeae isolates were resistant to tetracycline, 24.7% to ciprofloxacin, 7.0% to benzylpenicillin, 2.7% to cefixime, and 0.8% to azithromycin. No isolates were resistant to ceftriaxone, spectinomycin, or gentamicin. However, 14 (2.7%) isolates had a ceftriaxone MIC of 0.125 mg/L, exactly at the resistance breakpoint (MIC > 0.125 mg/L). Only one (0.2%) isolate, from 2013, produced β-lactamase. From 2009 to 2019, the levels of resistance to ciprofloxacin and tetracycline were relatively high and stable. Resistance to cefixime was not identified before 2013 but peaked at 22.2% in 2017. Only sporadic isolates with resistance to azithromycin were found in 2009 (n = 1), 2012 (n = 1), and 2018–2019 (n = 2). Overall, 862 (52.2%) patients received first-line treatment according to national guidelines (ceftriaxone 1 g). However, 154 (9.3%) patients received a nationally recommended alternative treatment (cefixime 400 mg or ofloxacin 400 mg), and 636 (38.5%) were given non-recommended treatment.

Conclusions

The gonococcal resistance to ciprofloxacin and tetracycline was high, however, the resistance to azithromycin was low and no resistance to ceftriaxone was identified. Ceftriaxone 1 g can continuously be recommended as empiric first-line gonorrhoea therapy in Belarus. Fluoroquinolones should not be prescribed for treatment if susceptibility has not been confirmed by testing. Timely updating and high compliance with national evidence-based gonorrhoea treatment guidelines based on quality-assured AMR data are imperative. The need for continued, improved and enhanced surveillance of gonococcal AMR in Belarus is evident.
Central and peripheral nervous system involvement by COVID-19: a systematic review of the pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings
Authors: Guerrero Juan I. , Barragán Luis A. , Martínez Juan D. , Montoya Juan P. , Peña Alejandra , Sobrino Fidel E. , Tovar-Spinoza Zulma , Ghotme Kemel A.
Published: June 2021

Background

SARS-CoV-2 can affect the human brain and other neurological structures. An increasing number of publications report neurological manifestations in patients with COVID-19. However, no studies have comprehensively reviewed the clinical and paraclinical characteristics of the central and peripheral nervous system’s involvement in these patients. This study aimed to describe the features of the central and peripheral nervous system involvement by COVID-19 in terms of pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings.

Methods

We conducted a comprehensive systematic review of all the original studies reporting patients with neurological involvement by COVID-19, from December 2019 to June 2020, without language restriction. We excluded studies with animal subjects, studies not related to the nervous system, and opinion articles. Data analysis combined descriptive measures, frequency measures, central tendency measures, and dispersion measures for all studies reporting neurological conditions and abnormal ancillary tests in patients with confirmed COVID-19.

Results

A total of 143 observational and descriptive studies reported central and peripheral nervous system involvement by COVID-19 in 10,723 patients. Fifty-one studies described pathophysiologic mechanisms of neurological involvement by COVID-19, 119 focused on clinical manifestations, 4 described neuropathology findings, 62 described neuroimaging findings, 28 electrophysiology findings, and 60 studies reported cerebrospinal fluid results. The reviewed studies reflect a significant prevalence of the nervous system’s involvement in patients with COVID-19, ranging from 22.5 to 36.4% among different studies, without mortality rates explicitly associated with neurological involvement by SARS-CoV-2. We thoroughly describe the clinical and paraclinical characteristics of neurological involvement in these patients.

Conclusions

Our evidence synthesis led to a categorical analysis of the central and peripheral neurological involvement by COVID-19 and provided a comprehensive explanation of the reported pathophysiological mechanisms by which SARS-CoV-2 infection may cause neurological impairment. International collaborative efforts and exhaustive neurological registries will enhance the translational knowledge of COVID-19’s central and peripheral neurological involvement and generate therapeutic decision-making strategies.

