bluuebunny/crossref_metadata_2025 huggingface dataset:
Experience With Proximal Median Nerve Entrapment by the Lacertus Fibrosus
Authors: Cline Justin A. , Frantz Lisa M. , Adams Jessica M. , Hearon Bernard F.
Published: March 2023

Background:

Unconscious bias of the clinician favors the diagnosis of carpal tunnel syndrome (CTS) in patients with median paresthesia. We hypothesized that more patients in this cohort would be diagnosed with proximal median nerve entrapment (PMNE) by strengthening our cognitive awareness of this alternative diagnosis. We also hypothesized that patients with PMNE may be successfully treated with surgical release of the lacertus fibrosus (LF).

Methods:

In this retrospective study, cases of median nerve decompression at the carpal tunnel and in the proximal forearm for the 2-year periods before and after adopting strategies to mitigate cognitive bias for CTS were enumerated. Patients diagnosed with PMNE and treated by LF release under local anesthesia were evaluated to determine surgical outcome at minimum 2-year follow-up. Primary outcome measures were changes in preoperative median paresthesia and proximal median-innervated muscle strength.

Results:

There was a statistically significant increase in PMNE cases identified after our heightened surveillance was initiated ( z = 3.433, P < .001). In 10 of 12 cases, the patient had previous ipsilateral open carpal tunnel release (CTR) but experienced recurrent median paresthesia. In 8 cases evaluated an average of 5 years after LF release, there was improvement in median paresthesia and resolution of median-innervated muscle weakness.

Conclusions:

Owing to cognitive bias, some patients with PMNE may be misdiagnosed with CTS. All patients with median paresthesia, particularly those with persistent or recurrent symptoms after CTR, should be assessed for PMNE. Surgical release limited to the LF may be an effective treatment for PMNE.
Vascularized versus non-vascularized bone grafting for scaphoid nonunion without avascular necrosis: a randomized clinical trial
Authors: Fan Stacy , Suh Nina , MacDermid Joy C. , Ross Douglas , Grewal Ruby
Published: March 2023

In this clinical trial, patients were randomized to receive a pedicled vascularized bone graft, based on the 1,2-intercompartmental supraretinacular artery, or a non-vascularized iliac crest graft. Fixation was done with K-wires. Union and time to union were assessed using CT scans at regular intervals. Twenty-three patients received a vascularized graft, and 22 received a non-vascularized graft. Thirty-eight patients were available for union assessment and 23 for clinical measurements. There were no significant differences in union incidence, time to union, incidence of complications, patient-reported outcome scores, or wrist mobility and grip strength at final follow-up between the treatment groups. Smokers were 60% less likely to achieve union, independent of graft type. When controlling for smoking, patients receiving a vascularized graft were 72% more likely to achieve union. Given our small sample size, results should be interpreted with caution.

Level of evidence: I
Reimagining Education for Successful and Sustainable Digital Shifting
Authors: Aldhafeeri Fayiz M. , Alotaibi Asmaa A.
Published: March 2023

This research paper seeks to explore a newly proposed model to assist public educational systems with properly integrating digital technology into their currently practiced teaching and learning processes. Digital learning has been adopted for the past two decades under various forms of internet-based learning, such as online learning, e-learning, blended learning, and hybrid learning. However, those practices and initiatives have encountered many obstacles that crippled educational communities in many parts of the world and prevented them from successfully and sustainably integrating digital learning into their systems. Unfortunately, the crisis of the COVID-19 outbreak has clearly revealed the need for immediate action to find effective methods to ensure the quality implementation of digital learning in K-12 education. Consequently, this paper benefits both individuals and governments with successful and sustainable solutions for K-12 education. This proposed digital education shifting (DES) model was constructed based on several learning theories, mainly the cognitive load theory, constructive learning theory, and connectivism theory. To achieve its objectives, this paper adopts a descriptive method by constructing an open-ended questionnaire to collect experts’ opinions and suggestions on DES. The results revealed high agreement among experts on DES effectiveness.
Presence and Impact of the Articles on Corporate Social Responsibility in the Different Research Areas
Authors: Cuervo-Carabel Tatiana , Repiso Rafael
Published: March 2023

The concept of Corporate Social Responsibility (CSR) has been the object of study by the academic world in recent years, however, despite the large number of published works, there are still many gaps in its conceptualization and the implications it has on business management. In this sense, despite the great interdisciplinarity of the concept, a large part of academic production is focused on the field of business, something that has limited the construction of new research perspectives which will allow to continue expanding in knowledge. The objective of this work is to provide evidence of the scientific production developed in the field of CSR that serves as a basis for researchers in making strategic decisions about the orientation of their work, taking into account new perspectives based on the impact generated by the publications in the different research areas. For this, a search of existing publications on the Web of Science (WoS) was carried out. The analysis of the results was developed through the use of the InCites citation analysis tool, which made it possible to evaluate the productivity and performance of the research developed. The results show the existence of research areas with low productivity in the topic under study, but with a high impact of their publications. It is concluded that publication in these research areas should be a priority for researchers, who, by directing their work toward them, might open up new research perspectives and continue to delve into the concept.
The Decomposition of Productivity Growth for India: Before and After 1991
Authors: Gangopadhyay Kausik , Mondal Debasis , Thasni T
Published: March 2023

