bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunoglobulin levels in systemic lupus erythematosus: A narrative review
Authors: Almaghlouth Ibrahim , Johnson Sindhu R , Pullenayegum Eleanor , Gladman Dafna , Urowitz Murray
Published: March 2021

Immunoglobulins play a fundamental role in the protection of the human body against internal and external threats. They also contribute to the immune system homeostasis and maintenance of self-tolerance. Hypogammaglobulinemia is occasionally encountered in routine clinical practice by rheumatologists. Low levels of immunoglobulins can occur as primary or secondary issues and may predispose patients to various forms of infection. However, the impact of the low immunoglobulin level abnormality varies with the underlying condition. In this narrative review, we shed light on the overall types and functions of immunoglobulins for clinicians. We discuss important principles of immunoglobulin measurements. We then consider the primary and secondary causes of low immunoglobulins with a special focus on hypogammaglobulinemia in patients with systemic lupus erythematosus (SLE).
Toy stories: The role of vibrators in domestic intimacies
Authors: Mayr Cornelia
Published: March 2021

This article draws on the findings of qualitative research on the ways in which the domestication of sexual objects, such as vibrators, is central to relationships amongst (non)household members and social interaction within the home. Interviews with a purposive sample of 32 female participants were subjected to interpretative phenomenological analysis. In analyzing experiences and complex senses of belonging, the paper identified different circumstances and issues of public presentation and private realization that lie behind the meaning and use of vibrators. I suggest that objects, such as vibrators, come to be experienced as offering emotional, spatial, relational, and moral structures of both social integration and social distancing. All objects, even sex toys, contain culture, and by examining the domestication of such objects we can enrich knowledge of the affordances that constitute the materiality of sex.
Impact of patient resilience on early recovery from rotator cuff repair
Authors: Wilson Charlie D , Welling Benjamin D , Hammonds Kendall AP , Robin Brett N
Published: March 2021

Aims

We sought to evaluate early recovery from rotator cuff repair by assessing the correlation between patient resilience and postoperative shoulder pain and function, and physical and mental health.

Methods

Patients scheduled to undergo arthroscopic rotator cuff repair were prospectively enrolled. Resilience was assessed using the Brief Resilience Scale (BRS), pain and function was measured by American Society of Shoulder and Elbow Surgeons (ASES) shoulder scores, and physical and mental health was measured by the Patient-Reported Outcome Measurement Information System Global Health-10 (PROMIS-10). All scores were obtained preoperatively and postoperatively at three- and six months. Spearman correlation coefficient (r) was used to assess the relationship between variables.

Results

Ninety-eight patients ultimately underwent rotator cuff repair; 76 and 68 patients provided three- and six-month follow-up, respectively. There was no statistically significant correlation between preoperative BRS and three- and six-month ASES. However, there was a statistically significant correlation between preoperative BRS and three-month PROMIS-10 (r = 0.3763, p = 0.009) and concurrent BRS and PROMIS-10 at three months (r = 0.5657, p = 0.0025) and six months (r = 0.5308, p = 0.0025).

Discussion

Resilience appears to be more predictive of global physical and mental health than shoulder pain and function in early recovery from rotator cuff repair.
Early anti IL-1 treatment replaces steroids in refractory Kawasaki disease: clinical experience from two case reports
Authors: Mastrolia Maria Vincenza , Abbati Giulia , Signorino Claudia , Maccora Ilaria , Marrani Edoardo , Pagnini Ilaria , Simonini Gabriele
Published: March 2021

Refractory Kawasaki disease (KD) is related to a major risk of coronary arteries abnormalities and its treatment is not standardized. In this regard, anakinra (ANA), an interleukin (IL)-1 receptor antagonist, represents an emerging therapeutic option. We report two cases of children, diagnosed with KD, nonresponsive to two doses of intravenous immunoglobulins, successfully treated with ANA, without a prior use of steroids. Patient 2 developed a coronary dilatation, that improved significantly after ANA therapy. Our experience highlights IL-1 blockade effectiveness in reducing KD inflammation and suggests ANA adoption as second-line therapy, with a timesaving and steroid-sparing strategy. Our results, combined with the evidence of the IL-1 key role in KD and coronary arteritis pathogenesis and to the recent clinical evidence reported by the KAWAKINRA trial, encourage an earlier recourse to ANA in patients with refractory KD, in order to fight inflammation, and to treat and prevent the development of coronary artery aneurysms. Further studies are needed to better define the place of IL-1 blockade in KD step-up treatment.
Impact of Compensation, Job Enrichment and Enlargement, and Training on Employee Motivation
Authors: Tumi Najameddin Sadeg , Hasan Ali Nawari , Khalid Jamshed
Published: March 2021

