bluuebunny/crossref_metadata_2025 huggingface dataset:
The oilfields of Mesopotamia: Resource conflict, oil extraction and heritage destruction in Iraq
Authors: Saymour Isra S
Published: March 2022

The 2003 invasion of Iraq, led by the US Coalition forces, is amongst the most politically and culturally significant events of the twenty-first century. Much research across disciplines has been dedicated to explaining the War, with a significant body of work in the social sciences illuminating the role of oil in fuelling war and ongoing instabilities in the region. Less attention has been paid, however, to the ways that resource conflicts in Iraq expand beyond physical militarized clashes, bleeding into social and cultural realms that are purportedly unconnected to oil. This paper attends to a particularly significant one of these realms: the passive and active destruction of the material cultural heritage of Iraq and the immaterial social, cultural, and political consequences of this on the Iraqi people, including the violent colonial ecologies of plunder-based conflict curation. Using a critical, multidisciplinary array of secondary sources, this paper links oil, conflict, and culture against a (neo)colonial backdrop to illustrate that Operation Iraqi Freedom was a resource war that targeted not only natural but also cultural resources, leading to the parallel extraction and displacement of oil and heritage. Reframing the Iraq War through the lens of culture reveals how the conflict and following instability dispossessed the Iraqi people of their autonomy and capacity for political mobilization, with the broader purpose of establishing a stable regime of extraction to mitigate the demands of resource dependency. This analysis presents a new reading and conceptualization of oil, and a broader understanding of how resource dependency creates holistic spheres of violence and dispossession that work to reproduce and reinforce colonial and imperial power relations.
Taking humor seriously
Authors: Crossa Verónica
Published: March 2022

Understanding humor on its own terms is not an easy task. This commentary responds to Ben Gerlofs' (2022) article, ‘Deadly serious: Humor and the politics of aesthetic transgression’, by highlighting some of the important contributions made in his article and drawing out the empirical richness of his discussion. In doing so, I hope to discuss some of the ways in which humor has been analyzed in the geographical literature as well as potential gaps that remain to be addressed.
Addressing TB-related mortality in adults living with HIV: a review of the challenges and potential solutions
Authors: Sullivan Amanda , Nathavitharana Ruvandhi R.
Published: March 2022

Tuberculosis (TB) is the leading cause of death in people living with HIV (PLHIV) globally, causing 208,000 deaths in PLHIV in 2019. PLHIV have an 18-fold higher risk of TB, and HIV/TB mortality is highest in inpatient facilities, compared with primary care and community settings. Here we discuss challenges and potential mitigating solutions to address TB-related mortality in adults with HIV. Key factors that affect healthcare engagement are stigma, knowledge, and socioeconomic constraints, which are compounded in people with HIV/TB co-infection. Innovative approaches to improve healthcare engagement include optimizing HIV/TB care integration and interventions to reduce stigma. While early diagnosis of both HIV and TB can reduce mortality, barriers to early diagnosis of TB in PLHIV include difficulty producing sputum specimens, lower sensitivity of TB diagnostic tests in PLHIV, and higher rates of extra pulmonary TB. There is an urgent need to develop higher sensitivity biomarker-based tests that can be used for point-of-care diagnosis. Nonetheless, the implementation and scale-up of existing tests including molecular World Health Organization (WHO)-recommended diagnostic tests and urine lipoarabinomannan (LAM) should be optimized along with expanded TB screening with tools such as C-reactive protein and digital chest radiography. Decreased survival of PLHIV with TB disease is more likely with late HIV diagnosis and delayed start of antiretroviral (ART) treatment. The WHO now recommends starting ART within 2 weeks of initiating TB treatment in the majority of PLHIV, aside from those with TB meningitis. Dedicated TB treatment trials focused on PLHIV are needed, including interventions to improve TB meningitis outcomes given its high mortality, such as the use of intensified regimens using high-dose rifampin, new and repurposed drugs such as linezolid, and immunomodulatory therapy. Ultimately holistic, high-quality, person-centered care is needed for PLHIV with TB throughout the cascade of care, which should address biomedical, socioeconomic, and psychological barriers.
Digital risk distribution and COVID-19: How contact tracing is promoted as a solution to equilibrate public health and economic prosperity during pandemics
Authors: Mahr Dana , Bloch Marylaure
Published: March 2022

Digital contact tracing appears as an ideal solution to tackle long-term economic damage due to necessary lockdown measures during a pandemic. This essay shows that the challenge of balancing citizen's health and a functioning society is not just coming up today. Commercial centres were already in the Middle Ages worried about their economic prosperity and adopted isolation measures. Although there are much more data available today, pandemic preparedness remains constrained by temporal and spatial realities, thus limiting public health management to the national state. Based on the examples of China and Switzerland, we elaborate on how individual and collective needs can be balanced differently regarding the implementation of a digital contact tracing system. While China's Health Code App is close to social surveillance, Switzerland has turned away from Europe to develop its own Swiss solution due to disagreement about data protection. It becomes clear that the attempts to properly balance public health and economic prosperity during a pandemic must be constantly readjusted and cannot simply be delegated to a digital technology.
Digital health for quality healthcare: A systematic mapping of review studies
Authors: Ibrahim Mohd Salami , Mohamed Yusoff Harmy , Abu Bakar Yasrul Izad , Thwe Aung Myat Moe , Abas Mohd Ihsanuddin , Ramli Ras Azira
Published: March 2022

Objective

To systematically catalogue review studies on digital health to establish extent of evidence on quality healthcare and illuminate gaps for new understanding, perspectives and insights for evidence-informed policies and practices.

