bluuebunny/crossref_metadata_2025 huggingface dataset:
Accelerating HIV epidemic control in Benue state, Nigeria, 2019–2021: the APIN program experience
Authors: Jwanle P , Ibiloye O , Obaje M , Ngwoke K , Usha T , Amoo O , Ogunsola O , Okezie U , Olaitan R , Ofuche E , Onwuatuelo I , Samuels J , Fagbamigbe J , Nwagagbo F , Ogbanufe O , Okoye M , Okonkwo P
Published: February 2023

Introduction:

As at 2019, Nigeria was ranked the fourth highest HIV burden in the world. There is varied geographical HIV prevalence in Nigeria. The progress made is inequitable across geographical locations and sub-populations (18). Benue state has the second highest HIV prevalence in Nigeria. In 2018, about 35,623 people living with HIV (PLHIV) were yet to commence antiretroviral treatment (ART) in the state, accounting for an estimated ART coverage gap of 11% out of the combined gap of 320,921 in the country. To close this gap, the Benue ART surge (BAS) was implemented. The aim of this study was to describe the BAS strategic approaches and demonstrate progress in expanding ART access for PLHIV in Benue State, Nigeria.

Methods:

BAS was implemented in 252 health facilities from May 2019 to September 2021. Data were collected and reported using an Excel-based dashboard and electronic medical records. The trend of HIV case identification, ART initiation, viral load suppression rate, and rate of interruption in treatment during the BAS period was then described and analyzed.

Results:

Out of 893,462 clients reached, 6.7% ( n = 60,297) were diagnosed with HIV and 99.8% ( n = 60,236) were initiated on ART. HIV case identification per month increased by 467% from 650 at baseline to a peak of 3685 in August 2020, and then declined by 35% to 2380 in September 2021. All new HIV-infected patients (100%) were linked to ART. Viral load testing coverage and viral load suppression rate increased from 30% (43,185/126,004) and 84% ( n = 36,165/43,185) at baseline to 95% ( n = 193,890/204,095) and 96% (185,785/193,890), respectively.

Conclusion:

Implementation of the BAS improved access to comprehensive HIV services in Benue State. The increase in HIV case identification and ART initiation significantly reduced the HIV treatment gap in the state. To fast track the attainment of UNAIDS 95-95-95 goals, lessons learnt from the BAS should be adapted and scaled up in the national HIV program in Nigeria.
Coronavirus disease 2019 information-seeking behavior globally: a systematic review
Authors: Anagaw Tadele Fentabil , Guadie Habtamu Alganeh
Published: February 2023

Objective:

This systematic review aimed to provide a global picture of information-seeking behavior, source information used, and its associated factors.

Methods:

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses steps. Databases such as PubMed/MEDLINE, Web of Science, Scopus, EMBASE, World Health Organization libraries, and Google Scholar were used to search all published articles. Articles on COVID-19 information-seeking behavior published until November 04, 2021, and the use of the English language was included. Two independent reviewers did the article selection and quality check.

Results:

For this systematic review, twenty articles were included in the final report. Information-seeking behavior was associated with digital health literacy, online information sources, and socio-demographic factors. The major sources of health information during the COVID-19 pandemic were digital media, television, public health portals like the world health organization, and center for communicable disease and prevention websites.

Conclusion:

This systematic review provides a valuable overview of available information on information-seeking behavior regarding COVID-19 globally. The studies used a heterogeneous study population, various research techniques, and various research questions. Digital literacy and online information sources play a vital role in information-seeking behavior.
Awareness and knowledge of familial Mediterranean fever among medical scope students in Syrian universities: A cross-sectional study
Authors: Ataya Jamal , Soqia Jameel , Alfawal Massa , Kara Tahhan Nour , Albani Nour , Hani Yahya
Published: February 2023

Introduction:

Familial Mediterranean fever is an autoinflammatory autosomal recessive disorder common among individuals of Mediterranean descent. It is characterized by recurrent episodes of fever accompanied by peritonitis, pleurisy, pericarditis, and/or arthritis, sometimes accompanied by an erysipelas-like rash. Mimicking manifestation of other inflammatory conditions and the diversity of symptoms leads to insufficient knowledge and understanding. General knowledge about this disease is considered low in most populations, but this bears greater consequences in people with high incidence rates. This study investigates the knowledge of familial Mediterranean fever among a group of medical students in public and private Syrian universities.

Methods:

A cross-sectional study was conducted in May 2022, and an international standard-based electronic questionnaire was adopted. The study included 758 current undergraduate medical scope students from public and private universities in Syria. The survey used for this study included inquiries made to assess awareness using global standards. It was divided into 2 sections, with 7 questions focusing on sociodemographic characteristics and 17 questions assessing the students’ understanding of Familial Mediterranean fever.

Results:

Our analysis showed strong correlations between the knowledge of Familial Mediterranean fever and certain specialization, college, academic year, and marital status. The mean score of answers was 9.39 out of 17 for all participants. The mean score of answers for medical students was 10.01 out of 17, while it was 8.81 for pharmaceutical students and 6.51 for dental students. These differences were statistically significant, p-value <0.001. This means medical students know better than pharmaceutical students, who already have better knowledge than dental students.

