bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel approach for scleral fixation using Carlevale lens
Authors: Fiore Tito , Messina Marco , Muzi Alessio , Lupidi Marco , Reibaldi Michele , Giansanti Fabrizio , Cagini Carlo
Published: January 2021

Purpose:

To evaluate the surgical outcomes and feasibility of a novel approach for scleral-fixation using a single-piece acrylic foldable Carlevale lens (Soleko).

Methods:

Eighteen eyes of 18 patients with aphakia, dislocated IOL, subluxated lens, anisometropia, perforated trauma, and retinal detachment who underwent IOL implantation with a Carlevale lens were evaluated. All the patients underwent a standard ophthalmologic examination. Anterior segment (AS)-OCT was used postoperatively to check plugs positioning and IOL tilt.

Results:

Mean patients age was 73 ± 19 years. Mean follow-up was 11.2 ± 4.1 months. Mean axial length was 23.7 ± 1.65 mm, white-to-white distance was 11.74 ± 0.40 mm, and axial length was 23.67 ± 1.65 mm. Refractive spherical equivalent prediction error was −0.31 ± 0.71D. Mean IOL tilt was 2.2° ± 1.6° and plugs were placed within the sclera. Five patients had aphakia, five in-the-bag IOL subluxation, three in-the-bag IOL luxation, one high residual myopia after previous verisyse implant, one Uveitis-Glaucoma-Hyphema syndrome, one perforating trauma with phacodonesis, one intraocular foreign body and retinal detachment, two lens subluxation. One eye developed cystoid macular edema which disappeared with topical steroids and FANS. No other complications were observed throughout the follow-up.

Conclusion:

Carlevale lens (Soleko) appears to be a viable option for both anterior and posterior segment surgeons in the management of complex cases providing less challenging maneuvers which lead to a good lens self-centration and minimal risk of haptic rupture and/or dislocation. The lens seems to offer a good compartmentalization between the anterior and posterior chamber reducing the risk of an inflammatory response.
Age is just a number: Is frailty being ignored in vascular access planning for dialysis?
Authors: Kuningas Kulli , Inston Nicholas
Published: January 2021

Current international guidelines advocate fistula creation as first choice for vascular access in haemodialysis patients, however, there have been suggestions that in certain groups of patients, in particular the elderly, a more tailored approach is needed. The prevalence of more senior individuals receiving renal replacement therapy has increased in recent years and therefore including patient age in decision making regarding choice of vascular access for dialysis has gained more relevance. However, it seems that age is being used as a surrogate for overall clinical condition and it can be proposed that frailty may be a better basis to considering when advising and counselling patients with regard to vascular access for dialysis. Frailty is a clinical condition in which the person is in a vulnerable state with reduced functional capacity and has a higher risk of adverse health outcomes when exposed to stress inducing events. Prevalence of frailty increases with age and has been associated with an increased risk of mortality, hospitalisation, disability and falls. Chronic kidney disease is associated with premature ageing and therefore patients with kidney disease are prone to be frailer irrespective of age and the risk increases further with declining kidney function. Limited data exists on the relationship between frailty and vascular access, but it appears that frailty may have an association with poorer outcomes from vascular access. However, further research is warranted. Due to complexity in decision making in dialysis access, frailty assessment could be a key element in providing patient-centred approach in planning and maintaining vascular access for dialysis.
Art, culture and paradox pedagogy in management learning: The case of Portuguese fado
Authors: Simpson Ace Volkmann , Berti Marco , Cunha Miguel Pina e , Clegg Stewart
Published: January 2021

We propose a reawakening of interest in the role of artistic knowing for managerial education, presenting a pedagogy that is sensitive to cultural context and aimed at enabling the phronetic management of paradox. Inspired by fado, the iconic Portuguese popular music, especially the ways in which it embodies the stresses of society, we develop strategies for management learning based on engagement with art that fosters sensitivity to paradox. We contribute to management learning by inviting practitioners to be sensitive to the complexity of competing tensions in the cultures and language in and through which everyday lives are lived by bringing attention to the potential of artistic knowing for highlighting and navigating management paradoxes, to develop phronesis.
Preschool teachers and caregivers’ lack of repositioning in response to changed responsibilities in policy documents
Authors: Cervantes Sara , Öqvist Anna
Published: January 2021

Preschool teachers and caregivers have a close working relationship as part of a working team to benefit the children in Swedish preschools. In 2011, a new educational reform was introduced according to which preschools became a school form in their own right within the overall educational system in Sweden. The objective of the policy was to strengthen the profession of preschool teachers by affording them clearer responsibility over the quality of educational practices and curriculum work. It also entailed a division of labour between the preschool teachers and caregivers in the working team. The current study explored how Swedish preschool teachers and caregivers positioned themselves in response to these changes in responsibility. In this qualitative study, data were collected from 17 preschool teachers and caregivers via an open-ended questionnaire. Preschool teachers and caregivers viewed themselves as having equal responsibility in the working team. Specifically, preschool teachers upgraded the competence and position of caregivers while downgrading their own professional competence and position. Caregivers downgraded the profession and position of preschool teachers and upgraded their own competence and position to be equal to that of preschool teachers.
Practical Methodological Reform Needs Good Theory
Authors: Gervais Will M.
Published: January 2021

