bluuebunny/crossref_metadata_2025 huggingface dataset:
A case report of ChAdOx1 nCoV-19 vaccine–associated encephalitis
Authors: Takata Junko , Durkin Simon M. , Wong Solomon , Zandi Michael S. , Swanton Josephine K. , Corrah Tumena W.
Published: December 2021

Background

Vaccination against COVID-19 continues apace, but side-effects, both common and severe, continue to be reported. We report here the first published case of COVID-19 vaccine-related encephalitis.

Case presentation

A young woman presented with acute neuropsychiatric symptoms following recent ChAdOx1 nCoV-19 vaccination. Extensive investigation did not identify alternative causes.

Conclusions

This difficult case is here described, including presentation, investigation, and management. Further study on neuropsychiatric side-effects of COVID-19 vaccination, including investigation as to whether there may be a causal link, is required.
Pregnant women’s decision-making capacity and adherence to iron supplementation in sub-Saharan Africa: a multi-country analysis of 25 countries
Authors: Zegeye Betregiorgis , Adjei Nicholas Kofi , Olorunsaiye Comfort Z. , Ahinkorah Bright Opoku , Ameyaw Edward Kwabena , Seidu Abdul-Aziz , Yaya Sanni
Published: December 2021

Background

Anaemia and related complications during pregnancy is a global problem but more prevalent in sub-Sahara Africa (SSA). Women’s decision-making power has significantly been linked with maternal health service utilization but there is inadequate evidence about adherence to iron supplementation. This study therefore assessed the association between household decision-making power and iron supplementation adherence among pregnant married women in 25 sub-Saharan African countries.

Methods

We used data from the Demographic and Health Surveys (DHS) of 25 sub-Saharan African countries conducted between 2010 and 2019. Women's decision-making power was measured by three parameters; own health care, making large household purchases and visits to her family or relatives. The association between women’s decision-making power and iron supplementation adherence was assessed using logistic regressions, adjusting for confounders. The results were presented as adjusted odds ratio (AOR) with 95% confidence intervals (CIs).

Results

Approximately 65.4% of pregnant married women had made decisions either alone or with husband in all three decisions making parameters (i.e., own health care, making large household purchases, visits to her family or relatives). The rate of adherence to iron medication during pregnancy was 51.7% (95% CI; 48.5–54.9%). Adherence to iron supplementation was found to be higher among pregnant married women who had decision-making power (AOR = 1.46, 95% CI; 1.16–1.83), secondary education (AOR = 1.45, 95% CI; 1.05–2.00) and antenatal care visit (AOR = 2.77, 95% CI; 2.19–3.51). Wealth quintiles and religion were significantly associated with adherence to iron supplementation.

Conclusions

Adherence to iron supplementation is high among pregnant women in SSA. Decision making power, educational status and antenatal care visit were found to be significantly associated with adherence to these supplements. These findings highlight that there is a need to design interventions that enhance women’s decision-making capacities, and empowering them through education to improve the coverage of antenatal iron supplementation.
Antenatal care attendance and risk of low birthweight in Burkina Faso: a cross-sectional study
Authors: Bountogo Mamadou , Sié Ali , Zakané Alphonse , Compaoré Guillaume , Ouédraogo Thierry , Lebas Elodie , Brogdon Jessica , Nyatigo Fanice , Arnold Benjamin F. , Lietman Thomas M. , Oldenburg Catherine E.
Published: December 2021

Background

Low birthweight is a major contributor to infant mortality. We evaluated the association between antenatal care (ANC) attendance and low birthweight among newborns in 5 regions of Burkina Faso.

Methods

We utilized data from the baseline assessment of a randomized controlled trial evaluating azithromycin distribution during the neonatal period for prevention of infant mortality. Neonates were eligible for the trial if the weighed at least 2500 g at enrollment and were 8–27 days of age. Data on ANC attendance and birthweight was extracted from each child’s carnet de santé, a government-issued health card on which pregnancy and birth-related data are recorded. We used linear and logistic regression models adjusting for potentially confounding variables to evaluate the relationship between ANC attendance (as total number of visits and ≥ 4 antenatal care visits) and birthweight (continuously and categorized into < 2500 g versus ≥2500 g).

Results

Data from 21,223 births were included in the analysis. The median number of ANC visits was 4 (interquartile range 3 to 5) and 69% of mothers attended at least 4 visits. Mean birthweight was 2998 g (standard deviation 423) and 8.1% of infants were low birthweight (< 2500 g). Birthweight was 63 g (95% CI 46 to 81 g, P < 0.001) higher in newborns born to mothers who had attended ≥4 ANC visits versus < 4 visits. The odds of low birthweight among infants born to mothers with ≥4 ANC visits was 0.71 (95% CI 0.63 to 0.79, P < 0.001) times the odds of low birthweight among infants born to mothers who attended < 4 ANC visits.

Conclusions

We observed a statistically significant association between ANC attendance and birthweight, although absolute differences were small. Improving access to ANC for all women may help improve birth outcomes.

