bluuebunny/crossref_metadata_2025 huggingface dataset:
mHealth intervention for carers of individuals with a history of stroke: Heuristic evaluation and user perspectives
Authors: Lobo Elton H , Kensing Finn , Frølich Anne , Rasmussen Lene J , Livingston Patricia M , Islam Sheikh Mohammed Shariful , Grundy John , Abdelrazek Mohamed
Published: March 2022

Background

Caregiving in stroke is complex, with most carers having little to no preparation to care for individuals with a history of stroke, leading to emotional impact. Technologies such as Mobile Health can provide the carer with real-time support and prepare the carer to assume their new roles and responsibilities.

Objectives

To perform a heuristic evaluation of mHealth interventions designed to support carers of individuals with a history of stroke and determine the user preferences in stroke caregiving technology to inform future researchers and developers regarding the best practices to support these individuals.

Methods

Twenty adults (i.e. 10 usability experts and 10 carers) participated in an iterative user-centred design study that focused on developing and modifying the mHealth intervention (StrokeCaregiver (SeCr)) created to support stroke caregiving. The intervention was repeated in four cycles, including two cycles with five usability experts each and five carers each.

Results

SeCr was iteratively improved to develop a highly usable product in multiple cycles. Participants demonstrated critical needs in personalized information support, communication with their healthcare needs, and the trust of the user, content, and developer. These critical needs are required to be met to promote long-term acceptance and adherence.

Conclusions

While SeCr was developed to address the needs of carers of individuals with a history of stroke, several considerations must be made to ensure it can be used in a real-world setting. Researchers and developers can use co-design or living lab approaches to further meet the needs and expectations of the carer and enable these individuals to be better prepared for stroke caregiving.
Combining multiple survey sources: A reproducible workflow and toolbox for survey data harmonization
Authors: Kołczyńska Marta
Published: March 2022

Ex-post harmonization of survey data creates new opportunities for research by extending the geographical and/or time coverage of analyses. Researchers increasingly combine data from different survey projects to analyze them as a single dataset, and while teams engaged in data harmonization continue to expand the information they provide to end users, there are still no commonly agreed standards for the documentation of data processing. Existing harmonization project typically opt for recode scripts that are generally hard to read, modify, and reuse, although some projects make efforts to facilitate verification and reproduction. This paper describes an alternative procedure and a set of simple tools for the exploration, recoding, and documentation of harmonization of survey data, relying on crosswalks. The presented tools are flexible and software-agnostic. The illustrative example uses the programming language R and spreadsheets—both common software choices among social scientists. Harmonization of variables on trust in institutions from four major cross-national survey projects serves as an illustration of the proposed workflow and of opportunities harmonization creates.
Forest, Adivasis and the Rule of Panchayats (Extension to the Scheduled Areas) in Jharkhand: A Critical Inquiry
Authors: Bara Anju Helen
Published: March 2022

Adivasis have always lived in symbiosis with the forest for generations. In the recent two decades, it has been realized that it is only through the process of democratic decentralization sustainable development could be achieved. The present model of development augments the participation of people in local governance. In the post-colonial India, the government enacted a new law known as Provisions of the Panchayats (Extension to the Scheduled Areas) Act, 1996, popularly known as PESA. Jharkhand, which has been a home for adivasis, conducted its first panchayat election in 2010. Consequently, the next election was conducted in 2015, and in 2022, the third panchayat election is going to be held. Being a tribal dominated region, it is governed by the regulations of PESA. Though PESA has been projected as a progressive Act, however, it has not been successfully implemented. Lack of political willingness, political apathy, internal conflicts, lack of knowledge and awareness among people are some of the reasons for the failure of PESA in the region. For the people who lived in the forest, these laws essentially overturned their unstructured, undocumented and ‘symbiotic’ relationship with the land, rivers and forests. Under this backdrop, this article addresses the issue of local self-governance and the fate of PESA in Jharkhand. It aims to uncover the factors which are creating hindrances in the functioning of PESA in Jharkhand. This article seeks to unfold the struggle of the adivasis for the protection of their resources, livelihoods and their own lives.
Caste Maters: An Empirical Study on Asset Structure of Dalit Woman Labour Households
Authors: Pal Dharam , Singh Gian , Kaur Veerpal , Kaur Gurinder , Jyoti
Published: March 2022

The primary data were collected from 927 Dalit woman labour households belonging to all the three geographical regions of Punjab (India) to analyse the asset structure of these households. The study revealed that a Dalit woman labour household had assets worth ₹128,750.98. Out of the total value of assets, 90.81% were durable assets and the remaining 9.19% were livestock assets. All the respondent households were found landless. The ratio of debt to household assets was found to be 0.41 which indicates that 41% of the household assets would be needed to pay off their current debt. More than 70% of the total value of durable assets was swallowed only by the dwelling house. Most of the durable items in these households were found useless, old and broken. Actually, the relatively rich households of the village used to give them these already used items in order to seek their cheap or free labour.
Pandit C. Iyothee Thass and Christianity
Authors: Dhanaraj T. Maria
Published: March 2022

