bluuebunny/crossref_metadata_2025 huggingface dataset:
Negative Predictive Value of Mri-Detected Medial Meniscus Tears is Reduced in Young Athletes with Chronic ACL Injury
Authors: Sliepka Joseph , Hagen Mia , Battan Shamele , Kweon Chris , Gee Albert , Schmale Gregory , Saper Michael
Published: May 2022

Background:

A delay in anterior cruciate ligament reconstruction (ACLR) is associated with an increase in the prevalence in medial meniscus tears identified at the time of surgery. However, the specific effect of time on the predictive value of magnetic resonance imaging (MRI) for detecting meniscus injury in the young athletic population with ACL tears is unclear.

Purpose:

To investigate the effect of time from MRI to ACLR on the predictive value of MRI to detect meniscus tears in adolescent and young adult athletes.

Methods:

A retrospective review was performed of patients aged 13-25 years who underwent primary ACLR at an academic institution from January 2017 to June 2020. Multi-ligament injuries were excluded. Primary data recorded included time from MRI to surgery and descriptions of medial and lateral meniscus tears on both MRI and operative reports. Time from MRI to surgery was divided into four intervals: 0 to 6 weeks, 6 weeks to 3 months, 3 months to 6 months, and beyond 6 months. Multivariable analysis was used to determine the positive (PPV) and negative predictive value (NPV) of MRI in detecting meniscus tears as compared to arthroscopic findings at each of the 4 time intervals.

Results:

432 patients (54% female) were included with a mean age of 18 ± 3.4 years. The mean time from injury to MRI was 78 ± 187 days; the mean time from MRI to surgery was 71 ± 98 days. 252 patients had pre-operative MRIs without meniscus tears; 33 (13.1%) of those had a medial meniscus tear identified at the time of surgery (Table 1). New medial meniscus tears (100% vertical tears) were identified in 7/18 (38.9%) patients with surgery 6 months from MRI. There was a statistically significant decrease in the NPV of MRI to identify medial meniscus tears in patients who underwent ACLR greater than 6 months after imaging (odds ratio 0.16 [0.05–0.53], P < 0.005). Age, gender, body mass index, mechanism of injury, primary sport, and ethnicity did not affect the predictive value of MRI. Sensitivity and specificity of MRI to predict a medial meniscus tear in the entire cohort was 79% and 80%, respectively.

Conclusion:

Surgeons should counsel patients preoperatively about increased possibility of undiagnosed medial meniscus tears being found at the time of ACLR if greater than 6 months have passed from MRI to surgery. [Table: see text]
Periods, Penises, and Patriarchy: Perspective Taking and Attitudes about Gender among Middle School, High School, and College Students
Authors: Trautner Mary Nell , Hoffman Jessica , Borland Elizabeth
Published: May 2022

Although many studies examine gender perceptions among adults, fewer ask children to report on their personal views and experiences of gender. The authors use an open-ended survey to ask middle school, high school, and college students what they think is best and worst about being a boy and a girl to analyze how gender perceptions vary between younger and older children. The authors find that girls’ perceptions of the benefits and drawbacks of being a boy are similar to boys’ perceptions, suggesting that girls are attuned to boys’ experiences. Students have an easier time identifying the social disadvantages boys and men face, but their recognition of how patriarchy affects girls and women is more limited. Instead, they emphasize perceived biological and appearance-related advantages and disadvantages. Such foci on the body, the authors argue, undercut the potential for change and collective action.
Spatialising antagonism: A post-foundational analysis of the spatial dynamics of violence in nineteenth century Derry
Authors: Hussey Gary
Published: May 2022

This article offers a post-foundational analysis of the spatial dynamics of inter-communal violence in nineteenth-century Derry city. In doing so, the theoretical category of ‘antagonism’ is mobilised to develop a post-foundational view of the spatial, one that is well-placed to shed an innovative theoretical light on conflict in divided societies and contested spaces. It has recently been recognised that antagonism not only offers a route towards a truly post-foundational approach to the political, but also a consciously post-foundational spatial analysis. Spatialising antagonism at both a theoretical and empirical level helps to bring into further relief the imbrications of space, the political and various modes of violence. Specifically, thinking antagonism spatially in the context of contested spaces such as Derry, underlines the ways through which ontological or foundational violence can be concretised through spatial practices, thereby structuring and driving the spatial dynamics of violence.
Does N‐acetylcysteine Improve Established Hearing Loss in Guinea Pigs?
Authors: Gill Gia , Blakley Brian W.
Published: May 2022

Objective

To assess whether multiple injections of a powerful antioxidant can improve established sensorineural hearing loss in guinea pigs.

Study Design

Animal study.

Setting

Animal science laboratory, University of Manitoba.

Methods

A total of 16 guinea pigs were used in our study: 8 underwent unilateral intracochlear neomycin injection, and 8 underwent unilateral saline to serve as controls. After a period of 3 weeks for hearing loss to stabilize, 4 guinea pigs from each group received weekly intraperitoneal injections of N‐acetylcysteine (NAC) for 4 weeks. Click auditory brainstem response (ABR) testing was conducted at baseline, weekly after the start of NAC injections, and after the last injection. Pure tone ABR tests were conducted prior to intracochlear injections and at completion of the study.

Results

Click ABR thresholds were significantly worse in ears treated with neomycin (P <. 001), as expected, but not significantly different when treated with NAC (P =. 664). Thresholds for pure tone ABR were also not statistically different in neomycin‐treated ears with or without NAC (P >. 99).

