bluuebunny/crossref_metadata_2025 huggingface dataset:
Reliability of maternal recall of delivery and immediate newborn care indicators in Sarlahi, Nepal
Authors: Carter Emily D. , Chang Karen T. , Mullany Luke C. , Khatry Subarna K. , LeClerq Steven C. , Munos Melinda K. , Katz Joanne
Published: January 2021

Background

The intrapartum period is a time of high mortality risk for newborns and mothers. Numerous interventions exist to minimize risk during this period. Data on intervention coverage are needed for health system improvement. Maternal report of intrapartum interventions through surveys is the primary source of coverage data, but they may be invalid or unreliable.

Methods

We assessed the reliability of maternal report of delivery and immediate newborn care for a sample of home and health facility births in Sarlahi, Nepal. Mothers were visited as soon as possible following delivery (< 72 h) and asked to report circumstances of labor and delivery. A subset was revisited 1–24 months after delivery and asked to recall interventions received using standard household survey questions. We assessed the reliability of each indicator by comparing what mothers reported immediately after delivery against what they reported at the follow-up survey. We assessed potential variation in reliability of maternal report by characteristics of the mother, birth event, or intervention prevalence.

Results

One thousand five hundred two mother/child pairs were included in the reliability study, with approximately half of births occurring at home. A higher proportion of women who delivered in facilities reported “don’t know” when asked to recall specific interventions both initially and at follow-up. Most indicators had high observed percent agreement, but kappa values were below 0.4, indicating agreement was primarily due to chance. Only “received any injection during delivery” demonstrated high reliability among all births (kappa: 0.737). The reliability of maternal report was typically lower among women who delivered at a facility. There was no difference in reliability based on time since birth of the follow-up interview. We observed over-reporting of interventions at follow-up that were more common in the population and under-reporting of less common interventions.

Conclusions

This study reinforces previous findings that mothers are unable to report reliably on many interventions within the peripartum period. Household surveys which rely on maternal report, therefore, may not be an appropriate method for collecting data on coverage of many interventions during the peripartum period. This is particularly true among facility births, where many interventions may occur without the mother’s full knowledge.
Knowledge, attitudes, practices, and influencing factors of anxiety among pregnant women in Wuhan during the outbreak of COVID-19: a cross-sectional study
Authors: Ding Wenping , Lu Jianmei , Zhou Yan , Wei Weizhong , Zhou Zhihong , Chen Min
Published: January 2021

Background

Prenatal anxiety has been a significant public health issue globally, leading to adverse health outcomes for mothers and children. The study aimed to evaluate the sociodemographic characteristics, knowledge, attitudes, and practices (KAP), and anxiety level of pregnant women during the coronavirus disease 2019 (COVID-19) epidemic in Wuhan and investigate the influencing factors for prenatal anxiety in this specific context.

Methods

Pregnant subjects’ KAP towards COVID-19 and their sociodemographics and pregnancy information were collected using questionnaires. The Zung Self-Rating Anxiety Scale (SAS) was used to assess anxiety status. Factors associated with the level of prenatal anxiety were analyzed by Pearson’s chi-square test and multivariable logistic regression analyses.

Results

The prenatal anxiety prevalence in this population was 20.8%. The mean score of knowledge was 13.2 ± 1.1 on a 0 ~ 14 scale. The attitudes and practices data showed that 580/ 817 (71.0%) were very concerned about the news of COVID-19, 455/817 (55.7%) considered the official media to be the most reliable information source for COVID-19, and 681/817 (83.4%) were anxious about the possibility of being infected by COVID-19. However, only 83/817 (10.2%) worried about contracting COVID-19 infection through the ultrasound transducer during a routing morphology scan. About two-thirds 528/817 (64.6%) delayed or canceled the antenatal visits. Approximately half of them 410/817 (50.2%) used two kinds of personal protection equipments (PPEs) during hospital visits. Logistic regression analysis revealed that the influential factors for prenatal anxiety included previous children in the family, knowledge score, media trust, worry of contracting the COVID-19 infection and worry about getting infected with COVID-19 from the ultrasound probe antenatal care (ANC) schedule.

Conclusion

Prenatal anxiety was prevalent among pregnant women in Wuhan during the outbreak of COVID-19. The current findings identified factors associated with the level of prenatal anxiety that could be targeted for psychological care.
Severe dyspnea and uncontrolled seizures following meperfluthrin poisoning: a case report
Authors: Zheng Shengkun , Zhang Shengxin , Hong Shaoxian , Lou Qing
Published: January 2021

Background

Meperfluthrin is a novel sanitary cyhalothrin insecticide invented in China and has increasingly been used to produce liquid mosquito repellents. Oral meperfluthrin poisoning in human has rarely been reported. Here, we reported a case of meperfluthrin poisoning by ingestion of a meperfluthrin-based liquid mosquito repellent in a 16-month-old infant.

Case presentation

A 16-month-old boy with a history of accident ingestion of meperfluthrin was admitted to our hospital’s emergency department. He exhibited severe dyspnea, and lung radiograph showed multiple patchy and cord-like high-density shadows bilaterally in a short time. He also suffered 35 min of seizures which were finally controlled by the intravenous infusion of propofol. He was diagnosed with meperfluthrin poisoning, status epilepticus and severe pneumonia. After treated with methylprednisolone, aerosolized beclomethasone dipropionate, anti-infection, and some critical supportive therapy, the patient was in good health and showed no symptoms during 12 months of follow-up.