In the face of unreplicable results, statistical anomalies, and outright fraud, introspection and changes in the psychological sciences have taken root. Vibrant reform and metascience movements have emerged. These are exciting developments and may point toward practical improvements in the future. Yet there is nothing so practical as good theory. This article outlines aspects of reform and metascience in psychology that are ripe for an injection of theory, including a lot of excellent and overlooked theoretical work from different disciplines. I review established frameworks that model the process of scientific discovery, the types of scientific networks that we ought to aspire to, and the processes by which problematic norms and institutions might evolve, focusing especially on modeling from the philosophy of science and cultural evolution. We have unwittingly evolved a toxic scientific ecosystem; existing interdisciplinary theory may help us intelligently design a better one.
Clinicopathological characteristics and long-term prognosis of monoclonal immunoglobulin light chain associated Fanconi syndrome
Authors: Chen Zhixin , Li Jiaying , Shi Xiaoxiao , Wang Ying , Xia Peng , Ye Wei , Ye Wenling , Qin Yan , Li Hang , Li Mingxi , Li Xuemei , Wen Yubing , Chen Limeng
Published: January 2021

Background and aims:

Monoclonal immunoglobulin light chain associated Fanconi syndrome (LC-FS) is a rare disease that involves proximal tubules. As most of the reported cases came from western countries, we aimed to analyze the clinicopathological characteristics of Asian LC-FS and its treatment responses to chemotherapy.

Methods:

A total of 26 LC-FS patients in a single-center were retrospectively studied.

Results:

At diagnosis, the mean age of the 26 Asian LC-FS patients was 54.7 ± 14.7 years, with females accounting for 57.7%. They presented with different degrees of proximal tubular dysfunctions with normoglycemic glycosuria (88.0%), hyperphosphaturia (84.2%) and aminoaciduria (84.0%) as the most common features. The mean estimated glomerular filtration rate (eGFR) was (68.0 ± 26.4) ml/min per 1.73 m2. After chemotherapy, renal response was achieved in 58.3% cases, which was accompanied by hematological response, and tubular response was acquired in 66.7% cases. During 3 years of follow-up, the eGFR levels significantly decreased in the monoclonal gammopathy of renal significance patients, few of whom (21.4%) had received chemotherapy.

Conclusion:

Asian LC-FS patients had mild renal function disorder. The chemotherapy could improve both renal and tubular functions, which may be related to the hematological response.
Risk evaluation of ballistic penetration by small caliber ammunition of live-fire shoot house facilities with comparison to numerical and experimental results
Authors: Davis Brad Gregory , Thompson Jacob , Morningstar William , McCool Ean , Peri Vishnu , Davidson F. Todd
Published: January 2021

The development of advanced small caliber weapon systems has resulted in rounds with more material penetration capabilities. The increased capabilities may mean that existing live-fire facilities will no longer be adequate for the training and certification of military and law enforcement personnel. Constraints on training in many live-fire shoot house facilities are already in place, with some allowing only single round impact during training. With little understanding of the probability of perforation, or failure, of existing containment systems, this study evaluates risk by studying the single round impact of small caliber ammunition against live-fire shoot house containment systems constructed from AR500 steel panels with two-inch ballistic rubber covering. An analytical and numerical study was conducted using an existing model for steel penetration developed by Alekseevskii-Tate and the EPIC finite element code. A modified form of the advancing cavity model for the ballistic resistance of the target material was used to account for the relatively unconfined material resulting from the studied impacts. These results are then compared to experimental tests conducted by Goodman for rounds of various small calibers impacting live-fire facility containment systems. Projectile and target characteristics were then modeled as continuous random variables, and Monte Carlo simulations were conducted using the validated analytical model to estimate the probability of a single round impact perforating the live-fire facility containment system. An importance sampling scheme was used to reduce the variance of the solution and provide a more accurate estimate of the probability of failure. The Alekseevskii-Tate model was found to provide accurate estimates of the depth of penetration when compared to experimental and numerical results at ordnance velocities and an estimate of the probability of failure is on the order of 1x10-5. This study provides useful tools for the analysis of existing live-fire facilities against future and existing ammunition, and for the design of new facilities. When coupled with Monte Carlo simulation techniques, a risk-based approach to certify live-fire facilities for use with any variety of small arms ammunition can be applied.
The virus of fear and anxiety: China, COVID-19, and the Australian media
Authors: Sun Wanning
Published: January 2021

This article analyses Australian media’s coverage of China’s efforts to contain COVID-19. The article is a critical discourse analysis of the major news stories, documentaries, opinions, and analyses published in the entire array of Australian media, including both television and radio programs from the taxpayer-funded public broadcaster the ABC, commercial media outlets such as Murdoch’s The Australian newspaper and Nine Entertainment’s The Sydney Morning Herald, and several tabloid papers. By identifying the key themes, perspectives, and angles used in these reports and narratives, this article finds that the more credible media outlets have mostly framed China’s efforts in political and ideological terms, rather than as an issue of public health. In comparison, the tabloid media—including commercial television, shock jock radio, and newspapers—have resorted to conspiratorial, racist, and Sino-phobic positions. In both instances, the coverage of China’s experience is a continuation and embodiment of the “China threat” and “Chinese influence” discourses that have now dominated the Australian media for a number of years.
“Looking for Better (Job) Opportunities”: A Qualitative Analysis of the Occupational Health of Immigrants in Southern Spain
Authors: de Diego-Cordero Rocío , Romero-Saldaña Manuel , Jigato-Calero Ana , Badanta Bárbara , Lucchetti Giancarlo , Vega-Escaño Juan
Published: January 2021

Background:

Spain hosts the fourth largest number of immigrants in Europe, resulting in a large proportion of migrant workers. To date, few studies have examined the working conditions of immigrants in Southern Spain who are known to be at risk for adverse working conditions. This study aimed to investigate the patterns of work and working conditions of immigrants living in southern Spain and to understand how these factors may affect their health.

