bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors shaping good and poor nurse-client relationships in maternal and child care: a qualitative study in rural Tanzania
Authors: Isangula Kahabi , Pallangyo Eunice S. , Mbekenga Columba , Ndirangu-Mugo Eunice , Shumba Constance
Published: September 2022

Background

Evidence indicates that poor nurse-client relationships within maternal and child health (MCH) continues to impact trust in formal healthcare systems, service uptake, continuity with care and MCH outcomes. This necessitates contextualized innovative solutions that places both nurses and clients at the forefront as agents of change in optimizing intervention designs and implementation. This study explored nurses and clients’ perspectives on the factors shaping nurse-client relationships in MCH care to generate evidence to guide subsequent steps of human centered design (HCD) that involve designing effective strategies for improving therapeutic relationships in Shinyanga, Tanzania.

Methods

Qualitative descriptive design was employed. About 9 Focus Group Discussions (FGDs) and 12 Key Informant Interviews (KIIs) with purposefully selected nurses and midwives, women attending MCH services and administrators were conducted using semi-structured interview guides in Swahili language. Data were transcribed and translated simultaneously, managed using Nvivo Software and analyzed thematically.

Results

Factors shaping nurse-client relationships were heuristically categorized into nurse, client and health system factors. Nurse contributors of poor relationship ranged from poor reception and hospitality, not expressing care and concern, poor communication and negative attitudes, poor quality of services, job dissatisfaction and unstable mental health. Client contributors of poor relationship include being ‘much know’, late attendance, non-adherence to procedures and instructions, negative attitudes, poor communication, inadequate education and awareness, poverty, dissatisfaction with care, faith in traditional healers and unstable mental health. Health system contributors were inadequate resources, poor management practices, inadequate policy implementation and absence of an independent department or agency for gathering and management of complaints. Suggestions for improving nurse-client relationship included awards and recognition of good nurses, improving complaints mechanisms, continued professional development, peer to peer learning and mentorship, education and sensitization to clients, improving service quality and working conditions, improving renumeration and incentives, strengthening nursing school’s student screening and nursing curriculum and improving mental health for both nurses and clients.

Conclusions

The factors shaping poor nurse- client relationships appear to extend beyond nurses to both clients and healthcare facilities and system. Implementation of effective interventions for addressing identified factors considering feasibility and acceptance to both nurses and clients using novel strategies such as HCD could pave the way for employing good nurse-client relationships as a tool for improving performance indicators and health outcomes within MCH care.
Increased expression of METTL3 in pancreatic cancer tissues associates with poor survival of the patients
Authors: Li Yuan , Huang Hao , Zhu Yulan , Xu Bin , Chen Junjun , Liu Yingting , Zheng Xiao , Chen Lujun
Published: September 2022

Background

Methyltransferase-like 3 (METTL3) expression could be found in various normal and cancerous tissues. As of now, the clinical significance of METTL3 expression in human pancreatic cancer (PC) tissues still remains to be understood. Our present study aims to investigate the prognostic value and clinical implications of METTL3 expression in PC tissues.

Methods

The TCGA, GTEx, and GEO public databases were used to study the mRNA expression level of the m6A family members and its relationship among PC tissues and normal pancreatic tissue. The immunohistochemistry was used to analyze the difference of METTL3 expression between cancer tissues and adjacent normal tissues. The prognostic value was evaluated by using the Log-rank survival analysis and Cox model analysis. PAAD samples from TCGA and GEO databases were used to perform the immune infiltration analysis and gene set enrichment analysis based on the genes that were highly correlated with METTL3.

Results

Based on the analysis of TCGA, GTEx, and GEO public database, we found that the m6A family members showed a higher correlation in PC tissues compared to normal pancreatic tissues, and the mRNA expression level of the m6A family members showed a significant difference between PC tissues and adjacent normal tissues. Moreover, scRNA-seq data indicated that METTL3 showed a higher expression level in malignant epithelial cells. Our immunohistochemistry results also confirmed that the intensity of METTL3 immunostaining in PC tissues was significantly higher than that in adjacent normal tissues (P = 0.015). The overall survival (OS) of PC patients with high expression of METTL3 protein were significantly poorer than those with low expression of METTL3 protein (HR = 1.788, 95% CI 1.071–2.984, P = 0.026). Further analysis of PC data from the database showed that METTL3 expression was associated with a variety of tumor-infiltrating immune cells and was involved in m6A modification and metabolism in PC tissues.

Conclusion

Increased METTL3 expression at the protein level could be found in PC tissues, suggesting that the METTL3 expression was involved in the progression of PC and could serve as an important marker for prognostic prediction of this malignancy.
Oropharynx and hyoid bone changes in female extraction patients with distinct sagittal and vertical skeletal patterns: a retrospective study
Authors: Guo Runzhi , Wang Shuo , Zhang Liwen , Li Linwei , Yu Qianyao , Huang Yiping , Li Weiran
Published: September 2022

Background

Previous studies have reported inconsistent effects of premolar extraction on the oropharynx and hyoid bones. Currently, no strong evidence is available regarding the effect of extraction on upper airway size. Hence, the aim of this study was to analyse the effects of first premolar extraction on the oropharynx and hyoid bone positions in female adult patients, and further explored differences in oropharynx and hyoid bone changes among skeletal patterns.

