bluuebunny/crossref_metadata_2025 huggingface dataset:
Metabolic impact of the VDR rs1544410 in diabetic retinopathy
Authors: Assis Caroline Severo de , Diniz Tainá Gomes , Alcântara João Otávio Scarano , Brito Vanessa Polyana Alves de Sousa , do Nascimento Rayner Anderson Ferreira , Nunes Mayara Karla dos Santos , Silva Alexandre Sérgio , de Queiroga Evangelista Isabella Wanderley , Viturino Marina Gonçalves Monteiro , de Lima Rafaela Lira Formiga Cavalcanti , Persuhn Darlene Camati
Published: February 2022

Aims

To investigate the association between BsmI and DM2 in patients with and without DR and to correlate with clinical parameters in a population in northeastern Brazil.

Methods

Cross-sectional case-control study in which data were collected from 285 individuals, including 128 patients with DM2 and 157 with DR. Clinical, biochemical and anthropometric parameters were analyzed, in addition to the single nucleotide polymorphism (SNP) BsmI of the VDR gene (rs1544410), genotyped by PCR-RFLP.

Results

In the DR group we found a greater number of patients using insulin therapy (p = 0.000) and with longer duration of DM2 (p = 0.000), in addition to higher serum creatinine values (p = 0.001). Higher fasting glucose levels and higher frequency of insulinoterapy were independently observed in patients with DR and b allele carriers, when compared to BB.

Conclusion

The association of the bb/Bb genotypes (rs1544410) of the VDR gene with increased blood glucose levels and insulinoterapy may represent worse glicemic control in rs1544410 b allele carriers in DR Latin American individuals.
A crew-operated data recording system for length-based stock assessment of Indonesia’s deep demersal fisheries
Authors: Wibisono Elle , Mous Peter , Firmana Edwison , Humphries Austin
Published: February 2022

Deep demersal fisheries in Indonesia yielded close to 90,000 metric tons of snapper and grouper in 2019, landed by a fleet of approximately 10,000 fishing boats. Prior to the present study, information on these multi-species, dispersed, small- to medium-scale fisheries was scarce, while reliable species-specific data on catch and effort were non-existent. This data-deficiency made stock assessments and design of harvest control rules impossible. We developed a new data collection method, the Crew Operated Data Recording System (CODRS), to collect verifiable species- and length-composition data from catches across all segments of the fleet. CODRS engaged crews of 579 fishing vessels to take pictures of each fish in their catch, in combination with the deployment of a tracking device on their boats. Furthermore, we also conducted a frame survey to map the fleet across the entire Indonesian archipelago. Using more than 2 million CODRS images, we aimed to understand the basic characteristics and challenges within the fishery. We updated life-history parameters for the top 50 species in the fishery based on the maximum observed length-frequency distribution of the catch (i.e., asymptotic length, size at maturity, optimum fishing length, total mortality, and spawning potential ratio). Length-based stock assessments using the updated life-history parameters showed high risks of overfishing for most of the major target species, especially for snapper species with large maximum sizes. Our results indicated that effective management and harvest strategies are urgently needed across Indonesia’s eleven Fishery Management Areas to prevent the collapse of these important fisheries.
Exploring the patterns of multisectoral approach in fighting COVID-19 Pandemic in SNNPR, Ethiopia: A qualitative case study approach
Authors: Ali Abraham A. , Usman Akmel M. , Badebo Fekadeselassie B. , Tilahun Solomon H.
Published: February 2022

Background

Since COVID-19 has been declared as a global pandemic, South Nations, Nationalities People’s Region, Ethiopia, has been responding by establishing strong structure. The response against the disease requires consolidated efforts, However, there is paucity of information about the patterns of multisectoral collaboration actions in the region. Therefore, this study was conducted with the aim of exploring the patterns of multisectoral collaboration against the COVID-19 using a qualitative case study design. Data were collected by key informant interview and document review and analyzed using a content analysis framework focused on case study data analysis.

Result

The study has indicated a unique perspective in establishing functional multisectoral approach with strong courage and motivation of most involved stakeholder. Almost all stakeholders have shown clear understanding about the multidimensional burdens the disease could cause and the necessities for joint efforts to tackle the multidimensional problems. The study further elucidated that despite the encouraging beginning, the eventual slowdown undertakings in the joint actions. This included failure to meet regularly to monitor and evaluate as stated earlier and societies’ reluctances despite consistent information dissemination.

Conclusion

A firm understanding about multidimensional impacts of COVID-19 by all stakeholders was revealed in the region. Remarkable achievements were observed at the early stage of disease prevention and control responses with encouraging multisectoral approach as guided by the convergence model. However, several setbacks were observed in the process of multisectoral approach intervention as indicated by the conceptual framework. Hence, to ensure sustainable MSA, revitalization of the initial commitment of all stakeholders and strengthening MSA considering end-to end approach of the convergence frame is crucial; subsequent quantitative study recommended to establish wider determinants on success of MSA.
Is there an increased risk of cesarean section in obese women after induction of labor? A retrospective cohort study
Authors: Bjorklund Jenny , Wiberg-Itzel Eva , Wallstrom Tove
Published: February 2022

Background

Obesity is increasing in Sweden and is also of huge global concern. Obesity increases the risk of complications during pregnancy and the need for the induction of labor. Induction of labor increases the number of complications during delivery, leading to women with more negative birth experience. This study investigated how maternal body mass index (BMI) during antenatal care enrollment affects labor outcomes (proportion of cesarean section at induction of labor).