Conclusion:

We conclude that medical scope students’ knowledge about the disease of Familial Mediterranean fever and its management is ineffective, especially among dental students, even in a country with high prevalence rates for Familial Mediterranean fever like Syria.
The three-glass test yields excellent results for diagnosis of chronic bacterial prostatitis: Study from a Pakistani tertiary care hospital
Authors: Hameed Farooq , Anwaar Adeel
Published: February 2023

Background:

Prostatitis is a common disorder affecting 10–14% of men. Chronic prostatitis is a bothersome disease affecting young, middle-aged and elderly men. Routine cultures often fail to localise the source of infection. Although the four-glass test is considered for evaluating chronic prostatitis, the three-glass urine test can also be performed. This test yields excellent results.

Methods:

Overall, 144 cases of Pakistani origin were enrolled. A three-glass test was performed, and the samples were labelled as VB1, VB2 and VB3+ expressed prostatic secretions (EPS). Qualitative culture and drug sensitivity test were performed for 16 antimicrobials.

Results:

Samples from 127 patients ( Mage = 37 years) were analysed. Chronic bacterial prostatitis was identified in 81 (63.77%) patients.

Conclusion:

In more than half of the cases examined in this study, the bacteria were localised to the prostate.

Level of evidence:

IIIb
Learning and Study Strategies as Predictors of Undergraduates’ Emotional Engagement: A Cross-Validation Approach
Authors: Abulela Mohammed A. A. , Mrutu Amaniel P. , Ismail Nasrah M.
Published: February 2023

Although emotional engagement has received much attention in educational research, relatively little is known about its predictors among undergraduates. Accordingly, to predict emotional engagement, we used the learning and study strategies model, proposed and revised by Weinstein and Palmer, which has 10 strategies namely; information processing, selecting main ideas, test strategies, anxiety, attitude, motivation, concentration, self-testing, study aids, and time management. Thus, an adapted Arabic version of the learning and study strategies inventory-second edition and an emotional engagement scale were administered to 522 undergraduates. To ascertain the accuracy and generalizability of the final selected model in future samples, six candidate models were cross-validated using the leave-one-out approach. Results revealed that the final five-predictor model, which included information processing, anxiety, attitude, concentration, study aids, was the most parsimonious and had the lowest mean square error, explaining approximately 40% of the variation in undergraduates’ scores on emotional engagement. The study aids strategy was found to be the strongest predictor of emotional engagement. Educational implications, limitations, and directions for future research were also discussed.
Should Firms Strive for the Educational Diversity of the Workforce? Estimation of the Impact of Firms’ Educational Structure on Sales Growth and Exports
Authors: Bartolj Tjaša
Published: February 2023

This study analyses the relationship between a firms’ growth and the educational diversity of their workforce. It differentiates itself from other studies by using two measures of human capital diversity—one for education levels and one for fields—instead of one. The results show that workers with more diverse specializations than the workforce of competitors benefit the firm’s growth and extensive margin of trade. Contrastingly, above-average workforce heterogeneity in education levels does not seem to affect firms’ performance. Furthermore, it is shown that the association between human capital diversity and firms’ performance differs among sectors. Compared to previous studies, which concentrated on one particular industry or one measure of educational diversity, this more comprehensive approach allows reconciling some of the contradicting results. The study shows that the mixed results in existing papers can result from dissimilar impacts of various measures of human capital diversity on firm performance or its differences among sectors.
Early Reduction in C-Reactive Protein Following Treatment for Spinal Epidural Abscess: A Potential Treatment Guide
Authors: Hunter Sarah , Ou Cindy , Baker Joseph F.
Published: February 2023

Study Design

Retrospective Cohort Study.

Objective

To assess the predictive value of early C-reactive protein (CRP) trends following diagnosis of spinal epidural abscess (SEA). Non-operative management with intravenous antibiotics has not demonstrated equivalent outcomes with regard to mortality and morbidity. Knowledge of specific patient and disease factors associated with worse outcomes may predict treatment failure.

Methods

All patients treated for spontaneous SEA in a tertiary centre in New Zealand over a 10-year period were followed for at least 2 years. CRP at diagnosis and day 4-5 following treatment initiation was analyzed to determine predictors of CRP reduction of at least 50%. Proportional Cox hazards regression investigated mortality over 2 years.

Results

94 patients met inclusion criteria and with CRP values available for analysis. Median age was 62 years (+/− 17.7) and 59 (63%) were treated operatively. Kaplan-Meier analysis estimate of 2-year survival was .81 (95% CI .72-.88). CRP reduction by 50% was seen in 34 patients. Patients who did not experience a 50% reduction were more likely to have thoracic infection (27 vs 8, P = .02) or multifocal sepsis (41 vs 13, P = .002). Failure to achieve a 50% reduction by day 4-5 was associated with worse post-treatment Karnofsky scores (70 vs 90, P = .03) and longer hospital stay (25 days vs 17.5 days, P = .04). Cox regression model showed mortality predicted by Charlson Comorbidity Index, thoracic location of infection, pre-treatment Karnofsky score, and failure to achieve a 50% CRP reduction by day 4-5.