Methods

The study population included 40 female adult patients who did not undergo extraction and 120 female adult patients who underwent extraction of four premolars; the including patients had four distinct sagittal and vertical skeletal patterns. Cone-beam computed tomography was performed before (T0) and after (T1) orthodontic treatment. Eight oropharynx variables and five hyoid bone variables were measured using Dolphin 3D Imaging software. Paired and independent t-tests were used to analyse measurements between timepoints and groups, respectively.

Results

The oropharynx volume increased significantly in the extraction group; changes did not differ significantly between extraction and non-extraction groups. Oropharynx variables did not differ significantly at T0 among the four skeletal pattern groups. After orthodontic extraction treatment, the oropharynx volume increased significantly in the class I-norm and class I-hyper subgroups, but not in the class II-norm and class II-hyper subgroups. Significant increases were observed in the oropharynx volume and most constricted axial area from T0 to T1 in the moderate retraction group, but not in the maximum retraction group. Extraction patients exhibited significant posterior movement of the hyoid, particularly among maximum retraction patients.

Conclusions

In female adult patients, first premolar extraction tends to increase the oropharynx size and cause posterior movement of the hyoid bone, particularly in skeletal class I patients. For skeletal class II and hyperdivergent patients with a narrow oropharynx, first premolar extraction does not negatively influence oropharynx size or hyoid bone position. The differences of oropharyngeal changes between moderate retraction patients and maximum retraction patients were not significant.
Can mobile-bearing unicompartmental knee arthroplasty achieve natural gap-balancing? An observational study with a novel pressure sensor
Authors: Nan Shaokui , Cao Zheng , Song Yue , Kong Xiangpeng , Li Haifeng , Chai Wei
Published: September 2022

Background

Mobile-bearing unicompartmental knee arthroplasty (MB-UKA) is an effective treatment for anteromedial knee osteoarthritis. Meticulous intraoperative soft tissue balancing remains challenging yet consequential for a successful operation. Currently, surgeons rely mostly on their experience during soft tissue balancing, yielding unreproducible results. The purpose of this study was to quantified measure the soft tissue tension of medial compartment and determine if an optimal "target" tension values with the natural state exists.

Methods

This was an observational study of 24 consecutive patients. All 30 UKAs were performed by a single surgeon. The piezoresistive sensor was custom designed to fit in the medial compartment gap. Contact pressures were measured at 5 angular positions of the knee intraoperatively: 0°, 20°, 45°, 90°, and 110° of flexion. The change in pressure from extension (20° position) and flexion (110° position) was also calculated (E-FPD). Data on age, sex, body mass index, operative side, and bearing size were collected. Outcome measures were measured at baseline and at the 6-month postoperative follow-up; Oxford Knee Score, visual analog scale score, and range of motion were compared to evaluate clinical outcomes.

Results

There was a significant improvement in patients in all measured outcomes at 6 months from baseline (P < 0.05). The E-FPD of 14.9 N (8.9, 24.6) was indicative of appropriate soft tissue balancing throughout the functional range of knee motion. Of 30 knees, 22 were 3-mm bearing and 8 were 4- or 5-mm bearing. The pressure data of the 3-mm bearing group was larger than that of the non-3-mm bearing group for each knee flexion degree, but the difference was not statistically significant (P > 0.05).

Conclusions

Objective data from sensor output may assist surgeons in decreasing loading variability during MB-UKA. The data suggested that MB-UKA could not accurately restore soft tissue tension to the natural state, which was related to the inability of MB-UKA surgical instruments to fine adjust the bone cut and soft tissue release.

Study registration

Chinese Clinical Trial Registry (http://www.chictr.org.cn): ChiCTR1900024146.
Clinical benefit of high tibial osteotomy combined with the intervention of platelet-rich plasma for severe knee osteoarthritis
Authors: Dong Conglei , Zhao Chao , Wang Fei
Published: September 2022

Purpose

The objective of present study was to investigate the therapeutic effects of high tibial osteotomy (HTO) combined with platelet-rich plasma (PRP) for severe knee osteoarthritis (KOA).

Methods

This was a double-blinded, randomized, placebo-controlled trial. The participants were randomly divided by computerderived random charts into 3 groups: 24 participants in group A (24 knees) received a treatment option of HTO combined with PRP, 25 participants in group B (25 knees) received a treatment program of HTO combined with hyaluronic acid, and 25 participants in group C (25 knees) received a treatment method of HTO combined with normal saline (NS) (physiological control/placebo). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) were measured preoperatively and at the final follow-up. Status of articular cartilage was assessed according to the International Cartilage Repair Society grade and the presence of newly formed cartilaginous tissue by arthroscopy. MRI was completed of knee joint to measure the cartilaginous thickness.

Results

Compared to Group B and C, the final follow-up results of knee function in Group A were significantly different (P < 0.001), such as the total WOMAC score 18.54 (SD 4.17), the VAS score 1.72 (SD 0.53). Cartilage regeneration of femur and tibia in Group A was observed in all patients. The cartilaginous thickness in Group A were significantly different (P < 0.001), such as the anterior patella femoral region 3.52 (SD 0.47), the anterior meniscal region 1.16 (SD 0.24), the posterior meniscal region 1.24 (SD 0.26) and the posterior condyle region 2.25 (SD 0.31).

