bluuebunny/crossref_metadata_2025 huggingface dataset:
Exercise interventions for people diagnosed with cancer: a systematic review of implementation outcomes
Authors: Czosnek Louise , Richards Justin , Zopf Eva , Cormie Prue , Rosenbaum Simon , Rankin Nicole M.
Published: May 2021

Purpose

Exercise is efficacious for people living after a cancer diagnosis. However, implementation of exercise interventions in real-world settings is challenging. Implementation outcomes are defined as ‘the effects of deliberate and purposive actions to implement new treatments, practices, and services’. Measuring implementation outcomes is a practical way of evaluating implementation success. This systematic review explores the implementation outcomes of exercise interventions evaluated under real-world conditions for cancer care.

Methods

Using PRISMA guidelines, an electronic database search of Medline, PsycInfo, CINAHL, Web of Science, SportsDiscus, Scopus and Cochrane Central Registry of Controlled Trials was conducted for studies published between January 2000 and February 2020. The Moving through Cancer registry was hand searched. The Implementation Outcomes Framework guided data extraction. Inclusion criteria were adult populations with a cancer diagnosis. Efficacy studies were excluded.

Results

Thirty-seven articles that described 31 unique programs met the inclusion criteria. Implementation outcomes commonly evaluated were feasibility (unique programs n = 17, 54.8%) and adoption (unique programs n = 14, 45.2%). Interventions were typically delivered in the community (unique programs n = 17, 58.6%), in groups (unique programs n = 14, 48.3%) and supervised by a qualified health professional (unique programs n = 14, 48.3%). Implementation outcomes infrequently evaluated were penetration (unique programs n = 1, 3.2%) and sustainability (unique programs n = 1, 3.2%).

Conclusions

Exercise studies need to measure and evaluate implementation outcomes under real-world conditions. Robust measurement and reporting of implementation outcomes can help to identify what strategies are essential for successful implementation of exercise interventions.

Implications for cancer survivors

Understanding how exercise interventions can be successful implemented is important so that people living after a cancer diagnosis can derive the benefits of exercise.
Developing a children’s health risk behaviour prevention program targeting grade 4–7 learners in the western cape, South Africa: a study protocol
Authors: Daniels Kurt John , Pharaoh Hamilton
Published: May 2021

Background

Health risk behaviour among South African youth is a significant public health concern. Despite a societal mind shift to educating the public on the prevention of health risk behaviour, behavioural change is not progressing at the rate needed to influence health risk behaviour positively. The project aims to explore behavioural trends and willingness to engage in risky behaviour among senior primary school children. Secondly, to design a health risk behaviour prevention program which adequately equips senior primary school children with the necessary life skills to alter risk behaviour engagement.

Methods

The study will make use of an intervention mapping framework and a sequential, explanatory mixed methods design. Stratified random probability sampling will be used to select three primary schools in the region. Nonprobability purposive sampling will be used to select the stakeholders participating in the focus group sessions. Data collection consists of five phases with the results of each stage informing the structure and application of the next. Phase 1 - baseline data collection (needs analysis) using the child health risk behaviour survey. Phase 2 - focus group interviews. Phase 3 - a systematic review of the literature for result analysis triangulation. Phase 4 – the development of the child risk behaviour prevention program based on the outcomes of phases 1,2 and 3. Phase 5 - implementation of the program. Descriptive statistics will be used to analyse the quantitative data. Chi-square, ANOVA and multiple regression analyses will be used to predict health risk behaviour engagement. Thematic analysis will be used to analyse qualitative data.

Discussion

To our knowledge, this is the first study that would attempt to establish a health risk behaviour prevention program in youth and young people in South Africa. Overwhelming evidence exists that adolescents engage in risky health behaviour which may potentially negatively impact their lives. This study provides an opportunity to address a gap in the current strategy by developing a prevention program for young people which could later be supported by further booster programs through their adolescents. This project would serve as a baseline prevention program that could assist in the reduction of risky health behaviour among various communities.
HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation
Authors: Hedge Barbara , Devan Karrish , Catalan Jose , Cheshire Anna , Ridge Damien
Published: May 2021

Background

The introduction of effective antiretroviral treatment in the late 1990s led to the perception that HIV was a chronic but manageable condition. Nevertheless, stigma remains one of the major hurdles for people living with HIV (PLWH) to accessing healthcare and biomedical preventions. Thus, Fast Track Cities has set a target of zero HIV discrimination by 2030 as part of its strategy to end HIV transmission.

Methods

Fifty-three participants from the United Kingdom, including PLWH (n = 21, 40%), health and social care workers (n = 24, 45%), and charity workers and activists (n = 13, 25%), were recruited. Semi-structured interviews investigated stigma and discrimination, focusing on both before and after the widespread use of effective antiretroviral treatment in the late 1990s. Data were analysed using a thematic approach.

Results

Before effective antiretroviral treatment narratives were shaped by two main themes: 1) the media’s role in influencing public opinion and contributing to misunderstandings of HIV transmission; and 2) personal experiences of HIV-related stigma, which for PLWH included incidents of physical violence and aggression, as well as fears of their HIV status being publicised. Contemporary narratives on stigma experiences were organised around four themes: 1) discrimination in healthcare settings; 2) stigma amongst men who have sex with men (MSM); 3) stigma towards African and Afro-Caribbean PLWH; and 4) the limits of change in public HIV-related knowledge and attitudes. Contemporary narratives indicated a reduction in enacted stigma, but continued anticipation of discrimination and self-reported shame, particularly in MSM and African and Afro-Caribbean PLWH.