Method

This was a retrospective cohort study of 3772 women with mixed parity and induction of labor at Soderhospital, Stockholm, in 2009–2010 and 2012–2013. The inclusion criteria were simplex, ≥34 gestational weeks, cephalic presentation and no previous cesarean section. The women were grouped according to BMI, and statistical analyzes were performed to compare the proportion of cesarean sections after induction of labor. The primary outcome was the proportion of cesarean section after induction of labor divided by group of maternal BMI. The secondary outcomes were postpartum hemorrhage >1000 ml, time of labor, fetal outcome data, and indication for emergency cesarean section.

Result

The induction of labor in women with a high BMI resulted in a significantly increased risk of cesarean section, with 18.4–24.1% of deliveries, depending on the BMI group. This outcome persisted after adjustment in women with BMI 25–29.9 (aOR 1.4; 95% CI; 1.1–1.7) and BMI 30–34.9 (aOR 1.5; 95% CI; 1.1–2.1). There was also a significantly higher risk for CS among primiparous women (aOR 3.6; 95% CI; 2.9–45) and if the newborn weighted ≥ four kilos (aOR 1.6; 95% CI; 1.3–2.0).

Conclusion

Our findings show that a higher BMI increased the risk of cesarean section after induction of labor in the groups with BMI 25–34.9. Parity seems to be the strongest risk factor for CS regardless other variables.
Proteasome inhibition-enhanced fracture repair is associated with increased mesenchymal progenitor cells in mice
Authors: Zhang Hengwei , Li Xing , Liu Jiatong , Lin Xi , Pei Lingpeng , Boyce Brendan F. , Xing Lianping
Published: February 2022

The ubiquitin/proteasome system controls the stability of Runx2 and JunB, proteins essential for differentiation of mesenchymal progenitor/stem cells (MPCs) to osteoblasts. Local administration of proteasome inhibitor enhances bone fracture healing by accelerating endochondral ossification. However, if a short-term administration of proteasome inhibitor enhances fracture repair and potential mechanisms involved have yet to be exploited. We hypothesize that injury activates the ubiquitin/proteasome system in callus, leading to elevated protein ubiquitination and degradation, decreased MPCs, and impaired fracture healing, which can be prevented by a short-term of proteasome inhibition. We used a tibial fracture model in Nestin-GFP reporter mice, in which a subgroup of MPCs are labeled by Nestin-GFP, to test our hypothesis. We found increased expression of ubiquitin E3 ligases and ubiquitinated proteins in callus tissues at the early phase of fracture repair. Proteasome inhibitor Bortezomib, given soon after fracture, enhanced fracture repair, which is accompanied by increased callus Nestin-GFP+ cells and their proliferation, and the expression of osteoblast-associated genes and Runx2 and JunB proteins. Thus, early treatment of fractures with Bortezomib could enhance the fracture repair by increasing the number and proliferation of MPCs.
Waves and currents decrease the available space in a salmon cage
Authors: Johannesen Ása , Patursson Øystein , Kristmundsson Jóhannus , Dam Signar Pætursonur , Mulelid Mats , Klebert Pascal
Published: February 2022

Due to increasing demand for salmon and environmental barriers preventing expansion in established sites, salmon farmers seek to move or expand their production to more exposed sites. In this study we investigate the effects of strong currents and waves on the behaviour of salmon and how they choose to use the space available to them. Observations are carried out in a site with strong tidal currents and well mixed water. Using video cameras and echo sounders, we show that salmon prefer to use the entire water column, narrowing their range only as a response to cage deformation, waves, or daylight. Conversely, salmon show strong horizontal preference, mostly occupying the portions of the cage exposed to currents. Additionally, waves cause salmon to disperse from the exposed side of the cage to the more sheltered side. Even when strong currents decrease the amount of available space, salmon choose to occupy the more exposed part of the cage. This indicates that at least with good water exchange, the high density caused by limited vertical space is not so aversive that salmon choose to move to less desirable areas of the cage. However, the dispersal throughout the entire available water column indicates that ensuring enough vertical space, even in strong currents, would be beneficial to salmon welfare.
Enhancing human aspects of care with young people with muscular dystrophy: An evaluation of a participatory qualitative study with clinicians
Authors: Setchell Jenny , Mosleh Donya , McAdam Laura , Thille Patricia , Abrams Thomas , McMillan Hugh J. , Mistry Bhavnita , Gibson Barbara E.
Published: February 2022

Purpose

This paper evaluates a study which aimed to enhance clinical care of young people with Duchenne or Becker muscular dystrophy (MD) and their families in two Canadian neuromuscular clinics. We report on how/why the study changed clinical practices in relation to the ‘human’ (e.g., emotional, social, existential, cultural) dimensions of living with MD.

Materials and methods

The intervention involved regular dialogical exchanges with clinicians across the two sites, during which direct observations of the clinics’ care practices were discussed and changes were planned. We drew from realist evaluation approaches to assess changes in clinical care associated with the intervention. Data sources included dialogical exchanges; clinic observations; interviews with clients, families and clinicians; and team analysis sessions.