Conclusions

The addition of combined PRP to HTO may be a more reasonable choice to relieve knee pain and decelerate the progression of the medial KOA.
RETRACTED ARTICLE: Aging exacerbates the brain inflammatory micro-environment contributing to α-synuclein pathology and functional deficits in a mouse model of DLB/PD
Authors: Iba Michiyo , McDevitt Ross A. , Kim Changyoun , Roy Roshni , Sarantopoulou Dimitra , Tommer Ella , Siegars Byron , Sallin Michelle , Kwon Somin , Sen Jyoti Misra , Sen Ranjan , Masliah Eliezer
Published: September 2022

Background

Although ɑ-synuclein (ɑ-syn) spreading in age-related neurodegenerative diseases such as Parkinson’s disease (PD) and Dementia with Lewy bodies (DLB) has been extensively investigated, the role of aging in the manifestation of disease remains unclear.

Methods

We explored the role of aging and inflammation in the pathogenesis of synucleinopathies in a mouse model of DLB/PD initiated by intrastriatal injection of ɑ-syn preformed fibrils (pff).

Results

We found that aged mice showed more extensive accumulation of ɑ-syn in selected brain regions and behavioral deficits that were associated with greater infiltration of T cells and microgliosis. Microglial inflammatory gene expression induced by ɑ-syn-pff injection in young mice had hallmarks of aged microglia, indicating that enhanced age-associated pathologies may result from inflammatory synergy between aging and the effects of ɑ-syn aggregation. Based on the transcriptomics analysis projected from Ingenuity Pathway Analysis, we found a network that included colony stimulating factor 2 (CSF2), LPS related genes, TNFɑ and poly rl:rC-RNA as common regulators.

Conclusions

We propose that aging related inflammation (eg: CSF2) influences outcomes of pathological spreading of ɑ-syn and suggest that targeting neuro-immune responses might be important in developing treatments for DLB/PD.
A fatal case of neonatal onset multiple acyl-CoA dehydrogenase deficiency caused by novel mutation of ETFDH gene: case report
Authors: De Pasquale Loredana , Meo Petronilla , Fulia Francesco , Anania Antonio , Meli Valerio , Mondello Antonina , Raimondo Maria Tindara , Tulino Viviana , Coletta Maria Sole , Cacace Caterina
Published: September 2022

Background

Multiple acyl-CoA dehydrogenase deficiency (MADD) or glutaric aciduria type II is an extremely rare autosomal recessive inborn error of fatty acid beta oxidation and branched-chain amino acids, secondary to mutations in the genes encoding the electron transfer flavoproteins A and B (ETFs; ETFA or ETFB) or ETF dehydrogenase (ETFDH). The clinical manifestation of MADD are heterogeneous, from severe neonatal forms to mild late-onset forms.

Case presentation

We report the case of a preterm newborn who died a few days after birth for a severe picture of untreatable metabolic acidosis. The diagnosis of neonatal onset MADD was suggested on the basis of clinical features displaying congenital abnormalities and confirmed by the results of expanded newborn screening, which arrived the day the newborn died. Molecular genetic test revealed a homozygous indel variant c.606 + 1 _606 + 2insT in the ETFDH gene, localized in a canonical splite site. This variant, segregated from the two heterozygous parents, is not present in the general population frequency database and has never been reported in the literature.

Discussion and conclusion

Recently introduced Expanded Newborn Screening is very important for a timely diagnosis of Inherited Metabolic Disorders like MADD. In some cases which are the most severe, diagnosis may arrive after symptoms are already present or may be the neonate already died. This stress the importance of collecting all possible samples to give parents a proper diagnosis and a genetic counselling for future pregnacies.
Immediate effects of hip strap and foot orthoses on self-reported measures and lower limb kinematics during functional tasks in individuals with patellofemoral osteoarthritis: protocol for a randomised crossover clinical trial
Authors: Souto Larissa Rodrigues , Serrão Paula Regina Mendes da Silva , Pisani Giulia Keppe , Tessarin Bruna Mariana , da Silva Hygor Ferreira , Machado Eliane de Morais , de Oliveira Sato Tatiana , Serrão Fábio Viadanna
Published: September 2022

Background

Elevated patellofemoral joint stress has been associated with patellofemoral osteoarthritis (PFOA). Changes in lower limb kinematics, such as excessive femoral adduction and internal rotation and excessive rearfoot eversion during the stance phase of functional activities, may increase patellofemoral stress. There is a lack of studies that assess the effects of interventions for controlling femur and subtalar joint movements during functional activities on self-reported measures in individuals with PFOA. Thus, the primary aim of the study is to determine the immediate effects of the hip strap and foot orthoses during level-ground walking and the single-leg squat test on self-reported outcomes. The secondary aim is to investigate whether the hip strap and foot orthoses result in the kinematic changes that these devices are purported to cause.

Methods

Twenty-nine individuals with PFOA aged 50 years or older will take part in the study. The main outcome is pain intensity. The secondary outcomes are other self-reported measures (global rating of change, acceptable state of symptoms, ease of performance, and confidence) and lower limb kinematics (peak femoral adduction and internal rotation, and peak rearfoot eversion). These outcomes will be assessed during functional tasks performed under three conditions: (i) control condition, (ii) hip strap intervention, and (iii) foot orthoses intervention. To investigate whether these interventions result in the lower limb kinematic changes that they are purported to cause, three-dimensional kinematics of the femur and rearfoot will be captured during each task. Linear mixed models with two fixed factors will be used to test associations between the interventions (control, hip strap, and foot orthoses) and conditions (level-ground walking and single-leg squat test) as well as interactions between the interventions and conditions.