Conclusions

The aggressive antioxidant therapy performed in this study was not successful in improving established hearing loss via an antioxidant regimen that is known to change the oxidation‐reduction potential in the cochlea.
A Tailored Music-Motor Therapy and Real-Time Biofeedback Mobile Phone App (‘GotRhythm’) to Promote Rehabilitation Following Stroke: A Pilot Study
Authors: Hankinson Katherine , Shaykevich Alex , Vallence Ann-Maree , Rodger Jennifer , Rosenberg Michael , Etherton-Beer Christopher
Published: May 2022

Background:

Stroke persists as an important cause of long-term disability world-wide with the need for rehabilitation strategies to facilitate plasticity and improve motor function in stroke survivors. Rhythm-based interventions can improve motor function in clinical populations. This study tested a novel music-motor software application ‘GotRhythm’ on motor function after stroke.

Methods:

Participants were 22 stroke survivors undergoing inpatient rehabilitation in a subacute stroke ward. Participants were randomised to the GotRhythm intervention (combining individualised music and augmented auditory feedback along with wearable sensors to deliver a personalised rhythmic auditory stimulation training protocol) or usual care. Intervention group participants were offered 6-weeks of the GotRhythm intervention, consisting of a supervised 20-minute music-motor therapy session using GotRhythm conducted 3 times a week for 6 weeks. The primary feasibility outcomes were adherence to the intervention and physical function (change in the Fugl-Meyer Assessment of Motor Recovery score) measured at baseline, after 3-weeks and at end of the intervention period (6-weeks).

Results:

Three of 10 participants randomised to the intervention did not receive any of the GotRhythym music-motor therapy. Of the remaining 7 intervention group participants, only 5 completed the 3-week mid-intervention assessment and only 2 completed the 6-week post-intervention assessment. Participants who used the intervention completed 5 (IQR 4,7) sessions with total ‘dose’ of the intervention of 70 (40, 201) minutes.

Conclusion:

Overall, adherence to the intervention was poor, highlighting that application of technology assisted music-based interventions for stroke survivors in clinical environments is challenging along with usual care, recovery, and the additional clinical load.
Revisiting anemia in sickle cell disease and finding the balance with therapeutic approaches
Authors: Xu Julia Zhe , Thein Swee Lay
Published: May 2022

Chronic hemolytic anemia and intermittent acute pain episodes are the 2 hallmark characteristics of sickle cell disease (SCD). Anemia in SCD not only signals a reduction of red cell mass and oxygen delivery, but also ongoing red cell breakdown and release of cell-free hemoglobin, which together contribute to a number of pathophysiological responses and play a key role in the pathogenesis of cumulative multiorgan damage. However, although anemia is clearly associated with many detrimental outcomes, it may also have an advantage in SCD in lowering risks of potential viscosity-related complications. Until recently, clinical drug development for SCD has predominantly targeted a reduction in the frequency of vaso-occlusive crises as an endpoint, but increasingly, more attention is being directed toward addressing the contribution of chronic anemia to poor outcomes in SCD. This article aims to explore the complex pathophysiology and mechanisms of anemia in SCD, as well as the need to balance the benefits of raising hemoglobin levels with the potential risks of increasing blood viscosity, in the context of the current therapeutic landscape for anemia in SCD.
Airway fibrin formation cascade in allergic asthma exacerbation: implications for inflammation and remodeling
Authors: Zhu Yanlong , Esnault Stephane , Ge Ying , Jarjour Nizar N. , Brasier Allan R.
Published: May 2022

Background

Airway remodeling in patients with asthma, which leads to a decline in pulmonary function, is likely the result of repeated exacerbations often provoked by aeroallergen exposures. Aeroallegen exposure triggers a stereotypic response orchestrated by growth factor cytokines and other protein mediators. This results in a late-phase allergic reaction characterized by vascular permeability, recruitment of activated leukocytes, and activation of structural cells of the airway. The spectrum of protein mediators and their functions are incompletely understood.

Methods

Bronchoalveolar lavage fluid (BALF) samples were obtained from 12 volunteers who exhibited robust eosinophilic recruitment following segmental bronchial provocation with allergen (SBP-Ag). We systematically identified and quantified proteins in BALF using high-performance liquid chromatography–high-resolution mass spectrometry (LC–MS/MS) followed by pathway analysis and correlations with airway physiology.

Results

Pairwise analysis of protein abundance in BALF pre- vs post-SBP-Ag revealed that 55 proteins were upregulated and 103 proteins were downregulated. We observed enrichment of groups of proteins mapping to hemostasis/fibrin clot, platelet activation, lipoprotein assembly, neutrophil degranulation proteins, and acute-phase inflammation-airway remodeling pathways. The abundances of F2 and Fibrinogen γ (FGG) correlated with eosinophil numbers, whereas SERPINA3 negatively correlated with change in FeNO. The coagulation proteins F2 and KNG negatively correlated with FN1 an index of airway remodeling. Interestingly, patients with lower FEV1 showed distinct allergen-induced patterns of 8 BALF proteins, including MUC1, alarmins (HSPB1), and actin polymerization factors.