Conclusion

The nature of stigma against those with HIV has evolved. The intersection of PLWH and minority groups (e.g. MSM and African and Afro-Caribbean persons) may enhance anticipatory and internalised stigma, with some suggestion that this may contribute to reduced engagement in HIV care and prevention services. Our findings indicate the need for further research in this area, as well as proactive interventions with community groups to enhance knowledge of HIV.
Knowledge, attitudes, practices, and the effects of COVID-19 among the youth in Kenya
Authors: Karijo Evalin , Wamugi Sylvia , Lemanyishoe Samuel , Njuki Jenny , Boit Faith , Kibui Vania , Karanja Sarah , Abuya Timothy
Published: May 2021

Background

Cases of the Corona Virus Disease of 2019 (COVID-19) in Kenya have continued to increase rapidly, since the first case in the country was confirmed in March 2020. In the wake of the pandemic, the health and socio-economic challenges experienced by the youth in Kenya are likely to be elevated. We assessed knowledge, practices, perceived risk of infection, adoption of recommended behaviour and the effects of COVID-19 among the youth in Kenya.

Methods

A cross sectional descriptive study was conducted between April 30th to May 7th, 2020 through a combined online survey and phone interviews. A total of 2156 youth across all 47 counties in Kenya completed the responses to the study questions. All survey responses analyzed using Stata version 15 were tabulated by gender, age, and education level to generate basic descriptive tables and tested for differences by category using chi-square tests. Where applicable, linear and logistic regression analysis model was conducted using covariates such as employment status, gender, and education level.

Results

Knowledge on symptoms of COVID-19 was generally high. Female respondents were more likely to identify more symptoms correctly compared to men (p < 0.001). However, youth reported very low levels of anyone being at risk of infection (7.1%). Most youth have adopted behavior necessary to slow down the infection. There were generally very low reported levels of inability to access health services related to sexual and reproductive health. About 50.0% of respondents reported significant decline in income during the pandemic period, nearly a third reported living in fear while 26.5% reported feeling stressed.

Conclusion

There was high knowledge of COVID-19 symptoms, preventive strategies, and high adoption of preventive practices. Strategies to sustain behaviors positively adopted among young people will be critical to reduce the spread of COVID-19. Despite the low reported rates of inability to access sexual and reproductive health, response measures should include strategies that facilitate continuity of services among young people. The reported social effects of the pandemic show the need for interventions to meet the health and socio-economic needs of the youth and minimize the long-term consequences of the pandemic.
The effect of surgeon-controlled variables on construct stiffness in lateral locked plating of distal femoral fractures
Authors: Weaver Michael J. , Chaus George W. , Masoudi Aidin , Momenzadeh Kaveh , Mohamadi Amin , Rodriguez Edward K , Vrahas Mark S. , Nazarian Ara
Published: June 2021

Background

Nonunion following treatment of supracondylar femur fractures with lateral locked plates (LLP) has been reported to be as high as 21 %. Implant related and surgeon-controlled variables have been postulated to contribute to nonunion by modulating fracture-fixation construct stiffness. The purpose of this study is to evaluate the effect of surgeon-controlled factors on stiffness when treating supracondylar femur fractures with LLPs:

Does plate length affect construct stiffness given the same plate material, fracture working length and type of screws?

Does screw type (bicortical locking versus bicortical nonlocking or unicortical locking) and number of screws affect construct stiffness given the same material, fracture working length, and plate length?

Does fracture working length affect construct stiffness given the same plate material, length and type of screws?

Does plate material (titanium versus stainless steel) affect construct stiffness given the same fracture working length, plate length, type and number of screws?

Methods

Mechanical study of simulated supracondylar femur fractures treated with LLPs of varying lengths, screw types, fractureworking lenghts, and plate/screw material. Overall construct stiffness was evaluated using an Instron hydraulic testing apparatus.

Results

Stiffness was 15 % higher comparing 13-hole to the 5-hole plates (995 N/mm849N vs. /mm, p = 0.003). The use of bicortical nonlocking screws decreased overall construct stiffness by 18 % compared to bicortical locking screws (808 N/mm vs. 995 N/mm, p = 0.0001). The type of screw (unicortical locking vs. bicortical locking) and the number of screws in the diaphysis (3 vs. 10) did not appear to significantly influence construct stiffness (p = 0.76, p = 0.24). Similarly, fracture working length (5.4 cm vs. 9.4 cm, p = 0.24), and implant type (titanium vs. stainless steel, p = 0.12) did also not appear to effect stiffness.

