bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of asinine gammaherpesviruses in association with pulmonary fibrosis in free-ranging donkeys
Authors: Maboni Grazieli , Kelly E. Jane , Clancy Chad S. , De Luca Eliana , Baldwin Thomas J. , Van Wettere Arnaud J. , Kane Albert J. , Peterson Summer , Warr V. Gus , Bastian Dona A. , Sanchez Susan
Published: October 2021

A mortality event among recently captured feral donkeys ( Equus asinus) occurred in south-central Utah in 2016. The deaths were sporadic, and clinical signs were indicative of respiratory disease, likely associated with an infectious etiology. Ten of 13 donkeys autopsied had moderate-to-severe interstitial fibrosing pneumonia, and one had pyogranulomatous pneumonia. Consensus PCRs directed toward the DNA polymerase and DNA packaging terminase subunit 1 for herpesviruses were performed followed by sequencing of the PCR amplicons and phylogenetic analysis. Asinine herpesvirus 4 (AsHV4) and 5 (AsHV5) were consistently identified in lung tissues of affected donkeys. No other herpesviruses were identified, and herpesviral DNA was not detected in lung tissues of 2 donkeys without evidence of respiratory disease. The detection of asinine gammaherpesviruses may have been associated with the lesions described. AsHV4 and AsHV5 have been reported in previous studies as novel gammaherpesviruses based on sequences obtained from donkeys with interstitial pneumonia and marked syncytial cell formation. Our findings suggest that the association of asinine gammaherpesviruses with respiratory conditions in equids deserves further attention.
On the Triumphs and Limits of Platonism: A Trinitarian Account
Authors: Korb Samuel J.
Published: October 2021

Beginning with Augustine’s remark that he discovered the Logos of God in the Platonists, I consider how a certain trinitarian sensibility is endemic to Platonism that might be particularly helpful for working out a trinitarian theology. In particular, the Platonic axiom that the Good is generative and self-diffusive, especially in its Plotinian form, where the Good is considered an infinite power of generation, represents a point of contact between the best of Neoplatonic metaphysics and orthodox trinitarian thinking. At the same time, however, the Platonic insight ultimately fails outside a trinitarian context, where alone the infinite goodness and power of God are secured. Special attention is given to Dionysius the Areopagite and Bonaventure both for showing the great link between Neoplatonism and trinitarian Christianity and for exposing the incoherence of the Platonic account without the requisite trinitarian translation and transformation.
An Empirical Examination of Representational Equity in Consolidated Governments, 1965–2002
Authors: Acuff Christopher
Published: October 2021

Research on the impacts of city–county consolidation often focuses on issues relating to efficiency, effectiveness, and economic development; yet, relatively few studies have addressed the issue of racial and ethnic minority representation. Although existing research is limited, findings indicate that consolidating city and county governments dilutes minority voting strength and has a disparate impact on minority representation. However, it is not clear if this is a nationwide trend, particularly in preclearance states previously covered by the Voting Rights Act. Thus, the question becomes, does consolidation negatively affect minority representation, and to what extent? This study employs a quasi-experimental interrupted time-series analysis to ascertain the overall impact of consolidation on the descriptive representation of African Americans since 1965. Results indicate that while descriptive representation has generally increased in recent decades, there are discernible declines following consolidation and noticeable representational disparities in counties previously covered by the Voting Rights Act.
Measuring and Explaining Stalled Gentrification in Newark, New Jersey: The Role of Racial Politics
Authors: Morel Domingo , Drake Rodriguez Akira , Sidney Mara , Garay Nakeefa Bernard , Straub Adam
Published: October 2021

Gentrification research focuses on timing and variation; how the racial makeup of cities and neighborhoods influences its extent; and the policies that foster or combat it. Most examines places with continuing or recent gentrification and majority-White leadership, such as New York City and San Francisco. We build on this by analyzing a majority-Black city where fear of gentrification is increasing, but gentrification is not widespread. To analyze Newark, NJ, a city with longstanding Black leadership, we adapt widely used measures to show that gentrification started but stalled during the 2000s. We examine whether policies explain this, and whether the racial politics of the city's majority-Black population and leadership play a role. Our findings suggest that mayoral administrations took similar, growth-driven approaches, except that the current mayor is the first to place “fighting gentrification” onto the agenda. We end by considering how the politics of race shape the politics of gentrification.
Effect of capsular tension ring implantation during phacoemulsification on postoperative refraction
Authors: Belov Dmitrii , Nikolaenko Vadim , Potemkin Vitaly
Published: October 2021

Purpose

To assess refractive outcomes of phacoemulsification (PE) with additional capsular tension ring (CTR) implantation.

Material and methods

In total, 37 eyes of 37 patient who underwent PE with intraocular lens (IOL) implantation were divided into 2 groups: study group (n = 18) with CTR co-implantation (inclusion criteria was preoperative irido-phacodonesis) and control group (n = 19) without CTR. Optical biometry (IOL-Master 500) was performed for each patient before PE. Barrett Universal II Formula was used for IOL calculation. IOL power calculation error was assessed by comparing target refraction and final refraction measured by Topcon-8800 autorefractometer 1 month after surgery.