Conclusions

Protein abundance of the fibrin formation cascade, platelet activation and remodeling are associated with late-phase leukocyte numbers and markers of remodeling. Patients with lower FEV1 have distinct dynamic responses to allergen.
Localization of EccA3 at the growing pole in Mycobacterium smegmatis
Authors: Kriel Nastassja L. , Newton-Foot Mae , Bennion Owen T. , Aldridge Bree B. , Mehaffy Carolina , Belisle John T. , Walzl Gerhard , Warren Robin M. , Sampson Samantha L. , Gey van Pittius Nico C.
Published: May 2022

Background

Bacteria require specialized secretion systems for the export of molecules into the extracellular space to modify their environment and scavenge for nutrients. The ESX-3 secretion system is required by mycobacteria for iron homeostasis. The ESX-3 operon encodes for one cytoplasmic component (EccA3) and five membrane components (EccB3 – EccE3 and MycP3). In this study we sought to identify the sub-cellular location of EccA3 of the ESX-3 secretion system in mycobacteria.

Results

Fluorescently tagged EccA3 localized to a single pole in the majority of Mycobacterium smegmatis cells and time-lapse fluorescent microscopy identified this pole as the growing pole. Deletion of ESX-3 did not prevent polar localization of fluorescently tagged EccA3, suggesting that EccA3 unipolar localization is independent of other ESX-3 components. Affinity purification - mass spectrometry was used to identify EccA3 associated proteins which may contribute to the localization of EccA3 at the growing pole. EccA3 co-purified with fatty acid metabolism proteins (FAS, FadA3, KasA and KasB), mycolic acid synthesis proteins (UmaA, CmaA1), cell division proteins (FtsE and FtsZ), and cell shape and cell cycle proteins (MurS, CwsA and Wag31). Secretion system related proteins Ffh, SecA1, EccA1, and EspI were also identified.

Conclusions

Time-lapse microscopy demonstrated that EccA3 is located at the growing pole in M. smegmatis. The co-purification of EccA3 with proteins known to be required for polar growth, mycolic acid synthesis, the Sec secretion system (SecA1), and the signal recognition particle pathway (Ffh) also suggests that EccA3 is located at the site of active cell growth.
Left atrial phasic function remodeling during its enlargement: a two-dimensional speckle-tracking echocardiography study
Authors: Chen Chuyun , Yang Ying , Ma Wei , Qi Litong , Zhang Baowei , Zhang Yan
Published: May 2022

Background

Left atrial (LA) size is often used as a surrogate marker of LA function in clinical practice, with larger atrial thought to represent a “dysfunctioning” atrium, since there is no accepted ‘gold’ standard to evaluate LA function. The exact relationship between LA size and phasic function, and whether LA dysfunction occur before LA enlargement (LAE) may be of clinical interest while have not been fully studied. Two-dimensional speckle-tracking echocardiography (2D STE) was showed a promising method in measuring LA physical deformation.

Materials and methods

A community cohort of 715 subjects at cardiovascular disease high risk accepted comprehensive echocardiography. LA longitudinal phasic strain Sa (absolute peak strain during atrial contraction), Se (peak strain at early diastole) and Stot (total atrial strain = Sa + Se), representing contractile, conduit, and reservoir function respectively, were measured using off-line 2D STE software in apical 4 chamber view, and data were compared among groups at different LA size and between subgroups in normal LA size with and without hypertension (HT).

Results

With LAE (from normal size, mild, moderate to severe LAE), the Stot (21.74 ± 5.97, 20.75 ± 4.99, 20.49 ± 5.27, 17.75 ± 4.71, respectively, ANOVA P = 0.003) and Sa (11.84 ± 3.92, 11.00 ± 3.29, 10.11 ± 2.57, 8.55 ± 2.88, respectively, ANOVA P < 0.001) reduced while Se had no change. Stot of Severe LAE group was significantly lower than that of Normal LA size group (P = 0.002). Sa of the three LAE groups were all significantly lower than that of Normal LA size group (P = 0.024, P = 0.002, P < 0.001, respectively). In normal sized LA subgroups, Stot (21.35 ± 5.91 vs. 23.01 ± 6.02, P = 0.008) and Se (9.51 ± 4.41 vs. 11.17 ± 4.89, P < 0.001) reduced in subjects with HT comparing with those without.

Conclusion

LA phasic function remodeling occurs before LAE and continues with LAE, with reservoir, conduit and contractile function being affected unparalleled.
Association between prehospital shock index variation and 28-day mortality among patients with septic shock
Authors: Jouffroy Romain , Gilbert Basile , Thomas Léa , Bloch-Laine Emmanuel , Ecollan Patrick , Boularan Josiane , Bounes Vincent , Vivien Benoit , Gueye Papa-Ngalgou
Published: May 2022

Purpose

Septic shock (SS) hyperdynamic phase is characterized by tachycardia and low-blood pressure reflecting the relative hypovolemia. Shock index (SI), the ratio between heart rate and systolic blood pressure, is a simple objective tool, usable for SS prognosis assessment.

This study aims to evaluate the relationship between prehospital SI variation and 28-day mortality of SS patients initially cared for in prehospital setting by a mobile intensive care unit (mICU).

Methods

From April 6th, 2016 to December 31st, 2020, 406 patients with SS requiring prehospital mICU were retrospectively analyzed. Initial SI, i.e. first measurement after mICU arrival to the scene, and final SI, i.e. last measurement of the prehospital stage, were used to calculate delta SI (initial SI—final SI) and to define positive and negative delta SI. A survival analysis after propensity score matching compared the 28-day mortality of SS patients with positive/negative delta SI.

Results

The main suspected origins of infection were pulmonary (42%), digestive (25%) and urinary (17%). The 28-day overall mortality reached 29%.

