bluuebunny/crossref_metadata_2025 huggingface dataset:
DOES BRAIN ACTIVATION DURING FUNCTIONAL MOVEMENT TASKS DIFFERENTIATE BETWEEN GOOD AND BAD MOVERS? AN INTEGRATED NEUROIMAGING ASSESSMENT OF MOTOR CONTROL IN YOUNG ATHLETES
Authors: Anand Manish , Diekfuss Jed A. , Grooms Dustin R. , Slutsky-Ganesh Alexis B. , Bonnette Scott , Riehm Christopher , Foss Kim D. Barber , DiCesare Christopher A. , Myer Gregory D.
Published: July 2021

Background:

Aberrant frontal and sagittal plane knee motor control biomechanics contribute to increased anterior cruciate ligament (ACL) injury risk. Emergent data further indicates alterations in brain function may underlie ACL injury high risk biomechanics and primary injury. However, technical limitations have limited our ability to assess direct linkages between maladaptive biomechanics and brain function.

Hypothesis/Purpose:

(1) Increased frontal plane knee range of motion would associate with altered brain activity in regions important for sensorimotor control and (2) increased sagittal plane knee motor control timing error would associate with altered activity in sensorimotor control brain regions.

Methods:

Eighteen female high-school basketball and volleyball players (14.7 ± 1.4 years, 169.5 ± 7 cm, 65.8 ± 20.5 kg) underwent brain functional magnetic resonance imaging (fMRI) while performing a bilateral, combined hip, knee, and ankle flexion/extension movements against resistance (i.e., leg press) Figure 1(a). The participants completed this task to a reference beat of 1.2 Hz during four movement blocks of 30 seconds each interleaved in between 5 rest blocks of 30 seconds each. Concurrent frontal and sagittal plane range of motion (ROM) kinematics were measured using an MRI-compatible single camera motion capture system.

Results:

Increased frontal plane ROM was associated with increased brain activity in one cluster extending over the occipital fusiform gyrus and lingual gyrus ( p = .003, z > 3.1). Increased sagittal plane motor control timing error was associated with increased brain activity in multiple clusters extending over the occipital cortex (lingual gyrus), frontal cortex, and anterior cingulate cortex ( p < .001, z > 3.1); see Figure 1 (b).

Conclusion:

The associations of increased knee frontal plane ROM and sagittal plane timing error with increased activity in regions that integrate visuospatial information may be indicative of an increased propensity for knee injury biomechanics that are, in part, driven by reduced spatial awareness and an inability to adequately control knee abduction motion. Increased activation in these regions during movement tasks may underlie an impaired ability to control movements (i.e., less neural efficiency), leading to compromised knee positions during more complex sports scenarios. Increased activity in regions important for cognition/attention associating with motor control timing error further indicates a neurologically inefficient motor control strategy.

[Figure: see text]
THE CLINICAL UTILITY OF THE VESTIBULAR AND OCULAR MOTOR SCREENING FOR PROTRACTED RECOVERY IN PEDIATRIC CONCUSSION PATIENTS
Authors: Caze Todd J. ,   August Price PsyD, Knell Gregory , Ellis Christine , Abt John , Burkhart Scott
Published: July 2021

Background:

Sports-related concussions (SRCs) are a concern for youth athletes and their subsequent healthy development into adulthood. Protracted recovery (>28 days) from a SRC may lead to long-term complications resultant of persistent symptoms. There is a current lack in understanding of the factors contributing to protracted recovery from SRC in children, and in particular no tools exist to identify those SRC patients that may be more likely have a protracted recovery in an acute clinical setting.

Hypothesis/Purpose:

To examine the relationship between initial Vestibular and Ocular Motor Screening (VOMS) and protracted recovery from concussion in youth.

Methods:

Children aged 8-12 years old, who were diagnosed with a SRC and seen in a concussion specialty clinic within 7-days of injury were included in the analysis. VOMS was administered during the initial visit. A positive VOMS score was defined as any 2-point increase from baseline in patient reported symptom severity on dizziness, fogginess, headache, and nausea, or any convergence measure greater than 6 centimeters. Recovery time (days) was the interval between date of injury and date of medical clearance. Multivariable logistic regressions were used to determine the odds of protracted recovery based on an initial positive VOMS.

Results:

A total of 108 males (mean age=10.8, sd=1.3) and 66 females (mean age=10.8, sd=1.4), took a median (IQR) 20.0 (15.0-28.5) and 22.0 (15.0-34.0) days to recover, respectively. After controlling for age and days since injury, those with a positive VOMS were 3.92 (95% CI = 1.58-9.71, p=0.003) times more likely to have a protracted recovery compared to those with a negative VOMS. When stratified by sex, observed effects were more amplified among males (OR=5.92, 95% CI=1.59-21.96, p=0.008), than among females (OR=2.44, 95% CI=0.61-9.71, p=0.21).

Conclusion:

There is a need to determine the relationship between SRC assessment measures and recovery time to improve clinical management and outcomes. In this sample of pediatric concussion patients aged 8-12 years, the VOMS displayed potential as a tool to screen for delayed recovery among males. Future studies should confirm these findings in other, larger samples, while taking into consideration other factors that may influence recovery time.
THE BENEFITS CONFERRED BY MULTI-SPORT PARTICIPATION MAY NOT INCLUDE IMPROVED FUNCTIONAL AND PSYCHOLOGICAL READINESS FOLLOWING INJURY
Authors: Kemper Craig , Wagner K. John , Carpenter Connor M. , Wilson Philip L. , Ellis Henry B.
Published: July 2021

Background:

Multi-sport participation has been advocated for youth as a means to foster athletic development and reduce over-use injury. Whether this sport variety may influence functional and psychological readiness after injury is unclear.