Registration

This review was registered in PROSPERO 2020 CRD42020193140 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193140
Prevalence of visceral artery involvement in patients with peripheral artery disease found on run-off MRA
Authors: Streckenbach Felix , Meinel Felix G. , Ammermann Felix , Busse Anke , Neumann Andreas , Heller Thomas , Weber Marc-André , Beller Ebba
Published: June 2021

Background

In patients with peripheral artery disease (PAD), run-off MR-angiography (MRA) is a commonly performed diagnostic test to obtain high-resolution images for evaluation of the arterial system from the aorta through the distal run-off vessels. The aim of this study was to investigate the prevalence of visceral artery involvement (VAI) in patients with PAD and leg symptoms examined with run-off MRA.

Methods

We retrospectively analyzed 145 patients (median age 68 years, range 27–91) who underwent MRA due to known or suspected PAD at our institution between 2012 and 2018. MRA examinations were re-evaluated for visceral artery stenosis. Patient dossiers were reviewed to determine cardiovascular risk factors, kidney function and Fontaine stage of PAD.

Results

Involvement of at least one visceral artery with ≥ 50% diameter stenosis was found in 72 (50%) patients. There were no differences in age, gender, MRA indication, Fontaine stage, levels of C-reactive protein (CRP), cardiovascular risk factors or vascular comorbidities between patients with and without VAI. Renal artery (RA) involvement with ≥ 50% diameter stenosis was observed in 28 (20%) of patients. Patients with involvement of the RA were more likely to suffer from hypertension (79 vs. 54%, p = 0.019) and reduced renal function (glomerular filtration rate 70 vs. 88 mL/min/1.73m2, p = 0.014).

Conclusion

Visceral artery stenosis can be seen in half of patients with known or suspected PAD and leg symptoms on run-off MRA. Investigating for RA stenosis in patients with PAD and hypertension and/or impaired renal function may have high diagnostic yield.
Cognitive performance in dialysis patients - "when is the right time to test?"
Authors: Karakizlis Hristos , Thiele Stefanie , Greene Brandon , Hoyer Joachim
Published: June 2021

Background

Cognitive impairment in chronic kidney disease, especially in end stage renal disease, is a public health problem. Nevertheless, the cause of chronic kidney disease still remains unclear. A prevalence of cognitive impairment in patients with end stage renal disease of up to 87% has been found.

Methods

The study at hand deals with the research on the – potential – effect of timing on cognitive performance when testing cognitive impairment in hemodialysis patients during the dialysis cycle. We tested cognitive performance with a neuropsychological test battery (RBANS, Repeatable Battery for the Assessment of Neuropsychological Status) on two occasions while patients were on dialysis as well as on a dialysis-free day. In addition, all participants were rated using the Geriatric Depression Scale (GDS) and several demographic and clinical variables were recorded in order to investigate their possible influence on cognitive performance.

The patients were recruited in three dialysis centers in the central region of Hesse, Germany. Twenty-six participants completed the 3 testings during a period of 6 weeks. The testing was carried out in the dialysis centers.

Results

Looking at the total scale score, patients achieved the best cognitive performance in the RBANS during the first 2 h on dialysis with 81.1 points. When comparing the scores of the three measurement occasions (first 2 h, Timepoint 1 vs. last 2 h, Timepoint 2 vs. dialysis free day, Timepoint 3, however, no significant difference in the total scale score was detected. But patients showed significantly better cognitive performance in language in the first 2 h (p < 0.001) as well as in the last 2 h (p < 0.001) compared with the dialysis-free day.

Conclusion

Due to the high prevalence of cognitive impairment, there is an increasing need to assess cognitive function in dialysis patients. Our data show that the time point of testing (first 2 h on hemodialysis vs. last 2 h on hemodialysis vs. Hemodialysis free day) had no influence of cognitive function in hemodialysis patients in routine indications.
Glycosylated hemoglobin levels and the risk for contrast-induced nephropathy in diabetic patients undergoing coronary arteriography/percutaneous coronary intervention
Authors: Zhang H. , Fu H. , Fu X. , Zhang J. , Zhang P. , Yang S. , Zeng Z. , Fu N. , Guo Z.
Published: June 2021

Backgrounds

Diabetes mellitus is an independent risk factor for Contrast-induced nephropathy (CIN) in patients undergoing Coronary arteriography (CAG)/percutaneous coronary intervention (PCI). Glycosylated hemoglobin (HbA1c) is the gold standard to measure blood glucose control, which has important clinical significance for evaluating blood glucose control in diabetic patients in the past 3 months. This study aimed to assess whether preoperative HbA1c levels in diabetic patients who received CAG/PCI impacted the occurrence of postoperative CIN.