Results

Despite almost identical preoperative values in both groups refractive result was different. Patients with CTR co-implantation had more hyperopic IOL power calculation error of 0.41 ± 0.52 D versus 0.04 ± 0.59 D in the control group (p = 0.043). Postoperative spherical equivalent in study group was more hyperopic (−0.40 ± 1.47 D) than in control group (−0.77 ± 1.24), nevertheless, this difference was insignificant ( p = 0.166).

Conclusion

CTR co-implantation in patients with weak zonules and preoperative irido-phacodonesis leads to more hyperopic IOL power calculation error compared with control group.
Factors associated with general practitioners’ contacts with sick-listed patients’ employers: A Swedish nationwide questionnaire study
Authors: Nordling Paula , Alexanderson Kristina , Hensing Gunnel , Lytsy Per
Published: October 2021

Background: General practitioners’ (GP) contacts with sick-listed patients’ employers have been shown to be of importance for return to work. This study aimed to explore GPs’ contacts with sick-listed patients’ employers and factors associated with such contacts. Methods: In this cross-sectional study, 4228 GPs responded to a nationwide questionnaire about sickness certification (SC) practices. Outcomes of interest were participation in stakeholder meetings, having other contacts with employers, and satisfaction with employer contacts. Logistic regression models were used to investigate associations with factors related to the GP and the GP’s workplace. Results: Among GPs, 34.8% participated in stakeholder meetings and 15.1% had other employer contacts; 39.4% had any or both of these contacts. Of GPs who had contacts with patients’ employers, 65.8% were satisfied with the contacts. GPs regularly collaborating with rehabilitation coordinators had the strongest adjusted odds ratio (OR) for participating in stakeholder meetings, OR 2.72 (95% confidence interval (CI) 2.24–3.31), and having other contacts with employers, OR 3.85 (95% CI 2.85–5.21). Other factors positively associated with employer contacts were being a specialist, collaborating with other health professionals, finding employer contacts valuable, and having a joint SC routine/policy at the clinic. GPs who did not find SC problematic, had managerial support, or had enough resources for SC tasks were more likely to be satisfied with their employer contacts. Conclusions: Both physician characteristics and organizational factors had importance for GPs’ contacts with sick-listed patients’ employers. The findings imply that GPs’ collaboration with patients’ employers may be improved by interventions targeting both individual and organizational factors.
Diesel Engine 2-Stroke Breathing for Aftertreatment Warm-Up
Authors: Foster John L , Vos Kalen , Joshi Mrunal C , Shaver Gregory M , McCarthy James , Holloway Eric , Farrell Lisa
Published: October 2021

Since the introduction of diesel urea SCR technology, aftertreatment thermal management has become critical for maintaining SCR catalyst light-off and thereby low cumulative cycle NOx emissions. A novel diesel engine aftertreatment thermal management strategy is proposed which utilizes a 2-stroke breathing variable value actuation strategy to increase the mass flow rate of exhaust gas. Experiments showed that when emissions are constrained to the same level as a state-of-the-art thermal management strategy, 2SB does not increase heat transfer to aftertreatment. However, if constraints are allowed to flex, temperatures comparable to a state-of-the-art thermal management calibration could be achieved with a 1.75× exhaust mass flow rate, potentially helping heat the SCR catalyst in a cold-start scenario.
Peer Support for People Living With HIV: A Scoping Review
Authors: Øgård-Repål Anita , Berg Rigmor C. , Fossum Mariann
Published: October 2021

Peer support for people living with HIV has gained increasing traction and is considered a way to take an active role in self-management. The existing research examining peer support interventions has reported promising evidence of the benefits of peer support. The purpose of our scoping review was to describe research on peer support for people living with HIV. We included 53 studies and sorted them into analytic categories and conducted descriptive analyses. The studies that were published between November/December 2000 and May 2021, had a range of study designs and heterogeneous priority groups, and included 20,657 participants from 16 countries. We identified 43 evaluations of the effect of peer support and 10 evaluations of implementation, process, feasibility, cost of peer support. We also categorized peer support by key functions, finding that the most common key functions were linkage to clinical care and community resources and assistance in daily management, with only one study directly related to chronic care. There is growing research interest in peer support for people living with HIV, particularly in high-income countries and related to the evaluation of effects. The revealed gaps of prioritized functions of peer support have implications for further research. Further focus on interventions addressing secondary prevention related to noncommunicable diseases as part of a care package is recommended to meet people’s needs and preferences and increase self-management related to a chronic lifelong condition.
COVID-19 Behaviors and Beliefs Toward Immunizations among College Students in Lima, Peru
Authors: Cuellar Norma G. , Lacey Micayla , Remuzgo Artezano Anika , Zegers Carli , Mariñas Acevedo Orfelina , Williams Jhonnel S. J. , Mendigure Juan , Moran Parades Gladys I.
Published: October 2021