Conclusions

Meperfluthrin poisoning is rare. Oral meperfluthrin poisoning shows neurotoxic effects and pulmonary toxicity. Controlling seizures rapidly and ensuring an adequate oxygen supply are critical to the successful treatment.
The association between men’s family planning networks and contraceptive use among their female partners: an egocentric network study in Madagascar
Authors: Comfort Alison B. , Harper Cynthia C. , Tsai Alexander C. , Perkins Jessica M. , Moody James , Rasolofomana Justin Ranjalahy , Alperin Cora , Schultz Margaret , Ranjalahy Anja Noeliarivelo , Heriniaina Ravo , Krezanoski Paul J.
Published: January 2021

Background

Ensuring women have information, support and access to family planning (FP) services will allow women to exercise their reproductive autonomy and reduce maternal mortality, which remains high in countries such as Madagascar. Research shows that women’s social networks - their ties with partners, family members, friends, and providers - affect their contraceptive use. Few studies have considered the role of men’s social networks on women’s contraceptive use. Insofar as women’s contraceptive use may be influenced by their male partners, women’s contraceptive use may also be affected by their partner’s social networks. Men may differ by the types of ties they rely on for information and advice about FP. It is unknown whether differences in the composition of men’s FP networks matter for couples’ contraceptive use. This study assessed the association between men’s FP networks and couples’ contraceptive use.

Methods

This egocentric network study was conducted among married/partnered men (n = 178) in rural Madagascar. Study participants listed who they relied on for FP information and advice, including health providers and social ties. They provided ties’ gender, age, relationship, and perceived support of contraceptive use. The primary outcome was couples’ contraceptive use, and explanatory variables included FP networks and their composition (no FP network, social-only network, provider-only network, and mixed network of social and provider ties). Analyses used generalized linear models specifying a Poisson distribution, with covariate adjustment and cluster robust standard errors.

Results

Men who had FP networks were 1.9 times more likely to use modern contraception as a couple compared to men with no FP network (95% confidence interval [CI] 1.64–2.52; p ≤ 0.001). Compared to men with no FP network, men were more likely to use modern contraception if they had a social-only network, relative risk (RR) = 2.10 (95% CI, 1.65–2.68; p ≤ 0.001); a provider-only network, RR = 1.80 (95% CI, 1.54–2.11; p ≤ 0.001); or a mixed network, RR = 2.35 (95% CI, 1.97–2.80; p ≤ 0.001).

Conclusions

Whether men have a FP network, be it provider or social ties, distinguishes if couples are using contraception. Interventions should focus on reaching men not only through providers but also through their social ties to foster communication and support for contraceptive use.
Using natural language processing to explore heterogeneity in moral terminology in palliative care consultations
Authors: van den Broek-Altenburg Eline , Gramling Robert , Gothard Kelly , Kroesen Maarten , Chorus Caspar
Published: January 2021

Background

High quality serious illness communication requires good understanding of patients’ values and beliefs for their treatment at end of life. Natural Language Processing (NLP) offers a reliable and scalable method for measuring and analyzing value- and belief-related features of conversations in the natural clinical setting. We use a validated NLP corpus and a series of statistical analyses to capture and explain conversation features that characterize the complex domain of moral values and beliefs. The objective of this study was to examine the frequency, distribution and clustering of morality lexicon expressed by patients during palliative care consultation using the Moral Foundations NLP Dictionary.

Methods

We used text data from 231 audio-recorded and transcribed inpatient PC consultations and data from baseline and follow-up patient questionnaires at two large academic medical centers in the United States. With these data, we identified different moral expressions in patients using text mining techniques. We used latent class analysis to explore if there were qualitatively different underlying patterns in the PC patient population. We used Poisson regressions to analyze if individual patient characteristics, EOL preferences, religion and spiritual beliefs were associated with use of moral terminology.

Results

We found two latent classes: a class in which patients did not use many expressions of morality in their PC consultations and one in which patients did. Age, race (white), education, spiritual needs, and whether a patient was affiliated with Christianity or another religion were all associated with membership of the first class. Gender, financial security and preference for longevity-focused over comfort focused treatment near EOL did not affect class membership.

Conclusions

This study is among the first to use text data from a real-world situation to extract information regarding individual foundations of morality. It is the first to test empirically if individual moral expressions are associated with individual characteristics, attitudes and emotions.
Student and supervisor perspectives on the effectiveness of community-based placements for occupational therapy students
Authors: Golos Anat , Tekuzener Esti
Published: January 2021

Background

Using a community-based model as an integral part of occupational therapy students' practice experiences can enable the development of new emerging practices within the community. The aims of this study were to examine the experiences of students and supervisors in community-based role-emerging practice placements, and to compare the two types of placements (full-time and part-time).

Methods

Data was collected from 41 undergraduate occupational therapy students and seven supervisors using pre-post questionnaires, as well as qualitative data through focus groups and a short online questionnaire. Conventional content analysis was used for qualitative data, Wilcoxon tests were used to examine the change in scores, and Mann-Whitney tests compared the two types of placements.

