bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and Associated Risk Factors of Anemia Among Hospitalized Children in a Tertiary Level Hospital in Botswana
Authors: Siamisang Aobakwe Betty , Gezmu Alemayehu M. , Slone Jeremy S. , Gabaitiri Lesego , David Thuso , Phetogo Bathusi , Joel Dipesalema
Published: February 2023

Anemia is a global health concern and has been associated with long term cognitive and behavioral adverse effects. A cross sectional study was conducted to determine the prevalence of and risk factors for anemia in infants and children between 6 months to 5 years of age admitted to a tertiary hospital in Botswana. Baseline full blood count of every patient admitted during the study period was assessed to determine if anemia was present. Data were collected from patient’s medical inpatient chart, electronic medical record (Integrated Patient Management System (IPMS)), and through interviewing parents and caregivers. Multivariate logistic regression model was used to identify risk factors of anemia. A total of 250 patients were included in the study. Prevalence of anemia in this cohort was 42.8%. There were 145 (58%) males. Of the patients with anemia, 56.1%, 39.2%, and 4.7% had mild, moderate, and severe anemia, respectively. Microcytic anemia consistent with iron deficiency was identified in 61 (57%) patients. Age was the only independent predictor of anemia. Children aged 24 months and more had a 50% lower risk of having anemia than their younger counterparts (odds ratio (OR) 0.52; 95% Confidence Interval (95% CI) 0.30 to 0.89). The findings of this study demonstrate anemia as a serious health concern in the pediatric population in Botswana.
Do radiolucencies affect the outcomes of a 4th generation total ankle prosthesis? A 2-year follow-up
Authors: Gross Christopher , Friscia David A. , Doty Jesse F. , Murphy G. Andrew , Bohay Donald , Fortin Paul , Vora Anand , Strasser Nicholas L.
Published: February 2023

Category:

Ankle Arthritis; Ankle

Introduction/ Purpose:

Fourth generation ankle replacements benefit from improved surgical technique, respect for bony preservation, and increased surgeon awareness of operative indications. The rate of radiolucencies around the tibial component observed in studies about 3rd generation total ankle replacements are reported at rates that range from 30% to 43%. To date, studies have not been shown to predict survivorship or patient reported outcomes (PROs) however. We hypothesize that radiolucenices do not affect PROs or survivorship.

Methods:

Patients presenting for a total ankle replacement at 9 institutions were prospectively enrolled in academic and private settings. Each patient received an INFINTY ankle prosthesis (Stryker, Memphis, TN, USA). Implants were assessed for subsidence and the presence of radiolucencies based on the analysis and comparison of all postoperative weightbearing ankle radiographs available. Subsidence was defined as a change of tibial component alignment greater than 5degrees or a change in the vertical position of the talar component of 5 mm or more. Subsidence and radiolucent lines were deemed nonprogressive when no change in position or size was noted with comparison of the last 2 radiographs. PROMs were recorded pre-operatively and at 6months, 12months, and 24month intervals. The following PROMs were collected: Ankle Osteoarthritis Score (AOS), PROMIS Global Physical Health, and Foot and Ankle Outcome Score (FAOS). The preoperative and latest follow-up scores for patients with two years of follow-up were analyzed.

Results:

110 patients were enrolled in the study who had 2-year follow-up with twenty-one patients (19.1%) exhibiting a radiographic lucency. To date, our survivorship is 97.3%, of which 2 patients were revised for aseptic loosening; both reporting radiolucencies. The radiolucencies for one identified at 6months became progressive for both tibia and talus with cysts above 5mm requiring revision at 1.5years post op. The other requiring revision at 2years post-op reported progressive radiolucency. There was no difference in rates of survivorship with or without radiolucencies. One patient had subsidence which required revision. All patients with radiolucencies had significant improvements in all domains of the AOS, PROMIS, and FAOS Scores (p< 0001). Radiolucency did not impact the PROs (AOA p=.741, PROMIS p=.964, FAOS p=.8937) in those with 2-year follow-up.

Conclusion:

Radiolucencies did not impact PROMs in patients undergoing implantation with a 4th generation total ankle replacement. In carefully selected patients, radiolucency did not correlate with an increased need for revision surgery nor had decreased survivorship.
Comparison of the Safety and Efficacy of a 3-Dimensional Heads-up Display vs a Standard Operating Microscope in Retinal Detachment Repair
Authors: Zeng Rebecca , Feng Yilin , Begaj Tedi , Baldwin Grace , Miller John B.
Published: February 2023

Purpose: To evaluate the safety, efficacy, and efficiency of the Ngenuity 3-dimensional (3D) heads-up display (HUD) visualization system for primary rhegmatogenous retinal detachment (RRD) repair at a large academic medical center in the United States. Methods: This retrospective review comprised consecutive patients aged 18 years or older who had primary RRD repair (pars plana vitrectomy [PPV] alone or combined PPV and scleral buckle) performed by the same fellowship-trained vitreoretinal surgeon using the 3D visualization system and a traditional standard operating microscope (SOM) at Massachusetts Eye and Ear from June 2017 to December 2021. The minimum follow-up was 90 days. Results: The 3D HUD group comprised 50 eyes of 47 patients and the SOM group, 138 eyes of 136 patients. There were no between-group differences in single surgery anatomic success rates at 3 months (98% HUD vs 99% SOM; P = 1.00) or at the last follow-up (94% HUD vs 98% SOM; P = .40). The rate of postoperative proliferative vitreoretinopathy was similar between the 2 groups (3 months: 3% HUD vs 5% SOM, P = .94; last follow-up, 2% HUD vs 3% SOM, P = .93). There was no difference in the mean duration of surgery (57.4 ± 28.9 minutes HUD vs 59.4 ± 29.9 minutes SOM; P = .68). Conclusions: Anatomic and functional outcomes, in addition to surgical efficiency, of noncomplex primary RRD repair with a 3D HUD system were similar to those of surgery performed with an SOM.
Power Consumption Characteristics Research on Mobile System of Electrically Driven Large-Load-Ratio Six-Legged Robot
Authors: Zhuang Hongchao , Wang Ning , Gao Haibo , Deng Zongquan
Published: February 2023

