bluuebunny/crossref_metadata_2025 huggingface dataset:
Minor amputation after revascularization in chronic limb-threatening ischemia: What is the optimal timing?
Authors: Tanda Elisabetta , Ruiu Giovanni , Casula Matteo , Lamia Irene , Serra Arianna , Boscolo Meneguolo Anna , Zappadu Sara , Sanfilippo Roberto , Camparini Stefano , Petruzzo Palmina
Published: November 2023

Objectives

Patients with chronic limb-threatening ischemia (CLTI) have a high risk of lower limb amputation and loss of walking independence. Minor amputations play a key role in ensuring walking independence and they represent a challenge in terms of timing and level for vascular surgeons. A major cause of re-amputation is a defect in wound healing and a possible predictor of re-amputation for non-healing wounds could be the incorrect timing of minor amputation after revascularization. The lack of evidence in the literature leads to a wide variability of choices in clinical practice. The purpose of this study was to try to find the optimal timing analysing the risk of re-amputation in CLTI patients who have undergone successful revascularization and minor amputation focussing on timing of minor amputation.

Methods

We conducted a single centre retrospective analysis on a cohort of 151 patients consecutively admitted to our hospital for CLTI (Rutherford 5) between January 2014 and April 2022. All the enrolled patients underwent successful revascularization of lower limbs and a minor amputation for dry acral necrosis. The characteristics of the patients and the revascularization procedures were collected and analysed. Patients were divided into two groups based on the timing of minor amputation performed before (group 1) or after the day (group 2) that best predicts the risk of re-amputation according to a Receiver Operating Characteristic (ROC) curve analysis. The primary outcome of this study was the risk of re-amputation during the first 60 days of follow-up after a primary minor amputation, with revascularization still effective. The impact of the timing of minor amputation after revascularization, the type of revascularization and the presence of risk factors known to prolong the wound healing process were evaluated in a uni- and multi-variable logistic regression model.

Results

Systemic hypertension, and type of revascularization (i.e. open vs endovascular) were independent predictors of the risk of re-amputation at 60 days (HR 4.26, 95% CI 1.30–14.04, p = .017 and HR 2.35, 95% CI 1.16–4.78, p = .018, respectively). Moreover, time ≤14 days between revascularization and first amputation was associate with a clear, albeit not statistically significant, trend toward increased risk of re-amputation (HR 2.09, 95% CI 0.97–4.51, p = .06).

Conclusions

In a cohort of patients who underwent a successful revascularization for CLTI and a minor amputation for dry gangrene in the first 14 days after revascularization, a higher -although not significant-risk of re-amputation was reported. In this cohort of patients, a delayed demolitive procedure should be considered to allow better tissue perfusion and to reduce the risk of re-amputation.
Indigenizing journalistic objectivity in an African context: How ‘indigenous’ journalistic practices (re)define professional norms
Authors: Gibrilu Abdul Wahab
Published: November 2023

Through comparative content analysis of online news reports ( N = 420), we examined how indigenous values and source citation practices (re)define journalistic objectivity away from the normative comfort domain of ‘The American standard’. We argue that ‘African’ journalistic practices will more possibly reflect more ‘objective’ narratives with a critical gaze to African values such as ‘ Ubuntu’ and ‘ Afriethics’. By comparing ‘grassroots’ with ‘elite’ source citations as reflected in ‘African’ media reportage, we found that African news narratives that embrace ‘Community Journalism’ reflect more grassroots than elite voices as distinct from ‘Western’ libertarian journalistic practices.
Ferroptosis triggers airway inflammation in asthma
Authors: Li Minming , Li Min , Hou Yunjiao , HE Huilin , Jiang Ruonan , Wang Chu , Sun Shibo
Published: November 2023

Ferroptosis is a regulatory cell death characterized by intracellular iron accumulation and lipid peroxidation that leads to oxidative stress. Many signaling pathways such as iron metabolism, lipid metabolism, and amino acid metabolism precisely regulate the process of ferroptosis. Ferroptosis is involved in a variety of lung diseases, such as acute lung injury, chronic obstructive pulmonary disease (COPD) and pulmonary fibrosis. Increasing studies suggest that ferroptosis is involved in the development of asthma. Ferroptosis plays an important role in asthma. Iron metabolism disorders, lipid peroxidation, amino acid metabolism disorders lead to the occurrence of ferroptosis in airway epithelial cells, and then aggravate clinical symptoms in asthmatic patients. Moreover, several regulators of ferroptosis are involved in the pathogenesis of asthma, such as Nrf2, heme oxygenase-1, mevalonate pathway, and ferroptosis inhibitor protein 1. Importantly, ferroptosis inhibitors improve asthma. Thus, the pathogenesis of ferroptosis and its contribution to the pathogenesis of asthma help us better understand the occurrence and development of asthma, and provide new directions in asthma treatment. This article aimed to review the role and mechanism of ferroptosis in asthma, describing the relationship between ferroptosis and asthma based on signaling pathways and related regulatory factors. At the same time, we summarized current observations of ferroptosis in eosinophils, airway epithelial cells, and airway smooth muscle cells in asthmatic patients.
What is the optimal duration, dose and frequency for anti-PD1 therapy of non-small cell lung cancer?
Authors: Kuah Chii Yang , Monfries Robert , Quartagno Matteo , Seckl Michael J. , Ghorani Ehsan
Published: November 2023