Results

Our evaluation suggests the clinical teams shifted their thinking and practices towards greater consideration of human aspects of living with MD including: more routinely attending to emotional, social and experiential dimensions of living with MD; reconceptualisation of risk; and considerations of affective aspects of clinical care. Not all clinicians changed their thinking and practices in the same ways, or to the same extent, and there were differences between the sites. These differences were likely due to numerous factors, including varying levels of clinician comfort with examining and shifting their own practices, and differing formal and informal clinic routines at each site.

Conclusions

Overall, this intervention was able to shift clinic practices, and could feasibly be adapted across rehabilitation settings.
The influence of corn trypsin inhibitor on the contribution of coagulation determinants to the Technoclone Thrombin Generation Assay (TGA) and the Calibrated Automated Thrombogram (CAT)
Authors: Touw Carolina E. , de Jong Ype , van Hylckama Vlieg Astrid
Published: February 2022

In thrombin generation (TG) assays, regarded as global coagulation tests, contact activation is considered a major problem which can be eliminated by adding Corn Trypsin Inhibitor (CTI). In previous studies, however, venous thrombosis risk prediction using TG assays did not improve after CTI addition. However, it is unknown whether CTI addition could help to detect subtle but relevant nuances in determinants of TG, making the assay more suitable to detect disturbances in the coagulation system. This study’s objective was to assess whether the addition of CTI is associated with a broader contribution of individual coagulation factors to the total amount of thrombin formed in Calibrated Automated Thrombogram (CAT) and Technoclone Thrombin Generation Assay (TGA). Thrombin generation was measured in 326 healthy individuals from THE VTE study at very low tissue factor concentrations, with and without addition of CTI prior to blood sampling. The influence of several coagulation factors on total amount of thrombin formed, i.e. area under the curve (AUC) or endogenous thrombin potential (ETP), was analysed using multiple linear regression with standardisation of all values resulting in Z-scores with 95% confidence intervals (95%CI). Association between coagulation factors and TG changed minimally after addition of CTI. Largest changes after CTI addition were found for following factors: for CAT: free protein S (from 0.00 (95%CI -0.12 to 0.12) to -0.29 (95%CI -0.43 to -0.15)) and protein S (from -0.05 (95%CI -0.18 to 0.08) to -0.21 (95%CI -0.37 to -0.05)); for TGA: antithrombin (from -0.11 (-0.23 to 0.02) to -0.19 (-0.30 to -0.07)), factor VIII (from 0.15 (0.03 to 0.27) to 0.24 (0.13 to 0.36)) and fibrinogen (from 0.12 (-0.01 to 0.26) to 0.19 (0.06 to 0.32)). In conclusion, there is no clear trend towards a broader contribution of coagulation factors in samples handled with CTI compared with those handled without CTI.
Competence assessment rubric in the Physiotherapy Practicum
Authors: Martiáñez-Ramírez Noa Lola , Pineda-Galán Consolación , Rodríguez-Bailón María , Romero-Galisteo Rita-Pilar
Published: February 2022

Introduction

Competence-based learning must be integrated into the practical development of Physiotherapy. Teamwork, interpersonal relations, analytical skills or critical/clinical thinking are some examples of internationally recommended competences in this kind of university studies. Therefore, there is a need to evaluate this learning in Physiotherapy through valid tools that facilitate this task.

Objective

To analyze the psychometric properties according to competences in Clinical Practices (RECOPC-FIS II) in order to assess 14 transversal or universal competences of under-graduate students in the Physiotherapy degree.

Methods

A validation study was conducted with 197 students in the 3rd and 4th year of the Physiotherapy degree and 202 clinical tutors who assessed these students using the RECOPC-FIS II. Different psychometric properties were analyzed: factor structure, internal consistency and sensitivity to change.

Results

The RECOPC-FIS II has a high internal consistency. Its 14 items saturate in a single factor. Regarding the sensitivity to change, the rubric showed higher scores in the Practicum of the 4th year with respect to that of the 3rd year, reaching significant differences in all of them.

Conclusion

The RECOPC-FIS II is a valid and reliable instrument to assess the transversal competencies of undergraduate students of Physiotherapy during their clinical practice. Therefore, it is intended to facilitate the acquisition of essential skills for the development of their professional career. The flexibility of this tool would allow its adaptation to other health science courses.
Sample-to-answer, extraction-free, real-time RT-LAMP test for SARS-CoV-2 in nasopharyngeal, nasal, and saliva samples: Implications and use for surveillance testing
Authors: Kundrod Kathryn A. , Natoli Mary E. , Chang Megan M. , Smith Chelsey A. , Paul Sai , Ogoe Dereq , Goh Christopher , Santhanaraj Akshaya , Price Anthony , Eldin Karen W. , Patel Keyur P. , Baker Ellen , Schmeler Kathleen M. , Richards-Kortum Rebecca
Published: February 2022