Motivation is the process of increasing employee commitment and it is considered one of the key fundamentals, which are essential for organizational success. In a globalized working environment, implementing an effective compensation system, job enrichment, and enlargement, and appropriate training are some of the critical challenges facing by organizations to keep motivated their employees. Thus, the present study aims to investigate possible influencing factors such as compensation, job enrichment and enlargement, training, and their effects on employee motivation in the telecommunication sector in Libya. The findings revealed that all investigative factors have significant relationships with employee motivation. This study suggests that telecommunication companies should formulate an appropriate compensation system comprising of monetary and non-monetary rewards, provide job training to enhance knowledge and skills, as well as offer job enrichment and enlargement opportunities for the employees to expand their motivation and therefore result in organizational success. The limitations of the study and future research recommendations are addressed at the end.
Impact of COVID-19 pandemic on orthopaedic surgeons in terms of anxiety, sleep outcomes and change in management practices: A cross-sectional study from India
Authors: Sharma Vyom , Kumar Narinder , Gupta Bhawna , Mahajan Akanksha
Published: March 2021

Purpose:

The aim of this study was to assess the effects of the COVID-19 pandemic on anxiety, sleep outcomes and change in clinical management practices among orthopaedic surgeons following a nation-wide lockdown.

Methods:

We conducted an online cross-sectional study using piloted structured questionnaires with self-reported responses from Indian orthopaedic surgeons. Study participants were identified through social networking sites: Facebook and WhatsApp. The extent of anxiety and sleep quality was assessed by the standardised seven-item Generalised Anxiety Disorder (GAD-7) scale, single-item sleep quality scale, questions on unavailability of personal protective equipment, training module on COVID-19 and change in orthopaedic patient management.

Results:

One hundred male orthopaedic surgeons responded to the survey with majority (79%) in 30–44 years age group. Severe anxiety scores were observed in 8%; moderate, mild and minimal anxiety was observed in 12%, 27% and 53% surgeons respectively. Changes in management practice due to the pandemic was admitted by 65% respondents. We also observed an association between higher anxiety among surgeons and primary or secondary level of healthcare facility: (p = 0.04). Sleep disturbance was significantly associated with change in management practice to non-operative procedures (p = 0.03).

Conclusion:

Anxiety among orthopaedic surgeons during the COVID-19 pandemic is related to factors like younger age group, working in a primary or secondary healthcare facility. Early recognition of anxiety is essential to prevent serious psychological sequelae.
The effect of gluteus maximus tenotomy in primary total hip arthroplasty with posterior approach: Kinematic analysis of hip extensor strength
Authors: Imren Yunus , Karslioglu Bulent , Dedeoglu Suleyman Semih , Cabuk Haluk , Atar Sevgi , Gurbuz Serhat , Gurbuz Hakan
Published: March 2021

Background:

The posterior approach (PA) is the most commonly used surgical approach for total hip arthroplasty (THA), but the proximity of the sciatic nerve may increase the likelihood of sciatic nerve injury (SNI). Gluteus maximus tenotomy can be performed to prevent SNI because tenotomy increases the distance between the femoral neck and sciatic nerve and prevents compression of the sciatic nerve by the gluteus maximus tendon (GMT) during hip movements. We aimed to kinematically compare the postoperative hip extensor forces of patients who have and have not undergone gluteus maximus tenotomy to determine whether there is a difference in hip extensor strength.

Methods:

Seventy-two patients who underwent gluteus maximus tenotomy during THA were included in the group 1, and 86 patients who did not undergo tenotomy were included in group 2. The Harris hip score, body mass index and hip extensor forces were measured both preoperatively, and 6 months after surgery with an isokinetic dynamometer and compared.

Results:

The mean age was 64.6 ± 2.3 years in group 1 and 63.8 ± 2.1 in group 2. Mean body mass index was 25.7 ± 1.1 in group 1, and 25.5 ± 1.3 in group 2. Baseline Harris hip score (HHS) was 42.36 ± 12 in group 1 and 44.07 ± 9.4 in group 2 (p = 0.31), whereas it was 89.1 ± 7.8 and 88.4 ± 8.1 at 6 months after surgery, respectively. Baseline hip extensor force (HEF) was 2 ± 0.4 Nm/kg in group 1, and 2.1 ± 0.7 Nm/kg in group 2 (p = 0.28), while it was 2.4 ± 0.6 Nm/kg, and 2.5 ± 0.5 Nm/kg, respectively at 6 month follow-up (p = 0.87). Both groups had significantly improved HHS and HEF when comparing baseline and postoperative measurements (p < 0.0001). No cases of sciatic nerve palsy were noted in group 1, whereas there were two (2.32%) cases in group 2, postoperatively.