Methods:

A qualitative study using semi-structured interviews was conducted throughout 2019 and included 93 immigrants. Transcription, literal reading, and theoretical categorization were performed and a narrative content analysis was carried out.

Results:

Three themes emerged on working conditions of this study population, including social and labor-related characteristics, working conditions, and occupational health issues. Four employment sectors were most commonly occupied by these immigrants, including caregiving and food service for women and agriculture and construction for men. Most immigrants were from Latin America, unemployed or working part-time jobs, and not hired under an employment contract. Most worked in low-qualified jobs, and were exposed to occupational hazards such as falls from heights, manual handling of materials, and psychological strain. The lack of training on occupational risk prevention and labor rights was related to a low identification of work situations having a negative impact on the health of immigrants.

Conclusions/Application to Practice:

These findings should be taken into account by the government and public health managers to provide better assistance to immigrant workers in Europe.
Caretaker Perceptions About Self-cutting in Institutionalised Adolescents: A Comparison Between Cutters and Non-cutters
Authors: Kumar K. Raghavendra , Rajendra K. M. , Seshadri Shekhar P. , Girimaji Satish Chandra , Srinath Shoba , Sagar John Vijay
Published: January 2021

Background:

Studies are sparse on caretaker perceptions about self-cutting (SC) in institutionalised adolescents.

Methods:

Five caretakers in a shelter home for adolescent girls were interviewed and the data were analysed using interpretative phenomenological analysis.

Results:

Nine major themes emerged: expected reactions from others led to secrecy; reasons were relational and academic difficulties; benefits were control of emotions/thoughts or to get others’ attention; learning happened by witnessing and change in thinking; challenges were systemic contagion, counselling repeaters of SC and adolescent infatuation; responses were ‘we are empathetic’ and ‘friends are helpful, but have a limit’; goals for self and reflection were helpful to stop SC; vulnerabilities were lack of skills and problems faced; and protective factors were good skills and family relations. These novel findings contribute to the existing sparse literature and are useful for gaining a deeper understanding about and better management of SC.
Adapting to Teaching During a Pandemic: Pedagogical Adjustments for the Next Semester of Teaching During COVID-19 and Future Online Learning
Authors: Hickling Siobhan , Bhatti Alexandra , Arena Gina , Kite James , Denny Justin , Spencer Nancy L. I. , Bowles Devin C.
Published: January 2021

COVID-19 has altered public health higher education and its impact on pedagogy will be felt long into the future. In response to social distancing measures, teaching academics implemented a number of changes to curricula. It is important to better understand and begin to evaluate these changes, as well as set a course for future changes to public health curricula both during and after the pandemic to best enable transformative learning. Teaching academics have an understanding of academic hierarchies and student perceptions and are well placed to provide insights into current and future changes to pedagogy in response to the pandemic. A survey was developed to examine changes that academics had made to their teaching in response to COVID-19. Responses were received from 63 public health teaching academics from five universities in Australia, the United States, and Canada. Public health teaching academics rapidly implemented a number of changes to their teaching, including alterations that enabled online teaching. The great majority of changes to teaching were related to tools or techniques, such as synchronous tutorials delivered in a video meeting room. There remains further work for the public health pedagogy community in reevaluating teaching aims and teaching philosophies in light of the COVID-19 pandemic. This could include examination of the weighting of different topics, including communicable diseases, in curricula. A series of questions to assist academics reformulating their curricula is provided. Public health teaching evolved rapidly to meet the challenges of COVID-19; however, ongoing adaptation is necessary to further enhance pedagogy.
Self-organizing maps with variable neighborhoods facilitate learning of chromatin accessibility signal shapes associated with regulatory elements
Authors: Eicher Tara , Chan Jany , Luu Han , Machiraju Raghu , Mathé Ewy A.
Published: January 2021

Background

Assigning chromatin states genome-wide (e.g. promoters, enhancers, etc.) is commonly performed to improve functional interpretation of these states. However, computational methods to assign chromatin state suffer from the following drawbacks: they typically require data from multiple assays, which may not be practically feasible to obtain, and they depend on peak calling algorithms, which require careful parameterization and often exclude the majority of the genome. To address these drawbacks, we propose a novel learning technique built upon the Self-Organizing Map (SOM), Self-Organizing Map with Variable Neighborhoods (SOM-VN), to learn a set of representative shapes from a single, genome-wide, chromatin accessibility dataset to associate with a chromatin state assignment in which a particular RE is prevalent. These shapes can then be used to assign chromatin state using our workflow.