Introduction: Peru has experienced one of the highest rates of COVID-19 with only 27% of the population vaccinated. College students must make decisions on vaccination based on their belief and knowledge about immunizations. The purpose of this study was to describe COVID-19 behaviors and beliefs toward immunization among college students in Lima, Peru. Methods: Undergraduate students from Universidad Maria Auxiliadora (UMA) participated in this descriptive study. The CDC National 2009 H1N1 Flu Survey was adapted to measure behaviors and beliefs about immunizations of COVID-19. Results: 818 students participated in the study during the 2020 academic year. Significant differences were identified about taking vaccine when it was available by age ( p = .02), gender ( p < .001), marital status ( p = .004), and income ( p = .002). Significant associations were found between participants’ ethnicity and location of last vaccination ( p < .001) and race and reason to not receive the COVID-19 vaccine ( p < .001). Conclusions: Peruvian students under the age of 32 are not eligible for the COVID-19 at this time. Findings can prepare academic institutions to promote education about the vaccine in this age group who have unique barriers in receiving health care and vaccinations.
GU-CA-COVID: a clinical audit among Italian genitourinary oncologists during the first COVID-19 outbreak
Authors: Bersanelli Melissa , Buti Sebastiano , Rizzo Mimma , Cortellini Alessio , Cattrini Carlo , Massari Francesco , Masini Cristina , Vitale Maria Giuseppa , Fornarini Giuseppe , Caffo Orazio , Atzori Francesco , Gatti Alice , Macrini Serena , Mucciarini Claudia , Galli Luca , Morelli Franco , Stellato Marco , Fanelli Martina , Corti Francesca , Zucali Paolo Andrea , Toscani Ilaria , Dalla Volta Alberto , Gernone Angela , Baldessari Cinzia , La Torre Leonardo , Zara Diego , Gennari Alessandra , Bracarda Sergio , Procopio Giuseppe , Porta Camillo
Published: October 2021

Background:

Considering the growing genitourinary (GU) cancer population undergoing systemic treatment with immune checkpoint inhibitors (ICIs) in the context of the COVID-19 pandemic, we planned a clinical audit in 24 Italian institutions treating GU malignancies.

Objective:

The primary objective was investigating the clinical impact of COVID-19 in GU cancer patients undergoing ICI-based therapy during the first outbreak of SARS-CoV-2 contagion in Italy.

Design, setting, and participants:

The included centers were 24 Oncology Departments. Two online forms were completed by the responsible Oncology Consultants, respectively, for metastatic renal cell carcinoma (mRCC) and metastatic urothelial carcinoma (mUC) patients receiving at least one administration of ICIs between 31 January 2020 and 30 June 2020.

Results and limitation:

In total, 287 mRCC patients and 130 mUC patients were included. The COVID-19 incidence was, respectively, 3.5%, with mortality 1%, in mRCC patients and 7.7%, with mortality 3.1%, in mUC patients. In both groups, 40% of patients developing COVID-19 permanently discontinued anticancer treatment. The pre-test SARS-CoV-2 probability in the subgroup of patients who underwent nasal/pharyngeal swab ranged from 14% in mRCC to 26% in mUC. The main limitation of the work was its nature of audit: data were not recorded at the single-patient level.

Conclusion:

GU cancer patients undergoing active treatment with ICIs have meaningful risk factors for developing severe events from COVID-19 and permanent discontinuation of therapy after the infection. Treatment delays due to organizational issues during the pandemic were unlikely to affect the treatment outcome in this population.
Psychometric Properties of the COVID-19 Protective Motivation Scale in Peruvians During the Health Emergency
Authors: Cornejo Bruno , Vela Brayan , Vilca Lindsey W. , Vallejos María , Huancahuire-Vega Salomón
Published: October 2021

Objective:

The COVID-19 protective motivation scale (EMP-COVID-19) has been developed for the assessment of protective motivation. This study aims to examine the psychometric properties of the EMP-COVID-19 for its application in the Peruvian community.

Methods:

This is an observational, cross-sectional, instrumental design study, 483 adults (≥18 years) participated in the study, in 2 samples of 81 and 402 participants from the different macro-regions of Peru through an online survey using non-probabilistic sampling. Content validation was performed through expert judgment. Exploratory factor analysis (EFA) to evaluate the factor model of the EMP-COVID-19 was performed with the first sample. The confirmatory factor analysis (CFA) to verify the goodness of fit of the analysis found in the EFA was performed with the second sample. The examination of convergent and discriminant validity included peer evaluations of each EMP-COVID-19 dimension. Finally, the reliability of the instrument was evaluated using Cronbach’s Alpha coefficient.

Results:

The 3-factor related model presents better fit indices (CFI = 0.99; TLI = 0.99; RMSEA = 0.077 [90% CI 0.069-0.085]) versus a unidimensional model (CFI = 0.91; TLI = 0.90; RMSEA = 0.206 [90% CI 0.199-0.213]). The scale present convergent and discriminant validity in all the dimensions Threat Appraisal (AVE = .57), Coping Appraisal (AVE = .81), and Response Costs (AVE = .67). The Coping Appraisal (α = .97; ω = .97), Threat Appraisal (α = .88; ω = .74), and Response Costs (α = .80; ω = .76) dimensions were also found to have adequate reliability indices.