The global COVID-19 pandemic has highlighted the need for rapid, accurate and accessible nucleic acid tests to enable timely identification of infected individuals. We optimized a sample-to-answer nucleic acid test for SARS-CoV-2 that provides results in <1 hour using inexpensive and readily available reagents. The test workflow includes a simple lysis and viral inactivation protocol followed by direct isothermal amplification of viral RNA using RT-LAMP. The assay was validated using two different instruments, a portable isothermal fluorimeter and a standard thermocycler. Results of the RT-LAMP assay were compared to traditional RT-qPCR for nasopharyngeal swabs, nasal swabs, and saliva collected from a cohort of patients hospitalized due to COVID-19. For all three sample types, positive agreement with RT-LAMP performed using the isothermal fluorimeter was 100% for samples with Ct <30 and 69–91% for samples with Ct <40. Following validation, the test was successfully scaled to test the saliva of up to 400 asymptomatic individuals per day as part of the campus surveillance program at Rice University. Successful development, validation, and scaling of this sample-to-answer, extraction-free real-time RT-LAMP test for SARS-CoV-2 adds a highly adaptable tool to efforts to control the COVID-19 pandemic, and can inform test development strategies for future infectious disease threats.
Cost-effectiveness of anti-SARS-CoV-2 antibody diagnostic tests in Brazil
Authors: de Assis Tália Santana Machado , Freire Mariana Lourenço , Carvalho Janaína de Pina , Rabello Ana , Cota Gláucia
Published: February 2022

Background

Although serologic tests for COVID-19 diagnosis are rarely indicated nowadays, they remain commercially available and widely used in Brazil. The objective of this study was to evaluate the cost-effectiveness of anti-SARS-CoV-2antibody diagnostic tests for COVID-19 in Brazil.

Methods

Eleven commercially available diagnostic tests, comprising five lateral-flow immunochromatographic assays (LFAs) and six immunoenzymatic assays (ELISA) were analyzed from the perspective of the Brazilian Unified Health System.

Results

The direct costs of LFAs ranged from US$ 11.42 to US$ 17.41and of ELISAs, from US$ 6.59 to US$ 10.31. Considering an estimated disease prevalence between 5% and 10%, the anti-SARS-CoV-2 ELISA (IgG) was the most cost-effective test, followed by the rapid One Step COVID-19 Test, at an incremental cost-effectiveness ratio of US$ 2.52 and US$ 1.26 per properly diagnosed case, respectively. Considering only the LFAs, at the same prevalence estimates, two tests, the COVID-19 IgG/IgM and the One Step COVID-19 Test, showed high effectiveness at similar costs. For situations where the estimated probability of disease is 50%, the LFAs are more costly and less effective alternatives.

Conclusions

Nowadays there are few indications for the use of serologic tests in the diagnosis of COVID-19 and numerous commercially available tests, with marked differences are observed among them. In general, LFA tests are more cost-effective for estimated low-COVID-19-prevalences, while ELISAs are more cost-effective for high-pretest-probability scenarios.
Cross-national harmonization of cognitive measures across HRS HCAP (USA) and LASI-DAD (India)
Authors: Vonk Jet M. J. , Gross Alden L. , Zammit Andrea R. , Bertola Laiss , Avila Justina F. , Jutten Roos J. , Gaynor Leslie S. , Suemoto Claudia K. , Kobayashi Lindsay C. , O’Connell Megan E. , Elugbadebo Olufisayo , Amofa Priscilla A. , Staffaroni Adam M. , Arce Rentería Miguel , Turney Indira C. , Jones Richard N. , Manly Jennifer J. , Lee Jinkook , Zahodne Laura B.
Published: February 2022

Background

As global populations age, cross-national comparisons of cognitive health and dementia risk are increasingly valuable. It remains unclear, however, whether country-level differences in cognitive function are attributable to population differences or bias due to incommensurate measurement. To demonstrate an effective method for cross-national comparison studies, we aimed to statistically harmonize measures of episodic memory and language function across two population-based cohorts of older adults in the United States (HRS HCAP) and India (LASI-DAD).

Methods

Data for 3,496 HRS HCAP (≥65 years) and 3,152 LASI-DAD (≥60 years) participants were statistically harmonized for episodic memory and language performance using confirmatory factor analysis (CFA) methods. Episodic memory and language factor variables were investigated for differential item functioning (DIF) and precision.

Results

CFA models estimating episodic memory and language domains based on a priori adjudication of comparable items fit the data well. DIF analyses revealed that four out of ten episodic memory items and five out of twelve language items measured the underlying construct comparably across samples. DIF-modified episodic memory and language factor scores showed comparable patterns of precision across the range of the latent trait for each sample.

Conclusions

Harmonization of cognitive measures will facilitate future investigation of cross-national differences in cognitive performance and differential effects of risk factors, policies, and treatments, reducing study-level measurement and administrative influences. As international aging studies become more widely available, advanced statistical methods such as those described in this study will become increasingly central to making universal generalizations and drawing valid conclusions about cognitive aging of the global population.
Toward mapping pragmatic impairment of autism spectrum disorder individuals through the development of a corpus of spoken Japanese
Authors: Kato Sumi , Hanawa Kazuaki , Linh Vo Phuong , Saito Manabu , Iimura Ryuichi , Inui Kentaro , Nakamura Kazuhiko
Published: February 2022