Over the past decade, immune checkpoint inhibitors (ICIs) have transformed the management of multiple malignancies including lung cancer. However, the optimal use of these agents in terms of duration, dose and administration frequency remains unknown. Focusing on anti-PD1 agents nivolumab and pembrolizumab in the context of non-small cell lung cancer, we argue that several lines of evidence suggest current administration regimens of these drugs may result in overtreatment with potentially important implications for cost, quality of life and toxicity. This review summarizes evidence for the scope to optimize anti-PD1 regimens, the limitations of existing data and potential approaches to solve these problems including with a novel multi-arm clinical trial design implemented in the recently opened REFINE-Lung study.
Nurturing Peaceful Minds: Fostering Peace Education Amid Conflict in Jammu and Kashmir
Authors: Ilyas Mohammad
Published: November 2023

The basic purpose of the paper is to explore the issues and challenges faced by educational administrators, parents, students, and teachers concerning the effects of armed conflict on educational outcomes. It emphasizes the significance of peace education initiatives in Jammu and Kashmir a region enduring unrest for nearly three decades, profoundly affecting its educational sector. Employing a descriptive qualitative survey method, the study examines the experiences of different stakeholders of education and the factors influencing various stakeholders. The results indicate that academic stress emerges as a dominant risk factor leading to physical and psychological difficulties among the students. The research advocates for integrating peace education into the curriculum, creating a conducive learning environment to empower students in overcoming such challenges. Empirical findings strongly suggest that introducing peace education into the curriculum and peace education as a subject can be instrumental in addressing conflict-related issues.
Comparison of the Effective Radiation Dose in the Region of the Facial Skull Between Multidetector CT, Dental Conebeam CT and Intraoperative 3D C-Arms
Authors: Pietzka Sebastian , Grieser Anne , Winter Karsten , Schramm Alexander , Metzger Marc , Semper-Hogg Wiebke , Grunert Michael , Ebeling Marcel , Sakkas Andreas , Wilde Frank
Published: November 2023

Study Design

Experimental single-centre study of X-ray absorption using a phantom skull.

Objective

This experimental study aimed to compare the radiation doses of different 3D imaging devices used in maxillofacial surgery, including one Multidetector CT (MDCT), two Conebeam CT (CBCT) and four intraoperative 3D C-arms.

Methods

Thermoluminescent dosimeters (TLD) were used to determine the absorbed radiation in an Alderson-Rando phantom skull. The phantom skull was positioned in the before mentioned seven devices and a defined 3D facial skull image was acquired. Subsequently, the TLD’S were read out and the effective doses (ED) and the organ doses (OD) were calculated and compared.

Results

OD varied significantly between tissues as well as between the 3D X-ray devices. The OD of the 3D C-arms were significantly lower than those of all other devices. The OD of the CT, especially in the standard setting, was the highest. Only by special adjustments of the scan protocol regarding CMF requirements for traumatology, the MDCT could achieve almost equivalent doses as the two tested CBCT-scanners. The calculated effective doses were also lowest for the 3D C-arm devices (11.2 to 129.9 μSv). The ED of the MDCT were significant higher (284.52–844.97 μSv) than in all other devices. The ED of the CBCTs (173.7–184.9) were lower than for MDCT but still higher than those of the 3D C-arms.

Conclusions

Intraoperative imaging using 3D C-arm devices is an effective method to verify reduction results in maxillofacial surgery intraoperatively with significantly lower ED than postoperatively CBCT and MDCT imaging.
The dangerous increasing support of Europol in national criminal investigations: An additional layer of complexity
Authors: Tas Sarah
Published: November 2023

Vice President for Promoting our European Way of Life Margaritis Schinas, stated at the time of the adoption of Europol’s amendment that “Europol is a true example of where EU action helps protect us all. Today’s agreement will give Europol the right tools and safeguard to support police forces in analysing big data to investigate crime and in developing pioneering methods to tackle cybercrime.” While some characterized the changes as an achievement for the adaptability and operational role of Europol, others argued that it undermines fundamental rights and weakens data protection. This paper analyses the amendments made to the Regulation and explores Europol’s increasing role of in national investigations and the associated dangers of it. The paper starts with a historical analysis of Europol’s legal framework and role in national criminal investigations, before diving into the core of the Regulation. After 2022, Europol supports Member States’ investigations in many ways. First, through the continuous retention of large and complex datasets, which was strongly criticized by NGOs and the EDPS. Second, through the transformation of Europol into the information hub and broker for the exchanges of data with private parties. Third, more indirectly, through Europol’s support of research and innovation projects, for national authorities to use and explore new technologies in their work. However, these amendments are not without dangers. The Regulation of 2022 pushes the boundaries of Europol’s competences further, by circumventing existing limits and questioning the legality of the operations. The stronger role of Europol lacks sufficient safeguards and efficient oversight. This is highly problematic considering the impact Europol may have on national investigations, and as a result on the situation of individuals.
Mediated (Un)Doing Family: Cross-Border Parenting in Chinese Families
Authors: Ou Chuyue , Sandel Todd , Lin Zhongxuan
Published: November 2023