Methods

We systematically searched PubMed database using sensitive search strings. Two reviewers independently conducted two-phase selection via title and abstract, followed by full-text appraisal. Consensuses were derived for any discrepancies. A standardized data extraction tool was used for reliable data mining.

Results

A total of 54 reviews from year 2014 to 2021 were included with notable increase in trend of publications. Systematic reviews constituted the majority (61.1%, (37.0% with meta-analyses)) followed by scoping reviews (38.9%). Domains of quality being reviewed include effectiveness (75.9%), accessibility (33.3%), patient safety (31.5%), efficiency (25.9%), patient-centred care (20.4%) and equity (16.7%). Mobile apps and computer-based were the commonest (79.6%) modalities. Strategies for effective intervention via digital health included engineering improved health behaviour (50.0%), better clinical assessment (35.1%), treatment compliance (33.3%) and enhanced coordination of care (24.1%). Psychiatry was the discipline with the most topics being reviewed for digital health (20.3%).

Conclusion

Digital health reviews reported findings that were skewed towards improving the effectiveness of intervention via mHealth applications, and predominantly related to mental health and behavioural therapies. There were considerable gaps on review of evidence on digital health for cost efficiency, equitable healthcare and patient-centred care. Future empirical and review studies may investigate the association between fields of practice and tendency to adopt and research the use of digital health to improve care.
Neuroscience nurses’ comprehension of collaborating with and involvement of relatives: A qualitative interview study
Authors: Guldager Rikke , Loft Mia Ingerslev , Poulsen Ingrid
Published: March 2022

Within the field of neurological disease, it seems that involvement of relatives is of utmost importance since the patients often are affected in several areas (physical, cognitive, and emotional) which impair their ability to participate in decision-making about their treatment and care. This study aimed to illuminate neuroscience nurses’ comprehension of collaborating with and involvement of relatives. Semi-structured interviews were conducted with 19 neuroscience registered nurses. The qualitative data were analyzed utilizing inductive thematic analysis. The COREQ checklist was applied. The analysis identified how collaboration with, and involvement of relatives are perceived as a focus for nursing care and a resource for both patients and registered nurses. Registered nurses having personal experience as a relative find it easier to establish a relationship with relatives. This study emphasizes the importance of the establishment of a trusting relationship between registered nurses and relatives for a positive collaboration and thus involvement of relatives.
Violence in Health Care: Trends and Disparities, Bureau of Labor Statistics Survey Data of Occupational Injuries and Illnesses, 2011–2017
Authors: Hawkins Devan , Ghaziri Mazen El
Published: March 2022

Background: The health care sector is one of the most rapidly growing industry sectors in the United States. This study examined differences in the rates and trends of violent occupational injuries among health care workers in the United States. Methods: This study used data about violent occupational injuries among health care workers in the United States collected by the Bureau of Labor Statistics (BLS) Survey of Occupational Injuries and Illnesses (SOII). The BLS SOII collects data about injuries that result in at least one lost workday. Violent injuries are defined as intentional injury by another person. Data were obtained for years 2011 to 2017. We examined injury rates and trends according to industry and occupation, as well as age, sex, and race/ethnicity. Results: Intentional injuries increased among health care workers between 2011 and 2017. Rates, expressed as injuries per 10,000 workers, were particularly elevated in residential care facilities (44.07) and among health practitioner support technologists and technicians (22.54); nursing, psychiatric, and home health aides (28.13); and occupational therapy and physical therapist assistants and aides (39.72). Black health care support and practitioners workers had injury rates three times higher than White workers. Conclusions/Application to practice: Efforts should be made to address the increasing rates of intentional occupational injuries among health care workers. These efforts should focus on comprehensive programs enforcing policies for prevention and management (including reporting and training) and employee engagement in such efforts. High-rate industries and occupations should receive particular attention.
Rheumatoid Arthritis in Spine Surgery: A Systematic Review and Meta-Analysis
Authors: Streufert Benjamin D. , Onyedimma Chiduziem , Yolcu Yagiz U. , Ghaith Abdul Karim , Elder Benjamin D. , Nassr Ahmad , Currier Bradford , Sebastian Arjun S. , Bydon Mohamad
Published: March 2022

Study Design

Systematic Review and Meta-analysis

Objective

The purpose of this study is to synthesize recommendations for perioperative medical management of RA patients and quantify outcomes after spine surgery when compared to patients without RA.

Methods

A search of available literature on patients with RA and spine surgery was performed. Studies were included if they provided a direct comparison of outcomes between patients undergoing spine surgery with or without RA diagnosis. Meta-analysis was performed on operative time, estimated blood loss, hospital length of stay, overall complications, implant-related complications, reoperation, infection, pseudarthrosis, and adjacent segment disease.