Conclusion:

The release of the GMT during primary hip arthroplasty performed with the PA did not lead to significant decrease in hip extension forces. Hip extensor strength improves after THA regardless of tenotomy. Gluteus maximus tenotomy with repair does not reduce muscle strength and may offer better visualization.
Correction to: DIALysis or not: Outcomes in older kidney patients with GerIatriC Assessment (DIALOGICA): rationale and design
Authors:   on behalf of the DIALOGICA study group, van Oevelen Mathijs , Abrahams Alferso C. , Bos Willem Jan W. , Emmelot-Vonk Mariëlle H. , Mooijaart Simon P. , van Diepen Merel , van Jaarsveld Brigit C. , van Eck van der Sluijs Anita , Voorend Carlijn G. N. , van Buren Marjolijn
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
Correction to: Reduced level of physical activity during COVID-19 pandemic is associated with depression and anxiety levels: an internet-based survey
Authors: Puccinelli Paulo José , da Costa Taline Santos , Seffrin Aldo , de Lira Claudio Andre Barbosa , Vancini Rodrigo Luiz , Nikolaidis Pantelis T. , Knechtle Beat , Rosemann Thomas , Hill Lee , Andrade Marilia Santos
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
Early rehabilitation relieves diaphragm dysfunction induced by prolonged mechanical ventilation: a randomised control study
Authors: Dong Zehua , Liu Ying , Gai Yubiao , Meng Pingping , Lin Hui , Zhao Yuxiao , Xing Jinyan
Published: March 2021

Background

Prolonged mechanical ventilation (MV) induces diaphragm dysfunction in patients in the intensive care units (ICUs). Our study aimed to explore the therapeutic efficacy of early rehabilitation therapy in patients with prolonged MV in the ICU.

Methods

Eighty eligible patients who underwent MV for > 72 h in the ICU from June 2019 to March 2020 were enrolled in this prospective randomised controlled trial. The patients were randomly divided into a rehabilitation group (n = 39) and a control group (n = 41). Rehabilitation therapy included six levels of rehabilitation exercises. Diaphragm function was determined using ultrasound (US).

Results

Diaphragmatic excursion (DE) and diaphragm thickening fraction (DTF) were significantly decreased in all patients in both groups after prolonged MV (p < 0.001). The rehabilitation group had significantly higher DTF (p = 0.008) and a smaller decrease in DTF (p = 0.026) than the control group after 3 days of rehabilitation training. The ventilator duration and intubation duration were significantly shorter in the rehabilitation group than in the control group (p = 0.045 and p = 0.037, respectively). There were no significant differences in the duration of ICU stay, proportion of patients undergoing tracheotomy, and proportion of recovered patients between the two groups.

Conclusions

Early rehabilitation is feasible and beneficial to ameliorate diaphragm dysfunction induced by prolonged MV and advance withdrawal from the ventilator and extubation in patients with MV. Diaphragm US is suggested for mechanically ventilated patients in the ICU.

Trial registration Chinese Clinical Trial Registry, ID: ChiCTR1900024046, registered on 2019/06/23.
Associations between curve severity and revised Scoliosis Research Society-22 and scoliosis Japanese Questionnaire-27 scores in female patients with adolescent idiopathic scoliosis: a multicenter, cross-sectional study
Authors: Doi Toru , Watanabe Kei , Doi Tokuhide , Inoue Hirokazu , Sugawara Ryo , Arai Yasuhisa , Shirado Osamu , Yamazaki Ken , Uno Koki , Yanagida Haruhisa , Kato So , Taniguchi Yuki , Matsubayashi Yoshitaka , Oshima Yasushi , Tanaka Sakae , Takeshita Katsushi
Published: March 2021

Background

Patient-reported outcome measures are widely utilized to assess health-related quality of life (HRQOL) in patients with adolescent idiopathic scoliosis (AIS). However, the association between HRQOL and curve severity is mostly unknown. The aim of this study is to clarify the association between HRQOL and curve severity, and to determine the optimal cutoff values of patient-reported outcomes for major curve severity in female patients with AIS.

Methods

Female patients with AIS treated conservatively were recruited. The patients’ HRQOL outcomes were examined using the revised Scoliosis Research Society-22 (SRS-22r) and the Scoliosis Japanese Questionnaire-27 (SJ-27). The correlations of the SRS-22r and SJ-27 scores with the major Cobb angle were assessed using Spearman’s correlation coefficient analysis. The association between HRQOL issues in the SJ-27 and the major Cobb angle was evaluated by calculating Akaike’s Information Criterion (AIC). Furthermore, the optimal cutoff values of the SRS-22r and SJ-27 scores for the major Cobb angle were determined by AIC analysis.

Results

The study cohort comprised 306 female patients with AIS. The SRS-22r and SJ-27 scores were significantly correlated with the major Cobb angle. Questions in the SJ-27 regarding discomfort when wearing clothes showed a lower AIC value in patients with severe scoliosis. The optimal cutoff values were a SRS-22r score of 3.2 for the discrimination of severe scoliosis (Cobb angle ≥48°), and a SJ-27 score of 32 for the discrimination of moderate scoliosis (Cobb angle ≥33°).