Results

We validate the performance of the SOM-VN workflow on 14 different samples of varying quality, namely one assay each of A549 and GM12878 cell lines and two each of H1 and HeLa cell lines, primary B-cells, and brain, heart, and stomach tissue. We show that SOM-VN learns shapes that are (1) non-random, (2) associated with known chromatin states, (3) generalizable across sets of chromosomes, and (4) associated with magnitude and multimodality. We compare the accuracy of SOM-VN chromatin states against the Clustering Aggregation Tool (CAGT), an unsupervised method that learns chromatin accessibility signal shapes but does not associate these shapes with REs, and we show that overall precision and recall is increased when learning shapes using SOM-VN as compared to CAGT. We further compare enhancer state assignments from SOM-VN in signals above a set threshold to enhancer state assignments from Predicting Enhancers from ATAC-seq Data (PEAS), a deep learning method that assigns enhancer chromatin states to peaks. We show that the precision-recall area under the curve for the assignment of enhancer states is comparable to PEAS.

Conclusions

Our work shows that the SOM-VN workflow can learn relationships between REs and chromatin accessibility signal shape, which is an important step toward the goal of assigning and comparing enhancer state across multiple experiments and phenotypic states.
Circulating MicroRNA-486 and MicroRNA-146a serve as potential biomarkers of sarcopenia in the older adults
Authors: Liu Huang-Chun , Han Der-Sheng , Hsu Chih-Chin , Wang Jong-Shyan
Published: January 2021

Background

Age-related sarcopenia meaningfully increases the risks of functional limitations and mortality in the older adults. Although circulating microRNAs (c-miRNAs) are associated with aging-related cellular senescence and inflammation, the relationships between c-miRNAs and sarcopenia in the older adults remain unclear. This study investigates whether circulating myo-miRNAs and inflammation-related miRNAs are associated with sarcopenia in the older adults.

Methods

This investigation recruited 77 eligible subjects (41 males and 36 females) from 597 community-dwelling older adults, and then divided them into normal (n = 24), dynapenic (loss of muscular function without mass, n = 35), and sarcopenic groups (loss of muscular function with mass, n = 18). Moreover, myo- (c-miRNA-133a and c-miRNA-486) and inflammation- (c-miRNA-21 and c-miRNA-146a) related miRNAs, as well as, inflammatory-related cytokine and peroxide levels in plasma were determined using quantitative polymerase chain reaction and ELISA, respectively.

Results

Sarcopenic group exhibited lesser skeletal muscle mass index (SMI), handgrip strength, and gait speed, as well as, lower c-miR-486 and c-miR-146a levels, compared to those of normal and dynapenic groups. Moreover, c-miR-486 level was positively related to SMI (r = 0.334, P = 0.003), whereas c-miR-146a level was positively associated with SMI (r = 0.240, P = 0.035) and handgrip strength (r = 0.253, P = 0.027). In the receiver operating characteristic analysis for predicting sarcopenia, the area under the curve in c-miR-486 was 0.708 (95% confidence interval: 0.561–0.855, P = 0.008) and c-miR-146a was 0.676 (95% CI: 0.551–0.801, P = 0.024). However, no significant relationships were observed between SMI/handgrip strength/gait speed and plasma myeloperoxidase/interleukin-1훽/interleukin-6 levels.

Conclusions

Myo-miRNA (c-miR-486) and inflammation-related miRNA (c-miR-146a) are superior to inflammatory peroxide/cytokines in plasma for serving as critical biomarkers of age-related sarcopenia.
Geriatric assessment and intervention in older vulnerable patients undergoing surgery for colorectal cancer: a protocol for a randomised controlled trial (GEPOC trial)
Authors: Dolin Troels G. , Mikkelsen Marta , Jakobsen Henrik L. , Nordentoft Tyge , Pedersen Trine S. , Vinther Anders , Zerahn Bo , Vistisen Kirsten K. , Suetta Charlotte , Nielsen Dorte , Johansen Julia S. , Lund Cecilia M.
Published: January 2021

Background

The incidence of colorectal cancer (CRC) increases with age. Older patients are a heterogeneous group ranging from fit to frail with various comorbidities. Frail older patients with CRC are at increased risk of negative outcomes and functional decline after cancer surgery compared to younger and fit older patients. Maintenance of independence after treatment is rarely investigated in clinical trials despite older patients value it as high as survival. Comprehensive geriatric assessment (CGA) is an evaluation of an older persons’ medical, psychosocial, and functional capabilities to develop an overall plan for treatment and follow-up. The beneficial effect of CGA is well documented in the fields of medicine and orthopaedic surgery, but evidence is lacking in cancer surgery. We aim to investigate the effect of CGA on physical performance in older frail patients undergoing surgery for CRC.

Methods

GEPOC is a single centre randomised controlled trial including older patients (≥65 years) undergoing surgical resection for primary CRC. Frail patients (≤14/17 points using the G8 screening tool) will be randomised 1:1 to geriatric intervention and exercise (n = 50) or standard of care along (n = 50) with their standard surgical procedure. Intervention includes preoperative CGA, perioperative geriatric in-ward review and postoperative follow-up. All patients in the intervention group will participate in a pre- and postoperative resistance exercise programme (twice/week, 2 + 12 weeks). Primary endpoint is change in 30-s chair stand test. Assessment of primary endpoint will be performed by physiotherapists blinded to patient allocation. Secondary endpoints: changes in health related quality of life, physical strength and capacity (handgrip strength, gait speed and 6 min walking test), patient perceived quality of recovery, complications to surgery, body composition (Dual-energy X-ray absorptiometry and bioelectric impedance), serum biomarkers, readmission, length of stay and survival.