Results

Included in the analysis were 9 studies with 703 patients with RA undergoing spine surgery and 2569 patients without RA. In RA patients compared to non-RA patients undergoing spine surgery, the relative risk of infection was 2.29 times higher (P = .036), overall complications 1.61 times higher (P < .0001), implant-related complications 3.93 times higher (P = .009), and risk of reoperation 2.45 times higher (P < .0001). Hospital length of stay was 4.6 days longer in RA patients (P < .0001).

Conclusions

Treatment of spinal pathology in patients with RA carries an increased risk of infection and implant-related complications. Spine-specific guidelines for perioperative management of antirheumatic medication deserve further exploration. All RA patients should be perioperatively co-managed by a rheumatologist. This review helps identify risk profiles in RA specific to spine surgery and may guide future studies seeking to medically optimize RA patients perioperatively.
Bilateral Carotid Stenosis in a Patient with Previous Neck Surgery: Difficulties in Endarterectomy
Authors: Elavarasi Arunmozhimaran , Narayan Sunil K. , Chandran Sai , Rath Durga Prasad
Published: March 2022

Carotid stenosis is an important cause of recurrent transient ischemic attacks and stroke. Carotid stenting and endarterectomy are considered equally effective in treating this condition. We report a patient with recurrent TIA and bilateral carotid stenosis who had undergone anterior cervical diskectomy and fusion and who was found to have fibrous bands encasing the right carotid artery. He was treated with endarterectomy on the left side and carotid stenting on the right side. With the widespread availability of procedures like carotid endarterectomy, more older people would undergo this surgery, who might have undergone anterior cervical surgery. Prior neck surgery and adhesions may lead to altered anatomy, risk of increased blood loss, and surgical complications. In such cases, carotid stenting could be an alternative to endarterectomy.
Cluster Headache Impact Questionnaire (CHIQ) – a short measure of cluster headache related disability
Authors: Kamm Katharina , Straube Andreas , Ruscheweyh Ruth
Published: March 2022

Background

Cluster headache (CH) is a severe, highly disabling primary headache disorder. However, there is little research on CH-related disability, and most of it is based on non CH-specific questionnaires. The aim of this study was to develop a short, CH-specific disability questionnaire.

Methods

The 8-item Cluster Headache Impact Questionnaire (CHIQ) was developed based on a literature review and patient and expert interviews. The questionnaire was tested in 254 CH patients (171 males; 47.5 ± 11.4 years; 111 chronic CH, 85 active episodic CH, 52 episodic CH in remission) from our tertiary headache center or from a German support group.

Results

Reliability and validity of the CHIQ was evaluated in active episodic and chronic CH patients (n = 196). Internal consistency (Cronbach’s α = 0.88) and test-retest reliability (ICC 0.91, n = 41) were good. Factor analysis identified a single factor. Convergent validity was shown by significant correlations with the Headache Impact Test (HIT-6, r = 0.58, p < 0.001), subscales of the depression, anxiety and stress scales (DASS, r = 0.46–0.62; p < 0.001) and with CH attack frequency (r = 0.41; p < 0.001). CHIQ scores significantly differentiated between chronic CH (25.8 ± 6.5), active episodic CH (23.3 ± 6.9) and episodic CH patients in remission (13.6 ± 11.9, p < 0.05 for all 3 comparisons).

Conclusions

The CHIQ is a short, reliable, valid, and easy to administer measure of CH-related disability, which makes it a useful tool for clinical use and research.
Genes and Their Molecular Functions Determining Seed Structure, Components, and Quality of Rice
Authors: Li Pei , Chen Yu-Hao , Lu Jun , Zhang Chang-Quan , Liu Qiao-Quan , Li Qian-Feng
Published: March 2022

With the improvement of people's living standards and rice trade worldwide, the demand for high-quality rice is increasing. Therefore, breeding high quality rice is critical to meet the market demand. However, progress in improving rice grain quality lags far behind that of rice yield. This might be because of the complexity of rice grain quality research, and the lack of consensus definition and evaluation standards for high quality rice. In general, the main components of rice grain quality are milling quality (MQ), appearance quality (AQ), eating and cooking quality (ECQ), and nutritional quality (NQ). Importantly, all these quality traits are determined directly or indirectly by the structure and composition of the rice seeds. Structurally, rice seeds mainly comprise the spikelet hull, seed coat, aleurone layer, embryo, and endosperm. Among them, the size of spikelet hull is the key determinant of rice grain size, which usually affects rice AQ, MQ, and ECQ. The endosperm, mainly composed of starch and protein, is the major edible part of the rice seed. Therefore, the content, constitution, and physicochemical properties of starch and protein are crucial for multiple rice grain quality traits. Moreover, the other substances, such as lipids, minerals, vitamins, and phytochemicals, included in different parts of the rice seed, also contribute significantly to rice grain quality, especially the NQ. Rice seed growth and development are precisely controlled by many genes; therefore, cloning and dissecting these quality-related genes will enhance our knowledge of rice grain quality and will assist with the breeding of high quality rice. This review focuses on summarizing the recent progress on cloning key genes and their functions in regulating rice seed structure and composition, and their corresponding contributions to rice grain quality. This information will facilitate and advance future high quality rice breeding programs.
Paeonol regulates NLRP3 inflammasomes and pyroptosis to alleviate spinal cord injury of rat
Authors: Zhao Houling , Wang Xi , Liu Shuheng , Zhang Qingguo
Published: March 2022

Background

Spinal cord injury (SCI) is a life-threatening traumatic disorder. Paeonol has been confirmed to be involved in a variety of diseases. The purpose of this study is to investigate the role of paeonol on SCI progression.