This article elucidates the emergence of technology-empowered family practices that cross-border families develop to re-spatialize and re-temporalize their family activities and daily rhythms. Standing on the concepts of “doing family” and polymedia, we propose a dual framework of mediated doing/undoing family and explain it in an integrated WeChat environment. Specifically, the frame contains three pairs of dimensions: active versus inactive, everyday co-presence versus absent-presence and invisibility, and historical roots versus anti-traditions. Drawing on a 2-year ethnography of cross-border students communicating with their parents, we use the frame to further illuminate a set of dialectical relations between mediated doing and undoing family, and between cultural motherhood and fatherhood—culturally (un)doing gender. Findings fill gaps in the existing literature on the undoing affordances of technologies, and supplement insights on the experiences of transnational/cross-border parenthood. Our study also discusses the dual dynamics of mediated (un)doing family and presents a critical reflection on the effects of technology on gender asymmetries and gender dynamics.
Towards a global nursing curriculum for the 21st century: Rethinking health through the lens of a sustainability paradigm – a contemporary issue
Authors: Holmgren Jessica , Eriksson Henrik
Published: November 2023

Nursing education has historically been designed in harmony with societal development. However, the world is becoming increasingly complex, and we face ongoing global challenges. A new, progressive step towards a global nursing curriculum is needed. This development is anticipated, and nursing students often request knowledge and perspectives that will prepare them to care in a sustainable way. To provide this and ensure equal health, intersectional perspectives must be at the foundation of future caring activities. There is thus a societal shift that makes it necessary to take a decisive step towards rethinking health through the lens of a sustainability paradigm.
Interventions addressing conflict in communities hosting climate-influenced migrants: Literature review
Authors: He Linlang , Kreske Elizabeth , Nawyn Stephanie J , Pearson Amber L , Axelrod Mark , Pokhrel Yadu , Gasteyer Stephen , Lawrie Sean , Kendall Anthony D
Published: November 2023

Existing scholarship hypothesizes a causal chain from climate change to resource availability constraints, to forced migration and conflict risks. Limited research, however, synthesizes findings about the efficacy of interventions to alleviate resources conflict in communities hosting climate migrants. This systematic literature review identified and analyzed 33 studies that explore interventions contributing to climate conflict resolution and environmental peacebuilding in receiving and migrant communities. Despite limitations of current research, the review shows that multi-scale and cross-sectoral interventions are necessary though challenging to establish. Community-level initiatives and local support networks that create social capital are key interventions leading from conflict to cooperation between climate-driven migrants and host communities. However, such interventions often require external resources that come with strings attached. Our analysis also identifies gaps in the extant literature. First, few scholars explore how adaptive capacity—especially influenced by power relations among stakeholders in newly formed communities—evolves over time in response to multiple repeated threat factors. Second, there is limited research on whether and how external interventions can help climate refugees gain access rights to natural resources for long-term conflict avoidance. Finally, there is a lack of community-based performance evaluation metrics to assess long or short-term impacts of interventions.
A database and empirical model for earthquake post-loss amplification
Authors: Hoyos Maria Camila , Silva Vitor
Published: November 2023

The impact of destructive earthquakes might exceed the local capacity to cope with disasters and lead to an increase in the reconstruction costs. This phenomenon is commonly termed as post-loss amplification, and its main causes include the increase in the cost of construction materials and labor due to the sudden demand, the need to reconstruct following higher standards, or other unexpected costs. We reviewed 70 past earthquakes to identify events where post-loss amplification was observed, and collected a set of seismogenic, socio-economic, geographical, and impact variables for those events. Using this database, we developed two models to predict post-loss amplification, using a composite indicator that reflects the level of destruction in the region, or a parameter that characterizes the frequency of the event. This study indicates increased costs (>10%) for events where the economic losses exceed 1% of the regional gross domestic product, or for events with an estimated return period of at least 10 years. These models can be applied directly in the amplification of economic losses in earthquake scenarios or in probabilistic seismic risk assessment.
Perspectives of Teachers of Students With Visual Impairments and Orientation and Mobility Specialists During COVID-19
Authors: Schultz Jessica E. , Savaiano Mackenzie E.
Published: November 2023