Purpose:

The purpose of this study was to compare presentation, and functional and psychological recovery between single sport and multi-sport pediatric athletes following an ACL reconstruction (ACLR).

Methods:

Following IRB approval, prospectively collected data in consecutive patients treated for ACL injury (1/2015-2/2017) in a pediatric sports medicine clinic was reviewed. Inclusion required primary ACLR. Injury and surgical data, patient reported outcome measures (PROM) including both functional (Pedi-IKDC) and psychological PROM (ACSI-28 and ACL-RSI), functional clearance data (Y balance testing), timing of return to play clearance, and any re-injuries were reviewed. Comparison of multi-sport and single sport athletes was performed using a Kruskal-Wallis test and ANOVA analysis followed by T-tests for multiple comparisons.

Results:

81.5% of patients who underwent an ACL reconstruction were single sport athletes. Single sport athletes presented with a higher initial BMI (24.47 ± 5.67 vs 22.45 ± 3.81, p = 0.03) than multi-sport athletes. In this cohort, soccer players (89%) were more likely to be specialized compared to football (61%) or basketball players (69%, p<0.01). No differences between groups were noted regarding surgical procedures or concomitant injuries. While no significant differences were found between the groups in time to functional clearance or clearance scores, it was noted that only ¾ of single sport athletes returned to sports (74.0% vs 92.3%, p = 0.06). Reported confidence in functional and psychological recovery improved in both groups throughout rehabilitation (see Table 1). Multi-sport athletes in this cohort demonstrated no advantage in either phase of recovery.

Conclusion:

Although multi-sport participation has been established to improve athletic development, and decrease burnout and over-use injury; it may not confer advantages in comparison to the specialized athlete for functional or psychological recovery following ACL reconstruction.

[Table: see text]
Soil applied glycine betaine with Arbuscular mycorrhizal fungi reduces chromium uptake and ameliorates chromium toxicity by suppressing the oxidative stress in three genetically different Sorghum (Sorghum bicolor L.) cultivars
Authors: Kumar Praveen
Published: July 2021

Background

Chromium is the most toxic pollutant that negatively affects a plant’s metabolic activities and yield. It reduces plant growth by influencing the antioxidant defence system’s activities. In the present study, a completely randomized block design experiment with three plants/pot in three replication was conducted on three varieties of sorghum viz. SSG 59–3, HJ 513 (multi-cut) and HJ 541 (single-cut) for amelioration of chromium toxicity (2 & 4 ppm) by exogenous application of GB (50 & 100 mM) with and without AMF in soil. The ameliorative effects were tested at two growth stages viz. vegetative (35 DAS) and grain filling (95 DAS), in terms of Cr uptake, grain yield, antioxidative defence system parameters (viz. enzymes – SOD, APX, CAT, GR, POX and metabolites – proline, glutathione, ascorbate, β-carotene) and indices of oxidative stress parameters (viz. PPO, H2O2, and MDA).

Results

The results delineated that Cr uptake and indices of oxidative stress were increased with increasing concentration of Cr stress in all the varieties (HJ 541, HJ513 & SSG 59–3) at both the growth stages (35 & 95 DAS). At higher concentration (4 ppm), Cr stress decreased the grain yield (45–50%) as compared with controls. Polyphenoloxidase activity, MDA and H2O2 content increased at both growth stages in all the varieties. However, antioxidative enzymes and metabolite activities increased due to Cr stress but this increase was not sufficient to counteract with ROS generated under Cr stress which was enhanced on the application of AMF and GB either individually or in combination (spiked in soil). It decreased the indices of oxidative stress and ameliorated the Cr toxicity and increased grain yield (65–70%) in all the varieties.

Conclusions

Both GB and AMF improved the antioxidative activities and stress tolerance capacity of the plant. Glycine betaine at both 50 and 100 mM level, significantly ameliorated Cr toxicity. However, AMF concomitantly with GB further boosts up the amelioration behaviour of the plant against Cr toxicity, at both growth stages in all the varieties. The combination of 100 mM GB with 10 g AMF was observed most effective among all the treatments. Among the varieties, SSG 59–3 had the lowest chromium uptake, indices of oxidative stress, and highest antioxidative system’s activity as compared to HJ 513 followed by HJ 541 variety. Thus AMF and GB either individually or in combination may be used to maintain plant yield attributes under Cr toxicity.
Differential gene expression patterns during gametophyte development provide insights into sex differentiation in the dioicous kelp Saccharina japonica
Authors: Zhang Jiaxun , Li Yan , Luo Shiju , Cao Min , Zhang Linan , Li Xiaojie
Published: July 2021

Background

In brown algae, dioicy is the prevalent sexual system, and phenotypic differences between male and female gametophytes have been found in many dioicous species. Saccharina japonica show remarkable sexual dimorphism in gametophytes before gametogenesis. A higher level of phenotypic differentiation was also found in female and male gametes after gametogenesis. However, the patterns of differential gene expression throughout gametophyte development and how these changes might relate to sex-specific fitness at the gamete stage in S. japonica are not well known.