Conclusion

Discomfort when wearing clothes was the most important HRQOL problem caused by severe scoliosis. The SRS-22r and SJ-27 scores are useful for the discrimination of clinical status in female patients with severe scoliosis or moderate scoliosis.
Mental burden and its risk and protective factors during the early phase of the SARS-CoV-2 pandemic: systematic review and meta-analyses
Authors: Kunzler Angela M. , Röthke Nikolaus , Günthner Lukas , Stoffers-Winterling Jutta , Tüscher Oliver , Coenen Michaela , Rehfuess Eva , Schwarzer Guido , Binder Harald , Schmucker Christine , Meerpohl Joerg J. , Lieb Klaus
Published: March 2021

Background

Mental burden due to the SARS-CoV-2 pandemic has been widely reported for the general public and specific risk groups like healthcare workers and different patient populations. We aimed to assess its impact on mental health during the early phase by comparing pandemic with prepandemic data and to identify potential risk and protective factors.

Methods

For this systematic review and meta-analyses, we systematically searched PubMed, PsycINFO, and Web of Science from January 1, 2019 to May 29, 2020, and screened reference lists of included studies. In addition, we searched PubMed and PsycINFO for prepandemic comparative data. Survey studies assessing mental burden by the SARS-CoV-2 pandemic in the general population, healthcare workers, or any patients (eg, COVID-19 patients), with a broad range of eligible mental health outcomes, and matching studies evaluating prepandemic comparative data in the same population (if available) were included. We used multilevel meta-analyses for main, subgroup, and sensitivity analyses, focusing on (perceived) stress, symptoms of anxiety and depression, and sleep-related symptoms as primary outcomes.

Results

Of 2429 records retrieved, 104 were included in the review (n = 208,261 participants), 43 in the meta-analysis (n = 71,613 participants). While symptoms of anxiety (standardized mean difference [SMD] 0.40; 95% CI 0.15–0.65) and depression (SMD 0.67; 95% CI 0.07–1.27) were increased in the general population during the early phase of the pandemic compared with prepandemic conditions, mental burden was not increased in patients as well as healthcare workers, irrespective of COVID-19 patient contact. Specific outcome measures (eg, Patient Health Questionnaire) and older comparative data (published ≥5 years ago) were associated with increased mental burden. Across the three population groups, existing mental disorders, female sex, and concerns about getting infected were repeatedly reported as risk factors, while older age, a good economic situation, and education were protective.

Conclusions

This meta-analysis paints a more differentiated picture of the mental health consequences in pandemic situations than previous reviews. High-quality, representative surveys, high granular longitudinal studies, and more research on protective factors are required to better understand the psychological impacts of the SARS-CoV-2 pandemic and to help design effective preventive measures and interventions that are tailored to the needs of specific population groups.
Prevalence of second victims, risk factors and support strategies among young German physicians in internal medicine (SeViD-I survey)
Authors: Strametz Reinhard , Koch Peter , Vogelgesang Anja , Burbridge Amie , Rösner Hannah , Abloescher Miriam , Huf Wolfgang , Ettl Brigitte , Raspe Matthias
Published: March 2021

Background

Second victims, defined as healthcare team members being traumatised by an unanticipated clinical event or outcome, are frequent in healthcare. Evidence of this phenomenon in Germany, however, is sparse. Recently, we reported the first construction and validation of a German questionnaire. This study aimed to understand this phenomenon better in a sample of young (<= 35 years) German physicians.

Methods

The electronic questionnaire (SeViD-I survey) was administered for 6 weeks to a sample of young physicians in training for internal medicine or a subspecialty. All physicians were members of the German Society of Internal Medicine. The questionnaire had three domains - general experience, symptoms, and support strategies - comprising 46 items. Binary logistic regression models were applied to study the influence of various independent factors on the risk of becoming a second victim, the magnitude of symptoms and the time to self-perceived recovery.

Results

The response rate was 18% (555/3047). 65% of the participants were female, the mean age was 32 years. 59% experienced second victim incidents in their career so far and 35% during the past 12 months. Events with patient harm and unexpected patient deaths or suicides were the most frequent key incidents. 12% of the participants reported that their self-perceived time to full recovery was more than 1 year or have never recovered. Being female was a risk factor for being a second victim (odds ratio (OR) 2.5) and experiencing a high symptom load (OR 2). Working in acute care was promoting a shorter duration to self-perceived recovery (OR 0.5). Support measures with an exceptionally high approval among second victims were the possibility to discuss emotional and ethical issues, prompt debriefing/crisis intervention after the incident and a safe opportunity to contribute insights to prevent similar events in the future.

Conclusion

The second victim phenomenon is frequent among young German physicians in internal medicine. In general, these traumatic events have a potentially high impact on physician health and the care they deliver. A better understanding of second victim traumatisations in Germany and broad implementation of effective support programs are warranted.
Human milk banks in the response to COVID-19: a statement of the regional human milk bank network for Southeast Asia and beyond
Authors: Olonan-Jusi Estrella , Zambrano Paul G. , Duong Vu H. , Anh Nguyen T. T. , Aye Nant S. S. , Chua Mei Chien , Kurniasari Hikmah , Moe Zaw Win , Ngerncham Sopapan , Phuong Nguyen T. T. , Datu-Sanguyo Janice
Published: March 2021

Background

The World Health Organization (WHO) recommendations on infant feeding in the context of COVID-19 uphold standing recommendations for breastfeeding, non-separation, and skin-to-skin contact, including the use of donor human milk when mother’s own milk is not available.