Results

A significant decrease was evident in students' scores from pre- to post-placement regarding setting and supervision (z = -3.557, p < .001), with a non-significant decrease regarding community. Significant increases in scores were seen regarding students' personal and professional skills (z = -2.805, -3.152, p < .01). Close-to-significant differences in personal skills scores were found between role-emerging types. Overall, students and supervisors expressed positive impressions, while students addressed challenges relating to setting and supervision.

Conclusions

Community-based role-emerging practice placements may contribute to the professional and personal development of occupational therapy students. The results supported the positive aspects of role-emerging practice placements; they also identified the challenges of such placements with regard to students' expectations from the settings and supervision. Exposing students to role-emerging models, and seeking better compatibility with their expectations from community partnerships and supervisors, may contribute to their professional development, which can in turn develop and expand areas of practice in the community. Additionally, role-emerging practice placements can serve as a valuable contribution to professionals and stakeholders within communities, who do not as yet benefit from occupational therapy services.
HIV prevention research and COVID-19: putting ethics guidance to the test
Authors: Rennie Stuart , Chege Wairimu , Schrumpf Leah A. , Luna Florencia , Klitzman Robert , Moseki Ernest , Brown Brandon , Wakefield Steven , Sugarman Jeremy
Published: January 2021

Background

Critical public health measures implemented to mitigate the spread of the novel coronavirus disease (COVID-19) pandemic have disrupted health research worldwide, including HIV prevention research. While general guidance has been issued for the responsible conduct of research in these challenging circumstances, the contours of the dueling COVID-19 and HIV/AIDS pandemics raise some critical ethical issues for HIV prevention research. In this paper, we use the recently updated HIV Prevention Trials Network (HPTN) Ethics Guidance Document (EGD) to situate and analyze key ethical challenges related to the conduct of HIV prevention research during the COVID-19 pandemic as well as identify potential areas for refinement of the guidance document based on this unprecedented state of affairs.

Main body

Necessary actions taken for HIV prevention research studies due to the COVID-19 pandemic involve an array of ethical issues including those related to: (1) risk mitigation; (2) behavior change; (3) compounding vulnerability; (4) community engagement; (5) trial reopening; and 6) shifting research priorities.

Conclusions

In the context of the dueling HIV and COVID-19 global pandemics, research teams and sponsors must be nimble in responding to the rapidly changing environment by being sensitive to the associated ethical issues. The HTPN EGD provides a rich set of tools to help identify, analyze and address many of these issues. At the same time, future refinements of the HPTN EGD and other research ethics guidance could be strengthened by providing explicit advice regarding the ethical issues associated with disrupted research and the reopening of studies. In addition, additional consideration should be given to appropriately balancing domains of risk (e.g., physical versus social), addressing the vulnerability of research staff and community partners, and responding to un-anticipatable ancillary care needs of participants and communities. Appropriately addressing these issues will necessitate conceptual work, which would benefit from the careful documentation of the actual ethical issues encountered in research, the strategies implemented to overcome them, and their success in doing so. Throughout all of these efforts, it is critical to remember that the HIV pandemic not be forgotten in the rush to deal with the COVID-19 pandemic.
Association of shared decision making with inpatient satisfaction: a cross-sectional study
Authors: Luo Huiwen , Liu Guohua , Lu Jing , Xue Di
Published: January 2021

Background

We assessed inpatient perceived shared decision making (SDM) and tested the association of SDM with inpatient satisfaction in public tertiary hospitals in Shanghai, China.

Methods

A cross-sectional survey of 2585 inpatients in 47 public tertiary hospitals in Shanghai in July and August 2018 was conducted. We assessed overall SDM and 4 aspects of SDM and tested the factors influencing SDM and the association of SDM with patient satisfaction (patient satisfaction with physician services, medical expenses, outcomes and overall inpatient care), by adopting linear or two-level regression models.

Results

The positive response rate (PRR) and high positive response rate (HPRR) to overall SDM among the inpatients of public tertiary hospitals in Shanghai were relatively high (95.30% and 87.86%, respectively), while the HPRR to “My physician informed me of different treatment alternatives” was relatively low (80.09%). In addition, the inpatients who underwent surgery during admission had higher HPRRs and adjusted HPRRs to overall SDM than those who did not undergo surgery. The study showed that the adjusted high satisfaction rates (HSRs) with physician services, medical expenses, outcomes and overall inpatient care among the inpatients with high level of overall SDM were higher (96.50%, 68.44%, 89.50% and 92.60%) than those among the inpatients without a high level of overall SDM (71.77%, 35.19%, 57.30% and 67.49%). The greatest differences in the adjusted HSRs between the inpatients with and without a high level of SDM were found in inpatient satisfaction with medical expenses and informed consent in SDM. Moreover, 46.22% of the variances in the HSRs with overall inpatient care across the hospitals were attributed to the hospital type (general hospitals vs. specialty hospitals).

Conclusions

Inpatient PRRs and HPRRs to SDM in public tertiary hospitals in Shanghai are relatively high overall but lower to information regarding alternatives. SDM can be affected by the SDM preference of both the patients and physicians and medical condition. Patient satisfaction can be improved through better SDM and should be committed at the hospital level.
Association of pericardial adipose tissue with left ventricular structure and function: a region‐specific effect?
Authors: Kim Jin-Seok , Kim Seon Won , Lee Jong Seok , Lee Seung Ku , Abbott Robert , Lee Ki Yeol , Lim Hong Euy , Sung Ki-Chul , Cho Goo-Yeong , Koh Kwang Kon , Kim Sun H. , Shin Chol , Kim Seong Hwan
Published: January 2021

Background

The independent role of pericardial adipose tissue (PAT) as an ectopic fat associated with cardiovascular disease (CVD) remains controversial. This study aimed to determine whether PAT is associated with left ventricular (LV) structure and function independent of other markers of general obesity.

