bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation of a Community-Based Psychosocial Support Focal Point Response for Internally Displaced Persons in Myanmar During COVID-19
Authors: Lee Catherine , Schojan Matthew , Myo Ko , Doe Gyaw Htet , San Lanau Htu , Bass Judith
Published: March 2022

Background

In response to the COVID-19 pandemic, the Global Mental Health research group at Johns Hopkins School of Public Health worked with three local partner organizations in Myanmar to develop a psychosocial support (PSS) program that could be delivered by community-based focal points in internally displaced persons camps. This PSS program was designed to be delivered in communities with limited access to regional mental health services due to pandemic travel restrictions. The content of the PSS program was based on materials from an ongoing Common Elements Treatment Approach (CETA) mental health program; CETA counselors based in the three partner organizations were available to provide telephone-based CETA counseling. In April 2020, the partners organizations recruited and trained PSS focal points in 25 IDP camps to establish a multi-tiered system of MHPSS supports.

Implementation

The PSS program including psychoeducation handouts focused on stress and coping during COVID-19 and skills for cognitive restructuring (i.e., changing unhelpful thoughts) in simplified terms, audio recordings of the content of these handouts and referral opportunities for telephone-based services by CETA counselors located outside of the camps. PSS focal points distributed the handouts, had the recordings played via radio and loudspeaker, and were available to answer questions and provide access to a PSS program phones to connect with the CETA counselors. After 6 months of implementation, program monitoring logs were reviewed and a cross-sectional evaluation was conducted to assess the PSS program's reach, understanding, and perceived utility.

Evaluation

Forty-one focal points implemented the PSS program in 25 IDP camps in Kachin and northern Shan States. From May to September 2020, the focal points distributed handouts to 5,725 households and reported 679 visits by IDPs, including facilitating 332 calls to a CETA counselor. Data from the program evaluation (n = 793 participants) found high levels of handout readership and perceived utility of the information, and good comprehension of the content and application of skills.

Discussion

Findings suggest that provision of a multi-tiered MHPSS program, with PSS focal points providing direct information and linkages to further mental health services via telephone, was feasible despite the constraints of the pandemic. Utilizing camp-based focal points was acceptable and successful in delivering basic psychosocial supports to a broad population while serving as points of contact for individuals who wanted and needed telephone-based counseling services.
COVID-19 Testing Unit Munich: Impact of Public Health and Safety Measures on Patient Characteristics and Test Results, January to September 2020
Authors: Hohl Hannah Tuulikki , Heumann Christian , Rothe Camilla , Hoelscher Michael , Janke Christian , Froeschl Guenter
Published: March 2022

To assess the course of the COVID-19 pandemic and the impact of non-pharmaceutical interventions, the number of reported positive test results is frequently used as an estimate of the true number of population-wide infections. We conducted a retrospective observational analysis of patient data of the Corona Testing Unit (CTU) in Munich, Bavaria, Germany between January 27th, and September 30th, 2020. We analyzed the course of daily patient numbers over time by fitting a negative binomial model with multiple breakpoints. Additionally, we investigated possible influencing factors on patient numbers and characteristics by literature review of policy papers and key informant interviews with individuals involved in the set-up of the CTU. The 3,963 patients included were mostly young (median age: 34, interquartile range: 27–48), female (66.2%), and working in the healthcare sector (77%). For these, 5,314 real-time RT-PCR tests were conducted with 157 (2.94%) positive results. The overall curve of daily tests and positive results fits the re-ported state-wide incidence in large parts but shows multiple breakpoints with considerable trend changes. These can be most fittingly attributed to testing capacities and -strategies and individual risk behavior, rather than public health measures. With the large impact on patient numbers and pre-test probabilities of various strategic and operational factors, we consider the derived re-ported incidence as a poor measurement to base policy decisions on. Testing units should be prepared to encounter these fluctuations with a quickly adaptable structure.
Patient Satisfaction of Telemedicine in Pediatric and Young Adult Type 1 Diabetes Patients During Covid-19 Pandemic
Authors: Bassi Marta , Strati Marina Francesca , Parodi Stefano , Lightwood Simone , Rebora Clara , Rizza Francesca , d'Annunzio Giuseppe , Minuto Nicola , Maghnie Mohamad
Published: March 2022

The aim of this study was to evaluate the satisfaction of the use of telemedicine and telenursing in children and young adults with Type 1 Diabetes and their families followed in the Regional Pediatric Diabetes Center of Giannina Gaslini Institute (Liguria, Italy). An anonymous survey form was administered to 290 patients (138 filled out by caregivers and 152 by patients). The questionnaire consisted of two parts: the first one included a series of questions related to the patient's personal and medical data; the second one was directed toward the satisfaction in the use of telemedicine and telenursing during Covid-19 pandemic. The data collected showed that 92.4% of the population was overall very satisfied with the quality of the service provided. Satisfaction was much higher especially in those who live outside of the province of Genoa (p = 0.017) and in those on insulin pump treatment (p = 0.037). Telemedicine and telenursing have an essential role in diabetology and are highly appreciated in our Center, where most patients prefer to continue regular follow-up via video-call as well as in person. Telenursing was also proved to be an effective and appreciated tool for educating and supporting patients using insulin pumps and glucose sensors.
Reducing Sodium Consumption in Mexico: A Strategy to Decrease the Morbidity and Mortality of Cardiovascular Diseases
Authors: Campos-Nonato Ismael , Vargas Meza Jorge , Nieto Claudia , Ariza Ana Carolina , Barquera Simón
Published: March 2022