Discussion

Using shorter plates and using bicortical nonlocking screws (vs. bicortical locking screws) reduced overall construct stiffness. Using more screws, using unicortical locking screws, increasing fracture working length and varying plate material (titanium vs. stainless steel) does not appear to significantly alter construct stiffness. Surgeons can adjust plate length and screw types to affect overall fracture-fixation construct stiffness; however, the optimal stiffness to promote healing remains unknown.
Information needs of patients with chronic diseases and their relatives for web-based advance care planning: a qualitative interview study
Authors: van der Smissen Doris , Rietjens Judith A. C. , van Gemert-Pijnen Lisette , van Dulmen Sandra , van der Heide Agnes , Korfage Ida J.
Published: May 2021

Background

Advance care planning (ACP) enables persons to identify preferences for future treatment and care, and to discuss, record and review these preferences. However, the uptake of ACP among patients with chronic diseases is relatively low. Web-based ACP programs can support patients and their relatives in ACP. However, information needs of patients and their relatives for ACP are unknown. The aim of this study is to explore information needs of patients with chronic disease and their relatives for web-based ACP.

Methods

We conducted semi-structured interviews with patients with chronic diseases and relatives at their home or at the study center. In three cases, the patient and relative were paired since they preferred to be interviewed together. We asked about information they would search for when to start with ACP, where they would search for information, what search terms they would use on the Internet, and what content and information they would consider important on an ACP website. The interviewer asked participants to clarify their responses during the interview. We used thematic analysis to analyze the interviewees’ responses.

Results

We interviewed nine patients with different chronic diseases including amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), chronic obstructive pulmonary disease (COPD) and kidney diseases, and seven relatives, namely partners or (adult) children. The interviewees were aged 24 to 80 years, nine were female and seven were male. Both patients with a chronic disease and relatives mentioned comparable information needs. Many interviewees indicated they would use the Internet to search for information about ACP. Mentioned search terms were “advance care planning”, “treatment plan”, “disease trajectory” and names of patient associations. Information needs concerned their disease trajectory and quality of life, medical treatment decisions, practical support in arranging care, the concept of ACP and guidance in ACP, communication of treatment and care preferences, peer support of others with chronic diseases, and information for relatives. Many appreciated encouragement of their healthcare providers to take a pro-active role in ACP.

Conclusions

We conclude that information needs for ACP included guidance in ACP, support in making decisions about medical treatment, and practical support in arranging care. We recommend adapting web-based ACP information to the information needs of patients and their relatives to increase its findability, uptake and usefulness.
Care pathway and prioritization of rapid testing for COVID-19 in UK hospitals: a qualitative evaluation
Authors: Hicks Timothy , Winter Amanda , Green Kile , Kierkegaard Patrick , Price D. Ashley , Body Richard , Allen A. Joy , Graziadio Sara ,   CONDOR Steering Group, Price D. Ashley , Body Richard , Allen A. Joy
Published: June 2021

Objectives

The second wave of the coronavirus pandemic is now established, occurring at a time of winter pressure on acute care in the NHS. This is likely to be more challenging then the first wave for the diagnosis of COVID-19 because of the similar symptomology with other respiratory conditions highly prevalent in winter. This study sought to understand the care pathways in place in UK NHS hospitals during the first wave (March–July 2020) for identification of patients with COVID-19 and to learn lessons to inform optimal testing strategies within the COVID-19 National Diagnostic Research and Evaluation Platform (CONDOR).

Design, setting & participants

Sixteen hospital-based clinicians from 12 UK NHS Trusts covering 10 different specialties were interviewed following a semi-structured topic guide. Data were coded soon after the interviews and analysed thematically.

Results

We developed a diagrammatic, high-level visualisation of the care pathway describing the main clinical decisions associated with the diagnosis and management of patients with suspected COVID-19. COVID-19 testing influenced infection control considerations more so than treatment decisions. Two main features of service provision influenced the patient management significantly: access to rapid laboratory testing and the number of single occupancy rooms. If time to return of result was greater than 24 h, patients with a presumptive diagnosis would often be cohorted based on clinical suspicion alone. Undetected COVID-19 during this time could therefore lead to an increased risk of viral transmission.

Conclusions

During the winter months, priority for provision of rapid testing at admission should be given to hospitals with limited access to laboratory services and single room availability. Access to rapid testing is essential for urgent decisions related to emergency surgery, maternity services and organ transplant. The pathway and prioritization of need will inform the economic modelling, clinical evaluations, and implementation of new clinical tests in UK.
Selecting contextually appropriate performance indicators in a circumpolar context: a modified Delphi approach
Authors: Rich Rebecca , D’Hont Thomsen , Murphy Kellie E. , Veillard Jeremy , Chatwood Susan
Published: May 2021

Background

Meaningful performance measurement requires indicators to be scientifically robust and strategically focused. For many circumpolar states, indicators aligned with national strategies may ignore the priorities of northern, remote, or Indigenous populations. The aim of this project was to identify contextually appropriate performance indicators for maternity care in circumpolar regions.

Methods

Fourteen maternity care and health systems experts participated in a modified Delphi consensus process. The list of proposed indicators was derived from a previously published scoping review. Fourteen participants rated each proposed indicator according to importance, circumpolar relevance, validity, and reliability and suggested additional indicators for consideration.

Results

Consensus was achieved after two rounds, as measured by a Cronbach’s alpha of 0.87. Eleven indicators, many of which represented physical health outcomes, were ranked highly on all four criteria. Twenty-nine additional indicators, largely focused on social determinants of health, health care responsiveness, and accessibility, were identified for further research. Travel for care, cultural safety and upstream structural determinants of health were identified as important themes.