Cox regression analysis revealed a significant association between 28-day mortality and delta SI. A negative delta SI was associated with an increase in mortality (adjusted hazard ratio (HRa) of 1.88 [1.07–3.31] (p = 0.03)), whereas a positive delta SI was associated with a mortality decrease (HRa = 0.53 [0.30–0.94] (p < 10–3)).

Conclusion

Prehospital hemodynamic delta SI among SS patients cared for by a mICU is associated with 28-day mortality. A negative prehospital delta SI could help physicians to identify SS with higher risk of 28-day mortality.
The efficacy of pivmecillinam in oral step-down treatment in hospitalised patients with E. coli bacteremic urinary tract infection; a single-arm, uncontrolled treatment study
Authors: Hansen Bjørn Åsheim , Grude Nils , Lindbæk Morten , Stenstad Tore
Published: May 2022

Background

The role of oral beta-lactam antibiotics in treating febrile urinary tract infections (UTI) is not yet definite. Today, fluoroquinolones together with trimethoprim–sulfamethoxazole (TMP–MTX) are considered standard of care and often the only available evidence-based oral treatment for febrile UTI. This study clarifies the efficacy and safety of pivmecillinam (PIV) used as step-down therapy for bacteremic urinary tract infection (UTI).

Methods

A single-arm, uncontrolled treatment trial was conducted in the period September 2017–March 2020. Candidates for inclusion were men and women suffering from E. coli bacteremia due to UTI and were consecutively included in a Norwegian hospital. Exclusion criteria were among others: other ongoing bacterial infection, septic shock, pyonephrosis/abscess and pregnancy. After 3 days of parenteral antibiotic, the treatment was converted to the study drug; oral PIV 400 mg QID for 1 week. Primary endpoint was a combination of three elements; afebrility, no need for retreatment and improvement in self-reported health status. Test Of Cure (TOC) was 1 week post-treatment. Secondary endpoints included among others microbiological efficacy and CRP value < 30 mg/L.

Results

Of 476 screened subjects, 53 patients were included. Median age was 67 years, 28 (56%) were women. 50 patients were evaluated for per-protocol analysis. 44 of 50 patients (88%) (95% CI [75.7–95.5]) reached the primary endpoint on TOC. 14 of 48 patients (29.2%) had significant growth (> 103 CFU/mL) of E.coli on TOC. CRP-level was strongly associated to treatment outcome, (OR 0.006 [95% CI 0.00–0.11], p < 0.001).

Conclusions

This trial documents that PIV 400 mg QID given for 1 week following 3 days of parenteral antibiotics, is a suitable treatment option in patients suffering from bacteremic UTI due to E. coli. Randomised clinical trials studying the efficacy of PIV vs standard of care of febrile UTI are warranted.

Trial registration The trial was registered at ClinicalTrials.gov under the identifier: NCT03282006 13/09/2017 and approved by The Regional Committees for Medical Research Ethics South East Norway (2015/2384/REK sør-øst) and the Norwegian Medicines Agency (SLV; reference No 16/06018-09; EudraCT No 2016-000984-18) before initiation
Bowel and bladder function in infant toilet training (BABITT) – protocol for a randomized, two-armed intervention study
Authors: Nilsson Terese , Leijon Anna , Sillén Ulla , Hellström Anna-Lena , Skogman Barbro Hedin
Published: May 2022

Background

In the last decades, the average age for toilet training has increased in the western world. It is suggested that the postponed initiation of toilet training is a contributing factor to problems related to bowel and bladder control. Functional gastrointestinal and urinary tract disorders are prevalent in childhood, causing suffering in affected children and for their families, and consuming healthcare resources. To evaluate whether assisted infant toilet training can prevent functional gastrointestinal and urinary tract disorders in young children, we are conducting a randomized intervention study with a 4-year follow-up.

Methods

This randomized two-armed intervention study will include 268 Swedish infants recruited at six child healthcare centers in Region Dalarna located in the central part of Sweden. The intervention entails parents being instructed and practicing assisted infant toilet training with their child. Children are randomized to start assisted infant toilet training at 0–2 months or at 9–11 months of age.

The primary objective is to determine the efficacy of assisted infant toilet training initiated at 0–2 months on the prevalence of functional gastrointestinal disorders (defined as infant colic, infant dyschezia and/or functional constipation) up to the age of 9 months. Secondary objectives are to evaluate whether assisted toilet training initiated during the first year of life reduce the prevalence of functional gastrointestinal disorders (defined as functional constipation, gastrointestinal symptoms and/or stool toileting refusal) and urinary tract disorders (defined as bladder dysfunction and/or urinary tract infections) up to the age of 4 years. Furthermore, infant-to-mother attachment, parental stress, the toilet training process and overall parental experiences will be evaluated/explored.

Discussion

This protocol article presents the rationale and design of a randomized two-armed intervention study that will determine the efficacy of assisted infant toilet training on functional gastrointestinal disorders up to the age of 9 months. Furthermore, the study will evaluate whether assisted infant toilet training during the first year of life can prevent functional gastrointestinal and urinary tract disorders in children up to 4 years of age. If effective, assisted infant toilet training could be recommended in child healthcare settings and new evidence-based guidelines on infant toilet training could be implemented.

Trial registration

The study protocol was retrospectively registered at ClinicalTrials. gov  (NCT04082689), initial release June 12th, 2019)
Dietary intake and meal patterns among young adults with high caries activity: a cross-sectional study
Authors: Guo Annie , Wide Ulla , Arvidsson Louise , Eiben Gabriele , Hakeberg Magnus
Published: May 2022

Background

Dental caries is a multifactorial disease that is highly dependent on diet, where a lower consumption and intake frequency of sugar would be favorable. The aims were (i) to examine dietary intake and meal patterns, more specifically sugar intake and foods high in sugar, among young adults with high caries activity, and (ii) to investigate the association between dietary and meal patterns consumption, and level of caries activity.