Methods

We reviewed the incidence of preoperative HbA1c and postoperative CIN in 670 patients with CAG/PCI from January 1, 2020 to October 30, 2020 and divided the preoperative HbA1c levels into 5 groups. Blood samples were collected at admission, 48 h and 72 h after operation to measure the Scr value of patients. Categorical variables were compared using a chi-square test, and continuous variables were compared using an analysis of variance. Fisher’s exact test was used to compare the percentages when the expected frequency was less than 5. Univariable and multivariable logistic regression analysis was used to exclude the influence of confounding factors, and P for trend was used to analyze the trend between HbA1c levels and the increased risk of CIN.

Results

Patients with elevated HbA1c had higher BMI, FBG, and LDL-C, and they were more often on therapy with hypoglycemic agents, Insulin and PCI. They also had higher basal, 48 h and 72 h Scr. The incidence of CIN in the 5 groups of patients were: 9.8, 11.9, 15.2, 25.3, 48.1%. (p < 0.0001) The multivariate analysis confirmed that in the main high-risk subgroup, patients with elevated HbA1C levels (≥8.8%) had a higher risk of CIN disease. Trend test showed the change of OR (1.000,1.248,1.553,2.625,5.829).

Conclusions

Studies have shown that in diabetic patients undergoing CAG/PCI, elevated HbA1c is independently associated with the risk of CIN, and when HbA1c > 9.5%, the incidence of CIN trends increase. Therefore, we should attach great importance to patients with elevated HbA1c at admission and take more active measures to prevent CIN.
LINC_00355 promotes gastric cancer progression by upregulating PHF19 expression through sponging miR-15a-5p
Authors: Zhang Jishui , Lv Wenhao , Liu Yagang , Fu Weihua , Chen Baosheng , Ma Qiutong , Gao Xin
Published: June 2021

Background

Long non-coding RNAs exert vital roles in several types of cancer. The objective of this study was to explore the role of LINC_00355 in gastric cancer (GC) progression and its potential mechanism.

Methods

The expression levels of LINC_00355 in GC tissues and cells were detected by quantitative real-time PCR, followed by assessing the effects of LINC_00355 knockdown or overexpression on cell properties. Dual-luciferase reporter assay was utilized to identify the relationship between LINC_00355 and microRNA (miR)-15a-5p and miR-15a-5p and PHD finger protein 19 (PHF19), followed by the rescue experiments.

Results

The results showed that LINC_00355 was highly expressed in GC tissues and cells compared with the corresponding control. LINC_00355 knockdown decreased the viability, migration, and invasion and increased the accumulation of GC cells in G1 phase and apoptosis. Meanwhile, LINC_00355 downregulation markedly increased cleaved caspase 3 and cleaved poly (ADP-ribose) polymerase protein levels, whereas decreased cyclin D1, cyclin E, matrix metalloproteinase (MMP) 9, MMP2, and N-cadherin protein levels in GC cells. However, LINC_00355 overexpression had the opposite effects. It was verified that LINC_00355 upregulated the expression of PHF19 through sponging miR-15a-5p. Furthermore, PHF19 overexpression reversed the effect of LINC_00355 knockdown on GC cell properties, including cell viability, migration, invasion, and apoptosis.

Conclusions

Collectively, these results suggest that LINC_00355 promotes GC progression by up-regulating PHF19 through sponging miR-15a-5p. Our findings may provide an important clinical basis for reversing the malignant phenotype of GC.
Survival in endometrial cancer in relation to minimally invasive surgery or open surgery – a Swedish Gynecologic Cancer Group (SweGCG) study
Authors: Borgfeldt Christer , Holmberg Erik , Marcickiewicz Janusz , Stålberg Karin , Tholander Bengt , Lundqvist Elisabeth Åvall , Flöter-Rådestad Angelique , Bjurberg Maria , Dahm-Kähler Pernilla , Hellman Kristina , Hjerpe Elisabet , Kjölhede Preben , Rosenberg Per , Högberg Thomas
Published: June 2021

Background

The aim of this study was to analyze overall survival in endometrial cancer patients’ FIGO stages I-III in relation to surgical approach; minimally invasive (MIS) or open surgery (laparotomy).