Hypertension (HTN) and cardiovascular diseases (CVD) are important public health problems in Mexico. High sodium intake is linked to high blood pressure and increased risk of developing CVD. International organizations suggest consuming <2 g of sodium/day; however, the Mexican population consumes amounts above what is recommended: 3.1 g/day. Although efforts have been made to mitigate this problem, interventions are needed to improve cardiovascular health. This policy brief offers a short review of the current sodium consumption situation in Mexico and the importance of why decision makers should consider actions to reduce consumption. Recommendations to reduce sodium/salt intake include: Reformulation of ultra-processed-foods, promote the use warning labels, communication campaign, reduce the use of table salt, and monitor sodium intake.
The Relevance of a Diagnostic and Counseling Service for People Living With HTLV-1/2 in a Metropolis of the Brazilian Amazon
Authors: Lopes Felipe Teixeira , de Sousa Renata Santos , Carvalho Gomes Jayanne L. , Vallinoto Mariana Cayres , de Lima Aline Cecy Rocha , Lima Sandra Souza , Freitas Felipe Bonfim , Feitosa Rosimar N. Martins , Rangel da Silva Andrea Nazaré M. , Machado Luiz Fernando A. , Aben-Athar Cintia Y. P. , Maia da Silva Eduardo Leitão , Cayres Vallinoto Izaura M. V. , Vallinoto Antonio Carlos R.
Published: March 2022

Introduction

To identify the prevalence of infection in the urban area of the capital city of Belém, Brazil, the Laboratory of Virology of the Federal University of Pará implemented, as a public service, serological screening for human T-lymphotropic viruses 1 and 2 (HTLV-1/2) infection and, if necessary, counseling service and referral to specialized medical care. The project is funded by the National Council of Science and Technology, the Ministry of Health of Brazil and the Pan American Health Organization.

Methods

From January 2020 to June 2021, 1,572 individuals of both sexes were approached to answer a questionnaire and were tested using an enzyme immunoassay (Murex HTLV-I+II, DiaSorin, Dartford, UK). Seropositive samples were confirmed as HTLV-1 and HTLV-2 infection by line immunoassay (INNO-LIA® HTLV I/II Score, Fujirebio, Japan) and/or by real-time polymerase chain reaction. G and Fisher's exact tests were applied to identify the association between epidemiological characteristics and HTLV-1/2 infection.

Results

Of the 1,572 screened individuals, 63.74% were females between the ages of 30 and 59 years (49.04%). Infection was confirmed in six individuals (0.38%), among whom three (0.19%) were infected with HTLV-1 and three with HTLV-2 (0.19%). Blood transfusion before 1993 was the main risk factor associated with the route of exposure to the virus (p = 0.0442). The infected individuals were referred to a counseling session with a nursing professional, and two patients who manifested signs and symptoms suggestive of myelopathy associated with HTLV were referred to a neurologist.

Conclusion

The implementation of the screening service revealed the occurrence of moderate endemicity of HTLV-1/2 in Belém, reinforcing the importance of continuing the service as a means of establishing an early diagnosis and providing counseling as a measure to prevent and control viral transmission in the general population.
European Union Structural Funds as the Source of Financing Health Care Infrastructure Investments in Poland—A Longitudinal Analysis
Authors: Dubas-Jakóbczyk Katarzyna , Kozieł Anna
Published: March 2022

European Union (EU) structural funds aim at reducing economic and social disparities between the member states regions. The objectives of the study were to (1) provide a summary overview of all health related projects co-financed by EU structural funds in Poland between 2004 and 2020, (2) define the share of projects/funds devoted to infrastructure investments, and (3) assess the total value of EU structural funds' contribution to health care infrastructure investments in comparison to the national public budgets. Data on projects co-financed by EU structural funds covered all projects realized under three financial perspectives: 2004–2006; 2007–2013; 2014–2020. The extraction of “health-related” projects was done according to both the type priority under which the project was realized as well as the type of beneficiary. Results showed that between 2004 and 2020, 14,179 health related projects were implemented, with a total value of 33.2 billion PLN, including EU contribution of 22.8 billion PLN (68.7%). Although projects focused on education and public health prevailed in terms of their total number, infrastructural projects consumed the vast majority of funds. Within the analyzed period, a total of 6,689 health infrastructure projects were implemented with a total value of 29.5 billion PLN, including 19.7 billion PLN of EU contributions. The results confirm that the EU structural funds constituted an important source of infrastructural investments in the Polish health system and majority of them were consumed by investments in public hospitals.
SARS-CoV-2 Omicron Variant: Exploring Healthcare Workers' Awareness and Perception of Vaccine Effectiveness: A National Survey During the First Week of WHO Variant Alert
Authors: Temsah Mohamad-Hani , Aljamaan Fadi , Alenezi Shuliweeh , Alhasan Khalid , Alrabiaah Abdulkarim , Assiri Rasha , Bassrawi Rolan , Alhaboob Ali , Alshahrani Fatimah , Alarabi Mohammed , Alaraj Ali , Alharbi Nasser S. , Halwani Rabih , Jamal Amr , Al-Eyadhy Ayman , AbdulMajeed Naif , Alfarra Lina , Almashdali Wafa , Fayed Amel , Alzamil Fahad , Barry Mazin , Memish Ziad A. , Al-Tawfiq Jaffar A. , Alsubaie Sarah
Published: March 2022

Background

As the SARS-CoV-2 Omicron variant spreads in several countries, healthcare workers' (HCWs) perceptions and worries regarding vaccine effectiveness and boosters warrant reassessment.