Iyothee Thass (1845–1914), a forgotten Dalit activist, has become part of serious academic discussions in the recent times. Various studies had been carried out, such as I. Thass as a Dalit journalist; I. Thass as a Forerunner of Buddhist Renaissance in the Tamil region and I. Thass as an anti-caste activist. This article analyses Thass’ articles related to Christianity. These articles can roughly be classified into two categories: articles that are exegetical (explaining the Biblical passages/events/personalities) and articles that are critical of the institution of the Church and its mission. The analysis of all the articles on Christianity reveals that Thass emerges both as a strong critic of Christianity in India, specially its adaptation of caste in its Indian version and a Buddhist exegete who could explain the whole Bible as a veiled doctrine of Buddhism.
Cadaveric Examination of the Radiographic Safe Zone for Open Reduction and Internal Fixation of the Calcaneus Posterior Facet
Authors: Brand Jordan , Elaydi Ali , Moran Jay , Yoo Brad
Published: March 2022

Background:

The purpose of this study is to define a safe zone for screw placement on a lateral radiograph of the calcaneus taking into account the lateral to medial convexity of the posterior facet. Such findings may serve to improve surgical quality during open reduction and internal fixation (ORIF) of the posterior facet of the calcaneus.

Methods:

Eleven cadaveric calcanei were harvested and the articular margins of the posterior facet were outlined with a radiopaque wire. Lateral radiographs, similar to those used for intraoperative fluoroscopy, of each specimen were obtained and calibrated to a standardized marker. The proximal-to-distal length of the posterior facet was then divided into quadrants. The greatest height difference between the superolateral and inferomedial surfaces outlined by the radiopaque marker were measured in the 2 most posterior quadrants, as screw insertion in this area would be mostly likely to risk screw penetration during ORIF.

Results:

The average distance from the osseous surface to the radiographic marker was 3.3 ± 1.2 mm in the most posterior quadrant (fourth quadrant) and 3.2 ± 1.6 mm in the quadrant just anterior to this (third quadrant). The range for unsafe screw placement was 1.7 to 5.6 mm below the osseous surface in the fourth quadrant and 1.1 to 6.6 mm in the third quadrant.

Conclusion:

Intraoperative radiographic assessment of the safety of subchondral posterior facet screws does not correlate to its osteology. Because of the superolateral to inferomedial convexity of the posterior facet of the calcaneus, overly long screws may appear to be radiographically intraosseous, though in actuality the screw may be intra-articular. On average, screws placed in the fourth quadrant of the facet are at less risk if 3.3 mm inferior to the upper margin of the osseous shadow on fluoroscopic imaging and 3.2 mm inferior in the third quadrant. Though limited by a small sample size, this study sets a foundation for future research into this complex osteology.

Level of Evidence:

Level V, mechanism-based reasoning.
Corporate Accountability for Involvement in Gross Human Rights Violations During the Brazilian Civil-Military Dictatorship – The Role of the Truth Commissions and the Case of Volkswagen Do Brasil
Authors: Moreira da Silva Filho José Carlos
Published: March 2022

The article describes, analyzes, and evaluates transitional justice measures that were adopted in Brazil regarding corporate responsibility for complicity with the civil-military dictatorship in the practice of gross human rights violations. The main focus is on the performance of the National Truth Commission and the São Paulo State Truth Commission, as well as on the agreement reached between the Prosecution Service and Volkswagen do Brasil in the scope of the civil inquiry established to determine the company’s responsibility for complicity with the civil-military dictatorship. The measures are considered incipient and not problem free, though they represent a breakthrough in corporate responsibility related to transitional justice, encouraging further development and continuity through acknowledgment and the allocation of resources.
Capitalism, Socialism, and the Climate Crisis
Authors: Adler Paul S.
Published: March 2022

The climate crisis calls for a massive and rapid retooling of our economy and society. I argue that we have reasons to doubt that capitalism, even reformed, could meet that challenge. As an alternative solution, authoritarian socialism such as existed in the former Soviet Union or China would be neither attractive nor effective; by contrast, a democratic form of socialism might be both. In a democratic socialist society, we would govern democratically both our enterprises and our economy as a whole. Democratizing the governance of enterprises would help them make better tradeoff decisions and internalize some important externalities. But if they remain at the mercy of capitalist competition in product, labor, and financial markets, many enterprises will be economically unable to retool fast enough, so we also need to pool the country’s economic resources and manage them democratically, collectively, and strategically towards our shared environmental, social, and economic goals. Organizational research on corporate strategic management offers insights into how such an economic system could satisfy four key requirements for a successful fight against climate change—democracy, innovation, efficiency, and motivation.
Studies of a mosaic patient with DBA and chimeric mice reveal erythroid cell–extrinsic contributions to erythropoiesis
Authors: Doty Raymond T. , Fan Xing , Young David J. , Liang Jialiu , Singh Komudi , Pakbaz Zahra , Desmond Ronan , Young-Baird Sara K. , Chandrasekharappa Settara C. , Donovan Frank X. , Phelps Susan R. , Winkler Thomas , Dunbar Cynthia E. , Abkowitz Janis L.
Published: March 2022