Conclusions:

The EMP-COVID-19 scale demonstrated adequate reliability and validity based on internal structure in the study sample.
Does Economic Freedom in Host Countries Lead to Increased Non-Life Insurance Development?
Authors: Lee Hui Shan , Chong Shyue Chuan , Yap Shen , Sia Bik Kai , Chen Ying Xi
Published: October 2021

The journey to reinforce connectivity between China and ASEAN-5 through the Belt and Road Initiative (BRI) presents various risks and non-life insurance development opportunities. This research investigates the factors that affect non-life insurance development in China and ASEAN-5. This study has offered novel evidence highlighting the impacts of trade variables and a multidimensional economic freedom measure consisting of nine components on non-life insurance development. Panel regression results indicate that trade and the BRI itself are decisive factors that stimulate insurance development. Higher economic freedom, however, has a negative influence on non-life insurance development. In terms of policy implications, regulatory interventions represent a more practical way to enhance the resilience and development of the non-life insurance sector to accomplish the BRI goals.
Internet survey on factors associated with care-seeking behaviours of people with chronic musculoskeletal pain in Japan
Authors: Sugai Keiko , Tsuji Osahiko , Takahashi Shoko , Matsumoto Morio , Nakamura Masaya , Fujita Nobuyuki
Published: October 2021

Purpose: Many people with chronic musculoskeletal pain (CMP) seek healthcare from conventional and complementary and alternative medicine. However, treatment/therapy is not always adequate, patients often change healthcare providers, and some patients are left untreated. This study clarified care-seeking behaviours and explored factors behind the behaviours in people with CMP. Methods: Using a Japanese cross-sectional online survey, participants aged ≥ 20 years with non-cancer/fracture CMP lasting for ≥ 6 months and presenting ≤1 month, interfering with daily living activities and/or work were enrolled. We summarized and analysed the characteristics and factors associated with choice of healthcare providers; information on socio-demographics, including employment; ability to use healthcare, including income; and need for healthcare, including pain intensity, using a logistic regression model. Results: Among the 9105 respondents, 24.5% consulted physicians, 18.3% complementary and alternative medicine practitioners, and 57.2% were untreated. More respondents who had moderate–severe pain visited physician, more regularly employed and with high income visited complementary and alternative medicine, and less respondents who had moderate–severe pain were untreated. These were found to be associated with the respective healthcare use versus untreated. Conclusions: People with severe conditions, higher income and regular employment, and less severe conditions have visited physicians, complementary and alternative medicine practitioners and none, respectively. By applying this result at each type of healthcare provider, it may be possible to treat patients more appropriately.
Unique Severe HyperEkplexia-Like Apneic Events (SHELAE) Improved by High-Dose Piracetam
Authors: Krishnappa Janardhan , Ngoh Adeline , Hong Yeo Tong , ChunLiang Chen , Derrick Chan Wei Shih
Published: October 2021

Breath-holding spells are common non-epileptic events with onset between 6 months and 18 months of age that are usually triggered by minor painful events or strong emotions. Symptomatic treatments for breath-holding spells include iron supplementation, glycopyrrolate and piracetam. Hyperekplexia is a rare non-epileptic disorder characterized by generalized hypertonia and exaggerated startle. Prolonged stiffening triggered by startle can lead to desaturation, cardiac asystole and sudden infant death. It is commonly treated with Clonazepam and other anti-epileptic drugs. Piracetam has been reported to be effective in some anecdotal cases. We describe a case of an infant with frequent hyperekplexia-like breath-holding events who failed to respond adequately to glycopyrrolate, pace-maker insertion and clonazepam, who had marked improvement in his symptoms with high dose Piracetam. High dose Piracetam should be considered in infants with similar severe hyperekplexia-like/breath-holding events as it may be beneficial in ameliorating the acute and chronic course in these children.
The disconnect between visual assessment of air trapping and lung physiology for assessment of small airway disease in scleroderma-related interstitial lung disease: An observation from the Scleroderma Lung Study II Cohort
Authors: Bae Sangmee Sharon , Pourzand Lila , Hyun Kim Grace , Villegas Bianca E , Oh Andrea , Furst Daniel E , Goldin Jonathan , Tashkin Donald P
Published: October 2021

Objective:

To explore the presence of small airway disease (SAD) and emphysema in scleroderma-related interstitial lung disease (SSc-ILD) and to evaluate the physiologic and clinical correlates of SAD in SSc-ILD.

Methods:

Thoracic high-resolution computed tomography (HRCT) images obtained from the Scleroderma Lung Study II (SLSII) participants were reviewed by a group of thoracic radiologists. The presence of SAD was assessed by visual assessment for air trapping. HRCT scans were also evaluated for the presence of emphysema. The association of the presence of air trapping and emphysema with physiological measures of airway disease and clinical variables was evaluated.

Results:

A total of 155 baseline HRCT scans were reviewed. For assessment of air trapping, images needed to be adequate end-expiratory examinations, leaving 123 scans. Air trapping was seen in 13/123 (10.6%) of the SSc-ILD cohort and was independent of smoking history, asthma or the presence of gastroesophageal reflux. Air trapping on HRCT was not associated with physiologic evidence of SAD. We also identified 8/155 (5.2%) patients with emphysema on HRCT, which was independent of SAD and found mostly in prior smokers.