Conclusions

Patients who fail to reduce CRP values by 50% at day 4-5 following treatment initiation are more likely to experience prolonged hospital stay, have poorer functional outcome and have greater mortality risk at 2 years. This group has severe illness regardless of treatment type. Failure to achieve a biochemical response to treatment should prompt reassessment.
Experiences of Disabled Older Adults in Urban Area Adult Day Care Centers: A Multisite Case Study
Authors: Naruse Takashi , Hatsushi Masakazu , Tsuchiya-Ito Rumiko , Kobayashi Masayuki , Kato Junichi
Published: February 2023

This study described clients’ experiences within adult day care (ADC) and its related impacts. A multisite case study was conducted with 26 older adults from six ADCs in Tokyo, with interviews and field observations conducted between November 2020 and July 2022. The transcribed interviews and field notes were analyzed qualitatively. Three categories pertaining to context (“guilt and resignation to the current living conditions,” “desire for social connection despite frustrating limitations,” and “supported life based on weekly ADC routine”) and four categories about the experiences within ADC (“savoring disability- and age-friendly conversations,” “feeling happy about something new and positive,” “challenges for changes in self-image,” and “discomfort with others and the waste of time”) were extracted. Clients’ increased vulnerability due to disabilities and COVID-19 affected their experiences. ADCs provide a safe place for interaction, and their use must be encouraged to develop a disability- and age-friendly society.
The association between perihaematomal oedema and functional outcome after spontaneous intracerebral haemorrhage: A systematic review and meta-analysis
Authors: Cliteur Maaike P , Sondag Lotte , Cunningham Laura , Al-Shahi Salman Rustam , Samarasekera Neshika , Klijn Catharina JM , Schreuder Floris HBM
Published: February 2023

Purpose:

Perihaematomal oedema (PHO) formation has gained increasing interest as a therapeutic target after spontaneous intracerebral haemorrhage (ICH). Whether PHO contributes to poor outcome is unclear. We aimed to determine the association between PHO and outcome in patients with spontaneous ICH.

Method:

We searched five databases up to 17 November 2021 for studies of ⩾10 adults with ICH reporting the presence of PHO and outcome. We assessed risk of bias, extracted aggregate data and used random effects meta-analysis to pool studies that reported odds ratios (OR) with 95% confidence intervals (CI). Primary outcome was poor functional outcome defined as modified Rankin Scale score of 3–6 at 3 months. Additionally, we assessed PHO growth and poor outcome at any time of follow-up. We prospectively registered the protocol in PROSPERO (CRD42020157088).

Findings:

We identified 12,968 articles, of which we included 27 studies ( n = 9534). Eighteen studies reported an association between larger PHO volume and poor outcome, six a neutral result and three an inverse relationship. Larger absolute PHO volume was associated with poor functional outcome at 3 months (OR per mL increase of absolute PHO 1.03, 95% CI 1.00–1.06, I2 44%, four studies). Additionally, PHO growth was associated with poor outcome (OR 1.04, 95% CI 1.02–1.06, I2 0%, seven studies).

Discussion:

In patients with spontaneous ICH, larger PHO volume is associated with poor functional outcome at 3 months. These findings support the development and investigation of new therapeutic interventions targeting PHO formation to evaluate if reduction of PHO improves outcome after ICH.
Exudative Retinal Detachment and Ciliochoroidal Effusion in Preeclampsia
Authors: Munsell Mary K. , Carducci Nicholas M. , Eton Emily A.
Published: February 2023

Purpose: To describe a novel case of focal exudative retinal detachment, choroidal effusion, and acute angle closure in preeclampsia. Methods: A case report is presented. Results: A 37-year-old woman at 38 weeks gestation presented with 2 weeks of progressive blurred vision in the left eye. She had a visual acuity (VA) of 20/800 and an intraocular pressure (IOP) of 26 mm Hg in the left eye (compared with 17 mm Hg in the right eye). Examination showed subretinal fluid in the posterior pole, ciliochoroidal effusion, and angle closure in the left eye without pathology in the right eye. She was found to have hypertension and proteinuria consistent with preeclampsia. The visual symptoms resolved after delivery. At the 1-month follow-up, she had a VA of 20/60 OS, symmetric IOPs, and resolved subretinal and choroidal effusions. Conclusions: To our knowledge, this is the first reported case of ciliochoroidal effusion in the setting of preeclampsia. It may aid in the diagnosis of preeclampsia’s ocular manifestations and broaden pathophysiological understanding.
Management of Atypical Central Serous Chorioretinopathy Mimicking Vogt-Koyanagi-Harada Disease
Authors: Nguyen Nam V. , Khan Farid , Emig Mark , Yeh Steven
Published: February 2023