Discussion

To the best of the authors’ knowledge, this is the first study to evaluate the immediate effects of the hip strap and foot orthoses on self-reported measures and lower limb kinematics during functional tasks in individuals with PFOA. The findings of this study will enable future trials to investigate the effects of these interventions in rehabilitation programmes.

Trial registration

ClinicalTrials.gov NCT04332900. Registered on 3 April 2020.
Theoretical and practical development of the TOPSY self-management intervention for women who use a vaginal pessary for pelvic organ prolapse
Authors: Dwyer Lucy , Bugge Carol , Hagen Suzanne , Goodman Kirsteen , Agur Wael , Dembinsky Melanie , Graham Margaret , Guerrero Karen , Hemming Christine , Khunda Aethele , McClurg Doreen , Melone Lynn , Thakar Ranee , Kearney Rohna ,   The TOPSY Team
Published: September 2022

Background

Pelvic organ prolapse (POP) is a common condition in women, where the downward descent of pelvic organs into the vagina causes symptoms which impacts quality of life. Vaginal pessaries offer an effective alternative to surgery for the management of POP. However, the need for regular follow-up can be burdensome for women and requires significant healthcare resources. The TOPSY study is a randomised controlled trial which aims to determine the clinical and cost-effectiveness of self-management of vaginal pessaries. This paper describes the theoretical and practical development of the self-management intervention.

Methods

The intervention was developed using the MRC complex intervention framework, normalisation process theory (NPT) and self-management theory. The intervention aims to boost perceived self-efficacy in accordance with Bandura’s social cognitive theory and is guided by the tasks and skills Lorig and Hollman describe as necessary to self-manage a health condition.

Results

The TOPSY intervention was designed to support women to undertake the medical management, role management and emotional management of their pessary. The six self-management skills described by Lorig and Hollman: problem-solving, decision-making, resource utilisation, formation of a patient-provider partnership role, action planning and self-tailoring, are discussed in detail, including how women were supported to achieve each task within the context of pessary self-management. The TOPSY intervention includes a self-management support session with a pessary practitioner trained in intervention delivery, a follow-up phone call 2 weeks later and ongoing telephone or face-to-face support as required by the woman initiated by contacting a member of the research team.

Conclusions

The TOPSY study intervention was developed utilising the findings from a prior service development project, intervention development and self-efficacy theory, relevant literature, clinician experience and feedback from pessary using women and members of the public. In 2022, the findings of the TOPSY study will provide further evidence to inform this important aspect of pessary management.

Trial registration

ISRCTN Registry ISRCTN62510577. Registered on June 10, 2017
Using a qualitative sub-study to inform the design and delivery of randomised controlled trials on medicinal cannabis for symptom relief in patients with advanced cancer
Authors: Olson Rebecca E. , Smith Alexandra , Huggett Georgie , Good Phillip , Dudley Morgan , Hardy Janet
Published: September 2022

Background

Recruitment for randomised controlled trials in palliative care can be challenging; disease progression and terminal illness underpin high rates of attrition. Research into participant decision-making in medicinal cannabis randomised controlled trials (RCTs) is very limited. Nesting qualitative sub-studies within RCTs can identify further challenges to participation, informing revisions to study designs and recruitment practices. This paper reports on findings from a qualitative sub-study supporting RCTs of medicinal cannabis for symptom burden relief in patients with advanced cancer in one Australian city.

Methods

Semi-structured qualitative interviews were conducted with 48 patients with advanced cancer, eligible to participate in a medicinal cannabis RCT (n=28 who consented to participate in an RCT; n=20 who declined). An iterative and abductive approach to thematic analysis and data collection fostered exploration of barriers and enablers to participation.

Results

Key enablers included participants’ enthusiasm and expectations of medicinal cannabis as beneficial (to themselves and future patients) for symptom management, especially after exhausting currently approved options, and a safer alternative to opioids. Some believed medicinal cannabis to have anti-cancer effects. Barriers to participation were the logistical challenges of participating (especially due to driving restrictions and fatigue), reluctance to interfere with an existing care plan, cost, and concerns about receiving the placebo and the uncertainty of the benefit. Some declined due to concerns about side-effects or a desire to continue accessing cannabis independent of the study.

Conclusions

The findings support revisions to subsequent medicinal cannabis RCT study designs, namely, omitting a requirement that participants attend weekly hospital appointments. These findings highlight the value of embedding qualitative sub-studies into RCTs. While some challenges to RCT recruitment are universal, others are context (population, intervention, location) specific. A barrier to participation found in research conducted elsewhere—stigma—was not identified in the current study. Thus, findings have important implications for those undertaking RCTs in the rapidly developing context of medical cannabis.
Infection with pathogenic Blastocystis ST7 is associated with decreased bacterial diversity and altered gut microbiome profiles in diarrheal patients
Authors: Deng Lei , Lee Jonathan W. J. , Tan Kevin S. W.
Published: September 2022

Background

Blastocystis is a common protistan parasite inhabiting the gastrointestinal tract of humans and animals. While there are increasing reports characterizing the associations between Blastocystis and the gut microbiome in healthy individuals, only a few studies have investigated the relationships between Blastocystis and the gut microbiota in diarrheal patients.

Methods

The effects of a specific subtype (ST7) of Blastocystis on the composition of gut microbiota in diarrheal patients were investigated using 16S ribosomal RNA (rRNA) gene sequencing and bioinformatic analyses.