Methods

A population-based retrospective study of 7275 endometrial cancer patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed from 2010 to 2018. Cox proportional hazard models were used in univariable and multivariable survival analyses.

Results

In univariable analysis open surgery was associated with worse overall survival compared with MIS hazard ratio, HR, 1.39 (95% CI 1.18–1.63) while in the multivariable analysis, surgical approach (MIS vs open surgery) was not associated with overall survival after adjustment for known risk factors (HR 1.12, 95% CI 0.95–1.32). Higher FIGO stage, non-endometrioid histology, non-diploid tumors, lymphovascular space invasion and increasing age were independent risk factors for overall survival.

Conclusion

The minimal invasive or open surgical approach did not show any impact on survival for patients with endometrial cancer stages I-III when known prognostic risk factors were included in the multivariable analyses.
Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists
Authors: Dragan Tatiana , Duprez Fréderic , Van Gossum André , Gulyban Akos , Beauvois Sylvie , Digonnet Antoine , Lalami Yassine , Van Gestel Dirk
Published: June 2021

Background

Nutritional complications in patients with locally advanced head and neck cancer (LA-HNC) treated by concurrent chemoradiotherapy (CCRT) often lead to placement of a prophylactic gastrostomy (PG) tube, while indication lacks harmonization. Our aim was to explore the current PG tube utilization among Belgian radiation oncology centers.

Methods

A survey was distributed to all 24 Belgian Radiation oncology departments, with questions about the number of patient treated per year, whether the PG indication is discussed at the multidisciplinary board, placement technique, time of starting nutrition and removal, its impact on swallowing function and importance of clinical factors. For the latter Relative Importance and Discordance Indexes were calculated to describe the ranking and agreement.

Results

All 24 centers submitted the questionnaire. Twenty three treat more than 20 head and neck (HNC) patients per year, while four (1 in 21–50; 3 in 51–100) are not discussing the gastrostomy tube indication at the multidisciplinary board. For the latter, endoscopic placement (68%) is the dominant technique, followed by the radiologic (16%) and laparoscopic (16%) methods. Seventy-five percent start the enteral nutrition when clinically indicated, 17% immediately and 8% from the start of radiotherapy. Majority of specialists (19/24) keep the gastrostomy tube until the patient assume an adequate oral feeding. Fifteen centres are considering PG decrease swallowing function. Regarding factors and their importance in the decision for the PG, foreseen irradiated volume reached highest importance, followed by ‘anatomical site’, ‘patients’ choice’ and ‘postoperative versus definitive’ and ‘local expertise’, with decreasing importance respectively. Disagreement indexes showed moderate variation.

Conclusions

The use of a PG tube for LAHNC patients treated by CCRT shows disparity at national level. Prospective studies are needed to ensure proper indication of this supportive measure.
Family involvement practices for persons with psychotic disorders in community mental health centres – a cross-sectional fidelity-based study
Authors: Hestmark Lars , Heiervang Kristin Sverdvik , Pedersen Reidar , Hansson Kristiane Myckland , Ruud Torleif , Romøren Maria
Published: June 2021

Background

Family involvement for persons with psychotic disorders is supported by scientific evidence, as well as legal and ethical considerations, and recommended in clinical practice guidelines. This article reports a cross-sectional measurement of the level of implementation of such guidelines in fifteen community mental health centre units in Norway, and presents a novel fidelity scale to measure basic family involvement and support. The aim was to investigate current family involvement practices comprehensively, as a basis for targeted quality improvement.

Methods

We employed three fidelity scales, with 12–14 items, to measure family involvement practices. Items were scored from 1 to 5, where 1 equals no implementation and 5 equals full implementation. Data was analysed using descriptive statistics, a non-parametric test, and calculation of interrater reliability for the scales.