Purpose: To report a case of multifocal central serous chorioretinopathy (CSCR) mimicking Vogt-Koyanagi-Harada (VKH) disease. Methods: A 42-year-old man was evaluated for an exudative retinal detachment (RD) with a presumptive diagnosis of VKH while being treated with corticosteroids. The examination showed subretinal fibrin deposition with a bullous, exudative, macula-involved RD in the left eye and a progressive decline in visual acuity (VA) to hand motions. Multimodal imaging showed multifocal hyperfluorescent leaks bilaterally by angiography, highly suggestive of CSCR exacerbated by corticosteroids. Results: After the multifocal CSCR diagnosis, the systemic corticosteroids were tapered and eventually discontinued. The patient was then managed with focal laser photocoagulation, photodynamic therapy, and acetazolamide. The VA improved to 20/30 with complete resolution of the bullous RD at the 12-month follow-up. Conclusions: Extensive bullous RD with subretinal fibrin deposition is an infrequent manifestation of CSCR commonly associated with corticosteroid use that can mimic VKH. Thus, it is important to distinguish CSCR from VKH and the potential of combination therapy in managing chronic multifocal CSCR with a bullous RD.
Entrepreneurship Out of Shame: Entrepreneurial Pathways at the Intersection of Necessity, Emancipation, and Social Change
Authors: Bacq Sophie , Toubiana Madeline , Ruebottom Trish , Ormiston Jarrod , Ajunwa Ifeoma
Published: February 2023

Shame has been identified as a debilitating emotion that impedes entrepreneurial action. Yet, there are many examples of people who experience shame and go on to create entrepreneurial ventures. How then is entrepreneurship possible in the face of such shame? To address this question, we develop a theoretical process model that highlights the connection between individual and collective experiences of shame and elaborates when and how such experiences may lead to entrepreneurship. We suggest that third-person experiences of shame can transform first-person experiences and trigger identification with a community of similarly stigmatized others. We argue that the distinct narratives provided by these communities can reduce or enhance entrepreneurial self-efficacy, and therefore lead to different entrepreneurial pathways: some individuals may create ventures out of necessity, while others will create ventures that act as shame-free havens for themselves and others, and become a source of emancipation and social change. By outlining distinct entrepreneurial pathways out of shame, we extend current research at the intersection of entrepreneurship, necessity, emancipation, and social change.
Mortality among Canadian population with multimorbidity: A retrospective cohort study
Authors: Xiao Xiang , Beach Jeremy , Senthilselvan Ambikaipakan
Published: February 2023

Objective

The aim of this study was to examine the effect of multimorbidity and the joint effect of chronic diseases on all-cause mortality among subjects aged 35 years and above.

Study Design

Population-based retrospective cohort study.

Methods

Multimorbidity was defined by the respondent’s self-report of having two or more chronic diseases of the nine considered. The Canadian Community Health Surveys conducted in 2003/2004, 2005/2006 and 2007 to 2014 were linked with the Canadian Vital Statistics Death Database to examine the association between multimorbidity and all-cause mortality in subjects aged 35 years and above. Cox’s proportional hazards models were used to estimate risk of multimorbidity on death after adjusting for the confounders in three age groups.

Results

Multimorbidity had an increased risk of death in all three age groups with the youngest having the highest risk after adjusting for potential confounders (35 to 54 years: hazard ratio (HR) = 3.77, 95% CI: 3.04, 4.67; 55 to 64 years: HR = 2.64, 95% CI: 2.36, 2.95; 65 years and above: HR = 1.71; 95% CI:1.63,1.80). Subjects with cancer had the highest risk of death in the three age groups. When the interactions between chronic diseases were considered, subjects with COPD and diabetes had a significantly increased risk of death in comparison to those without COPD or diabetes in the 55 to 64 years. (HR = 2.59, 95% CI: 2.01, 3.34).

Conclusions

Prevention of multimorbidity should be targeted not only in the older population but also in the younger populations. Synergistic effects of chronic diseases should be considered in the management of multimorbidities.
Possibilities and human reasoning
Authors: Johnson-Laird PN
Published: February 2023

This article describes how human reasoning differs from standard logics. It tells the story of three sorts of inference, for example: the possibility of rain implies the possibility of no rain; a forecast of rain or snow implies the possibility of rain and the possibility of snow; and a forecast of frost does not imply a forecast of frost or snow or both. People accept these inferences, which each violate the semantics of standard logics. But, they are predictions from the theory that assertions refer to mental models of possibilities that each hold in default of knowledge to the contrary. The moral of the story is that inconsistencies in human reasoning, unlike those in standard logics, have only local consequences.
Cross-border ageing in China’s Greater Bay Area in the digital age: A comparative study of mobile application adoption by Hong Kong older migrants and local older adults in Shenzhen
Authors: Yang Chun , Ma Chun Yin , Wang Juan , Zhou Yuqiong
Published: February 2023