Results

In this study, differences in gene expression between male and female gametophytes in different developmental stages were investigated using comparative transcriptome analysis. Among the 20,151 genes expressed in the haploid gametophyte generation, 37.53% were sex-biased. The abundance of sex-biased genes in mature gametophytes was much higher than that in immature gametophytes, and more male-biased than female-biased genes were observed in the mature stage. The predicted functions of most sex-biased genes were closely related to the sex-specific characteristics of gametes, including cell wall biosynthesis, sperm motility, and sperm and egg recognition. In addition, 51 genes were specifically expressed in males in both stages, showing great potential as candidate male sex-determining region (SDR) genes.

Conclusions

This study describes a thorough investigation into differential gene expression between male and female gametophytes in the dioicous kelp S. japonica. A large number of sex-biased genes in mature gametophytes may be associated with the divergence of phenotypic traits and physiological functions between female gametes (eggs) and male gametes (sperm) during sexual differentiation. These genes may mainly come from new sex-biased genes that have recently evolved in the S. japonica lineage. The duplication of sex-biased genes was detected, which may increase the number of sex-biased genes after gametogenesis in S. japonica to some extent. The excess of male-biased genes over female-biased genes in the mature stage may reflect the different levels of sexual selection across sexes. This study deepens our understanding of the regulation of sex development and differentiation in the dioicous kelp S. japonica.
Absolute mortality risk assessment of COVID-19 patients: the Khorshid COVID Cohort (KCC) study
Authors: Marateb Hamid Reza , von Cube Maja , Sami Ramin , Haghjooy Javanmard Shaghayegh , Mansourian Marjan , Amra Babak , Soltaninejad Forogh , Mortazavi Mojgan , Adibi Peyman , Khademi Nilufar , Sadat Hosseini Nastaran , Toghyani Arash , Hassannejad Razieh , Mañanas Miquel Angel , Binder Harald , Wolkewitz Martin
Published: July 2021

Background

Already at hospital admission, clinicians require simple tools to identify hospitalized COVID-19 patients at high risk of mortality. Such tools can significantly improve resource allocation and patient management within hospitals. From the statistical point of view, extended time-to-event models are required to account for competing risks (discharge from hospital) and censoring so that active cases can also contribute to the analysis.

Methods

We used the hospital-based open Khorshid COVID Cohort (KCC) study with 630 COVID-19 patients from Isfahan, Iran. Competing risk methods are used to develop a death risk chart based on the following variables, which can simply be measured at hospital admission: sex, age, hypertension, oxygen saturation, and Charlson Comorbidity Index. The area under the receiver operator curve was used to assess accuracy concerning discrimination between patients discharged alive and dead.

Results

Cause-specific hazard regression models show that these baseline variables are associated with both death, and discharge hazards. The risk chart reflects the combined results of the two cause-specific hazard regression models. The proposed risk assessment method had a very good accuracy (AUC = 0.872 [CI 95%: 0.835–0.910]).

Conclusions

This study aims to improve and validate a personalized mortality risk calculator based on hospitalized COVID-19 patients. The risk assessment of patient mortality provides physicians with additional guidance for making tough decisions.
Influence of low FODMAP-gluten free diet on gut microbiota alterations and symptom severity in Iranian patients with irritable bowel syndrome
Authors: Naseri Kaveh , Dabiri Hossein , Rostami-Nejad Mohammad , Yadegar Abbas , Houri Hamidreza , Olfatifar Meysam , Sadeghi Amir , Saadati Saeede , Ciacci Carolina , Iovino Paola , Zali Mohammad Reza
Published: July 2021

Background and objective

Recently, dietary restriction of fermentable carbohydrates (a low-FODMAP diet) in combination with a gluten-free diet (GFD) has been proposed to reduce the symptoms in irritable bowel syndrome (IBS) patients. Different studies reported that IBS has been associated with dysbiosis in the gut microbiota. Additionally, a few studies have reported inflammation in the gastrointestinal (GI) system of adults with IBS. In this study, we aimed to investigate the effects of low FODMAP-gluten free diet (LF-GFD) on clinical symptoms, intestinal microbiota diversity, and fecal calprotectin (FC) level in Iranian patients with IBS.

Design

In this clinical trial study, 42 patients with IBS (Rome IV criteria) underwent LF-GFD intervention for 6 weeks. Symptoms were assessed using the IBS symptom severity scoring (IBS-SSS), and fecal samples were collected at baseline and after intervention and analyzed by quantitative 16 S rRNA PCR assay. The diversity of gut microbiota compared before and after 6 weeks of dietary intervention. FC was also analyzed by the ELISA method.

Results

Thirty patients (mean age 37.8 ± 10.7 years) completed the 6-week diet. The IBS-SSS was significantly (P = 0.001) reduced after LF-GFD intervention compared to the baseline. Significant microbial differences before and after intervention were noticed in fecal samples. A significant increase was found in Bacteroidetes, and the Firmicutes to Bacteroidetes (F/B) ratio was significantly (P = 0.001) decreased after the dietary intervention. The value of FC was significantly decreased after 6 weeks of dietary intervention (P = 0.001).

Conclusions

Our study suggests that patients with IBS under an LF-GFD had a significant improvement in IBS symptoms severity, with reduced FC level following normalization of their gut microbiota composition. Further rigorous trials are needed to establish a long-term efficacy and safety of this dietary intervention for personalized nutrition in IBS.