Methods

We studied 2471 participants (50.9 % women) without known CVD from the Korean Genome Epidemiology Study, who underwent 2D-echocardiography with tissue Doppler imaging (TDI) and computed tomography measurement for PAT.

Results

Study participants with more PAT were more likely to be men and had higher cardiometabolic indices, including blood pressure, glucose, and cholesterol levels (all P < 0.001). Greater pericardial fat levels across quartiles of PAT were associated with increased LV mass index and left atrial volume index (all P < 0.001) and decreased systolic (P = 0.015) and early diastolic (P < 0.001) TDI velocities, except for LV ejection fraction. These associations remained after a multivariable-adjusted model for traditional CV risk factors and persisted even after additional adjustment for general adiposity measures, such as waist circumference and body mass index. PAT was also the only obesity index independently associated with systolic TDI velocity (P < 0.001).

Conclusions

PAT was associated with subclinical LV structural and functional deterioration, and these associations were independent of and stronger than with general and abdominal obesity measures.
Synergistic optimisation of expression, folding, and secretion improves E. coli AppA phytase production in Pichia pastoris
Authors: Navone Laura , Vogl Thomas , Luangthongkam Pawarisa , Blinco Jo-Anne , Luna-Flores Carlos , Chen Xiaojing , von Hellens Juhani , Speight Robert
Published: January 2021

Background

Pichia pastoris (Komagataella phaffii) is an important platform for heterologous protein production due to its growth to high cell density and outstanding secretory capabilities. Recent developments in synthetic biology have extended the toolbox for genetic engineering of P. pastoris to improve production strains. Yet, overloading the folding and secretion capacity of the cell by over-expression of recombinant proteins is still an issue and rational design of strains is critical to achieve cost-effective industrial manufacture. Several enzymes are commercially produced in P. pastoris, with phytases being one of the biggest on the global market. Phytases are ubiquitously used as a dietary supplement for swine and poultry to increase digestibility of phytic acid, the main form of phosphorous storage in grains.

Results

Potential bottlenecks for expression of E. coli AppA phytase in P. pastoris were explored by applying bidirectional promoters (BDPs) to express AppA together with folding chaperones, disulfide bond isomerases, trafficking proteins and a cytosolic redox metabolism protein. Additionally, transcriptional studies were used to provide insights into the expression profile of BDPs. A flavoprotein encoded by ERV2 that has not been characterised in P. pastoris was used to improve the expression of the phytase, indicating its role as an alternative pathway to ERO1. Subsequent AppA production increased by 2.90-fold compared to the expression from the state of the AOX1 promoter.

Discussion

The microbial production of important industrial enzymes in recombinant systems can be improved by applying newly available molecular tools. Overall, the work presented here on the optimisation of phytase production in P. pastoris contributes to the improved understanding of recombinant protein folding and secretion in this important yeast microbial production host.
Malaria vectors diversity, insecticide resistance and transmission during the rainy season in peri-urban villages of south-western Burkina Faso
Authors: Soma Dieudonné Diloma , Poda Serge Bèwadéyir , Hien Aristide Sawdetuo , Namountougou Moussa , Sangaré Ibrahim , Sawadogo John Marie Emmanuel , Fournet Florence , Ouédraogo Georges Anicet , Diabaté Abdoulaye , Moiroux Nicolas , Dabiré Roch Kounbobr
Published: January 2021

Background

This study reports an updated description on malaria vector diversity, behaviour, insecticide resistance and malaria transmission in the Diébougou and Dano peri-urban areas, Burkina Faso.

Methods

Mosquitoes were caught monthly using CDC light traps and pyrethrum spray catches. Mosquitoes were identified using morphological taxonomic keys. PCR techniques were used to identify the species of the Anopheles gambiae complex and insecticide resistance mechanisms in a subset of Anopheles vectors. The Plasmodium sporozoite infection status and origins of blood meals of female mosquitoes were determined by ELISA methods. Larvae were collected, breed in the insectary and tested for phenotypic resistance against four insecticides using WHO bioassays.

Results

This study contributed to update the entomological data in two peri-urban areas of Southwest Burkina Faso. Anopheles populations were mostly anthropophilic and endophilic in both areas and exhibit high susceptibility to an organophosphate insecticide. This offers an alternative for the control of these pyrethroid-resistant populations. These data might help the National Malaria Control Programme for decision-making about vector control planning and resistance management.

Conclusions

This study contributed to update the entomological data in two peri-urban areas of Southwest Burkina Faso. Anopheles populations were mostly anthropophilic and endophilic in both areas and exhibit high susceptibility to an organophosphate insecticide. This offers an alternative for the control of these pyrethroid-resistant populations. These data might help the National Malaria Control Programme for decision-making about vector control planning and resistance management.
The impact of health insurance on poverty among rural older adults: an evidence from nine counties of western China
Authors: Zhai Shaoguo , Yuan Shuiping , Dong Quanfang
Published: January 2021

Background

Older adults are more prone to various diseases. Health insurance becomes effective mechanism to relieve financial burden when the insured is sick. In China, most older adults live in the countryside, and New Rural Cooperative Medical Scheme is a kind of health insurance system in rural areas. The relationship between New Rural Cooperative Medical Scheme and financial burden due to health expenditure of older adults in China was investigated. This paper aims at the impact of New Rural Cooperative Medical Scheme on the poverty among rural older adults.