Methods

An online questionnaire among HCWs in Saudi Arabia (KSA) was distributed from Dec 1st−6th 2021 to assess their perceptions, vaccine advocacy to the Omicron variant, and their perception of the effectiveness of infection prevention measures and vaccination to prevent its spread, their Omicron variant related worries in comparison to the other variants, and their agreement with mandatory vaccination in general for adults.

Results

Among the 1,285 HCW participants, two-thirds were female, 49.8 % were nurses, 46.4% were physicians, and 50.0% worked in tertiary care hospitals. 66.9% considered vaccination to be the most effective way to prevent the spread of the Omicron variant and future variants. The respondents however perceived social distancing (78.0%), universal masking (77.8%), and avoiding unnecessary travel (71.4%) as slightly superior to vaccination to prevent the spread of SARS-CoV-2 variants. HCWs aging 55 or older agreed significantly with vaccine ineffectiveness to control Omicron spread, while those who believed in non-pharmacological infection prevention measures agreed significantly with vaccination for that purpose. Male HCWs had a significant agreement with mandatory vaccination of all eligible adult populations. On the other hand, unwilling HCWs to receive the vaccine had strong disagreements with mandatory vaccination.

Conclusions

The current study in the first week of Omicron showed that only two-thirds of HCWs felt that vaccination was the best option to prevent the spread of the Omicron variant, indicating the need for further motivation campaigns for vaccination and booster dose. HCWs had a strong belief in infection prevention measures to contain the spread of SARS-CoV-2 variants that should be encouraged and augmented.
Roles of Hormone Replacement Therapy and Menopause on Osteoarthritis and Cardiovascular Disease Outcomes: A Narrative Review
Authors: Mei Yixue , Williams Jennifer S. , Webb Erin K. , Shea Alison K. , MacDonald Maureen J. , Al-Khazraji Baraa K.
Published: March 2022

Osteoarthritis (OA) is a highly prevalent condition characterized by degradation of the joints. OA and cardiovascular disease (CVD) are leading contributors to disease burden worldwide, with a high level of overlap between the risk factors and occurrence of both conditions. Chief among the risk factors that contribute to OA and CVD are sex and age, which are both independent and interacting traits. Specifically, the prevalence of both conditions is higher in older women, which may be mediated by the occurrence of menopause. Menopause represents a significant transition in a women's life, and the rapid decline in circulating sex hormones, estrogen and progesterone, leads to complex physiological changes. Declines in hormone levels may partially explain the increase in prevalence of OA and CVD in post-menopausal women. In theory, the use of hormone therapy (HT) may buffer adverse effects of menopause; however, it is unclear whether HT offers protective effects for the onset or progression of these diseases. Studies have shown mixed results when describing the influence of HT on disease risk among post-menopausal women, which warrants further exploration. The roles that increasing age, female sex, HT, and CVD play in OA risk demonstrate that OA is a multifaceted condition. This review provides a timely consolidation of current literature and suggests aims for future research directions to bridge gaps in the understanding of how OA, CVD, and HT interact in post-menopausal women.
Work-Life Conflict Among Higher Education Institution Workers' During COVID-19: A Demands-Resources Approach
Authors: Garraio Carolina , Freitas Jorge Peixoto , Magalhães Sara Isabel , Matias Marisa
Published: March 2022

Higher Education Institutions' (HEI) workers were highly impacted by the COVID-19 pandemic, which magnified gender differences in terms of management of work and personal life. Most studies published so far have primarily focused on a group of HEI workers' (i.e., teachers and researchers), but not on staff members, despite their crucial role for HEI functioning. Following the Job Demands-Resources theory, we aimed to: (i) characterize work-life conflict (WLC) among men and women workers from an HEI (staff and teachers/researchers) during the COVID-19 pandemic; and (ii) explore the major predictors of WLC for both staff and teachers/researchers. This study includes a sample of 262 workers from one Portuguese HEI (n = 128 staff members; n = 134 teachers/researchers) who answered an online survey. An Independent Samples T-Test showed that the reported current WLC was significantly higher for teachers/researchers compared to staff. Moreover, women teachers/researchers showed higher WLC than men. Additionally, using a Repeated Measures ANOVA, we found that the increase in the reported levels of WLC (before the pandemic and currently) was significantly more prominent among teachers/researchers than in the staff group. Regarding the predictors of WLC for both groups separately, a Multiple Hierarchical Linear Regression showed that role overload, conceptualized as a demand, was a predictor for both staff and teachers/researchers. As for potential resources, work dedication negatively predicted WLC for staff, whereas family-friendly organization perceptions predicted less WLC for teachers/researchers. These results highlight the importance of understanding HEIs holistically, by considering workers' individual characteristics such as gender, but also distinct careers inside the institutions. As most European HEIs are currently making active efforts to promote gender-equal academic workplaces, these findings may help them design tailored and effective measures to address employees' work-life balance issues, not only considering gender, but also the different types of demands associated with each group of workers within HEIs.
Identification and Gene Mapping of the Lesion Mimic Mutant lm8015-3
Authors: Wang Chen , Wang Beifang , Cao Liyong , Zhang Yingxin , Gao Yu , Cao Yongrun , Zhang Yue , Liu Qunen , Zhang Xiaohui
Published: March 2022