We analyse how structural shifts affected India’s productivity growth from 1983 to 2017. The analysis is carried out within a broad three-sector level of disaggregation of the aggregate economy. We show that about 29% of the aggregate productivity growth of India during this period comes from structural change. While this contribution has declined since 2007, the remaining 71% of the productivity growth originates within the individual sectors, especially within the tertiary sector, which alone explains about 30% of this productivity growth. About a quarter of the total productivity growth that occurred prior to economic liberalization in 1991 is attributed to the tertiary sector. We found that between 2007 and 2017, the tertiary sector was responsible for almost 38% of India’s total productivity growth. This contribution is much larger than the contribution made by structural change, and, therefore, the significance of the tertiary sector in Indian economic expansion is growing. Our findings also indicate that the most structural change occurred between 1998 and 2007, which may have contributed to productivity increase in the decade.
A tale of two crises: The emergence of an eco-Keynesian coalition in Swedish transport decarbonisation discourse
Authors: Haikola Simon , Anshelm Jonas
Published: March 2023

The paper traces a discursive shift in Swedish transport decarbonisation discourse, by which neoliberal hegemony has been increasingly challenged through the emergence of an eco-Keynesian discourse coalition encompassing trade unions, business and industry, and green and left-wing members of parliament. The investigation testifies to the importance of political ideas in effecting discursive change, and in restricting subject positions within discourses. The Swedish case is informative for transport decarbonisation in general for the tensions it harbours between classic Social Democratic industrial policy and neoliberalism, and between historical continuity and radical discontinuity. In particular, it reveals how the return to a specific historical idea of the state determines the subject positions of actors within the new discourse coalition.
The mitochondrial genome of Heterosentis pseudobagri (Wang & Zhang, 1987) Pichelin & Cribb, 1999 reveals novel aspects of tRNA genes evolution in Acanthocephala
Authors: Gao Jin-Wei , Yuan Xi-Ping , Jakovlić Ivan , Wu Hao , Xiang Chuan-Yu , Xie Min , Song Rui , Xie Zhong-Gui , Wu Yuan-An , Ou Dong-Sheng
Published: March 2023

Background

Acanthocephala is a clade of obligate endoparasites whose mitochondrial genomes (mitogenomes) and evolution remain relatively poorly understood. Previous studies reported that atp8 is lacking from acanthocephalan mitogenomes, and that tRNA genes often have nonstandard structures. Heterosentis pseudobagri (Arhythmacanthidae) is an acanthocephalan fish endoparasite for which no molecular data are currently available, and biological information is unavailable in the English language. Furthermore, there are currently no mitogenomes available for Arhythmacanthidae.

Methods

We sequenced its mitogenome and transcriptome, and conducted comparative mitogenomic analyses with almost all available acanthocephalan mitogenomes.

Results

The mitogenome had all genes encoded on the same strand and unique gene order in the dataset. Among the 12 protein-coding genes, several genes were highly divergent and annotated with difficulty. Moreover, several tRNA genes could not be identified automatically, so we had to identify them manually via a detailed comparison with orthologues. As common in acanthocephalans, some tRNAs lacked either the TWC arm or the DHU arm, but in several cases, we annotated tRNA genes only on the basis of the conserved narrow central segment comprising the anticodon, while the flanking 5’ and 3’ ends did not exhibit any resemblance to orthologues and they could not be folded into a tRNA secondary structure. We corroborated that these are not sequencing artefacts by assembling the mitogenome from transcriptomic data. Although this phenomenon was not observed in previous studies, our comparative analyses revealed the existence of highly divergent tRNAs in multiple acanthocephalan lineages.

Conclusions

These findings indicate either that multiple tRNA genes are non-functional or that (some) tRNA genes in (some) acanthocephalans might undergo extensive posttranscriptional tRNA processing which restores them to more conventional structures. It is necessary to sequence mitogenomes from yet unrepresented lineages and further explore the unusual patterns of tRNA evolution in Acanthocephala.
Fine-scale spatial variation shape fecal microbiome diversity and composition in black-tailed prairie dogs (Cynomys ludovicianus)
Authors: Neha Sufia Akter , Salazar-Bravo Jorge
Published: March 2023

Background

Host associated gut microbiota are important in understanding the coevolution of host-microbe, and how they may help wildlife populations to adapt to rapid environmental changes. Mammalian gut microbiota composition and diversity may be affected by a variety of factors including geographic variation, seasonal variation in diet, habitat disturbance, environmental conditions, age, and sex. However, there have been few studies that examined how ecological and environmental factors influence gut microbiota composition in animals' natural environments. In this study, we explore how host habitat, geographical location and environmental factors affect the fecal microbiota of Cynomys ludovicianus at a small spatial scale. We collected fecal samples from five geographically distinct locations in the Texas Panhandle classified as urban and rural areas and analyzed them using high throughput 16S rRNA gene amplicon sequencing.