Conclusions

This study identified the important gaps between current performance measurement strategies and the context and values that permeate maternal-child health in circumpolar regions. The indicators identified in this study provide an important foundation for ongoing work. We recommend that future work encompass an appreciation for the intersectoral nature of social, structural, and colonial determinants of maternal-child health in circumpolar regions.
Primary health care facilities capacity gaps regarding diagnosis, treatment and knowledge of schistosomiasis among healthcare workers in North-western Tanzania: a call to strengthen the horizontal system
Authors: Mazigo Humphrey Deogratias , Uisso Cecilia , Kazyoba Paul , Mwingira Upendo J.
Published: May 2021

Background

The World Health Organization (WHO) calls for schistosomiasis endemic countries to integrate schistosomiasis control measures into the primary health care (PHC) services; however, in Tanzania, little is known about the capacity of the primary health care system to assume this role. The objective of this study was to assess the capacity of the primary health care system to diagnose and treat schistosomiasis in endemic regions of north-western Tanzania.

Methods

A total of 80 randomly-selected primary health care facilities located in the Uyui, Geita and Ukerewe districts of North-western Tanzania participated in the study. At each facility, the in-charge clinician, or any other healthcare worker appointed by the in-charge clinician, participated in the questionnaire survey. A quantitative questionnaire installed in a Data Tool Kit software was used to collect data. Healthcare workers working at various stations (laboratory, pharmacy, data clerks, outpatient section) were interviewed. The questionnaire collected information related to healthcare workers’ knowledge about urogenital and intestinal schistosomiasis symptoms, human and material resources, laboratory services, data capture, and anti-schistosomiasis treatment availability.

Results

A total of 80 healthcare workers were interviewed. Bloody stool (78.3 %) and haematuria (98.7 %) were the most common symptoms of intestinal and urogenital schistosomiasis mentioned by healthcare workers. Knowledge on the chronic symptoms such as hepatosplenomegaly and hematemesis for intestinal schistosomiasis, and oliguria and dysuria for urogenital schistosomiasis, were inadequate. Laboratory services were only available in 33.8 % (27/80) of the health facilities and direct wet preparation was the most common diagnostic technique used for both urine and stool samples. All healthcare workers knew that praziquantel was the drug of choice for the treatment of schistosomiasis and the drug was available in 91.3 % (73/80) of the health facilities.

Conclusions

The capacity of the primary health care facilities included in the current study is inadequate in terms of diagnosis, treatment, reporting and healthcare workers’ knowledge of schistosomiasis. Thus, the integration of schistosomiasis control activities into the primary healthcare system requires these gaps to be addressed.
Exosomal lncRNA UCA1 modulates cervical cancer stem cell self-renewal and differentiation through microRNA-122-5p/SOX2 axis
Authors: Gao Zhihui , Wang Qianqing , Ji Mei , Guo Xiangcui , Li Li , Su Xiaoke
Published: May 2021

Background

There is growing evidence discussing the role of long non-coding RNAs (lncRNAs) in cervical cancer (CC). We performed this study to explore the impact of exosomal lncRNA urothelial cancer-associated 1 (UCA1) in CC stem cells by sponging microRNA-122-5p (miR-122-5p) and regulating SOX2 expression.

Methods

CC stem cells (CD133+CaSki) and exosomes were extracted and identified. The synthesized UCA1- and miR-122-5p-related sequences were transfected into CaSki cells, CaSki cells-derived exosomes were extracted and then co-cultured with CD133+CaSki cells. The functional roles of UCA1 and miR-122-5p in self-renewal and differentiation ability of CC stem cells were determined using ectopic expression, knockdown/depletion and reporter assay experiments. An in vivo experiment was performed to verify the in vitro results.

Results

Up-regulated UCA1 and SOX2 and down-regulated miR-122-5p were found in CaSki-Exo. Exosomes promoted invasion, migration, proliferation and restrained apoptosis of CD133+CaSki cells. Silencing UCA1 or up-regulating miR-122-5p degraded SOX2 expression, and reduced invasion, migration and proliferation of CD133+CaSki cells while advanced apoptosis and suppressed the tumor volume and weight in nude mice.

Conclusion

Our study provides evidence that CaSki-Exo can promote the self-renewal and differentiation ability of CC stem cells while silencing UCA1 or up-regulating miR-122-5p restrains self-renewal and differentiation of CC stem cells.
Is maternal cigarette or water pipe use associated with stopping breastfeeding? Evidence from the Jordan population and family health surveys 2012 and 2017–18
Authors: Can Özalp Esra , Yalçın S. Songül
Published: May 2021

Background

Maternal smoking is suspected to have negative impacts on breastfeeding, such as decreasing the quantity of breast milk, and reducing vitamin and fat concentrations in the milk in the late lactation period. Cigarette and water pipe tobacco products are widely used in Jordan. We aimed to estimate the association between use of different tobacco products and the rates of current breastfeeding.

Methods

Data from Jordan’s Population and Family Health Surveys 2012 and 2017–18 were examined. Last-born, living children, aged < 25 months, from singleton births, ever breastfed, and living with their mother were included. The key outcome variables were the current breastfeeding (during last 24 h) and tobacco usage status [water pipe tobacco (hookah or narghile) and/or cigarette tobacco]. Complex sample multivariate logistic regression analysis was used to evaluate the association of the current breastfeeding with maternal smoking status.