Results

Compared with diarrheal patients without Blastocystis, diarrheal patients infected with Blastocystis ST7 exhibited lower bacterial diversity. Beta diversity analysis revealed significant differences in bacterial community structure between ST7-infected and Blastocystis-free patients. The proportion of Enterobacteriaceae and Escherichia-Shigella were significantly enriched in ST7-infected patients. In contrast, the abundance of Bacteroides and Parabacteroides were more prevalent in Blastocystis-free patients.

Conclusions

The results of this study revealed, for the first time, that infection with Blastocystis ST7 is associated with lower bacterial diversity and altered microbial structure in diarrheal patients. Our study on clinical diarrheal patients is also the first to reinforce the notion that ST7 is a pathogenic subtype of Blastocystis.

Graphical Abstract
Hypermethylation of tumor suppressor lncRNA MEF2C-AS1 frequently happened in patients at all stages of colorectal carcinogenesis
Authors: Qian Sangni , Lin Shujuan , Xu Xin , Bai Hao , Yeerken Aibuta , Ying Xiaojiang , Li Zhenjun , Fei Xinglin , Yang Jinhua , Tang Mengling , Wang Jianbing , Jin Mingjuan , Chen Kun
Published: September 2022

Background

The novel long noncoding RNA MEF2C-AS1 has been identified to play suppressor roles during tumorigenesis. DNA methylation has a regulatory effect on gene expression in cancer initiation and progression. However, the methylation status of MEF2C-AS1 and its role in colorectal cancer (CRC) development remain unclear.

Methods

The expression and methylation levels of MEF2C-AS1 were systematically analyzed among 31 cancers with available qualified data in GEPIA and UCSC Xena databases. Then, the MEF2C-AS1 methylation status was firstly examined among 12 CRCs by Illumina Infinium MethylationEPIC BeadChip in in-house step 1 and further quantified among 48 CRCs by the MassARRAY method in in-house step 2. Subsequently, its methylation and expression levels were quantified among 81 non-advanced adenomas (NAAs), 81 advanced adenomas (AAs), and 286 CRCs using the MassARRAY method, and among 34 NAAs, 45 AAs, and 75 CRCs by qRT-PCR, in in-house step 3, respectively. The effect of MEF2C-AS1 methylation on CRC survival was analyzed by the Kaplan–Meier method. Additionally, in vitro cell proliferation, migration and invasion assays, and bioinformatics analysis were performed to explore the role of MEF2C-AS1 in colorectal carcinogenesis.

Results

Lower expression and higher methylation of MEF2C-AS1 were found in CRC by online databases. In the comparisons of lesion tissues with adjacent normal tissues, MEF2C-AS1 hypermethylation of each individual site and mean level was found among CRC patients in in-house step 1 and step 2, more meaningfully, among NAA patients, AA patients, and CRC patients at all stages during colorectal carcinogenesis in in-house step 3 (all p < 0.05). Further comparisons demonstrated significant differences between CRC and NAA (p = 0.025), AA and NAA (p = 0.020). Moreover, MEF2C-AS1 hypermethylation was associated with poorer disease-specific survival of CRC patients (p = 0.044). In addition, hypermethylation and lower expression of MEF2C-AS1 were verified in RKO cells, and the MEF2C-AS1 overexpression significantly suppressed RKO cell proliferation, migration, and invasion.

Conclusions

The findings reveal that MEF2C-AS1 hypermethylation might be an early driven event during colorectal carcinogenesis. It might serve as a promising prognostic biomarker for CRC survival. Our study also indicates the potential tumor-suppressing role of MEF2C-AS1 in CRC.
Effectiveness of work-related interventions for return to work in people on sick leave: a systematic review and meta-analysis of randomized controlled trials
Authors: Tingulstad Alexander , Meneses-Echavez Jose , Evensen Line Holtet , Bjerk Maria , Berg Rigmor C.
Published: September 2022

Background

Long-term sick leave is a serious concern in developed countries and the cost of sickness absence and disability benefits cause major challenges for both the individual and society as a whole. Despite an increasing body of research reported by existing systematic reviews, there is uncertainty regarding the effect on return to work of workrelated interventions for workers with different diagnoses. The objective of this systematic review was to assess and summarize available research about the effects of work-related interventions for people on long-term sick leave and those at risk of long-term sick leave.

Methods

We conducted a systematic review in accordance with international guidelines. Campbell Collaboration (Area: Social Welfare), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Embase, Epistemonikos, MEDLINE, PsycINFO, Scopus, and Sociological Abstracts were systematically searched in March 2021. Two authors independently screened the studies. We conducted risk of bias assessments and meta-analyses of the available evidence in randomized controlled trials (RCTs). The remaining comparisons were synthesized narratively. The certainty of evidence for each outcome was assessed.

Results

We included 20 RCTs comprising 5753 participants at baseline from 4 different countries. The studies had generally low risk of bias. Our certainty in the effect estimates ranged from very low to moderate. Eight different interventions were identified. Meta-analysis revealed no statistically significant difference between multidisciplinary rehabilitation (MR) and usual care (US) (Risk Ratio [RR] 1.01; Confidence Interval [CI] 95% 0.70-1.48 at 12 months follow-up) and between MR and other active intervention (Risk Ratio [RR] 1.04; Confidence Interval [CI] 95% 0.86-1.25 at 12 months follow-up). Remaining intervention groups revealed marginal, or no effect compared to the control group. The results for the secondary outcomes (self-efficacy, symptom reduction, function, cost-effectiveness) showed varied and small effects in the intervention groups.