Trial registration

The parent trial is registered at clinicaltrials.gov: NCT03682653; first registered 24 September 2018.
When first line treatment of neonatal infection is not enough: blood culture and resistance patterns in neonates requiring second line antibiotic therapy in Bangui, Central African Republic
Authors: Nebbioso Andrea , Ogundipe Oluwakemi F. , Repetto Ernestina Carla , Mekiedje Calorine , Sanke-Waigana Hugues , Ngaya Gilles , Ingelbeen Brecht , Gil-Cuesta Julita
Published: December 2021

Background

Infectious diseases account for the third most common cause of neonatal deaths. Globally, antibiotic resistance (ABR) has been increasingly challenging neonatal sepsis treatment, with 26 to 84% of gram-negative bacteria resistant to third-generation cephalosporins. In sub-Saharan Africa, limited evidence is available regarding the neonatal microbiology and ABR. To our knowledge, no studies have assessed neonatal bacterial infections and ABR in Central-African Republic (CAR). Therefore, this study aimed to describe the pathogens isolated and their specific ABR among patients with suspected antibiotic-resistant neonatal infection admitted in a CAR neonatal unit.

Methods

This retrospective cohort study included neonates admitted in the neonatal unit in Bangui, CAR, from December 2018 to March 2020, with suspected antibiotic-resistant neonatal infection and subsequent blood culture. We described the frequency of pathogens isolated from blood cultures, their ABR prevalence, and factors associated with fatal outcome.

Results

Blood cultures were positive in 33 (26.6%) of 124 patients tested (17.9% for early-onset and 46.3% for late-onset infection; p = 0.002). Gram-negative bacteria were isolated in 87.9% of positive samples; with most frequently isolated bacteria being Klebsiella pneumoniae (39.4%), Escherichia coli (21.2%) and Klebsiella oxytoca (18.2%). All tested bacteria were resistant to ampicillin. Resistance to third-generation cephalosporins was observed in 100% of tested Klebsiella pneumoniae, 83.3% of isolated Klebsiella oxytoca and 50.0% of tested Escherichia coli. None of the tested bacteria were resistant to carbapenems. Approximately 85.7 and 77.8% of gram-negative tested bacteria were resistant to first-line (ampicillin-gentamicin) and second-line (third-generation cephalosporins) treatments, respectively. In hospital mortality, adjusted for blood culture result, presence of asphyxia, birth weight and sex was higher among neonates with positive blood culture (adjusted relative risk [aRR] = 2.32; 95% confidence interval [CI] = 1.17–4.60), male sex (aRR = 2.07; 95% CI = 1.01–4.26), asphyxia (aRR = 2.42; 95% CI = 1.07–5.47) and very low birth weight (1000–1499 g) (aRR = 2.74; 95% CI = 1.3–5.79).

Conclusion

Overall, 77.8% of confirmed gram-negative neonatal infections could no longer effectively be treated without broad-spectrum antibiotics that are not routinely used in sub-Saharan Africa referral hospitals. Carbapenems should be considered an option in hospitals with surveillance and antibiotic stewardship.
Ten years of China’s new healthcare reform: a longitudinal study on changes in health resources
Authors: Chen Jiang , Lin Zhuochen , Li Li-an , Li Jing , Wang Yuyao , Pan Yu , Yang Jie , Xu Chuncong , Zeng Xiaojing , Xie Xiaoxu , Xiao Liangcheng
Published: December 2021

Background

China launched a new round of healthcare-system reform in 2009 and proposed the goal of equal and guaranteed essential medical and health services for all by 2020. We aimed to investigate the changes in China’s health resources over the past ten years after the healthcare reform.

Methods

Data were collected from the China Statistical Yearbook and China Health Statistics Yearbook from 2009 to 2018. Four categories and ten indicators of health resources were analyzed. A descriptive analysis was used to present the overall condition. The Health Resource Density Index was applied to showcase health-resource distribution in demographic and geographic dimensions. The global and local Moran’s I were used to assess the spatial autocorrelation of health resources. Concentration Index (CI) was used to quantify the equity of health-resource distribution. A Geo-Detector model and Geographic Weighted Regression (GWR) were applied to assess the association between gross domestic product (GDP) per capita and health resources.

Results

Health resources have increased over the past ten years. The global and local Moran’s I suggested spatial aggregation in the distribution of health resources. Hospital beds were concentrated in wealthier areas, but this inequity decreased yearly (from CI=0.0587 in 2009 to CI=0.0021 in 2018). Primary medical and health institutions (PMHI) and their beds were concentrated in poorer areas (CI remained negative). Healthcare employees were concentrated in wealthier areas (CI remained positive). In 2017, the q-statistics indicated that the explanatory power of GDP per capita to beds, health personnel, and health expenditure was 40.7%, 50.3%, and 42.5%, respectively. The coefficients of GWR remained positive with statistical significance, indicating the positive association between GDP per capita and health resources.

Conclusions

From 2009 to 2018, the total amount of health resources in China has increased substantially. Spatial aggregation existed in the health-resources distribution. Health resources tended to be concentrated in wealthier areas. When allocating health resources, the governments should take economic factors into account.
Musculoskeletal biomechanics of patients with or without adjacent segment degeneration after spinal fusion
Authors: Farshad Mazda , Furrer Pascal Raffael , Wanivenhaus Florian , Urbanschitz Lukas , Senteler Marco
Published: December 2021

Study design

A retrospective, single center, case-control study was performed.