Methods

This study employs Probit model and Tobit model to assess the impact of New Rural Cooperative Medical Scheme on alleviating poverty among rural older adults based on a survey in nine representative counties in western China.

Results

The findings show that diseases have significantly negative impact on rural elderly poverty. New Rural Cooperative Medical Scheme has impact on alleviating of the health-payment poverty due to catastrophic health expenditure, but the impact is limited. The impact of health insurance on poverty alleviation is greater for men, older adults aged between 60 to 69 and households in in economically poorer area than their counterparts.

Conclusions

This study show the relationship between New Rural Cooperative Medical Scheme and catastrophic health expenditure of older adults in China. The results draw policy attention to introduce different reimbursement expense ratios for different groups to alleviate them from poverty based on more comprehensive insurance packages.
Impact of antipsychotics in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis
Authors:   On Behalf of the ISACA Guideline Working Group, D’Alò Gian Loreto , De Crescenzo Franco , Amato Laura , Cruciani Fabio , Davoli Marina , Fulceri Francesca , Minozzi Silvia , Mitrova Zuzana , Morgano Gian Paolo , Nardocci Franco , Saulle Rosella , Schünemann Holger Jens , Scattoni Maria Luisa
Published: January 2021

Background

The net health benefit of using antipsychotics in children and adolescents with ASD is unclear. This review was performed to provide the evidence necessary to inform the Italian national guidelines for the management of ASD.

Methods

We performed a systematic review of randomized controlled trials (RCTs) comparing antipsychotics versus placebo for the treatment of ASD in children and adolescents. For efficacy, acceptability and safety we considered outcomes evaluated by the guideline panel critical and important for decision-making. Continuous outcomes were analyzed by using standardized mean difference (SMD), and dichotomous outcomes by calculating the risk ratio (RR), with their 95% confidence interval (95% CI). Data were analyzed using a random effects model. We used the Cochrane tool to assess risk of bias of included studies. Certainty in the evidence of effects was assessed according to the GRADE approach.

Results

We included 21 RCTs with 1,309 participants, comparing antipsychotics to placebo. Antipsychotics were found effective on “restricted and repetitive interests and behaviors” (SMD − 0.21, 95% CI − 0.35 to − 0.07, moderate certainty), “hyperactivity, inattention, oppositional, disruptive behavior” (SMD − 0.67, 95% CI − 0.92 to − 0.42, moderate certainty), “social communication, social interaction” (SMD − 0.38, 95% CI − 0.59 to − 0.16, moderate certainty), “emotional dysregulation/irritability” (SMD − 0.71, 95% CI − 0.98 to − 0.43, low certainty), “global functioning, global improvement” (SMD − 0.64, 95% CI − 0.96 to − 0.33, low certainty), “obsessions, compulsions” (SMD − 0.30, 95% CI − 0.55 to − 0.06, moderate certainty). Antipsychotics were not effective on “self-harm” (SMD − 0.14, 95% CI − 0.58 to 0.30, very low certainty), “anxiety” (SMD − 0.38, 95% CI − 0.82 to 0.07, very low certainty). Antipsychotics were more acceptable in terms of dropout due to any cause (RR 0.61, 95% CI 0.48 to 0.78, moderate certainty), but were less safe in terms of patients experiencing adverse events (RR 1.19, 95% CI 1.07 to 1.32, moderate certainty), and serious adverse events (RR 1.07, 95% CI 0.48 to 2.43, low certainty).

Conclusions

Our systematic review and meta-analysis found antipsychotics for children and adolescents with ASD more efficacious than placebo in reducing stereotypies, hyperactivity, irritability and obsessions, compulsions, and in increasing social communication and global functioning. Antipsychotics were also found to be more acceptable, but less safe than placebo.
Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China
Authors: Sun Shufang , Goldberg Simon B. , Lin Danhua , Qiao Shan , Operario Don
Published: January 2021

Background

The COVID-19 pandemic has made unprecedented impact on the psychological health of university students, a population vulnerable to distress and mental health disorders. This study investigated psychiatric symptoms (anxiety, depression, and traumatic stress) during state-enforced quarantine among university students in China (N = 1912) through a cross-sectional survey during March and April 2020.

Results

Psychiatric symptoms were alarmingly prevalent: 67.05% reported traumatic stress, 46.55% had depressive symptoms, and 34.73% reported anxiety symptoms. Further, 19.56% endorsed suicidal ideation. We explored risk and protective factors of psychological health, including demographic variables, two known protective factors for mental health (mindfulness, perceived social support), four COVID-specific factors (COVID-19 related efficacy, perceived COVID-19 threat, perceived COVID-19 societal stigma, COVID-19 prosocial behavior) and screen media usage. Across symptom domains, mindfulness was associated with lower symptom severity, while COVID-19 related financial stress, perceived COVID-19 societal stigma, and perceived COVID-19 threat were associated with higher symptom severity. COVID-19 threat and COVID-19 stigma showed main and interactive effects in predicting all mental health outcomes, with their combination associated with highest symptom severity. Screen media device usage was positively associated with depression. Female gender and COVID-19 prosocial behavior were associated with higher anxiety, while COVID-19 self-efficacy associated with lower anxiety symptoms.

