bluuebunny/crossref_metadata_2025 huggingface dataset:
Competitive employer positioning through career path analysis: the case of the Swiss nursing sector
Authors: Aeschbacher Remo , Addor Véronique
Published: April 2021

Background

The global shortage of nurses has caused strategic employer positioning and strengthened employer branding to become progressively relevant addressing the increased competition in the recruitment of nurses. This study provides competition-oriented strengths-and-weaknesses profiles for nurse attraction and attrition for the major types of healthcare institutions to advise on competitive employer positioning.

Methods

We applied bivariate weighted logistic regressions with cluster-adjusted standard errors to evaluate 4844 employer changes of 3011 nurses participating in thenurses at workstudy, whereby the reasons to quit (RQs) acted as both predictors of the former and the follow-up type of employer. For each employer type, we introduce a coordination system allocating each workplace criterion along its push and implicit pull characteristics, given through the specific odds ratios, to derive different strategic implications for an organisation’s competitive nurse recruitment.

Results

Depending on the employer type, workplace criteria were variously acting as push or pull factors in nurses’ career decisions.

Conclusions

Nurses’ career choices are affected by experienced and presumed workplace characteristics associated with specific employer types. Becoming aware of these associations and experiences, employers should leverage workplace criteria with relatively strong pull or/and weak push characteristics by intensified communication measurements and criteria with relatively weak pull or/and strong push characteristics should be enhanced to a competitive level.
Implementation research training for learners in low- and middle-income countries: evaluating behaviour change after participating in a massive open online course
Authors: Launois Pascal , Maher Dermot , Certain Edith , Ross Bella , Penkunas Michael J.
Published: April 2021

Background

Implementation research (IR) can play a critical role in the delivery of disease control interventions, particularly in low- and middle-income countries (LMICs). The growing demand for IR training has led to the development of a range of training programmes and university courses, the majority of which can not be accessed by learners in LMICs. This article reports on the evaluation of the massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases hosted by WHO on the topic of IR with a focus on infectious diseases of poverty. This study followed the Kirkpatrick Model to evaluate training programmes with a specific focus on post-training changes in behaviour.

Methods

MOOC participants were invited to take part in an anonymous online survey examining their knowledge of IR and how they applied it in their professional practice approximately 1–1.5 years after completing their course. The survey contained 43 open-ended, multiple choice and Likert-type questions. Descriptive statistics were calculated for the quantitative data and responses to the open-ended questions were thematically coded.

Results

A total of 748 MOOC participants responded to the survey. The demographic profile of the survey respondents aligned with that of the MOOC participants, with nearly 70% of respondents originating from Africa. Responses to the quantitative and open-ended survey questions revealed that respondents’ knowledge of IR had improved to a large extent as a result of the MOOC, and that they used the knowledge and skills gained in their professional lives frequently and had consequently changed their professional behaviour. Respondents most often cited the problem-solving aspect of IR as a substantial area of behavioral change influenced by participating in the MOOC.

Conclusions

These findings indicate that the MOOC was successful in targeting learners from LMICs, in strengthening their IR knowledge and contributing to their ability to apply it in their professional practice. The utility of MOOCs for providing IR training to learners in LMICs, where implementation challenges are encountered often, makes this platform an ideal standalone learning tool or one that could be combined with other training formats.
Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review
Authors: Elshahat Sarah , Treanor Charlene , Donnelly Michael
Published: April 2021

Background

It has been posited that physical activity (PA) has the potential to improve health outcomes and the health-related quality of life of people living with or beyond cancer. Despite the well-documented health benefits of PA, there is a low level of PA among cancer patients. A systematic scoping review was conducted to investigate attitudes, perceptions, preferences and barriers vs. facilitators to cancer patients’ PA participation.

Methods

A systematic search was performed across four automated databases (PubMed, Embase, PsycINFO and Medline) in keeping with the PRISMA guideline. All cancer types were included, and any age/gender groups were eligible. Both qualitative and quantitative studies were included. The Health Belief Model provided a conceptual framework for the conduct of the scoping review as well as guiding thinking to inform evidence-based interventions.

Results

Ninety-eight articles were included in this review. Nearly half of the studies focused on mixed cancer sites; breast cancer was the most commonly examined cancer type (19%). Post-treatment was the most commonly investigated stage (33%), followed by studies of mixed stages of the cancer trajectory (27%), the acute treatment stage (23%) and pre-treatment stage (1%). Patient treatment stage was not reported in 16% of studies. Cancer patients reported positive attitudes to PA and recognized its benefits for health and wellbeing. Cancer-related side effects (e.g. fatigue) were a leading physiological barrier to PA participation, whereas effective symptom management techniques/tools acted as a powerful facilitator. Psychosocial barriers included low motivation and kinesiophobia, and perceived health benefits and social support/guidance by healthcare providers were significant facilitators. Inaccessible fitness facilities hindered cancer patients’ PA engagement though the availability of tailored amenities appeared to be a strong facilitator. PA preferences varied in terms of type, place, time, company and source of information and pointed to the need for individualized PA programs.