The electrically driven large-load-ratio six-legged robot with engineering capability can be widely used in outdoor and planetary exploration. However, due to the particularity of its parallel structure, the effective utilization rate of energy is not high, which has become an important obstacle to its practical application. To research the power consumption characteristics of robot mobile system is beneficial to speed up it toward practicability. Based on the configuration and walking modes of robot, the mathematical model of the power consumption of mobile system is set up. In view of the tripod gait is often selected for the six-legged robots, the simplified power consumption model of mobile system under the tripod gait is established by means of reducing the dimension of the robot's statically indeterminate problem and constructing the equal force distribution. Then, the power consumption of robot mobile system is solved under different working conditions. The variable tendencies of the power consumption of robot mobile system are respectively obtained with changes in the rotational angles of hip joint and knee joint, body height, and span. The articulated rotational zones and the ranges of body height and span are determined under the lowest power consumption. According to the walking experiments of prototype, the variable tendencies of the average power consumption of robot mobile system are respectively acquired with changes in duty ratio, body height, and span. Then, the feasibility and correctness of theory analysis are verified in the power consumption of robot mobile system. The proposed analysis method in this paper can provide a reference on the lower power research of the large-load-ratio multi-legged robots.
Alteration of the cortical morphology in classical trigeminal neuralgia: voxel-, deformation-, and surface-based analysis
Authors: Ge Xiuhong , Wang Luoyu , Pan Lei , Ye Haiqi , Zhu Xiaofen , Fan Sandra , Feng Qi , Du Quan , Yu Wenhua , Ding Zhongxiang
Published: February 2023

Objective

This study aimed to combine voxel-based morphometry, deformation-based morphometry, and surface-based morphometry to analyze gray matter volume and cortex shape in classical trigeminal neuralgia patients.

Methods

This study included 79 classical trigeminal neuralgia patients and age- and sex-matched 81 healthy controls. The aforementioned three methods were used to analyze brain structure in classical trigeminal neuralgia patients. Spearman correlation analysis was used to analyze the correlation of brain structure with the trigeminal nerve and clinical parameters.

Results

The bilateral trigeminal nerve was atrophied, and the ipsilateral trigeminal nerve volume was smaller than the contralateral volume in the classical trigeminal neuralgia. The gray matter volume of Temporal_Pole_Sup_R and Precentral_R was found to be decreased using voxel-based morphometry. The gray matter volume of Temporal_Pole_Sup_R had a positive correlation with disease duration and a negative correlation with the cross-section area of the compression point and the quality-of-life score in trigeminal neuralgia. The gray matter volume of Precentral_R was negatively correlated with the ipsilateral volume of the trigeminal nerve cisternal segment, cross-section area of compression point, and visual analogue scale. The gray matter volume of Temporal_Pole_Sup_L was found to be increased using deformation-based morphometry and had a negative correlation with the self-rating anxiety scale. The gyrification of the middle temporal gyrus_L increased and the Postcentral_L thickness decreased, as detected using surface-based morphometry.

Conclusions

The gray matter volume and cortical morphology of pain-related brain regions were correlated with clinical and trigeminal nerve parameters. voxel-based morphometry, deformation-based morphometry, and surface-based morphometry complemented each other in analyzing the brain structures of patients with classical trigeminal neuralgia and provided a basis for studying the pathophysiology of classical trigeminal neuralgia.

Graphical Abstract
A tale of two data sets: comparing German administrative and survey data using wage inequality as an example
Authors: Stüber Heiko , Grabka Markus M. , Schnitzlein Daniel D.
Published: February 2023

The IAB’s Sample of Integrated Labour Market Biographies (SIAB) and the Socio-Economic Panel (SOEP) are the two data sets most commonly used to analyze wage inequality in Germany. While the SIAB is based on administrative reports by employers to the social security system, the SOEP is a survey data set in which respondents self-report their wages. Both data sources have their specific advantages and disadvantages. The objective of this study is to describe and compare the evolution of wage inequality for these two types of data. For this purpose, different sample restrictions are applied. The comparison without any harmonization of the data shows different levels and trends. When the information is largely harmonized, comparable trends and similar levels emerge.
The role of dexmedetomidine as an adjuvant for high-thoracic erector spinae plane block for analgesia in shoulder arthroscopy; a randomized controlled study
Authors: Hamed Mohamed Ahmed , Fargaly Omar Sayed , Abdelghaffar Rana Ahmed , Moussa Mohammed Ahmed , Algyar Mohammad Fouad
Published: February 2023

Background

Management of postoperative pain after shoulder arthroscopy is an important issue. Dexmedetomidine, as an adjuvant, improves nerve block efficacy and decreases postoperative consumption of opioids. As a result, we designed this study to determine if adding dexmedetomidine to an erector spinae plane block (ESPB) that is guided by ultrasound (US) is beneficial for treating immediate postoperative pain following shoulder arthroscopy.