This study lies in the burgeoning literature on the contextual effects of the adoption of mobile applications (apps) on the everyday lives and integration of older migrants into a host society, taking the Guangdong-Hong Kong-Macao Greater Bay Area (GBA) in South China as a case. Despite recent advocacy of healthy ageing and regional integration, most GBA studies related to cross-border ageing have focused on welfare portability instead of the everyday life adaptation of older migrants through use of digital technologies. This article investigates and compares how mobile apps have facilitated/hindered the integration of Hong Kong older migrants in Shenzhen, through a comparative investigation of mobile app adoption between Hong Kong older migrants and local Shenzhen older adults. A mixed-method approach is adopted including focus group meetings with Hong Kong older migrants living in Shenzhen, and questionnaire surveys with Shenzhen local older adults between September 2021 and March 2022. The study sheds light on two major findings. First, facing the highly digitalized Shenzhen, Hong Kong older migrants have caught up more with using instrumental apps (e.g. mobile payment), as compared with recreational, informational, and open (one-to-many) communication apps. Second, Hong Kong older migrants have emphasized the use of apps for cross-border interactions. The digital gaps in terms of different using patterns of mobile apps highlight Hong Kong older migrants’ lack of socio-cultural integration and feeling of separation from the host society. This study advocates for more active involvement of older migrants’ specific needs in designing mobile apps. Multi-scalar cooperation among various localities in the GBA region is deemed important for older migrants to further integrate into the host society with the widespread use of digital technologies in everyday life.
The study on interacting factors and functions of GASA6 in Jatropha curcas L.
Authors: Li Xue , Zhang Ming-sheng , Zhao Liang-qing , Ling-hu Qian-qian , Xu Gang
Published: February 2023

Background

The gibberellic acid-stimulated Arabidopsis (GASA) gene encodes a class of cysteine-rich functional proteins and is ubiquitous in plants. Most GASA proteins are influence the signal transmission of plant hormones and regulate plant growth and development, however, their function in Jatropha curcas is still unknown.

Results

In this study, we cloned JcGASA6, a member of the GASA family, from J. curcas. The JcGASA6 protein has a GASA-conserved domain and is located in the tonoplast. The three-dimensional structure of the JcGASA6 protein is highly consistent with the antibacterial protein Snakin-1. Additionally, the results of the yeast one-hybrid (Y1H) assay showed that JcGASA6 was activated by JcERF1, JcPYL9, and JcFLX. The results of the Y2H assay showed that both JcCNR8 and JcSIZ1 could interact with JcGASA6 in the nucleus. The expression of JcGASA6 increased continuously during male flower development, and the overexpression of JcGASA6 was associated with filament elongation of the stamens in tobacco.

Conclusion

JcGASA6, a member of the GASA family in J. curcas, play an important role in growth regulation and floral development (especially in male flower). It is also involved in the signal transduction of hormones, such as ABA, ET, GA, BR, and SA. Also, JcGASA6 is a potential antimicrobial protein determined by its three-dimensional structure.
Evaluation of a novel technology-supported fall prevention intervention – study protocol of a multi-centre randomised controlled trial in older adults at increased risk of falls
Authors: Morat Tobias , Snyders Melina , Kroeber Philipp , De Luca Alice , Squeri Valentina , Hochheim Martin , Ramm Philipp , Breitkopf Annika , Hollmann Michael , Zijlstra Wiebren
Published: February 2023

Background

Increasing number of falls and fall-related injuries in an aging society give rise to the need for effective fall prevention and rehabilitation strategies. Besides traditional exercise approaches, new technologies show promising options for fall prevention in older adults. As a new technology-based approach, the hunova robot can support fall prevention in older adults.

The objective of this study is to implement and evaluate a novel technology-supported fall prevention intervention using the hunova robot compared to an inactive control group. The presented protocol aims at introducing a two-armed, multi-centre (four sites) randomised controlled trial, evaluating the effects of this new approach on the number of falls and number of fallers as primary outcomes.

Methods

The full clinical trial incorporates community-dwelling older adults at risk of falls with a minimum age of 65 years. Including a one-year follow-up measurement, all participants are tested four times. The training programme for the intervention group comprises 24-32 weeks in which training sessions are scheduled mostly twice a week; the first 24 training sessions use the hunova robot, these are followed by a home-based programme of 24 training sessions. Fall-related risk factors as secondary endpoints are measured using the hunova robot. For this purpose, the hunova robot measures the participants’ performance in several dimensions. The test outcomes are input for the calculation of an overall score which indicates the fall risk. The hunova-based measurements are accompanied by the timed-up-and-go test as a standard test within fall prevention studies.

Discussion

This study is expected to lead to new insights which may help establish a new approach to fall prevention training for older adults at risk of falls. First positive results on risk factors can be expected after the first 24 training sessions using the hunova robot. As primary outcomes, the number of falls and fallers within the study (including the one-year follow-up period) are the most relevant parameters that should be positively influenced by our new approach to fall prevention. After the study completion, approaches to examine the cost-effectiveness and develop an implementation plan are relevant aspects for further steps.