Conclusion:

We report the first study of air trapping on standardized, high-quality HRCT images as a reflection of SAD in a relatively large, well characterized SSc-ILD cohort. The presence of SAD in non-smoking SSc-ILD patients supports that SSc may cause not only restrictive lung disease (SSc-ILD), but also, to a lesser extent, obstructive disease. Physiologic measures alone may be inadequate to detect airway disease in patients with SSc-ILD.
The evolution of endoscopic therapy for Barrett’s esophagus
Authors: Condon Ashwinee , Muthusamy V. Raman
Published: October 2021

Barrett’s esophagus is the condition in which a metaplastic columnar epithelium replaces the stratified squamous epithelium that normally lines the distal esophagus. The condition develops as a consequence of chronic gastroesophageal reflux disease and predisposes the patient to the development of esophageal adenocarcinoma. The diagnosis and management of Barrett’s esophagus have undergone dramatic changes over the years and continue to evolve today. Endoscopic eradication therapy has revolutionized the management of dysplastic Barrett’s esophagus and early esophageal adenocarcinoma by significantly reducing the morbidity and mortality associated with the prior gold standard of therapy, esophagectomy. The purpose of this review is to highlight current principles in the management and endoscopic treatment of this disease.
Feasibility and acceptability of a peer youth led curriculum to improve HIV knowledge in Northern Tanzania: resilience and intervention experience from the perspective of peer leaders
Authors: Hosaka Kalei R. J. , Mmbaga Blandina T. , Gallis John A. , Dow Dorothy E.
Published: October 2021

Background

Youth Living with HIV (YLWH) have reduced adherence to antiretroviral therapy (ART) and worse virologic outcomes compared to children and adults. HIV peer youth led (PYL) interventions contribute to improved retention in care and psychosocial wellbeing. The study objective was to assess the feasibility and acceptability of a PYL HIV curriculum and describe change in participants’ knowledge and impact of leadership on peer leaders’ lives.

Methods

An HIV curriculum was taught during monthly Saturday adolescent HIV clinics at two clinical sites in Moshi, Tanzania (2018–2019). Youth attending clinics were ages 12 to 24 years and received the HIV curriculum during routine clinical care. Peer leaders previously participated in a mental health and life skills intervention called Sauti ya Vijana (The Voice of Youth; SYV) and were recommended for leadership by SYV facilitators and clinic staff. Peer leaders were trained and supervised weekly in curriculum delivery using a “train the trainer” model. Data were collected and analyzed using mixed methods. Fidelity checklists were used to measure adherence to the curriculum. Youth participants answered written pre- and post-knowledge questions and evaluated PYL teaching. Semi-structured interviews and the Connor Davidson Resilience scale were conducted with peer leaders before and after assuming the leadership role.

Results

Peer leaders (N = 4 male; 3 female) demonstrated high fidelity (96%) to activities in each lesson and participant feedback was positive for curriculum delivery. Participants’ knowledge improved in nine of ten sessions. All but one leader—who moved away before the study ended—demonstrated stable or improved resilience with a mean difference of 3.8 (SD = 7.0) from before the intervention to after assuming the leadership role. Peer leaders reported improved leadership confidence and resilience, and their perception was that the curriculum helped normalize the HIV experience for YLWH attending clinic. Nevertheless, anticipated stigma, difficulty disclosing HIV status, and teaching ability remained barriers.

Conclusions

This study demonstrated that a PYL curriculum to improve HIV knowledge integrated into routine adolescent HIV clinic in Tanzania was feasible, acceptable, and improved knowledge while also benefiting peer leaders, thus providing evidence to continue to support efforts to scale and sustain PYL interventions for YLWH.
Psychological responses and associated factors during the initial stage of the coronavirus disease (COVID-19) epidemic among the adult population in Poland - a cross-sectional study
Authors: Sozański Bernard , Ćwirlej-Sozańska Agnieszka , Wiśniowska-Szurlej Agnieszka , Jurek Krystian , Górniak Patryk , Górski Karol , Englert-Bator Anna , Perenc Lidia
Published: October 2021

Introduction

The study aimed to assess the emotional state, the occurrence of symptoms of depression, anxiety, and stress, as well as the quality of life of adults living in Poland during the first weeks of the COVID-19 pandemic.

Method

The study was conducted on a group of 700 people aged 18 and over living in Poland. An anonymous online questionnaire was used in this cross-sectional study. The psychological impact of COVID-19 was measured using the Revised Event Impact Scale (IES-R) and the Depression, Anxiety, and Stress Scale (DASS - 21). The quality of life was assessed using the WHOQOL-BREF.

Results

In Poland, a high average level of post-traumatic stress was found as a result of the COVID-19 pandemic, with at least the minimum level occurring in all surveyed people. There was also a high incidence of depression (48.00%), anxiety (39.29%), and stress (54.86) in the first phase of the pandemic. The average level of quality of life in Poland was the lowest for the physical domain and amounted to 49.56 (SD = 11.71). The standard of living in the psychological domain was 60.26 (SD = 13.14).