Results

The mean score was 2.33 on the fidelity scale measuring basic family involvement and support. Among patients with psychotic disorders, only 4% had received family psychoeducation. On the family psychoeducation fidelity assessment scale, measuring practice and content, the mean score was 2.78. Among the eight units who offered family psychoeducation, it was 4.34. On the general organizational index scale, measuring the organisation and implementation of family psychoeducation, the mean score was 1.78. Among the units who offered family psychoeducation, it was 2.46. As a measure of interrater reliability, the intra-class correlation coefficient was 0.99 for the basic family involvement and support scale, 0.93 for the family psychoeducation fidelity assessment scale and 0.96 for the general organizational index scale.

Conclusions

The implementation level of the national guidelines on family involvement for persons with psychotic disorders was generally poor. The quality of family psychoeducation was high, but few patients had received this evidence-based treatment. Our novel fidelity scale shows promising psychometric properties and may prove a useful tool to improve the quality of health services. There is a need to increase the implementation of family involvement practices in Norway, to reach a larger percentage of patients and relatives.

Trial registration

ClinicalTrials.gov Identifier NCT03869177. Registered 11.03.19.
Interfaces of occupational health management and corporate social responsibility: a multi-centre qualitative study from Germany
Authors: Kuhn Eva , Müller Sebastian , Teusch Christoph , Tanner Grit , Schümann Marlies , Baur Carolin , Bamberg Eva , Heidbrink Ludger , McLennan Stuart , Buyx Alena
Published: June 2021

Background

The workplace has been identified as a priority setting for health promotion. There are potential advantages of systematically integrating Occupational Health Management (OHM) and Corporate Social Responsibility (CSR). However, OHM and CSR are usually overseen by different management branches with different sets of values, and there is a lack of empirical research regarding interfaces between OHM and CSR. Germany offers a particularly useful setting due to legislation requiring health to be promoted in the workplace. This study aims to examine key stakeholders’ views and experiences regarding interfaces between OHM and CSR in German companies.

Methods

Individual semi-structured qualitative interviews were conducted with a sample of 77 German stakeholders from three different groups: experts in occupational health and corporate social responsibility from various companies (n = 35), business partners (n = 19), and various non-business partners (n = 23). Transcripts were analysed using qualitative content analysis.

Results

Participants identified several areas in which OHM and CSR are already interacting at strategic, structural and cultural levels, but also highlighted several barriers that undermine a more meaningful interaction. Participants reported difficulties in articulating the underlying ethical values relevant to both OHM and CSR at the strategic level. Several structural barriers were also highlighted, including a lack of resources (both financial and knowledge), and OHM and CSR departments not being fully developed or undertaken at entirely different operational levels. Finally, the missing practical implementation of corporate philosophy was identified as a critical cultural barrier to interfaces between OHM and CSR, with existing guidelines and companies’ philosophies that already connect OHM and CSR not being embraced by employees and managers.

Conclusions

There is already significant overlap in the focus of OHM and CSR, at the structural, strategic and cultural levels in many German companies. The potential is there, both in theory and practice, for the systematic combination of OHM and CSR. The insights from this study will be useful to ensure that closer integration between both management branches is set up in a socially sustainable and ethical manner.
Distance learning in Italian primary and middle school children during the COVID-19 pandemic: a national survey
Authors: Scarpellini Francesca , Segre Giulia , Cartabia Massimo , Zanetti Michele , Campi Rita , Clavenna Antonio , Bonati Maurizio
Published: June 2021

Background

School closure created difficulties for parents, who were asked to care for their children and help them with schooling, while working at home. We aimed to explore the experiences in organising school for children at home and its implications on children’s psychological well-being and educational progress during the quarantine for the COVID-19 pandemic.

Methods

A nationwide online survey of mothers of primary and middle school students was conducted during the COVID-19 pandemic. Demographic data and information on distance learning organisation and children’s attitudes and behavioural changes were collected.