Conclusions

Findings suggest high need for psychological health promotion among university students during the COVID-19 pandemic and inform an ecological perspective on the detrimental role of stigma during an emerging infectious disease outbreak. Interventions targeting multi-level factors, such as promoting mindfulness and social support at individual and interpersonal levels while reducing public stigma about COVID-19, may be particularly promising. Attending to the needs of disadvantaged groups including those financially impacted by COVID-19 is needed.
Patellar resurfacing versus nonresurfacing in total knee arthroplasty: an updated meta-analysis of randomized controlled trials
Authors: Chen Kai , Dai Xiaoyu , Li Lidong , Chen Zhigang , Cui Haidong , Lv Shujun
Published: January 2021

Background

Whether resurface the patella or not in total knee arthroplasty (TKA) was controversial. In 2013, we conducted a meta-analysis of randomized controlled trials (RTCs). After that, plenty of studies have been carried out, but there still existed a great deal of controversy. In order to update our previous study, we conducted this update meta-analysis to evaluate the efficacy of patellar resurfacing in TKA.

Methods

Databases were searched for RCTs comparing the outcomes of patellar resurfacing and nonresurfacing in TKA. Outcomes of knee relevant indicators were analysed. To see the short- and long-term effects, we calculated the data in total and divided the patients who were followed up for ≤ 3 years and ≥ 5 years into two subgroups as well.

Results

Thirty-two trials assessing 6887 knees were eligible. There was a significant difference in terms of reoperation (in total and ≥ 5 years), Knee Society Score (KSS), function score (in total and ≥ 5 years) and noise. While no significant difference was found in the following items: reoperation (≤ 3 years), anterior knee pain (AKP), function score (≤ 3 years), range of motion (ROM), Oxford score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), visual analogue score (VAS), Feller score, patellar tilt and the patients’ satisfaction.

Conclusions

We found that patellar resurfacing could reduce the occurrence of reoperation and noise after surgery, as well as increase the KSS and function score, while it might not influence the outcomes such as AKP, ROM, Oxford score, KOOS, VAS, Feller score, patellar tilt and the patients’ satisfaction. The results are different from our previous finding in the meta-analysis. In conclusion, we prefer patellar resurfacing in TKA.
Revised recommendations of the Italian Society of Pediatrics about the general management of Kawasaki disease
Authors: Marchesi Alessandra , Rigante Donato , Cimaz Rolando , Ravelli Angelo , Tarissi de Jacobis Isabella , Rimini Alessandro , Cardinale Fabio , Cattalini Marco , De Zorzi Andrea , Dellepiane Rosa Maria , Salice Patrizia , Secinaro Aurelio , Taddio Andrea , Palma Paolo , El Hachem Maya , Cortis Elisabetta , Maggio Maria Cristina , Corsello Giovanni , Villani Alberto
Published: January 2021

Aim of these revised recommendations for the general management of Kawasaki disease is to encourage its prompter recognition and warrant the most appropriate therapy, based on ascertained scientific data, raising awareness of the complications related to misdiagnosis or delayed treatment. A set of 20 synthetic operative statements is herein provided, including the definition of Kawasaki disease, its protean presentations, clinical course and seminal treatment modalities of all disease phases. The application of these recommendations should improve prognosis of Kawasaki disease and prevent the progression to permanent vascular abnormalities, thereby diminishing morbidity and mortality.
Correction to: The social health impact of Eritrean refugees on the host communities: the case of May-ayni refugee camp, Northern Ethiopia
Authors: Gebrehiwet Kahsay , Abrha Fitsum , Gebreyesus Hailay , Teweldemedhin Mebrahtu
Published: January 2021

An amendment to this paper has been published and can be accessed via the original article.
Effect of sex-specific differences on function of induced hepatocyte-like cells generated from male and female mouse embryonic fibroblasts
Authors: Ullah Imran , Shin Yurianna , Kim Yeongji , Oh Keon Bong , Hwang Seongsoo , Kim Young-Im , Lee Jeong Woong , Hur Tai-Young , Lee Seunghoon , Ock Sun A
Published: January 2021

Background

The liver is one of the vital organs involved in detoxification and metabolism. The sex-based differences between the functionality of male and female liver have been previously reported, i.e., male’s liver are good in alcohol clearance and lipid metabolism, while female’s liver are better in cholesterol metabolism. To date, studies on novel drug toxicity have not considered the sex-specific dimorphic nature of the liver. However, the use of hepatocyte-like cells to treat liver diseases has increased recently.

Methods

Mouse embryos were isolated from a pregnant female C57BL/6J mouse where mouse embryonic fibroblasts (MEFs) were isolated from back skin tissue of each embryo. MEFs were transduced with human transcription factors hHnf1α, hHnf4α, and hFoxa3 using the lentiviral system. The transduced MEFs were further treated with hepatocyte-conditioned media followed by its analysis through RT-qPCR, immunofluorescence, functional assays, and finally whole-transcriptome RNA sequencing analysis. For in vivo investigation, the mouse hepatocyte-like cells (miHep) were transplanted into CCl4-induced acute liver mouse model.