The central symptom of autism spectrum disorder (ASD) is deficiency in social communication, which is generally viewed as being caused by pragmatic impairment (PI). PI is difficulty in using language appropriately in social situations. Studies have confirmed that PI is the result of neurological, cognitive, linguistic, and sensorimotor dysfunctions involving intricately intertwined factors. To elucidate the whole picture of this impairment, an approach from a multifaceted perspective fusing those factors is necessary. To this end, comprehensive PI mapping is a must, since no comprehensive mapping has yet been developed. The aim of this research is to present a model of annotation scheme development and corpus construction to efficiently visualize and quantify for statistical investigation occurrences of PI, which enables comprehensive mapping of PI in the spoken language of Japanese ASD individuals. We constructed system networks (lexicogrammatical option systems speakers make choices from) in the theoretical framework of Systemic Functional Linguistics, from which we developed an annotation scheme to comprehensively cover PI. Since system network covers all possible lexicogrammatical choices in linguistic interaction, it enables a comprehensive view of where and in what lexicogrammar PI occurs. Based on this annotation scheme, we successfully developed theCorpus of ASD + Typically Developed Spoken Languageconsisting of texts from 1,187 audiotaped tasks performed by 186 ASD and 106 typically developed subjects, accommodating approximately 1.07 million morphemes. Moreover, we were successful in the automatization of the annotation process by machine learning, accomplishing a 90 percent precision rate. We exemplified the mapping procedure with a focus on the spoken use of negotiating particles. Our model corpus is applicable to any language by incorporating our method of constructing the annotation scheme, and would give impetus to defining PI from a cross-linguistic point of view, which is needed because PI of ASD reflects cross-linguistic differences.
Judgement bias of group housed gestating sows predicted by behavioral traits, but not physical measures of welfare
Authors: Horback Kristina M. , Parsons Thomas D.
Published: February 2022

Judgement bias testing has emerged as a potential tool for assessing affective states in animals. Researchers infer an animal’s affective state based on an animal’s response to an ambiguous stimulus that is intermediate to both the rewarded and punished conditioned stimuli. Animals can be classified as “optimistic” or having a positive affective state if the animal displays behaviors that suggest an increased expectation of reward in the face of ambiguous stimuli. Alternatively, animals can be classified “pessimistic” or having a negative affective state if the animal displays behaviors that suggest an increased expectation of punishment in the face of ambiguous stimuli. Recent reports in multiple species question what factors influence performance in judgement bias testing, and which may allow for erroneous conclusions regarding individual affective state. In order to better understand this concern, 25 female swine were subjected to behavioral assessments at critical rearing stages to determine response variability. These same individuals were then assessed for physical measures of welfare and judgement bias using the “go/no-go” task as breeding adults. Sows which were more aggressive approached the ambiguous, but not the positive, stimulus significantly faster than others. Both optimistic and pessimistic biases were observed despite all sows living in enriched housing, and, sows with more positive physical welfare measures (fewer skin lesions and healthy body condition) did not exhibit more optimistic judgement biases. Our data demonstrate that behavior traits, such as aggressiveness, can affect a sow’s performance in a judgement bias test, while measures of physical health did not. We suggest that individual differences in behavior (e.g., bold-aggressive behavioral syndrome, or, proactive coping style) generate different emotional responses and can contribute to the animal’s overall affective state more so than physical ailment. Our findings highlight the complexity of how different factors impact an animal’s overall affective state and support the need for complementary measures in future JBT studies, including personality assessment.
Incidence of preventable cardiopulmonary arrest in a mature part-time rapid response system: A prospective cohort study
Authors: Song Myung Jin , Lee Dong-Seon , Choi Yun-Young , Lee Da-Yun , Jo Hye-min , Lim Sung Yoon , Park Jong Sun , Cho Young-Jae , Yoon Ho Il , Lee Jae Ho , Lee Choon-Taek , Lee Yeon Joo
Published: February 2022

Background

The purpose of a rapid response system (RRS) is to reduce the incidence of preventable cardiopulmonary arrests (CPAs) and patient deterioration in general wards. The objective of this study is to investigate the incidence and temporal trends of preventable CPAs and determine factors associated with preventable CPAs in a hospital with a mature RRS.

Methods

This was a single-center prospective cohort study of all CPAs occurring in the general ward between March 2017 and June 2020. The RRS operates from 07:00 to 23:00 on weekdays and from 07:00 to 12:00 on Saturdays. All CPAs were reviewed upon biweekly conference, and a panel of intensivists judged their preventability. Trends of preventable CPAs were analyzed using Poisson regression models and factors associated with preventable CPAs were analyzed using multivariable logistic regression.

Results

There were 253 CPAs over 40 months, and 64 (25.3%) of these were preventable. The incidence rate of CPAs was 1.07 per 1000 admissions and that of preventable CPAs was 0.27 per 1000 admissions. The number of preventable CPAs decreased by 24% each year (incidence rate ratio = 0.76; p = 0.039) without a change in the total CPA incidence. The most common contributor to the preventability was delayed response from physicians (n = 41, 64.1%). A predictable CPA with a pre-alarm sign had increased odds in the occurrence of preventable CPAs, while a cardiac cause of CPAs and RRS operating hours had decreased odds in terms of occurrence of preventable CPA.