Clinical Trial Registry Number: IRCT20100524004010N26.
Prevalence and factors associated with ocular morbidity among prisoners of Luzira prison (Uganda)
Authors: Zalwango Charity , Ayebare Pauline , Mwanja Pius , Denis Erima , Kasadhakawo Moses , Mugerwa Micheal , Ampaire Anne
Published: July 2021

Background

Globally, ocular morbidity has emerged as a major public concern with at least 2.2 billion people having vision impairment or blindness. Prisoners (inmates) tend to have limited access to health care especially eye health, and as a result some conditions may go undiagnosed or mismanaged. With the increasing prison population in Uganda and in the face of limited facilities, little is known about the prevalence and factors associated with ocular morbidity amongst inmates of Luzira prison.

Method

This was a descriptive cross-sectional study conducted on inmates of Luzira prison. The study included both male (334) and female (33) inmates using the proportionate stratified random sampling. Data on social demographic characteristics, medical, imprisonment factors and ocular assessment was collected using a questionnaire. All complete data was entered using an Epidata version 3.1 entry template, and logistic regression was used to determine associated factors.

Results

Overall, a total of 367 inmates were examined consisting of 334 (91%) males and 33(8.9%) females. The male-to-female ratio was 10:1 with ages ranging from 18 to 76 years. The mean age being 39 years (SD + 13.4) and the overall ocular morbidity was found to be 49%. The most common ocular morbidity included; presbyopia (27.4%), allergic conjunctivitis (19.6%) and cataracts (11.4%). Other disorders included; refractive errors, pterygia, optic atrophy and vitamin A deficiency. There was a statistically significant relationship between ocular morbidity and age (OR 11.96, CI 0.85–2.74), trauma (OR 5.21, CI 1.52–17.87), non-prison food (OR 0.45, CI 0.26–0.79).

Conclusion

The prevalence of ocular morbidity among inmates was found to be high and significantly associated with age, trauma and having meals besides prison food. A fully functional eye unit established within the prison, and timely referral of complicated cases would help in offering quality eye services to the inmates.
Association between socioeconomic position and diabetic foot ulcer outcomes: a population-based cohort study in South Korea
Authors: Ha Jeong Hyun , Jin Heejin , Park Ji-Ung
Published: July 2021

Background

Low socioeconomic position (SEP) is associated with a high incidence of diabetic foot ulcers (DFUs). However, reports on the association between SEP and DFU outcomes are limited. Therefore, in this study, we investigated this association and determined the prognostic factors of DFU outcomes.

Methods

The total cohort comprised 976,252 individuals. Using probability sampling, we randomly selected a sample of patients by reviewing the data from the Health Insurance Review and Assessment Service database of South Korea during 2011–2015. Residence, household income, and insurance type represented SEP. The primary outcome was amputation, and the secondary outcome was mortality. A multivariate model was applied to identify the predictive factors. Amputation-free survival and overall survival were calculated using the Kaplan-Meier method.

Results

Among 976,252 individuals in the cohort, 1362 had DFUs (mean age 62.9 ± 12.2 years; 42.9% were women). Overall amputation and mortality rates were 4.7 and 12.3%, respectively. Male sex (hazard ratio [HR], 2.41; p < 0.01), low SEP (HR 5.13, 5.13; p = 0.018), ophthalmopathy (HR, 1.89; p = 0.028), circulatory complications (HR, 2.14; p = 0.020), and institutional type (HR, 1.78; p = 0.044) were prognostic factors for amputation. Old age (HR, 1.06; p < 0.01), low SEP (HR, 2.65; p < 0.01), ophthalmopathy (HR, 1.74; p < 0.01), circulatory complications (HR, 1.71; p < 0.01), and institution type (HR 1.84; p < 0.01) were predictors of mortality.

Conclusions

DFU patients with a low SEP are strongly associated with increased amputation and mortality rates. Along with age and comorbidities, SEP could provide the basis for risk assessment of adverse outcomes in DFU. Providing targeted care for this population considering SEP may improve the prognosis.
Morbidity and mortality after liver surgery for colorectal liver metastases: a cohort study in a high-volume fast-track programme
Authors: Egeland Charlotte , Rostved Andreas Arendtsen , Schultz Nicolai Aagaard , Pommergaard Hans-Christian , Daugaard Thomas Røjkjær , Thøfner Line Buch , Rasmussen Allan , Hillingsø Jens G.
Published: July 2021

Background

For colorectal liver metastases, surgery is a high-risk procedure due to perioperative morbidity. The objective was to assess severity of complications after fast-track liver surgery for colorectal liver metastases and their impact on morbidity and mortality.

Methods

All patients were treated according to the same fast-track programme. Complications were graded according to the Clavien–Dindo classification for patients undergoing surgery from 2013 to 2015. Correlation between complications and length of stay was analysed by multivariate linear regression.

Results

564 patient cases were included of which three patients died within 3 months (0.53%, 95% CI: 0.17–1.64%). Complications were common with Grade ≤ 2 in 167 patients (30%) and ≥ Grade 3a in 93 (16%). Patients without complications had a mean length of stay of 4.1 days, which increased with complications: 1.4 days (95% CI: 1.3–1.5) for Grade 2, 1.7 days (1.5–2.0) for Grade 3a, 2.3 days (1.7–3.0) for Grade 3b, 2.6 days (1.6–4.2) for Grade 4a, and 2.9 days (2.8–3.1) for Grade 4b. Following were associated with increased length of stay: complication severity grade, liver insufficiency, ascites, biliary, cardiopulmonary, and infectious complications.