Results

The results showed that microbiota of these fecal samples was largely dominated by the phylum Bacteroidetes. Fecal microbiome diversity and composition differed significantly across sampling sites and habitats. Prairie dogs inhabiting urban areas showed reduced fecal diversity due to more homogenous environment and, likely, anthropogenic disturbance. Urban prairie dog colonies displayed greater phylogenetic variation among replicates than those in rural habitats. Differentially abundant analysis revealed that bacterial species pathogenic to humans and animals were highly abundant in urban areas which indicates that host health and fitness might be negatively affected. Random forest models identified Alistipes shahii as the important species driving the changes in fecal microbiome composition. Despite the effects of habitat and geographic location of host, we found a strong correlation with environmental factors and that- average maximum temperature was the best predictor of prairie dog fecal microbial diversity.

Conclusions

Our findings suggest that reduction in alpha diversity in conjunction with greater dispersion in beta diversity could be indicative of declining host health in urban areas; this information may, in turn, help determine future conservation efforts. Moreover, several bacterial species pathogenic to humans and other animals were enriched in prairie dog colonies near urban areas, which may in turn adversely affect host phenotype and fitness.
Preoperative frailty assessment could be a predictive factor for the prognosis of elderly patients undergoing coronary artery bypass grafting: a retrospective case-control study
Authors: Pan Rui , Li Xiaohui , Han Jingjing , Li Qian , Lei Zheng , Huang He , Chen Yu
Published: March 2023

Background

Frailty has been considered to be associated with major mortality and increased length of stay after cardiac surgery. This study aimed to explore the predictive potential of frailty assessment in the prognosis of elderly patients undergoing bypass surgery.

Methods

This study assessed the preoperative frailty according to the Fried’s frailty phenotype, and included 150 frail and 150 non-frail elderly patients (≥ 65 y) who underwent bypass surgery. The present study evaluated the prognosis of elderly patients based on sequential organ failure assessment (SOFA) score, and collected clinical indicators to construct logistic regression models with the prognosis as the dependent variable, to explore the potential predictive ability of preoperative frailty. Moreover, this study focused on the complications and analyzed the relationship between preoperative frailty and postoperative complications.

Results

In the present study, 244 patients were divided into the favorable prognosis group and 56 patients were divided into the unfavorable prognosis group. Logistic regression analysis showed that increased myoglobin and high cardiac function classification were independent risk factors for unfavorable prognosis in elderly patients undergoing bypass surgery. The discrimination of the clinical prediction model was determined by the receiver operating characteristic (ROC) curve, and the area under curve (AUC) was 0.928. After adding preoperative frailty assessment, the AUC was improved to 0.939. This study found a significant correlation between preoperative frailty and postoperative complications, mainly in the circulatory system.

Conclusion

Preoperative frailty assessment could be a predictive factor for the prognosis of elderly patients undergoing coronary artery bypass grafting. According to our study, frailty assessment and appropriate intervention before bypass surgery may be beneficial to the enhanced recovery after cardiac surgery.

Trial registration

The clinical study was approved by the Medical Ethics Committee of The First Affiliated Hospital of Nanjing Medical University (2021-SR-393). All patients signed an informed consent form.
The capacity of primary healthcare facilities in Bangladesh to prevent and control non-communicable diseases
Authors: Kabir Ashraful , Karim Md Nazmul , Billah Baki
Published: March 2023

Background

The rapid rise of non-communicable diseases (NCDs) has become a significant public health concern in Bangladesh. This study assesses the readiness of primary healthcare facilities to manage the following NCDs: diabetes mellitus (DM), cervical cancer, chronic respiratory diseases (CRIs), and cardiovascular diseases (CVDs).

Methods

A cross-sectional survey was conducted between May 2021 and October 2021 among 126 public and private primary healthcare facilities (nine Upazila health complexes (UHCs), 36 union-level facilities (ULFs), 53 community clinics (CCs), and 28 private hospitals/clinics). The NCD-specific service readiness was assessed using the World Health Organization’s (WHO) Service Availability and Readiness Assessment (SARA) reference manual. The facilities’ readiness was assessed using the following four domains: guidelines and staff, basic equipment, diagnostic facility, and essential medicine. The mean readiness index (RI) score for each domain was calculated. Facilities with RI scores of above 70% were considered ‘ready’ to manage NCDs.

Results

The general services availability ranged between 47% for CCs and 83% for UHCs and the guidelines and staff accessibility were the highest for DM in the UHCs (72%); however, cervical cancer services were unavailable in the ULFs and CCs. The availability of basic equipment was the highest for cervical cancer (100%) in the UHCs and the lowest for DM (24%) in the ULFs. The essential medicine for CRI was 100% in both UHCs and ULFs compared to 25% in private facilities. The diagnostic capacity for CVD and essential medicine for cervical cancer was unavailable at all levels of public and private healthcare facilities. The overall mean RI for each of the four NCDs was below the cut-off value of 70%, with the highest (65%) for CRI in UHCs but unavailable for cervical cancer in CCs.

Conclusion

All levels of primary healthcare facilities are currently not ready to manage NCDs. The notable deficits were the shortage of trained staff and guidelines, diagnostic facilities, and essential medicine. This study recommends increasing service availability to address the rising burden of NCDs at primary healthcare levels in Bangladesh.
Analysis of risk factors for neurological symptoms in patients with purely hepatic Wilson’s disease at diagnosis
Authors: Diao Sheng-Peng , Zhuang Yang-Sha , Huang Ye-Qing , Zhou Zhi-Hua , Liu Ai-Qun , Hong Ming-Fan
Published: March 2023

Objective

To analyze and explore the risk factors for neurological symptoms in patients with purely hepatic Wilson's disease (WD) at diagnosis.