Conclusions

There is a need for further research to identify barriers and facilitators to PA that are faced by patients with particular cancer types. Recommended PA promoting-strategies involve including exercise science professionals in healthcare teams and ensuring that fitness facilities are accessible.
A critical discourse analysis of adolescent fertility in Zambia: a postcolonial perspective
Authors: Munakampe Margarate N. , Michelo Charles , Zulu Joseph M.
Published: April 2021

Background

Despite global and regional policies that promote the reduction of adolescent fertility through ending early marriages and reducing early child-bearing, adolescent fertility remains high in most sub-Saharan countries. This study aimed to explore the competing discourses that shape adolescent fertility control in Zambia.

Methods

A qualitative case study design was adopted, involving 33 individual interviews and 9 focus group discussions with adolescents and other key-informants such as parents, teachers and policymakers. Thematic and critical discourse analysis were used to analyze the data.

Results

Adolescents’ age significantly reduced their access to Sexual and Reproductive Health, SRH services. Also, adolescent fertility discussions were influenced by marital norms and Christian beliefs, as well as health and rights values. While early marriage or child-bearing was discouraged, married adolescents and adolescents who had given birth before faced fewer challenges when accessing SRH information and services compared to their unmarried or nulliparous counterparts. Besides, the major influencers such as parents, teachers and health workers were also conflicted about how to package SRH information to young people, due to their varying roles in the community.

Conclusion

The pluralistic view of adolescent fertility is fueled by “multiple consciousnesses”. This is evidenced by the divergent discourses that shape adolescent fertility control in Zambia, compounded by the disempowered position of adolescents in their communities. We assert that the competing moral worlds, correct in their own right, viewed within the historical and social context unearth significant barriers to the success of interventions targeted towards adolescents’ fertility control in Zambia, thereby propagating the growing problem of high adolescent fertility. This suggests proactive consideration of these discourses when designing and implementing adolescent fertility interventions.
Comparative efficacy and safety profile for the treatment of humeral bone cysts in children: curettage and mixed bone grafting either with or without elastic intramedullary nailing
Authors: Wang Xuan , Han Jiuhui , Li Yazhou , Liu Yuchang , Luo Junzhong
Published: April 2021

Purpose

The primary aim of our study was to evaluate the comparative efficacy and safety profile of curettage and mixed bone grafting without instrument or with elastic intramedullary nailing in the treatment of humeral bone cyst in children.

Methods

Our retrospective study included a total of 48 children harboring humeral bone cyst in our hospital from August 2012 to February 2019. The patients enrolled were divided into elastic nailing group with the application of elastic intramedullary nailing (n= 25) and control group without using instrument (n= 23) during the management of curettage and mixed bone grafting. The following medical outcomes of the two groups were monitored and recorded: the amount of intraoperative blood loss, operation time and postoperative full weight-bearing time, in addition to postoperative clinical effects after 1 year, the function and pain level of shoulder joint before and 1, 3, 6, 9, 12, and 16 months after operation. Follow-up radiographic outcomes were reviewed to observe bone healing, local recurrence and internal fixation loosening, and other postoperative complications.

Results

The clinical curative effect of the elastic nailing group was higher than that of the control group 16 months after operation (96.00% > 73.91%,P< 0.05). The intraoperative blood loss and postoperative full weight-bearing time in the elastic nailing group were less than those in the control group (P< 0.05), but the operation time was statistically insignificant between the two groups (P> 0.05). Before operation, the shoulder joint function of the two groups was comparable (P> 0.05), while the function showed remarkably better outcome in the elastic nailing group than control group 1 to 16 months after operation (P< 0.05). Before operation, the pain level of the two groups was comparable (P> 0.05), while 1 to 16 months after operation, the pain level of the elastic nailing group was significantly lower than that of the control group (P< 0.05). Patients in both groups were followed up for 16 months. Mixed bone grafting fusion was indicated by imaging CT and X-ray during the follow-up period, with an average fusion time of 11.3 ± 1.2 months (range, 8–16 months). Three months after operation, there was 1 case of incomplete pathological fracture in the control group, while no related complications occurred in the elastic nailing group. Moreover, no tumor recurrence was observed in the two groups. The two groups were comparable in terms of the incidence of complications (P> 0.05).

Conclusion

Children with humeral cyst treated with curettage and mixed bone grafting with the additional use of elastic intramedullary nailing exerted superior results to those without using instrument as there are beneficial outcomes and safety profile and no complications.
Conservative treatment of left ventricular pseudoaneurysm after mitral valve replacement due to early left ventricular rupture: a case report
Authors: Duan Qun-Jun , Duan Cui-Ting , Yang Wei-Jun , Dong Ai-Qiang
Published: April 2021

Background

Left ventricular pseudoaneurysm due to early left ventricle rupture is a serious complication after cardiac surgery. Urgent surgery is recommended in most cases with a high mortality rate. Conservative treatment of a left ventricular pseudoaneurysm due to early left ventricle rupture is very rare.