Insufficient guidance on the use of donor human milk and the role of human milk banks in the pandemic response

COVID-19 clinical management guidelines in seven countries in Southeast Asia are not aligned with WHO recommendations despite the lack of evidence of transmission through either breastmilk or breastfeeding. The use of safe donor human milk accessed through human milk banks is also insufficiently recommended, even in countries with an existing human milk bank, leading to a gap in evidence-based management of COVID-19. This highlights long-standing challenges as well as opportunities in the safe, equitable, and resilient implementation of human milk banks in the region.

Conclusions

This statement reflects the expert opinion of the Regional Human Milk Bank Network for Southeast Asia and Beyond on the need to revisit national guidelines based on the best evidence for breastfeeding during the COVID-19 pandemic, to incorporate human milk bank services in national obstetric and newborn care guidelines for COVID-19 where possible, and to ensure that operations of human milk banks are adapted to meet the needs of the current pandemic and to sustain donor human milk supply in the long-term. The Network also recommends sustained engagement with the global human milk bank community.
VATS right posterior segmentectomy with anomalous bronchi and pulmonary vessels: a case report and literature review
Authors: Zhang Jianbin , Zhu Yilv , Li Hongwei , Yu Caihua , Min Weiwei
Published: March 2021

Background

Anatomic variation may increase the difficulty and risk of anatomic segmentectomy. The preoperative three-dimensional computed tomography bronchography and angiography (3D-CTBA) can provide a detailed model of the segmental structure, and contribute to precise and safe segmentectomy.

Case presentation

This is a case of anomalous bronchi and pulmonary vessels in the right upper posterior segment (RS2). Under the guidance of 3D-CTBA, anatomic RS2 segmentectomy was performed accurately and safely. The postoperative condition was uneventful.

Conclusions

This rare case highlights the importance of 3D-CTBA to guild accurate segmentectomy with anatomic variation.
Comparison of free and bound phenolic compositions and antioxidant activities of leaves from different mulberry varieties
Authors: Wang Zhenjiang , Tang Cuiming , Xiao Gengsheng , Dai Fanwei , Lin Sen , Li Zhiyi , Luo Guoqing
Published: March 2021

Mulberry leaves are used in traditional Chinese medicine and contain numerous active substances that are known to be beneficial for human health. The aim of this study was to investigate the phenolic compositions and antioxidant activities of the leaves from 23 mulberry cultivars. Qualitative LC-ESI-QTOF analysis revealed the presence of 11 phenolic compounds in the free phenolic extracts and 10 phenolic compounds in the bound fractions. Chlorogenic acid and caffeic acid were the major components in the free and bound fractions, respectively. The results revealed that the changguosang cultivar from Taiwan contained the greatest content of phenolic compounds as well as the highest antioxidant activity among the 23 cultivars examined, as determined using three separate antioxidant assays. The isoquercitrin, chlorogenic acid, and rutin contents of the free phenolic extracts displayed significant correlations with the antioxidant activities, while syringic acid and rutin were the main contributors to the antioxidant activities of the bound phenolic fractions. The obtained results demonstrate that mulberry leaves contain a variety of beneficial phenolic substances and may be suitable for further development as a herbal medicine.
Bronchiolitis obliterans following toxic epidermal necrolysis: a case report
Authors: Khanal Ujjwal Prakash , Roy Akash , Sharma Arun Kumar
Published: March 2021

Background

Toxic epidermal necrolysis (TEN) is a rare, acute and potentially fatal skin condition usually induced by drugs. Although much attention is focused on the life threatening acute cutaneous and sight threatening ocular manifestations of this disease, chronic pulmonary complications like bronchiolitis obliterans are occasionally encountered. However, little is known about its incidence, pathogenesis, clinical course and outcome in children recovering from TEN.

Case presentation

We report a five-year-old boy who presented four months after the first manifestation of drug-induced TEN with cough and shortness of breath and was subsequently diagnosed with bronchiolitis obliterans. He was treated with supportive therapy that improved his hypercapnia allowing him to be discharged on domiciliary oxygen, chest physiotherapy and bronchodilators.

Conclusions

This case highlights the need to be vigilant for adverse drug reactions and consider chronic pulmonary complications like Bronchiolitis Obliterans in children recovering from TEN.
The effect of bone marrow-derived mesenchymal stem cell co-transplantation with hematopoietic stem cells on liver fibrosis alleviation and survival in patients with class III β-thalassemia major
Authors: Rostami Tahereh , Kasaeian Amir , Maleki Nasrollah , Nikbakht Mohsen , Kiumarsi Azadeh , Tavangar Seyed Mohammad , Taheri Amir Pejman Hashemi , Mousavi Seied Asadollah , Ghavamzadeh Ardeshir
Published: March 2021

Background

Hepatic fibrosis is a common complication in transfusion-dependent thalassemia patients. Data on the co-transplantation of mesenchymal stem cells (MSCs) with hematopoietic stem cells (HSCs) in beta-thalassemia major patients are scarce. Therefore, we aimed to evaluate the effect of co-transplantation of bone marrow-derived MSC with HSCs on the liver fibrosis alleviation and transplant outcomes in class III beta-thalassemia major.