Conclusions

The pandemic is having a significant impact on human mental health. The very high average levels of post-traumatic stress, stress, anxiety, and depression as well as low quality of life make it necessary to consider interventions that will favor the use of more adaptive defense mechanisms and build mental resilience during an infectious disease pandemic and its long-term consequences.
Understanding multidisciplinary care for people with rheumatic disease in British Columbia, Canada, through patients, nurses and physicians voices: a qualitative policy evaluation
Authors: Apantaku Glory , Aguiar Magda , Kaal K. Julia , Munro Sarah , Teo Michelle , Harrison Mark
Published: October 2021

Background

In 2011, the province of British Columbia (BC) moved to allow patients with complex rheumatic disease to be seen by nurses along with their rheumatologist by introducing a ‘Multidisciplinary Care Assessments’ (MCA) billing code (G31060).

Objective

To describe multidisciplinary care introduced as part of MCAs across BC and investigate the perceived impact of this intervention, the addition of nurses to the care team, on patient care from the perspective of patients, nurses, and rheumatologists.

Methods

We conducted semi-structured interviews, informed by a qualitative evaluation approach with patients, nurses, and rheumatologists from September 2019 – August 2020. Interviews investigated 1) the experiences of all stakeholders with adopting the multidisciplinary care billing code, 2) the perceived role of the nurse in the care team, and 3) the perceived impact of multidisciplinary care on patient experience and outcomes. We purposefully sampled practices for maximum variation of geographical location (rural vs. urban), size of practice (i.e., patient caseload), and number of nurses employed.

Results

We interviewed 21 patients, 13 nurses, and 12 rheumatologists from across BC. Our analysis identified variation in the way rheumatologists adopted multidisciplinary care across BC. Our analysis showed some heterogeneity in the way the MCA was delivered in rheumatology practices; however, patient education was identified as the core role of nurses across practices. We identified six core themes describing the impact of this model of care, all representing improvements in the way practices functioned, from improved efficiency to access, patient experience, time management, clinician experience, and patient health outcomes. Contextual factors that influenced the presence of these themes were related to the time the nurses spent with patients and the professional roles they performed.

Conclusion

Our results suggest nurse care can complement physician care by extending contact time for patients and promoting the efficient use of health care professionals’ skills, time, and resources. These data may encourage future uptake of the billing code to help ensure the policy delivers maximum benefits to patients given the wide range of perceived benefits described by clinicians and patients.
In-hospital COVID-19 infection echocardiographic analysis: a Brazilian, tertiary single-centre experience
Authors: Vieira Marcelo Luiz Campos , Afonso Tania Regina , Oliveira Alessandra Joslin , Stangenhaus Carolina , Dantas Juliana Cardoso Dória , de França Lucas Arraes , Daminelo Edgar , Cordovil Adriana , Martins Lara A. S. , Meirelles Rodrigo A. C. , Piveta Rafael B. , Barros-Gomes Sérgio , Aguiar Miguel O. D. , Roveri Patrícia O. , Oliveira Wércules A. , Lianza Alessandro C. , Ponchirolli Andrea P. L. , Silva Líria M. L. , Costa Rodrigo C. P. L. , Fischer Cláudio H. , Morhy Samira Saady
Published: October 2021

Background

Information is lacking concerning in-hospital echocardiography analysis of COVID-19 infection in Brazil. We evaluated echocardiographic parameters to predict a composite endpoint of mortality, pulmonary thromboembolism or acute renal failure.

Methods

A prospective full echocardiographic study of consecutive patients hospitalized with COVID-19, single tertiary centre in Brazil. We correlated echocardiographic findings to biomarkers, clinical information, thoracic tomography, and in-hospital composite endpoint of mortality, pulmonary thromboembolism or renal failure.

Results

One hundred eleven patients from March to October 2020, 67 ± 17 years, 65 (58.5%) men, death was observed in 21/111 (18.9%) patients, 48 (43%) required mechanical ventilation, myocardial infarction occurred in 10 (9%), pulmonary thromboembolism in 7 (6.3%) patients, haemodialysis was required for 9 (9.8%). Echocardiography was normal in 51 (46%) patients, 20 (18%) presented with decreased left ventricle ejection, 18 (16.2%) had abnormal left ventricle global longitudinal strain, 35 (31%) had diastolic dysfunction, 6 (5.4%) had an E/e’ratio > 14, 19 (17.1%) presented with right ventricle dilated/dysfunction, 31 (28%) had pericardial effusion. The echocardiographic parameters did not correlate with mortality, biomarkers, clinical events. Tricuspid velocity was related to the composite endpoint of mortality, pulmonary thromboembolism or acute renal failure (p: 00.3; value: 2.65 m/s; AUC ROC curve: 0.739; sensitivity: 73.3; specificity: 66.7; CI: 0.95, inferior: 0.613; superior: 0,866).

Conclusions

Among hospitalized patients with COVID-19, echocardiography was normal in 51(46%) patients, and 20 (18%) patients presented with a decreased left ventricle ejection fraction. Tricuspid velocity was related to the composite endpoint of mortality, pulmonary thromboembolism or acute renal failure.
Estimation of the global number of e-cigarette users in 2020
Authors: Jerzyński Tomasz , Stimson Gerry V. , Shapiro Harry , Król Grzegorz
Published: October 2021

Background

The combustion of tobacco is the main cause of tobacco-related morbidity and mortality. E-cigarettes are potentially disruptive innovations with considerable potential for population health. A key question is whether e-cigarettes are replacing tobacco cigarettes, which requires mapping their prevalence. Collecting information on nicotine use is difficult for many countries due to cost. The objective of this study was to derive a global estimate of e-cigarette use (vaping).