Methods

This randomized controlled double-blind trial recruited 60 cases 18–65 years old of both sexes, American Society of Anesthesiologists (ASA) physical status I-II, scheduled for elective shoulder arthroscopy. Random allocation of 60 cases was done equally into two groups according to the solution injected in US-guided ESPB at T2 before general anesthetic induction. Group (ESPB): 20 ml 0.25% bupivacaine. Group (ESPB + DEX): 19 ml bupivacaine 0.25% + 1 mL dexmedetomidine 0.5 µg/kg. The primary outcome was The total rescue morphine consumption in the first 24 postoperative hours.

Results

The mean intraoperative fentanyl consumption was significantly lower in the group (ESPB + DEX) compared to the group (ESPB) (82.86 ± 13.57 versus 100.74 ± 35.07, respectively, P = 0.015). The median (IQR) time of the 1st rescue analgesic request was significantly delayed in the group (ESPB + DEX) compared to group (ESPB) [18.5 (18.25–18.75) versus 12 (12–15.75), P = 0.044]. The number of cases that required morphine was significantly lower in the group (ESPB + DEX) than in the group (ESPB) (P = 0.012). The median (IQR) of total postoperative morphine consumption in 1st 24 h was significantly lower in the group (ESPB + DEX) compared to the group (ESPB) [0 (0–0) versus 0 (0–3), P = 0.021].

Conclusion

The dexmedetomidine as an adjuvant to bupivacaine in ESPB produced adequate analgesia by reducing the intraoperative and postoperative opioid requirements in shoulder arthroscopy.

Trial Registration

This study is registered on ClinicalTrials.gov (NCT05165836; principal investigator: Mohammad Fouad Algyar; registration date: 21/12/ 2021).
Assessment of a serum calcification propensity test for the prediction of all-cause mortality among hemodialysis patients
Authors: Zawada Adam M , Wolf Melanie , Rincon Bello Abraham , Ramos-Sanchez Rosa , Hurtado Munoz Sara , Ribera Tello Laura , Mora-Macia Josep , Fernández-Robres M. Amparo , Soler-Garcia Jordi , Aguilera Jover Josep , Moreso Francesc , Stuard Stefano , Stauss-Grabo Manuela , Winter Anke , Canaud Bernard
Published: February 2023

Background

Vascular calcification is a major contributor to the high cardiac burden among hemodialysis patients. A novel in vitro T50-test, which determines calcification propensity of human serum, may identify patients at high risk for cardiovascular (CV) disease and mortality. We evaluated whether T50 predicts mortality and hospitalizations among an unselected cohort of hemodialysis patients.

Methods

This prospective clinical study included 776 incident and prevalent hemodialysis patients from 8 dialysis centers in Spain. T50 and fetuin-A were determined at Calciscon AG, all other clinical data were retrieved from the European Clinical Database. After their baseline T50 measurement, patients were followed for two years for the occurrence of all-cause mortality, CV-related mortality, all-cause and CV-related hospitalizations. Outcome assessment was performed with proportional subdistribution hazards regression modelling.

Results

Patients who died during follow-up had a significantly lower T50 at baseline as compared to those who survived (269.6 vs. 287.7 min, p = 0.001). A cross-validated model (mean c statistic: 0.5767) identified T50 as a linear predictor of all-cause-mortality (subdistribution hazard ratio (per min): 0.9957, 95% CI [0.9933;0.9981]). T50 remained significant after inclusion of known predictors. There was no evidence for prediction of CV-related outcomes, but for all-cause hospitalizations (mean c statistic: 0.5284).

Conclusion

T50 was identified as an independent predictor of all-cause mortality among an unselected cohort of hemodialysis patients. However, the additional predictive value of T50 added to known mortality predictors was limited. Future studies are needed to assess the predictive value of T50 for CV-related events in unselected hemodialysis patients.
Clinical characteristics, medication use, and impact of primary headache on daily activities: an observational study using linked online survey and medical claims data in Japan
Authors: Hirata Koichi , Sano Hiromi , Kondo Hiroyuki , Shibasaki Yoshiyuki , Koga Nobuyuki
Published: February 2023

Background

Limited epidemiological data are available for headache disorders in Japan, and no recent studies have reported the impact of several primary headache disorders in Japan. This study aimed to report the up-to-date epidemiological data and impact of primary headaches on daily activities as well as the use of medical care, clinical features, and pain severity/activity impairment using nationwide data in Japan.

Methods

We used anonymized online survey data coupled with medical claims data, from individuals aged 19–74 years old, that were provided by DeSC Healthcare Inc. The outcomes included the prevalence of migraine, tension-type headache, cluster headache, and other headache types stratified by age and sex, use of medical care, clinical features, medication use, and severity of pain/activity impairment. All outcomes were examined separately for each headache type. This is the second paper reported concurrently with this research.