The COVID-19 pandemic was unprecedented in scope and nature, altering everyday life for people across the United States. One major change involved how schools provided educational services. Prior to the pandemic, schools used in-person instruction as their service delivery model for educational and education-related services, such as services for the blind and visually impaired. To document the effects of this historic event, an exploratory survey through Qualtrics was conducted on the perceptions of (a) teachers of students with visual impairments and (b) orientation and mobility specialists in four categories: service delivery models, student demographics, instruction and engagement, and preparation and training. Percentages were calculated with closed questions, and open-ended responses were used to clarify the data. There were some significant post-hoc correlations between ability to provide educational services and instructional delivery models. The results have implications for practitioners and professionals working in higher education.
Febuxostat ameliorates muscle degeneration and movement disorder of the dystrophin mutant model in Caenorhabditis elegans
Authors: Yoshina Sawako , Izuhara Luna , Mashima Rei , Maejima Yuka , Kamatani Naoyuki , Mitani Shohei
Published: November 2023

Duchenne muscular dystrophy (DMD) is an inherited disorder with mutations in the dystrophin gene characterized by progressive muscle degeneration and weakness. Therapy such as administration of glucocorticoids, exon skipping of mutant genes and introduction of dystrophin mini-genes have been tried, but there is no radical therapy for DMD. In this study, we used C. elegans carrying mutations in the dys-1 gene as a model of DMD to examine the effects of febuxostat (FBX). We applied FBX to dys-1 mutant animals harboring a marker for muscle nuclei and mitochondria, and found that FBX ameliorates the muscle loss. We next used a severer model dys-1; unc-22 double mutant and found the dys-1 mutation causes a weakened muscle contraction. We applied FBX and other compounds to the double mutant animals and assayed the movement. We found that the administration of FBX in combination of uric acid has the best effects on the DMD model.
ATACAmp: a tool for detecting ecDNA/HSRs from bulk and single-cell ATAC-seq data
Authors: Cheng Hansen , Ma Wenhao , Wang Kun , Chu Han , Bao Guangchao , Liao Yu , Yuan Yawen , Gou Yixiong , Dong Liting , Yang Jian , Cai Haoyang
Published: November 2023

Background

High oncogene expression in cancer cells is a major cause of rapid tumor progression and drug resistance. Recent cancer genome research has shown that oncogenes as well as regulatory elements can be amplified in the form of extrachromosomal DNA (ecDNA) or subsequently integrated into chromosomes as homogeneously staining regions (HSRs). These genome-level variants lead to the overexpression of the corresponding oncogenes, resulting in poor prognosis. Most existing detection methods identify ecDNA using whole genome sequencing (WGS) data. However, these techniques usually detect many false positive regions owing to chromosomal DNA interference.

Results

In the present study, an algorithm called “ATACAmp” that can identify ecDNA/HSRs in tumor genomes using ATAC-seq data has been described. High chromatin accessibility, one of the characteristics of ecDNA, makes ATAC-seq naturally enriched in ecDNA and reduces chromosomal DNA interference. The algorithm was validated using ATAC-seq data from cell lines that have been experimentally determined to contain ecDNA regions. ATACAmp accurately identified the majority of validated ecDNA regions. AmpliconArchitect, the widely used ecDNA detecting tool, was used to detect ecDNA regions based on the WGS data of the same cell lines. Additionally, the Circle-finder software, another tool that utilizes ATAC-seq data, was assessed. The results showed that ATACAmp exhibited higher accuracy than AmpliconArchitect and Circle-finder. Moreover, ATACAmp supported the analysis of single-cell ATAC-seq data, which linked ecDNA to specific cells.

Conclusions

ATACAmp, written in Python, is freely available on GitHub under the MIT license: https://github.com/chsmiss/ATAC-amp. Using ATAC-seq data, ATACAmp offers a novel analytical approach that is distinct from the conventional use of WGS data. Thus, this method has the potential to reduce the cost and technical complexity associated ecDNA analysis.
Evaluation of a newly developed first aid training programme adapted for older people
Authors: Dolenc Šparovec Eva , Slabe Damjan , Eržen Ivan , Kovačič Uroš
Published: November 2023

Background

Older people need to acquire knowledge and skills at first aid (FA) training tailored to them. Our research aimed to evaluate an FA training programme adapted for older people. We assumed that satisfaction with FA training, as well as knowledge of FA, would be higher among older people who received training according to an adapted programme compared to those who received training according to the existing programme for the general public.

Methods

We trained older people according to the existing FA programme for the general public and according to a new FA training programme adapted for older people. The new training program is shorter and focuses on FA contents that are more relevant for older people. We evaluated participants with a general assessment questionnaire (consisting of items regarding satisfaction, comprehensibility, length, and physical difficulty), a test on theoretical FA knowledge, and a test on practical cardiopulmonary resuscitation (CPR) knowledge. To ensure the homogeneity of the groups and to verify the impact on the results of the test of practical CPR knowledge, we also tested the participants regarding their psychophysical capabilities.