Case presentation

We present a 61-year-old woman with left ventricular pseudoaneurysm after mitral valve replacement due to early left ventricle rupture. This patient was treated in a conservative approach. This patient had an uneventful recovery. She was in good condition and remained asymptomatic 3.5 years after mitral valve surgery.

Conclusion

This case suggests that medical treatment left ventricular pseudoaneurysm patients has a limited but acceptable role in selected and unusual circumstances.
Correction to: French recommendations for the management of systemic necrotizing vasculitides (polyarteritis nodosa and ANCA-associated vasculitides)
Authors:   Collaborators, Terrier Benjamin , Darbon Raphaël , Durel Cécile-Audrey , Hachulla Eric , Karras Alexandre , Maillard Hélène , Papo Thomas , Puechal Xavier , Pugnet Grégory , Quemeneur Thomas , Samson Maxime , Taille Camille , Guillevin Loïc
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
Palmitate reduces starvation-induced ER stress by inhibiting ER-phagy in hypothalamic cells
Authors: Lim Yun , Kim Seolsong , Kim Eun-Kyoung
Published: April 2021

Palmitate is a saturated fatty acid that is well known to induce endoplasmic reticulum (ER) stress and autophagy. A high-fat diet increases the palmitate level in the hypothalamus, the main region of the brain regulating energy metabolism. Interestingly, hypothalamic palmitate level is also increased under starvation, urging the study to distinguish the effects of elevated hypothalamic palmitate level under different nutrient conditions. Herein, we show that ER-phagy (ER-targeted selective autophagy) is required for progress of ER stress and that palmitate decreases ER stress by inhibiting ER-phagy in hypothalamic cells under starvation. Palmitate inhibited starvation-induced ER-phagy by increasing the level of B-cell lymphoma 2 (Bcl-2) protein, which inhibits autophagy initiation. These findings suggest that, unlike the induction of ER stress under nutrient-rich conditions, palmitate protects hypothalamic cells from starvation-induced stress by inhibiting ER-phagy.
Structure, function and inhibition of critical protein–protein interactions involving mixed lineage leukemia 1 and its fusion oncoproteins
Authors: Li Xin , Song Yongcheng
Published: April 2021

Mixed lineage leukemia 1 (MLL1, also known as MLL or KMT2A) is an important transcription factor and histone-H3 lysine-4 (H3K4) methyltransferase. It is a master regulator for transcription of important genes (e.g., Hox genes) for embryonic development and hematopoiesis. However, it is largely dispensable in matured cells. Dysregulation of MLL1 leads to overexpression of certain Hox genes and eventually leukemia initiation. Chromosome translocations involving MLL1 cause ~ 75% of acute leukemia in infants and 5–10% in children and adults with a poor prognosis. Targeted therapeutics against oncogenic fusion MLL1 (onco-MLL1) are therefore needed. Onco-MLL1 consists of the N-terminal DNA-interacting domains of MLL1 fused with one of > 70 fusion partners, among which transcription cofactors AF4, AF9 and its paralog ENL, and ELL are the most frequent. Wild-type (WT)- and onco-MLL1 involve numerous protein–protein interactions (PPI), which play critical roles in regulating gene expression in normal physiology and leukemia. Moreover, WT-MLL1 has been found to be essential for MLL1-rearranged (MLL1-r) leukemia. Rigorous studies of such PPIs have been performed and much progress has been achieved in understanding their structures, structure–function relationships and the mechanisms for activating gene transcription as well as leukemic transformation. Inhibition of several critical PPIs by peptides, peptidomimetic or small-molecule compounds has been explored as a therapeutic approach for MLL1-r leukemia. This review summarizes the biological functions, biochemistry, structure and inhibition of the critical PPIs involving MLL1 and its fusion partner proteins. In addition, challenges and perspectives of drug discovery targeting these PPIs for the treatment of MLL1-r leukemia are discussed.
Magnitude and associated factors of virological failure among children on ART in Bahir Dar Town public health facilities, Northwest Ethiopia: a facility based cross-sectional study
Authors: Gelaw Belete , Mulatu Getasew , Tesfa Getasew , Marew Chalie , Chekole Bogale , Alebel Animut
Published: April 2021

Background

Despite the rapid scale-up of antiretroviral therapy, virologic failure has become global public health concern and challenge, especially in developing countries. Viral load monitoring is an important approach to identify treatment failure and develop public health interventions in children receiving antiretroviral therapy. Thus, this study aims to assess the magnitude and associated factors of virological failure among children on antiretroviral therapy.