Trial registration

German Clinical Trial Register (DRKS), ID: DRKS00025897. Prospectively registered 16 August 2021, https://drks.de/search/de/trial/DRKS00025897.
Protocol for a randomised, placebo-controlled, double-blinded clinical trial on the effect of oestrogen replacement on physical performance to muscle resistance exercise for older women with osteoarthritis of knee joint: the EPOK trial
Authors: Mitoma Tomohiro , Maki Jota , Ooba Hikaru , Eto Eriko , Takahashi Kasumi , Kondo Tsunemasa , Ikeda Tomohiro , Sakamoto Yoko , Mitsuhashi Toshiharu , Masuyama Hisashi
Published: February 2023

Background

Knee osteoarthritis (KOA) is highly prevalent in older women, and previous studies suggest the involvement of hormonal factors play a role in the pathogenesis of osteoarthritis. KOA causes musculoskeletal impairment, resulting in decreased physical activity, muscle mass, and strength, which leads to sarcopenia and further increases the burden on healthcare systems. Oestrogen replacement therapy (ERT) improves joint pain and muscle performance in early menopausal women. Muscle resistance exercise (MRE) is a non-pharmacological method that preserves the physical functions of patients with KOA. However, data on short-term oestrogen administration combined with MRE in postmenopausal women, especially in those aged > 65 years, are limited. Therefore, this study presents a protocol of a trial aimed to examine the synergistic effect of ERT and MRE on lower-limb physical performance in older women with KOA.

Methods

We will conduct a double-blinded, randomised placebo-controlled trial in 80 Japanese women aged > 65 years living independently with knee pain. The participants will be randomly categorised into two groups: (1) 12-week MRE programme with transdermal oestrogen gel containing 0.54 mg oestradiol per push and (2) 12-week MRE programme with placebo gel. The primary outcome measured using the 30-s chair stand test, and secondary outcomes (body composition, lower-limb muscle strength, physical performance, self-reported measure of knee pain, and quality of life) will be measured at baseline, 3 months, and 12 months, and these outcomes will be analysed based on the intention-to-treat.

Discussion

The EPOK trial is the first study to focus on the efficacy of ERT on MRE among women aged > 65 years with KOA. This trial will provide an effective MRE to prevent KOA-induced lower-limb muscle weakness, confirming the benefit of short-term oestrogen administration.

Trial registration

Japan Registry of Clinical Trials: jRCTs061210062. Registered 17th December 2021,
https://jrct.niph.go.jp/en-latest-detail/jRCTs061210062.
Burden of chronic kidney diseases and underlying causes in Zambia: evidence from the global burden of disease study 2019
Authors: Bosomprah Samuel , Bjonstad Erica C. , Musuku John , Siyumbwa Namasiku , Ngandu Mwila , Chisunka Mukobe , Banda Patrick , Goma Fastone , Mweemba Aggrey
Published: February 2023

Introduction

Chronic kidney disease (CKD) has been a global public health problem and a major source of suffering and poor quality of life for those afflicted. Using data from the global burden of disease (GBD) study 2019, we estimated the magnitude of the burden of CKD as well as the underlying causes of CKD in the Zambian population.

Method

The data used for this study were extracted from the GBD 2019 study. The GBD 2019 provides estimates of several metrics of disease burden including the commonly used disability-adjusted life year (DALYs) for over 369 diseases and injuries, and 87 risk factors and combinations of these in 204 countries and territories from 1990 to 2019. We estimated the burden of CKD as the number and rates (per 100,000 population) of DALYs, disaggregated by year, sex, and age group. We examined the underlying causes of CKD by estimating the population attributable fraction as the percentage contributions of risk factors to CKD DALY.

Results

The number of DALYs for CKD was estimated as 76.03 million (95% UI: 61.01 to 93.36) in 2019 compared to 39.42 million (95% UI: 33.09 to 45.90) in 1990, representing 93% increase whereas the DALYs rate per 100,000 population was estimated as 416.89 (95% UI: 334.53 to 511.93) in 2019 compared to 496.38 (95% UI: 416.55 to 577.87) in 1990, representing 16% reduction. CKD due to hypertension accounted for 18.7% of CKD DALYs and CKD due to diabetes (types 1 and 2) accounted for 22.7%, while CKD from glomerulonephritis accounted for the most DALYs at 33%. The age group most impacted from CKD were adolescents and young adults.

Conclusion

The burden of CKD remains high in the Zambian population with diabetes, high blood pressure, and glomerulonephritis as important causes. The results highlight the need to develop a comprehensive action plan to prevent and treat kidney disease. Increasing the awareness of CKD among the public as well as adaptation of guidelines for treating patients with end stage kidney disease are important considerations.
COVID – 19 in two dialysis centers situated in two neighbouring states of the Western Balkans
Authors: Mesic Enisa , Aleckovic-Halilovic Mirna , Paunovic Karolina , Woywodt Alexander , Pjanic Mirha , Paunovic Goran
Published: February 2023

Background

Bosnia and Herzegovina (BiH) and Serbia are countries in the Western Balkans that share parts of their social and political legacy from the former Yugoslavia, such as their health care system and the fact that they are not members of European Union. There are very scarce data on COVID – 19 pandemic from this region when compared to other parts of the world and even less is known about its impact on the provision of renal care or differences between countries in the Western Balkans.