Results

A total of 120 people completed the free FA training sessions. The general assessment questionnaire score of participants who were trained based on the new FA training program was 19.3 (out of 20), which was statistically significantly (p < 0.05) higher than that of those trained based on the old program (general assessment score of 17.1). Participants who were trained based on the new program scored an average of 8.6 points on the theoretical FA knowledge test, while those who were trained based on the old program scored an average of 7.1 points, which was statistically significantly (p < 0.05) lower. In both programs, the same average scores (7.5 out of 10 points) on the practical CPR knowledge test was achieved. However, participants who participated in the FA course adapted for the older people gained practical CPR knowledge in a shorter time. Older people with a greater psychophysical capacity were more successful in performing CPR, regardless of which FA training programme they received.

Conclusions

The effectiveness of FA training is greater if older people are trained in accordance with a targeted programme adapted to the psychophysical limitations of the older people.
Phase I non-randomized clinical trial of allogeneic natural killer cells infusion in acute myeloid leukemia patients
Authors: Ahmadvand Mohammad , Barough Mahdieh Shokrollahi , Barkhordar Maryam , Faridfar Ali , Ghaderi Afshin , Jalaeikhoo Hasan , Rajaienejad Mohsen , Majidzadeh Keivan , Ghavamzadeh Ardeshir , Sarrami-Forooshani Ramin
Published: November 2023

Introduction

A new type of immune cell transplantation called allogeneic NK cell infusion is proposed as a potential universal off-the-shelf cell product for adoptive immune cell therapy in hematologic malignancies.

Design

A multicentral phase I non-randomized clinical trial was conducted to assess the safety, feasibility, and potential efficacy of adoptively infused NK cells in patients with refractory/relapsed AML. We evaluated the feasibility of the trial by considering cell production, patient selection, and treatment protocol.

Method

Allogeneic NK cells were produced from random healthy unrelated donors; 10 patients were selected according to the inclusion criteria and were included in two groups in case of NK cell dose escalation. Two cell infusions were given, spaced 7 days apart, following a lymphodepletion conditioning regimen of fludarabin-endoxan administered 7 days before the first infusion. The intervention safety was scored using Common Terminology Criteria for Adverse Events (CTCAE) based on variations in vital signs due to cell infusion. NK cell chimerism, tumor burden, and duration of relapse were considered to be components of efficacy. The pilot feasibility evaluation was checked using the CONSORT platform.

Results

The NK cell infusion procedure was well tolerated, and no grade 2–5 toxicities related (possible or probable) to PB-NK cell infusion were observed. Four patients developed grade 1 transient chills, headaches, vomiting, and bone pain following each PB-NK cell infusion that were not required hospitalization. One of these patients (p01) died because of severe acute respiratory syndrome. Of 9 evaluable patients, 6 (66.6%) showed stable disease (SD) and 3 (33.3%) presented progressive disease (PD). Of 6 SD patients, 2 (p08 and p09) remained alive in SD and 3 patients (p04, p05 and p07) converted to PD at 9 months after infusion of NK cells, and 1 (p03) was not evaluable due to follow-up loss. No patient achieved complete remission.

Conclusion

The study demonstrated the feasibility and safety of adoptive transfer of random healthy unrelated donor PB-NK cells in refractory/relapsed AML patients and supports continued study in phase II clinical trials in relapsed/refractory AML patients.
Efficacy and safety of diphereline 11.25 mg, microrelin 11.25 mg, and microrelin 3.75 mg in premenopausal patients with breast cancer: a non-inferiority randomized clinical trial
Authors: Najafi Safa , Ansari Maryam , Omidi Zahra , Olfatbakhsh Asiie , Moghadam Shiva , Hashemi Esmat-o-Sadat , Najafi Niki , Haghighat Shahpar
Published: November 2023

Background

Diphereline is a Gonadotropin-Releasing Hormone agonist commonly used in patients with breast cancer. This study aimed to compare the efficacy and safety of one-month and three-month Microrelin injections produced by Homa Pharmed Company with three-month Diphereline injections manufactured by IPSEN, France.

Methods

The study was a non-inferiority randomized clinical trial conducted between 2019 and 2023 on premenopausal women candidates for endocrine therapy. The participants were randomly assigned in blocks of six to one of three groups named A (Diphereline 11.25 mg), B (Microrelin 11.25 mg), and C (Microrelin 3.75 mg). The participants’ menopausal symptoms, estradiol, and FSH serum levels were recorded in three-month intervals for one year. The efficacy of each medication and its side effects were compared among the three groups by statistical analysis during the one-year follow-up.

Results

The study included 133 patients with breast cancer. A decreasing trend in the serum levels of FSH and estradiol and an increasing trend of menopausal symptoms were recorded during the study. No specific side effects leading to drug disruption, hospitalization, or exclusion from the study were observed. Adjusting the effect of study group and time showed no significant changes in estradiol levels between groups B (p = 0.506) and C (p = 0.607) and group A. Also, serum FSH changes between groups B (p = 0.132) and C (p = 0.104) compared to group A were not significant. Moreover, the menopausal symptoms during the one-year follow-up did not significantly increase in group B (p = 0.108) and C (p = 0.113) compared to group A.