Methods

A facility-based cross-sectional study was conducted among 399 HIV-positive children on antiretroviral therapy from 2016 to 2019 in Bahir Dar Town public health facilities. Data were extracted from children’s charts using a standardized data extraction tool, adapted from ART intake and follow-up forms. Data were entered using Epi-Data Version 3.1, and analyzed using SPSS Version 25. Bivariable and multivariable binary logistic regression models were done to identify factors associated with virological failure. Variables with p-values < 0.25 were fitted into the multivariable analysis. Finally, variables with p-values <0.05 were considered as statistically significant factors.

Results

The period prevalence of virological failure was found to be 14.8% (95% CI: 11.5–19.3%). Opportunistic infections (AOR = 2.19, CI: 1.13–4.25), history of treatment interruption and restart (AOR = 2.21, CI: 1.09–4.54), younger age (AOR = 2.42, CI: 1.02–5.74), poor/fair ART adherence (AOR = 2.19, CI: 1.05–4.57), and advanced baseline WHO clinical staging (AOR = 2.32, CI: 1.14–4.74) were found to be factors significantly associated with virological failure.

Conclusion

The magnitude of virological failure among HIV-infected children remained high. Children with poor/fair ART adherence, history of treatment interruption, advanced baseline WHO clinical staging, younger age, and opportunistic infections were significantly associated with virologic failure. Thus, special attention should be given to children who had poor/fair ART adherence and presenting with opportunistic infections.
Effect of the combination of automated peripheral mechanical stimulation and physical exercise on aerobic functional capacity and cardiac autonomic control in patients with Parkinson’s disease: a randomized clinical trial protocol
Authors: Zelada-Astudillo Nicolle , Moreno Vinicius Christianini , Herrera-Santelices Andrea , Barbieri Fabio Augusto , Zamunér Antonio Roberto
Published: April 2021

Background

Automated peripheral mechanical stimulation (AMPS) has been proposed as a new complementary therapy with potential for improving motor and cardiovascular abnormalities in Parkinson’s disease (PD). However, AMPS long-term effects and its combination with physical exercise are unknown. Thus, this study aims to compare the effects of a program of 12 weeks of physical exercise with a 12-week intervention program combining physical exercise and AMPS on the aerobic capacity, cardiac autonomic control, and gait parameters in patients with PD.

Methods

A randomized, controlled clinical trial will be conducted. Older volunteers with PD will be randomly assigned to one of the two groups studied: (1) exercise or (2) AMPS + exercise. Both groups will undergo an exercise program of 24 sessions, for 12 weeks, performed twice a week. Before exercise sessions, the group AMPS + exercise will receive a session of active AMPS, while the group exercise will receive an AMPS sham intervention. Shapiro-Wilk’s and Levene’s tests will be used to check for data normality and homogeneity, respectively. In case parametric assumptions are fulfilled, per-protocol and intention-to-treat analyses will be performed using a mixed model analysis of variance to check for group*time interaction. Significance level will be set at 5%.

Discussion

Several non-pharmacological treatment modalities have been proposed for PD, focusing primarily on the reduction of motor and musculoskeletal disorders. Regular exercise and motor training have been shown to be effective in improving quality of life. However, treatment options in general remain limited given the high prevalence and adverse impact of these disorders. So, developing new strategies that can potentiate the improvement of motor disabilities and also improve non-motor symptoms in PD is relevant. It is expected that the participants from both groups will improve their quality of life, gait parameters, and their cardiac autonomic control, with greater improvements being observed in the group combining active AMPS and physical exercise.

Trial registration

ClinicalTrials.govNCT04251728. Registered on February 05, 2020.
Developing a complex intervention whilst considering implementation: the TANDEM (Tailored intervention for ANxiety and DEpression Management) intervention for patients with chronic obstructive pulmonary disease (COPD)
Authors: Steed Liz , Heslop-Marshall Karen , Sohanpal Ratna , Saqi-Waseem Sarah , Kelly Moira , Pinnock Hilary , Taylor Stephanie
Published: April 2021

Background

Guidelines now call for a thorough and comprehensive description of the development of healthcare interventions to aid evaluation and understanding of the processes of change. This was the primary aim of this study but we also recognised that effective interventions are commonly not implemented in clinical practice. It is suggested that insufficient attention is given to the implementation process at the development phase of interventions. This study outlines the 5 step iterative process we adopted for considering both implementation and effectiveness issues from the outset of intervention development. We use the development of a complex intervention Tailored intervention for ANxiety and DEpression Management (TANDEM) in patients with chronic obstructive pulmonary disease to illustrate this process.

Methods

Intervention development built upon the Medical Research Council framework for developing complex interventions and the person-based approach for development of behavioural interventions. Building an expert team, specifying theory, qualitative data collection and pre-piloting were all critical steps in our intervention development and are described here.

Results

Contact with experts in the field, and explicitly building on previous work, ensured efficiency of design. Qualitative work suggested guiding principles for the intervention such as introducing mood in relation to breathlessness, and providing flexible tailoring to patients’ needs, whilst implementation principles focused on training selected respiratory professionals and requiring supervision to ensure standards of care. Subsequent steps of intervention development, pre-piloting and intervention refinement led to an intervention that was deemed acceptable and if successful will be ready for implementation.