Discussion

This ongoing trial will provide valuable knowledge on whether preoperative CGA and postoperative geriatric follow-up and intervention including an exercise program can counteract physical decline and improve quality of life in frail CRC patients undergoing surgery.

Trial registration

Prospectively registered at Clinicaltrials.gov NCT03719573 (October 2018).
Self-rated health among people living with HIV in Spain in 2019: a cross-sectional study
Authors:   on behalf of the Hospital Survey Study Group, Ruiz-Algueró Marta , Hernando Victoria , Marcos Henar , Gutiérrez Gonzalo , Pérez-Elías Maria Jesus , López-Bernaldo de Quirós Juan Carlos , Pulido Federico , Górgolas Miguel , Sanz Jesus , Suarez-García Ines , Fernandez Maria Teresa , Losa Juan Emilio , Pérez Jose Luis , Ladrero Maria Oliva , Prieto Miguel Ángel , González Gustavo , Izquierdo Ana , Viloria Luis Javier , López Irene , Martínez Eva , Castrillejo Daniel , Aranguren Rosa , Belmonte Maria Antonia , Aranda-García I V , Arraiza Antonio , Diaz Asuncion
Published: January 2021

Background

HIV infection has become a chronic disease and well-being of people living with HIV (PLHIV) is now of particular concern. The objectives of this paper were to describe self-rated health among PLHIV, on ART and on ART virally suppressed and to analyse its determinants.

Methods

Data were obtained from a second-generation surveillance system based on a cross-sectional one-day survey in public hospitals. Epidemiological and clinical data were collected among HIV-infected inpatients and outpatients receiving HIV-related care the day of the survey in 86 hospitals in 2019. Self-rated health was measured using a question included in the National Health Survey: “In the last 12 months, how would you rate your health status?” an ordinal variable with five categories (very good, good, moderate, bad and very bad). For the analysis, these responses were dichotomized into two categories: 1 = very good/good and 0 = moderate, bad or very bad health status. Factors associated with very good/good self-rated health were estimated using logistic regression.

Results

Of 800 PLHIV, 67.5% perceived their health as very good/good, 68.4% among PLHIV on ART and 71.7% of those virally suppressed. Having university education (adjusted odds ratio (aOR):2.1), being unemployed (aOR:0.3) or retired (aOR:0.2), ever being diagnosed of AIDS (aOR:0.6), comorbidities (aOR:0.3), less than 2 year since HIV diagnosis (aOR:0.3) and not receiving ART (aOR:0.3) were associated with good self-rated health. Moreover, among PLHIV on ART, viral load less than 200 copies (aOR:3.2) were related to better perceived health. Bad adherence was inversely associated with good self-rated health among PLHIV on ART (aOR:0.5) and of those virally suppressed (aOR:0.4).

Conclusions

Nearly seven in 10 PLHIV in Spain considered their health status as very good/good, being higher among virally suppressed PLHIV. Both demographic and clinical determinants affect quality of life.
Seroprevalence of hepatitis c virus infection among blood donors in Ethiopia: a systematic review and meta-analysis
Authors: Lake Eyasu Alem , Fite Robera Olana , Gebrekirstos Lielt Gebreselassie , Gebremedhin Meron Hadis , Obsa Mohammed Suleiman , Gelaw Kelemu Abebe
Published: January 2021

Background

Blood transfusion is one of the routine therapeutic interventions in hospitals that can be lifesaving. However, this intervention is related to several transfusion-related infections. Hepatitis C viral infection is one of the most common causes of transfusion-related hepatitis. Subsequently, this systematic review and meta-analysis was aimed to estimate the seroprevalence of hepatitis C virus infection among blood donors in Ethiopia.

Methods

PubMed, Google Scholar, Health InterNetwork Access to Research Initiative (HINARI), Excerpta Medica database (EMBASE), and Cochrane library, the web of science, African journal of online (AJOL), and Google Scholar was searched. The data were extracted using Microsoft Excel and analyzed by using STATA version 14. Publication bias was checked by funnel plot, contour-enhanced funnel plots, trim and fill analysis and more objectively through Egger’s regression test, with P <  0.05 considered to indicate potential publication bias. The heterogeneity of studies was checked using I2 statistics. Pooled analysis was conducted using a weighted inverse variance random-effects model. Subgroup analysis was done by region and study period. A sensitivity analysis was employed.

Result

A total of 25 studies with 197,172 study participants were used to estimate the seroprevalence of hepatitis c virus among blood donors. The overall seroprevalence of hepatitis C virus was 0.819% (95% CI: 0.67–0.969; I2 = 92.3%). Regional sub-group analysis showed that the pooled prevalence of hepatitis c virus infection among blood donors found to be 0.563% in Somali, 1.08% in Oromia, 0.847% in Amhara, and 0.908% in south nations nationalities and peoples region.