Conclusions

It can be concluded that injections of both Microrelin 11.25 mg and 3.75 mg, produced by Homa Pharmed, Iran, are non-inferior in terms of effectiveness and incidence of menopausal symptoms compared to Diphereline, manufactured by IPSEN, France.

Trial registration

IRCT.ir, IRCT20201227049847N1; Registered on 09/01/2021.
Morganella morganii and Enterococcus faecalis endophthalmitis following intravitreal injection
Authors: Kvopka Michael , Chan WengOnn , Baranage Duleepa , Sia David
Published: November 2023

Background

Endophthalmitis following intravitreal injection is a potentially devastating complication of anti-VEGF injections. Post-injection endophthalmitis due to Enterococcus faecalis is rare, and no previous case of Morganella morganii endophthalmitis after intravitreal injection has been reported.

Case presentation

We present the first reported case of Morganella morganii and Enterococcus faecalis endophthalmitis after intravitreal injection in an immunocompetent patient in the absence of recent ocular surgery. Our patient presented with hand movement visual acuity one day after anti-VEGF injection and demonstrated no clinical improvement despite repeated intravitreal ceftazidime and vancomycin injections. A decision was made to proceed with early vitrectomy given failure of intravitreal antibiotics. Visual acuity improved to 6/90 at 12 weeks after vitrectomy without any evidence of disease recurrence.

Conclusions

Post-injection endophthalmitis due to concurrent Morganella morganii and Enterococcus faecalis infections can have visually devastating consequences despite repeated empirical and targeted intravitreal antibiotics. Lack of clinical improvement following intravitreal antibiotics should warrant consideration of early vitrectomy. Our experience is a pertinent reminder of the ever-growing threat of uncommon and multi-resistant bacteria that must be considered when treating infections such as post-injection endophthalmitis.
Refractive and corneal astigmatism in Chinese 4–15 years old children: prevalence and risk factors
Authors: Zhang Luoli , Zeng Li , Ye Yuhao , Zhang Zhe , Liu Fang , Xian Yiyong , Shen Yang , Sun Ling , Xu Ye , Zheng Ke , Zhou Xingtao , Zhao Jing
Published: November 2023

Background

To investigate the prevalence and risk factors of refractive astigmatism (RA) and corneal astigmatism (CA) in preschool children and school-aged children in Shanghai, China.

Methods

In this school-based, cross-sectional study, 4–15 years old children across three learning stages of kindergarten, primary school, and junior high school underwent noncycloplegic autorefraction and completed comprehensive questionnaires involving time spent on daily homework and outdoor activities. Data from the right eyes were analysed.

Results

Overall, 7084 children (mean ± standard deviation (SD) of age: 8.08 ± 3.11 years) were included, and the prevalence rates of RA/CA ( ≤ − 1.0 D) in children were 15.8%/64% in kindergartens, 16.5%/65% in primary schools, and 32.8%/76.9% in junior high schools. The magnitude and prevalence of RA and CA all increased with age or with learning stage (all P < 0.001). The presence of RA was associated with more myopic spherical power (odds ratio (OR) 0.956, P = 0.021), junior high school (OR 1.973, P < 0.001), longer homework time on weekdays (OR 1.074, P = 0.029), and shorter outdoor activity time on weekends (odds ratio 0.929, P = 0.013).

Conclusion

In the wide age range of 4 to 15 years, the magnitude and prevalence of RA and CA increased with the learning stage, and these increases mainly began at the primary school stage. Factors, including longer homework time and shorter outdoor time were correlated with the presence of RA.
The relationship between parental health literacy levels and anthropometric measurements of children in Turkey
Authors: Aygun Ozcan , Topcu Mine
Published: November 2023

Objective

The aim of this study was to identify the relationship between parental health literacy levels and anthropometric measurements of children in Turkey.

Methods

The research was of cross-sectional/correlational design and carried out with 378 consenting parents registered at a Family Health Center. A Sociodemographic Data Form and the Health Literacy Scale for Turkey-32 was used to collect the study data. Data collection was completed at face-to-face interviews held in the consultation department of the family health center. The data were analyzed with the chi-square test and Ordinal Logistic Regression Analysis.

Results

It was determined that parental health literacy levels were associated with level of education, income status and the state of the parents’ employment (p < .05). A relationship was also found between adequate levels of parental health literacy and the health status, weight and height standard deviation scores by age of the parents’ children (p < .05).