We follow a patient with Diamond-Blackfan anemia (DBA) mosaic for a pathogenic RPS19 haploinsufficiency mutation with persistent transfusion-dependent anemia. Her anemia remitted on eltrombopag (EPAG), but surprisingly, mosaicism was unchanged, suggesting that both mutant and normal cells responded. When EPAG was withheld, her anemia returned. In addition to expanding hematopoietic stem/progenitor cells, EPAG aggressively chelates iron. Because DBA anemia, at least in part, results from excessive intracellular heme leading to ferroptotic cell death, we hypothesized that the excess heme accumulating in ribosomal protein-deficient erythroid precursors inhibited the growth of adjacent genetically normal precursors, and that the efficacy of EPAG reflected its ability to chelate iron, limit heme synthesis, and thus limit toxicity in both mutant and normal cells. To test this, we studied Rpl11 haploinsufficient (DBA) mice and mice chimeric for the cytoplasmic heme export protein, FLVCR. Flvcr1-deleted mice have severe anemia, resembling DBA. Mice transplanted with ratios of DBA to wild-type marrow cells of 50:50 are anemic, like our DBA patient. In contrast, mice transplanted with Flvcr1-deleted (unable to export heme) and wild-type marrow cells at ratios of 50:50 or 80:20 have normal numbers of red cells. Additional studies suggest that heme exported from DBA erythroid cells might impede the nurse cell function of central macrophages of erythroblastic islands to impair the maturation of genetically normal coadherent erythroid cells. These findings have implications for the gene therapy of DBA and may provide insights into why del(5q) myelodysplastic syndrome patients are anemic despite being mosaic for chromosome 5q deletion and loss of RPS14.
The behavioural phenotype of SATB2-associated syndrome: a within-group and cross-syndrome analysis
Authors: Bissell Stacey , Oliver Chris , Moss Joanna , Heald Mary , Waite Jane , Crawford Hayley , Kothari Vishakha , Rumbellow Lauren , Walters Grace , Richards Caroline
Published: March 2022

Background

SATB2-associated syndrome (SAS) is a multisystem neurodevelopmental disorder characterised by intellectual disability, speech delay, and craniofacial anomalies. Although the clinical presentation of SAS is well-delineated, behaviours associated with SAS are less well-defined. Given the varied social profile reported in SAS of a ‘jovial’ predisposition and autistic behaviours, there may be phenotypic overlap with both Angelman syndrome (AS) and non-syndromal autism. This study aimed to describe behaviours in SAS in relation to chronological age and level of ability and contrast aspects of the behavioural phenotype with AS and non-syndromal autism.

Methods

Informant report questionnaire measures of behaviour, emotion, and autism characteristics were completed for 81 individuals with SAS (aged 1–36 years; 43 male). Within-group associations were analysed, and categorical data were compared between pre-school (1–5 years), school-age (6–15 years), and adolescent and adult SAS sub-groups (16 years and over). Cross-syndrome subscale and item-level analyses were conducted for 63 individuals with SAS (aged 1–27 years; 31 male), who were matched according to age and level of ability to 63 individuals with AS (aged 2–25 years; 32 male) and 63 individuals with non-syndromal autism (aged 3–26 years; 53 male).

Results

In SAS, higher rates of overactivity were moderately associated with lower self-help ability, and higher general anxiety scores were reported for males compared with females. Cross-syndrome subscale analyses uncovered several significant differences (p < .01), with comparatively low rates of stereotyped behaviour, overactivity, insistence on sameness and positive affect, and comparatively greater interest and pleasure and compulsive behaviour in individuals with SAS. Item-level analyses revealed a distinct profile of repetitive and autistic behaviours.

Limitations

Developmental analysis was based on a cross-sectional rather than a longitudinal research design, the contribution of pain and sleep to behaviour was not explored, and molecular genetic testing to determine genotype–phenotype behavioural relationships was not possible.

Conclusions

This study highlights the importance of behavioural comparisons to well-delineated groups and the utility of fine-grained item-level analyses to elucidate aspects of behaviour that might be syndrome related or shared across neurodevelopmental disorders. Future research is needed to further describe the distinctive repetitive and autistic behavioural phenotype in SAS.
Genome-wide association analysis reveal the genetic reasons affect melanin spot accumulation in beak skin of ducks
Authors: Liu Hehe , Wang Jianmei , Hu Jian , Wang Lei , Guo Zhanbao , Fan Wenlei , Xu Yaxi , Liu Dapeng , Zhang Yunsheng , Xie Ming , Tang Jing , Huang Wei , Zhang Qi , Zhou Zhengkui , Hou Shuisheng
Published: March 2022

Background

Skin pigmentation is a broadly appearing phenomenon of most animals and humans in nature. Here we used a bird model to investigate why melanin spot deposits on the skin.

Results

Our result showed that growth age and the sunlight might induce melanin deposition in bird beak skin which was determined by genetic factors. GWAS helped us to identify two major loci affecting melanin deposition, located on chromosomes 13 and 25, respectively. The fine mapping works narrowed the candidate regions to 0.98 Mb and 1.0 Mb on chromosomes 13 and 25. The MITF and POU2F3 may be the causative genes and synergistically affect melanin deposition during duck beak skin. Furthermore, our data strongly demonstrated that the pathway of melanin metabolism contributes to melanin deposition on the skin.