Objective

The present study employed patient-specific biomechanical modeling to find potential biomechanical differences after spinal fusion at L4/5 in patients with and without subsequent development of adjacent segment disease (ASD).

Methods

The study population comprised patients who underwent primary spinal fusion at L4/5 and were either asymptomatic during > 4 years of follow-up (CTRL; n = 18) or underwent revision surgery for ASD at L3/4 (n = 20). Landmarks were annotated on preoperative and follow-up lateral radiographs, and specific musculoskeletal models were created using a custom-built modeling pipeline. Simulated spinal muscle activation and lumbar intervertebral shear loads in unfused segments were analyzed in upright standing and forward flexion. Differences between the pre- and postoperative conditions were computed for each patient.

Results

The average postoperative muscle activity in the upright standing posture was 88.4% of the preoperative activity in the CTRL group (p <  0.0001), but did not significantly change from pre- to postoperatively in the ASD group (98.0%). The average shear load magnitude at the epifusional joint L3/4 during upright standing increased from pre- to postoperatively in the ASD group (+ 3.9 N, +/− 17.4 (n = 18)), but decreased in the CTRL group (− 4.6 N, +/− 23.3 (n = 20); p <  0.001).

Conclusion

Patient-specific biomechanical simulation revealed that spinal fusion surgery resulted in greater shear load magnitude and muscle activation and therefore greater forces at the epifusional segment in those with ASD compared with those without ASD. This is a first report of patient-specific disc load and muscle force calculation with predictive merits for ASD.
A retrospective study about functional outcome and quality of life after surgical fixation of insufficiency pelvic ring injuries
Authors: Jäckle Katharina , Meier Marc-Pascal , Seitz Mark-Tilmann , Höller Sebastian , Spering Christopher , Acharya Mehool R. , Lehmann Wolfgang
Published: December 2021

Background

Fragility fractures without significant trauma of the pelvic ring in older patients were often treated conservatively. An alternative treatment is surgery involving percutaneous screw fixation to stabilize the posterior pelvic ring. This surgical treatment enables patients to be mobilized quickly and complications associated with bedrest and temporary immobility are reduced. However, the functional outcome following surgery and quality of life of the patients have not yet been investigated. Here, we present a comprehensive study addressing the long-term well-being and the quality of life of patients with fragility pelvic ring fractures after surgical treatment.

Methods

Between 2011–2019, 215 geriatric patients with pelvic ring fractures were surgically treated at the university hospital in Göttingen (Germany). Of these, 94 patients had fragility fractures for which complete sets of computer tomography (CT) and radiological images were available. Fractures were classified according to Tile and according to the FFP classification of Rommens and Hofmann. The functional outcome of surgical treatment was evaluated using the Majeed pelvic score and the Short Form Health Survey-36 (SF-36).

Results

Thirty five tile type C and 48 type B classified patients were included in the study. After surgery eighty-three patients scored in average 85.92 points (± 23.39) of a maximum of 100 points using the Majeed score questionnaire and a mean of 1.60 points on the numerical rating scale ranging between 0 and 10 points where 0 points refers to “no pain” and 10 means “strongest pain”. Also, the SF-36 survey shows that surgical treatment positively effects patients with respect to their general health status and by restoring vitality, reducing bodily pain and an increase of their general mental health.

Conclusions

Patients who received a percutaneous screw fixation of fragility fractures of the posterior pelvic ring reported an overall positive outcome concerning their long-term well-being. In particular, older patients appear to benefit from surgical treatment.

Trial registration

Functional outcome and quality of life after surgical treatment of fragility fractures of the posterior pelvic ring, DRKS00024768. Registered 8th March 2021 - Retrospectively registered. Trial registration number DRKS00024768.
Orthostatic hypotension following posterior spinal fusion surgeries for spinal deformity correction in adolescents: prevalence and risk factors
Authors: Yang Ying , Chen Yaping , Tong Bingdu , Tian Xue , Yu Chunjie , Su Zhe , Zhang Jianguo
Published: December 2021

Study design

Retrospective case series.

Objectives

This study aimed to determine the prevalence and risk factors for orthostatic hypotension (OH) in adolescents undergoing posterior spinal fusion for spinal deformity correction.

Methods

The data of 282 consecutive adolescents who underwent posterior spinal fusion for spinal deformity correction in our center over 12 months were retrieved. Patient characteristics, including whether laminectomy or osteotomy was performed during the surgery, the occurrence of postoperative nausea and vomiting (PONV), perioperative hemoglobin albumin changes, perioperative blood transfusion, length of bed rest, willingness to ambulate, length of postoperative exercises of the lower limbs, and length of hospital stay, were collected and compared statistically between patients who did and did not develop postoperative OH.

Results

Of 282 patients, 197 (69.86%) developed OH postoperatively, and all cases completely resolved 5 days after the first out-of-bed exercises. Significant differences in the incidence of PONV, the willingness to ambulate and the length of postoperative exercises of the lower limbs were observed. The mean length of hospital stay of the patients with OH was longer than that of the patients without OH.