Conclusion

Overall, the present data showed no conclusive evidence of which work-related intervention is most effective for return to work. However, a handful of potential interventions exist, that may contribute to a foundation for future research. Our findings support the need for adequately powered and methodologically strong studies.
Asymptotic behavior of solution curves of nonlocal one-dimensional elliptic equations
Authors: Shibata Tetsutaro
Published: September 2022

We study the one-dimensional nonlocal elliptic equation $$\begin{aligned}& -A\bigl( \bigl\Vert u' \bigr\Vert _{p}^{p} \bigr) u''(x) = \lambda B\bigl( \bigl\Vert u' \bigr\Vert _{q}^{q} \bigr)u(x)^{r} , \quad x \in I:= (0,1), u(x) > 0, x \in I, \\& u(0) = u(1) = 0, \end{aligned}$$

−
A

(

∥

u
′

∥

p
p

)

u
″

(
x
)
=
λ
B

(

∥

u
′

∥

q
q

)

u

(
x
)

r

,

x
∈
I
:
=
(
0
,
1
)
,
u
(
x
)
>
0
,
x
∈
I
,

u
(
0
)
=
u
(
1
)
=
0
,

where $A = A(y)$
A
=
A
(
y
)
and $B = B(y)$
B
=
B
(
y
)
are continuous functions, satisfying $A(y) > 0$
A
(
y
)
>
0
, $B(y) > 0$
B
(
y
)
>
0
for $y > 0$
y
>
0
, $p \ge 1$
p
≥
1
, $q \ge 1$
q
≥
1
, and $r > 1$
r
>
1
are given constants, and $\lambda > 0$
λ
>
0
is a bifurcation parameter. We establish the global behavior of solution curves and precise asymptotic formulas for $u_{\lambda}(x)$

u
λ

(
x
)
as $\lambda \to \infty $
λ
→
∞
.
Fundamental Discrepancy of Chemical Reactivity of Tricalcium Oxy Silicate (alite), Dicalcium Silicate (Belite), and Their Polymorphs: A Density Functional Theory Study
Authors: Kim Seungchan , Lee Yangwoo , Plank J. , Moon Juhyuk
Published: September 2022

Tricalcium oxy silicate (C3S) and dicalcium silicate (C2S) are the major constituents of cement. In this study, the reactivity of polymorphs of calcium silicates is quantitatively investigated using Density Functional Theory. The result of combining the DFT calculation and the Bader charge analysis elucidates that the main difference in reactivity between C3S and C2S is the presence of oxy ions in C3S which has smaller partial charge compared to that of other oxygen in the crystals. For the C3S, the reactivity of among different C3S polymorphs is decisively affected by the Bader charge of oxy ions. In contrast, total internal energy of C2S determines the quantitative chemical reactivity of C2S polymorphs. This result suggests that oxy ion has more dominant impact on the thermodynamic stability of calcium silicates. Furthermore, total energy can be used to estimate the chemical reactivity of calcium silicates, where there is no oxy ion exists.
Occurrence of asymptomatic malaria infection and living conditions in the lowlands of Ethiopia: a community-based cross-sectional study
Authors: Goshu Endale Mengesha , Zerefa Meseret Dessalegne , Tola Habteyes Hailu
Published: September 2022

Background

A significant decline in malaria burden was documented in previously high burden African countries. Even though the global decline in malaria burden is significant, about 95% of it was typically found in 29 African countries and the decline was affected by COVID-19 in 2020. The considerable reduction in malaria incidence was noted due to effective prevention and treatment efforts, and rapid changes in living conditions. The relationship between the occurrence of asymptomatic malaria infection and household living conditions is well unstudied. This study aimed to determine the association between household living conditions and the occurrence of asymptomatic malaria in the lowlands of Ethiopia.

Methods

A community-based cross-sectional study was conducted from January to March 2021 in twelve villages of Gambella, Southern Nation Nationalities and People Region and Afar in Ethiopia. A total of 1366 households were randomly selected, interviewed, and tested for malaria by rapid diagnostic test and blood film microscopic examination. Multiple logistic regression model was used to determine the independent association between living conditions and asymptomatic malaria infection.

Results

The prevalence of asymptomatic malaria infection among individuals living in dwellings built with traditional floor/wall/roof ranges from 8.1% to 8.4% while it ranges from 2.0% to 4.6% among those living in modern floor/wall/roof houses. Dwellings built with traditional wall materials (P = 0.050), spending nights with cattle in the same house (P < 0.001), and availability of kitchen in the main house with no partition (P = 0.004) were significantly associated with asymptomatic malaria infection.