Results

2149 mothers completed the survey, with a final sample of 1601 subjects. Large differences between primary and middle school emerged: lessons were less organised and routines were more instable for the youngest, who could not pay attention for more than 20 min (28.3%) and needed breaks every 10 min (21.6%), with lower quality of learning (40.6%), increased restlessness (69.1%), and aggressiveness (33.3%). A large use of screens was reported, with an abuse in screen time in 2%. Two thirds of mothers did not approve of distance learning (72.2%) because of their role in replacing teachers (77.8%), the effort required (66%), and the great commitment required (78.3%).

Conclusions

Distance learning increased educational deprivation and social inequalities, especially for the youngest children, who lost almost one year of school. The situation was even worse for children with disabilities, who were neglected by the institutions. This period should be considered as an opportunity to correct the weaknesses of our school system.
Incidence and risk factors of congenital heart disease in Qingdao: a prospective cohort study
Authors: Jin Xiao , Ni Wei , Wang Guolan , Wu Qin , Zhang Jun , Li Guoju , Jiao Na , Chen Wenjing , Liu Qing , Gao Li , Xing Quansheng
Published: June 2021

Background

Many studies have been conducted to assess the incidence of congenital heart disease (CHD). However, results were greatly inconsistent among these studies with a broad range of findings.

Methods

A prospective census-based cohort study was conducted in Qingdao, China, from August 1, 2018 to April 30, 2019. All of the local registered pregnant women were continuously investigated and followed from 15 to 20 weeks of gestation to delivery, tracking the CHD cases in both the fetal and neonatal stages. A logistic regression model was applied to assess the association between CHD and possible risk factors.

Results

The positive rate of prenatal CHD screening was 14.36 per 1000 fetuses and the incidence of CHD was 9.38 per 1000 live births. Results from logistic regression indicated that, living in the countryside (odds ratio, (OR): 0.771; 95% confidence interval, (CI): 0.628–0.946) and having a childbearing history (OR: 0.802; 95%CI: 0.676–0.951) were negatively associated with CHD. However, twin pregnancy (OR: 1.957, 95% CI: 1.245–3.076), illness in the first trimester (OR: 1.306; 95% CI: 1.048–1.628), a family history of CHD (OR: 7.156; 95% CI: 3.293–15.552), and having a child with a birth defect (OR: 2.086; 95% CI: 1.167–3.731) were positively associated with CHD.

Conclusion

CHD is a serious health problem in Qingdao. The CHD incidence found in this study was similar to existing research. The positive rate of prenatal CHD screening was higher than the incidence of neonatal CHD. Moreover, CHD risk factors were identified in our study, and our findings may have great implications for formation CHD intervention strategies.
Long lasting insecticidal mosquito nets (LLINs) ownership, use and coverage following mass distribution campaign in Lake Victoria basin, Western Kenya
Authors: Ng’ang’a Peter N. , Aduogo Polycarp , Mutero Clifford M.
Published: June 2021

Background

Long-lasting insecticidal nets (LLINs) are the most widely used malaria prevention and control intervention in Africa. However, their effectiveness may vary depending on their local geographic coverage, ownership and use at household level. This study aimed at assessing LLINs ownership and use following mass distribution campaign in western Kenya.

Methods

A cross-sectional study was conducted in November 2017. A total of 160 households were randomly selected from 16 villages. Structured questionnaires were used to collect data on households’ knowledge on malaria, LLINs ownership, utilization and their perceived benefits. Data was analyzed using IBM Statistical Package for Social Sciences (SPSS) version 21 for windows. Variables were presented as proportions and associations between variables tested using Pearson’s chi-square test.

Results

Malaria was reported to be the most frequently occurring disease (87.5%) in the area. Children under 5 years of age were reported to be at higher risks of malaria infection (28.6%). Around 31% of the respondents reported to have at least one member of the household sick with malaria a week before the interview. Commonly cited signs and symptoms of malaria were; fever (24.1%), headache (17.7%), vomiting (14.5%) feeling cold (12.6%) and loss of appetite (10%). There were 382 reported LLINs among 753 occupants in the 160 households surveyed. The average LLIN ownership was 2.4 nets per household and 1.97 persons per LLIN. Among the surveyed households, 96.9% owned at least one LLIN and 64.1% owned at least one LLIN for every two people. Among those who owned LLINs, 98.1% reported using them the previous night. Ownership per household ranged from 0 to 6 with a mean of 2.39. More than three quarter of the nets were acquired through free mass distribution campaigns and 80% were acquired less than 6 months prior to the survey.