Conclusion

Our study suggests that temporary OH is a common manifestation following posterior spinal fusion for spinal deformity correction in adolescents. Postoperative OH may increase the length of hospital stay in these patients. Patients with PONV, who are not willing to ambulate and who perform postoperative lower limb exercises for a shorter time are more likely to have OH.
Application of the PRECEDE -PROCEED model in prevention of brucellosis focused on livestock vaccination process
Authors: Bahadori Farhad , Ghofranipour Fazlollah , Zarei Fatemeh , Ziaei Reza , Ghaffarifar Saeideh
Published: December 2021

Background

This article reports the steps of an educational intervention, which is designed to change livestock breeders’ preventive behavior in terms of vaccinating their livestock against brucellosis. The study has been conducted in a rural area in a country with the second highest brucellosis prevalence in the world.

Methods

In a quasi-experimental study and applying PRECEDE-PROCEED model, 45 livestock breeders were trained through basket method, accompanied with constructive feedback from researchers and peers and a brief interactive lecture at the end. The livestock breeders’ awareness, attitude and practice level in the intervention group was compared with those of other 45 livestock breeders in a control group, 1 and 6 months after the intervention. According to the results of the Rose Bengal tests (RBTs), as a rapid and simple screening test, the presence or absence of Brucella antibodies in the animals’ serum was investigated.

Results

Immediately and 1 month after the intervention, the mean scores of knowledge, awareness and practice of livestock breeders in the intervention group were significantly higher. Six months after the intervention, the results of the RBTs were positive in more livestock in the intervention group compared to the animals in the control group. The positive result of RBT after educational intervention, in livestock whose test results were negative immediately before intervention, accompanying the results of observation indicating a good general condition of livestock was considered as a probable evidence of the success of the educational intervention.

Conclusion

The model-driven educational intervention could significantly increase livestock breeders’ awareness, attitude and practice regarding prevention of brucellosis and vaccination of their livestock against brucellosis; however, a period of non-continuous reinforcement and gradual reduction of the number of the reinforcements by health educator workers is recommended in order to increase the maintenance of the learnt behavior.

Trial registration

Conducting this study was registered at Iranian Registry of Clinical Trials (IRCT20180304038945N1). Registered 24 December 2018. The proposal was registered before enrollment of the first participant.
Intimate partner violence and associated factors among reproductive age women during COVID-19 pandemic in Southern Ethiopia, 2020
Authors: Shitu Solomon , Yeshaneh Alex , Abebe Haimanot
Published: December 2021

Background

World health organization (WHO) defines intimate partner violence (IPV) is physical, sexual, or emotional abuse by an intimate partner or ex-partner or spouse to a woman. From all forms of violence, ~ 1.3 million people worldwide die each year, accounting for 2.5% of global mortality. During the COVID-19 crisis, control and prevention measures have brought women and potential perpetrators together which increase the risk of IPV. Therefore, this study was aimed to assess the magnitude and associated factors of IPV against women during COVID-19 in Ethiopia.

Methods

Community based cross-section study was employed among 462 reproductive-age women to assess IPV and associated factors during COVID-19 pandemic. To select study participants one-stage cluster sampling technique was used. The data were entered into Epi data version 4.2 and exported to SPSS for analysis. Bivariate and multivariate analysis was used to check the association of dependent and independent variables and statistical significance was declared at P < 0.05.

Result

A total of 448 study subjects were responded making a response rate of 96.97%. Two- third (67.6%) of the respondent's age range was between 20 and 29 years. All of the participants heard about the pandemic of COVID-19 at the time of onset. The lifetime and the last twelve months prevalence of women with IPV was 42.19% and 24.11%, respectively. About 58 (12.9%) had experienced all three types of violence. Participants age ≥ 35 (AOR = 2.02; 95% CI: 1.99–4.29), rural residence (AOR = 3.04; 95% CI: 2.59–6.25), husband’s educational status of diploma and above (AOR = 0.35; 95% CI: 0.14–0.83), COVID-19 pandemic (AOR = 4.79; 95% CI: 1.13–6.86), and low social support (AOR = 3.23; 95% CI: 1.99–6.23) were independent predictors.

Conclusions

In this study two in five women undergo one type of violence in their lifetime. The occurrence of the COVID-19 pandemic has its impact on violence. Age ≥ 35, rural residence, husband’s educational status of diploma and above, history of child death, COVID-19 pandemic, and low social support were independent predictors of violence. This implies insight to concerned bodies like policymakers and stakeholders to design appropriate policies to avert this magnitude and making zero tolerance for violence in society.
A descriptive study of sports chiropractors with an International Chiropractic Sport Science Practitioner qualification: a cross-sectional survey
Authors: Nelson Luke , Pollard Henry , Ames Rick , Jarosz Brett , Garbutt Pete , Da Costa Cliff
Published: December 2021

Background

This paper describes the education and case management profile of sports chiropractors with the Federation of International Sports Chiropractors (FICS) postgraduate qualification: International Chiropractic Sport Science Practitioner (ICSSP). The ICSSP is the predominant international sports chiropractic qualification.

Methods

A cross-sectional survey, carried out between 22/10/2014 and 22/12/2014,was utilized with a 39-item web-based survey examining practitioner, practice and clinical management characteristics, and was distributed via email to all sports chiropractors who held an ICSSP qualification (n = 240) in 2014.