Conclusions

We demonstrated that age and sunlight induce melanin deposition in bird beak skin, while heredity is fundamental. The MITF and POU2F3 likely played a synergistic effect on the regulation of melanin synthesis, and their mutations contribute to phenotypic differences in beak melanin deposition among individuals. It is pointed out that melanin deposition in the skin is related to the pathway of melanin metabolism, which provided insights into the molecular regulatory mechanisms and the genetic improvement of the melanin deposition in duck beak.
Prospective telehealth analysis of functional performance, frailty, quality of life, and mental health after COVID-19 hospitalization
Authors: Capin Jacob J. , Wilson Melissa P. , Hare Kristine , Vempati Swati , Little Carley E. , McGregor Donna , Castillo-Mancilla Jose , Stevens-Lapsley Jennifer E. , Jolley Sarah E. , Erlandson Kristine M.
Published: March 2022

Background

COVID-19 is a global pandemic with poorly understood long-term consequences. Determining the trajectory of recovery following COVID-19 hospitalization is critical for prioritizing care, allocating resources, facilitating prognosis, and informing rehabilitation. The purpose of this study was to prospectively evaluate recovery following COVID-19 hospitalization.

Methods

Participants age 18 years or older who were hospitalized for ≥24 h due to COVID-19 completed phone/video call virtual assessments (including the 10-time chair rise test) and survey forms at three time points (2–6, 12, and 18 weeks) after hospital discharge. Univariate logistic and linear regression models assessed the associations of the outcomes with primary predictors (categorical age, sex, race/ethnicity group, and categorical pre-hospitalization frailty) at baseline; the same were used to assess differences in change from week 2–6 (continuous outcomes) or outcome persistence/worsening (categorical) at last contact.

Results

One hundred nine adults (age 53.0 [standard deviation 13.1]; 53% female) participated including 43 (39%) age 60 or greater; 59% identified as an ethnic and/or racial minority. Over 18 weeks, the mean time to complete the 10-time chair rise test decreased (i.e., improved) by 6.0 s (95% CI: 4.1, 7.9 s; p < 0.001); this change did not differ by pre-hospital frailty, race/ethnicity group, or sex, but those age ≥ 60 had greater improvement. At weeks 2–6, 67% of participants reported a worse Clinical Frailty Scale category compared to their pre-hospitalization level, whereas 42% reported a worse frailty score at 18 weeks. Participants who did not return to pre-hospitalization levels were more likely to be female, younger, and report a pre-hospitalization category of ‘very fit’ or ‘well’.

Conclusions

We found that functional performance improved from weeks 2–6 to 18 weeks of follow-up; that incident clinical frailty developed in some individuals following COVID-19; and that age, sex, race/ethnicity, and pre-hospitalization frailty status may impact recovery from COVID-19. Notably, individuals age 60 and older were more likely than those under age 45 years to return to their pre-hospitalization status and to make greater improvements in functional performance. The results of the present study provide insight into the trajectory of recovery among a representative cohort of individuals hospitalized due to COVID-19.
Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study
Authors: Lagerlund Hanna , Thunborg Charlotta , Sandborgh Maria
Published: March 2022

Background

Persons with dementia living in nursing homes need assistance with moving and transfers; however, caregivers assisting persons with dementia in their daily person transfers report strain-related and complicated transfer-related behavioural problems. The reciprocity of complex dyadic transfer-related behaviours is affected by environmental factors, the health status of the person with dementia and the caregiver’s skills and knowledge. The aim of this study was to explore tailored interventions guided by a functional behaviour analysis for problematic person transfer situations in two dementia care dyads.

Methods

This study was a quasi-experimental single-case study with an A-B design. Tailored interventions were developed in a five-step model for functional behavioural analysis. The study was conducted in a dementia special care unit at a nursing home, and the inclusion criteria were caregivers’ experiences of physical strain and/or resistiveness to care, which led to complex transfer-related behaviour. Two care dyads were included. Transfer situations were video-recorded and evaluated with the Dyadic Interaction in Dementia Transfer Assessment Scale, Pain Assessment in Advanced Dementia Scale, and Resistiveness to Care Scale for Dementia of the Alzheimer’s Type. The caregiver experience was evaluated with study-specific items addressing caregiver self-efficacy, catastrophizing thoughts, perceived control, and perceived physical strain. Scorings were graphically displayed. The graphs were inspected visually to identify changes in trend, level, latency, and variability. Nonoverlap of all pairs (NAP), including 90% confidence intervals (CIs), was calculated to complement the visual inspection.

Results

Verbal and nonverbal discomfort decreased in care dyad 1, which mirrored the caregiver changes in adapting their actions to the needs of the person with dementia. High variability was seen in both the intervention and the baseline phases in care dyad 2. In both care dyads, caregiver transfer-related behaviour improved.

Conclusions

The results indicate that the transfer-related behaviours of the care dyad might be improved through a behaviour-directed intervention tailored to meet the care dyad´s needs. The small number of cases and observations limits the generalizability, and the results should be interpreted in consideration of the piloting approach of the study.
The association between a lifestyle score, socioeconomic status, and COVID-19 outcomes within the UK Biobank cohort
Authors: Foster Hamish M. E. , Ho Frederick K. , Mair Frances S. , Jani Bhautesh D. , Sattar Naveed , Katikireddi Srinivasa Vittal , Pell Jill P. , Niedzwiedz Claire L. , Hastie Claire E. , Anderson Jana J. , Nicholl Barbara I. , Gill Jason M. R. , Celis-Morales Carlos , O’Donnell Catherine A.
Published: March 2022

Background

Infection with SARS-CoV-2 virus (COVID-19) impacts disadvantaged groups most. Lifestyle factors are also associated with adverse COVID-19 outcomes. To inform COVID-19 policy and interventions, we explored effect modification of socioeconomic-status (SES) on associations between lifestyle and COVID-19 outcomes.