Methods

Sprague Dawley (SD) rat was used for the establishment of SCI model to explore the anti-inflammation, anti-oxidation, and neuroprotective effects of paeonol (60 mg/kg) on SCI in vivo. For in vitro study, mouse primary microglial cells (BV-2) were induced by lipopolysaccharide (LPS)/adenosine triphosphate (ATP) treatment. The effect of paeonol on the polarization of LPS/ATP-induced BV-2 cells was determined by detection the expression inducible nitric oxide synthase (iNOS), tumour necrosis factor alpha (TNF-α), arginase-1 (Arg-1), and interleukin (IL)-10 using qRT-PCR. ELISA was used to assess the levels of IL-1β, IL-18, TNF-α, malondialdehyde (MDA), and glutathione (GSH). Western blotting was conducted to determine the levels of NLRP3 inflammasomes and TLR4/MyD88/NF-κB (p65) pathway proteins.

Results

Paeonol promoted the recovery of locomotion function and spinal cord structure, and decreased spinal cord water content in rats following SCI. Meanwhile, paeonol reduced the levels of apoptosis-associated speck-like protein (ASC), NLRP3, active caspase 1 and N-gasdermin D (N-GSDMD), repressed the contents of IL-1β, IL-18, TNF-α and MDA, and elevated GSH level. In vitro, paeonol exerted similarly inhibiting effects on pyroptosis and inflammation. Meanwhile, paeonol promoted BV-2 cells M2 polarization. In addition, paeonol also inactivated the expression of TLR4/MyD88/NF-κB (p65) pathway.

Conclusion

Paeonol may regulate NLRP3 inflammasomes and pyroptosis to alleviate SCI, pointing out the potential for treating SCI in clinic.
Apnoeic oxygenation with high-flow oxygen for tracheal resection and reconstruction surgery
Authors: Ly Nguyen Minh , Van Dinh Ngo , Trang Dinh Thi Thu , Hai Ngo Vi , Hung Tong Xuan
Published: March 2022

Background

Tracheal resection and reconstruction are the most effective treatments for tracheal stenosis, but the difficulties are surgery and maintaining ventilation performed on the patient’s same airway. High-flow oxygen has begun to be applied to prolong the apnoea time in the tracheal anastomosis period for tracheal resection and reconstruction. This study aims to evaluate the effectiveness of apneic conditions with high-flow oxygen as the sole method of gas exchange during anastomosis construction.

Methods

A prospective study was performed on 16 patients with tracheal stenosis, with ages ranging from 19 to 70, who underwent tracheal resection and reconstruction from April 2019 to August 2020 in 108 Military Central Hospital. During the anastomosis phase using high flow oxygen of 35–40 l.min-1 delivered across the open tracheal with an endotracheal tube (ETT) at the glottis in apnoeic conditions.

Results

The mean (SD) apnoea time was 20.91 (2.53) mins. Mean (SD) time anastomosis was 22.9 (2.41) mins. The saturation of oxygen was stable during all procedures at 98–100%. Arterial blood gas analysis showed mean (SD) was hypercapnia and acidosis acute respiratory after 10 mins of apnoea and 20 mins apnoea respectively. However, after 15 mins of ventilation, the parameters are ultimately returned to normal. All 16 patients were extubated early and safely at the end of the operation. There were no complications, such as bleeding, hemothorax, pneumothorax, or barotrauma.

Conclusion

High-flow oxygen across the open tracheal under apnoeic conditions can provide a satisfactory gas exchange to allow tubeless anesthesia for tracheal resection and reconstruction.
The impact of implementing an endocarditis team in comparison to the classic heart team in a tertiary referral centre
Authors: van den Heuvel F. M. A. , Bos M. , Geuzebroek G. S. C. , Aarntzen E. H. J. G. , Maat I. , Dieker H. J. , Verkroost M. , Rodwell L. , ten Oever J. , van Crevel R. , Habets J. , Kouijzer I. J. E. , Nijveldt R.
Published: March 2022

Background

Infective endocarditis (IE) is a complex disease for which the European Society of Cardiology guideline recommends a dedicated multidisciplinary endocarditis team (ET) approach since 2015. It is currently unknown whether this ET approach is beneficial compared to a classic heart team approach including bedside consultation by an infectious disease specialist in Western Europe.

Methods

This retrospective single centre, observational cohort study was conducted at the Radboudumc, a tertiary referral centre in the Netherlands. Consecutive patients treated for IE were included from September 2017 to September 2018 before implementation of a dedicated ET and from May 2019 to May 2020 afterwards.