Methods

This study presents baseline data from an ongoing randomized controlled trial. A total of 50 young adults (aged 23.0 ± 3.0 years) with ≥ 2 decayed tooth surfaces were included. Dietary intake was captured with a 59-item food frequency questionnaire (FFQ) and a three-day food diary. Adherence to dietary guidelines was analyzed by comparing the dietary intake to the Nordic Nutritional Recommendations (NNR) 2012 and by using the Healthy Dietary Adherence score (HDAS). Participants were categorized into two groups: (i) the Caries group with 2–4 decayed surfaces, and (ii) the High caries group with ≥ 5 decayed surfaces.

Results

The High caries group reported a statistically significantly higher snack and total meal intake compared to the Caries group, as well as a sugar intake exceeding the Nordic nutritional recommendations. The majority of the participants reported a high intake frequency (> 2.5/day) of sweet foods and drinks and less than one intake of fruit and vegetables, respectively, per day. Similar results were found when analyzing adherence by using the HDAS, where the lowest adherence according to dietary guidelines was shown for the food groups of sugar, whole meal products, and fruit and vegetables.

Conclusion

The results indicated a high intake of sugar and low intake of fruit, vegetables, and fiber in high caries-active individuals.
Effect of erosive media on microhardness and fracture toughness of CAD-CAM dental materials
Authors: Elraggal Alaaeldin , Afifi Rania , Abdelraheem Islam
Published: May 2022

Background

Erosive acids might create surface flaws and deteriorate the mechanical properties of CAD-CAM materials. This invitro study aimed to investigate the effect of simulated gastric HCl and extrinsic erosive acids on surface microhardness and fracture toughness of CAD-CAM materials.

Methods

400 bar-shaped specimens (17×4×2 mm3) were prepared from 4 different CAD-CAM dental materials (n = 100/group); monolithic zirconia (Ceramill Zolid HT+, Amanngirbach, Austria), lithium disilicate ceramic (IPS e.max CAD, Ivoclar Vivadent, Liechtenstein), nanohybrid resin composite (Grandio Blocs, VOCO) and polymer-infiltrated glass network (Vita Enamic, VITA Zahnfabrik). Specimens from each material type were further subdivided into 5 groups (n = 20) according to the erosive media applied (simulated gastric HCl, white wine, Coca-Cola®, orange juice, and artificial saliva that served as a control). Specimens were immersed for 24 h in an incubator at 37 ℃, then ultrasonically cleaned in distilled water and air-dried. Half of the specimens were tested for Vickers microhardness (VHN) at parameters of 500 gf for 10 s, while the rest of the specimens underwent 3-point flexure till fracture. Fractured surfaces were examined under a scanning electron microscope (SEM) for fracture toughness (KIC) calculation using the quantitative fractographic analysis method. Data collected were statistically analyzed using two-way analysis of variance (α = 0.05) after verification of data normality and homogeneity of variances.

Results

Erosive media created surface flaws that lowered the surface microhardness of the material and initiated the fracture pattern under different loads according to material type. The material type was a more predominant factor than erosive media that affected either the microhardness or the fracture toughness of CAD-CAM dental materials. The highest VHN and KIC values were found among Ceramill Zolid HT+ groups followed by IPS e.max CAD and Grandio Blocs regardless of the erosive media employed. Erosive media significantly reduced the VHN and KIC in Vita Enamic specimens compared to the rest of the material types.

Conclusion

All CAD-CAM materials used, except Vita Enamic, showed high resistance against the erosive acids indicating higher longevity of the material in patients frequently exposed to either extrinsic or intrinsic acid.
Decentralizing oxygen availability and use at primary care level for children under-five with severe pneumonia, at 12 Health Centers in Ethiopia: a pre-post non-experimental study
Authors: Tolla Habtamu Seyoum , Woyessa Dinkineh Bikila , Balkew Rahel Belete , Asemere Yigeremu Abebe , Fekadu Zinabie Feleke , Belete Alemayehu Berhanu , Gartley Martha , Battu Audrey , Lam Felix , Desale Alebel Yaregal
Published: May 2022

Background

Pneumonia is the leading infectious cause of death in children worldwide, accounting for 15% of all deaths in children under the age of five. Hypoxemia is a major cause of death in patients suffering from pneumonia. There is strong evidence that using pulse oximetry and having reliable oxygen sources in health care facilities can reduce deaths due to pneumonia by one-third. Despite its importance, hypoxemia is frequently overlooked in resource-constrained settings. Aside from the limited availability of pulse oximetry, evidence showed that healthcare workers did not use it as frequently to generate evidence-based decisions on the need for oxygen therapy. As a result, the goal of this study was to assess the availability of medical oxygen devices, operating manuals, guidelines, healthcare workers’ knowledge, and skills in the practice of hypoxemia diagnosis and oxygen therapy in piloted health centers of Ethiopia.

Methods

A pre-post non-experimental study design was employed. An interviewer-administered questionnaire was used to collect primary data and review medical record charts. A chi-square test with a statistical significance level of P < 0.05 was used as a cut-off point for claiming statistical significance.