Methods

Since 2018 we have collected information on the prevalence of e-cigarette use. To estimate the prevalence of vaping in countries lacking information, we used the method of assumed similarity between countries in the same region and economic condition. Based on surveys, we calculated the average prevalence of vaping for each WHO region, World Bank income classification group, and the legal status of e-cigarettes in each country. For each of these groups the average prevalence of vaping was calculated. These values were used as substitutes for the prevalence figures in the countries with absent data. The number of vapers was calculated by taking as the denominator the adult population.

Results

Survey data on e-cigarette users were available for 49 countries covering 2.8 b of the adult population in 2018 and unavailable for 2.9 b. Information on vaping was lacking for half of the world's population. We estimated a total of 58.1 m vapers worldwide in 2018. By reference to market growth the data were adjusted to arrive at estimates for 2020. Results were fitted to revenue data at the 2018. For the year 2020, the projection is for 68 m vapers globally.

Conclusions

Many global epidemiological studies use the method of assumed similarity between countries with shared characteristics in order to estimate missing data. The methodological limitations are likely to overestimate the global number of vapers. Our estimate of 68 m vapers indicates considerable uptake given that: e-cigarettes have been available on most markets for only a decade; there is either no support, or there is opposition to vaping in many countries; and countries which regulate e-cigarettes have controls over advertising and promotion. However, given the global scale of tobacco smoking (at 1.1 billion people), progress in adoption of alternative products is slow. Those using e-cigarettes are still a small fraction of those who smoke.
Updated distribution maps of predominant Culex mosquitoes across the Americas
Authors: Gorris Morgan E. , Bartlow Andrew W. , Temple Seth D. , Romero-Alvarez Daniel , Shutt Deborah P. , Fair Jeanne M. , Kaufeld Kimberly A. , Del Valle Sara Y. , Manore Carrie A.
Published: October 2021

Background

Estimates of the geographical distribution of Culex mosquitoes in the Americas have been limited to state and provincial levels in the United States and Canada and based on data from the 1980s. Since these estimates were made, there have been many more documented observations of mosquitoes and new methods have been developed for species distribution modeling. Moreover, mosquito distributions are affected by environmental conditions, which have changed since the 1980s. This calls for updated estimates of these distributions to understand the risk of emerging and re-emerging mosquito-borne diseases.

Methods

We used contemporary mosquito data, environmental drivers, and a machine learning ecological niche model to create updated estimates of the geographical range of seven predominant Culex species across North America and South America: Culex erraticus, Culex nigripalpus, Culex pipiens, Culex quinquefasciatus, Culex restuans, Culex salinarius, and Culex tarsalis.

Results

We found that Culex mosquito species differ in their geographical range. Each Culex species is sensitive to both natural and human-influenced environmental factors, especially climate and land cover type. Some prefer urban environments instead of rural ones, and some are limited to tropical or humid areas. Many are found throughout the Central Plains of the USA.

Conclusions

Our updated contemporary Culex distribution maps may be used to assess mosquito-borne disease risk. It is critical to understand the current geographical distributions of these important disease vectors and the key environmental predictors structuring their distributions not only to assess current risk, but also to understand how they will respond to climate change. Since the environmental predictors structuring the geographical distribution of mosquito species varied, we hypothesize that each species may have a different response to climate change.

Graphical abstract
Drivers of global media attention and representations for antimicrobial resistance risk: an analysis of online English and Chinese news media data, 2015–2018
Authors: Liao Qiuyan , Yuan Jiehu , Dong Meihong , Paterson Pauline , Lam Wendy Wing Tak
Published: October 2021

Background

How antimicrobial resistance (AMR) risk is communicated in news media can shape public understanding and the engagement of different sectors with AMR. This study examined online news media attention for AMR risk and analyzed how AMR risk was communicated using a global sample of English and Chinese news articles.

Methods

A total of 16,265 and 8335 English and Chinese news relevant to AMR risk, respectively, published in 2015–2018 were retrieved from a professional media-monitoring platform, to examine media attention for AMR and its drivers, of which, 788 articles from six main English-speaking countries and three main Chinese-speaking territories were drawn using constructed-week sampling for content analysis.

Results

Media attention mainly fluctuated around official reports or scientific discovery of AMR risks or solutions but seldom around reports of inappropriate antimicrobial use (AMU), and not consistently increased in response to World Antimicrobial Awareness Week. The content analysis found that (1) heterogeneous medical terminologies and the ‘superbug’ frame were most commonly used to define AMR or AMR risk; (2) a temporal increase in communicating microbial evolution as a process of AMR was identified but communication about inappropriate AMU in general consumers as the cause of AMR remained inadequate; and (3) the multifaceted consequences of AMR and individual actions that can be taken to tackle AMR were inadequately communicated.