Conclusion

This study found that adequate levels of parental health literacy were significantly lower than the European average. The study found that adequate parental health literacy had a positive effect on children’s anthropometric measurements. Health institutions and health professionals should plan training programs to improve the health literacy of parents when they apply to health institutions.
Establishing the health and wellbeing needs of mining host community in Brazil, Chile and Peru: a mixed-method approach to identify priority areas for action to help communities meet their SDG3 targets
Authors: Rice Brian , Buller Ana Maria , Boccia Delia , Bazan Cesar , Miranda Rafael , Cea Ximena , Laro Rodrigo , Fontes Miguel , Hayes Rosalie , de Wit Mariken , Carter Daniel J. , Plowright Alexandra , Chadwick Matthew , Gafos Mitzy
Published: November 2023

Background

The global mining industry is an important partner in advancing the 2030 Agenda for Sustainable Development. In 2018, Anglo American plc published their Sustainable Mining Plan, containing a goal for improving health and wellbeing aligned with the Sustainable Development Goal 3 (SDG3) targets. Having formed an independent multidisciplinary research consortium, we designed and implemented a mixed-methods approach to attain a deeper understanding of SDG3 priorities within the local context of communities hosting Anglo American mining operations located in Latin America.

Methods

In 2019, within the host communities of three mining operations in Chile, three in Brazil, and one in Peru, we conducted a qualitative study which included stakeholder workshops and key informant interviews. We also quantitatively appraised existing health data. Findings emerging from the qualitative and quantitative assessments were compared to identify health and wellbeing priority areas for action relevant to each community.

Results

Across the three countries, 120 people took part in workshops and 35 in interviews. In these workshops and interviews, non-communicable diseases (SDG3.4), harmful alcohol consumption (SDG3.5), and pollution, particularly air pollution (SDG3.9), were consistently identified as areas for priority action. There were similarities in the reporting of individual, interpersonal, community, societal, and structural factors underlying these priority areas across the different communities. The availability of quantitative data was generally good at the state level, becoming increasing sparse as we focused on smaller geographies. The priorities identified in the quantitative assessments generally aligned with those highlighted in the qualitative data.

Conclusions

We highlight the importance of engaging with local populations to understand and address health needs. To address the priorities identified, intervention packages tailored to the specific needs of host communities, that tackle associated upstream societal level factors, are required. To facilitate this, appropriate monitoring systems and epidemiological investigations should be implemented to better understand the local context and quantify health issues. In the host communities, it is essential for the mining sector to be a key health partner in promoting integrated programmes that contribute to achieving the priority objectives and targets aligned with the SDG3 agenda.
Trends in mortality from non-natural causes in children and adolescents (0–19 years) in Europe from 2000 to 2018
Authors: Tunesi Sara , Tambuzzi Stefano , Decarli Adriano , Cattaneo Cristina , Russo Antonio Giampiero
Published: November 2023

Background

Non-natural mortality in children and adolescents is a global public health problem that varies widely from country to country. Data on child and adolescent maltreatment are not readily available, and mortality due to violent causes is also underestimated.

Methods

Injury-related mortality rates (overall and by specific causes) from 2000 to 2018 in selected European countries were analysed to observe mortality patterns in children and adolescents using data from the Eurostat database. Age-standardized mortality rates per 100,000 person-years were calculated for each country. Joinpoint regression analysis with a significance level of 0.05 and 95% confidence intervals was performed for mortality trends.

Results

Children and adolescent mortality from non-natural causes decreased significantly in Europe from 10.48 around 2005 to 5.91 around 2015. The Eastern countries (Romania, Bulgaria, Poland, Slovakia, Czech Republic) had higher rates; while Spain, Denmark, Italy, and the United Kingdom had the lowest. Rates for European Country declined by 5.10% per year over the entire period. Larger downward trends were observed in Ireland, Spain and Portugal; smaller downward trends were observed for Eastern countries (Bulgaria, Czech Republic, Poland, Slovakia) and Finland. Among specific causes of death, the largest decreases were observed for accidental causes (-5.9%) and traffic accidents (-6.8%).

Conclusions

Mortality among children and adolescents due to non-natural causes has decreased significantly over the past two decades. Accidental events and transport accidents recorded the greatest decline in mortality rates, although there are still some European countries where the number of deaths among children and adolescents from non-natural causes is high. Social, cultural, and health-related reasons may explain the observed differences between countries.
Partnering for change (P4C) in Sweden- a study protocol of a collaborative school-based service delivery model to create inclusive learning environments
Authors: Baric Vedrana B. , Yngve Moa , Holmefur Marie , Feldman Inna , Wilder Jenny , Johansen Kine , Klang Nina , Lidström Helene , Borgestig Maria
Published: November 2023

Background

Inclusive learning environments are considered as crucial for children’s engagement with learning and participation in school. Partnering for change (P4C) is a collaborative school-based service delivery model where services are provided at three levels of intensity based on children’s needs (class, group-, individual interventions). Interventions in P4C are provided universally to support all children with learning, not only children with special education needs (SEN), and as such are expected to be health-promoting.

Aim

The aim of the study is to evaluate the effectiveness and cost-effectiveness of P4C as well as school staff members’ and children’s experiences after P4C.