Methods

Between April 1998 and January 2017, a total of 224 consecutive patients with class III beta-thalassemia major underwent allogeneic HSCT in the Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran. To assess liver fibrotic changes after transplantation, 47 patients participated in the MSC plus HSC group and 30 patients in the HSC only group at the end of the follow-up period. All patients underwent laboratory tests, especially serum ferritin and liver function testing, hepatic T2* MRI, liver biopsy, and FibroScan before and 2 years after transplantation. Kaplan-Meier curves were derived to determine survival and were compared using the log-rank test. Repeated-measure, mixed-effect linear regression models were used to examine the changes in liver fibrosis over time.

Results

The 10-year OS rate was 71.84% in the mesenchymal group and 61.89% in the non-mesenchymal group (P value = 0.294), while the 10-year TFS rate was 63.64% in the mesenchymal group and 52.78% in the non-mesenchymal group (P value = 0.285). No significant difference was observed in the 10-year NRM, rejection rate, ANC engraftment, platelet engraftment, acute GvHD, and chronic GvHD between the two groups. In addition, the results of repeated-measure, mixed-effect linear regression models showed that none of the variables determining hepatic fibrosis had a significant difference between patients receiving MSCs and patients who did not receive MSCs.

Conclusions

Based on the results of this study, a single infusion of MSCs at the time of HSCT to patients with class III beta-thalassemia major could not significantly improve the liver fibrosis alleviation and transplantation outcomes, including OS, TFS, TRM, rejection rate, ANC engraftment, platelet engraftment, acute GvHD, and chronic GvHD.
Normative beliefs and values that shape care-seeking behaviours for skilled birth attendance (SBA) during birthing by mothers in Africa: a scoping review protocol
Authors: Jacobs Choolwe , Hyder Adnan A.
Published: March 2021

Background

Skilled birth attendance (SBA) during delivery has been associated with improved maternal health outcome. However, low utilisation of SBA during childbirth has continued in many developing countries including Zambia. The proposed scoping review aims to map literature on beliefs and values and how mothers are influenced by relational normative motivations in utilisation of SBAs in health facilities.

Methods

We designed and registered a study protocol for a scoping review. Literature searches will be conducted in multiple electronic databases (from January 2000 onwards), including PubMed, EMBASE, Scopus and Web of Science. Grey literature will be identified through searching dissertation databases, Google Scholar, EBSCOhost and ResearchGate. Keyword searches will be used to identify articles. Only articles published in English, related on beliefs and values surrounding childbirth, and on perceptions towards facility delivery or skilled health care providers will be considered eligible for inclusion. Two reviewers will independently screen eligible titles, abstracts and full articles with a third reviewer to help resolve any disputes. The study methodological quality (or bias) will be appraised using the Mixed Method Appraisal Tool. A narrative summary of findings will be conducted. We will employ NVIVO version 10 software package to extract the relevant outcomes from the included articles using content thematic analysis. This protocol is registered with the Open Science Framework (osf.io/9gn76).

Discussion

Understanding how individual mother’s health seeking behaviours for SBA and those close to them are influenced by their beliefs and values is critical to informing health systems on the possible ‘hidden’ barriers and facilitators to utilisation of SBA in public health facilities. The review will complement evidence base on normative beliefs and values shaping care-seeking behaviours for skilled birth attendance by mothers in Africa.
Retraction Note: Growth properties at infinity for solutions of modified Laplace equations
Authors: Sun Jianguo , He Binghang , Peixoto-de-Büyükkurt Corchado
Published: March 2021

This article has been retracted. Please see the Retraction Notice for more detail: 10.1186/s13660-021-02596-w
An inverse problem of reconstructing option drift rate from market observation data
Authors: Deng Z. C. , Zhao X. Y. , Yang L.
Published: March 2021

Drift rate is a very important parameter in the evolution of stock price, which has significant impact on the corresponding option pricing. This paper deals with an inverse problem of recovering the drift function by current market prices of options. Different from the usual inverse volatility problem, our mathematical model does not tend to zero at infinity, which may bring great trouble to theoretical analysis and numerical calculation. To overcome this difficulty, we use an artificial boundary and homogenization technique to transform the original problem into a homogeneous initial boundary value problem on a bounded domain. Then, based on the optimal control framework, we construct the corresponding optimization problem and strictly prove the well-posedness of the minimizer. Finally, we design an iterative algorithm to obtain the numerical solution. We give some typical examples to verify the validity of our method.
High throughput sequencing provides exact genomic locations of inducible prophages and accurate phage-to-host ratios in gut microbial strains
Authors: Zünd Mirjam , Ruscheweyh Hans-Joachim , Field Christopher M. , Meyer Natalie , Cuenca Miguelangel , Hoces Daniel , Hardt Wolf-Dietrich , Sunagawa Shinichi
Published: March 2021