Conclusions

The TANDEM study was developed efficiently by building on previous work and considering implementation issues from the outset, with the aim that if shown to be effective it will have more rapid translation in to the health care system with accelerated patient benefits.

Trial registration

ISRCTN ISRCTN59537391. Registered on 20 March 2017. Protocol version 6.0, 22 April 2018.
GSK3β rephosphorylation rescues ALPL deficiency-induced impairment of odontoblastic differentiation of DPSCs
Authors: Zhang Liqiang , Zhao Jiangdong , Dong Jiayi , Liu Yuting , Xuan Kun , Liu Wenjia
Published: April 2021

Background

Premature exfoliation of the deciduous teeth is a common manifestation in childhood patients with hypophosphatasia (HPP), which is an autosomal inherited disease caused by ALPL mutations. Dysplasia of the cementum, dentin, and alveolar bone has been proposed to be the main reasons for the exfoliation of teeth, while the extraordinarily complex intracellular mechanisms remain elusive. Dental pulp stem cells (DPSCs) have been demonstrated to successfully regenerate functional pulp-dentin-like tissue. Dental pulp cells derived from HPP patients impaired mineralization; however, insight into the deeper mechanism is still unclear.

Methods

The effects of ALPL on odontoblastic differentiation of DPSCs from HPP patient were assessed by Alizarin Red staining, immunofluorescent staining, Western blot and RT-PCR, and micro-CT assays.

Result

Here, we found DPSCs from HPP patient exhibited low ALP activity and impaired odontoblastic differentiation. Meanwhile, we found that loss of function of ALPL reduced phosphorylation of GSK3β in DPSCs. While GSK3β rephosphorylation improved odontoblastic differentiation of HPP DPSCs with LiCl treatment. Finally, we demonstrated systemic LiCl injection ameliorated tooth-associated defects in ALPL+/− mice by enhanced phosphorylation of GSK3β in the teeth.

Conclusions

Our study indicates that ALPL regulates odontoblastic differentiation of DPSCs and provides useful information for understanding how ALPL deficiency led to tooth dysplasia and, ultimately, may inform efforts at improvement tooth defects in HPP patients.
Mesenchymal stromal/stem cells and their exosomes for restoration of spermatogenesis in non-obstructive azoospermia: a systemic review
Authors: Zhankina Rano , Baghban Neda , Askarov Manarbek , Saipiyeva Dana , Ibragimov Almaz , Kadirova Bakhyt , Khoradmehr Arezoo , Nabipour Iraj , Shirazi Reza , Zhanbyrbekuly Ulanbek , Tamadon Amin
Published: April 2021

Stem cells have been introduced as new promising therapeutic agents in treatment of degenerative diseases because of having high differentiation potential while maintaining the ability to self-replicate and retaining features of their source cells. Among different type of cell therapies, mesenchymal stromal/stem cell (MSC) therapy is being increasingly developed as a new way to treat structural defects that need to be repaired and regenerated. Non-obstructive azoospermia (NOA) is a reproductive disease in men that causes infertility in 10% of infertile men. Based on in vitro studies, MSCs from different tissue sources have been differentiated into germ cells or gamete progenitor cells by simple methods in both male and female. On the other hand, the therapeutic effects of MSCs have been evaluated for the treatment of NOA animal models created by chemical or surgical compounds. The results of these studies confirmed successful allotransplantation or xenotransplantation of MSCs in the seminiferous tubules. As well, it has been reported that exosomes secreted by MSCs are able to induce the process of spermatogenesis in the testes of infertile animal models. Despite numerous advances in the treatment of reproductive diseases in men and women with the help of MSCs or their exosomes, no clinical trial has been terminated on the treatment of NOA. This systematic review attempts to investigate the possibility of MSC therapy for NOA in men.
Synthetic speech detection through short-term and long-term prediction traces
Authors: Borrelli Clara , Bestagini Paolo , Antonacci Fabio , Sarti Augusto , Tubaro Stefano
Published: April 2021

Several methods for synthetic audio speech generation have been developed in the literature through the years. With the great technological advances brought by deep learning, many novel synthetic speech techniques achieving incredible realistic results have been recently proposed. As these methods generate convincing fake human voices, they can be used in a malicious way to negatively impact on today’s society (e.g., people impersonation, fake news spreading, opinion formation). For this reason, the ability of detecting whether a speech recording is synthetic or pristine is becoming an urgent necessity. In this work, we develop a synthetic speech detector. This takes as input an audio recording, extracts a series of hand-crafted features motivated by the speech-processing literature, and classify them in either closed-set or open-set. The proposed detector is validated on a publicly available dataset consisting of 17 synthetic speech generation algorithms ranging from old fashioned vocoders to modern deep learning solutions. Results show that the proposed method outperforms recently proposed detectors in the forensics literature.
Reporting quality of clinical practice guidelines regarding gout and hyperuricemia according to the RIGHT checklist: systematic review
Authors: Wang Can , Luo Xufei , Li Maichao , Cui Lingling , Li Xinde , Han Lin , Wang Xuefeng , Ren Wei , He Yuwei , Sun Wenyan , Li Changgui , Chen Yaolong , Liu Zhen
Published: April 2021

Background

The Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist was used to assess the reporting quality of 2009–2019 clinical practice guidelines (CPGs) regarding gout and hyperuricemia, aimed to improve the reporting quality of future guidelines.