Methods

In a parallel, non-randomised controlled intervention design, 400 children, aged 6–12 years, and their teachers, will be recruited to either intervention classes, working according to the P4C, or to control classes (allocation ratio 1:1). Data will be collected at baseline, post-intervention (4 months), and 11 months follow-up post baseline. The primary outcome is children’s engagement with learning in school. Secondary outcomes include for example children’s health-related quality of life and wellbeing, occupational performance in school, attendance, and special educational needs. The difference-in-differences method using regression modelling will be applied to evaluate any potential changes following P4C. Focus group interviews focusing on children, and professionals’ experiences will be performed after P4C. A health economic evaluation of P4C will be performed, both in the short term (post intervention) and the long term (11-month follow-up). This study will provide knowledge about the effectiveness of P4C on children’s engagement with learning, mental health, and wellbeing, when creating inclusive learning environments using a combination of class-, group- and individual-level interventions.

Trial registration number

NCT05435937.
Fear of movement was associated with sedentary behaviour 12 months after lumbar fusion surgery in patients with low back pain and degenerative disc disorder
Authors: Jakobsson Max , Hagströmer Maria , Lotzke Hanna , von Rosen Philip , Lundberg Mari
Published: November 2023

Background

Movement behaviours, such as sedentary behaviour (SB) and moderate to vigorous physical activity (MVPA), are linked with multiple aspects of health and can be influenced by various pain-related psychological factors, such as fear of movement, pain catastrophising and self-efficacy for exercise. However, the relationships between these factors and postoperative SB and MVPA remain unclear in patients undergoing surgery for lumbar degenerative conditions. This study aimed to investigate the association between preoperative pain-related psychological factors and postoperative SB and MVPA in patients with low back pain (LBP) and degenerative disc disorder at 6 and 12 months after lumbar fusion surgery.

Methods

Secondary data were collected from 118 patients (63 women and 55 men; mean age 46 years) who underwent lumbar fusion surgery in a randomised controlled trial. SB and MVPA were measured using the triaxial accelerometer ActiGraph GT3X+. Fear of movement, pain catastrophising and self-efficacy for exercise served as predictors. The association between these factors and the relative time spent in SB and MVPA 6 and 12 months after surgery was analysed via linear regression models, adjusting for potential confounders.

Results

Preoperative fear of movement was significantly associated with relative time spent in SB at 6 and 12 months after surgery (β = 0.013, 95% confidence interval = 0.004 to 0.022, p = 0.007). Neither pain catastrophising nor self-efficacy for exercise showed significant associations with relative time spent in SB and MVPA at these time points.

Conclusions

Our study demonstrated that preoperative fear of movement was significantly associated with postoperative SB in patients with LBP and degenerative disc disorder. This finding underscores the potential benefits of preoperative screening for pain-related psychological factors, including fear of movement, preoperatively. Such screenings could aid in identifying patients who might benefit from targeted interventions to promote healthier postoperative movement behaviour and improved health outcomes.
Replantation of lamina spinous process ligament complex and miniature titanium plate shaping internal fixation in the treatment of tumors in the spinal canal
Authors: Dai Guohua , Zhang Min , Su Weiliang , Zhao Jiaqing , Yu Xiankai , Sun Zhaozhong , Dou Yongfeng , Geng Xiaopeng
Published: November 2023

Objective

Purpose This study aims to explore the clinical efficacy of laminospinous process ligament complex reimplantation combined with mini-titanium plate fixation in the treatment of thoracolumbar intraspinal tumors.

Methods

A retrospective analysis was performed on 43 cases of intraspinal tumors treated with thoracolumbar intraspinal tumor resection from August 2018 to March 2021, and 27 cases underwent laminospinous process ligament complex reimplantation combined with micro titanium plate shaping. Fixation (laminar replantation group), and 16 patients underwent laminectomy combined with pedicle screw internal fixation (laminectomy group). The operation time, blood loss, drainage tube removal time, cerebrospinal fluid leakage, spinal instability, and the incidence of secondary spinal stenosis were compared between the two groups. The pain VAS score, ODI score, and modified Macnab at the last follow-up were compared between the two groups. And the laminar fusion rate of the laminoplasty group was measured.

Results

Both groups successfully completed the surgery and obtained complete follow-up. The incidence of cerebrospinal fluid leakage and secondary spinal canal stenosis in the laminectomy group was lower than that in the laminectomy group, and the difference was statistically significant (P < 0.05). There was no statistically significant difference in the incidence of spinal instability between the two groups (P > 0.05). The operation time and intraoperative blood loss in the laminectomy group were less than those in the laminectomy group, and the drainage tube removal time was earlier than that in the laminectomy group. The difference was statistically significant (P < 0.05). At the final follow-up, there was no statistically significant difference in the pain VAS score, ODI score, and modified Macnab between the two groups (P > 0.05), but they were all significantly improved compared with preoperative ones. Fusion evaluation was conducted on the laminoplasty group. Two years after surgery, the fusion rate was 97.56% (40/41).

Conclusions

The application of laminospinous process ligament complex reimplantation combined with mini titanium plate fixation during thoracolumbar intraspinal tumor resection can effectively reconstruct the spinal canal and posterior column structure, reduce the incidence of cerebrospinal fluid leakage and secondary spinal stenosis. The laminar fusion rate is high.