Methods

This retrospective study was conducted at the First Affiliated Hospital of the Guangdong Pharmaceutical University on 68 patients with purely hepatic WD aged 20.6 ± 7.2 years. The physical examinations, laboratory tests, color Doppler ultrasound of the liver and spleen, and magnetic resonance imaging (MRI) of the brain were performed.

Results

The elevated alanine transaminase (ALT) and aspartate transaminase (AST) levels and 24-h urinary copper level were higher in the purely hepatic WD who developed neurological symptoms (NH-WD) group than those in the purely hepatic WD (H-WD) group. Adherence to low-copper diet, and daily oral doses of penicillamine (PCA) and zinc gluconate (ZG) were lower in the NH-WD group than those in the H-WD group. Logistic regression analysis showed that insufficient doses of PCA and ZG were associated with the development of neurological symptoms in patients with purely hepatic WD at diagnosis.

Conclusion

The development of neurological symptoms in patients with purely hepatic WD was closely associated with insufficient doses of PCA and ZG, and the inferior efficacy of copper-chelating agents. During the course of anti-copper treatment, the patient's medical status and the efficacy of copper excretion should be closely monitored.
Comprehensive analysis of the role of ICOS ( CD278 ) in pan-cancer prognosis and immunotherapy
Authors: Zhao Xiashuang , Wang Yongfeng , Jiang Xianglai , Mo Bangqian , Wang Chenyu , Tang Mingzheng , Rong Yao , Zhang Guiqian , Hu Ming , Cai Hui
Published: March 2023

Background

The immunological checkpoint known as Inducible T Cell Costimulatory Factor (ICOS, Cluster of Differentiation, CD278) is activated and expressed on T cells. Both somatic cells and antigen-presenting cells expressed its ligand, ICOSL (including tumor cells in the tumor microenvironment).It is important for immunosuppression. Uncertainty surrounds the function of ICOS in tumor immunity.

Methods

Several bioinformatics techniques were employed by us to thoroughly examine the expression and prognostic value of ICOS in 33 cancers based on data collected from TCGA and GTEx. In addition, ICOS was explored with pathological stage, tumor-infiltrating cells, immune checkpoint genes, mismatch repair (MMR) genes, DNA methyltransferases (DNMTs), microsatellite instability (MSI),and tumor mutation burden (TMB).In addition,To ascertain the level of ICOS expression in various cells, qRT-PCR was employed.

Results

The findings revealed that ICOS expression was up regulation in most cancer types. The high expression of ICOS in tumor samples was related to the poor prognosis of UVM and LGG; The positive prognosis was boosted by the strong expression of ICOS in OV, SARC, SKCM, THYM, UCEC, and HNSC. The result is that the expression of malignancy was revealed by the immune cells’ invasion.profile of ICOS in different types of cancer. Different ways that ICOS expression is connected to immune cell infiltration account for variations in patient survival. Additionally, the TMB, MSI, MMR, and DNMT genes as well as ICOS expression are linked in many cancer types.The results of PCR showed that it is highly expressed in gastric, breast, liver and renal cell carcinoma cell lines compared with normal cells.

Conclusion

This study suggests that ICOS may be a potential tumor immunotherapy target and prognostic marker.
Quality of option B + prevention of mother-to-child transmission of HIV services in public hospitals of Gamo zone, Southern Ethiopia, mixed approach
Authors: Haile Yosef , Gebru Zeleke , Feleke Tesfaye , Adem Yonas Fissha
Published: March 2023

Background

Prevention of mother-to-child transmission service is a comprehensive package of services planned to reduce the risk of mother-to-child transmission of HIV. It is very crucial to determine the level of quality of PMTCT services in this study area since other studies in our country omitted several variables in each category of the Donobedian model. Therefore, this study aimed to determine the level of quality of option B + PMTCT of HIV services.

Methods

An institution-based cross-sectional study design with both quantitative and qualitative data collection method was employed. Donabedian’s model was used to assess the level of quality of PMTCT service. A total of 422 pregnant women were used to assess the level of satisfaction of clients. An inventory of resources and direct observation was done to assess the quality of the input and output component of the Donobedian model respectively. In addition to satisfaction items, 12 output-related items were also used to assess quality in the output dimension. Finally, those hospitals that scored above 90% in each component of the Donovedian model were categorized as having good quality. Finally, twelve in-depth interviews were conducted to explore barriers to the quality of option B + PMTCT services. The qualitative data were analyzed using the thematic analysis method and finally, it was presented with the quantitative result through triangulation.

Results

No hospitals simultaneously met the requirements for good quality in all three dimensions of option B + PMTCT service quality. Only one hospital out of the four hospitals met the requirements for good quality of PMTCT service in the input dimension. Regarding the process and output dimension's quality of PMTCT services, two of the hospitals met the criteria for good quality. One hospital out of the total exhibited poor performance in all three dimensions of service quality for option B + PMTCT services.