Results

In this study, we evaluated the sex-specific effect of miHep induced from male- and female-specific mouse embryonic fibroblasts (MEFs). We observed miHeps with a polygonal cytoplasm and bipolar nucleus and found that male miHeps showed higher mHnf4a, albumin secretion, and polyploidization than female miHeps. Transcriptomes from miHeps were similar to those from the liver, especially for Hnf4a of male miHeps. Male Cyps were normalized to those from females, which revealed Cyp expression differences between liver and miHeps. In both liver and miHeps, Cyp 4a12a and Cyp 4b13a/2b9 predominated in males and females, respectively. After grafting of miHeps, AST/ALT decreased, regardless of mouse sex.

Conclusion

In conclusion, activation of endogenic Hnf4a is important for generation of successful sex-specific miHeps; furthermore, the male-derived miHep exhibits comparatively enhanced hepatic features than those of female miHep.
Correction to: Hyperinsulinism associated with GLUD1 mutation: allosteric regulation and functional characterization of p.G446V glutamate dehydrogenase
Authors: Luczkowska Karolina , Stekelenburg Caroline , Sloan-Béna Frédérique , Ranza Emmanuelle , Gastaldi Giacomo , Schwitzgebel Valérie , Maechler Pierre
Published: January 2021

An amendment to this paper has been published and can be accessed via the original article.
p63 expression in human tumors and normal tissues: a tissue microarray study on 10,200 tumors
Authors: Steurer Stefan , Riemann Claudia , Büscheck Franziska , Luebke Andreas M. , Kluth Martina , Hube-Magg Claudia , Hinsch Andrea , Höflmayer Doris , Weidemann Sören , Fraune Christoph , Möller Katharina , Menz Anne , Fisch Margit , Rink Michael , Bernreuther Christian , Lebok Patrick , Clauditz Till S. , Sauter Guido , Uhlig Ria , Wilczak Waldemar , Dum David , Simon Ronald , Minner Sarah , Burandt Eike , Krech Rainer , Krech Till , Marx Andreas H.
Published: January 2021

Background

Tumor protein 63 (p63) is a transcription factor of the p53 gene family involved in differentiation of several tissues including squamous epithelium. p63 immunohistochemistry is broadly used for tumor classification but published data on its expression in cancer is conflicting.

Methods

To comprehensively catalogue p63 expression, tissue microarrays (TMAs) containing 12,620 tissue samples from 115 tumor entities and 76 normal tissue types were analyzed.

Results

p63 expression was seen in various normal tissues including squamous epithelium and urothelium. At least occasional weak p63 positivity could be detected in 61 (53%) of 115 different tumor types. The frequencies of p63 positivity was highest in squamous cell carcinomas irrespective of their origin (96–100%), thymic tumors (100%), urothelial carcinomas (81–100%), basal type tumors such as basal cell carcinomas (100%), and various salivary gland neoplasias (81–100%). As a rule, p63 was mostly expressed in cancers derived from p63 positive normal tissues and mostly not detectable in tumors derived from p63 negative cancers. However, exceptions from this rule occurred. A positive p63 immunostaining in cancers derived from p63 negative tissues was unrelated to aggressive phenotype in 422 pancreatic cancers, 160 endometrium cancers and 374 ovarian cancers and might be caused by aberrant squamous differentiation or represent stem cell properties. In 355 gastric cancers, aberrant p63 expression occurred in 4% and was linked to lymph node metastasis (p = 0.0208). Loss of p63 in urothelial carcinomas - derived from p63 positive urothelium - was significantly linked to advanced stage, high grade (p < 0.0001 each) and poor survival (p < 0.0001) and might reflect clinically relevant tumor dedifferentiation.

Conclusion

The high prevalence of p63 expression in specific tumor types makes p63 immunohistochemistry a suitable diagnostic tool. Loss of p63 expression might constitute a feature of aggressive cancers.
Impact of ICD-9-CM to ICD-10-CM coding transition on trauma hospitalization trends among young adults in 12 states
Authors: Sebastião Yuri V. , Metzger Gregory A. , Chisolm Deena J. , Xiang Henry , Cooper Jennifer N.
Published: January 2021

Background

We aimed to estimate the impact of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding transition on traumatic injury-related hospitalization trends among young adults across a geographically and demographically diverse group of U.S. states.

Methods

Interrupted time series analyses were conducted using statewide inpatient databases from 12 states and including traumatic injury-related hospitalizations in adults aged 19–44 years in 2011–2017. Segmented regression models were used to estimate the impact of the October 2015 coding transition on external cause of injury (ECOI) completeness (percentage of hospitalizations with a documented ECOI code) and on population-level rates of injury-related hospitalizations by nature, intent, mechanism, and severity of injury.