Methods

We searched PubMed, the Chinese Biomedical Literature database, the Wanfang Database, and the China National Knowledge Infrastructure from January 2009 to June 2019 for guidelines regarding gout and hyperuricemia. We also searched the websites of guideline development organizations (the Guidelines International Network, the National Institute for Health and Clinical Excellence, the American College of Rheumatology, and the European League Against Rheumatism (EULAR)). Furthermore, supplementary guidelines reported in included articles were systematically searched, as well as Google Scholar.

Results

Seventeen guidelines were included, of which one was in Chinese and 16 were in English. The mean reporting rate of the 35 items specified was 14.9 (42.5%); only five CPGs (29.4%) had a reporting rate >50%. Of the 35 items, three were very frequently reported. The reporting proportion of the seven domains (basic information, background, evidence, recommendations, review and quality assurance, funding and declaration and management of interests, and other information) were 64.7%, 36.8%, 50.6%, 42.9%, 8.82%, 33.8%, and 31.4%, respectively.

Conclusion

The reporting quality of the present guidelines for gout and hyperuricemia is relatively poor. We suggest that the RIGHT reporting checklist should be used by CPG developers to ensure higher reporting quality of future guidelines.
Evaluation of a multimodal intervention to promote rational antibiotic use in primary care
Authors:   RAI Study Group, Petruschke Inga , Salm Florian , Kaufmann Michelle , Freytag Antje , Gensichen Jochen , Behnke Michael , Kramer Tobias Siegfried , Hanke Regina , Gastmeier Petra , Schneider Sandra
Published: April 2021

Background

Increasing antimicrobial resistance is a serious societal challenge affecting outpatient, inpatient and veterinary care. The GermanOne-Healthproject, RAI (Rational use of Antibiotics via Information and Communication) addresses all three sectors. In the outpatient sector, General Practitioners (GPs) are the main prescribers of antibiotics and were therefore, targeted for this study. A multimodal intervention focusing on Acute Respiratory Tract infections (ARI) was designed and implemented. The aim of this study was to evaluate acceptance, rating and the self-reported impact of the intervention among GPs.

Methods

The intervention offered six tools: a GP training on rational antibiotic use, an app for self-monitoring, a leaflet and a set of posters (both for use as information materials in waiting rooms) and both digital and printed information prescriptions (material for ‘prescribing’ information instead of an antibiotic to the patient). The tools could be used according to individual preferences. The intervention was conducted between August 2016 and July 2017. Following the intervention, a three pages anonymous questionnaire was sent to all 271 participants. Items covered socio-demographic and professional background, use and judgement of the intervention tools (6 point Likert scale), impact of the intervention tools (4 point Likert scale).

Results

The response rate was 39% (n = 107). On average, respondents used 3.1 of the six available tools, with printed information prescriptions used most frequently (79%). Digital information prescriptions were used more frequently by men than by women (OR 2.8; 95% CI 1.16–7.24;p = 0.02). Eighty-seven percent of respondents stated that information prescriptions supported doctor-patient communication. In a comparison of the overall impression of the different intervention tools the GP training on rational antibiotic use was rated best (1.67 on a 6 point scale with 1 = highest, 6 = lowest) and most often noted as having had a “strong” or “very strong” impact on personal antibiotic prescribing behavior.

Conclusions

The multimodal intervention addressing education and communication was well accepted among GPs and could help in fostering rational use of antibiotics in primary care.
Role of oregano and Citrus species-based essential oil preparation for the control of coccidiosis in broiler chickens
Authors: Gordillo Jaramillo Francisco Xavier , Kim Da-Hye , Lee Sang Hyeok , Kwon Sun-Kwan , Jha Rajesh , Lee Kyung-Woo
Published: April 2021

Background

Due to presence of drug-resistant Eimeria strains and raised public health safety concerns about drug residues in the meat, there is renewed interest in the search for natural alternatives to the coccidiosis control agents. This study was conducted to test the anticoccidial efficacy of oregano and Citrus spp.-based essential oils for broilers.

Methods

A total of 280 7-day-old broiler chicks were fed a control diet or diets with salinomycin or essential oils for up to 35 d of age. On d 14, half of the control groups and the treated groups were orally challenged with a coccidiosis vaccine at 25 times higher than the recommended vaccine dose. Control diet-fed chickens that were gavaged with phosphate-buffered saline were considered non-challenged control group.