Results

Eighty one percent of healthcare workers received oxygen therapy training, up from 6% at baseline. As a result of the interventions, knowledge of pulse oximetry use and oxygen therapy provision, skills such as oxygen saturation and practices of oxygen therapy have significantly improved among healthcare workers in the piloted Health Centers. In terms of availability of oxygen devices (e.g. cylinders, concentrators, and pulse oximeters) in the facilities, seven (58%) facilities did not have any at baseline, but due to the interventions, all facilities were equipped with the oxygen devices.

Conclusions

Given the prevalence of pneumonia and hypoxemia, a lack of access to oxygen delivery devices, as well as a lack of knowledge and skills among healthcare workers in the administration of oxygen therapy, may represent an important and reversible barrier to improving child survival. Therefore, scaling up clinician training, technical support, availability of oxygen devices, guidelines, manuals, strengthening maintenance schemes, and close monitoring of healthcare workers and health facilities is strongly advised.
Temporal relationship among adiposity, gut microbiota, and insulin resistance in a longitudinal human cohort
Authors: Deng Kui , Shuai Menglei , Zhang Zheqing , Jiang Zengliang , Fu Yuanqing , Shen Luqi , Zheng Ju-Sheng , Chen Yu-ming
Published: May 2022

Background

The temporal relationship between adiposity and gut microbiota was unexplored. Whether some gut microbes lie in the pathways from adiposity to insulin resistance is less clear. Our study aims to reveal the temporal relationship between adiposity and gut microbiota and investigate whether gut microbiota may mediate the association of adiposity with insulin resistance in a longitudinal human cohort study.

Methods

We obtained repeated-measured gut shotgun metagenomic and anthropometric data from 426 Chinese participants over ~3 years of follow-up. Cross-lagged path analysis was used to examine the temporal relationship between BMI and gut microbial features. The associations between the gut microbes and insulin resistance-related phenotypes were examined using a linear mixed-effect model. We examined the mediation effect of gut microbes on the association between adiposity and insulin resistance-related phenotypes. Replication was performed in the HMP cohort.

Results

Baseline BMI was prospectively associated with levels of ten gut microbial species. Among them, results of four species (Adlercreutzia equolifaciens, Parabacteroides unclassified, Lachnospiraceae bacterium 3 1 57FAA CT1, Lachnospiraceae bacterium 7 1 58FAA) were replicated in the independent HMP cohort. Lachnospiraceae bacterium 3 1 57FAA CT1 was inversely associated with HOMA-IR and fasting insulin. Lachnospiraceae bacterium 3 1 57FAA CT1 mediated the association of overweight/obesity with HOMA-IR (FDR<0.05). Furthermore, Lachnospiraceae bacterium 3 1 57FAA CT1 was positively associated with the butyrate-producing pathway PWY-5022 (p < 0.001).

Conclusions

Our study identified one potentially beneficial microbe Lachnospiraceae bacterium 3 1 57FAA CT1, which might mediate the effect of adiposity on insulin resistance. The identified microbes are helpful for the discovery of novel therapeutic targets, as to mitigate the impact of adiposity on insulin resistance.
Four novel genes associated with longevity found in Cane corso purebred dogs
Authors: Korec Evžen , Ungrová Lenka , Hejnar Jiří , Grieblová Adéla
Published: May 2022

Background

Longevity-related genes have been found in several animal species as well as in humans. The goal of this study was to perform genetic analysis of long-lived Cane corso dogs with the aim to find genes that are associated with longevity.

Results

SNPs with particular nucleotides were significantly overrepresented in long-lived dogs in four genes,TDRP,MC2R,FBXO25andFBXL21. InFBXL21, the longevity-associated SNP localises to the exon. In the FBXL21 protein, tryptophan in long-lived dogs replaced arginine present in reference dogs.

Conclusions

Four SNPs associated with longevity in dogs were identified using GWAS and validated by DNA sequencing. We conclude that genesTDRP,MC2R,FBXO25andFBXL21are associated with longevity in Cane corso dogs.
Transmembrane transport process and endoplasmic reticulum function facilitate the role of gene cel1b in cellulase production of Trichoderma reesei
Authors: Pang Ai-Ping , Luo Yongsheng , Hu Xin , Zhang Funing , Wang Haiyan , Gao Yichen , Durrani Samran , Li Chengcheng , Shi Xiaotong , Wu Fu-Gen , Li Bing-Zhi , Lu Zuhong , Lin Fengming
Published: May 2022

Background

A total of 11 β-glucosidases are predicted in the genome of Trichoderma reesei, which are of great importance for regulating cellulase biosynthesis. Nevertheless, the relevant function and regulation mechanism of each β-glucosidase remained unknown.

Results

We evidenced that overexpression of cel1b dramatically decreased cellulase synthesis in T. reesei RUT-C30 both at the protein level and the mRNA level. In contrast, the deletion of cel1b did not noticeably affect cellulase production. Protein CEL1B was identified to be intracellular, being located in vacuole and cell membrane. The overexpression of cel1b reduced the intracellular pNPGase activity and intracellular/extracellular glucose concentration without inducing carbon catabolite repression. On the other hand, RNA-sequencing analysis showed the transmembrane transport process and endoplasmic reticulum function were affected noticeably by overexpressing cel1b. In particular, some important sugar transporters were notably downregulated, leading to a compromised cellular uptake of sugars including glucose and cellobiose.