Conclusion

According to this study no hospitals simultaneously met the requirements for good quality in all three dimensions of option B + PMTCT service quality. PMTCT unit performance must be continuously monitored, reviewed, and supervised. To obtain the minimum required resources primary hospitals must be supported.
Comparison of suture-bridge and independent double-row techniques for medium to massive posterosuperior cuff tears: a two-year retrospective study
Authors: Chen Poyu , Yeh Han-Wei , Lu Yi , Chen Alvin Chao-Yu , Chan Yi-Sheng , Lädermann Alexandre , Chiu Joe Chih-Hao
Published: March 2023

Background

Transosseous-equivalent suture-bridge (TOE-SB) and independent double-row (IDR) repair techniques were developed to treat rotator cuff tears. The study was designed to prove that both TOE-SB and IDR techniques provided comparable clinical results and retear rate for medium to massive posterosuperior rotator cuff tears, while the surgical time and number of suture anchor used were less in the IDR group.

Study design

Level of evidence: level III, Retrospective comparative study.

Methods

Patients with medium to massive posterosuperior rotator cuff tears receiving arthroscopic TOE-SB and IDR between November 2016 to October 2019 were retrospectively enrolled. All patients were confirmed to have grade ≤ 2 fatty infiltration in the muscles of the torn tendons. Revision, concomitant subscapularis tear, acromiohumeral distance < 7 mm, glenohumeral osteoarthritis, partial repair, incomplete repair, partial thickness, or irreparable posterosuperior cuff tear were excluded. Surgical time, number of suture anchor used for the surgery, pre-operative, and post-operative clinical scores such as Constant-Murley score, subjective shoulder value (SSV), and visual analog scale (VAS) were compared. The retear rates between groups were evaluated by ultrasound.

Results

Thirty-five IDR and thirty-five TOE-SB repairs were enrolled. The IDR technique required much fewer anchors than TOE-SB did to complete the cuff repair. The mean operation time in IDR and TOE-SB group were 86(18.23), and 114(18.7) (min), respectively (P <  0.01). The mean number of anchors used to complete the cuff repair was 2(0.17) in IDR and 3(0.61) in TOE-SB (P <  0.01). The Constant-Murley score improved from 34.9 ± 6.6 to 80.6 ± 9.4 in the IDR group, and 37.4 ± 6 to 81.9 ± 4.6 in the TOE-SB group (both P <  0.001). SSV improved from 24.6 ± 9.6 to 79.3 ± 10.6 in the IDR, and 27.9 ± 9 to 82.9 ± 6.9 in the TOE-SB group (both P <  0.001). VAS improved from 7.9 ± 0.6 to 1.5 ± 0.7 in the IDR, and 8 ± 0.5 to 1.3 ± 0.6 in the TOE-SB group (both P <  0.001) at final follow-up. No significant difference was found between the retear rates (14.3% in the IDR vs. 17.1% in the TOE-SB, respectively) in the 2-year follow-up.

Conclusions

Both IDR and TOE-SB group provided comparable clinical results and retear rates for medium to massive posterosuperior rotator cuff tears. The surgical time and number of anchors used were less in the IDR group than in the TOE-SB group.
Determining minimal important differences for patient-reported outcome measures in shoulder, lateral elbow, patellar and Achilles tendinopathies using distribution-based methods
Authors: Challoumas Dimitris , Zouvani Andrea , Creavin Kevin , Murray Elspeth , Crosbie Gearoid , Ng Nigel , Millar Neal L.
Published: March 2023

Background

Minimal important difference (MID) is a concept used inconsistently and arbitrarily in tendinopathy research. Our aim was to determine the MIDs for the most commonly used tendinopathy outcome measures using data-driven approaches.

Methods

Recently published systematic reviews of randomised controlled trials (RCTs) on tendinopathy management were identified and used for extraction of eligible studies through a literature search. Each eligible RCT was used to obtain information on MID where this was used and it also contributed data for the calculation of the baseline pooled standard deviation (SD) for each tendinopathy (shoulder, lateral elbow, patellar and Achilles). The rule of “half SD” was used for the computation of MIDs for patient-reported pain (visual analogue scale, VAS 0–10, single-item questionnaire) and function (multi-item questionnaires) and the rule of “one standard error of measurement (SEM)” was additionally used for the multi-item functional outcome measures.

Results

A total of 119 RCTs were included for the 4 tendinopathies. MID was defined and used by 58 studies (49%) and there were significant inconsistencies amongst studies where the same outcome measure was used as MID. From our data-driven methods the following suggested MIDs were obtained: a) Shoulder tendinopathy, pain VAS (combined) 1.3 points, Constant-Murley score 6.9 (half SD) and 7.0 (one SEM) points; b) lateral elbow tendinopathy, pain VAS (combined) 1.0 point, Disabilities of Arm, Shoulder and Hand questionnaire 8.9 (half SD) and 4.1 (one SEM) points; c) Patellar tendinopathy, pain VAS (combined) 1.2 points, Victorian Institute of Sport Assessment – Patella (VISA-P) 7.3 (half SD) and 6.6 points (one SEM); d) Achilles tendinopathy, pain VAS (combined) 1.1 points, VISA-Achilles (VISA-A) 8.2 (half SD) and 7.8 points (one SEM). The rules of half SD and one SEM produced very similar MIDs except for DASH due to its very high internal consistency. MIDs were also calculated for different pain settings for each tendinopathy.