Results

The survey response rate was 64% (n = 154). 36% of chiropractors were aged between 31 and 40 years, just over three quarters were male, and 27% had been in practice for 5–10 years. The majority of respondents were based in North America. All sports chiropractors surveyed reported treating neuromusculoskeletal conditions outside of the spine. 91% utilized a multimodal approach in most of their treatments, prescribing rehabilitative exercises in 76% of consultations. Almost 64% of respondents reported current treatment of professional athletes, and 78% reported current treatment of semi-professional athletes, whilst the vast majority of those surveyed endorsed past treatment of professional (91%) and semi-professional (95%) athletes. All respondents reported referring to a range of conventional and allied health providers.

Conclusions

This study of ICSSP-qualified sports chiropractors describes a small but well-educated workforce treating high-level athletes, managing a wide range of spine and non-spinal neuromusculoskeletal conditions, utilising multimodal approaches (including active and passive strategies), and referring to and co-managing with other health practitioners.
Pancreatic medullary carcinoma developed on a pancreatic intraductal papillary mucinous neoplasm with loss of MSH2 and MSH6 expression: a case report
Authors: Verocq Camille , Racu Marie-Lucie , Bafort Dominique , Butorano Gloria , Perez-Casanova Garcia Luis , Navez Julie , Witterwulghe Marc , Sheahan Kieran , Swan Niall , Closset Jean , Van Laethem Jean-Luc , Maris Calliope , D’Haene Nicky
Published: December 2021

Background

Pancreatic medullary carcinoma (PMC) is a rare pancreatic tumor, usually showing the presence of microsatellite instability, mostly MLH1 silencing, and a wild-type KRAS mutation status. We report here a PMC arising from a Pancreatic Intraductal Papillary Mucinous Neoplasm (IPMN), both having KRAS and TP53 mutations.

Case presentation

We report the case of a 73-year-old woman presenting with right iliac fossa pain. MRI revealed a 16 mm diameter mass in the pancreas, leading to a pancreatic duct stricture and upstream a dilatation of the distal pancreatic duct of Wirsung. A fine needle aspiration was performed, and pathology analysis revealed malignant glandular cells. The patient underwent distal pancreatectomy.

Gross examination revealed an12 mm indurated white lesion, adjacent to a cystic lesion extending into the rest of the pancreatic body.

Microscopically, the cystic area represented a mixed (gastric-type and pancreatobiliary-type) IPMN, involving the main and secondary pancreatic ducts with low-grade and high-grade dysplasia. In the periphery of this IPMN, a 14mm associated invasive carcinoma was observed, characterized by focal gland formation and by poorly differentiated cells with a syncytial appearance, associated with a dense lymphoplasmocytic and neutrophilic infiltrate.

Immunohistochemical analyses showed loss of MSH2 and MSH6 expression. Microsatellite instability was confirmed by molecular test.

Molecular analysis was performed both on the invasive carcinoma and on the high-grade dysplasia IPMN, revealing the same mutation profile with KRAS and TP53 mutations.

The proposed diagnosis was mixed IPMN with associated invasive medullary carcinoma that presented loss of MSH2 and MSH6 expression.

Conclusions

The present case reports for the first time, at the best of our knowledge, the coexistence of IPMN lesions and PMC, both having the same molecular alterations. It also describes the second case of PMC with microsatellite instability, MSH2 and MSH6 silenced.
High performance methylated DNA markers for detection of colon adenocarcinoma
Authors: Klein Kranenbarg Romy A. M. , Vali Abdul Hussain , IJzermans Jan N. M. , Pisanic Thomas R. , Wang Tza-Huei , Azad Nilofer , Sukumar Saraswati , Fackler Mary Jo
Published: December 2021

Background

Colon cancer (CC) is treatable if detected in its early stages. Improved CC detection assays that are highly sensitive, specific, and available at point of care are needed. In this study, we systematically selected and tested methylated markers that demonstrate high sensitivity and specificity for detection of CC in tissue and circulating cell-free DNA.

Methods

Hierarchical analysis of 22 candidate CpG loci was conducted using The Cancer Genome Atlas (TCGA) COAD 450K HumanMethylation database. Methylation of 13 loci was analyzed using quantitative multiplex methylation-specific PCR (QM-MSP) in a training set of fresh frozen colon tissues (N = 53). Hypermethylated markers were identified that were highest in cancer and lowest in normal colon tissue using the 75th percentile in Mann–Whitney analyses and the receiver operating characteristic (ROC) statistic. The cumulative methylation status of the marker panel was assayed in an independent test set of fresh frozen colon tissues (N = 52) using conditions defined and locked in the training set. A minimal marker panel of 6 genes was defined based on ROC area under the curve (AUC). Plasma samples (N = 20 colorectal cancers, stage IV and N = 20 normal) were tested by cMethDNA assay to evaluate marker performance in liquid biopsy.

Results

In the test set of samples, compared to normal tissue, a 6-gene panel showed 100% sensitivity and 90% specificity for detection of CC, and an AUC of 1.00 (95% CI 1.00, 1.00). In stage IV colorectal cancer plasma versus normal, an 8-gene panel showed 95% sensitivity, 100% specificity, and an AUC of 0.996 (95% CI 0.986, 1.00) while a 5-gene subset showed 100% sensitivity, 100% specificity, and an AUC of 1.00 (95% CI 1.00, 1.00), highly concordant with our observations in tissue.