Results

The study population comprised 691/1,441/21/5,208 individuals with migraine/tension-type headache/cluster headache/other headache types, respectively. The prevalence of migraine and tension-type headache was higher in women than in men but was similar for cluster headache (male vs. female, 1.7% vs. 7.4%, 5.3% vs. 10.8%, and 0.1% vs. 0.1%, respectively). The percentage of individuals with migraine, tension-type headache, cluster headache who had not seen a doctor was 81.0%, 92.0%, 57.1%, respectively. The common headache triggers were fatigue in migraine and tension-type headache, and weather-related phenomena and turning of the seasons in migraine. Common activities refrained from or reduced by headaches were “operating a computer or smartphone”, “drinking alcohol”, and “going to crowded places” in all three headache types and housework-related activities in women. Among individuals taking medicines, 16.8%, 15.8%, 47.6% with migraine, tension-type headache, and cluster headache reported moderate to severe pain, respectively, and 12.6%, 7.7%, 19.0% reported moderate to severe disability, respectively.

Conclusions

This study found various triggers of headache attacks, and daily activities refrained from or reduced by headaches. Additionally, this study suggested that the disease burden in people possibly experiencing tension-type headaches, many of whom had not seen a doctor. The study findings are of clinical value for the diagnosis and treatment of primary headaches.
MLXIPL promotes the migration, invasion, and glycolysis of hepatocellular carcinoma cells by phosphorylation of mTOR
Authors: Chang Xiaowei , Tian Chang , Jia Yuanyuan , Cai Yu , Yan Pu
Published: February 2023

Background

Hepatocellular carcinoma (HCC) is associated with a high occurrence, mortality, and poor prognosis. MLX interacting protein like (MLXIPL) is an important regulator of glucolipid metabolism and is involved in tumor progression. We aimed to clarify the role of MLXIPL in HCC and its underlying mechanisms.

Methods

The level of MLXIPL was predicted using bioinformatic analysis and verified using quantitative real-time PCR (qPCR), immunohistochemical analysis, and western blot. We assessed the effects of MLXIPL on biological behaviors using the cell counting kit-8, colony formation, and Transwell assay. Glycolysis was evaluated using the Seahorse method. The interaction between MLXIPL and mechanistic target of rapamycin kinase (mTOR) was confirmed using RNA immunoprecipitation and co-immunoprecipitation. mTOR expression was detected in HCC cells using qPCR, immunofluorescence analysis, and western blot.

Results

The results showed that MLXIPL levels were elevated in both HCC tissues and HCC cell lines. Knockdown of MLXIPL impeded HCC cell growth, invasion, migration, and glycolysis. Moreover, MLXIPL combined with mTOR to induce phosphorylation of mTOR. Activated mTOR abrogated the effects on cellular processes induced by MLXIPL.

Conclusion

MLXIPL promoted the malignant progression of HCC by activating phosphorylation of mTOR, suggesting an important role of the combination of MLXIPL and mTOR in HCC.
Comparison of treatment outcomes of 360° intraoperative laser retinopexy and focal laser retinopexy with pars plans vitrectomy in patients with primary rhegmatogenous retinal detachment
Authors: Zheng Ying , Schindler Philip , Druchkiv Vasyl , Schulz Jan , Spitzer Stephan Martin , Skevas Christos
Published: February 2023

Background

This study was to compare the outcomes of 360° intra-operative laser retinopexy (ILR) and focal laser retinopexy in treating patients with pars plans vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD). To identify other potential risk factors for retinal re-detachment after primary PPV.

Methods

This was a retrospective cohort study. Three hundred and forty-four consecutive cases of primary rhegmatogenous retinal detachment treated with PPV were included between July 2013 and July 2018. Clinical characteristics and surgical outcomes were compared between focal laser retinopexy and additional 360° intra-operative laser retinopexy groups. Both univariate and multiple variable analysis were used to identify potential risk factors for retinal re-detachment.

Results

Median follow-up was 6.2 months (Q1, Q3:2.0, 17.2). As estimated with survival analysis, the 360º ILR group had the incidence of 9.74% and focal laser 19.54% at 6 months postoperatively. At 12 months postoperatively the difference was 10.78% vs. 25.21%. The difference in survival rates was significant (p = 0.0021). In multivariate Cox regression, the risk factors for retinal re-detachment were without additional 360° ILR, diabetes and macula off before the primary surgery (relatively OR = 0.456, 95%-CI [0.245–0.848], p < 0.05; OR = 2.301, 95% CI [1.130–4.687], p < 0.05; OR = 2.243, 95% CI [1.212–4.149], p < 0.05).

Conclusion

Additional 360° ILR group had a significantly lower rate of retinal re-detachment when compared with focal laser retinopexy group. Our study also elucidated that diabetes and macular off before the primary surgery might also be the potential risk factors for higher rate of retinal re-detachment outcome.

Trial registration

This was a retrospective cohort study.
Comparison of visual outcomes, keratometric parameters and biomechanical profiles between deep anterior lamellar keratoplasty with big-bubble technique vs. Melles technique for keratoconus: a retrospective study
Authors: Jamali Hossein , Saluoti Ramin , Maalhagh Mehrnoosh , Hosseini Shahla , Shirvani Mohammad
Published: February 2023

Objective

Comparing results of two different DALK surgery techniques (big bubble vs. Melles) in patients with advanced keratoconus.

Design

a retrospective comparative clinical study.

Participants

This study conducted on 72 eyes of 72 participants.

Introduction

This study designed to compare the results of two different DALK surgery techniques (big bubble vs. Melles) in patients with advanced keratoconus.

Method

Thirty-seven eyes were treated using the big bubble DALK method, while 35 eyes were treated using the Melles approach. Uncorrected visual acuity (UCVA), best corrected spectacle visual acuity (BCSVA), manifest refraction, keratometric characteristics, contrast sensitivity, corneal aberrations, corneal biomechanical characteristics, and endothelial cell profile are the outcome measurements.