Conclusions

Complications after liver surgery for colorectal liver metastases, in a fast track setting, were associated with low mortality, and even severe complications only prolonged length of stay to a minor degree.
Ten-gene signature reveals the significance of clinical prognosis and immuno-correlation of osteosarcoma and study on novel skeleton inhibitors regarding MMP9
Authors: Li Weihang , Ding Ziyi , Wang Dong , Li Chengfei , Pan Yikai , Zhao Yingjing , Zhao Hongzhe , Lu Tianxing , Xu Rui , Zhang Shilei , Yuan Bin , Zhao Yunlong , Yin Yanjiang , Gao Yuan , Li Jing , Yan Ming
Published: July 2021

Objectives

This study aimed to identify novel targets in the carcinogenesis, therapy and prognosis of osteosarcoma from genomic level, together with screening ideal lead compounds with potential inhibition regarding MMP-9.

Methods

Gene expression profiles from GSE12865, GSE14359, GSE33382, GSE36001 and GSE99671 were obtained respectively from GEO database. Differentially expressed genes were identified, and functional enrichment analysis, such as GO, KEGG, GSEA, PPI were performed to make a comprehensive understanding of the hub genes. Next, a series of high-precision computational techniques were conducted to screen potential lead compounds targeting MMP9, including virtual screening, ADME, toxicity prediction, and accurate docking analysis.

Results

10 genes, MMP9, CD74, SPP1, CXCL12, TYROBP, FCER1G, HCLS1, ARHGDIB, LAPTM5 and IGF1R were identified as hub genes in the initiation of osteosarcoma. Machine learning, multivariate Cox analysis, ssGSEA and survival analysis demonstrated that these genes had values in prognosis, immune-correlation and targeted treatment. Tow novel compounds, ZINC000072131515 and ZINC000004228235, were screened as potential inhibitor regarding MMP9, and they could bind to MMP9 with favorable interaction energy and high binding affinity. Meanwhile, they were precited to be efficient and safe drugs with low-ames mutagenicity, none weight evidence of carcinogenicity, as well as non-toxic with liver.

Conclusions

This study revealed the significance of 10-gene signature in the development of osteosarcoma. Besides, drug candidates identified in this study provided a solid basis on MMP9 inhibitors’ development.
Dissecting systemic racism: policies, practices and epistemologies creating racialized systems of care for Indigenous peoples
Authors: Fraser Sarah Louise , Gaulin Dominique , Fraser William Daibhid
Published: July 2021

In this paper we explore some of the ways systemic racism operates and is maintained within our health and social services. We look at a very specific context, that of Nunavik Quebec, land and home to 13,000 Nunavimmiut, citizens of Quebec and Canada, signatories of the James Bay and Northern Quebec Agreement. We operationalize some of the ways in which policies and practices create and support social hierarchies of knowledges, also called epistemic racism, and how it impacts our ability to offer quality care that Indigenous peoples can trust and use.
Clinical and virological course of patients with coronavirus disease 2019 in Jiangsu province, China: a retrospective, multi-center cohort study
Authors: Huang Rui , Zhu Li , Xue Leyang , Yan Xuebing , Wang Jian , Huang Songping , Zhang Biao , Xu Tianmin , Ji Fang , Li Chunyang , Ming Fang , Zhao Yun , Li Yang , Cheng Juan , Wang Yinling , Shao Huaping , Hong Shuqin , Chen Kang , Zhao Xiang-an , Sang Dawen , Zou Lei , Zhao Haiyan , Guan Xinying , Chen Xiaobing , Xu Biyun , Xia Juan , Chen Yuxin , Yan Xiaomin , Wei Jie , Liu Jiacheng , Liu Longgen , Zhu Chuanwu , Wu Chao
Published: July 2021

Background

The clinical and virological course of patients with coronavirus disease 2019 (COVID-19) are lacking. We aimed to describe the clinical and virological characteristics of COVID-19 patients from 10 designated hospitals in 10 cities of Jiangsu province, China. The factors associated with the clearance of SARS-CoV-2 were investigated.

Methods

A total of 328 hospitalized patients with COVID-19 were retrospectively recruited. The epidemiological, clinical, laboratory, radiology and treatment data were collected. The associated factors of SARS-CoV-2 clearance were analyzed.

Results

The median duration of hospitalization was 16.0 days (interquartile range [IQR] 13.0–21.0 days). On multivariate Cox regression analysis, age > 60 years (hazard ratio [HR] 0.643, 95% confidence interval [CI] 0.454–0.911, P = 0.013) was associated with the delayed SARS-CoV-2 clearance, while the atomized inhalation of interferon α-2b could improve the clearance of SARS-CoV-2 (HR, 1.357, 95% CI 1.050–1.755, P = 0.020). Twenty-six (7.9%) patients developed respiratory failure and 4 (1.2%) patients developed ARDS. Twenty (6.1%) patients were admitted to the ICU, while no patient was deceased.

Conclusions

Our study found that age > 60 years was associated with the delayed SARS-CoV-2 clearance, while treated with atomized inhalation of interferon α-2b could promote the clearance of SARS-CoV-2.
Adult residual rectourethral fistula and diverticulum presenting decades after imperforate anus repair: a case report
Authors: McShane Erin K. , Gurland Brooke , Sheth Vipul R. , Bruzoni Matias , Enemchukwu Ekene
Published: July 2021

Background

This report describes a rare surgical case of an intraabdominal mass in a middle-aged patient 40 years after imperforate anus repair.