Results

In total, 90 IE patients (45 patients before and 45 patients after the implementation of the ET) were included. No significant differences were found in diagnostic workup, surgical treatment (surgery performed 69% vs. 71%, p = 0.82), time to surgery because of an urgent indication (median 4 vs. 6 days, p = 0.82), in-hospital complications (53% vs. 67%, p = 0.20), and 6-month mortality (11% vs. 13%, p = 0.75) between IE patients treated before and after the implementation of the ET.

Conclusion

Formalization of the recommended multidisciplinary endocarditis team might not significantly improve the complication rate nor the short term outcome.
Biliary balloon dilator impaction in a non-dilated bile duct with anatomical variations: a case report
Authors: Okamoto Takeshi , Yamamoto Kazuki , Fukuda Katsuyuki
Published: March 2022

Background

While techniques for extracting large stones from dilated bile ducts are increasing, options for small stones impacted in non-dilated bile ducts are limited.

Case presentation

We report the case of an impacted biliary balloon dilator in a choledocholithiasis patient with a non-dilated bile duct and multiple anatomical variations, including low insertion of the cystic duct. After unsuccessful attempts with a stone extraction basket and balloon, a biliary balloon dilator with a sharp catheter tip was advanced into the bile duct. The balloon could not be removed from the bile duct even when deflated. The duodenoscope fell back into the stomach, causing the shaft of the dilator to break near the ampulla. We then removed the broken tip with a snare, which caused the balloon sheath to separate from the shaft and remain in the bile duct. Finally, we removed the sheath with rat-tooth forceps, leading to successful extraction of the stone-and-balloon complex.

Conclusions

The exceedingly rare possibility of balloon impaction should be kept in mind when using biliary balloon dilators in non-dilated bile ducts.
Family caregivers’ involvement in caring for frail older family members using welfare technology: a qualitative study of home care in transition
Authors: Glomsås Heidi Snoen , Knutsen Ingrid Ruud , Fossum Mariann , Christiansen Karin , Halvorsen Kristin
Published: March 2022

Background

Demographic, economic and organisational changes challenge home care services. Increased use of welfare technology and involvement of family members as co-producers of care are political initiatives to meet these challenges. However, these initiatives also involve ethical aspects.

Method

The aim of this qualitative study was to explore family caregivers’ experience of involvement and possible ethical aspects of caring for frail older family members receiving home care services supported by welfare technology.

This study used a qualitative explorative and descriptive design within a phenomenological-hermeneutical approach. Sixteen interviews with eighteen family caregivers were conducted. The participants were sons, daughters, siblings and spouses of frail older people receiving home care services with the support of welfare technology. Data were analysed using reflexive thematic analysis. The COREQ checklist was used.

Results

The analysis led to five main themes. First, the family caregivers’ experienced caring as meaningful but increasingly demanding concerning the changes in home care services. Second, they experienced a change in relationships, roles, tasks, and responsibilities related to more family involvement and the use of welfare technology. This also challenged their sense of autonomy. However, welfare technology helped them deal with responsibilities, especially safety. The family caregivers requested early involvement, dialogue for care decisions, more cooperation and support from health professionals. Third, the participants experienced that health professionals decided the conditions for co-production without discussion. Their need for information and knowledge about welfare technology were not met. Fourth, the family caregivers felt that the health professionals did not adequately recognise their unique knowledge of the care receiver and did not use this knowledge for customising the welfare technology to the care receiver and their families. Fifth, the family caregivers expressed concern about service and welfare technology inequality in home care services.

Conclusions

Co-production in the involvement of family caregivers in care is still not an integral part of home care service. Welfare technology was appreciated, but the family caregivers called for early involvement to ensure successful and safe implementation and use. More attention needs to be given to ethical concerns about the change in relations, transfer of tasks and responsibility, and risk of inequality.
Postvitrectomy endophthalmitis caused by Morganella morganii: a case report and literature review
Authors: Wang Chung-Ting , Chang Yin-Hsi , Chen Kuan-Jen , Chou Hung-Da
Published: March 2022

Background

Postvitrectomy endophthalmitis is a rare and serious complication following vitreoretinal surgeries. Morganella morganii, an emerging gram-negative, facultative anaerobic rod, is related to severe nosocomial infections in various organs and thus has gained importance in recent decades. Morganella morganii infection following intraocular surgery is rarely reported.

Case presentation

We report an immunocompetent patient with Morganella morganii-related endophthalmitis after vitrectomy for retinal detachment who presented with hand motion visual acuity, hypopyon and a unique retrolental exudative membrane. Initially, the patient was unresponsive to empirical intravitreal ceftazidime and vancomycin but recovered with vision preservation (20/63) after surgical removal of the membrane and silicone oil tamponade.