Results

Mean UCVA in big bubble group was 0.61 ± 25 LogMAR and in Melles group was 0.89 ± 0.41 LogMAR (p-value 0.043). Mean BCSVA in big bubble group (0.18 ± 0.12 Log MAR) was significantly better than Melles group (0.35 ± 0.16 Log MAR). Mean of sphere and cylinder refraction showed no significant difference between two groups. Comparing the endothelial cell profile, corneal aberrations, corneal biomechanical properties and keratometry had no significantdifferences. Contrast sensitivity reported as modulation transfer function (MTF) showed higher values in big bubble group and differences with Melles group weresignificant. Results of point spread function (PSF) in big bubble group had superiority to Melles group with considerable statistical P value of 0.023.

Conclusion

When opposed to the Melles approach, the big bubble technique generates a smooth interface with less stromal residue, which results in higher visual quality and contrast sensitivity.
The social determinants of national tuberculosis incidence rates in 116 countries: a longitudinal ecological study between 2005–2015
Authors: Költringer Fiona A. , Annerstedt Kristi Sidney , Boccia Delia , Carter Daniel J. , Rudgard William E.
Published: February 2023

Background

Accelerating declines in tuberculosis (TB) incidence is paramount for achieving global goals set for 2030 by the Sustainable Development Goals and the End TB Strategy. The aim of this study was to identify key country-level social determinants of national TB incidence trends.

Methods

This longitudinal ecological study used country-level data extracted from online databases from the period 2005–2015. We used multivariable Poisson regression models allowing for distinct within- and between-country effects to estimate associations between national TB incidence rates and 13 social determinants of health. The analysis was stratified by country income status.

Results

The study sample included 48 low- and lower-middle-income countries (LLMICs) and 68 high- and upper-middle income countries (HUMICs), with a total of 528 and 748 observations between 2005–2015, respectively. National TB incidence rates declined in 108/116 countries between 2005–2015, with an average drop of 12.95% in LLMICs and 14.09% in HUMICs. Between LLMICs, higher Human Development Index (HDI), social protection spending, TB case detection, and TB treatment success were associated with lower TB incidence. Higher prevalence of HIV/AIDS was associated with higher TB incidence. Within LLMICs, increases in HDI over time were associated with lower TB incidence rates. Between HUMICs, higher HDI, health spending, and diabetes prevalence were associated with lower TB incidence, whereas higher prevalence of HIV/AIDS and alcohol-use were associated with higher TB incidence. Within HUMICs, increases in HIV/AIDS and diabetes prevalence over time were associated with higher TB incidence.

Conclusions

In LLMICs, TB incidence rates remain highest in countries with low human development, social protection spending and TB programme performance, and high rates of HIV/AIDS. Strengthening human development is likely to accelerate declines in TB incidence. In HUMICs, TB incidence rates remain highest in countries with low human development, health spending and diabetes prevalence, and high rates of HIV/AIDS and alcohol use. Here, slowing rising rates of HIV/AIDS and diabetes is likely to accelerate declines in TB incidence.
Media regulation strategies in parents of 4- to 16-year-old children and adolescents: a cross-sectional study
Authors: Poulain Tanja , Meigen Christof , Kiess Wieland , Vogel Mandy
Published: February 2023

Background

Since children can only control and limit their own media use to a limited extent, it is often the parents who regulate their children’s media use. However, there is insufficient research on which strategies they use and on how these strategies are related to socio-demographic and behavioral parameters.

Methods

The parental media regulation strategies co-use, active mediation, restrictive mediation, monitoring, and technical mediation were assessed in a sample of 563 four- to 16-year-old children and adolescents from middle to high social strata participating in the German cohort study LIFE Child. We investigated cross-sectional associations with socio-demographic characteristics (age and sex of child, age of parent, and socio-economic status (SES)) and other behavioral parameters of children (media use, ownership of media devices, engagement in extracurricular activities) and their parents (media use).

Results

All media regulation strategies were applied frequently, with restrictive mediation occurring most frequently. Overall, parents of younger children and of boys mediated media use more frequently, while we observed no differences depending on SES. Regarding child behavior, the ownership of a smartphone and a tablet/personal computer/laptop was associated with more frequent technical restriction, while screen time and engagement in extracurricular activities was not associated with parental media regulation. In contrast, parental screen time was related to more frequent co-use and less frequent use of restrictive and technical mediation.

Conclusion

Parental regulation of child media use is influenced by parental attitudes and a perceived need for mediation (e.g., in younger children or children owning internet-enabled devices) rather than child behavior.
Disability-adjusted life years (DALYs) based COVID-19 health impact assessment: a systematic review
Authors: Gebeyehu Daniel Teshome , East Leah , Wark Stuart , Islam Md Shahidul
Published: February 2023

Background

The emergence of COVID-19 has resulted in health, socio-economic, and political crises. The overall health impact of this disease can be measured by disability-adjusted life years (DALYs) which is the sum of the life years lost due to disability (YLDs) and the years life lost due to premature death (YLLs). The overarching objective of this systematic review was to identify the health burdens of COVID-19 and summarise the literature that can aid health regulators to make evidence-based decisions on COVID-19 mitigation strategies.