Background

Temperate phages influence the density, diversity and function of bacterial populations. Historically, they have been described as carriers of toxins. More recently, they have also been recognised as direct modulators of the gut microbiome, and indirectly of host health and disease. Despite recent advances in studying prophages using non-targeted sequencing approaches, methodological challenges in identifying inducible prophages in bacterial genomes and quantifying their activity have limited our understanding of prophage-host interactions.

Results

We present methods for using high-throughput sequencing data to locate inducible prophages, including those previously undiscovered, to quantify prophage activity and to investigate their replication. We first used the well-established Salmonella enterica serovar Typhimurium/p22 system to validate our methods for (i) quantifying phage-to-host ratios and (ii) accurately locating inducible prophages in the reference genome based on phage-to-host ratio differences and read alignment alterations between induced and non-induced prophages. Investigating prophages in bacterial strains from a murine gut model microbiota known as Oligo-MM12 or sDMDMm2, we located five novel inducible prophages in three strains, quantified their activity and showed signatures of lateral transduction potential for two of them. Furthermore, we show that the methods were also applicable to metagenomes of induced faecal samples from Oligo-MM12 mice, including for strains with a relative abundance below 1%, illustrating its potential for the discovery of inducible prophages also in more complex metagenomes. Finally, we show that predictions of prophage locations in reference genomes of the strains we studied were variable and inconsistent for four bioinformatic tools we tested, which highlights the importance of their experimental validation.

Conclusions

This study demonstrates that the integration of experimental induction and bioinformatic analysis presented here is a powerful approach to accurately locate inducible prophages using high-throughput sequencing data and to quantify their activity. The ability to generate such quantitative information will be critical in helping us to gain better insights into the factors that determine phage activity and how prophage-bacteria interactions influence our microbiome and impact human health.
Are poor set-shifting and central coherence associated with everyday function in anorexia nervosa? A systematic review
Authors: Dann Kelly M. , Hay Phillipa , Touyz Stephen
Published: March 2021

Background

There is increasing interest in associations between cognitive impairments and clinical symptoms in Anorexia Nervosa (AN), however, the relationship with everyday function is unclear. The current review synthesizes existing data regarding associations between scores on tests of set-shifting and central coherence and functional outcome measures for individuals with AN.

Method

A systematic electronic database search yielded 13 studies which included participants with current or lifetime AN where scores on a neuropsychological test of set-shifting or central coherence were directly or indirectly compared to a functional outcome measure.

Results

Associations between set-shifting and central coherence performance measures and functional outcomes were limited in number and noted only in adult or mixed-age cohorts. Associations were noted at subscale level, suggesting they are specific in nature. In younger cohorts, assessments of executive functioning in everyday life appear sensitive to cognitive-behavioral flexibility issues.

Conclusions

Associations between cognitive performance and functional outcome have not been as systematically assessed in AN as in other psychiatric disorders. Key factors to address in future research include: (a) the use of function measures which are sensitive to both the level of impairment, and specific rather than general impairments (b) the ecological validity of measures, (c) the task impurity problem, especially in regard to cognitive flexibility assessment, and (d) the need to measure both cognitive deficits and strengths, because tests of specific cognitive processes may underestimate the ability to function in daily life due to compensatory strategies.
Apprenticeship non-completion in Germany: a money matter?
Authors: Neuber-Pohl Caroline
Published: March 2021

German establishments heavily rely on the apprenticeship system for skill supply. With one in four apprenticeship contracts ending before successful completion, it is in the interest of establishments and policy-makers to determine factors, which reduce non-completion. This paper investigates the role of apprenticeship wages and income prospects after completion for apprenticeship non-completion in Germany. For this purpose, this study identifies incidences of apprenticeship non-completion in a large sample of administrative data on employment biographies and estimates a piecewise exponential model of the non-completion hazard with shared frailties by occupations. The results suggest a robust and significant association with both apprenticeship wages and skilled worker wages. All else at means, apprenticeships which are paid 5% more than the mean apprenticeship wage, on average have a 0.8 percentage points higher estimated survival rate. In turn, an apprenticeship expected to lead to a skilled job that is paid 5% above average, has an estimated survival rate, which is 3.1 percentage points higher on average. These findings highlight the importance of income prospects for apprenticeship non-completion.
Efficiency of the teaching-industry linkage in the Australian vocational education and training
Authors: Tran Carolyn-Thi Thanh Dung
Published: March 2021