Conclusion

Despite high net coverage and use, a number of households experienced malaria episodes in the study area. There is need to investigate the likelihood of outdoor malaria transmission and assess the physical integrity of the existing LLINs and their insecticidal effectiveness in protecting household members against malaria.
Who or what is to blame? Examining sociodemographic relationships to beliefs about causes, control, and responsibility for cancer and chronic disease prevention in Alberta, Canada
Authors: Curtin Kimberley D. , Thomson Mathew , Nykiforuk Candace I. J.
Published: June 2021

Background

Beliefs about causes and responsibility for chronic diseases can affect personal behaviour and support for healthy policies. In this research we examined relationships between socio-demographics (sex, age, education, employment, political alignment, perceived health, household income, household size) and perceptions of causes and responsibility for health behaviour, chronic disease correlates, and attitudes about cancer prevention and causes.

Methods

Using data from the 2016 Chronic Disease Prevention survey in which participants (N = 1200) from Alberta, Canada responded to items regarding how much they believed personal health behaviours, prevention beliefs, and environmental factors (i.e., healthy eating, physical activity, alcohol, smoking, and where a person lives or works) are linked to getting cancer. Participants also responded to questions about causes and responsibility for obesity, alcohol, and tobacco (i.e., individual or societal). Relationships were examined using multinomial logistic regression on socio-demographics and survey items of interest.

Results

Men (compared to women) were less likely to link regular exercise, or drinking excessive alcohol, to reducing or increasing cancer risk. Similarly, men were less likely to link environmental factors to cancer risk, and more likely to agree that cancer was not preventable, and that treatment is more important than prevention. Finally, men were more likely to believe that alcohol problems are an individual’s fault. Left and central voters were more likely to believe that society was responsible for addressing alcohol, tobacco, and obesity problems compared to right voters. Those with less than post-secondary education were less likely to believe that regular exercise, maintaining a healthy body weight, or eating sufficient fruits and vegetables were linked to cancer - or that society should address obesity - compared to those with more education. Households making above the median income (versus below) were more likely to link a balanced diet with cancer and were less likely to think that tobacco problems were caused by external circumstances.

Conclusions

These results provide insight into the importance of health literacy, message framing, and how socio-demographic factors may impact healthy policy. Men, those with less education, and those with less income are important target groups when promoting health literacy and chronic disease prevention initiatives.
Child marriage among Somali refugees in Ethiopia: a cross sectional survey of adolescent girls and adult women
Authors: Elnakib Shatha , Hunersen Kara , Metzler Janna , Bekele Hailu , Robinson W. Courtland
Published: June 2021

Background

Despite child marriage receiving increased attention over the past two decades, research on child marriage in humanitarian settings remains scarce. This study sought to quantify child marriage among Somali adolescent girls residing in Kobe refugee camp in Ethiopia and to identify its correlates and consequences.

Methods

A cross-sectional survey was conducted using multi-stage cluster-based sampling with probability proportional to size. We randomly sampled households that have at least one female aged 15–49 and at least one adolescent female aged 10–19. In addition to calculating the proportion of girls married under age 18, we used survival methods – namely Kaplan Meier graphs and Cox proportional hazard models – to identify risk factors associated with child marriage in this context. We also used descriptive statistics to describe marital age preferences among female adults and presented measures of important sexual and reproductive health indicators among married adolescent girls.

Results

A total of 603 adult women were surveyed and a household roster was created with information on 3319 household members, of whom 522 were adolescent girls aged 15–19. Of those, 14% were currently married (95% Confidence Interval [CI] 0.11–0.18), and 11% were ever married under age 18 (95% CI 8–15%). Several variables were found to be significantly associated with hazard of child marriage including schooling, sex and employment status of head of household, as well as number of girls under age 18 in the childhood home.. Adult women tended to incorrectly identify minimum legal age at marriage and preferred low marital age for boys and girls – particularly in households of child brides. Among married adolescent girls, contraceptive use was very low (11%; 95% CI 4.94–22.40), and early childbearing was common (60%; 95% CI 45.56–72.89).