Conclusions

Morganella morganii intraocular infection is often devastating, likely due to its high multidrug-resistance rate via intrinsic ß-lactamase production, multiple acquired traits related to additional genetic mechanisms, and fimbrial adhesion, urease production, and type III secretion system-associated biofilm formation. The above characteristics of M. morganii may lead to an inadequate response to empirical intravitreal antibiotics, and early surgical intervention should be considered.
The effect of schistosomiasis and soil-transmitted helminths on expressive language skills among African preschool children
Authors: Mazibuko Xolisile I. , Chimbari Moses
Published: March 2022

Background

Schistosomiasis and soil transmitted helminths (STH) have been associated with compromised child development. We determined the effect of schistosomiasis and STH on expressive language skills among isiZulu speaking preschool children focusing on the variables: age, gender, school and stunting.

Methods

We quantitatively compared the performance of a cohort of infected and non-infected children using a 2 phased approach. In phase 1 infected children were treated with praziquantel and matched with non-infected children and both groups were tested for expressive language performance. In phase 2 both groups of children were re-tested for expressive language skills using a similar but modified test. The participants were 106 preschool children between the age of 4 and 6 years, 11 months. The Developmental Language Test was adapted as a linguistically and culturally appropriate tool for assessing isiZulu expressive language skills.

Results

The overall performance of the children in phases 1 and 2 were statistically similar. There was significant Pearson’s correlation of expressive language skills to age (0.002, P < 0.01), schistosomiasis i.e. vocabulary 1 (0.024, P < 0.05) and narrative skills (0.001, P < 0.01) and soil-transmitted helminths i.e. vocabulary 1 (0.006, P < 0.05), colours (0.029, P < 0.05) and narrative skills (0.001, P < 0.01) in phase 2 with small to high Cohen’s d effect size for various language subtests.

Conclusion

We concluded that even mild schistosomiasis and STH may compromise the performance of preschool children on expressive language. However poor ability in following instructions may have contributed to general poor performance across the two groups tested. Diet, school effect and stunting did not influence the performance of the children on expressive language.
The impact of cardiopulmonary hemodynamic factors in volumetry for pulmonary nodule management
Authors: Guedes Pinto Erique , Penha Diana , Hochhegger Bruno , Monaghan Colin , Marchiori Edson , Taborda-Barata Luís , Irion Klaus
Published: March 2022

Background

The acceptance of coronary CT angiogram (CCTA) scans in the management of stable angina has led to an exponential increase in studies performed and reported incidental findings, including pulmonary nodules (PN). Using low-dose CT scans, volumetry tools are used in growth assessment and risk stratification of PN between 5 and 8 mm in diameter. Volumetry of PN could also benefit from the increased temporal resolution of CCTA scans, potentially expediting clinical decisions when an incidental PN is first detected on a CCTA scan, and allow for better resource management and planning in a Radiology department. This study aims to investigate how cardiopulmonary hemodynamic factors impact the volumetry of PN using CCTA scans. These factors include the cardiac phase, vascular distance from the main pulmonary artery (MPA) to the nodule, difference of the MPA diameter between systole and diastole, nodule location, and cardiomegaly presence.

Materials and methods

Two readers reviewed all CCTA scans performed from 2016 to 2019 in a tertiary hospital and detected PN measuring between 5 and 8 mm in diameter. Each observer measured each nodule using two different software packages and in systole and diastole. A multiple linear regression model was applied, and inter-observer and inter-software agreement were assessed using intraclass correlation.

Results

A total of 195 nodules from 107 patients were included in this retrospective, cross-sectional and observational study. The regression model identified the vascular distance (p < 0.001), the difference of the MPA diameter between systole and diastole (p < 0.001), and the location within the lower or posterior thirds of the field of view (p < 0.001 each) as affecting the volume measurement. The cardiac phase was not significant in the model. There was a very high inter-observer agreement but no reasonable inter-software agreement between measurements.

Conclusions

PN volumetry using CCTA scans seems to be sensitive to cardiopulmonary hemodynamic changes independently of the cardiac phase. These might also be relevant to non-gated scans, such as during PN follow-up. The cardiopulmonary hemodynamic changes are a new limiting factor to PN volumetry. In addition, when a patient experiences an acute or deteriorating cardiopulmonary disease during PN follow-up, these hemodynamic changes could affect the PN growth estimation.
Establishing content validity for the migraine Global Impression Item (mGI-I) assessment: a modified single-item migraine symptom severity questionnaire
Authors: Chandler David , Navetta Marco , Shah Shweta , Cline Jennifer , Phinney Michael
Published: March 2022

Objective

To establish content validity of a single-item, migraine-specific symptom severity questionnaire for completion by migraine patients, key family members (KFMs) of migraine patients, and Healthcare Professionals (HCPs) who treat migraine patients.

Background

Migraine is a common disabling primary headache disorder with high prevalence and significant socioeconomic burden and personal impacts. There is a need for a global assessment of migraine symptom severity to evaluate potential new therapies from multiple perspectives.

Methods

The migraine Global Impression Item (mGI-I) was drafted and tested in a non-interventional, qualitative study comprising telephone interviews with 15 migraine patients, 15 KFMs of migraine patients, and 15 migraine treating HCPs. The mGI-I was drafted with two different item stem options and two different response scale options to ask about the patient’s migraine from the perspective of each respondent. Cognitive interviews were conducted to test comprehensiveness, clarity and ease of completion of the different versions of the mGI-I iteratively in three sequential waves of respondents.