Conclusions

We identified high performance methylated DNA marker panels for detection of CC. This knowledge has set the stage for development and implementation of novel, automated, self-contained CC detection assays in tissue and blood which can expeditiously and accurately detect colon cancer in both developed and underdeveloped regions of the world, enabling optimal use of limited resources in low- and middle-income countries.
Severe leptospirosis complicated with multiorgan dysfunction successfully managed with plasma exchange: a case report
Authors: Kularathna Manana Dewage Sankani Vishvara , Kularatne Senanayake Abeysinghe Mudiyanselage , Pathirage Manoji , Nanayakkara Pala Thanthirige Madhushi Anuradha
Published: December 2021

Background

Leptospirosis is a common zoonotic infection caused by the spirochete Leptospira. The disease is more prevalent in the tropics, causing subclinical to severe illness leading to high morbidity and mortality.

Case presentation

A 77-year-old healthy Sri Lankan man presented to the Teaching Hospital Peradeniya with severe leptospirosis complicated with acute kidney injury, pulmonary hemorrhages, myocarditis, and severe thrombocytopenia. He was deteriorating despite treatment with intravenous antibiotics and methylprednisolone boluses. He made a dramatic improvement with two cycles of plasma exchange.

Conclusion

Therapeutic plasma exchange is a life-saving treatment modality in severe leptospirosis with multiorgan failure.
Characterization of novel interactions with membrane NEU1 highlights new regulatory functions for the Elastin Receptor Complex in monocyte interaction with endothelial cells
Authors: Bocquet Olivier , Tembely Dignê , Rioult Damien , Terryn Christine , Romier Béatrice , Bennasroune Amar , Blaise Sébastien , Sartelet Hervé , Martiny Laurent , Duca Laurent , Maurice Pascal
Published: December 2021

Background

Vascular aging is associated with remodeling of elastin, one of the main extracellular matrix component of the arterial wall, and production of elastin-derived peptides (EDP). These extracellular matrix degradation products have been shown to trigger biological activities through the elastin receptor complex (ERC) and data from the last decade have brought significant insights on the critical role played by its NEU1 subunit in the biological effects mediated by EDP and the ERC in vascular and metabolic diseases.

Results

Using a proteomic approach, we previously identified new potential interaction partners of membrane NEU1. Here, we validated the interaction between NEU1 and the β2integrin in human monocytes and show that binding of EDP to the ERC leads to desialylation of β2integrin through NEU1. A similar action mechanism was identified in human umbilical vein endothelial cells (HUVEC) for intercellular cell adhesion molecule-1 (ICAM-1). Importantly, these effects were associated with a significant increase in monocyte adhesion to endothelial cells and monocyte transendothelial migration.

Conclusions

These results demonstrate that membrane NEU1 sialidase interacts and modulates the sialylation levels of the β2integrin and ICAM-1 through the ERC in monocytes and endothelial cells, respectively, and suggest that EDP and the ERC, through this newly identified common mode of action governed by NEU1, may be important regulators of circulating monocyte recruitment to inflamed vascular sites. Moreover, by its ability to interact with and to modulate the sialylation of key membrane glycoproteins through NEU1, new biological functions are anticipated for EDP and the ERC in elastin remodeling-associated disorders.
Clinical pharmacy in Israel versus the US, can we "compare apples to apples"?—commentary
Authors: Schwartzberg Eyal , Marom Eli
Published: December 2021

Clinical pharmacy is an umbrella of pharmaceutical services that is practiced by clinical pharmacists. Clinical pharmacists improve the quality of drug therapy, minimize the risk for drug related problems, reduce the risk of morbidity and mortality associated with polypharmacy and decrease the overall healthcare expenditure. Consequently, clinical pharmacy is focused on both the needs of the individual patient, as well as of the healthcare system. Clinical pharmacy is now well-established and practiced worldwide and in the last two decades has been implemented successfully in Israel. This commentary maintains that the comparison of clinical pharmacy practice in Israel and in the United States, published by AJ Rose et al., has several limitations that need to be considered when devising a road map that will fit the Israeli health care system and its environment. Emphasis should be placed on the implementation of automation and robotics, promulgating regulations to allow for integration of pharmacy technicians, and allocating funds for such services.
Dysphagia rehabilitation following acquired brain injury, including cerebral palsy, across the lifespan: a scoping review protocol
Authors: Halfpenny Rhiannon , Stewart Alexandra , Kelly Paula , Conway Eleanor , Smith Christina
Published: December 2021

Background

Swallowing impairment (dysphagia) following brain injury can lead to life-threatening complications such as dehydration, aspiration pneumonia and acute choking episodes. In adult therapeutic practice, there is research and clinical evidence to support the use of swallowing exercises to improve swallowing physiology in dysphagia; however, the use of these exercises in treating children with dysphagia is largely unexplored. Fundamental questions remain regarding the feasibility and effectiveness of using swallowing exercises with children. This review aims to outline the published literature on exercise-based treatment methods used in the rehabilitation of dysphagia secondary to an acquired brain injury across the lifespan. This will allow the range and effects of interventions utilised to be mapped alongside differential practices between adult and child populations to be formally documented, providing the potential for discussions with clinicians about which rehabilitative interventions might be appropriate for further trial in paediatrics.