Results

The transition to ICD-10-CM was associated with a drop in ECOI completion in the transition month (− 3.7%; P < .0001), but there was no significant change in the positive trend in ECOI completion from the pre- to post-transition periods. There were significant increases post-transition in the measured rates of hospitalization for traumatic brain injury (TBI), unintentional injury, mild injury (injury severity score (ISS) < 9), and injuries caused by drowning, firearms, machinery, other pedestrian, suffocation, and unspecified mechanism. Conversely, there were significant decreases in October 2015 in the rates of hospitalization for assault, injuries of undetermined intent, injuries of moderate severity (ISS 9–15), and injuries caused by fire/burn, other pedal cyclist, other transportation, natural/environmental, and other specified mechanism. A significant increase in the percentage of hospitalizations classified as resulting from severe injury (ISS > 15) was observed when the general equivalence mapping maximum severity method for converting ICD-10-CM codes to ICD-9-CM codes was used. State-specific results for the outcomes of ECOI completion and TBI-related hospitalization rates are provided in an online supplement.

Conclusions

The U.S. transition from ICD-9-CM to ICD-10-CM coding led to a significant decrease in ECOI completion and several significant changes in measured rates of injury-related hospitalizations by injury intent, mechanism, nature, and severity. The results of this study can inform the design and analysis of future traumatic injury-related health services research studies that use both ICD-9-CM and ICD-10-CM coded data.

Level of evidence

II (Interrupted Time Series)
Correction to: Evaluation of endoscopic ultrasoundguided gastric botulinum toxin injections in the treatment of obesity
Authors: Gameel Asmaa , Bahgat Monir , Seif Seham , Habeeb Maha , El-Ghany Mohammed Abd , Altonbary Ahmed Youssef
Published: January 2021

An amendment to this paper has been published and can be accessed via the original article.
Significance of continuing audiovestibular practice during Covid-19 pandemic
Authors: Yilmaz Oğuz , Bayazit Dilara , Yaman Handan , Mutlu Berna Özge
Published: January 2021

Background

We aimed to evaluate the significance of continuing audiovestibular practice during the Covid-19 pandemic in the audiology clinic of the university hospital.

Methods

The precautions, test procedures, and risk factors associated with the practice of audiology were evaluated. The number and diagnoses of the cases between 23 March and 23 May 2020 were also compared with the results of the same 2 months in 2019 in an attempt to evaluate the alterations in the audiology practice.

Results

The audiology practice has continued during the pandemic, and numerous audiovestibular tests like newborn hearing screening, pure tone and speech audiometry, auditory brainstem response (ABR) test, bedside vestibular assessment, videomystagmography (VNG), caloric test, vestibular evoked myogenic potential (VEMP), computerized dynamic posturography (CDP), video head impulse test (vHIT), intraoperative cochlear implant measurement, and postop cochlear implant fittings were performed. The number of tests has decreased significantly in the course of the pandemic (p < 0.01). No evidence of Covid-19 disease was detected in the audiology staff and patients. In general, no major risk was seen during testing under protective measures except for vestibular testing which induced vomiting and taking out the mask for lip reading during cochlear implant fitting in the elderly.

Conclusion

It is possible to perform audiovestibular tests during the Covid-19 pandemic by wearing necessary protective equipment and disinfecting the potential surfaces. Vomiting during vestibular tests, uncovering the nose and mouth for lip reading, and small-sized test cabins are the main risk factors of contamination in the audiology clinics.
Feasibility of Fitness Tracker Usage to Assess Activity Level and Toxicities in Patients With Colorectal Cancer
Authors: Ward William H. , Meeker Caitlin R. , Handorf Elizabeth , Hill Maureen V. , Einarson Margret , Alpaugh R. Katherine , Holden Thomas L. , Astsaturov Igor , Denlinger Crystal S. , Hall Michael J. , Reddy Sanjay S. , Sigurdson Elin R. , Dotan Efrat , Zibelman Matthew , Meyer Joshua E. , Farma Jeffrey M. , Vijayvergia Namrata
Published: January 2021

PURPOSE

Performance status (PS) is a subjective assessment of patients' overall health. Quantification of physical activity using a wearable tracker (Fitbit Charge [FC]) may provide an objective measure of patient's overall PS and treatment tolerance.

MATERIALS AND METHODS

Patients with colorectal cancer were prospectively enrolled into two cohorts (medical and surgical) and asked to wear FC for 4 days at baseline (start of new chemotherapy [± 4 weeks] or prior to curative resection) and follow-up (4 weeks [± 2 weeks] after initial assessment in medical and postoperative discharge in surgical cohort). Primary end point was feasibility, defined as 75% of patients wearing FC for at least 12 hours/d, 3 of 4 assigned days. Mean steps per day (SPD) were correlated with toxicities of interest (postoperative complication or ≥ grade 3 toxicity). A cutoff of 5,000 SPD was selected to compare outcomes.

RESULTS

Eighty patients were accrued over 3 years with 55% males and a median age of 59.5 years. Feasibility end point was met with 68 patients (85%) wearing FC more than predefined duration and majority (91%) finding its use acceptable. The mean SPD count for patients with PS 0 was 6,313, and for those with PS 1, it was 2,925 (122 and 54 active minutes, respectively) ( P = .0003). Occurrence of toxicity of interest was lower among patients with SPD > 5,000 (7 of 33, 21%) compared with those with SPD < 5,000 (14 of 43, 32%), although not significant ( P = .31).

CONCLUSION

Assessment of physical activity with FC is feasible in patients with colorectal cancer and well-accepted. SPD may serve as an adjunct to PS assessment and a possible tool to help predict toxicities, regardless of type of therapy. Future studies incorporating FC can standardize patient assessment and help identify vulnerable population.