Results

Revisions were made to the draft mGI-I after Wave 1 and Wave 2 of the interviews. Changes were made to simplify the item stem (removing unnecessary text), make language more patient-friendly (e.g. use of “migraine attack”), and add clarity to the item stem for consistent interpretation (include descriptive language of migraine attacks). Across both waves there was a preference for a 5-point response scale compared to a 7-point scale. In Wave 3, all respondents found the revised instructions, item stem, and 5-point response scale comprehensive, easy to understand and to answer. No further changes to the mGI-I were made after Wave 3.

Conclusions

This qualitative study of 45 total respondents across 3 subpopulations, established the content validity and appropriateness of the mGI-I in migraine patients, KFMs, and migraine-treating HCPs. The study specifically confirmed that the mGI-I is comprehensive, easily understood and answered for each respondent population.
Prevalence, associated factors and perinatal outcomes of antepartum depression in Ibadan Nigeria
Authors: Adeoye Ikeola A. , Sogbesan Abiodun , Esan Oluyomi
Published: March 2022

Background

Antepartum depression is the most common mental health disorder in pregnancy and it is also a risk factor for adverse perinatal outcomes. Low and middle income countries like Nigeria bear a higher burden of antepartum depression compared with high income countries. Prioritizing mental health issues among pregnant women is crucial to achieving the Sustainable Development Goals. We determined the prevalence, associated factors and perinatal outcomes of antepartum depression among pregnant women in Ibadan, Nigeria.

Methods

A prospective cohort study was conducted among 1745 pregnant women enrolled early in pregnancy (≤ 20 weeks) at four comprehensive obstetric facilities within Ibadan metropolis. Antepartum depression was ascertained during the third trimester using the Edinburg Postpartum Depression Scale ≥ 12. The primary exposure was antepartum depression and the outcome variables were the perinatal outcomes. The associated factors assessed included sociodemographic, obstetric, psychological, and lifestyle characteristics. Bi-variate logistic and Poisson regression analyses were used to assess the factors and relative risk for perinatal outcomes of antepartum depression.

Results

The prevalence of antepartum depression was 14.1%. The significant factors associated with APD after adjusting for confounders were: high income (≥ 20, 000) which was protective (AOR) = 0.59; 95% CI: (0.40 – 0.88); p-value: 0.010] and perceived stress increased the odds of APD in a monotonic fashion: moderate stress [AOR = 2.39; 95% CI: (1.01 – 5.7); p-value: 0.047], high stress [AOR = 6.43; 95% CI: (2.28 – 18.2); p-value: < 0.001]. Preterm delivery was the only significant perinatal outcome [Relative Risk (RR) = 1.66; 95% CI (1.14 – 2.39); p-value =  0.007]. Depression did not increase the risk of having low birth weight babies (p = 0.513), macrosomia (p = 0.894), birth asphyxia (p = 0.317), and caesarean section (p = 0.298).

Conclusions

APD was prevalent among our study population. The significant factors identified in this study can be targeted to reduce the occurrence of APD among pregnant women in Nigeria through appropriate social and public health interventions which include APD screening, counselling, and the provision of emotional support for pregnant women during antenatal care.
New diagnosis of cancer in mild and moderate/severe traumatic brain injury patients in a 12-year population-based study
Authors: Lu Chung-Che , Nyam Tee-Tau Eric , Ho Chung-Han , Kuo Jinn-Rung , Chio Chung-Ching , Wang Jhi-Joung , Wang Che-Chuan
Published: March 2022

Background

Traumatic brain injury (TBI) has been reported as a risk factor for brain cancer development. However, the magnitude of the impact of TBI on systemic cancer development has not been clarified.

Methods

A retrospective longitudinal cohort study was conducted using the Taiwan Longitudinal Health Insurance Database between January 2000 and December 2011. A total of 35,306 patients were initially enrolled, and 14,795 patients with mild TBI and 14,795 patients with moderate/severe TBI were matched using the National Health Insurance Research Database in Taiwan. The Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of TBI adjusted for potential confounding factors.

Results

After matching, the results showed that patients with moderate/severe TBI had a high mortality rate (17.7% vs. 10.4%) and shorter time interval from TBI to death (mean 3.6 years vs. 5.8 years). No differences were observed in cancer incidence (4.1% vs. 4.1%) or risk factors for mortality between mild and moderate/severe TBI patients. However, patients aged between 46 and 55 years, female patients, and patients with pre-existing renal disease had a significant higher cancer incidence risk in moderate/severe TBI compared with mild TBI patients. The top 15 most common cancers showed that mild TBI patients had a higher percentage of head and neck cancer. The overall mortality rate in all TBI patients diagnosed with cancer was about 50%, and the cancer-specific mortality is approximately 85% in death of TBI patients with cancer.