Lesion mimic mutants (LMMs) exhibit spots on leaves without fungal infection pressure. The spots confer variable resistance to pathogens in different LMM, making them useful research materials. It is unclear how the rice immune system responds to infection with the fungal pathogen Magnaporthe oryzae (M. oryzae). Here, we identified a rice LMM, lm8015-3, which shows reduced resistance to M. oryzae. We used Quantitative Real-Time PCR (qRT-PCR) to observe the immune system response to M. oryzae–induced lm8015-3. Lm8015-3, obtained from an ethyl methane sulfonate (EMS)–induced Zhonghui8015 (ZH8015) library, showed orange-yellow spots starting in the seedling stage and accumulated more H2O2, resulting in severe degradation of the chloroplast. With map-based cloning, the target gene was located on chromosome 12. Once inoculated with M. oryzae, the expression level of pathogen-related genes of lm8015-3 was downregulated between 48 and 72 h. In addition, more germinating spores appeared in lm8015-3. Therefore, we conclude that M. oryzae weakening the immune system of lm8015-3 from 48 to 72 h makes lm8015-3 more susceptible to M. oryzae. These results suggested that understanding how LMMs defend against M. oryzae infection will contribute to improving rice breeding.
Factors Influencing Soil Nitrification Process and the Effect on Environment and Health
Authors: Ayiti Oluwatobi Esther , Babalola Olubukola Oluranti
Published: March 2022

To meet the global demand for food, several factors have been deployed by agriculturists to supply plants with nitrogen. These factors have been observed to influence the soil nitrification process. Understanding the aftermath effect on the environment and health would provoke efficient management. We review literature on these factors, their aftermath effect on the environment and suggest strategies for better management. Synthetic fertilizers and chemical nitrification inhibitors are the most emphasized factors that influence the nitrification process. The process ceases when pH is <5.0. The range of temperature suitable for the proliferation of ammonia oxidizing archaea is within 30 to 37oC while that of ammonia oxidizing bacteria is within 16 to 23oC. Some of the influencing factors excessively speed up the rate of the nitrification process. This leads to excess production of nitrate, accumulation of nitrite as a result of decoupling between nitritation process and nitratation process. The inhibition mechanism of chemical nitrification inhibitors either causes a reduction in the nitrifying micro-organisms or impedes the amoA gene's function. The effects on the environment are soil acidification, global warming, and eutrophication. Some of the health effects attributed to the influence are methemoglobinemia, neurotoxicity, phytotoxicity and cancer. Biomagnification of the chemicals along the food chain is also a major concern. The use of well-researched and scientifically formulated organic fertilizers consisting of microbial inoculum, well-treated organic manure and good soil conditioner are eco-friendly. They are encouraged to be used to efficiently manage the process. Urban agriculture could promote food production, but environmental sustainability should be ensured.
A Review of Nutrient Losses to Waters From Soil- and Ground-Based Urban Agriculture—More Nutrient Balances Than Measurements
Authors: van de Vlasakker Paulien C. H. , Tonderski Karin , Metson Geneviève S.
Published: March 2022

Urban agriculture has a high potential to contribute to local circular economies, for instance by using nitrogen, phosphorus, and potassium in city organic waste streams as fertilizer inputs. However, inefficient use of waste-derived fertilizers could contribute to local water quality impairment related to nitrogen and phosphorus losses. Organic waste derived fertilizers are particularly challenging from a nutrient stoichiometry perspective, making over- and under-application of a particular nutrient likely. Where, and under what conditions, urban agriculture acts as a net positive for a circular nutrient economy vs. a nutrient water quality risk remains unclear. Here we review empirical peer-reviewed studies (2000–2021) on soil- and ground-based urban agriculture with a stated concern for nutrient losses to water. Of the 20 publications retained and reviewed (out of 241 screened), only seven measured losses to waters. There were four experimental studies, of which three measured nutrient leachate losses under different garden management practices. Of the 16 studies done in real-world conditions, only four quantified losses to water as leachate; average losses spanned 0.005 to 6.5 kg ha−1 for phosphorus, and 0.05 to 140 kg ha−1 for nitrogen. 13 of the 16 non-experimental studies provided data on nutrient inputs and harvested crop outputs, which could be used to calculate garden nutrient balances—an indicator of nutrient use efficiency. Although the value ranges were large, most studied gardens showed nutrient surpluses (inputs > crop harvest) for nitrogen and phosphorus (but not potassium); these surpluses were identified as a risk for losses to water. Contextual factors such as different access to fertilizers and knowledge, along with regulations and environmental factors can help explain the wide range of balance values and nutrient losses observed. Although a large surplus of inputs was often linked to increased leachate losses, it was not always the case in the limited number of studies we identified. Our review suggests that more field studies that measure losses to waters, and document contextual factors, are needed to determine how urban agriculture may contribute to a sustainable circular economy for all three nutrients without nutrient-related water quality impairment.
Non-Invasive Evaluation of Cerebral Hemodynamic Changes After Surgery in Adult Patients With Moyamoya Using 2D Phase-Contrast and Intravoxel Incoherent Motion MRI
Authors: Gao Feng , Zhao Wei , Zheng Yu , Li Shihong , Duan Yu , Zhu Zhenfang , Ji Ming , Liu Jun , Lin Guangwu
Published: March 2022

Objective

To explore the feasibility of 2D phase-contrast MRI (PC-MRI) and intravoxel incoherent motion (IVIM) MRI to assess cerebrovascular hemodynamic changes after surgery in adult patients with moyamoya disease (MMD).

Methods

In total, 33 patients with MMD who underwent 2D PC-MRI and IVIM examinations before and after surgery were enrolled. Postsurgical changes in peak and average velocities, average flow, forward volume, and the area of superficial temporal (STA), internal carotid (ICA), external carotid (ECA), and vertebral (VA) arteries were evaluated. The microvascular perfusion status was compared between the hemorrhage and non-hemorrhage groups.