Conclusions

Our computed MIDs can be used in tendinopathy research to increase consistency. Clearly defined MIDs should be used with consistency in tendinopathy management studies in the future.
Black glucose-releasing silicon elastomer rings for fed-batch operation allow measurement of the oxygen transfer rate from the top and optical signals from the bottom for each well of a microtiter plate
Authors: Sparviero Sarah , Barth Laura , Keil Timm , Dinter Carl , Berg Christoph , Lattermann Clemens , Büchs Jochen
Published: March 2023

Background

In industrial microbial biotechnology, fed-batch processes are frequently used to avoid undesirable biological phenomena, such as substrate inhibition or overflow metabolism. For targeted process development, fed-batch options for small scale and high throughput are needed. One commercially available fed-batch fermentation system is the FeedPlate®, a microtiter plate (MTP) with a polymer-based controlled release system. Despite standardisation and easy incorporation into existing MTP handling systems, FeedPlates® cannot be used with online monitoring systems that measure optically through the transparent bottom of the plate. One such system that is broadly used in biotechnological laboratories, is the commercial BioLector. To allow for BioLector measurements, while applying the polymer-based feeding technology, positioning of polymer rings instead of polymer disks at the bottom of the well has been proposed. This strategy has a drawback: measurement requires an adjustment of the software settings of the BioLector device. This adjustment modifies the measuring position relative to the wells, so that the light path is no longer blocked by the polymer ring, but, traverses through the inner hole of the ring. This study aimed at overcoming that obstacle and allowing for measurement of fed-batch cultivations using a commercial BioLector without adjustment of the relative measurement position within each well.

Results

Different polymer ring heights, colours and positions in the wells were investigated for their influence on maximum oxygen transfer capacity, mixing time and scattered light measurement. Several configurations of black polymer rings were identified that allow measurement in an unmodified, commercial BioLector, comparable to wells without rings. Fed-batch experiments with black polymer rings with two model organisms, E. coli and H. polymorpha, were conducted. The identified ring configurations allowed for successful cultivations, measuring the oxygen transfer rate and dissolved oxygen tension, pH, scattered light and fluorescence. Using the obtained online data, glucose release rates of 0.36 to 0.44 mg/h could be determined. They are comparable to formerly published data of the polymer matrix.

Conclusion

The final ring configurations allow for measurements of microbial fed-batch cultivations using a commercial BioLector without requiring adjustments of the instrumental measurement setup. Different ring configurations achieve similar glucose release rates. Measurements from above and below the plate are possible and comparable to measurements of wells without polymer rings. This technology enables the generation of a comprehensive process understanding and target-oriented process development for industrial fed-batch processes.
Validation of student academic advising and counseling evaluation tool among undergraduate nursing students
Authors: Selim Abeer , Omar Abeer , Awad Shaimaa , Miligi Eman , Ayoub Nahed
Published: March 2023

Background

Academic advising and counseling services support students in achieving their educational outcomes. Unfortunately, there is a paucity of research on academic advising and student-support systems among nursing students. Therefore, the current study aims to develop a student academic advising and counseling survey (SAACS) and measure its validity and reliability.

Methods

Cross-sectional design was used to collect online self-administered data from undergraduate nursing students in Egypt and Saudi Arabia. The SAACS is developed based on relevant literature and tested for content and construct validity.

Results

A total of 1,134 students from both sites completed the questionnaire. Students’ mean age was 20.3 ± 1.4, and the majority of them were female (81.9%), single (95.6%), and unemployed (92.3%). The content validity index (CVI) of SAACS overall score (S-CVI) is 0.989, and S-CVI/UA (universal agreement) is 0.944, which indicates excellent content validity. The overall SAACS reliability showed an excellent internal consistency with a Cronbach’s Alpha of 0.97 (95% CI: 0.966 – 0.972).

Conclusions

The SAACS is a valid and reliable tool for assessing students’ experience with academic advising and counseling services and can be utilized to improve those services in nursing school settings.
Perceived quality of medical services at outpatient department of public hospitals in Dawro Zone, Southern Ethiopia
Authors: Utino Legese , Birhanu Bezawit , Getachew Nigusu , Ereso Berhane Megerssa
Published: March 2023

Background

Quality of care is fundamental to universal health coverage. Perceived quality of medical services is one of the most determining factors of modern health care service utilization. Between 5.7 and 8.4 million deaths are attributed to poor-quality care each year in low- and middle-income countries (LMICs), and up to 15% of overall deaths are due to poor quality. For instance, in sub-Saharan Africa (SSA), public health facilities lack basic facilities such as a physical environment. Hence, this study aims to assess the perceived quality of medical services and associated factors at outpatient departments of public hospitals in the Dawro zone, Southern Ethiopia.