Conclusion

Our study showed that one-fourth of all CPAs occurring in the general wards were preventable, and these arrests decreased each year. A mature RRS can evolve to reduce preventable CPAs with regular self-evaluation. Efforts should be directed at improving physicians’ response time since a delay in their response was the most common cause of preventable CPAs.
Assessment of cognitive functioning after living kidney donation: A cross-sectional pilot study
Authors: Mikuteit Marie , Gueler Faikah , Pollmann Iris , Pflugrad Henning , Dirks Meike , de Zwaan Martina , Weissenborn Karin
Published: February 2022

Background

Chronic kidney disease (CKD) has emerged as a risk factor for cognitive impairment. Living kidney donation results in reduction of the donors’ renal function. This is considered acceptable in general but possible associations with cognitive function have not yet been studied.

Methods

Sixty living kidney donors (LKD), who had donated between 2003 and 2012 at Hannover Medical School, underwent neurocognitive testing including attentional and memory testing. In a cross-sectional design results were compared with data of healthy controls (n = 40) and with norm data given in the respective test manuals adjusted for age, sex, and education.

Results

The median age of the LKD was 58 (range 39–70) years and the median time since donation was 7 (range 4–14) years. The LKD did not differ from controls in most of the cognitive test results and a composite attention test sum score. However, LKD did worse than controls in tests of working memory, parallel processing of stimuli, and sustained attention. No differences were found regarding quality of life. In LKD cognitive test results correlated significantly only with educational level but not with time since transplantation, eGFR, somatic comorbidity, quality of life and levels of fatigue, distress, depression, and anxiety.

Conclusions

Our data show a fairly normal performance of LKD in most attentional and memory tests. However, our pilot study also suggests some cognitive impairment in attention tests in LKD which would need to be confirmed in longitudinal prospective studies.
A comprehensive method for the quantification of medication error probability based on fuzzy SLIM
Authors: Ghasemi Fakhradin , Babamiri Mohammad , Pashootan Zahra
Published: February 2022

Medication errors can endanger the health and safety of patients and need to be managed appropriately. This study aimed at developing a new and comprehensive method for estimating the probability of medication errors in hospitals. An extensive literature review was conducted to identify factors affecting medication errors. Success Likelihood Index Methodology was employed for calculating the probability of medication errors. For weighting and rating of factors, the Fuzzy multiple attributive group decision making methodology and Fuzzy analytical hierarchical process were used, respectively. A case study in an emergency department was conducted using the framework. A total number of 17 factors affecting medication error were identified. Workload, patient safety climate, and fatigue were the most important ones. The case study showed that subtasks requiring nurses to read the handwritten of other nurses and physicians are more prone to human error. As there is no specific method for assessing the risk of medication errors, the framework developed in this study can be very useful in this regard. The developed technique was very easy to administer.
Fifteen-year trajectories of multimorbidity and polypharmacy in Dutch primary care—A longitudinal analysis of age and sex patterns
Authors: Vos Rein , Boesten Jos , van den Akker Marjan
Published: February 2022

Objective

After stratifying for age, sex and multimorbidity at baseline, our aim is to analyse time trends in incident multimorbidity and polypharmacy in the 15-year clinical trajectories of individual patients in a family medicine setting.

Methods

This study was carried out using data from the Registration Network Family Medicine in the South of the Netherlands. The clinical trajectories of 10037 subjects during the 15-year period (2000–2014) were analyzed in a repeated measurement of using a generalized estimating equations model as well as a multilevel random intercept model with repeated measurements to determine patterns of incident multimorbidity and polypharmacy. Hierarchical age-period-cohort models were used to generate age and cohort trajectories for comparison with prevalence trends in multimorbidity literature.

Results

Multimorbidity was more common in females than in males throughout the duration of the 15-year trajectory (females: 39.6%; males: 33.5%). With respective ratios of 11.7 and 5.9 between the end and the beginning of the 15-year period, the youngest female and male groups showed a substantial increase in multimorbidity prevalence. Ratios in the oldest female and male groups were 2.2 and 1.9 respectively. Females had higher levels of multimorbidity than males in the 0-24-year and 25-44-year age groups, but the levels converged to a prevalence of 92.2% in the oldest male and 90.7% in the oldest female group. Similar, albeit, moderate differences were found in polypharmacy patterns.

Conclusions

We sought to specify the progression of multimorbidity from an early age. As a result, our study adds to the multimorbidity literature by specifying changes in chronic disease accumulation with relation to polypharmacy, and by tracking differences in patient trajectories according to age and sex. Multimorbidity and polypharmacy are common and their prevalence is accelerating, with a relatively rapid increase in younger groups. From the point of view of family medicine, this underlines the need for a longitudinal approach and a life course perspective in patient care.
Human IL-2Rɑ subunit binding modulation of IL-2 through a decline in electrostatic interactions: A computational and experimental approach
Authors: Beig Parikhani Arezoo , Bagherzadeh Kowsar , Dehghan Rada , Biglari Alireza , Shokrgozar Mohammad Ali , Riazi Rad Farhad , Zeinali Sirous , Talebkhan Yeganeh , Ajdary Soheila , Ahangari Cohan Reza , Behdani Mahdi
Published: February 2022