Conclusions

Asymptomatic malaria infection was 4.3 times higher among occupants residing in dwellings built with traditional wall materials; 5.6 times higher among households spending nights with cattle in the same house, and 2.3 times higher among households with kitchen in the main house with no partition. Therefore, policies and strategies on malaria elimination need to address or target improvements of the above listed living conditions for the community. A multi sectoral action is required to use these social determinants as a vector control strategic addition; and malaria elimination programs are expected to coordinate the implementation.
Purkinje cell vulnerability induced by diffuse traumatic brain injury is linked to disruption of long-range neuronal circuits
Authors: Özen Ilknur , Mai Hongcheng , De Maio Alessandro , Ruscher Karsten , Michalettos Georgios , Clausen Fredrik , Gottschalk Michael , Ansar Saema , Arkan Sertan , Erturk Ali , Marklund Niklas
Published: September 2022

Cerebellar dysfunction is commonly observed following traumatic brain injury (TBI). While direct impact to the cerebellum by TBI is rare, cerebellar pathology may be caused by indirect injury via cortico-cerebellar pathways. To address the hypothesis that degeneration of Purkinje cells (PCs), which constitute the sole output from the cerebellum, is linked to long-range axonal injury and demyelination, we used the central fluid percussion injury (cFPI) model of widespread traumatic axonal injury in mice. Compared to controls, TBI resulted in early PC loss accompanied by alterations in the size of pinceau synapses and levels of non-phosphorylated neurofilament in PCs. A combination of vDISCO tissue clearing technique and immunohistochemistry for vesicular glutamate transporter type 2 show that diffuse TBI decreased mossy and climbing fiber synapses on PCs. At 2 days post-injury, numerous axonal varicosities were found in the cerebellum supported by fractional anisotropy measurements using 9.4 T MRI. The disruption and demyelination of the cortico-cerebellar circuits was associated with poor performance of brain-injured mice in the beam-walk test. Despite a lack of direct input from the injury site to the cerebellum, these findings argue for novel long-range mechanisms causing Purkinje cell injury that likely contribute to cerebellar dysfunction after TBI.
Dual-mode SERS-based lateral flow assay strips for simultaneous diagnosis of SARS-CoV-2 and influenza a virus
Authors: Lu Mengdan , Joung Younju , Jeon Chang Su , Kim Sunjoo , Yong Dongeun , Jang Hyowon , Pyun Sung Hyun , Kang Taejoon , Choo Jaebum
Published: September 2022

Since COVID-19 and flu have similar symptoms, they are difficult to distinguish without an accurate diagnosis. Therefore, it is critical to quickly and accurately determine which virus was infected and take appropriate treatments when a person has an infection. This study developed a dual-mode surface-enhanced Raman scattering (SERS)-based LFA strip that can diagnose SARS-CoV-2 and influenza A virus with high accuracy to reduce the false-negative problem of the commercial colorimetric LFA strip. Furthermore, using a single strip, it is feasible to detect SARS-CoV-2 and influenza A virus simultaneously. A clinical test was performed on 39 patient samples (28 SARS-CoV-2 positives, 6 influenza A virus positives, and 5 negatives), evaluating the clinical efficacy of the proposed dual-mode SERS-LFA strip. Our assay results for clinical samples show that the dual-mode LFA strip significantly reduced the false-negative rate for both SARS-CoV-2 and influenza A virus.
Development and implementation of an online community as a strategy for mixed methods research during a pandemic
Authors: Shea Lisa , Bushen Jennifer , Ahmad Nina , Geonnotti Gabrielle , LaMori Joy , Terrey Stephanie , Gonzalez Pepa , Shuman Jill
Published: September 2022

Conducting mixed methods research is critical for healthcare researchers to understand attitudes, behaviors, and experiences on health-related topics, such as vaccine acceptance. As the COVID-19 pandemic has made it difficult to employ traditional, face-to-face qualitative methodologies, this paper describes the use of a virtual platform to conduct person-centered research. To overcome these challenges and better understand the attitudes and behaviors of vaccine-eligible individuals in the United States, an online health community called the Virtual Engagement Research Community (VERC) was designed and implemented. Using the Health Belief Model as a framework, the VERC employed a mixed methods approach to elicit insights, which included discussion topics, rapid polls, and surveys. Throughout the initial enrollment period of April–October 2021, continuous improvement efforts were made to bolster recruitment and member engagement. This agile research strategy was successful in utilizing mixed methods to capture community sentiments regarding vaccines. While this community focused on vaccination, the methodology holds promise for other areas of health research such as obesity, HIV, mental health disorders, and diabetes.
The cholera outbreak in Lahore, Pakistan: challenges, efforts and recommendations
Authors: Naveed Aiman , Umer Mohammad , Ehsan Muhammad , Ayyan Muhammad , Shahid Abia , Zahid Afra , Essar Mohammad Yasir , Cheema Huzaifa Ahmad
Published: September 2022

The Punjab health authorities have declared a cholera outbreak with over 2000 acute diarrheal cases being reported in Lahore in April 2022 and 25 laboratory-confirmed cases as of 27 May 2022. Overpopulation, poor sanitation, and a substandard water drainage system contribute to the spread of cholera. The increasing hydro-toxicity of underground water is another challenge to the disease spread. The lack of public awareness about the disease and their poor hygiene practices serve as a portal for the disease to spread to humans. There is a need to establish an effective surveillance system, increase public awareness, and implement the WHO-recommended plan for cholera control. This includes the provision of drugs and diagnostic kits to healthcare centres, the supply of clean water, and the development of a drainage system for sewage and rainwater.
Myocardial protection with histidine-tryptophan-ketoglutarate solution in comparison with hypothermic hyperkalemic blood solution in the correction of acyanotic congenital heart diseases
Authors: Ali Ahmed M. , Seif Elnasr Gihan , Kamal Manal M. , Aboseif Eman M. , Abdel Twab Samar M.
Published: September 2022