Methods

Using data from UK-Biobank, a large prospective cohort of 502,536 participants aged 37–73 years recruited between 2006 and 2010, we assigned participants a lifestyle score comprising nine factors. Poisson regression models with penalised splines were used to analyse associations between lifestyle score, deprivation (Townsend), and COVID-19 mortality and severe COVID-19. Associations between each exposure and outcome were examined independently before participants were dichotomised by deprivation to examine exposures jointly. Models were adjusted for sociodemographic/health factors.

Results

Of 343,850 participants (mean age > 60 years) with complete data, 707 (0.21%) died from COVID-19 and 2506 (0.76%) had severe COVID-19. There was evidence of a nonlinear association between lifestyle score and COVID-19 mortality but limited evidence for nonlinearity between lifestyle score and severe COVID-19 and between deprivation and COVID-19 outcomes. Compared with low deprivation, participants in the high deprivation group had higher risk of COVID-19 outcomes across the lifestyle score. There was evidence for an additive interaction between lifestyle score and deprivation. Compared with participants with the healthiest lifestyle score in the low deprivation group, COVID-19 mortality risk ratios (95% CIs) for those with less healthy scores in low versus high deprivation groups were 5.09 (1.39–25.20) and 9.60 (4.70–21.44), respectively. Equivalent figures for severe COVID-19 were 5.17 (2.46–12.01) and 6.02 (4.72–7.71). Alternative SES measures produced similar results.

Conclusions

Unhealthy lifestyles are associated with higher risk of adverse COVID-19, but risks are highest in the most disadvantaged, suggesting an additive influence between SES and lifestyle. COVID-19 policy and interventions should consider both lifestyle and SES. The greatest public health benefit from lifestyle focussed COVID-19 policy and interventions is likely to be seen when greatest support for healthy living is provided to the most disadvantaged groups.
A case report of severe Fusobacterium nucleatum sepsis secondary to nephrectomy
Authors: Liu Chang , Jia Qiming , Wang Lifeng , Yang Dong
Published: March 2022

Background

Fusobacterium nucleatum (F. nucleatum) is a resident anaerobic bacterium, which in rare cases may invade blood from the head and neck or the digestive tract to cause bacteremia and induce venous thrombosis. F. nucleatum is closely related to abdominal tumors, but it has not been reported in relation to renal tumors. We report herein a possible case.

Case presentation

This patient had kidney cancer with thrombosis in the right renal vein but had no sign of infection. After radical nephrectomy, thrombi formed in his left renal vein, and when removed, severe sepsis occurred. He did not respond to treatment with antibiotics and died, but the blood culture done confirmed that he had F. nucleatum bacteremia.

Conclusion

F. nucleatum may also be associated with kidney cancer, and could cause post-operative renal vein thrombosis, and sepsis or septic shock after thrombectomy.
Skeletal muscle loss during neoadjuvant chemotherapy predicts poor prognosis in patients with breast cancer
Authors: Amitani Masatsugu , Oba Takaaki , Kiyosawa Nami , Morikawa Hiroki , Chino Tatsunori , Soma Ai , Shimizu Tadafumi , Ohno Koichi , Ono Mayu , Ito Tokiko , Kanai Toshiharu , Maeno Kazuma , Ito Ken-ichi
Published: March 2022

Background

The skeletal muscle index (SMI), which is calculated as the ratio of skeletal muscle area at the third lumbar vertebral level divided by height squared, has been considered a prognostic factor in patients with breast cancer. However, the prognostic impact of changes in SMI during treatment remains unclear. This study aimed to evaluate the influence of SMI changes in patients with breast cancer undergoing neoadjuvant chemotherapy (NAC).

Methods

We reviewed patients with breast cancer who underwent NAC and subsequent surgery for breast cancer between 2010 and 2017. The rate of SMI change during NAC was calculated, and the association between SMI changes and prognosis was retrospectively analyzed.

Results

In total, 141 patients were evaluated. 48 (34.0%), 53 (37.6%), and 40 (28.4%) patients exhibited increased (≥ 3%), maintained (− 3% <, < 3%), and decreased (− 3% ≥) SMI during NAC, respectively. The decreased SMI group showed significantly poorer disease-free survival than the maintained and increased SMI groups (hazard ratio [HR] 8.29, p <  0.001 for the decreased vs. increased SMI groups; HR 3.49, p <  0.001 for the decreased vs. maintained SMI groups). Moreover, decreased SMI was an independent risk factor for disease-free survival in multivariate analysis (HR 3.68, p <  0.01).

Conclusions

Skeletal muscle loss during NAC predicts poor prognosis. Our results underscore the importance of monitoring and maintaining skeletal muscle mass during NAC.
Walking orientation randomness metric (WORM) score: pilot study of a novel gait parameter to assess walking stability and discriminate fallers from non-fallers using wearable sensors
Authors: Mobbs Ralph Jasper , Natarajan Pragadesh , Fonseka R. Dineth , Betteridge Callum , Ho Daniel , Mobbs Redmond , Sy Luke , Maharaj Monish
Published: March 2022

Background

Musculoskeletal disorders can contribute to injurious falls and incur significant societal and healthcare burdens. Identification of fallers from non-fallers through wearable-based gait analysis can facilitate timely intervention to assist mobility and prevent falls whilst improving care and attention for high fall-risk patients. In this study, we use wearable sensor-based gait analysis to introduce a novel variable to assess walking stability in fallers and non-fallers – the Walking Orientation Randomness Metric. The WORM score quantifies the stability, or ‘figure-of-eight’ motion of a subject’s trunk during walking as an indicator of a falls-predictive (pathological) gait.