Although high-dose IL-2 has clear antitumor effects, severe side effects like severe toxicity and activation of Tregs by binding of IL-2 to high-affinity IL-2R, hypotension, and vascular leak syndrome limit its applications as a therapeutic antitumor agent. Here in this study, a rational computational approach was employed to develop and design novel triple-mutant IL-2 variants with the aim of improving IL-2-based immunotherapy. The affinity of the mutants towards IL-2Rα was further computed with the aid of molecular dynamic simulations and umbrella sampling techniques and the obtained results were compared to those of wild-type IL-2. In vitro experiments by flow cytometry showed that the anti-CD25 mAb was able to bind to PBMC cells even after mutant 2 preincubation, however, the binding strength of the mutant to α-subunit was less than of wtIL-2. Additionally, reduction of IL-2Rα subunit affinity did not significantly disturb IL-2/IL2Rβγc subunits interactions.
Health facility readiness to provide integrated Family Planning, Maternal and Child Health (FPMCH) services in Nepal: Evidence from the comprehensive health facility survey
Authors: Acharya Kiran , Subedi Dipak , Acharya Pawan
Published: February 2022

Introduction

This study aimed to build the emergent body of evidence of family planning and maternal and child health (FPMCH) service integration benefits that can be useful in reaching the target of sustainable development goals (SDGs).

Methods

We utilized data from the 2015 Nepal Health Facility Survey and used the World Health Organization service readiness manual for defining the service readiness indicator score of all services related to FPMCH integration. Composite readiness index for all services including family planning, antenatal care service, delivery and newborn service readiness index, and curative child care service readiness index was considered for the integration of all services (i.e. readiness for FPMCH). Multivariable linear regression models were fitted to examine the association between covariates and readiness score to provide integrated services.

Results

The mean readiness score of integrated services in health facilities in Nepal was 52.1%. The services in private hospitals and peripheral health facilities had significantly lower readiness scores of integrated services compared to government hospitals. Compared to Province 3(Province 3 holds the national capital), Province 2 had significantly lower and Province 7 had significantly higher readiness scores. There is a marginally significantly higher readiness score of integrated services in the facilities where management meetings are held compared to where management meetings are never conducted. Interestingly, health facilities where external supervision occurred in the last 4 months had better service readiness of integrated services compared with those facilities with no external supervision. Similarly, the facilities that performed the routine quality assurance activities and facilities having a system for collecting opinion and being reviewed had a higher integrated services readiness score than their counterparts.

Conclusion

This study found a scope of improvement in management practices in the health sector of Nepal especially for supportive supervision, quality assurance (QA) activities, monthly management meetings, and a system of collecting and reviewing opinions from the clients. Strengthening management practices especially, promoting supportive supervision and adhering to QA protocols may improve HF readiness to implement integrated FPMCH in Nepal. Being low readiness, there is an urgent need for policy reform to improve the integrated service readiness, particularly in Province 2.
Progress towards controlling the HIV epidemic in urban Ethiopia: Findings from the 2017–2018 Ethiopia population-based HIV impact assessment survey
Authors: Lulseged Sileshi , Melaku Zenebe , Habteselassie Abebe , West Christine A. , Gelibo Terefe , Belete Wudinesh , Tefera Fana , Farahani Mansoor , Demissie Minilik , Teferi Wondimu , Abdella Saro , Birhanu Sehin , Ross Christine E. ,   the EPHIA Study Group
Published: February 2022

Introduction

In 2014, the Joint United Nations Programme on HIV/AIDS set an ‘ambitious’ 90-90-90 target for 2020. By 2016, there were disparities observed among countries in their progress towards the targets and some believed the targets were not achievable. In this report, we present the results of data from the Ethiopia Population-based HIV Impact Assessment survey analyzed to assess progress with the targets and associated factors.

Methods

We conducted a nationally representative survey in urban areas of Ethiopia. Socio-demographic and behavioural data were collected from consenting participants using a structured interview. HIV testing was done following the national HIV rapid testing algorithm and seropositivity confirmed using a supplemental laboratory assay. HIV viral suppression was considered if the viral load was <1,000 RNA copies/ml. Screening antiretroviral drugs was done for efavirenz, lopinavir, and tenofovir, which were in use during the survey period. In this analysis, we generated weighted descriptive statistics and used bivariate and logistic regression analysis to examine for associations. The 95% confidence interval was used to measure the precision of estimates and the significance level set at p<0.05.

Results

Of 19,136 eligible participants aged 15–64 years, 614 (3% [95% CI: 0.8–3.3]) were HIV-positive, of which 79.0% (95% CI: 4.7–82.7) were aware of their HIV status, and 97.1% (95% CI: 95.0–98.3 were on antiretroviral therapy, of which 87.6% (95% CI: 83.9–90.5) achieved viral load suppression. Awareness about HIV-positive status was significantly higher among females (aOR = 2.8 [95% CI: 1.38–5.51]), significantly increased with age, the odds being highest for those aged 55–64 years (aOR = 11.4 [95% CI: 2.52–51.79]) compared to those 15–24 years, and was significantly higher among those who used condom at last sex in the past 12 months (aOR = 5.1 [95% CI: 1.68–15.25]). Individuals with secondary education and above were more likely to have achieved viral suppression (aOR = 8.2 [95% CI: 1.82–37.07]) compared with those with no education.