Results

Overall, 6726 infants were included in the study. The current breastfeeding rate in infants aged 0–6 months was 87%, compared with 43.9% in infants aged 12–17 months and 19.4% in infants aged 18–24 months. Overall, 4.4% had mothers who smoked cigarettes, 5.4% smoked water pipe, and 1.6% both cigarettes and water pipe. The proportion of breastfed infants in non-smoking mothers was 57.7% and, those in smoke water pipe, cigarette and both tobacco products were 55.4, 44.9, and 51.0% respectively. Univariate analysis revealed that women cigarette smokers had a lower odds ratio (OR) for current breastfeeding (OR 0.60, 95% Confidence Interval [CI] 0.39, 0.92). Multivariate analysis revealed that maternal cigarette smoking was associated with a lower odds ratio for current breastfeeding compared with mothers who smoked neither water pipe nor cigarettes (AOR 0.51, 95% Cl 0.30, 0.87).

Conclusions

These results indicate that maternal smoking is associated with termination of breastfeeding, suggesting that structured training should be organized for healthcare professionals, expectant mothers and the general public about the association between maternal smoking and cessation of lactation.
Nervous system modulation through electrical stimulation in companion animals
Authors: Martins Ângela , Gouveia Débora , Cardoso Ana , Gamboa Óscar , Millis Darryl , Ferreira António
Published: May 2021

Domestic animals with severe spontaneous spinal cord injury (SCI), including dogs and cats that are deep pain perception negative (DPP−), can benefit from specific evaluations involving neurorehabilitation integrative protocols. In human medicine, patients without deep pain sensation, classified as grade A on the American Spinal Injury Association (ASIA) impairment scale, can recover after multidisciplinary approaches that include rehabilitation modalities, such as functional electrical stimulation (FES), transcutaneous electrical spinal cord stimulation (TESCS) and transcranial direct current stimulation (TDCS). This review intends to explore the history, biophysics, neurophysiology, neuroanatomy and the parameters of FES, TESCS, and TDCS, as safe and noninvasive rehabilitation modalities applied in the veterinary field. Additional studies need to be conducted in clinical settings to successfully implement these guidelines in dogs and cats.
Measuring the effectiveness of integrated vector management with targeted outdoor residual spraying and autodissemination devices on the incidence of dengue in urban Malaysia in the iDEM trial (intervention for Dengue Epidemiology in Malaysia): study protocol for a cluster randomized controlled trial
Authors: Saadatian-Elahi Mitra , Alexander Neal , Möhlmann Tim , Langlois-Jacques Carole , Suer Remco , Ahmad Nazni Wasi , Mudin Rose Nani , Ariffin Farah Diana , Baur Frederic , Schmitt Frederic , Richardson Jason H. , Rabilloud Muriel , Hamid Nurulhusna Ab
Published: May 2021

Background

In common with many South East Asian countries, Malaysia is endemic for dengue. Dengue control in Malaysia is currently based on reactive vector management within 24 h of a dengue case being reported. Preventive rather than reactive vector control approaches, with combined interventions, are expected to improve the cost-effectiveness of dengue control programs. The principal objective of this cluster randomized controlled trial is to quantify the effectiveness of a preventive integrated vector management (IVM) strategy on the incidence of dengue as compared to routine vector control efforts.

Methods

The trial is conducted in randomly allocated clusters of low- and medium-cost housing located in the Federal Territory of Kuala Lumpur and Putrajaya. The IVM approach combines: targeted outdoor residual spraying with K-Othrine Polyzone, deployment of mosquito traps as auto-dissemination devices, and community engagement activities. The trial includes 300 clusters randomly allocated in a 1:1 ratio. The clusters receive either the preventive IVM in addition to the routine vector control activities or the routine vector control activities only. Epidemiological data from monthly confirmed dengue cases during the study period will be obtained from the Vector Borne Disease Sector, Malaysian Ministry of Health e-Dengue surveillance system. Entomological surveillance data will be collected in 12 clusters randomly selected from each arm.

To measure the effectiveness of the IVM approach on dengue incidence, a negative binomial regression model will be used to compare the incidence between control and intervention clusters. To quantify the effect of the interventions on the main entomological outcome, ovitrap index, a modified ordinary least squares regression model using a robust standard error estimator will be used.

Discussion

Considering the ongoing expansion of dengue burden in Malaysia, setting up proactive control strategies is critical. Despite some limitations of the trial such as the use of passive surveillance to identify cases, the results will be informative for a better understanding of effectiveness of proactive IVM approach in the control of dengue. Evidence from this trial may help justify investment in preventive IVM approaches as preferred to reactive case management strategies.