Methods

WORM is calculated as the ‘figure-of-eight’ oscillation mapped out in the transverse-plane by the upper body’s centre-point during a walking bout. A sample of patients presenting to the Prince of Wales Hospital (Sydney, Australia) with a primary diagnosis of “falls for investigation” and age-matched healthy controls (non-fallers) from the community were recruited. Participants were fitted at the sternal angle with the wearable accelerometer, MetaMotionC (Mbientlab Inc., USA) and walked unobserved (at self-selected pace) for 5-50 m along an obstacle-free, carpeted hospital corridor.

Results

Participants comprised of 16 fallers (mean age: 70 + 17) and 16 non-fallers (mean age: 70 + 9) based on a recent fall(s) history. The (median) WORM score was 17-fold higher (p < 0.001) in fallers (3.64 cm) compared to non-fallers (0.21 cm). ROC curve analyses demonstrate WORM can discriminate fallers from non-fallers (AUC = 0.97). Diagnostic analyses (cut-off > 0.51 cm) show high sensitivity (88%) and specificity (94%).

Conclusion

In this pilot study we have introduced the WORM score, demonstrating its discriminative performance in a preliminary sample size of 16 fallers. WORM is a novel gait metric assessing walking stability as measured by truncal way during ambulation and shows promise for objective and clinical evaluation of fallers.
Effects of back exercises versus transcutaneous electric nerve stimulation on relief of pain and disability in operating room nurses with chronic non-specific LBP: a randomized clinical trial
Authors: Jalalvandi Fereshteh , Ghasemi Reza , Mirzaei Maryam , Shamsi MohammadBagher
Published: March 2022

Background

Low back pain (LBP) is one of the most common musculoskeletal disorders related to working. Due to the nature of nursing work, this problem is often seen in nurses, including those who work in the operating rooms. Depending on the cause, there are various surgical and non-surgical methods to treat LBP. The present study was aimed to compare the effect of two therapeutic methods of back exercises and transcutaneous electrical nerve stimulation (TENS) on the disability and pain of operating room nurses with LBP.

Methods

In this clinical trial forty-four eligible operating room nurses (30 women, 14 men, mean age: 37.86 ± 6.74) with chronic nonspecific LBP were randomly assigned to back exercises (including the strengthening and stretching exercise (n = 22)) or TENS (n = 22) groups by permuted block randomization method.

These interventions were performed in both groups three sessions of 15 min per week for 6 weeks. The McGill pain questionnaire for back pain and the Oswestry disability questionnaire for disability assessment were completed immediately before and after the interventions.

Results

After 6 weeks, the mean of pain and disability decreased significantly in both groups compared to the baseline. Based on the results, significant decreases in the pain score (mean difference (95% CI): − 8.95 (− 12.77 to − 5.14); P-value < 0.001) and disability score (mean difference (95% CI): − 8.73(− 12.42 to − 5.03); P-value < 0.001) were revealed in the back exercises group after the intervention compared to the baseline. In addition, after the intervention in TENS group, the mean pain intensity and disability showed significant decrease, respectively (mean difference (95% CI): − 16.18 (− 19.81 to − 12.55); P-value < 0.001; mean difference (95% CI): − 15.82 (− 19.24 to − 12.40); P-value < 0.001).

After adjusting for the baseline values, the TENS group had a significantly higher pain score reduction than the back exercises group (mean difference (95% CI): − 4.23 (− 8.03 to − 0.44); P-value =0.030; Cohen’s d = 0.81). In addition, TENS led to a significant more decrease in the disability scores compared to the back exercises (mean difference (95% CI): − 3.99 (− 7.35 to − 0.64); P-value =0.021; Cohen’s d = 0.73). Furthermore, a statistically significant time by group interaction effect on pain and disability score was found (interaction p < 0.001).

Conclusion

Pain and disability were improved in both groups following 18 intervention sessions. However, pain and disability were improved to a greater extent in the TENS group than in the back exercises group.

Trial registration

The trial was retrospectively registered in the Iranian Registry of Clinical Trials (www.irct.ir) on 03/02/2019 as IRCT20180408039227N1.
Distribution of hounsfield unit values in the pelvic bones: a comparison between young men and women with traumatic fractures and older men and women with fragility fractures: a retrospective cohort study
Authors: Inagaki Naoya , Tanaka Takaaki , Udaka Jun , Akiyama Shoshi , Matsuoka Tatsuki , Saito Mitsuru
Published: March 2022

Background

The fixation strength of bone screws depends on bone mineral density (BMD), so it is important to evaluate bone strength at fracture sites. Few studies have investigated BMD in the pelvis. The aims of this study were to measure the regional Hounsfield unit (HU) values in the cancellous bone of the acetabulum and pelvic ring and to compare these values between young and older patients.