Conclusion

Ethiopia made encouraging progress towards the UNAIDS 90-90-90 targets. The country needs to intensify its efforts to achieve the targets. A particular focus is required to fill the gaps in knowledge of HIV-positive status to increase case identification among population groups such as males, the youth, and those with low education.
Olfaction and kidney function in community-dwelling older adults
Authors: Wang Keran , Luo Zhehui , Li Chenxi , Pinto Jayant M. , Shiroma Eric J. , Simonsick Eleanor M. , Chen Honglei
Published: February 2022

Background

In older adults, kidney function declines with age. People with advanced kidney diseases may have poor olfaction. However, it is unclear whether poor olfaction is a marker for declining renal function or future risk of chronic kidney disease (CKD). We therefore investigated olfaction in relation to kidney function and risk of CKD.

Methods

These secondary data analyses were limited to participants of the year 3 clinical visit of the Health Aging and Body Composition Study. The analytic sample size varied between 1427 to 2531, depending on participant eligibility and data availability for each analysis. Olfaction was tested using the Brief Smell Identification Test (B-SIT), defined as anosmia (score≤6), hyposmia (7–8), moderate (9–10), and good function (10–11) at baseline. We estimated glomerular filter rate (eGFR) at baseline and seven years later using the CKD-EPI creatinine-cystatin C equation, and defined incident CKD as eGFR<60 ml/min/1.73m2 and eGFR decline ≥1 ml/min/1.73m2/year. Further, we identified CKD hospitalization events from hospitalization and death records. We used inverse probability weighting and weighted multivariable regressions to account for censoring in the prospective analyses and used absolute risk regression to account for competing risk of death.

Results

At baseline, compared to participants with good olfaction, the multivariable-adjusted mean eGFR was 3.00 ml/min/1.73m2 lower (95% confidence interval (CI): -5.25, -0.75) for those with anosmia and 1.87 lower (95% CI: -3.94, 0.21) for those with hyposmia with a P for linear trend < 0.001. Those with anosmia at baseline was had a significantly lower eGFR seven years later (-5.31, 95% CI: -8.58, -2.04, P for trend = 0.002), but the association was attenuated after further accounting for baseline eGFR (-2.37, 95%CI: -4.91, 0.16, P for linear trend = 0.147). Olfactory function was not associated with incident CKD or CKD hospitalization.

Conclusion

In older adults > age 70 years, poor olfaction is associated with lower kidney function, but not future CKD risk. These associations should be further investigated in relatively younger population.
Government influence on e-government adoption by citizens in Colombia: Empirical evidence in a Latin American context
Authors: Ramirez-Madrid Juan Pablo , Escobar-Sierra Manuela , Lans-Vargas Isaias , Montes Hincapie Juan Manuel
Published: February 2022

This study aims to identify government influence in the adoption of e-government by citizens (AEC) through a case study analyzing actions in Antioquia, Colombia, to increase AEC in annual vehicle tax filing and payment services. We classified these actions employing institutional theory, institutional interventions, and legitimation strategies. An analysis correlating AEC actions (including the COVID-19 containment measures) with over 16 million transactions in these two services during 2015–2020 found a strong government influence on AEC. We established coercive pressure and conformance to the environment as important predictors of AEC, but the COVID-19 containment measures only influenced electronic tax payments. Service type was also an essential predictor for these services; however, mobilization was not. Increasing AEC should be considered a necessary objective for public administrations, especially in developing countries that face shortages of resources and facilities.
Association of depression and antidepressant therapy with antiretroviral therapy adherence and health-related quality of life in men who have sex with men
Authors: Yen Yung-Feng , Lai Hsin-Hao , Kuo Yen-Chun , Chan Shang-Yih , Chen Lian-Yu , Chen Chu-Chieh , Wang Teng-Ho , Wang Chien Chun , Chen Marcelo , Yen Tsen-Fang , Kuo Li-Lan , Kuo Shu-Ting , Chuang Pei-Hung
Published: February 2022

UNAIDS’ HIV treatment targets require that 90% of people living with HIV/AIDS (PLWHA) receiving antiretroviral treatment (ART) achieve viral suppression and 90% of people with viral suppression have good health-related quality of life (HRQOL). This study aimed to examine the association of depression and antidepressant therapy with ART adherence and HRQOL in HIV-infected men who have sex with men (MSM). From 2018 through 2020, HIV-infected MSMs were consecutively recruited (N = 565) for the evaluation of ART adherence and HRQOL at Taipei City Hospital HIV clinics. Non-adherence to ART was defined as a Medication Adherence Report Scale score of < 23. HRQOL in PLWHHA was evaluated using WHOQOL-BREF, Taiwan version. Overall, 14.0% had depression and 12.4% exhibited non-adherence to ART. The nonadherence proportion was 21.8% and 10.5% in depressed and nondepressed HIV-infected MSM, respectively. After adjusting for other covariates, depression was associated with a higher risk of nonadherence to ART (adjusted odds ratio = 2.02; 95% confidence interval: 1.02–4.00). Physical, psychological, social, and environmental HRQOL were significantly negatively associated with depression. Considering antidepressant therapy, ART nonadherence was significantly associated with depression without antidepressant therapy but not with antidepressant therapy. The depressed HIV-infected MSM without antidepressant therapy had worse psychological, social, and environmental HRQOL than those with antidepressant therapy. Our study suggests that depression is associated with poor ART adherence and HRQOL, particularly in those without antidepressant therapy. Adequate diagnosis and treatment of depression should be provided for PLWHA to improve their ART adherence and HRQOL.