Conclusions

This research contributes to the evidence base on child marriage in humanitarian settings. Insights generated from this study have the potential to inform programs and interventions aiming to prevent and mitigate the impacts of this harmful practice.
The correlation between the change of Hounsfield units value and Modic changes in the lumbar vertebral endplate
Authors: Zhu Jiandong , Wu Hao , Chen Yilei , Liu Junhui , Shan Zhi , Fan Shunwu , Zhao Fengdong
Published: June 2021

Objectives

To evaluate the changes of Hounsfield units (HU) value in different types of Modic changes (MCs) and to analyze the correlation between the change of HU value and area ratio of MCs region, bone mineral density (BMD), and degree of intervertebral disc degeneration.

Methods

One hundred fifty-eight endplates with MCs were included and analyzed. HU values of MCs regions and adjacent vertebral corresponding regions without MCs were measured. The area ratio of MCs region was defined as the area of MCs divided by the area of endplate or the vertebral sagittal plane. BMD was measured by Dual-energy x-ray absorptiometry (DXA). Degree of intervertebral disc degeneration was evaluated based on Pfirrmann classification. According to the types of variables, descriptive statistics, Kolmogorove-Smirnov test, paired t-test, Wilcoxon signed-rank test, Independent-Samples T Test, and Pearson correlation analysis were used.

Results

The HU values in any types of MCs are significantly higher than that of adjacent vertebral corresponding regions without MCs (P < 0.001). The HU value of the type III MCs is higher than that of the type I and type II MCs. HU value was positively correlated with BMD. In the levels with Grade V disc degeneration, the area ratio of MCs region was significant increased.

Conclusions

HU values of the vertebral endplate and bone marrow were increased in most MCs regions with all types of MCs. HU value of endplates had a significantly positive correlation with BMD. Higher area ratio of MCs region is associated with more severe intervertebral disc degeneration.
Research activities and critical appraisal skills among Saudi orthopedic residents
Authors: Al-Mohrej Omar A. , Alsadoun Nouf F. , Alshaalan Fawaz N. , Alturki Rayan I. , Al-Rabiah Anwar M. , Hamdi Nezar B. , Ilyas Imran , AlHussainan Thamer S.
Published: June 2021

Background

Medical research is a central part of any residency training. In view of the new Saudi orthopedic committee promotion regulation that mandates each resident to participate in a research project, the challenges that stand in the way of completion of substantial research within surgical residency must be investigated. The aim of this study was to assess the practice, attitudes, perception, and limitations associated with research among residents in the Saudi orthopedic program in the central region.

Methods

A cross-sectional study was conducted between June and July 2020 using an online-based survey. The total number of study participants was 128 orthopedic residents out of the 191 residents enrolled in the central region program. Data were analyzed, and descriptive statistics in the form of frequency and percentage were determined, analytical tests were performed with P < 0.05 being statistically significant.

Results

Most residents (95 %) participated in a research project during residency. Most projects (53.10 %) were case reports followed by retrospective studies (48.40 %). The majority (79.70 %) did not attend a research methods course during residency. Experience in research differed significantly (P < 0.05) by age, residency year, and center. The mean involvement score was significantly higher among males at 3 (± 1) than among females at 2 (± 0) (P < 0.001). Only 40.60 % have access to orthopedic journals, and the same percentage (40.60 %) knew how to Critique original articles. There was a statistically significant difference in the accessibility score according to the training center. Lack of faculty support and mentorship were the main barriers to medical research at 62.50 and 39.10 %, respectively. A total of 68.80 % reported that funding was not available through their institutes.

Conclusions

In Saudi Arabia, the level of meaningful clinical research and publications by orthopedic residents is still low. The results of this study should be taken into consideration before the implementation of the new promotion criteria in the centers under the umbrella of Saudi orthopedic committee.