The vocational education and training (VET) sector plays a crucial role in Australia’s education system. Associated closely between the VET provision and industry, VET training quality is continually at the heart of debates in the process of implementing the Australian VET reform agenda. In response of key themes of this reform process, investigating the training efficiency of VET through the linked efficiency between teaching and industry responsiveness is imperative. The paper aims to address this objective by using the dynamic network data envelopment analysis in a balanced panel data for 2008–2012. This advanced model allows to assess simultaneously the efficiency of two nodes, teaching and industry responsiveness, and the overall dynamic training efficiency of VET based on fields of education in a network structure. We found that the overall training efficiency of VET is, on average, 0.835 while the mean divisional efficiencies of the teaching efficiency and industry responsiveness are 0.763 and 0.908, respectively. Sensitivity analysis is conducted to examine dynamic changes of the efficiency of the teaching and industry linkage following various period weights. Policy implications are drawn for the Australian VET sector.
Skills-based intervention to enhance collaborative decision-making: systematic adaptation and open trial protocol for veterans with psychosis
Authors: Treichler Emily B. H. , Rabin Borsika A. , Spaulding William D. , Thomas Michael L. , Salyers Michelle P. , Granholm Eric L. , Cohen Amy N. , Light Gregory A.
Published: March 2021

Background

Collaborative decision-making is an innovative decision-making approach that assigns equal power and responsibility to patients and providers. Most veterans with serious mental illnesses like schizophrenia want a greater role in treatment decisions, but there are no interventions targeted for this population. A skills-based intervention is promising because it is well-aligned with the recovery model, uses similar mechanisms as other evidence-based interventions in this population, and generalizes across decisional contexts while empowering veterans to decide when to initiate collaborative decision-making. Collaborative Decision Skills Training (CDST) was developed in a civilian serious mental illness sample and may fill this gap but needs to undergo a systematic adaptation process to ensure fit for veterans.

Methods

In aim 1, the IM Adapt systematic process will be used to adapt CDST for veterans with serious mental illness. Veterans and Veteran’s Affairs (VA) staff will join an Adaptation Resource Team and complete qualitative interviews to identify how elements of CDST or service delivery may need to be adapted to optimize its effectiveness or viability for veterans and the VA context. During aim 2, an open trial will be conducted with veterans in a VA Psychosocial Rehabilitation and Recovery Center (PRRC) to assess additional adaptations, feasibility, and initial evidence of effectiveness.

Discussion

This study will be the first to evaluate a collaborative decision-making intervention among veterans with serious mental illness. It will also contribute to the field’s understanding of perceptions of collaborative decision-making among veterans with serious mental illness and VA clinicians, and result in a service delivery manual that may be used to understand adaptation needs generally in VA PRRCs.

Trial registration

ClinicalTrials.gov Identifier: NCT04324944
Enriching context descriptions for enhanced LA scalability: a case study
Authors: Samuelsen Jeanette , Chen Weiqin , Wasson Barbara
Published: March 2021

Learning analytics (LA) is a field that examines data about learners and their context, for understanding and optimizing learning and the environments in which it occurs. Integration of multiple data sources, an important dimension of scalability, has the potential to provide rich insights within LA. Using a common standard such as the Experience API (xAPI) to describe learning activity data across multiple sources can alleviate obstacles for data integration. Despite their potential, however, research indicates that standards are seldom used for integration of multiple sources in LA. Our research aims to understand and address the challenges of using current learning activity data standards for describing learning context with regard to interoperability and data integration. In this paper, we present the results of an exploratory case study involving in-depth interviews with stakeholders having used xAPI in a real-world project. Based on the subsequent thematic analysis of interviews, and examination of xAPI, we identified challenges and limitations in describing learning context data, and developed recommendations (provided in this paper in summarized form) for enriching context descriptions and enhancing the expressibility of xAPI. By situating the research in a real-world setting, our research also contributes to bridge the gap between the academic community and practitioners in learning activity data standards and scalability, focusing on description of learning context.
Debrief it all: a tool for inclusion of Safety-II
Authors: Bentley Suzanne K. , McNamara Shannon , Meguerdichian Michael , Walker Katie , Patterson Mary , Bajaj Komal
Published: March 2021

Safety science in healthcare has historically focused primarily on reducing risk and minimizing harm by learning everything possible from when things go wrong (Safety-I). Safety-II encourages the study of all events, including the routine and mundane, not only bad outcomes. While debriefing and learning from positive events is not uncommon or new to simulation, many common debriefing strategies are more focused on Safety-I. The lack of inclusion of Safety-II misses out on the powerful analysis of everyday work.

A debriefing tool highlighting Safety-II concepts was developed through expert consensus and piloting and is offered as a guide to encourage and facilitate inclusion of Safety-II analysis into debriefings. It allows for debriefing expansion from the focus on error analysis and “what went wrong” or “could have gone better” to now also capture valuable discussion of high yield Safety-II concepts such as capacities, adjustments, variation, and adaptation for successful operations in a complex system. Additionally, debriefing inclusive of Safety-II fosters increased debriefing overall by encouraging debriefing when “things go right”, not historically what is most commonly debriefed.