Methods

This study enrolled young patients with high-energy trauma (aged 20–44 years; young group) and older patients with low-energy trauma (aged 65–89 years; older group). Patients without pelvic computed tomography (CT) scans, those with pelvic bone implants, and those who died were excluded. The HU values on the contralateral (non-fractured) side of the pelvis were measured on CT scans. The CT data were divided into 7 areas: the pubic bone, the anterior and posterior walls and roof of the acetabulum, the ischial tuberosity, the body of the ilium, and the third lumbar vertebra. The HU values in each area were compared between the young and older groups.

Results

Sixty-one young patients and 154 older patients were included in the study. The highest HU value was in the roof of the acetabulum regardless of age and sex. HU values were significantly higher in the ischial tuberosity and body of the ilium and lower in the pubic bone and anterior wall. The HU values in all pelvic areas were significantly lower in the older group than in the young group, especially in the anterior area.

Conclusions

HU values in the 6 pelvic areas were not uniform and were strongly related to load distribution. The HU distribution and age-related differences could explain the characteristic causes and patterns of acetabular fractures in the older and may help in surgical treatment.
Risk factors for progression of Urolith Associated with Obstructive Urosepsis to severe sepsis or septic shock
Authors: Cao J. D. , Wang Z. C. , Wang Y. L. , Li H. C. , Gu C. M. , Bai Z. G. , Chen Z. Q. , Wang S. S. , Xiang S. T.
Published: March 2022

Introduction

To analyze the risk factors for progression of urolith associated with obstructive urosepsis to severe sepsis or septic shock, we had done the retrospective cross-sectional study, which would facilitate the early identification of high-risk patients.

Materials and methods

Datas were retrospectively reviewed from 160 patients, suffering from obstructive urosepsis associated with urolith between December 2013 and December 2019. There were 49 patients complicating by severe sepsis (severe sepsis group), 12 patients complicating by septic shock (septic shock group), and 99 patients without progressing to severe sepsis or septic shock (sepsis group). The data covered age, gender, BMI (body mass index), time interval from ED (emergency department) to admission, WBC count (white blood cell count), NLR (neutrophil/lymphocyte ratio), HGB (hemoglobin), etc. Datas were analyzed by univariate analyses and multivariate logistic regression analysis. The corresponding nomogram prediction model was drawn according to the regression coefficients.

Results

Univariate analysis showed that the differences of age, the time interval from ED to admission, history of diabetes mellitus, history of CKI (chronic kidney disease), NLR, HGB, platelet count, TBil (total bilirubin), SCr (serum creatinine), ALB (albumin), PT (prothrombin time), APTT (activated partial thromboplastin time), INR (international normalized ratio), PCT (procalcitonin), and positive rate of pathogens in blood culture were statistically significant (P < 0.05). Multivariatelogistic regression analysis showed that age, SCr, and history of CKI were independent risk factors for progression to severe sepsis, or septic shock (P < 0.05).

Conclusions

Aged ≥ 65 years, SCr ≥ 248 mol/L, and history of CKI were independent risk factors for progression of urolith associated with obstructive urosepsis to severe sepsis or septic shock. We need to pay more attention to these aspects, when coming across the patients with urolithic sepsis.
Transcriptional atlas analysis from multiple tissues reveals the expression specificity patterns in beef cattle
Authors: Zhang Tianliu , Wang Tianzhen , Niu Qunhao , Xu Lei , Chen Yan , Gao Xue , Gao Huijiang , Zhang Lupei , Liu George E. , Li Junya , Xu Lingyang
Published: March 2022

Background

A comprehensive analysis of gene expression profiling across tissues can provide necessary information for an in-depth understanding of their biological functions. We performed a large-scale gene expression analysis and generated a high-resolution atlas of the transcriptome in beef cattle.

Results

Our transcriptome atlas was generated from 135 bovine tissues in adult beef cattle, covering 51 tissue types of major organ systems (e.g., muscular system, digestive system, immune system, reproductive system). Approximately 94.76% of sequencing reads were successfully mapped to the reference genome assembly ARS-UCD1.2. We detected a total of 60,488 transcripts, and 32% of them were not reported before. We identified 2654 housekeeping genes (HKGs) and 477 tissue-specific genes (TSGs) across tissues. Using weighted gene co-expression network analysis, we obtained 24 modules with 237 hub genes (HUBGs). Functional enrichment analysis showed that HKGs mainly maintain the basic biological activities of cells, while TSGs were involved in tissue differentiation and specific physiological processes. HKGs in bovine tissues were more conserved in terms of expression pattern as compared to TSGs and HUBGs among multiple species. Finally, we obtained a subset of tissue-specific differentially expressed genes (DEGs) between beef and dairy cattle and several functional pathways, which may be involved in production and health traits.

Conclusions

We generated a large-scale gene expression atlas across the major tissues in beef cattle, providing valuable information for enhancing genome assembly and annotation. HKGs, TSGs, and HUBGs further contribute to better understanding the biology and evolution of multiple tissues in cattle. DEGs between beef and dairy cattle also fill in the knowledge gaps about differential transcriptome regulation of bovine tissues underlying economically important traits.
Predicting protein–protein interactions between banana and Fusarium oxysporum f. sp. cubense race 4 integrating sequence and domain homologous alignment and neural network verification
Authors: Fang Hui , Zhong Cheng , Tang Chunyan
Published: March 2022

Background

The pathogen of bananaFusarium oxysporumf. sp. cubense race 4(Foc4) infects almost all banana species, and it is the most destructive. The molecular mechanism of the interactions betweenFusarium oxysporumand banana still needs to be further investigated.