Trial registration

ISRCTN ISRCTN81915073. Retrospectively registered on 17 April 2020.
Longitudinal remotely mentored self-performed lung ultrasound surveillance of paucisymptomatic Covid-19 patients at risk of disease progression
Authors: Kirkpatrick Andrew W. , McKee Jessica L. , Conly John M.
Published: May 2021

COVID-19 has impacted human life globally and threatens to overwhelm health-care resources. Infection rates are rapidly rising almost everywhere, and new approaches are required to both prevent transmission, but to also monitor and rescue infected and at-risk patients from severe complications. Point-of-care lung ultrasound has received intense attention as a cost-effective technology that can aid early diagnosis, triage, and longitudinal follow-up of lung health. Detecting pleural abnormalities in previously healthy lungs reveal the beginning of lung inflammation eventually requiring mechanical ventilation with sensitivities superior to chest radiographs or oxygen saturation monitoring. Using a paradigm first developed for space-medicine known as Remotely Telementored Self-Performed Ultrasound (RTSPUS), motivated patients with portable smartphone support ultrasound probes can be guided completely remotely by a remote lung imaging expert to longitudinally follow the health of their own lungs. Ultrasound probes can be couriered or even delivered by drone and can be easily sterilized or dedicated to one or a commonly exposed cohort of individuals. Using medical outreach supported by remote vital signs monitoring and lung ultrasound health surveillance would allow clinicians to follow and virtually lay hands upon many at-risk paucisymptomatic patients. Our initial experiences with such patients are presented, and we believe present a paradigm for an evolution in rich home-monitoring of the many patients expected to become infected and who threaten to overwhelm resources if they must all be assessed in person by at-risk care providers.
Retraction Note to: Improving the measurement of alexithymia in autistic adults: a psychometric investigation and refinement of the twenty-item Toronto Alexithymia Scale
Authors: Williams Zachary J. , Gotham Katherine O.
Published: May 2021

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s13229-021-00446-6
Durvalumab-induced myocarditis, myositis, and myasthenia gravis: a case report
Authors: Cham Jason , Ng Daniel , Nicholson Laura
Published: May 2021

Background

Immune checkpoint inhibitors are effective therapies for a wide range of malignancies. Their increased use has led to a wide range of immune-related adverse effects including skin, gastrointestinal, pulmonary, endocrine, cardiac, and neurologic complications.

Case presentation

We present the case of a 72-year-old Caucasian man with non-small cell lung cancer who was admitted for dyspnea after two cycles of durvalumab. He was found to have significantly elevated levels of serum creatinine kinase and troponin with a negative cardiac catheterization. During his hospitalization, he developed progressive dyspnea and new-onset axial weakness, ultimately leading to the diagnosis of durvalumab-induced myocarditis, myasthenia gravis, and myositis.

Conclusion

This is, to our knowledge, the first reported case of anti-programmed cell death ligand 1-induced combination of myocarditis, myasthenia gravis, and myositis. While the use of immunologic agents has resulted in overall improved cancer outcomes, their increased use has led to a vast spectrum of immune-related adverse effects. We review the diagnostic workup and management of patients with these immune-related adverse effects, underscoring the importance of early identification given the potential for rapid deterioration.
Subhepatic appendix: an ectopic topography not to be disregarded: a case report
Authors: Ibrahim Mamadou Abdoul Kadir , Mounkaila Souleymane , Hama Aghali Nouhou , Harouna Amadou Mahaman Laouali , Adakal Ousseini
Published: May 2021

Introduction

Subhepatic appendix is most often due to an anomaly of rotation of the primary intestine occurring during embryogenesis. This ectopic topography associated with advanced age can be a serious diagnosis problem at the stage of appendicitis or appendicular peritonitis.

Case presentation

We report the case of a 60-year-old melanoderm man, with a history of urinary pathology and peptic ulcer, referred from a health district for abdominal pain of the right hypochondrium evolving for about 5 days, secondarily generalized, in whom we suspected peritonitis, the etiology of which remains to be determined. During the surgical intervention, after preoperative resuscitations measures, a phlegmonous perforated appendix was found under the liver. No postoperative complication was noted, and he was discharged home 8 days after his operation.

Conclusion

Subhepatic appendicular peritonitis occurring in an elderly patient poses enormous diagnostic problems. When faced with right upper quadrant pain, considering acute ectopic appendicitis would significantly reduce complications.
The practice of writing inside an Egyptian monastic settlement: preliminary material characterisation of the inks used on Coptic manuscripts from the Monastery of Apa Apollo at Bawit
Authors: Ghigo Tea , Albarrán Martínez María Jesús
Published: May 2021

Over the last few years, the Federal Institute for material research (BAM, Berlin) together with the Centre for the Study of Manuscript Cultures (CSMC, University of Hamburg) have initiated a systematic material investigation of black inks produced from Late Antiquity to the Middle Ages (ca. fourth century CE–fourteenth/fifteenth centuries CE), aimed primarily at extending and complementing findings from previous sporadic studies. Part of this systematic investigation has focused on Egyptian Coptic manuscripts, and the present preliminary study is one of its outputs. It centres on a corpus of 45 Coptic manuscripts—43 papyri and 2 ostraca—preserved at the Palau-Ribes and Roca-Puig collections in Barcelona. The manuscripts come from the Monastery of Apa Apollo at Bawit, one of the largest monastic settlements in Egypt between the Late Antiquity and the Early Islamic Period (sixth–eighth centuries CE). The composition of their black inks was investigated in situ using near-infrared reflectography (NIRR) and X-ray fluorescence (XRF). The analyses determined that the manuscripts were written using different types of ink: pure carbon ink; carbon ink containing iron; mixed inks containing carbon, polyphenols and metallic elements; and iron-gall ink. The variety of inks used for the documentary texts seems to reflect the articulate administrative system of the monastery of Bawit. This study reveals that, in contrast to the documents, written mostly with carbon-based inks, literary biblical texts were written with iron-gall ink. The frequent reuse of papyrus paper for certain categories of documents may suggest that carbon-based inks were used for ephemeral manuscripts, since they were easy to erase by abrasion.
Analysis of meteorological droughts in the Lake’s Region of Ethiopian Rift Valley using reconnaissance drought index (RDI)
Authors: Mohammed Yimer , Yimam Asnake
Published: June 2021