Conclusion

The pooled seroprevalence of hepatitis C virus infection among blood donors in Ethiopia found to be low. Moreover, there should be systematic strategies that enhance donor screening and retention of safe regular donors.
The influence of the CRS-R score on functional outcome in patients with severe brain injury receiving early rehabilitation
Authors: Boltzmann Melanie , Schmidt Simone B. , Gutenbrunner Christoph , Krauss Joachim K. , Stangel Martin , Höglinger Günter U. , Wallesch Claus-W. , Rollnik Jens D.
Published: January 2021

Background

The aim of the study was to determine the role of the Coma Recovery Scale-Revised (CRS-R) in the prediction of functional status at the end of neurological early rehabilitative treatment.

Methods

Patients consecutively admitted to intensive or intermediate care units of a neurological rehabilitation center were enrolled in the study. Consciousness and functional status were assessed with the Coma Recovery Scale-Revised (CRS-R) and the Early Rehabilitation Barthel Index (ERBI), respectively. Both assessments were carried out weekly within the first month and at the end of early rehabilitation. Patient and clinical data were entered into a binary logistic regression model to predict functional status at discharge.

Results

327 patients (112 females, 215 males) with a median age of 63 years (IQR = 53–75) and a median disease duration of 18 days (IQR = 12–28) were included. Most patients suffered from stroke (59 %), followed by traumatic brain injury (31 %), and hypoxic ischemic encephalopathy (10 %). Upon admission, 12 % were diagnosed as comatose, 31 % as unresponsive wakefulness syndrome (UWS), 35 % as minimally conscious state (MCS) and 22 % already emerged from MCS (eMCS). Of all patients undergoing complete early rehabilitative treatment (n = 180), 72 % showed improvements in level of consciousness (LOC). In this group, age, initial CRS-R score and gains in CRS-R score after four weeks independently predicted functional outcome at discharge.

Conclusions

The study confirms the relevance of the CRS-R score for functional outcome prediction. High CRS-R scores and young age facilitate functional improvements and increase the probability to continue treatment in subsequent rehabilitation phases. Moreover, results indicate that recovery might occur over a period of time that extends beyond acute care.
Real-world assessment of the impact of “OFF” episodes on health-related quality of life among patients with Parkinson’s disease in the United States
Authors: Thach Andrew , Jones Eddie , Pappert Eric , Pike James , Wright Jack , Gillespie Alexander
Published: January 2021

Background

Many patients with Parkinson’s disease (PD) who receive carbidopa/levodopa experience symptom reemergence or worsening, or “OFF” episodes. This study assessed the association of “OFF” episodes with health-related quality of life (HRQoL).

Methods

US-specific data from the 2017 and 2019 Adelphi Real World Disease Specific Programme for PD, a real-world cross-sectional survey, were used. Neurologists provided data for 10–12 consecutive patients with PD who completed the 39-item Parkinson’s Disease Questionnaire (PDQ-39) and the EuroQol 5-Dimension (EQ-5D). Data were grouped by patients who experienced “OFF” episodes versus those who did not and by average hours of daily “OFF” time. Differences between patient groups were assessed for demographics and clinical characteristics; regression analyses were used to model the relationship between HRQoL and “OFF” episodes with age, sex, body mass index, current PD stage on the Hoehn and Yahr scale, and number of concomitant conditions related and unrelated to mobility as covariates.

Results

Data from 722 patients were analyzed. Overall, 321 patients (44%) had “OFF” episodes (mean of 2.9 h of daily “OFF” time). Patients who experienced “OFF” episodes were less likely to work full-time and more likely to live with family members other than their spouse/partner or reside in a long-term care facility than those without “OFF” episodes. The presence of “OFF” episodes, regardless of the average hours of daily “OFF” time, was significantly associated with high scores (reflecting poor HRQoL) on most PDQ-39 dimensions and the summary index and low scores (reflecting poor health status) on the EQ-5D health utility index, visual analog scale (VAS), and all dimensions. Furthermore, increased average hours of daily “OFF” time was significantly correlated with higher scores for all PDQ-39 dimensions and the summary index, as well as with the EQ-5D health utility index and VAS scores. Patients with “OFF” episodes experienced reduced HRQoL even after correcting for potentially confounding variables.

Conclusions

This study demonstrated that the occurrence of “OFF” episodes in patients with PD is associated with reduced HRQoL and that the impact on HRQoL increased incrementally with increasing average hours of daily “OFF” time.
Association of placental chorangiosis with pregnancy complication and prenatal outcome: a case-control study
Authors: Vafaei Homeira , Karimi Zinat , Akbarzadeh-Jahromi Mojgan , Asadian Fatemeh
Published: January 2021

Background

Chorangiosis is a vascular change involving the terminal chorionic villi in the placenta. It results from longstanding, low-grade hypoxia in the placental tissue, and is associated with such conditions as intrauterine growth restriction (IUGR), diabetes, and gestational hypertension in pregnancy. Chorangiosis rarely occurs in normal pregnancies. However, its prevalence is 5–7% of all placentas from infants admitted to newborn intensive care units. The present study was aimed at determining the association of chorangiosis with pregnancy complications and perinatal outcomes.

Methods

In this case-control study, 308 chorangiosis cases were compared with 308 controls (with other diagnoses in pathology) in terms of maternal, placental, prenatal, and neonatal characteristics derived from the medical records of participants retrospectively. R and SPSS version 22 software tools were used, and the statistical significance level was considered 0.05 for all the tests.