Results

The peak velocity, average flow, forward volume, area of both the ipsilateral STA and ECA, and average velocity of the ipsilateral STA were increased (p < 0.05). The average flow and forward volume of both the ipsilateral ICA and VA and the area of the ipsilateral VA were increased (p < 0.05). The peak velocity, average velocity, average flow and forward volume of the contralateral STA, and the area of the contralateral ICA and ECA were also increased (p < 0.05), whereas the area of the contralateral VA was decreased (p < 0.05). The rf value of the ipsilateral anterior cerebral artery (ACA) supply area was increased (p < 0.05) and more obvious in the non-hemorrhage group (p < 0.05).

Conclusion

Two-dimensional PC-MRI and IVIM may have the potential to non-invasively evaluate cerebrovascular hemodynamic changes after surgery in patients with MMD. An improvement in the microvascular perfusion status is more obvious in patients with ischemic MMD than in patients with hemorrhagic MMD.
Impact of Early Oral Feeding on Nasogastric Tube Reinsertion After Elective Colorectal Surgery: A Systematic Review and Meta-Analysis
Authors: Wang Yan , Zhang Yanji , Hu Xing , Wu Hui , Liang Shan , Jin Jing , Wu Yunjun , Cen Yao , Wei Zairong , Wang Dali
Published: March 2022

Background

Colorectal cancer is a common malignant tumor appearing in the gastrointestinal tract. Surgical resection is recognized as the best means to improve patient survival. However, it is controversial whether early oral feeding (EOF) after elective colorectal resection demonstrates safety and efficacy in concerned clinical outcomes.

Methods

We searched PubMed, Embase, Cochrane Library, and CNKI from inception to September 2021. Two authors independently screened the retrieved records and extracted data. EOF was defined as feeding within 24 h after surgery, while traditional oral feeding (TOF) was defined as feeding that started after the gastrointestinal flatus or ileus was resolved. The primary outcome was nasogastric tube insertion, and the secondary outcomes were the length of hospital stay and total complications. Categorical data were combined using odds ratio (OR), and continuous data were combined using mean difference (MD).

Results

We screened 10 studies from 34 records after full-text reading, with 1,199 patients included in the analysis. Nasogastric tube reinsertion (OR 1.69; 95% CI 1.08 to 2.64, p=0.02) was more frequent in the EOF group, and older ages (>60 years) were associated with higher risk of nasogastric tube reinsertion (OR 2.05; 95% CI 1.05 to 3.99, p = 0.04). Reduced length of hospital stay (MD −1.76; 95% CI −2.32 to −1.21; p < 0.01) and the rate of total complications (OR 0.49; 95% CI 0.37 to 0.65, p < 0.01) were observed in EOF compared with TOF.

Conclusions

EOF was safe and effective for patients undergoing elective colorectal surgery, but the higher rate of nasogastric tube reinsertion compared with TOF should not be ignored.
Emerging Issues Questioning the Current Treatment Strategies for Lumbar Disc Herniation
Authors: Wan Zhong Y. , Shan Hua , Liu Tang F. , Song Fang , Zhang Jun , Liu Zhi H. , Ma Kun L. , Wang Hai Q.
Published: March 2022

Lumbar disc herniation is among the common phenotypes of degenerative lumbar spine diseases, significantly affecting patients' quality of life. The practice pattern is diverse. Choosing conservative measures or surgical treatments is still controversial in some areas. For those who have failed conservative treatment, surgery with or without instrumentation is recommended, causing significant expenditures and frustrating complications, that should not be ignored. In the article, we performed a literature review and summarized the evidence by subheadings to unravel the cons of surgical intervention for lumbar disc herniation. There are tetrad critical issues about surgical treatment of lumbar disc herniation, i.e., favorable natural history, insufficient evidence in a recommendation of fusion surgery for patients, metallosis, and implant removal. Firstly, accumulating evidence reveals immune privilege and auto-immunity hallmarks of human lumbar discs within the closed niche. Progenitor cells within human discs further expand the capacity with the endogenous repair. Clinical watchful follow-up studies with repeated diagnostic imaging reveal spontaneous resolution for lumbar disc herniation, even calcified tissues. Secondly, emerging evidence indicates long-term complications of lumbar fusion, such as adjacent segment disease, pseudarthrosis, implant failure, and sagittal spinal imbalance, which get increasing attention. Thirdly, systemic and local reactions (metallosis) for metal instrumentation have been noted with long-term health concerns and toxicity. Fourthly, the indications and timing for spinal implant removal have not reached a consensus. Other challenging issues include postoperative lumbar stiffness. The review provided evidence from a negative perspective for surgeons and patients who attempt to choose surgical treatment. Collectively, the emerging underlying evidence questions the benefits of traditional surgery for patients with lumbar disc herniation. Therefore, the long-term effects of surgery should be closely observed. Surgical decisions should be made prudently for each patient.
The Role of Acupuncture in Relieving Post-Hemorrhoidectomy Pain: A Systematic Review of Randomized Controlled Trials
Authors: Chen Huan , Zhang Weina , Sun Yuanjie , Jiao Ruimin , Liu Zhishun
Published: March 2022

Background

Post-hemorrhoidectomy pain (PHP) remains one of the complications of hemorrhoidectomy and can delay patient's recovery. Current clinical guideline on PHP remains skeptical on the effectiveness of acupuncture, which has been applied for PHP in practice with inconsistent evidence.

Objectives

This systematic review aimed to evaluate the effectiveness of acupuncture on PHP by reviewing existing evidence.