Methods

A facility-based cross-sectional study was conducted on the quality of care among outpatient department attendants of Dawro zone public hospitals from May 23 to June 28, 2021. A total of 420 study participants were included via a convenient sampling technique. An exit interview was used to collect data using a pretested and structured questionnaire. Then it was analyzed using the Statistical Package for Social Science (SPSS) version 25. Both bivariable and multivariable linear regressions were carried out. Significant predictors were reported atp < 0.05 with a 95% confidence interval.

Result

with a 100% response rate. The overall perceived quality was 51.15%. Fifty-six percent of study participants rated perceived quality as poor, 9% as average, and 35% of participants rated it as good perceived quality. The highest mean perception result was related to the tangibility (3.17) domain. Waiting time less than one hour (β = 0.729,p < 0.001), availability of prescribed drugs (β = 0.185,p < 0.003), having information on diagnoses (illness) (β = 0.114,p < 0.047), and privacy maintained (β = 0.529,p < 0.001) were found to be predictors of perceived good quality of care.

Conclusion

A majority of the study participants rated the perceived quality as poor. Waiting time, availability of prescribed drugs, information on diagnoses (illness), and provision of service with privacy were found to be predictors of client-perceived quality. Tangibility is the predominant and most important domain of client-perceived quality. The regional health bureau and zonal health department should understand the issue and work with hospitals to improve outpatient service quality by providing necessary medication, reducing wait times, and designing job training for health care providers.
Senior Health Clinic for 75-year-old home-dwelling Finns – study design, clinic protocol and non-response analysis
Authors: Salminen Marika , Stenholm Sari , Koskenniemi Jaana , Korhonen Päivi , Pitkänen Tiina , Viikari Paula , Wuorela Maarit , Viitanen Matti , Viikari Laura
Published: March 2023

Background

In the Finnish policy on older people preventive activities, which maintain functional capacity and independent living, are emphasized. The Turku Senior Health Clinic, aimed at maintaining independent coping of all home-dwelling 75-year-old citizens in the city of Turku, was founded in the beginning of 2020. The aim of this paper is to describe design and protocol of the Turku Senior Health Clinic Study (TSHeC) and provide results of the non-response analysis.

Methods

The non-response analysis used data from 1296 participants (71% of those eligible) and 164 non-participants of the study. Sociodemographic, health status, psychosocial and physical functional ability indicators were included in the analysis. Participants and non-participants were also compared in respect to their neighborhood socioeconomic disadvantage. Differences between participants and non-participants were tested using the Chi squared or Fisher´s exact test for categorical variables and t-test for continuous variable.

Results

The proportions of women (43% vs. 61%) and of those with only satisfying, poor or very poor self-rated financial status (38% vs. 49%) were significantly lower in non-participants than in participants. Comparison of the non-participants and participants in respect to their neighborhood socioeconomic disadvantage showed no differences. The prevalence of hypertension (66% vs. 54%), chronic lung disease (20% vs. 11%), and kidney failure (6% vs. 3%) were higher among non-participants compared to participants. Feelings of loneliness were less frequent among non-participants (14%) compared to participants (32%). The proportions of those using assistive mobility devices (18% vs. 8%) as well as those having previous falls (12% vs. 5%) were higher in non-participants than in participants.

Conclusions

The participation rate of TSHeC was high. No neighborhood differences in participation were found. Health status and physical functioning of non-participants seemed to be slightly worse than those of the participants, and more women than men participated. These differences may weaken the generalizability of the findings of the study. The differences have to be taken into account when recommendation for the content and implementation of preventive nurse-managed health clinic in primary health care in Finland is going to be given.

Trial registration

ClinicalTrials.gov Identifier: NCT05634239; registration date; 1st of December 2022. Retrospectively registered.
Evaluation of in silico pathogenicity prediction tools for the classification of small in-frame indels
Authors: Cannon S. , Williams M. , Gunning A. C. , Wright C. F.
Published: March 2023

Background

The use of in silico pathogenicity predictions as evidence when interpreting genetic variants is widely accepted as part of standard variant classification guidelines. Although numerous algorithms have been developed and evaluated for classifying missense variants, in-frame insertions/deletions (indels) have been much less well studied.

Methods

We created a dataset of 3964 small (< 100 bp) indels predicted to result in in-frame amino acid insertions or deletions using data from gnomAD v3.1 (minor allele frequency of 1–5%), ClinVar and the Deciphering Developmental Disorders (DDD) study. We used this dataset to evaluate the performance of nine pathogenicity predictor tools: CADD, CAPICE, FATHMM-indel, MutPred-Indel, MutationTaster2021, PROVEAN, SIFT-indel, VEST-indel and VVP.

Results

Our dataset consisted of 2224 benign/likely benign and 1740 pathogenic/likely pathogenic variants from gnomAD (n = 809), ClinVar (n = 2882) and, DDD (n = 273). We were able to generate scores across all tools for 91% of the variants, with areas under the ROC curve (AUC) of 0.81–0.96 based on the published recommended thresholds. To avoid biases caused by inclusion of our dataset in the tools’ training data, we also evaluated just DDD variants not present in either gnomAD or ClinVar (70 pathogenic and 81 benign). Using this subset, the AUC of all tools decreased substantially to 0.64–0.87. Several of the tools performed similarly however, VEST-indel had the highest AUCs of 0.93 (full dataset) and 0.87 (DDD subset).