Conclusions

Our data suggests that the cellulase inhibition by cel1b overexpression was not due to the β-glucosidase activity, but probably the dysfunction of the cellular transport process (particularly sugar transport) and endoplasmic reticulum (ER). These findings advance the knowledge of regulation mechanism of cellulase synthesis in filamentous fungi, which is the basis for rationally engineering T. reesei strains to improve cellulase production in industry.
A policy analysis of policies and strategic plans on Maternal, Newborn and Child Health in Ethiopia
Authors: Rono Josea , Kamau Lynette , Mangwana Jane , Waruguru Jacinta , Aluoch Pauline , Njoroge Maureen
Published: May 2022

Significant progress has been made to advance Maternal, Newborn and Child Health (MNCH) in Ethiopia. Further, the country has enshrined equity as a core value in their strategic and development frameworks and policies. Although national statistics show improved health outcomes, there exists persistent inequities in avoidable health risks and premature deaths. Additionally, the improving health statistics mask the disparities in health outcomes based on education, employment status, income level, gender and ethnicity dimensions.

The EquiFrame framework was used to assess the extent to which equity was entrenched in MNCH health policies and plans. The framework, which describes core concepts against which health policies and plans can be assessed, also provides a scoring criterion for policy assessment. The framework was modified to include the concept of intersectionality, which is increasingly gaining significance in the health policy ecosystems. The policies and plans reviewed in this analysis exercise were selected based on (1) their relevance – only policies and plans in force as of the year 2020 were considered; (2) availability in the public domain as this study was limited to desk research; and (3) relevance to MNCH. A total of five policies and plans were analyzed and evaluated against the 15 core concepts presented in the modified EquiFrame framework. Following the outcomes of the assessment, documents were ranked as either being low, moderate, or high, in exhaustively addressing the core concepts.

The Ethiopia Health Sector Transformation Plan (2016–2020) is the only policy or plan that earned a high ranking. The other four policies and plans were ranked as moderate. This shows that while majority of the Ethiopian health sector policies and plans exist and address the core health equity concepts, they fail to: (i) spell out plans to implement and monitor the proposed interventions; and (ii) demonstrate evidence that the interventions were implemented or monitored. With the global goal of leaving no one behind, future policy development in Ethiopia needs to prioritize equity considerations in order to enhance the ongoing health improvement.
Exploring the impact of the COVID-19 pandemic on syringe services programs in rural Kentucky
Authors: Glick Jennifer L. , Grieb Suzanne M. , Harris Samantha J. , Weir Brian W. , Smith Katherine C. , Puryear Tyler , Hamilton White Rebecca , Allen Sean T.
Published: May 2022

Background

The coronavirus pandemic (COVID-19) exacerbated risks for adverse health consequences among people who inject drugs by reducing access to sterile injection equipment, HIV testing, and syringe services programs (SSPs). Several decades of research demonstrate the public health benefits of SSP implementation; however, existing evidence primarily reflects studies conducted in metropolitan areas and before the COVID-19 pandemic.

Objectives

We aim to explore how the COVID-19 pandemic affected SSP operations in rural Kentucky counties.

Methods

In late 2020, we conducted eighteen in-depth, semi-structured interviews with persons (10 women, 8 men) involved in SSP implementation in rural Kentucky counties. The interview guide broadly explored the barriers and facilitators to SSP implementation in rural communities; participants were also asked to describe how COVID-19 affected SSP operations.

Results

Participants emphasized the need to continue providing SSP-related services throughout the pandemic. COVID-19 mitigation strategies (e.g., masking, social distancing, pre-packing sterile injection equipment) limited relationship building between staff and clients and, more broadly, the pandemic adversely affected overall program expansion, momentum building, and coalition building. However, participants offered multiple examples of innovative solutions to the myriad of obstacles the pandemic presented.

Conclusion

The COVID-19 pandemic impacted SSP operations throughout rural Kentucky. Despite challenges, participants reported that providing SSP services remained paramount. Diverse adaptative strategies were employed to ensure continuation of essential SSP services, demonstrating the commitment and ingenuity of program staff. Given that SSPs are essential for preventing adverse injection drug use-associated health consequences, further resources should be invested in SSP operations to ensure service delivery is not negatively affected by co-occurring crises.
Postoperative analgesic effectiveness of quadratus lumborum block: systematic review and meta-analysis for adult patients undergoing hip surgery
Authors: Xiong Haolan , Chen Xiaohua , Zhu Wenxiu , Yang Wuke , Wang Fuming
Published: May 2022

Background

Quadratus lumborum block is a truncal block with several technique variations. It has been reported as providing effective analgesia for postoperative pain. The aim of this study is to determine the efficacy of the QL block in providing postoperative analgesia for hip surgery when compared with placebo or no block or other analgesic techniques.

Methods

Randomized trials evaluating quadratus lumborum block benefits in elective hip surgery were sought. The primary outcome was the 24 h opioid requirement after surgery. Two independent reviewers selected the studies and extracted the data.

Results

Thirteen randomized-controlled trials were included in this study. The included studies had significant heterogeneity regarding comparator groups; therefore, a limited quantitative analysis was undertaken for the comparison of QL block versus no block or placebo only. QL block reduced the opioid use by 15.78 (95% CI, 2.31 to 29.26) mg IME in the first postoperative 24 h compared with no block or placebo with no difference in static pain scores, pain grade was reduced by 2.95 (95% CI, 2.40 to 3.60) in the QL block group compared with placebo or no block in the first postoperative 24 h during movement.