Conclusions

We concluded that the incidence risk of a new cancer diagnosis and mortality risk of TBI patients with cancer between the mild TBI and moderate/severe TBI patients were not significantly different.
Subjective well-being among AIDS orphans in southwest China: the role of school connectedness, peer support, and resilience
Authors: Lai Shimin , Zhou Junmin , Xu Xiaohe , Li Shiying , Ji Yuanyi , Yang Shujuan , Tang Wanjie , Zhang Jianxin , Jiang Jianjun , Liu Qiaolan
Published: March 2022

Background

Few studies have explored the health and development of AIDS orphans using the positive youth development (PYD) framework. Grounded in this framework, the main objective of this study is to examine how internal assets (i.e., resilience) and external assets (i.e., school connectedness, peer support) affect subjective well-being among Yi AIDS orphans in the Liangshan Yi Autonomous Prefecture, Sichuan province, China.

Methods

A cross-sectional survey was conducted by interviewing 571 AIDS orphans and 979 non-orphans of Yi ethnic minority from 5th-10th grades. Structural equation models (SEM) were utilized to identify and estimate the direct and indirect effects of internal and external assets on subjective well-being.

Results

The average score of subjective well-being was significantly lower for AIDS orphans than for in non-orphans (P < 0.05). Resilience, school connectedness, peer support (number of friends, caring friends), and self-rated physical health had significant and positive direct effects on subjective well-being. In addition, the effects of school connectedness, and peer support on subjective well-being were mediated by resilience.

Conclusions

Positive individual and school-related contextual assets can bolster subjective well-being among AIDS orphans. The design of health intervention programs for AIDS orphans should incorporate these positive development assets.
Complete home smoking ban survey analysis: an opportunity to improve health equity among sexual minority adults in California, USA
Authors: Boman-Davis Marie C. , Irvin Veronica L. , Westling Erika
Published: March 2022

Background

Increasing the proportion of adults living in smoke-free homes is a US Healthy People 2020 objective. Complete home smoking bans are associated with higher odds of smoking cessation attempts and cessation duration. Sexual minority adults have disproportionality higher rates of smoking. This study investigates correlates of having a complete home smoking ban among sexual minority adults in California.

Methods

Secondary data analyses of the California Behavioral Risk Factor Surveillance System (CA BRFSS), 2014–2016. The CA BRFSS telephone survey of adults was conducted in English and Spanish and used random digit dial for landline and cell numbers. Weighted descriptives were stratified by sexual orientation and biological sex. Weighted bivariate and multivariable logistic regression analyses included only sexual minorities (i.e., lesbian, gay, bisexual) and were analyzed as a group and separately by biological sex to account for intragroup variances. The final weighted total of sexual minority adults (N = 359,236) included sexual minority adult females (N = 163,490) and sexual minority adult males (N = 195,746).

Results

Sexual minority adults in California had a lower prevalence of complete home smoking bans (Female 76.2%; Male 75.7%), higher prevalence of current cigarette smoking (Female 23.3%; Male 17.4%) and of e-cigarette use (Female 5.8%; Male 6.4%) than their straight counterparts. Sexual minorities that smoke everyday (Female Adjusted Odds Ratio (AOR) 0.26, 95% Confidence Interval (CI) 0.11–0.63; Male AOR 0.24, 95% CI 0.01–0.56) or some days (Female AOR 0.28, 95% CI 0.09–0.90) had lower adjusted odds of having a complete home smoking ban compared to those who never smoked.

Conclusions

Smoking everyday was the only consistent predictor of not having a complete home smoking ban among sexual minority adults. Focused efforts to increase prevalence of complete home smoking bans should address smoking status to improve health equity among sexual minority adults.
A National Communications Campaign to decrease childhood stunting in Tanzania: an analysis of the factors associated with exposure
Authors: Moffat Ryan , Sayer Alexis , DeCook Kiersten , Cornia Alise , Linehan Mary , Torres Scott , Mulokozi Generose , Crookston Benjamin , Hall Cougar , West Josh
Published: March 2022

Background

Childhood stunting is a major problem in Tanzania, affecting an estimated 2.7 million children under 5 years of age. The purpose of this study was to examine the factors associated with exposure to mass media (radio and television) and IPC (interpersonal communication) components integrated in a national communications campaign aiming to decrease stunting in Tanzania.

Methods

A cross-sectional survey was conducted among 3082 men and 4996 women dyads after the campaign. The average age of men was 34.7 years (SD = 8.9) and 28.1 years (SD = 6.9) for women. Several factors affecting exposure to the campaign were studied. Comparisons were made between radio, TV, and IPC exposure.

Results

Mothers who reported i) higher wealth, ii) being the primary decision-makers in the home, iii) receiving support from their husbands, iv) frequent access to radio and TV and, v) ownership of a cell phone, were more likely to report exposure to the mass media component of the communications campaign. Contrarily, the same factors were not predictors of exposure to the IPC component. Fathers who reported: i) higher wealth and education, ii) ownership of a cell phone, iii) recently listened to the radio, iv) that the mother made the decisions in the home and v) helping at home, were more likely to be exposed to the mass media component.

Conclusion

Significant factors affecting exposure to the communications campaign were varied but not consistent between mass media and IPC. Because of the high frequency of exposure to the campaign overall, both media and IPC components are important in a large-scale, health-related communications campaign.