Conclusions

Algorithms designed for predicting the pathogenicity of in-frame indels perform well enough to aid clinical variant classification in a similar manner to missense prediction tools.
Triglyceride-glucose index for predicting repeat revascularization and in-stent restenosis in patients with chronic coronary syndrome undergoing percutaneous coronary intervention
Authors: Guo Xuantong , Shen Ruihuan , Yan Siyu , Su Yanni , Ma Lihong
Published: March 2023

Background

The triglyceride-glucose (TyG) index, a reliable surrogate indicator of insulin resistance, is independently associated with coronary artery disease of various clinical manifestations. This study aimed to investigate the prognostic value of the TyG index in predicting repeat revascularization and in-stent restenosis (ISR) in chronic coronary syndrome (CCS) patients undergoing percutaneous coronary intervention (PCI).

Methods

A total of 1414 participants were enrolled and divided into groups according to the tertiles of the TyG index. The primary endpoint was a composite of PCI complications, including repeat revascularization and ISR. The associations between the TyG index and the primary endpoint were assessed by multivariable Cox proportional hazards regression analysis with restricted cubic splines (RCS). The TyG index was calculated as Ln (fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2).

Results

Over a median follow-up of 60 months, 548 (38.76%) patients had experienced at least one primary endpoint event. The follow-up incidence of the primary endpoint increased with the TyG index tertiles. After adjusting for potential confounders, the TyG index was independently associated with the primary endpoint in CCS patients (HR, 1.191; 95% CI 1.038–1.367; P = 0.013). Additionally, the highest tertile of the TyG group was correlated with a 1.319-fold risk of the primary endpoint compared with the lowest tertile of the TyG group (HR, 1.319; 95% CI 1.063–1.637; P = 0.012). Furthermore, a linear and dose–response relationship was observed between the TyG index and the primary endpoint (non-linear P = 0.373, P overall = 0.035).

Conclusions

An increased TyG index was associated with elevated risk for long-term PCI complications, including repeat revascularization and ISR. Our study suggested that the TyG index could be a potent predictor in evaluating the prognosis of CCS patients undergoing PCI.
Sub-microscopic Plasmodium falciparum parasitaemia, dihydropteroate synthase (dhps) resistance mutations to sulfadoxine–pyrimethamine, transmission intensity and risk of malaria infection in pregnancy in Mount Cameroon Region
Authors: Mbacham Harry F. , Mosume Diange M , Apinjoh Tobias O. , Ntui Vincent N. , Moyeh Marcel N. , Kalaji Laken N. , Wepnje Godlove B. , Ghogomu Stephen M , Dionne Jodie A , Tita Alan T.N. , Achidi Eric A. , Anchang-Kimbi Judith K.
Published: March 2023

Background

Plasmodium falciparumresistance to intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) continues to spread throughout sub-Saharan Africa. This study assessed the occurrence of microscopic and sub-microscopicP. falciparumparasitaemia, dihydropteroate synthase mutations associated with resistance to SP and maternal anaemia in the Mount Cameroon area.

Methods

Consenting pregnant women living in semi-rural and semi-urban/urbanized settings were enrolled in this cross-sectional study. Socio-demographic, antenatal and clinical data were documented. Microscopic and sub-microscopic parasitaemia were diagnosed using peripheral blood microscopy and nested polymerase chain reaction (PCR) respectively. Thedhpsmutations were genotyped by restriction fragment length polymorphism analysis. The presence of A437G, K540E, and A581G was considered a marker for high-level resistance. Haemoglobin levels and anaemia status were determined.

Results

Among the women, the prevalence of microscopic and sub-microscopicP. falciparuminfection were 7.7% (67/874) and 18.6% (93/500) respectively. Predictors of microscopic infection were younger age (< 21 years) (AOR = 2.89; 95% CI 1.29–6.46) and semi-rural settings (AOR = 2.27; 95% CI 1.31–3.96). Determinants of sub-microscopic infection were the rainy season (AOR, 3.01; 95% CI 1.77–5.13), primigravidity (AOR = 0.45; 95% CI 0.21–0.94) and regular ITN usage (AOR = 0.49; 95% CI 0.27–0.90). Of the145P. falciparumisolates genotyped, 66.9% (97) carried mutations associated with resistance to SP; 33.8% (49), 0%, 52.4% (76) and 19.3% (28) for A437G, K540E, A581G and A437G + A581G respectively. The A581G mutation was associated with ≥ 3 SP doses evident only among sub-microscopic parasitaemia (P = 0.027) and multigravidae (P = 0.009). Women with microscopic infection were more likely from semi-rural settings (AOR = 7.09; 95% CI 2.59–19.42), to report history of fever (AOR = 2.6; 95% CI 1.07–6.31), to harbour parasites with double resistant mutations (AOR = 6.65; 95% CI 1.85–23.96) and were less likely to have received 2 SP doses (AOR = 0.29; 95% CI 1.07–6.31). Microscopic infection decreased Hb levels more than sub-microscopic infection.

Conclusion

The occurrence of sub-microscopicP. falciparumparasites resistant to SP and intense malaria transmission poses persistent risk of malaria infection during pregnancy in the area. ITN usage and monitoring spread of resistance are critical.