Results

Eimeria challenge or dietary additives failed to affect growth performance during the 7 to 20 d growth period although essential oil-fed chickens exhibited the lowest body wight gain (P = 0.332) and the highest feed conversion ratio (P = 0.062). Oocysts in the litter were detected in the challenged control diet group and the challenged/essential oil-fed groups at 21 and 35 d, respectively. Superoxide dismutase activity in the serum was elevated (P = 0.059) in the salinomycin-fed chickens compared to the challenged controls. Alpha-1-acid glycoprotein was decreased by 28.7% in the salinomycin-fed chickens but increased by 38.1% in the essential oil group compared with the challenged control group. Challenged control group exhibited a significantly higher cooking loss of the thigh meat, compared to the non-challenged control diet group, which was marginally mitigated by dietary supplementation with essential oils. Chickens fed essential oil-added diet had the highest branched-chain fatty acids contents in the cecum.

Conclusions

In conclusion, this study shows that oregano and Citrus-based essential oil preparation did not affect growth performance in broiler chickens challenged with the coccidiosis vaccine nor did Eimeria-specific duodenal lesion. However, dietary essential oil preparation lowered oocysts present in litter materials and altered branched-chain fatty acids in cecal digesta. Beneficial findings of the essential oil preparation on volatile fatty acids and oocysts output may warrant further research into assessing its effectiveness and its efficacy in pathogenic field-isolate Eimeria spp.-induced coccidiosis disease model.
Repetitive mild traumatic brain injury in mice triggers a slowly developing cascade of long-term and persistent behavioral deficits and pathological changes
Authors: Xu Xiaoyun , Cowan Matthew , Beraldo Flavio , Schranz Amy , McCunn Patrick , Geremia Nicole , Brown Zalman , Patel Maitray , Nygard Karen L. , Khazaee Reza , Lu Lihong , Liu Xingyu , Strong Michael J. , Dekaban Gregory A. , Menon Ravi , Bartha Robert , Daley Mark , Mao Haojie , Prado Vania , Prado Marco A. M. , Saksida Lisa , Bussey Tim , Brown Arthur
Published: April 2021

We have previously reported long-term changes in the brains of non-concussed varsity rugby players using magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI) and functional magnetic imaging (fMRI). Others have reported cognitive deficits in contact sport athletes that have not met the diagnostic criteria for concussion. These results suggest that repetitive mild traumatic brain injuries (rmTBIs) that are not severe enough to meet the diagnostic threshold for concussion, produce long-term consequences. We sought to characterize the neuroimaging, cognitive, pathological and metabolomic changes in a mouse model of rmTBI. Using a closed-skull model of mTBI that when scaled to human leads to rotational and linear accelerations far below what has been reported for sports concussion athletes, we found that 5 daily mTBIs triggered two temporally distinct types of pathological changes. First, during the first days and weeks after injury, the rmTBI produced diffuse axonal injury, a transient inflammatory response and changes in diffusion tensor imaging (DTI) that resolved with time. Second, the rmTBI led to pathological changes that were evident months after the injury including: changes in magnetic resonance spectroscopy (MRS), altered levels of synaptic proteins, behavioural deficits in attention and spatial memory, accumulations of pathologically phosphorylated tau, altered blood metabolomic profiles and white matter ultrastructural abnormalities. These results indicate that exceedingly mild rmTBI, in mice, triggers processes with pathological consequences observable months after the initial injury.
Blended and more: instructors organize sensemaking opportunities for mathematical equations in different ways when teaching the same scientific phenomenon
Authors: Zhao Fang Fang , Chau Linh , Schuchardt Anita
Published: April 2021

Background

Many students solving quantitative problems in science struggle to apply mathematical instruction they have received to novel problems. The few students who succeed often draw on both their mathematical understanding of the equation and their scientific understanding of the phenomenon. Understanding the sensemaking opportunities provided during instruction is necessary to develop strategies for improving student outcomes. However, few studies have examined the types of sensemaking opportunities provided during instruction of mathematical equations in science classrooms and whether they are organized in ways that facilitate integration of mathematical and scientific understanding. This study uses a multiple case study approach to examine the sensemaking opportunities provided by four different instructors when teaching the same biological phenomenon, population growth. Two questions are addressed: (1) What types of sensemaking opportunities are provided by instructors, and (2) How are those sensemaking opportunities organized? The Sci-Math Sensemaking Framework, previously developed by the authors, was used to identify the types of sensemaking. Types and organization of sensemaking opportunities were compared across the four instructors.

Results

The instructors provided different opportunities for sensemaking of equations, even though they were covering the same scientific phenomenon. Sensemaking opportunities were organized in three ways, blended (previously described in studies of student problem solving as integration of mathematics and science resources), and two novel patterns, coordinated and adjacent. In coordinated sensemaking, two types of sensemaking in the same dimension (either mathematics or science) are explicitly connected. In adjacent sensemaking, two different sensemaking opportunities are provided within the same activity but not explicitly connected. Adjacent sensemaking was observed in three instructors’ lessons, but only two instructors provided opportunities for students to engage in blended sensemaking.