Methods

This systematic review was conducted using the PRISMA 2020 guidelines. DALYs-based primary studies were collected from databases, manual searches, and included studies’ references. The primary studies published in English language, conducted since the emergence of COVID-19, and using DALYs or its subsets (years life lost due to disability and/or years life lost due to premature death) as health impact metrics, were the inclusion criteria. The combined disability and mortality health impact of COVID-19 was measured in DALYs. The risk of bias due to literature selection, identification, and reporting processes was assessed using the Joanna Bridges Institute critical appraisal tool for cross-sectional studies, and the certainty of evidence was assessed using the GRADE Pro tool.

Result

Of the 1459 identified studies, twelve of them were eligible for inclusion in the review. The years life lost due to COVID-19 related mortality was dominant over the years life lost due to COVID-19 related disability (disability times from the onset of COVID-19 to recovery, from diseases occurrence to mortality, and the long-term consequences of COVID-19) in all included studies. The long-term consequence disability time and the pre-death disability time were not assessed by most of the reviewed articles.

Conclusion

The impact of COVID-19 on both the length and quality of life has been substantial and has been causing considerable health crises worldwide. The health burden of COVID-19 was greater than other infectious diseases. Further studies focussing on issues examining increasing preparedness for future pandemics, public sensitization, and multi-sectorial integration are recommended.
Hyperbaric oxygen therapy efficacy on mandibular defect regeneration in rats with diabetes mellitus: an animal study
Authors: Eldisoky Rodina H. , Younes Salwa A. , Omar Samia S. , Gharib Hagar S. , Tamara Tarek A.
Published: February 2023

Background

This study aimed to investigate the influence of hyperbaric oxygen therapy on mandibular critical-sized defect regeneration in rats with experimentally induced type I diabetes mellitus. Restoration of large osseous defects in an impaired osteogenic condition such as diabetes mellitus is a challenging task in clinical practice. Therefore, investigating adjunctive therapies to accelerate the regeneration of such defects is crucial.

Materials and methods

Sixteen albino rats were divided into two groups (n = 8/group). To induce diabetes mellitus, a single streptozotocin dosage was injected. Critical-sized defects were created in the right posterior mandibles and filled with beta-tricalcium phosphate graft. The study group was subjected to 90-min sessions of hyperbaric oxygen at 2.4 ATA, for 5 consecutive days per week. Euthanasia was carried out after 3 weeks of therapy. Bone regeneration was examined histologically and histomorphometrically. Angiogenesis was assessed by immunohistochemistry against vascular endothelial progenitor cell marker (CD34) and the microvessel density was calculated.

Results

Exposure of diabetic animals to hyperbaric oxygen resulted in superior bone regeneration and increased endothelial cell proliferation, which were revealed histologically and immunohistochemically, respectively. These results were confirmed by histomorphometric analysis which disclosed a higher percentage of new bone surface area and microvessel density in the study group.

Conclusions

Hyperbaric oxygen has a beneficial effect on bone regenerative capacity, qualitatively and quantitively, as well as the ability to stimulate angiogenesis.
Baicalein alleviates fibrosis and inflammation in systemic sclerosis by regulating B-cell abnormalities
Authors: Peng Bo , Hu Qin , He Rong , Hou Hongping , Lian Dongyin , Chen Ying , Li Han , Song Ling , Gao Yunhang , Chen Tengfei , Zhang Guangping , Li Jianrong
Published: February 2023

Background

Systemic sclerosis (SSc; also known as “scleroderma”) is an autoimmune disorder characterized by extensive fibrosis, vascular changes, and immunologic dysregulation. Baicalein (phenolic flavonoid derived from Scutellaria baicalensis Georgi) has been used to treat the pathological processes of various fibrotic and inflammatory diseases. In this study, we investigated the effect of baicalein on the major pathologic characteristics of SSc: fibrosis, B-cell abnormalities, and inflammation.

Methods

The effect of baicalein on collagen accumulation and expression of fibrogenic markers in human dermal fibroblasts were analyzed. SSc mice were produced by injecting bleomycin and treated with baicalein (25, 50, or 100 mg/kg). The antifibrotic features of baicalein and its mechanisms were investigated by histologic examination, hydroxyproline assay, enzyme-linked immunosorbent assay, western blotting and flow cytometry.

Results

Baicalein (5–120 μM) significantly inhibited the accumulation of the extracellular matrix and fibroblast activation in transforming growth factor (TGF)-β1- and platelet derived growth factor (PDGF)-induced human dermal fibroblasts, as evidenced by abrogated deposition of total collagen, decreased secretion of soluble collagen, reduced collagen contraction capability and downregulation of various fibrogenesis molecules. In a bleomycin-induced model of dermal fibrosis in mice, baicalein (25–100 mg/kg) restored dermal architecture, ameliorated inflammatory infiltrates, and attenuated dermal thickness and collagen accumulation in a dose-dependent manner. According to flow cytometry, baicalein reduced the proportion of B cells (B220+ lymphocytes) and increased the proportion of memory B cells (B220+CD27+ lymphocytes) in the spleens of bleomycin-induced mice. Baicalein treatment potently attenuated serum levels of cytokines (interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-17A, tumor necrosis factor-α), chemokines (monocyte chemoattractant protein-1, macrophage inflammatory protein-1 beta) and autoantibodies (anti-scleroderma 70 (Scl-70), anti-polymyositis-scleroderma (PM-Scl), anti-centromeres, anti-double stranded DNA (dsDNA). In addition, baicalein treatment can significantly inhibit the activation of TGF-β1 signaling in dermal fibroblasts and bleomycin-induce mice of SSc, evidenced by reducing the expression of TGF-β1 and IL-11, as well as inhibiting both small mother against decapentaplegic homolog 3 (SMAD3) and extracellular signal-related kinase (ERK) activation.