Methods

Nine databases such as PubMed and Embase were searched for randomized controlled trials (RCTs) from inception to 30th September 2021. The outcome measures on pain level after hemorrhoidectomy, dose of rescue analgesic drug used, quality of life, adverse events, etc., were extracted and analyzed in a narrative approach.

Results

Four RCTs involving 275 patients were included in the analysis. One study showed that the visual analog scale (VAS) score was significantly lower in the electro-acupuncture (EA) group compared to that in the sham acupuncture (SA) group at 6, 24 h after surgery and during the first defecation (p < 0.05). Similar trends were found in the verbal rating scale (VRS) and Wong-Baker Faces scale (WBS) score but at different time points. Another study also found EA was effective on relieving pain during defecation up to 7 days after surgery when compared with local anesthetics (p < 0.05). However, two studies evaluating manual acupuncture (MA) compared with active medications for PHP showed inconsistent results on effectiveness. Variability was found in the quality of included studies.

Conclusions

Although benefit of acupuncture on PHP, especially EA on defecation after surgery, was observed at some time points, evidence on effectiveness of acupuncture on PHP was not conclusive.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/, PROSPERO, identifier: CRD42018099961.
Enhanced Recovery Care vs. Traditional Care in Laparoscopic Hepatectomy: A Systematic Review and Meta-Analysis
Authors: Zhou Xueyin , Zhou Xueyi , Cao Jiasheng , Hu Jiahao , Topatana Win , Li Shijie , Juengpanich Sarun , Lu Ziyi , Zhang Bin , Feng Xu , Shen Jiliang , Chen Mingyu
Published: March 2022

Background

Enhanced recovery care could alleviate surgical stress and accelerate the recovery rates of patients. Previous studies showed the benefits of enhanced recovery after surgery program in liver surgery, but the exact role in laparoscopic hepatectomy is still unclear.

Aim

We aimed to perform a meta-analysis to evaluate the safety and efficacy of enhanced recovery after a surgery program in laparoscopic hepatectomy.

Methods

The relative studies from a specific search of PUBMED, EMBASE, OVID, and Cochrane database from June 2008 to February 2022 were selected and included in this meta-analysis. The primary outcomes included length of hospital stay, duration to functional recovery, and overall postoperative complication rate. The secondary outcomes included operative time, intraoperative blood loss, cost of hospitalization, readmission rate, Grade I complication rate, and Grade II–V complication rate.

Results

A total of six studies with 643 patients [enhanced recovery care (n = 274) vs. traditional care (n = 369)] were eligible for analysis. These comprised three randomized controlled trials and three retrospective studies. Enhanced recovery care group was associated with decreased hospital stay [standard mean difference (SMD) = −0.56, 95% confidence interval (CI) = −0.83~−0.28, p < 0.0001], shorter duration to functional recovery (SMD = −1.14, 95% CI = −1.92~−0.37, p = 0.004), and lower cost of hospitalization Mean Difference (MD) = −1,539.62, 95% CI = −1992.85~−1086.39, p < 0.00001). Moreover, a lower overall postoperative complication rate was observed in enhanced recovery care group [Risk ratio (RR) = 0.64, 95% CI = 0.51~0.80, p < 0.0001] as well as lower Grade II–V complication rate (RR = 0.55, 95% CI = 0.38~0.80, p = 0.002), while there was no significant difference in intraoperative blood loss (MD = −65.75, 95% CI = −158.47~26.97, p = 0.16), operative time (MD = −5.44, 95% CI = −43.46~32.58, p = 0.78), intraoperative blood transfusion rate [Odds ratio (OR) = 0.71, 95% CI = 0.41~1.22, p = 0.22], and Grade I complication rate (RR = 0.73, 95% CI = 0.53~1.03, p = 0.07).

Conclusion

Enhanced recovery care in laparoscopic hepatectomy should be recommended, because it is not only safe and effective, but also can accelerate the postoperative recovery and lighten the financial burden of patients.
Effect of Perioperative Blood Transfusion on the Postoperative Prognosis of Ruptured Hepatocellular Carcinoma Patients With Different BCLC Stages: A Propensity Score Matching Analysis
Authors: Xia Feng , Zhang Qiao , Huang Zhiyuan , Ndhlovu Elijah , Zhang Mingyu , Chen Xiaoping , Zhang Bixiang , Zhu Peng
Published: March 2022

Background and Aim

The effect of perioperative blood transfusion (PBT) on the prognosis of patients with ruptured hepatocellular carcinoma (rHCC) with different Barcelona Clinic Liver Cancer (BCLC) stages is not clear. We identified the independent predictors of PBT for postoperative rHCC and investigated the effects of PBT on the prognosis of patients with rHCC at different BCLC stages.

Methods

A total of 340 patients who underwent curative hepatectomy for rHCC between January 2010 and March 2018 were abstracted from the databases of two centers. A total of 166 patients underwent PBT. The prognosis of patients who received PBT and those who did not was compared before and after propensity score matching (PSM) in different BCLC stages. Univariate and multivariate Cox regression analyses were also used to identify independent predictors of PBT.

Results

We divided the 340 patients into two groups: early tumor stage (BCLC-A) n = 196 and advanced tumor stage (BCLC-B/C) n = 144. Overall, the median survival time of the PBT group was lower than that of the nonPBT group before and after PSM. However, in the BCLC-BC group, the prognosis of patients with PBT was not statistically different from that of patients without blood transfusion. Univariate Cox analysis showed that PBT was a risk factor affecting the overall survival (OS) and recurrence-free survival (RFS) in BCLC-A, and PBT was not a risk factor for poor OS and RFS in BCLC-B/C.