Results

Preeclampsia, diabetes mellitus, maternal hemoglobin, maternal hematocrit, C/S, oligohydramnios, fetal anomaly, dead neonates, NICU admissions were significantly higher in the chorangiosis group OR = 1.6, 3.98, 1.68, 1.92, 2.1, 4.47, 4.22, 2.9, 2.46, respectively (p-value< 0.05 for all). Amniotic fluid index, birth weight, cord PH amount, 1st, and 5th Apgar score was lower in the chorangiosis group OR = 0.31, 1, 0.097, 0.83, 0.85, respectively (p-value< 0.05 for all). Moreover, fundal placenta, retro placental hemorrhage, perivillous fibrin deposition, calcification, and acute chorioamnionitis were higher in the chorangiosis group OR = 2.1, 11.8, 19.96, 4.05, and 6.38 respectively, (p-value< 0.05). There was a high agreement between the two pathologists, and the power of the study was estimated at 99%.

Conclusion

Although chorangiosis is an uncommon condition, it is associated with a higher incidence of perinatal and neonatal morbidity and mortality. Therefore, it should be considered an important clinical sign of adverse pregnancy outcomes and should be reported in the pathology evaluation.
“Mine did not breastfeed”, mothers’ experiences in breastfeeding children aged 0 to 24 months with oral clefts in Uganda
Authors: Nabatanzi Maureen , Seruwagi Gloria Kimuli , Tushemerirwe Florence Basiimwa , Atuyambe Lynn , Lubogo David
Published: January 2021

Background

Appropriate breastfeeding is vital for infant and young child nutrition. Annually, oral clefts affect 0.73 per 1000 children in Uganda. Despite this low incidence, children with a cleft face breastfeeding difficulty which affect their nutrition status. In addition, knowledge on maternal experiences with breastfeeding and support is limited. We explored maternal perceptions, experiences with breastfeeding and support received for their children 0 to 24 months with a cleft attending Comprehensive Rehabilitative Services of Uganda (CoRSU) Hospital.

Methods

This cross-sectional study combined quantitative and qualitative methods. We consecutively recruited 32 mothers of children with a cleft aged 0 to 24 months attending CoRSU hospital between April and May 2018. A structured questionnaire collected data on breastfeeding practices and device use (n = 32). To gain a broad understanding of mothers’ perceptions and experiences with breastfeeding and support received, we conducted two Focus Group Discussions (in each, n = 5), and 15 In Depth Interviews. Descriptive statistics were analyzed using SPSS software. Qualitative data were analyzed thematically.

Results

Of the 32 children with a cleft, 23(72%) had ever breastfed, 14(44%) were currently breastfeeding, and among those under 6 months, 7(35%) exclusively breastfed. Of 25 mothers interviewed in IDIs and FGDs, 17(68%; IDIs = 8/15, FGD1 = 5/5 and FGD2 = 4/5) reported the child’s failure to latch and suckle as barriers to breastfeeding. All ten mothers who used the soft squeezable bottle reported improved feeding. Nineteen (76%) mothers experienced anxiety and 14(56%), social stigma. Family members, communities and hospitals supported mothers with feeding guidance, money, child’s feeds and psycho-social counselling. Appropriate feeding and psycho-social support were only available at a specialized hospital which delayed access.

Conclusions

Breastfeeding practices were sub-optimal. Mothers experienced breastfeeding difficulties, anxiety and social stigma. Although delayed, feeding, social and psycho-social support helped mothers cope. Routine health care for mothers and their children with a cleft should include timely support.
Monozygotic twins discordant for homologous Robertsonian translocation trisomy 21 of 46, XX, + 21, der (21;21) (q10; q10) in a twin-to-twin transfusion syndrome, case report
Authors: Cao Dingya , Sun Jimei , Li Nan , Li Zhihua , Liu Weiqiang , Chen Min
Published: January 2021

Background

Monozygotic twins are nearly identical in genotype and phenotype because monozygotic twins arise from one fertilized oocyte. In all cases of discordant karyotype in monozygotic twins, trisomy 21 accounts for about one in 385,000. Monozygotic twins discordant for Robertsonian translocation trisomy 21 of the der (21;21)(q10;q10), in which the additional chromosome originates from the father is rare.

Case presentation

A 28-year-old parous woman, G3P1A0, came to our institution for a dating scan at 8 weeks of gestation. The transvaginal ultrasound examination demonstrated a monochorionic diamniotic pregnancy. She and her husband were healthy, with no family history of trisomy 21 or other congenital diseases. The ultrasound examination of nuchal translucency thickness was discordant in twins at 13 weeks (twin A, NT 1.4 mm with CRL being 65 mm; twin B, NT 7.8 mm with CRL being 69 mm). At 17+ 4weeks, twin A was normal, but ventricular septal defect and the hypoplastic left heart was detected in twin B. The deepest vertical pocket was 18 mm in twin A (oligohydramnios) and 102 mm in Twin B (polyhydramnios). The bladder in twin A was absent. Ultrasound findings indicated TTTS Stage II. Amniocentesis was performed for the two fetuses. The karyotyping results revealed 46, XX in twin A but 46,XX,+ 21,der (21;21)(q10;q10) in twin B.