Materials and methods

This observational prospective study was conducted in two regional renal centres in BiH and Serbia, during the COVID – 19 pandemic. We obtained demographic and epidemiological data, clinical course and outcomes of dialysis and transplant patients with COVID – 19 in both units. Data were collected a via questionnaire for two consecutive time periods: February – June 2020 with a total number of 767 dialysis and transplant patients in the two centres, and July – December 2020 with a total number of 749 studied patients, corresponding to two of the largest waves of the pandemic in our region. Departmental policies and infection control measures in both units were also recorded and compared.

Results

For a period of 11 months, from February to December 2020, 82 patients on in-centre haemodialysis (ICHD), 11 peritoneal dialysis patients and 25 transplant patients who tested positive for COVID-19. In the first study period, the incidence of COVID – 19 positive in Tuzla was 1.3% among ICHD patients, and there were no positive peritoneal dialysis patients, or any transplant patients who tested positive. The incidence of COVID-19 was significantly higher in both centres in the second time period, which corresponds to the incidence in general population. Total deaths of COVID-19 positive patients was 0% in Tuzla and 45.5% in Niš during first, and 16.7% in Tuzla and 23.4% in Niš during the second period. There were notable differences in the national and local/departmental approach to the pandemic between the two centres.

Conclusion

There was poor survival overall when compared to other regions of Europe. We suggest that this reflects the lack of preparedness of both of our medical systems for such situations. In addition, we describe important differences in outcome between the two centres. We emphasize the importance of preventative measures and infection control and highlight the importance of preparedness.
Antisecretory factor is safe to use as add-on treatment in newly diagnosed glioblastoma
Authors: Ehinger Erik , Kopecky Jan , Darabi Anna , Visse Edward , Edvardsson Charlotte , Tomasevic Gregor , Cederberg David , Belting Mattias , Bengzon Johan , Siesjö Peter
Published: February 2023

Purpose

Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. Despite the best available treatment, prognosis remains poor. Current standard therapy consists of surgical removal of the tumor followed by radiotherapy and chemotherapy with the alkylating agent temozolomide (TMZ). Experimental studies suggest that antisecretory factor (AF), an endogenous protein with proposed antisecretory and anti-inflammatory properties, may potentiate the effect of TMZ and alleviate cerebral edema. Salovum is an egg yolk powder enriched for AF and is classified as a medical food in the European Union. In this pilot study, we evaluate the safety and feasibility of add-on Salovum in GBM patients.

Methods

Eight patients with newly diagnosed, histologically confirmed GBM were prescribed Salovum during concomitant radiochemotherapy. Safety was determined by the number of treatment-related adverse events. Feasibility was determined by the number of patients who completed the full prescribed Salovum treatment.

Results

No serious treatment-related adverse events were observed. Out of 8 included patients, 2 did not complete the full treatment. Only one of the dropouts was due to issues directly related to Salovum, which were nausea and loss of appetite. Median survival was 23 months.

Conclusions

We conclude that Salovum is safe to use as an add-on treatment for GBM. In terms of feasibility, adherence to the treatment regimen requires a determined and independent patient as the large doses prescribed may cause nausea and loss of appetite.

Trial registration

ClinicalTrials.gov NCT04116138. Registered on 04/10/2019.
Spinal muscular atrophy with hypoplasia of the corpus callosum: a case report
Authors: Zhu Xiaomei , Li Hui , Hu Chaoping , Wu Min , Zhou Shuizhen , Wang Yi , Li Wenhui
Published: February 2023

Background

Spinal Muscular Atrophy (SMA) is a severe neuromuscular disorder due to a defect in the survival motor neuron 1 (SMN1) gene. Hypoplasia of the corpus callosum is underdevelopment or thinness of the corpus callosum. SMA and callosal hypoplasia are relatively rare, and there is limited information sharing the diagnosis and treatment for SMA patients with callosal hypoplasia.

Case description

A boy with callosal hypoplasia, small penis, and small testes had been perceived with motor regression at 5 months. He was referred to the rehabilitation department and neurology department at 7 months. Physical examination showed absent deep tendon reflexes, proximal weakness and significant hypotonia. He was recommended to perform trio whole-exome sequencing (WES) and array comparative genomic hybridization (aCGH) for his complicated conditions. The subsequent nerve conduction study revealed some characteristics of motor neuron diseases. We identified a homozygous deletion in exon 7 of the SMN1 gene by multiplex ligation-dependent probe amplification and failed to find further pathogenic variations responsible for multiple malformations by trio WES and aCGH. He was diagnosed as SMA. Despite some concerns, he received the therapy of nusinersen for nearly 2 years. He gained the milestone of sitting without support, which he had never accomplished, after the seventh injection, and he continued to improve. During follow-up, there were no adverse events reported and no signs of hydrocephalus.