Conclusion

Perioperative blood transfusion has a negative impact on the postoperative prognosis of patients with rHCC in the early stage, but has no significant impact on the postoperative prognosis of patients with rHCC in the advanced stage.
Transcriptomic Analysis of Liver Indicates Novel Vaccine to Porcine Reproductive and Respiratory Virus Promotes Homeostasis in T-Cell and Inflammatory Immune Responses Compared to a Commercial Vaccine in Pigs
Authors: Fleming Damarius S. , Miller Laura C. , Li Jiuyi , Van Geelen Albert , Sang Yongming
Published: March 2022

One of the largest impediments for commercial swine production is the presence of Porcine Reproductive and Respiratory Syndrome Virus (PRRSV), a devastating RNA viral infection that is responsible for over $1 billion in loss in the U.S. annually. The challenge with combating PRRSV is a combination of the effect of an extraordinary rate of mutation, the ability to infect macrophages, and subversion of host immune response through a series of actions leading to both immunomodulation and immune evasion. Currently there are a handful of commercial vaccines on the market that have been shown to be effective against homologous infections, but struggle against heterologous or mixed strain infections. However, vaccination is the current best strategy for combating PRRSV, making research into new vaccine technology key. To address these issues with PRRSV and host antiviral functions a novel modified-live vaccine (MLV) able to stimulate known antiviral interferons was created and examined for its ability to potentiate effective immunity and better protection. Here, we examine gene expression in the liver of pigs vaccinated with our novel vaccine, given the liver's large role in antiviral responses and vaccine metabolism. Our study indicated that pigs administered the novel vaccine experience homeostatic gene expression consistent with less inflammation and T-cell depletion risk than pigs administered the commercial vaccine.
Rapid Detection of Actinobacillus pleuropneumoniae From Clinical Samples Using Recombinase Polymerase Amplification
Authors: Stringer Oliver W. , Li Yanwen , Bossé Janine T. , Forrest Matthew S. , Hernandez-Garcia Juan , Tucker Alexander W. , Nunes Tiago , Costa Francisco , Mortensen Preben , Velazquez Eduardo , Penny Paul , Rodriguez-Manzano Jesus , Georgiou Pantelis , Langford Paul R.
Published: March 2022

Actinobacillus pleuropneumoniae (APP) is the causative agent of porcine pleuropneumonia, resulting in high economic impact worldwide. There are currently 19 known serovars of APP, with different ones being predominant in specific geographic regions. Outbreaks of pleuropneumonia, characterized by sudden respiratory difficulties and high mortality, can occur when infected pigs are brought into naïve herds, or by those carrying different serovars. Good biosecurity measures include regular diagnostic testing for surveillance purposes. Current gold standard diagnostic techniques lack sensitivity (bacterial culture), require expensive thermocycling machinery (PCR) and are time consuming (culture and PCR). Here we describe the development of an isothermal point-of-care diagnostic test - utilizing recombinase polymerase amplification (RPA) for the detection of APP, targeting the species-specific apxIVA gene. Our APP-RPA diagnostic test achieved a sensitivity of 10 copies/μL using a strain of APP serovar 8, which is the most prevalent serovar in the UK. Additionally, our APP-RPA assay achieved a clinical sensitivity and specificity of 84.3 and 100%, respectively, across 61 extracted clinical samples obtained from farms located in England and Portugal. Using a small subset (n = 14) of the lung tissue samples, we achieved a clinical sensitivity and specificity of 76.9 and 100%, respectively) using lung imprints made on FTA cards tested directly in the APP-RPA reaction. Our results demonstrate that our APP-RPA assay enables a suitable rapid and sensitive screening tool for this important veterinary pathogen.
Evaluation of the Best Region for Measuring Eye Temperature in Dairy Cows Exposed to Heat Stress
Authors: Shu Hang , Li Yongfeng , Fang Tingting , Xing Mingjie , Sun Fuyu , Chen Xiaoyang , Bindelle Jérôme , Wang Wensheng , Guo Leifeng
Published: March 2022

Eye temperature (ET) has long been used for predicting or indicating heat stress in dairy cows. However, the region of interest (ROI) and temperature parameter of the eye have not been standardized and various options were adopted by previous studies. The aim of this study was to determine the best ROI for measuring ET as the predictor of heat stress in dairy cows in consideration of repeatability and validity. The ET of 40 lactating Holstein dairy cows was measured using infrared thermography. The mean and maximum temperature of five ROIs—medial canthus (MC), lateral canthus, eyeball, whole eye (WE), and lacrimal sac (LS)—were manually captured. The results show that the ET of left eyes was slightly higher than that of right eyes. The ET taken in MC, WE, and LS within 2 min had a moderate to substantial repeatability. The maximum temperature obtained at the LS had the highest correlation coefficients with respiration rate and core body temperature (allp< 0.001). Therefore, the maximum temperature of LS should be considered by future studies that want to use ET as the predictor or indicator of heat stress in dairy cows.
Serum Proteomics Identifies Immune Pathways and Candidate Biomarkers of Coronavirus Infection in Wild Vampire Bats
Authors: Becker Daniel J. , Lei Guang-Sheng , Janech Michael G. , Bland Alison M. , Fenton M. Brock , Simmons Nancy B. , Relich Ryan F. , Neely Benjamin A.
Published: March 2022