Conclusions

Instructors provide different types of sensemaking opportunities when teaching the same biological phenomenon, making different resources available to students. The organization of sensemaking also differed with only two instructors providing blended sensemaking opportunities. This result may explain why few students engage in the successful strategy of integrating mathematics and science resources when solving quantitative problems. Documentation of these instructional differences in types and organization of sensemaking provides guidance for future studies investigating the effect of instruction on student sensemaking.
Do root modules still exist after they die?
Authors: Li Jihong , You Chengming , Zhang Li , Li Han , Tan Bo , Liu Yang , Wang Lixia , Liu Sining , Xu Zhenfeng
Published: April 2021

Background

The terminal branch orders of plant root systems are increasingly known as an ephemeral module. This concept is crucial to recognize belowground processes. However, it is unknown if root modules still exist after they die?

Methods

The decomposition patterns of the first five root orders were observed for 3 years using a branch-order classification, a litter-bag method and sequential sampling in a common subalpine tree species (Picea asperata) of southwestern China.

Results

Two root modules were observed during the 3-year incubation. Among the first five branch orders, the first three order roots exhibited temporal patterns of mass loss, nutrients and stoichiometry distinct from their woody mother roots throughout the experimental period. This study, for the first time, reported the decomposition pattern of each individual root order and found a similar decomposition dynamic among ephemeral root branches in a forest tree species.

Conclusions

Results from this study suggest that root modules may also exist after death, while more data are needed for confirmation. The findings may further advance our understanding of architecture-associated functional heterogeneity in the fine-root system and also improve our ability to predict belowground processes.
Evaluation and Validation of a Joint Stress Test to Induce Activity-Related Knee Joint Discomfort — a Prospective Case-Control Study
Authors: Schön Christiane , Reule Claudia , Knaub Katharina , Micka Antje , Wilhelm Manfred , Alt Wilfried , Menzel Daniel
Published: April 2021

Background

The assessment of improvement or maintenance of joint health in healthy subjects is a great challenge. The aim of the study was the evaluation of a joint stress test to assess joint discomfort in subjects with activity-related knee joint discomfort (ArJD).

Results

Forty-five subjects were recruited to perform the single-leg-step-down (SLSD) test (15 subjects per group). Subjects with ArJD of the knee (age 22–62 years) were compared to healthy subjects (age 24–59 years) with no knee joint discomfort during daily life sporting activity and to subjects with mild-to-moderate osteoarthritis of the knee joint (OA, Kellgren score 2–3, age 42–64 years). The subjects performed the SLSD test with two different protocols: (I) standardization for knee joint discomfort; (II) standardization for load on the knee joint. In addition, range of motion (ROM), reach test, acute pain at rest and after a single-leg squat and knee injury, and osteoarthritis outcome score (KOOS) were assessed.

In OA and ArJD subjects, knee joint discomfort could be reproducibly induced in a short time interval of less than 10 min (200 steps). In healthy subjects, no pain was recorded. A clear differentiation between study groups was observed with the SLSD test (maximal step number) as well as KOOS questionnaire, ROM, and reach test. In addition, a moderate to good intra-class correlation was shown for the investigated outcomes.

Conclusions

These results suggest the SLSD test is a reliable tool for the assessment of knee joint health function in ArJD and OA subjects to study the improvements in their activities. Further, this model can be used as a stress model in intervention studies to study the impact of stress on knee joint health function.
Studies on the anthelmintic potentials of the roots of Asparagus racemosus willd. (Asparagaceae)
Authors: Soren Amar Deep , Yadav Arun Kumar
Published: April 2021

Background

The Santhal tribe in Assam, India use the roots of Asparagus racemosus (Asparagaceae) as a deworming remedy. The study aimed to investigate the anthelmintic credentials of this plant, using two representative groups of helminth parasites.

Methods

The in vitro testing was conducted against Hymenolepis diminuta (cestode) and Syphacia obvelata (nematode). Parasites were exposed to 10, 20 and 30 mg/ml concentrations of plant extract, and efficacy was adjudged on the basis of parasites paralysis and mortality. In vivo efficacy was examined using H. diminuta-rat and S. obvelata-mice models where animals were administered 125, 250 and 500 mg/kg doses of extract.

Results

In vitro assay, against H. diminuta revealed that at 30 mg/ml concentration the extract showed almost a comparable efficacy with that of reference drug praziquantel (PZQ) (1 mg/ml). The in vitro efficacy of extract against S. obvelata was however lower than H. diminuta. In vivo studies against H. diminuta at 500 mg/kg revealed 53.88 and 24 % reduction in eggs per gram (EPG) and worm counts respectively. Against S. obvelata the extract showed 26.61 and 30.93 % reduction for the same.

Conclusions

The findings of this study present suggest that the roots of A. racemosus are effective against intestinal helminthic infections and justifies its use as an anthelmintic in the traditional medicine of the Santhals.