Methods

This study will use a scoping review framework to identify and systematically review the existing literature using Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews (PRISMA) scoping review guidelines. Electronic databases (MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Allied and Complementary Medicine Database (AMED)), grey literature and the reference lists of key texts including systematic reviews will be searched. Information about the rehabilitation design, dosage and intensity of exercise programmes used as well as demographic information such as the age of participants and aetiology of dysphagia will be extracted. The number of articles in each area and the type of data source will be presented in a written and visual format. Comparison between the literature in adult and child populations will be discussed.

Discussion

This review is unique as it directly compares dysphagia rehabilitation in adults with that of a paediatric population in order to formally identify and discuss the therapeutic gaps in child dysphagia rehabilitation. The results will inform the next stage of research, looking into the current UK-based speech and language therapy practices when working with children with acquired dysphagia.

Systematic review registration

Open science framework osf.io/ja4dr
Risk factors and outcomes associated with postoperative ileus following ileostomy formation: a retrospective study
Authors: Greenberg Anya L. , Kelly Yvonne M. , McKay Rachel E. , Varma Madhulika G. , Sarin Ankit
Published: December 2021

Background

Postoperative ileus (POI) is associated with increased patient discomfort, length of stay (LOS), and healthcare cost. There is a paucity of literature examining POI in patients who have an ileostomy formed at the time of surgery. We aimed to identify risk factors for and outcomes associated with POI following ileostomy formation.

Methods

We included 261 consecutive non-emergent cases that included formation of an ileostomy by a board-certified colorectal surgeon at our institution from July 1, 2015, to June 30, 2020. Demographic, clinical, and intraoperative factors associated with increased odds of POI were evaluated. Post-procedure LOS, hospitalization cost, and re-admissions between patients with and without POI were compared.

Results

Out of 261 cases, 85 (32.6%) were associated with POI. Patients with POI had significantly higher body mass index (BMI) than those without POI (26.6 kg/m2 vs. 24.8kg/m2; p = 0.01). Intraoperatively, patients with POI had significantly longer procedure duration than those without POI (313 min vs. 279 min; p = 0.02). Patients with POI had a significantly higher net fluid balance at postoperative day (POD) 2 than those without POI (+ 2.65 L vs. + 1.80 L; p = 0.004), with POD2 fluid balance greater than + 807 mL (determined as the maximum Youden index for sensitivity over 80%) associated with a higher rate of POI (p = 0.006). This difference remained significant when adjusted for age, gender, BMI, pre-operative opioid use, procedure duration, and operative approach (p = 0.01). Patients with POI had significantly longer LOS (11.40 days vs. 5.12 days; p < 0.001) and direct cost of hospitalization ($38K vs. $22K; p < 0.001).

Conclusions

Minimizing fluid overload, particularly in the first 48 h after surgery, may be a strategy to reduce POI in patients undergoing ileostomy formation, and thus decrease postoperative LOS and hospitalization cost. Fluid restriction, diuresis, and changes in diet advancement or early stoma intubation should be considered measures that may improve outcomes and should be studied more intensively.
What evidence exists on how changes in marine ecosystem structure and functioning affect ecosystem services delivery? A systematic map protocol
Authors: Campagne C. Sylvie , Langridge Joseph , Claudet Joachim , Mongruel Rémi , Thiébaut Eric
Published: December 2021

Background

The current biodiversity crisis calls for an urgent need to sustainably manage human uses of nature. The Ecosystem Services (ES) concept defined as « the benefits humans obtain from nature » support decisions aimed at promoting nature conservation. However, marine ecosystems, in particular, endure numerous direct pressures (e.g., habitat loss and degradation, overexploitation, pollution, climate change, and the introduction of non-indigenous species) all of which threaten ecosystem structure, functioning, and the very provision of ES. While marine ecosystems often receive less attention than terrestrial ecosystems in ES literature, it would also appear that there is a heterogeneity of knowledge within marine ecosystems and within the different ES provided. Hence, a systematic map on the existing literature will aim to highlight knowledge clusters and knowledge gaps on how changes in marine ecosystems influence the provision of marine ecosystem services. This will provide an evidence base for possible future reviews, and may help to inform eventual management and policy decision-making.

Methods

We will search for all evidence documenting how changes in structure and functioning of marine ecosystems affect the delivery of ES, across scientific and grey literature sources. Two bibliographic databases, Scopus and Web of Science Core Collection, will be used with a supplementary search undertaken in Google scholar. Multiple organisational websites related to intergovernmental agencies, supra-national or national structures, and NGOs will also be searched. Searches will be performed with English terms only without any geographic or temporal limitations. Literature screening, against predefined inclusion criteria, will be undertaken on title, abstract, and then full texts. All qualifying literature will be subjected to coding and meta-data extraction. No formal validity appraisal will be undertaken. Indeed, the map will highlight how marine ecosystem changes impact the ES provided. Knowledge gaps will be identified in terms of which ecosystem types, biodiversity components, or ES types are most or least studied and how these categories are correlated. Finally, a database will be provided, we will narratively describe this evidence base with summary figures and tables of pertinent study characteristics.
The economic impact of schistosomiasis
Authors: Rinaldo Daniele , Perez-Saez Javier , Vounatsou Penelope , Utzinger Jürg , Arcand Jean-Louis
Published: December 2021

Background

The economic impact of schistosomiasis and the underlying tradeoffs between water resources development and public health concerns have yet to be quantified. Schistosomiasis exerts large health, social and financial burdens on infected individuals and households. While irrigation schemes are one of the most important policy responses designed to reduce poverty, particularly in sub-Saharan Africa, they facilitate the propagation of schistosomiasis and other diseases.