Background

Intraoperative myocardial preservation is essential in pediatric cardiac surgeries. The combination of hypothermia and hyperkalemic cardioplegia is commonly used. Histidine-tryptophan-ketoglutarate (HTK–Custodiol) is a long-acting crystalloid cardioplegia which induces cardiac arrest by reducing the extracellular sodium concentration. Cold blood cardioplegia has many modifications differing in the blood: crystalloid ratio, buffers, substrates, and final potassium concentration which induces cardiac arrest in diastole as the main role. We compared cold histidine-tryptophan-ketoglutarate crystalloid (HTK) solution with hypothermic hyperkalemic blood (HHB) cardioplegia solution regarding their efficacy in myocardial preservation in patients undergoing total repair of non-cyanotic congenital cardiac defects. We assessed postoperative cardiac troponin level, myocardial function, inotropic support, intensive care unit (ICU) length of stay, hospital length of stay, and the incidence of prolonged postoperative mechanical ventilation as indicators of myocardial protection.

Results

This interventional, single-blinded, randomized, comparative, and prospective clinical study was conducted randomly on 60 patients, aged between 6 and 24 months undergoing total surgical repair. We found no statistically significant difference regarding patients’ personal, demographics, and operative details (surgery duration, cardiopulmonary bypass time, aorta clamp time). However, patients who were given HTK cardioplegia were found to stay less in the ICU (with a p value <0.05). However, there was no statistically significant difference between both groups as regards hospital length of stay. Also, all patients were extubated in less than 24-h duration. There was a statistically significant difference between both groups regarding troponin levels after 8, 12, and 24 h post-bypass in favor of the HHB solution. Interestingly, no significant correlation was proved between both groups regarding myocardial function (EF%, FS) and level of inotropic support (assessed by maximum vasoactive inotropic score).

Conclusions

Hypothermic hyperkalemic blood cardioplegia showed better results in myocardial preservation than the cold histidine-tryptophan-ketoglutarate solution in the repair of noncyanotic congenital cardiac defects.

Trial registration

Pan African Clinical Trial Registry, PACTR202109777317416. Registered on 28 September 2021—Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=16154
Combining abilities and genetic parameters for grain yield and some agronomic traits in maize (Zea mays L.)
Authors: Habiba Rehab Mohamed Mohamed , El-Diasty Mohamed Zakaria , Aly Rizk Salah Hassanin
Published: September 2022

Background

The improvement of maize hybrids relies on significant genetic variability among the inbred lines used and the degree to which it is transferred to progeny. Understanding the genetic parameters and heritability of traits in every population is an essential precondition for selection program. This study was designed to estimate the magnitude of genetic parameters and heritability of traits in line × tester mating design. Fifteen yellow maize inbred lines derived from different sources were crossed with two lines as tester i.e., Gm-1001 and Gm-1002 in 2019 summer season. During 2020 season, the resulted 30 crosses along with check hybrid SC-168 were evaluated in a yield trial at two locations: Gemmeiza and Sids Agric. Res. Station.

Results

The mean squares among two locations were highly significant for all studied traits except KR−1. TheL1andL3had the best general combiners for GY ard fed−1. In addition, theT1as a tester was a GCA effects good combiner for earliness, shorter plants and lower ear placement traits. WhileT2was good combiner for grain yield and some of attributes. CrossesL5×T1andL7×T2had positive and significant SCA effects for grain yield. The GCA variances were higher than SCA variances for all studied traits except for ED trait, indicating that additive genetic variance played the major role than non-additive genetic variance in the inheritance of these traits. Generally, phenotypic coefficient of variability was higher than genotypic coefficient of variability for all studied traits, suggesting that there was an influence by environments in the expression of these traits. Recorded heritability percentage in broad sense ranged from low for (ear position%, no. of ears/100 plants, ear diameter and grain yield) traits, medium for (days to 50% silking, plant height, ear height and no. of kernels/row) traits to moderate high for ear length trait.

Conclusion

Our investigation concluded that most of the studied lines exhibited highly general combiners and the superior crosses were as a result of a good × good combiner for most of yield components traits.
Atypical angiofibroma: a very rare case report and review of literature
Authors: Mustafa Ahmad , Yared Tamar
Published: September 2022

Background

Extranasopharyngeal angiofibroma (ENPA) has been stratified to nodules consisting of blood vessels and fibrous tissue, which occur outside the nasopharynx. ENPA is histologically similar to nasopharyngeal angiofibroma (NA), differing in clinical and epidemiologic characteristics. Since these differences, ENPA considers as a diagnostic challenge and a painstaking appraisal with a high index of doubt is major in determining the true diagnosis and treatment. Fewer than a hundred cases of “atypical angiofibroma” are represented in the international literature, with only 6 cases having been reported previously about ENPA originating from the nasal septum.

Case presentation

We submit a summarized literature review with a case of ENPA emerging from the nasal septum in a 6-year-old child. Under general anesthesia and endoscopically, the mass that emerged from the septum was resected. Histopathology examination confirmed the diagnosis of ENPA. No recurrence over 1 year after surgery. Our patient had an age of onset and site of lesion different from most ENPAs, supporting the rareness of this case.

Conclusion

Our aim is to shed light on a very rare clinical presentation, describe the diagnostic and therapeutic workup, and suggest that ENPA must be regarded as a differential diagnosis with any complaint of nasal occlusion and epistaxis accompanied by a unilateral nasal tumor.