This study investigated the intensity, trend and spatio-temporal variability of meteorological drought in the Lakes’ Region of Ethiopian Rift Valley using monthly rainfall and maximum and minimum temperature records for the period 1986–2019. Reconnaissance Drought Index (RDI) was employed to generate the intensity of drought at 3 and 12-months timescale. Mann-Kendall trend test was used to determine the trend of the changes in the RDI time series. The spatial extent of droughts has been interpolated by inverse distance weighted (IDW) method using the spatial analyst tool of ArcGIS. Results indicated the occurrence of different intensity and trend signals across seasons and over space in the study area. A total of 33 extreme drought months were observed in all stations during summer with varying intensity (− 2.01 at Halaba to − 3.52 at Wolaita) and 168 extreme drought months at annual timescale ranging from − 2.10 at Hawassa to − 4.51 at Wolaita. The intensity of drought events observed in Wolaita in 1986 at all timescales (RDI value of − 3.19, − 3.52 and − 4.51 for spring, summer and annual respectively) were very extraordinary and devastating. Drought magnitude showed increasing signal at 6 out of 10 stations, although statistically significant at only two stations (Arsi Negelle at all timescale and Butajira at spring and annual timescale). However, the spatial patterns of drought events didn’t exhibit clear pattern rather more localized distribution and variability. The frequency of drought incidence became intense in the study area from 2008 onwards at all timescales compared to the 1990s and 2000s.The increasing tendency of drought in recent years might be the manifestation of borderless global warming. The empirical evidences showed that drought events and their negative effects are highly localized in the study area and provide useful information for local-scale planning for drought management and response.
Evaluating human-centred design for public health: a case study on developing a healthcare app with refugee communities
Authors: Bartlett Rebeccah , Boyle Jacqueline A. , Simons Smith Jessica , Khan Nadia , Robinson Tracy , Ramaswamy Rohit
Published: May 2021

Background

Australian women from migrant and refugee communities experience reduced access to sexual and reproductive healthcare. Human-centred design can be a more ethical and effective approach to developing health solutions with underserved populations that are more likely to experience significant disadvantage or social marginalisation. This study aimed to evaluate how well Shifra, a small Australian-based not-for-profit, applied human-centred design when developing a web-based application that delivers local, evidence-based and culturally relevant health information to its non-English speaking users.

Methods

This study undertook a document review, survey, and semi-structured interviews to evaluate how well Shifra was able to achieve its objectives using a human-centred design approach.

Results

A co-design process successfully led to the development of a web-based health app for refugee and migrant women. This evaluation also yielded several important recommendations for improving Shifra’s human-centred design approach moving forward.

Conclusions

Improving refugees’ access to sexual and reproductive health is complex and requires innovative and thoughtful problem solving. This evaluation of Shifra’s human-centred design approach provides a helpful and rigorous guide in reporting that may encourage other organisations undertaking human-centred design work to evaluate their own implementation.
Measurement properties of PROMIS short forms for pain and function in total hip arthroplasty patients
Authors: Stephan Anika , Stadelmann Vincent A. , Leunig Michael , Impellizzeri Franco M.
Published: May 2021

Introduction

While the Patient-Reported Outcomes Measurement Information System (PROMIS) is mainly designed for computer adaptive testing, its static short forms (SF) are used when a paper-pencil format is preferred or item banks are not yet translated into the target language. This study examined the measurement properties of the German PROMIS-SF for pain intensity (PAIN), pain interference (PI) and physical function (PF) in total hip arthroplasty (THA) patients.

Methods

SF were collected before and 12 months post-surgery. Higher scores indicate more PAIN, higher PI and better PF. Oxford Hip Score (OHS) was the main reference measure. Six months post-surgery, a subsample completed the SF twice within 14 days to test reliability.

Results

Of 172 eligible patients, 147 consented to participate and received questionnaires; 132 (74 males) returned baseline questionnaires (mean age 65.8 ± 10.2 years) and 116, 12-month questionnaires. Forty-five patients provided test-retest data.

Correlations of all SF with OHS were large (│r│ ≥ 0.7; confidence intervals did not include 0.50). Cronbach’s alpha values were: PAIN, 0.86; PI, 0.93; PF, 0.91. Intraclass correlation coefficients were: PAIN, 0.77; PI, 0.81; PF, 0.69. Standard errors of measurement were: PAIN, 3.8; PI, 2.8; PF, 3.6. Smallest detectable change thresholds were: PAIN, 8.8; PI, 6.6; PF, 8.4. Follow-up data showed a ceiling effect (best score) for PAIN (66%), PI (76%), and PF (66%). SF change scores showed large correlations with OHS change scores (│r│ > 0.6).