Methods

We estimate the economic impact of schistosomiasis in Burkina Faso via its effect on agricultural production. We create an original dataset that combines detailed household and agricultural surveys with high-resolution geo-statistical disease maps. We develop new methods that use the densities of the intermediate host snails of schistosomiasis as instrumental variables together with panel, spatial and machine learning techniques.

Results

We estimate that the elimination of schistosomiasis in Burkina Faso would increase average crop yields by around 7%, rising to 32% for high infection clusters. Keeping schistosomiasis unchecked, in turn, would correspond to a loss of gross domestic product of approximately 0.8%. We identify the disease burden as a shock to the agricultural productivity of farmers. The poorest households engaged in subsistence agriculture bear a far heavier disease burden than their wealthier counterparts, experiencing an average yield loss due to schistosomiasis of between 32 and 45%. We show that the returns to water resources development are substantially reduced once its health effects are taken into account: villages in proximity of large-scale dams suffer an average yield loss of around 20%, and this burden decreases as distance between dams and villages increases.

Conclusions

This study provides a rigorous estimation of how schistosomiasis affects agricultural production and how it is both a driver and a consequence of poverty. It further quantifies the tradeoff between the economics of water infrastructures and their impact on public health. Although we focus on Burkina Faso, our approach can be applied to any country in which schistosomiasis is endemic.

Graphical Abstract
Strain engineering and bioprocessing strategies for biobased production of porphobilinogen in Escherichia coli
Authors: Lall Davinder , Miscevic Dragan , Bruder Mark , Westbrook Adam , Aucoin Marc , Moo-Young Murray , Perry Chou C.
Published: December 2021

Strain engineering and bioprocessing strategies were applied for biobased production of porphobilinogen (PBG) using Escherichia coli as the cell factory. The non-native Shemin/C4 pathway was first implemented by heterologous expression of hemA from Rhodopseudomonas spheroids to supply carbon flux from the natural tricarboxylic acid (TCA) pathways for PBG biosynthesis via succinyl-CoA. Metabolic strategies were then applied for carbon flux direction from the TCA pathways to the C4 pathway. To promote PBG stability and accumulation, Clustered Regularly Interspersed Short Palindromic Repeats interference (CRISPRi) was applied to repress hemC expression and, therefore, reduce carbon flowthrough toward porphyrin biosynthesis with minimal impact to cell physiology. To further enhance PBG biosynthesis and accumulation under the hemC-repressed genetic background, we further heterologously expressed native E. coli hemB. Using these engineered E. coli strains for bioreactor cultivation based on ~ 30 g L−1 glycerol, we achieved high PBG titers up to 209 mg L−1, representing 1.73% of the theoretical PBG yield, with improved PBG stability and accumulation. Potential biochemical, genetic, and metabolic factors limiting PBG production were systematically identified for characterization.

Graphical Abstract
The influence of night length: Activity of the northern bat Eptesicus nilssonii under conditions of continuous light in midnight sun compared to a southern population
Authors: Frafjord Karl
Published: December 2021

Background

Nearly all insectivorous bats (Chiroptera) are strictly nocturnal, flying and feeding only between sunset and sunrise despite lower insect availability than by day, most likely to avoid predation by diurnal birds. This may represent a great challenge to bats living north of the Arctic Circle, which are exposed to bright nights in the period of the midnight sun. The northern bat Eptesicus nilssonii was studied at different latitudes in Norway (69, 66 and 58°N) by three techniques; visual counts of exits from and returns to roosts, infrared detection with a datalogger and an ultrasound data recorder, to reveal how their activity varied across latitude, season, and night, as well as across light levels. How does a nocturnal bat adjust to perpetual light and what light levels are tolerated?

Results

In the north the bats’ active season lasted 2.5 months, 1.5 months shorter than in the south. The bats only flew in 3-4 weeks of midnight sun, and hardly ever left the roost until the sun went behind a hill in the evening. In addition, the timing of their nightly hunting was highly influenced by the darkness of the sky, and they very rarely flew in light levels above 200 foot-candles (FC). As the night became darker than twilight from early August, the bats restricted their activity to between sunset and sunrise. This was the normal situation in southern Norway, where the bats tracked sunset and sunrise throughout the entire season. Those bats appeared to prefer light levels below 100-50 FC and hence, also did fly in twilight conditions.

Conclusions

The willingness to fly in twilight by the southern population may be a prerequisite to the northern bat’s survival in the land of the midnight sun. These bats must accept short nights in the first part of their summer season and must be willing to fly in light levels 2-4 times higher than in the south. Most likely, this depends on a reduced predation risk and good abundance of insects at night.