Conclusions

These findings suggest that baicalein has therapeutic potential against SSc, exerting modulating B-cell abnormalities, anti-inflammatory effects, and antifibrosis.
“You’re actually part of the team”: a qualitative study of a novel transitional role from medical student to doctor
Authors: Edmiston Natalie , Hu Wendy , Tobin Stephen , Bailey Jannine , Joyce Caroline , Reed Krista , Mogensen Lise
Published: February 2023

Background

Optimizing transitions from final year of medical school and into first post graduate year has important implications for students, patients and the health care system. Student experiences during novel transitional roles can provide insights into potential opportunities for final year curricula. We explored the experiences of medical students in a novel transitional role and their ability to continue learning whilst working as part of a medical team.

Methods

Novel transitional role for final year medical students were created in partnership by medical schools and state health departments in 2020 in response to the COVID-19 pandemic and the need for a medical surge workforce. Final year medical students from an undergraduate entry medical school were employed as Assistants in Medicine (AiMs) in urban and regional hospitals. A qualitative study with semi-structured interviews at two time points was used to obtain experiences of the role from 26 AiMs. Transcripts were analyzed using deductive thematic analysis with Activity theory as a conceptual lens.

Results

This unique role was defined by the objective of supporting the hospital team. Experiential learning opportunities in patient management were optimized when AiMs had opportunities to contribute meaningfully. Team structure and access to the key instrument, the electronic medical record, enabled participants to contribute meaningfully, whilst contractual arrangements and payments formalized the obligations to contribute.

Conclusions

The experiential nature of the role was facilitated by organizational factors. Structuring teams to involve a dedicated medical assistant position with specific duties and access to the electronic medical record sufficient to complete duties are key to successful transitional roles. Both should be considered when designing transitional roles as placements for final year medical students.
Seroprevalence of zoonotic abortive diseases and their associated risk factors in Tunisian sheep
Authors: Guesmi Kaouther , Kalthoum Sana , Mamlouk Aymen , Baccar Mohamed Naceur , BelHajMohamed Bassem , Hajlaoui Haikel , Toumi Aymen , Cherni Jamel , Seghaier Chédia , Messadi Lilia
Published: February 2023

Background

Abortion is a serious problem for sheep flocks and it is responsible for considerable economic losses. The epidemiological situation of abortion causing agents in sheep is poorly documented in Tunisia. This study aims to investigate the status of three abortion causing agents (Brucella spp, Toxoplasma gondii, and Coxiella burnetii) among organized flocks in Tunisia.

Results

A total of 793 sample blood collected from twenty-six flocks in seven governorates in Tunisia, were tested by indirect enzyme-linked immunosorbent assay (i-ELISA) for antibodies against three abortion causing agents (Brucella spp, Toxoplasma gondii, and Coxiella burnetii). Risk factors for individual-level seroprevalence were analyzed using a logistic regression model. Results revealed that 19.7%, 17.2%, and 16.1% of the tested sera were positive for toxoplasmosis, Q fever, and brucellosis, respectively. Mixed infection was found in all the flocks with 3 to 5 responsible abortive agents simultaneously.

Logistic regression showed that the management practices (control of new introduction, common grazing and watering point, workers exchange, presence of lambing box on the farm) and the history of infertility and the presence of abortion in neighboring flocks were likely to increase the probability of being infected by the three abortive agents.

Conclusions

Evidence of the positive relationship between seroprevalence of abortion causing agents and several risk factors, suggests further investigations to better understand the etiology of infectious abortions in flocks to develop an applicable preventive and control program.
A comparative assessment of the community frontline health workers for their knowledge and practices of malaria diagnosis and treatment in three contiguous districts Mandla, Balaghat, and Dindori of Madhya Pradesh, India
Authors: Singh Mrigendra P. , Rajvanshi Harsh , Nisar Sekh , Singh Akansha , Jayswar Himanshu , Singh Srinath , Mehra R. K. , Shrivastava S. K. , Sahu Ram Shankar , Patel Brajesh , Bhalavi Ramji , Saha Kalyan B. , Sharma Ravendra K. , Mishra Ashok K. , Kaur Harpreet , Das Aparup , Bharti Praveen K. , Lal Altaf A.
Published: February 2023

Background

Global malaria cases rose by 14 million, and deaths by 69,000, in 2020. In India, a 46% decline has been reported between 2020 and 2019. In 2017, the Malaria Elimination Demonstration Project conducted a needs-assessment of the Accredited Social Health Activists (ASHAs) of Mandla district. This survey revealed the inadequate level of knowledge in malaria diagnosis and treatment. Subsequently, a training programme was launched for enhancing malaria-related knowledge of ASHAs. The present study was conducted in 2021 to evaluate the impact of training on malaria-related knowledge and practices of ASHAs in Mandla. This assessment was also done in two adjoining districts: Balaghat and Dindori.

Methods

A cross-sectional survey using a structured questionnaire was administered to ASHAs to measure their knowledge and practices related to malaria etiology, prevention, diagnosis, and treatment. A comparison of information collected from these three districts was performed using simple descriptive statistics, comparison of means and multivariate logistic regression analysis.