Conclusions

Some extra features which could not belong to neuromuscular manifestation made the diagnosis and treatment of SMA more complicated.
Total serum N-glycans associate with response to immune checkpoint inhibition therapy and survival in patients with advanced melanoma
Authors: Visconti Alessia , Rossi Niccolò , Deriš Helena , Lee Karla A , Hanić Maja , Trbojević-Akmačić Irena , Thomas Andrew M. , Bolte Laura A. , Björk Johannes R. , Hooiveld-Noeken Jahlisa S. , Board Ruth , Harland Mark , Newton-Bishop Julia , Harries Mark , Sacco Joseph J. , Lorigan Paul , Shaw Heather M. , de Vries Elisabeth G.E. , Fehrmann Rudolf S.N. , Weersma Rinse K. , Spector Tim D. , Nathan Paul , Hospers Geke A. P. , Sasieni Peter , Bataille Veronique , Lauc Gordan , Falchi Mario
Published: February 2023

Background

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of melanoma and other cancers. However, no reliable biomarker of survival or response has entered the clinic to identify those patients with melanoma who are most likely to benefit from ICIs. Glycosylation affects proteins and lipids’ structure and functions. Tumours are characterized by aberrant glycosylation which may contribute to their progression and hinder an effective antitumour immune response.

Methods

We aim at identifying novel glyco-markers of response and survival by leveraging the N-glycome of total serum proteins collected in 88 ICI-naive patients with advanced melanoma from two European countries. Samples were collected before and during ICI treatment.

Results

We observe that responders to ICIs present with a pre-treatment N-glycome profile significantly shifted towards higher abundancy of low-branched structures containing lower abundances of antennary fucose, and that this profile is positively associated with survival and a better predictor of response than clinical variables alone.

Conclusion

While changes in serum protein glycosylation have been previously implicated in a pro-metastatic melanoma behaviour, we show here that they are also associated with response to ICI, opening new avenues for the stratification of patients and the design of adjunct therapies aiming at improving immune response.
The relationship between hematological indices as indicators of inflammation and 25-hydroxyvitamin D3 status in newborns
Authors: Elgormus Yusuf , Okuyan Omer , Uzun Hafize
Published: February 2023

Background

There is still much unknown about the relationship between hematological parameters and vitamin D status in newborns. The aim of the study is to evaluate the relationship between 25(OH)D3 (vitamin D) status and new defined systemic inflammatory markers neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and platelet to lymphocyte ratio (PLR) in newborns.

Methods

One hundred newborns were enrolled in the study. Serum vitamin D status, below < 12 ng/mL (< 30 nmol/L) as deficient, 12–20 ng/mL (30–50 nmol/L) as insufficient, and > 20 ng/mL (> 50 nmol/L) was considered as sufficient.

Results

Parallel to maternal and newborn vitamin D status were also statistically different between the groups (p < 0.05). Moreover, there was a statistically significant difference was found between the deficient, sufficient and insufficient groups in terms of newborn hemoglobin, neutrophil, monocytes, NLR, PLT, PLR and neutrophil to monocyte ratio (NMR) (p < 0.05, in all). There was also a positive correlation between maternal and newborn vitamin D status (r = 0.975,p = 0.000). The newborn NLR were negative correlated with newborn vitamin D status (r = -0.616,p = 0.000).

Conclusions

The results of this study suggest that there may be potential new biomarkers to predict inflammation associated with the inflammatory state that may arise due to changes in NLR, LMR, and PLR in vitamin D deficiency in newborns. NLR and other hematologic indices may be non-invasive, simple, easily measurable, cost-effective markers of inflammation in newborns.
Perceptions, facilitators and barriers of physical activity among people living with HIV: a qualitative study
Authors: Kitilya Brenda , Sanga Erica , PrayGod George , Kavishe Bazil Baltazar , Ditlevsen Kia , Peck Robert , Olsen Mette Frahm
Published: February 2023

Background

People living with HIV (PLWH) have low levels of physical activity. Using the social ecological model to understand perceptions, facilitators and barriers of physical activity in this population is of importance for developing contextualised interventions to improve physical activity in PLWH.

Method

This was a qualitative sub-study conducted between august and November 2019 as part of a cohort study on diabetes and associated complications in HIV infected in Mwanza, Tanzania. Sixteen in-depth interviews and three focus groups with nine participants in each were conducted. The interviews and focus groups were audio recorded, transcribed and translated into English. The social ecological model was considered during the coding and interpretation of the results. Transcripts were discussed, coded and analyzed using deductive content analysis.

Results

Forty-three PLWH aged 23–61 years participated in this study. The findings showed that most PLWH perceived physical activity as beneficial to their health. However, their perceptions of physical activity were rooted within existing gender stereotypes and roles in the community. Running and playing football were perceived as activities for men while household chores activities were for women. Further, men were perceived to do more physical activity than women. For women, household chores and income-generating activities were perceived as sufficient physical activity. Social support and engagement of family members and friends in physical activity were reported as facilitators of physical activity. Reported barriers of physical activity were lack of time, money, availability of physical activity facilities and social support groups, and poor information on physical activity from health care providers in HIV clinics. Human-immunodeficiency virus (HIV) HIV infection was not perceived by PLWH as a barrier for doing physical activity but most family members did not support them to do physical activity, fearing that it might worsen their condition.

Conclusion

The findings demonstrated differing perceptions, facilitators and barriers of physical activity among PLWH. Interventions addressing awareness, gender stereotypes and roles related to physical activity from individual to community level are needed. Supportive environment and infrastructures are needed to improve physical activity levels in PLWH in Tanzania.