Case presentation

A 44-year-old Latino male with history of repaired anorectal malformation presented with recurrent urinary tract infections and rectal prolapse with bothersome bleeding and fecal incontinence. During his preoperative evaluation, he was initially diagnosed with a prostatic utricle cyst on the basis of magnetic resonance imaging findings, which demonstrated a cystic, thick-walled mass with low signal contents that extended inferiorly to insert into the distal prostatic urethra. However, at the time of surgical resection, the thick-walled structure contained an old, firm fecaloma. The final pathology report described findings consistent with colonic tissue, suggesting a retained remnant of the original fistula and diverticulum.

Conclusions

Although rare, persistent rectourethral fistula tracts and rectal diverticula after imperforate anus repair can cause symptoms decades later, requiring surgical intervention. This is an important diagnostic consideration for any adult patient with history of imperforate anus.
Knowledge of the community regarding mental health problems: a cross-sectional study
Authors: Tesfaye Yonas , Agenagnew Liyew , Anand Susan , Tucho Gudina Terefe , Birhanu Zewdie , Ahmed Gutema , Getnet Masrie , Yitbarek Kiddus
Published: July 2021

Background

Knowledge of the community regarding mental health problems has a remarkable impact on the attitude, the help-seeking path, and prevention of stigma and discrimination against patients with mental health problems. It is also the cornerstone for designing evidence-based community mental health interventions. However, the evidence is scarce in developing countries like Ethiopia. This study aimed to assess the knowledge regarding mental health problems and associated factors among communities of Jimma Zone, Oromia, Ethiopia.

Methods

A community-based cross-sectional study was conducted in the Jimma zone from March 1 to 22, 2020. A structured, pretested, and interviewer-administered questionnaire was used to collect data from 420 study participants selected through a systematic sampling technique. The knowledge about mental health was measured by the adapted version of the Mental Health Knowledge Schedule tool. Data were entered into Epi-data version 3.1 and exported to SPSS version 23.0 for analysis. Multivariate logistic regression analysis was done, andp-value < 0.05 and 95% CI were used to determine the predictors of the outcome variable.

Results

The overall knowledge score showed (188, 44.8%) of the respondents had inadequate knowledge. Moreover, (75, 17.9%) of the respondents reported psychiatric disorders are contagious, and (138, 32.9%) mentioned leaving alone is the treatment for mental illness. Talking or laughing alone and showing strange or unusual behaviors were described as symptoms of mental illness by the majority (407, 96.9%) and (403, 96.0%) of respondents, respectively. Brain dysfunction was attributed to the cause of mental illness by most (390, 92.9%) of the study participants. Similarly, the percentage of responses that attributed the causes of mental illness to possession by an evil spirit, God’s punishment, and witchcraft were significantly high (368, 87.6%), (321, 76.4%) and (259, 67.1%), respectively. Furthermore, regression analysis showed that respondents who were able to read and write were 64% less likely to have adequate knowledge than those in secondary school and above educational status (AOR = 0.34, 95% CI (0.16–0.69)).

Conclusion

Knowledge of mental illness among the general public was relatively poor and higher levels of education were associated with good knowledge of mental health problems; this suggests the need for due emphasis on public education to improve the mental health literacy status of the community.
The costs of standardized apprenticeship curricula for training firms
Authors: Schweri Jürg , Aepli Manuel , Kuhn Andreas
Published: July 2021

Standardized curricula define the set of skills that must be trained within a training occupation and thus are a key regulatory element of apprenticeship systems. Although clear economic rationales support the usage of such curricula, they necessarily impose costs, especially on firms that train apprentices, but do not use the full set of skills in their productive process and/or train other skills that are not covered by the curriculum. In this paper, we identify the trade-offs involved in setting up training curricula and use data from the most recent survey on the costs and benefits of apprenticeship training among Swiss firms to quantify the associated costs to training firms. On average, training firms state that they do not use 17% of the training content prescribed by the relevant curriculum, and 11% of the companies train additional skills not covered by the curriculum. We show that both kinds of misfit are associated with higher training costs and lower productive output from apprentices. This shows that the regulator imposes costs on firms in order to guarantee broad skills development for apprentices. It also cautions against overly broad curricula that may impose disproportionate costs on firms.
The safety and efficacy of fecal microbiota transplantation in a population with bipolar disorder during depressive episodes: study protocol for a pilot randomized controlled trial
Authors: Cooke Noah C. A. , Bala Asem , Allard Johane P. , Hota Susy , Poutanen Susan , Taylor Valerie H.
Published: July 2021

Background

Bipolar disorder (BD) is a chronic, debilitating illness with significant medical morbidity, often secondary to current treatments, and a high recurrence rate. This burden of disease reflects limitations in the tolerability and efficacy of current treatments. There is a compelling body of evidence linking the gut microbiota to mental illness, and while microbial manipulation via probiotic use has been studied as a therapeutic in BD, targeted trials of fecal microbiota transplantation (FMT) have not been conducted in this population.