Methods

We use both the interolog and domain-domain method to predict the protein–protein interactions (PPIs) between banana and Foc4. The predicted protein interaction sequences are encoded by the conjoint triad and autocovariance method respectively to obtain continuous and discontinuous information of protein sequences. This information is used as the input data of the neural network model. The Long Short-Term Memory (LSTM) neural network five-fold cross-validation and independent test methods are used to verify the predicted protein interaction sequences. To further confirm the PPIs between banana and Foc4, the GO (Gene Ontology) and KEGG (Kyoto Encylopedia of Genes and Genomics) functional annotation and interaction network analysis are carried out.

Results

The experimental results show that the PPIs for banana and foc4 predicted by our proposed method may interact with each other in terms of sequence structure, GO and KEGG functional annotation, and Foc4 protein plays a more active role in the process of Foc4 infecting banana.

Conclusions

This study obtained the PPIs between banana and Foc4 by using computing means for the first time, which will provide data support for molecular biology experiments.
Health workers’ and hospital administrators’ perspectives on mistreatment of women during facility-based childbirth: a multicenter qualitative study in Ghana
Authors: Adu-Bonsaffoh Kwame , Tamma Evelyn , Maya Ernest , Vogel Joshua P. , Tunçalp Özge , Bohren Meghan A.
Published: March 2022

Background

Globally, mistreatment of women during facility-based childbirth continues to impact negatively on the quality of maternal healthcare provision and utilization. The views of health workers are vital in achieving comprehensive understanding of mistreatment of women, and to design evidence-based interventions to prevent it. We explored the perspectives of health workers and hospital administrators on mistreatment of women during childbirth to identify opportunity for improvement in the quality of maternal care in health facilities.

Methods

A qualitative study comprising in-depth interviews (IDIs) with 24 health workers and hospital administrators was conducted in two major towns (Koforidua and Nsawam) in the Eastern region of Ghana. The study was part of a formative mixed-methods project to develop an evidence-based definition, identification criteria and two tools for measuring mistreatment of women in facilities during childbirth. Data analysis was undertaken based on thematic content via the inductive analytic framework approach, using Nvivo version 12.6.0.

Result

Health workers and hospital administrators reported mixed feelings regarding the quality of care women receive. Almost all respondents were aware of mistreatment occurring during childbirth, describing physical and verbal abuse and denial of preferred birthing positions and companionship. Rationalizations for mistreatment included limited staff capacity, high workload, perceptions of women’s non-compliance and their attitudes towards staff. Health workers had mixed responses regarding the acceptability of mistreatment of women, although most argued against it. Increasing staff strength, number of health facilities, refresher training for health workers and adequate education of women about pregnancy and childbirth were suggestions to minimize such mistreatment.

Conclusion

Health workers indicated that some women are mistreated during birth in the study sites and provided various rationalizations for why this occurred. There is urgent need to motivate, retrain or otherwise encourage health workers to prevent mistreatment of women and promote respectful maternity care. Further research on implementation of evidence-based interventions could help mitigate mistreatment of women in health facilities.
Prevalence of and factors associated with lactational mastitis in eastern and southern Africa: an exploratory analysis of community-based household surveys
Authors: Ouedraogo Mariame O. , Benova Lenka , Smekens Tom , Sinke Gezahegn G. , Hailu Abraha , Wanyonyi Herbert B. , Tolani Madalitso , Zumbe Caristus , Abejirinde Ibukun-Oluwa O.
Published: March 2022

Background

Lactational mastitis is an extremely painful and distressing inflammation of the breast, which can seriously disrupt breastfeeding. Most of the evidence on the frequency of this condition and its risk factors is from high-income countries. Thus, there is a crucial need for more information on lactational mastitis and its associated factors in Sub-Saharan Africa (SSA).

Methods

We used data from representative, community-based cross-sectional household surveys conducted in 2020 with 3,315 women from four countries (Ethiopia, Kenya, Malawi, and Tanzania) who reported ever-breastfeeding their last child born in the two years before the survey. Our measure of lactational mastitis was self-reported and defined using a combination of breast symptoms (breast redness and swelling) and flu-like symptoms (fever and chills) experienced during the breastfeeding period. We first estimated country-specific and pooled prevalence of self-reported lactational mastitis and examined mastitis-related breastfeeding discontinuation. Additionally, we examined factors associated with reporting mastitis in the pooled sample using bivariate and multivariable logistic regression accounting for clustering at the country level and post-stratification weights.

Results

The prevalence of self-reported lactational mastitis ranged from 3.1% in Ethiopia to 12.0% in Kenya. Close to 17.0% of women who experienced mastitis stopped breastfeeding because of mastitis. The adjusted odds of self-reported lactational mastitis were approximately two-fold higher among women who completed at least some primary school compared to women who had no formal education. Study participants who delivered by caesarean section had 1.46 times higher odds of reporting lactational mastitis than women with a vaginal birth. Despite wide confidence intervals, our models also indicate that young women (15 – 24 years) and women who practiced prelacteal feeding had higher odds of experiencing lactational mastitis than older women (25 + years) and women who did not give prelacteal feed to their newborns.

Conclusions

The prevalence of lactational mastitis in four countries of SSA might be somewhat lower than estimates reported from other settings. Further studies should explore the risk and protective factors for lactational mastitis in SSA contexts and address its negative consequences on breastfeeding.