Conclusions

Our meta-analysis indicates that QL block may be effective for analgesia in patients after hip surgery compared with placebo or no block. There is currently limited evidence comparing QL block with other analgesic techniques for hip surgery.
Superficial spreading cervical squamous cell carcinoma in situ involving the endometrium: a case report and review of the literature
Authors: Martín-Vallejo Javier , Laforga Juan B. , Molina-Bellido Patricia , Clemente-Pérez Pedro A.
Published: May 2022

Background

The spread of cervical squamous cell carcinoma to the inner surface of the uterus with replacement of the endometrium is rare. Continuity of the lesion must be demonstrated to confirm superficial spread and rule out concomitant endometrial cancer.

Case presentation

We present the case of a 66-year-old white woman with superficial spreading squamous cell carcinoma of the cervix that involved the endometrium. Her relevant past history included conization of the cervix to treat cervical intraepithelial neoplasia III with positive margins. She subsequently had three negative cervical vaginal cytology results, each with a positive high-risk human papillomavirus test. Transvaginal ultrasound showed occupation of the entire uterine cavity by dense material consistent with pyometra in addition to myometrial thinning due to tension and cervical dilation. The patient presented with greenish vaginal discharge of 3 months’ duration. The cervix was not visible during speculum examination. Access for endometrial sampling was not possible, raising suspicion of post-conization cervical stenosis. The patient was treated with laparoscopic hysterectomy with double adnexectomy. Histologic examination showed superficial squamous cell carcinoma invading the cervix to a depth of 2.8 mm; superficial spreading squamous cell carcinomain situwas also observed in the lower uterine segment and endometrium. The patient was free of symptoms 12 months after surgery.

Conclusions

Squamous cell carcinoma of the cervix with superficial spread to the endometrium is not included in the 2020 (fifth edition) World Health Organization Classification of Female Genital Tract Tumors or the 2018 International Federation of Gynecology and Obstetrics cervical cancer staging system. More clinical cases are needed to identify other prognostic factors and inform clinical practice guidelines on the management of this disease.
Food hygiene practices and determinants among food handlers in Ethiopia: a systematic review and meta-analysis
Authors: Zenbaba Demisu , Sahiledengle Biniyam , Nugusu Fikadu , Beressa Girma , Desta Fikreab , Atlaw Daniel , Chattu Vijay Kumar
Published: May 2022

Background

Food-borne diseases are a major public health concern worldwide, particularly in low and middle-income countries (LMICs), such as Ethiopia. Poor food hygiene practices primarily exacerbate food-borne illness transmission. Prior studies on the food hygiene practices among food handlers in Ethiopia were inconsistent. Therefore, this meta-analysis and systematic review aimed to estimate the pooled proportion of good food hygiene practices and identify the determinants in Ethiopia.

Methods

The preferred reporting items for systematic review and meta-analysis (PRISMA) instruments were used, and a systematic search was performed in the PubMed/MEDLINE, POPLINE, HINARI, Science Direct, Cochrane Library databases, and Google Scholar were systematically last searched on the 24th February 2022 for relevant articles. Only the observational studies that reported the proportion of good food hygiene practices and their associated factors among food handlers were included. The quality of the included studies was assessed by two independent authors. Articles with unclear methodologies and did not report the overall proportions of good food hygiene practice were excluded. The effect estimates for pooled proportion and pooled odds ratio (POR) along with a 95% confidence interval (CI) were determined conducting using DerSimonian–Laird's random effect model.

Results

Among 817 retrieved studies, 23 eligible articles with a total sample size of 7153 study participants were included in the meta-analysis. The pooled proportion of good food hygiene practices among food handlers was 50.5% [95% CI: (41.6, 59.4%]; I2 = 98.7%, p value = 0.001]. Food handlers with formal education (POR = 4.60, 95% CI: 3.05, 6.93), good knowledge (POR = 1.98, 95% CI: 1.26, 3.11), training (POR = 3.52, 95% CI: 2.35, 5.28), and a positive attitude (POR = 3.41, 95% CI: 2.52, 4.61) about food hygiene components, as well as regular medical checkups (POR = 6.75, 95% CI: 4.49) were significantly associated with good food hygiene practice.

Conclusions

Only half of Ethiopia's food handlers had good food hygiene practice.

Implication of the study

The key elements of effective food hygiene practice that will aid in the development of feasible interventions to increase food handler compliance with food hygiene components have been identified.
Wave-induced thermal flux and scattering of P waves in a medium with aligned circular cracks
Authors: Wei Jia , Fu Li-Yun , Carcione José M. , Han Tongcheng
Published: May 2022

High temperature affects the seismic properties of cracked and faulted reservoirs and can be an indicator for their detection. To this purpose, the authors study the wave-induced thermal flux (WITF) and develop two exact solutions for the scattering of compressional waves by a circular crack filled with a compressible fluid, in which the approach is based on thermally permeable and impermeable boundary conditions. The authors obtained the phase velocity and attenuation as a function of frequency, which found that there are two loss mechanisms, i.e., thermoelastic dissipation at low frequencies and elastic scattering at high frequencies. Basically, when the crack size is comparable to the thermal and elastic wavelengths, there are substantial dispersion and attenuation (anelasticity) in the WITF and scattering frequency ranges, respectively. This means that the spatial inhomogeneity scale for inducing WITF is much smaller than that of scattering and the two mechanisms can be discriminated. The dependence of the compressional-wave velocity and attenuation on the compressibility and thermal expansion of the crack-filling fluid are different depending on the thermal diffusion rates at the crack interface. The anelasticity is much higher in the fully permeable case. This model has the potential to evaluate thermoelastic properties and heterogeneity at different scales from seismic responses.