Conclusions

The media should be encouraged or reoriented to communicate more about actions that can be taken by general consumers to enable collective actions and the multifaceted conseuqences of AMR to encourage one-health approach for tackling AMR.
Protective effects of some antioxidants against long-term intake of aspartame toxicity on liver and kidney: biochemical and histopathological approach in rats
Authors: Abdel-ghaffar Sary Kh. , Adly Mohamed Araf , El-Sayed Mohamed F. , Abd-Elsamei Walaa Magdy
Published: October 2021

Background

Aspartame is used to treat obesity, and the diabetic people could induce changes in liver and kidney structures and function. Garlic extract, melatonin and thymoquinone have an important role against aspartame toxicity due to their antioxidant properties. The current study was designed to examine the protective effects of garlic, melatonin and thymoquinone against aspartame-induced hepatorenal toxicity in albino rates.

Results

The results indicated that aspartame induced changes in the serum levels of liver parameters function (glucose, ALT, AST and ALP) and renal parameters function (urea and creatinine). Garlic, melatonin and thymoquinone reversed the values of liver and kidney enzymes levels near to or similar to that of control. The histopathological effects of aspartame on the histological structures of liver and kidney were either reduced or removed by garlic, melatonin and thymoquinone.

Conclusion

Long-term (6 months) administration of aspartame induced toxic effects on hepatorenal function and structure, whereas garlic, melatonin and thymoquinone resulted in hepatorenal ameliorative and protective effects.
Astronomical causes of climate change. Milanković–Bacsák cycle and the
last ice age
Authors: Hágen András
Published: October 2021

György Bacsák, a Hungarian polyhistor, was born 150 years ago and died
50 years ago. He played an important role in refining and further developing
the Milanković cycle. Milanković's theory describes the effect of changes in
Earth's movements on the climate. The theory came from its creator, Milutin
Milanković, a Serbian geophysicist and astronomer. The Serbian scientist was
imprisoned in the Austro-Hungarian Monarchy during World War I as a citizen
of a hostile state. He developed his theory in the library of the Hungarian
Academy of Sciences. Understanding the essence of the theory, György Bacsák
enjoyed the theoretical support of Milanković in the form of regular
correspondence between 1938 and 1955. In total, György Bacsák wrote 56
letters to Milutin Milanković, while the Serbian scholar wrote 10 letters,
all of which can be found in the Library of the Hungarian Academy of
Sciences. The language of the letters was German, since both Bacsák and
Milanković spoke German fluently. Three articles from György Bacsák, from
the year 1940, were published in the Magazine “Weather” and a part of his
book “Earth’s history of the last 600,000 years” was published in 1944 both
of them were based on this letter exchange.
Studying the growth characteristics of urban trees using an example from Szeged, Hungary
Authors: Kacsova Csenge , Kiss Márton , Gulyás Ágnes
Published: October 2021

The spatial expansion of urbanised areas and the steady increase in the urban population, as well as climate change trends, are increasing the need for the development of adequate urban green infrastructure. The social demand for combating climate change is accompanied by the revaluation of green spaces, and in this context woody vegetation plays a key role. In a changing climatic context and under intense anthropogenic stress, the challenge of developing a tree population that is climate-friendly and resistant to disturbance is a major one. In our research, we investigate all growth parameters of the newly planted trees from the start of a street reconstruction involving a complete tree replacement (Gutenberg Street, Szeged). The structural analysis of the revealed not only the growth rate over the 8 years since planting, but also the significant differences between the two sides of the street. In order to find a possible reason for this, we examined (using SAGA GIS software) potential incoming solar radiation of the street, which could explain the significant difference in growth rate. The data collected also provided an opportunity to analyse the allometric relationships. This will partly allow the prediction of the growth rate and can provide baseline data for planning and decision-making processes in the dilemma of whether to retain older trees or plant new stocks.
Phytochemistry and medicinal properties of Psidium guajava L. leaves: A review
Authors: Bulugahapitiya Vajira P , Kokilananthan Shanthirasekaram , Manawadu Harshi , Gangabadage Chinthaka Sanath
Published: October 2021

Psidium guajava L. (Myrtaceae), also known as guava, is a medicinal tree native to tropical America that has been introduced and is widely available in many countries. Almost all plant parts of P. guajava have a long history of being used to treat a variety of ailments, in addition to applications as foods. Guava leaves are used as both medicine and food purposes, and there are numerous scientific reports on their medicinal uses, chemical composition and pharmacological properties. Cancer, blood pressure, diarrhea, bowel irregularities, diabetes, cough, cold, constipation, dysentery, scurvy, weight loss, improves skins tonicity are some of the diseases treated with guava leaves. Polyphenols, flavonoids, saponins, tannins, terpenoids, glycosides, flavones, cardiac glycosides, cardenolides, phlobatanins, steroids and other classes of bioactive compounds have been identified from the leaves. The primary chemical constituents of guava leaves are phenolic compounds, iso-flavonoids, gallic acid, catechin, quercetin, epicathechin, rutin, naringenin, kaempferol, caryophyllene oxide, p-selinene etc. Several studies have demonstrated its pharmacological activities including antioxidant, antimicrobial, antidiabetic, antitumor, anticancer, antidiarrheal, healing, cytotoxic, hepatoprotective, anti-inflammatory, antimalarial/ anti-plasmodial, dental plaque, antiglycative and many more. This review is aimed on compiling all the literature reported on pharmacological activities and phytochemical compositions of guava leaves as a support to the scientific community for further studies and to provide scientific data to validate its traditional uses.