Conclusion

Our results provide some evidence of construct validity, and acceptable reliability and responsiveness of PROMIS-SF for pain and function in THA patients. These SF can thus be considered acceptable for use, although patients’ improvement in physical function might be underestimated due to the large follow-up PF score ceiling effects.
Telephone-based assessment of multiple sclerosis patients at Ain Shams University Hospital in the coronavirus disease 2019 pandemic
Authors: Abdel Hafeez Mohamed A. , Zamzam Dina A. , Swelam Mahmoud S. , Steit Alaa Abo , Masoud Janet , Nasser Azza Abdel , Hazzou Ahmed , Hamid Eman , Aref Hany , Zakaria Magd F. , Fouad Mohamed M.
Published: May 2021

Background

Assessment of multiple sclerosis (MS) patients during the era of the coronavirus disease 2019 (COVID-19) pandemic was confronted with the overwhelmed healthcare facilities in Egypt and fear of the patients to get infected while attending the follow-up visits. This study aimed to assess the value of telephone-based assessments in the follow-up of MS patients. It includes one hundred and five patients who participated in the study and completed 3 telephone-based assessments which are the Hauser Ambulation index, Multiple Sclerosis Neuropsychology Questionnaire (MSNQ), and Symptoms of Multiple Sclerosis Scale (SMSS).

Results

The Hauser Ambulation index was significantly correlated with the latest Expanded Disability Status Scale (EDSS) score done within 1 month from the telephone call (r=0.738, P<0.001). The analysis of MSNQ scores showed that one-third of the study population had evidence of cognitive and/or neuropsychological impairment. Post hoc analysis regarding the cognitive and psychological impairment component of SMSS revealed that the patients who answered “Never” had significantly lower MSNQ scores compared to those who answered “Sometimes” (P=0.016), “Often” (P=0.022), and “Always” (P=0.001). The comparison of the EDSS scores of the patients regarding the sensory-motor impairment component of SMSS showed a non-significant difference.

Conclusion

The Hauser Ambulation index may be a reliable telephone-based tool for the assessment of physical disability. The MSNQ and the cognitive and psychological impairment component of SMSS can be used for the assessment of cognitive and psychological impairment among patients with MS.
Surgical outcomes of decompression alone versus transpedicular screw fixation for upper lumbar disc herniation
Authors: Soliman Ahmed Y. , Elfadle Amr Abu
Published: May 2021

Background

Surgical outcomes of upper lumbar disc herniations (ULDHs) including T12-L1, L1-L2, and L2-L3 levels are characteristically less favorable and more unpredictable.

Objectives

This study was conducted to compare the surgical outcomes of decompression alone versus decompression combined with transpedicular screw fixation in treating upper lumbar disc herniation.

Methods

This retrospective cohort study was carried out at Neurosurgery Departments, Tanta University. The study included 46 patients with a symptomatic high lumbar herniated disc at T12-L1, L1-L2, and L2-L3 levels. The enrolled patients were divided into two groups depending on whether they were operated on via decompression and partial medial facetectomy (group 1, 22 patients) or via the previous maneuver plus transpedicular screw fixation (group 2, 24 patients). All patients were medically evaluated immediately after the operation; then, they were followed up at the 3rd and the 6th months following surgery. Patients’ outcomes were assessed by visual analogue score (VAS) and Oswestry Disability Index (ODI) scores.

Results

Median VAS scores in each group revealed significant reduction immediately following surgery and at each of 7 days, 3 months, and 6 months in comparison with the preoperative VAS score (p<0.001). Furthermore, each group showed significant stepwise reduction in the median ODI score at the 3rd and the 6th months postoperative compared to the preoperative ODI score (group 1 = 68.0, 19.0, 15.0; p< 0.001 and group 2 = 66.5, 20.0, 15.0; p< 0.001), with no significant differences between both groups (p> 0.05).

Conclusions

Both standalone decompression and decompression combined with transpedicular screw fixation revealed comparable favorable outcomes in patients with ULDH.
Influences and consequences resulting in addictions in general and to chronic alcoholism, especially for patients with spinal cord injury
Authors: STOICA Simona-Isabelle , TĂNASE Ioana , ONOSE Gelu
Published: May 2021

Introduction: Spinal cord injury can be a cause of severe disability, with important consequences at the individual and social levels. Causes are often produced by falls or road accidents; and addictions (particularly chronic ethylism) also increase the risk of vertebral-medullary lesions.
Materials and Methods: With with the approval of the TEHBA Ethics Commission (no.17464/14.06.2019), we used specific tests (DASS-21, MOS SF-36, SMAST, AUDIT, CAGE, AIS) and we questioned a group of patients admitted to the THEBA Neuro-Muscle Recovery Clinic after being treated in the Spinal Neurosurgery Service for acute and subacute vertebral medullary trauma.
Results: We evaluated the link between addictions (especially ethanol), the risk of spinal cord injury, and the underlying subacute evolution of patients with this pathology.
Conclusions: Substance abuse (especially ethanol) increases the risk of spinal cord injury and is a serious public health problem.

Keywords: SCI, DASS-21, MOS SF-36, AUDIT, CAGE, SMAST, Neuromuscular Recovery