The apparent ability of bats to harbor many virulent viruses without showing disease is likely driven by distinct immune responses that coevolved with mammalian flight and the exceptional longevity of this order. Yet our understanding of the immune mechanisms of viral tolerance is restricted to a small number of bat–virus relationships and remains poor for coronaviruses (CoVs), despite their relevance to human health. Proteomics holds particular promise for illuminating the immune factors involved in bat responses to infection, because it can accommodate especially low sample volumes (e.g., sera) and thus can be applied to both large and small bat species as well as in longitudinal studies where lethal sampling is necessarily limited. Further, as the serum proteome includes proteins secreted from not only blood cells but also proximal organs, it provides a more general characterization of immune proteins. Here, we expand our recent work on the serum proteome of wild vampire bats (Desmodus rotundus) to better understand CoV pathogenesis. Across 19 bats sampled in 2019 in northern Belize with available sera, we detected CoVs in oral or rectal swabs from four individuals (21.1% positivity). Phylogenetic analyses identified all RdRp gene sequences in vampire bats as novel α-CoVs most closely related to known human CoVs. Across 586 identified serum proteins, we found no strong differences in protein composition nor abundance between uninfected and infected bats. However, receiver operating characteristic curve analyses identified seven to 32 candidate biomarkers of CoV infection, including AHSG, C4A, F12, GPI, DSG2, GSTO1, and RNH1. Enrichment analyses using these protein classifiers identified downregulation of complement, regulation of proteolysis, immune effector processes, and humoral immunity in CoV-infected bats alongside upregulation of neutrophil immunity, overall granulocyte activation, myeloid cell responses, and glutathione processes. Such results denote a mostly cellular immune response of vampire bats to CoV infection and identify putative biomarkers that could provide new insights into CoV pathogenesis in wild and experimental populations. More broadly, applying a similar proteomic approach across diverse bat species and to distinct life history stages in target species could improve our understanding of the immune mechanisms by which wild bats tolerate viruses.
MANIFESTAÇÕES BUCAIS EM PACIENTES PORTADORES DE DOENÇA RENAL CRÔNICA: REVISÃO SISTEMÁTICA
Authors: De Sousa Janiny Conceição Barros , Saraiva Layse Mayara De Lima , De Mendonça Raissa Pinheiro
Published: March 2022

Introdução: A doença renal crônica (DRC) é uma alteração estrutural renal geralmente progressiva e irreversível, que implica na redução ou na limitação da capacidade de filtração dos rins, e afetam direta ou indiretamente o fluxo, concentrações e composição da saliva, causando manifestações orais. Objetivo: Realizar uma revisão sistemática sobre as manifestações orais causadas pela doença renal crônica. Métodos: Foram incluídos 60 artigos, extraídos das bases de dados Cochrane, LILACS, PubMed, Scopus e Web of Science, por duas pesquisadoras independentes. Resultados: Diversas manifestações orais foram encontradas, sendo as mais presentes: xerostomia, palidez na mucosa oral, cálculos dentários, inflamação na mucosa e odor urêmica. Conclusão: As manifestações e alterações orais são causadas por alterações sistêmicas provenientes da doença renal crônica, por morbidades da doença, pelas terapias dialíticas e medicamentosas.
PROTOCOLOS UTILIZADOS PARA HIGIENIZAÇÃO BUCAL DE PACIENTES EM UTI: UMA REVISÃO SISTEMÁTICA
Authors: Fonseca Alda Biatriz Assunção , Farias Iasmim Freitas , Ferreira Marcos Souza , De Mendonça Raissa Pinheiro
Published: March 2022

Introdução: Disseminação de infecções bucais e do trato respiratório são consequência de uma má higiene bucal ou ausência da mesma, influenciando no tempo de permanência do paciente no ambiente hospitalar. Objetivo: investigar e discutir qual o protocolo mais utilizado e eficaz descrito na literatura. Método: As estratégias de busca eletrônica foram desenvolvidas individualmente para cada um dos seguintes bancos de dados: LILACS, Scopus, Web of Science e Chrocrane. Foram encontrados 3476 estudos, após aplicação dos critérios de inclusão e exclusão, resultaram em 38 artigos entre 2016-2020, na língua portuguesa e inglesa. Resultados: Pode-se observar que o método mecânico mais eficaz e utilizado é a escovação dentária associada ou não a antissépticos ou pastas de dente. Dentre as substâncias químicas, a clorexidina, em várias concentrações, foi a mais citada e com ótimos resultados. Conclusão: Não houve uma padronização em relação à frequência diária que a higienização deve ser realizada.
Genç Kalp Krizlerinde Klinik, Laboratuvar ve Anjiyografi Özellikleri: Çok merkezli retrospektif çalışma
Authors: GÜNDÜZ Ramazan , USALP Songül
Published: March 2022

Giriş ve Amaç: 45 yaş altında akut koroner sendrom (ST segment yükselmeli kalp krizi ve ST segment yükselmesi olmayan kalp krizi) ile yatırılan hastaların klinik, laboratuvar ve anjiyografi özelliklerini 45-65 yaş arasındaki orta yaş grubundaki hastalarla karşılaştırmak amacı ile bu çalışma planlandı.

Gereç ve Yöntemler: Çalışma retrospektif olarak planlamıştır. Akut koroner sendrom tanısı ile yatırılan ve ilk defa koroner anjiyografi yapılan hastaların dosyaları taranmıştır. 45 yaş ve altında olanlar genç kalp krizi olarak kabul edilirken 45 yaş üstü ve 65 yaş ve altı olanlar kontrol grubu olarak kabul edilmiştir.

Bulgular: Tek değişkenli lojistik regresyon analiz sonuçlarında, hipertansiyon (odds oranı (OO): 4.367, %95 güven aralığı (GA) [2.631-7.248], p