Results

Significant improvement was noted amongst ASHAs of district Mandla between 2017 (baseline) and 2021 (endline) in knowledge related to malaria transmission, preventive measures, adherence to the national drug policy, diagnosis using rapid diagnostic tests, and identification of age group-specific, colour-coded artemisinin combination therapy blister packs (p < 0.05). The multivariate logistic regression analysis revealed that odds of Mandla baseline was 0.39, 0.48, 0.34, and 0.07 times lower for malaria-related knowledge on disease etiology, prevention, diagnosis, and treatment, respectively (p < 0.001). Further, participants in districts Balaghat and Dindori showed significantly lower odds for knowledge (p < 0.001) and treatment practices (p < 0.01) compared to Mandla endline. Education, attended training, having a malaria learner’s guide, and minimum 10 years’ work experience were potential predictors for good treatment practices.

Conclusion

The findings of the study unequivocally establishes significant improvement in overall malaria-related knowledge and practices of ASHAs in Mandla as a result of periodic training and capacity building efforts. The study suggests that learnings from Mandla district could be helpful in improving level of knowledge and practices among frontline health workers.
Persistent bacteremia predicts poor outcomes among neutropenic patients with carbapenem-resistant gram-negative bloodstream infections receiving appropriate therapy
Authors: Sathya Kumar Abi Manesh , George Mithun Mohan , Bhanuprasad Kundakarla , John Grace Mary , Korula Anu , Abraham Aby , Mathews Vikram , Kulkarni Uday Prakash , Shankar Chaitra , Premkumar Prasanna Samuel , Chacko Binila , Subramani K. , Varghese George M. , Balaji V. , George Biju
Published: February 2023

Purpose

Identifying persistent bacteremia early in patients with neutropenia may improve outcome. This study evaluated the role of follow-up blood cultures (FUBC) positivity in predicting outcomes among patients with neutropenia and carbapenem-resistant gram-negative bloodstream infections (CRGNBSI).

Methods

This retrospective cohort study conducted between December 2017 and April 2022 included patients more than 15 years old with neutropenia and CRGNBSI, who survived for ≥ 48 h, receiving appropriate antibiotic therapy and had FUBCs. Patients with polymicrobial bacteremia within 30 days were excluded. The primary outcome was 30 day mortality. Persistent bacteremia, septic shock, recovery from neutropenia, prolonged or profound neutropenia, requirement of intensive care and dialysis, and initiation of appropriate empirical therapy were also studied.

Results

In our study cohort of 155 patients, the 30 day mortality rate was 47.7%. Persistent bacteremia was common in our patient cohort (43.8%). Carbapenem resistant isolates identified in the study were K.pneumoniae (80%), E.coli (12.26%), P.aeruginosa (5.16%), A.baumanii (1.94%) and E.cloacae (0.65%). The median time for sending a FUBC was 2 days (IQR, 1–3 days). Patients with persistent bacteremia had higher mortality than those without (56.76% versus 32.1%; p < 0.001). Appropriate initial empirical therapy was given to 70.9%. Recovery from neutropenia occurred in 57.4% while 25.8% had prolonged or profound neutropenia. Sixty-nine percent (107/155) had septic shock and needed intensive care; 12.2% of patients required dialysis. Non-recovery from neutropenia (aHR, 4.28; 95% CI 2.53–7.23), presence of septic shock (aHR, 4.42; 95%CI 1.47–13.28), requirement of intensive care (aHR,3.12;95%CI 1.23–7.93), and persistent bacteremia (aHR,1.74; 95%CI 1.05–2.89) significantly predicted poor outcomes in multivariable analysis.

Conclusion

FUBC showing persistent bacteremia predicted poor outcomes among neutropenic patients with carbapenem-resistant gram-negative bloodstream infections (CRGNBSI) and should be routinely reported.
Lung cancer immunotherapy: progress, pitfalls, and promises
Authors: Lahiri Aritraa , Maji Avik , Potdar Pravin D. , Singh Navneet , Parikh Purvish , Bisht Bharti , Mukherjee Anubhab , Paul Manash K.
Published: February 2023

Lung cancer is the primary cause of mortality in the United States and around the globe. Therapeutic options for lung cancer treatment include surgery, radiation therapy, chemotherapy, and targeted drug therapy. Medical management is often associated with the development of treatment resistance leading to relapse. Immunotherapy is profoundly altering the approach to cancer treatment owing to its tolerable safety profile, sustained therapeutic response due to immunological memory generation, and effectiveness across a broad patient population. Different tumor-specific vaccination strategies are gaining ground in the treatment of lung cancer. Recent advances in adoptive cell therapy (CAR T, TCR, TIL), the associated clinical trials on lung cancer, and associated hurdles are discussed in this review. Recent trials on lung cancer patients (without a targetable oncogenic driver alteration) reveal significant and sustained responses when treated with programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) checkpoint blockade immunotherapies. Accumulating evidence indicates that a loss of effective anti-tumor immunity is associated with lung tumor evolution. Therapeutic cancer vaccines combined with immune checkpoint inhibitors (ICI) can achieve better therapeutic effects. To this end, the present article encompasses a detailed overview of the recent developments in the immunotherapeutic landscape in targeting small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Additionally, the review also explores the implication of nanomedicine in lung cancer immunotherapy as well as the combinatorial application of traditional therapy along with immunotherapy regimens. Finally, ongoing clinical trials, significant obstacles, and the future outlook of this treatment strategy are also highlighted to boost further research in the field.