Methods and design

We describe a pilot randomized controlled trial of FMT in participants with BD depression to assess the feasibility, efficacy, safety, and tolerability of this intervention. Individuals between 18 and 65 years of age will be enrolled in the study if they meet diagnostic criteria for a major depressive episode of at least moderate severity in the context of a BD diagnosis and have not responded to treatment for BD. Participants will be randomized 1:1 to receive either screened and processed donor stool (allogenic FMT) or their own stool (autologous FMT) via colonoscopy and monitored for 24 weeks post intervention. Depressive and manic symptoms, treatment acceptability, and gastrointestinal and other side effects are assessed at baseline (prior to randomization) and weekly. Stool samples to assess microbiome composition are obtained at baseline and 3 and 6 months.

Discussion

Currently, FMT represents a novel therapeutic option for treating BD depression. This protocol allows for the assessment of the feasibility, efficacy, acceptability, and safety of an intervention aimed at changing the microbiome in those with BD. Results from this pilot study will guide the development of larger trials of FMT for BD depression and may give more insight into how the gut microbiome are altered in those with BD depression.

Trial registration

Clinical Trials GovNCT03279224
Cure and prevention of cardiovascular diseases: herbs for heart
Authors: Ray Suman , Saini Mahesh Kumar
Published: July 2021

Herbs contribute to more than 60-70% in development of modern medicines in the world market either directly or indirectly. The herbal treatments for congestive heart failure, systolic hypertension, angina, atherosclerosis, cerebral insufficiency and venous insufficiency etc. has been known since ancient times. Unlike allopathic medicines, Ayurveda medicines are considered safe, however, the adverse reactions of herbal drugs is also reported. In this paper, we have compiled 128 herbs and their parts that have medicinal value to prevent, alleviate or cure heart disease related disorders. Jaccard Neighbour-joining cluster analysis using Free Tree software was used to assess the relative importance of plants in context with its healing potential for heart related disease. Based on the medicinal value in context with the heart, five major clusters of the selected 128 herbs were made. Correlation of the distance between herbs revealed that most of these herbs were found to have more than one medicinal property. The distance in dendogram depicted closeness of properties curing heart disease; as less the distance between two medicinal plants or two groups they will more close to cure particular heart disease. During drug development, a medicinal plant can be replaced by another plant of same group or by another plant of its neighbour group but from same pedigree. Thus, in case of non-availability of herbs or if it belongs to the category of rare, threatened, and endangered species, such method may add to new ways of drug development.
Alertness in patients with treatment-resistant depression: interface between sleep medicine and psychiatry—review article
Authors: Kolar Dusan , Kolar Michael V.
Published: July 2021

Background

Treatment-resistant depression (TRD) is a significant problem in clinical practice and reason for the lack of functional recovery among depressed patients. Sleep disturbances and poor alertness are common residual symptoms.

Main body of the abstract

Many patients with refractory depression experience residual symptoms, such as insomnia, daytime sleepiness, and poor alertness. This is a literature review and we searched the electronic databases, including PubMed, the Cochrane database, Ovid MEDLINE, PsycINFO, and Google Scholar of all studies published between 2000 and 2020.

The literature on the relationship between sleep quality and alertness in a patient with depression is very sparse. One possible reason could be the difficulty in defining alertness as a mental function. Alertness itself has been described as a state of responsivity to both interoceptive and external stimuli. Subjective and objective measures of alertness, daytime somnolence, and quality of sleep are presented. Adjunctive treatment with stimulant medications (methylphenidate, amphetamine, modafinil) to the standard antidepressant medications might be warranted in patients in patients with daytime sleepiness, decreased alertness, fatigue, and poor work performance.

Short conclusion

Patients with treatment-resistant depression usually suffer from poor quality of sleep and decreased alertness. Stimulant medications may help with alertness, daily functioning, and work performance.
Approach to the Patient With Adrenal Incidentaloma
Authors: Bancos Irina , Prete Alessandro
Published: July 2021

Adrenal tumors are commonly discovered incidentally on cross-sectional abdominal imaging performed for reasons other than adrenal mass. Incidence of adrenal tumors increased 10-fold in the past 2 decades, with most diagnosed in older adults. In any patient with a newly discovered adrenal mass, determining whether the adrenal mass is malignant and whether it is hormonally active is equally important to guide the best management. Malignancy is diagnosed in 5% to 8% of patients with adrenal tumors, with a higher risk in young patients, if history of extra-adrenal malignancy, in those with large adrenal tumors with indeterminate imaging characteristics, and in bilateral adrenal tumors. Although overt hormone excess is uncommon in adrenal incidentalomas, mild autonomous cortisol secretion can be diagnosed in up to 30% to 50% of patients. Because autonomous cortisol secretion is associated with increased cardiovascular morbidity and metabolic abnormalities, all patients with adrenal incidentalomas require work up with dexamethasone suppression test. Management of adrenal tumors varies based on etiology, associated comorbidities, and patient’s preference. This article reviews the current evidence on the diagnosis and evaluation of patients with adrenal mass and focuses on management of the most common etiologies of adrenal incidentalomas.
The 2014 New York State Medicaid Expansion and Severe Maternal Morbidity During Delivery Hospitalizations
Authors: Guglielminotti Jean , Landau Ruth , Li Guohua
Published: July 2021

BACKGROUND:

Medicaid expansions under the Affordable Care Act have increased insurance coverage and prenatal care utilization in low-income women. However, it is not clear whether they are associated with any measurable improvement in maternal health outcomes. In this study, we compared the changes in the incidence of severe maternal morbidity (SMM) during delivery hospitalizations between low- and high-income women associated with the 2014 Medicaid expansion in New York State.