For twin B, the parents opted for selective fetal termination by radiofrequency ablation. The procedure was uneventful. At 40+ 5weeks, twin A was born with a birth weight of 4120 g by vaginal delivery.

Conclusions

The early detection of discordant karyotype and twin-to-twin transfusion syndrome is beneficial to the early intervention. In monozygotic twins with a discordant anomaly, the discordant karyotype should be considered.
Intraocular solitary extramedullary plasmacytoma presenting as unilateral anterior and intermediate uveitis preceded by refractory glaucoma
Authors: Ayton Tom , Cherepanoff Svetlana , Gottlieb David , Sewell William A. , Smith Sandy , Hooper Claire
Published: January 2021

Background

Solitary extramedullary plasmacytoma (SEP) is a localised proliferation of monoclonal plasma cells involving soft tissue with no or minimal bone marrow involvement and no other systemic evidence of multiple myeloma. Intraocular involvement is exceedingly rare.

Case presentation

We report a 78-year-old man who was referred with glaucoma in the right eye. He subsequently developed anterior chamber (AC) inflammation and refractory glaucoma then dense vitritis. A vitrectomy was performed with the biopsy revealing numerous plasma cells with atypical findings. In conjunction with the flow cytometry results, and a systemic work up excluding multiple myeloma, a diagnosis of SEP was made. The patient was treated with ocular external beam radiotherapy with resolution of the intraocular inflammation and control of the intraocular pressure. He remains well with no local recurrence and no development of multiple myeloma over a follow up period of 2.5 years.

Conclusions

This is the first case report of SEP presenting as intraocular inflammation without a uveal tract mass.
JOBS Program Germany for health promotion among the unemployed in the community setting with institutions for employment promotion (JobsProgramDtl): study protocol for a randomized controlled trial
Authors: Hollederer Alfons , Jahn Heiko J. , Klein Daniel
Published: February 2021

Background

Compared to the employed, the unemployed are characterized by a substantially worse health status, particularly with regards to mental health. At the same time, conventional offers of prevention and health promotion rarely reach the unemployed. The JOBS Program is a health promotion program that combines job application training with elements of social learning theory and self-efficacy. Randomized field studies in the USA and Finland found significant positive effects on reintegration into the labor market and health amongst the unemployed. In this confirmatory study, we analyze whether the JOBS Program produces similar positive effects for the unemployed in Germany.

Methods

This study is designed as a country-wide, multi-center, non-blinded, two-armed, parallel-group, randomized controlled trial over 6 months. A total of approximately 1500 unemployed, who are willing to participate, are randomly assigned either to an intervention group or a waiting control group with an allocation ratio of 1:1. Guided by a team of two trainers, the intervention group completes JOBS Program Germany in small groups of 8 to 15 unemployed for a period of 1 week in units of 5 h a day. Primary outcome measures are the reintegration into the labor market, self-efficacy, life satisfaction, subjective state of health, depressive symptoms, and psychological distress. Of secondary interest are moderating variables such as socio-demographic characteristics, the duration of unemployment, and the job-search intensity. Outcomes will be repeatedly assessed via computer-assisted telephone interviews at three points in time: immediately before the intervention (pre-test), immediately after the intervention (post-test), and 6 months after the intervention has ended (6-months follow-up).

Discussion

This confirmatory study will provide empirical evidence on the effectiveness of the JOBS Program on the reintegration and (mental) health of the unemployed in Germany. If our results from the randomized controlled trail in a country-wide field experiment confirm its effectiveness, the JOBS Program Germany could, perspectively, be implemented into the German employment promotion and social security system on a long-term basis.

Trial registration

German Clinical Trials Register (DRKS), DRKS00022388. Registered on 20 July, 2020.
Interventions to improve health literacy among Aboriginal and Torres Strait Islander Peoples: a systematic review
Authors: Nash Simone , Arora Amit
Published: January 2021

Background

Aboriginal and Torres Strait Islander peoples continue to experience poorer health outcomes than other population groups. While data specific to Indigenous Australians are scarce, a known social health literacy gradient exists linking low health literacy and poor health outcomes within many minority populations. Improving health literacy among Indigenous Australians is an important way to support self-determination and autonomy in both individuals and communities, by enhancing knowledge and improving health outcomes. This review aims to rigorously examine the effectiveness of health literacy interventions targeting Aboriginal and Torres Strait Islander peoples.

Methods

A systematic review across six databases (The Cochrane Library, PubMed, Embase, SCOPUS, ProQuest Dissertation and Thesis and Web of Science) was performed for publications evaluating interventions to improve health literacy among Indigenous Australian adults using search terms identifying a range of related outcomes.

Results

Of 824 articles retrieved, a total of five studies met the eligibility criteria and were included in this review. The included studies evaluated the implementation of workshops, structured exercise classes and the provision of discounted fruit and vegetables to improve nutrition, modify risk factors for chronic diseases, and improve oral health literacy. All interventions reported statistically significant improvement in at least one measured outcome. However, there was limited involvement of the Aboriginal and Torres Strait Islander community members in the research process and participant retention rates were sub-optimal.

Conclusion

There is limited evidence on interventions to improve health literacy in Indigenous Australian adults. Participation in interventions was often suboptimal and loss to follow-up was high. Future studies co-designed with Aboriginal and Torres Strait Islander community members are needed to improve health literacy in this population.