METHODS:

Data for this retrospective cohort study came from the 2006–2016 New York State Inpatient Database, a census of discharge records from community hospitals. The outcome was SMM during delivery hospitalizations, as defined by the Centers for Disease Control and Prevention. We used regression coefficients (β) from multivariable logistic models: (1) to compare independently in low-income women and in high-income women the changes in slopes in the incidence of SMM before (2006–2013) and after (2014–2016) the expansion, and (2) to compare low- and high-income women for the changes in slopes in the incidence of SMM before and after the expansion.

RESULTS:

A total of 2,286,975 delivery hospitalizations were analyzed. The proportion of Medicaid beneficiaries in parturients increased a relative 12.1% (95% confidence interval [CI], 11.8-12.4), from 42.9% in the preexpansion period to 48.1% in the postexpansion period, whereas the proportion of the uninsured decreased a relative 4.8% (95% CI, 2.8-6.8). Multivariable logistic modeling revealed that implementation of the 2014 Medicaid expansion was associated with a decreased slope during the postexpansion period both in low-income women (β = –0.0161 or 1.6% decrease; 95% CI, –0.0190 to –0.0132) and in high-income women (β = –0.0111 or 1.1% decrease; 95% CI, –0.0130 to –0.0091). The decrease in slope during the postexpansion period was greater in low- than in high-income women (β = –0.0042 or 0.42% difference; 95% CI, –0.0076 to –0.0007).

CONCLUSIONS:

Implementation of the Medicaid expansion in 2014 in New York State is associated with a small but statistically significant reduction in the incidence of SMM in low-income women compared with high-income women.
Beta-Blocker Therapy Is Associated With Increased 1-Year Survival After Hip Fracture Surgery: A Retrospective Cohort Study
Authors: Mohammad Ismail Ahmad , Ahl Rebecka , Forssten Maximilian Peter , Cao Yang , Wretenberg Per , Borg Tomas , Mohseni Shahin
Published: July 2021

BACKGROUND:

The high mortality rates seen within the first postoperative year after hip fracture surgery have remained relatively unchanged in many countries for the past 15 years. Recent investigations have shown an association between beta-blocker (BB) therapy and a reduction in risk-adjusted mortality within the first 90 days after hip fracture surgery. We hypothesized that preoperative, and continuous postoperative, BB therapy may also be associated with a decrease in mortality within the first year after hip fracture surgery.

METHODS:

In this retrospective cohort study, all adults who underwent primary emergency hip fracture surgery in Sweden, between January 1, 2008 and December 31, 2017, were included. Patients with pathological fractures and conservatively managed hip fractures were excluded. Patients who filled a prescription within the year before and after surgery were defined as having ongoing BB therapy. The primary outcome of interest was postoperative mortality within the first year. To reduce the effects of confounding from covariates due to nonrandomization in the current study, the inverse probability of treatment weighting (IPTW) method was used. Subsequently, Cox proportional hazards models were fitted to the weighted cohorts. These analyses were repeated while excluding patients who died within the first 30 days postoperatively. This reduces the effect of early deaths due to surgical and anesthesiologic complications as well as the higher degree of advanced directives present in the study population compared to the general population, which allowed for the evaluation of the long-term association between BB therapy and mortality in isolation. Results are reported as hazard ratios (HR) with 95% confidence intervals (CI). Statistical significance was defined as a 2-sided P value <.05.

RESULTS:

A total of 134,915 cases were included in the study. After IPTW, BB therapy was associated with a 42% reduction the risk of mortality within the first postoperative year (adjusted HR = 0.58, 95% CI, 0.57–0.60; P < .001). After excluding patients who died within the first 30 days postoperatively, BB therapy was associated with a 27% reduction in the risk of mortality (adjusted HR = 0.73, 95% CI, 0.71–0.75; P < .001).

CONCLUSIONS:

A significant reduction in the risk of mortality in the first year following hip fracture surgery was observed in patients with ongoing BB therapy. Further investigations into this finding are warranted.
Solid Oxide Fuel Cell Using Plastic Waste Directly as Fuel
Authors: Hibino Takashi , Kobayashi Kazuyo , Hitomi Takuma
Published: July 2021

Direct utilization of combustible waste as an energy resource is very attractive for improving waste-to-energy conversion efficiency. Herein, we report a high-performance solid oxide fuel cell (SOFC) that can be supplied continuously with plastic waste as a fuel. Iron(III) oxide powder functioned as a pseudofuel in the ion transfer process and as a catalyst for gasification of the plastic. The resultant SOFC provided peak power densities of 0.71, 0.68, and 0.57 W cm−2 for nylon 66, polyethylene, and polystyrene, respectively.
Characterizing Behavior of Fatty Acids in Natural Organic Samples during Loss on Ignition (LOI) at Each Temperature
Authors: Satoh Yuhi , Wada Shigeki
Published: July 2021

The loss on ignition (LOI) of fatty acids (FAs; including carbon numbers of C8–C24) in vegetal and animal organic reference samples at 200–500 °C was examined. The total FAs in the samples preferentially disappeared through LOI operation compared to the other compounds. The average carbon numbers in total FAs did not change substantially from their original values due to LOI, regardless of the temperature. However, the unsaturation ratios in each FA species fluctuated throughout the operation.