bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility and acceptability of daily testing at school as an alternative to self-isolation following close contact with a confirmed case of COVID-19: a qualitative analysis
Authors: Denford Sarah , Towler Lauren , Ali Behiye , Treneman-Evans Georgia , Bloomer Rachael , Peto Tim EA , Young Bernadette C. , Yardley Lucy
Published: April 2022

Background

Daily testing using a rapid Lateral Flow Device (LFD) has been suggested as an alternative to self-isolation. A randomised trial comparing daily contact testing (DCT) in schools with self-isolation found that SARS-CoV-2 transmission within school was comparable and low in both groups. However, if this approach is to be adopted widely, it is critical that we understand the perspective of those who will be delivering and receiving DCT. The aim of this qualitative process study embedded in the randomised controlled trial (RCT) was to improve understanding of a range of behavioural factors that could influence implementation.

Methods

Interviews were conducted with 63 participants, including staff, students, and parents of students who had been identified as being in close contact with someone with COVID-19. The topic guide explored perceptions of daily testing, understanding of positive and negative test results, and adherence to guidance. Data were analysed using an inductive thematic approach.

Results

Results were organised under three main headings: (1) factors influencing daily testing (2) interpretation of test results (3) behaviour during testing period. Participants recognized that daily testing may allow students to remain in school, which was viewed as necessary for both education and social needs. Whilst some felt safer as a result of daily testing, others raised concerns about safety. Participants did not always understand how to interpret and respond to test results, and although participants reported high levels of adherence to the guidance, improved communications were desired.

Conclusion

Daily testing may be a feasible and acceptable alternative to self-isolation among close contacts of people who test positive. However, improved communications are needed to ensure that all students and parents have a good understanding of the rationale for testing, what test results mean, how test results should be acted on, and how likely students are to test positive following close contact. Support is needed for students and parents of students who have to self-isolate and for those who have concerns about the safety of daily testing.
Factors associated with women’s healthcare decision-making during and after pregnancy in urban slums in Mumbai, India: a cross-sectional analysis
Authors: Batura Neha , Poupakis Stavros , Das Sushmita , Bapat Ujwala , Alcock Glyn , Skordis Jolene , Haghparast-Bidgoli Hassan , Pantvaidya Shanti , Osrin David
Published: April 2022

Background

Understanding factors associated with women's healthcare decision-making during and after pregnancy is important. While there is considerable evidence related to general determinants of women’s decision-making abilities or agency, there is little evidence on factors associated with women's decision-making abilities or agency with regards to health care (henceforth, health agency), especially for antenatal and postnatal care. We assessed women’s health agency during and after pregnancy in slums in Mumbai, India, and examined factors associated with increased participation in healthcare decisions.

Methods

Cross-sectional data were collected from 2,630 women who gave birth and lived in 48 slums in Mumbai. A health agency module was developed to assess participation in healthcare decision-making during and after pregnancy. Linear regression analysis was used to examine factors associated with increased health agency.

Results

Around two-thirds of women made decisions about perinatal care by themselves or jointly with their husband, leaving about one-third outside the decision-making process. Participation increased with age, secondary and higher education, and paid employment, but decreased with age at marriage and household size. The strongest associations were with age and household size, each accounting for about a 0.2 standard deviation difference in health agency score for each one standard deviation change (although in different directions). Similar differences were observed for those in paid employment compared to those who were not, and for those with higher education compared to those with no schooling.

Conclusion

Exclusion of women from maternal healthcare decision-making threatens the effectiveness of health interventions. Factors such as age, employment, education, and household size need to be considered when designing health interventions targeting new mothers living in challenging conditions, such as urban slums in low- and middle-income countries.
Tracking discussions of complementary, alternative, and integrative medicine in the context of the COVID-19 pandemic: a month-by-month sentiment analysis of Twitter data
Authors: Ng Jeremy Y. , Abdelkader Wael , Lokker Cynthia
Published: April 2022

Background

Coronavirus disease 2019 (COVID-19) is a novel infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite the paucity of evidence, various complementary, alternative and integrative medicines (CAIMs) have been being touted as both preventative and curative. We conducted sentiment and emotion analysis with the intent of understanding CAIM content related to COVID-19 being generated on Twitter across 9 months.

Methods

Tweets relating to CAIM and COVID-19 were extracted from the George Washington University Libraries Dataverse Coronavirus tweets dataset from March 03 to November 30, 2020. We trained and tested a machine learning classifier using a large, pre-labelled Twitter dataset, which was applied to predict the sentiment of each CAIM-related tweet, and we used a natural language processing package to identify the emotions based on the words contained in the tweets.

Results

Our dataset included 28 713 English-language Tweets. The number of CAIM-related tweets during the study period peaked in May 2020, then dropped off sharply over the subsequent three months; the fewest CAIM-related tweets were collected during August 2020 and remained low for the remainder of the collection period. Most tweets (n = 15 612, 54%) were classified as positive, 31% were neutral (n = 8803) and 15% were classified as negative (n = 4298). The most frequent emotions expressed across tweets were trust, followed by fear, while surprise and disgust were the least frequent. Though volume of tweets decreased over the 9 months of the study, the expressed sentiments and emotions remained constant.

Conclusion

The results of this sentiment analysis enabled us to establish key CAIMs being discussed at the intersection of COVID-19 across a 9-month period on Twitter. Overall, the majority of our subset of tweets were positive, as were the emotions associated with the words found within them. This may be interpreted as public support for CAIM, however, further qualitative investigation is warranted. Such future directions may be used to combat misinformation and improve public health strategies surrounding the use of social media information.
Peer relationships buffer the negative association of online education with education satisfaction and subsequently with study engagement among undergraduate medical students
Authors: Wissing R. O. , Hilverda F. , Scheepers R. A. , Nieboer A. P. , Vollmann M.
Published: April 2022

Background

Due to the COVID-19 pandemic, undergraduate medical students had to follow high amounts of online education. This does not match their preferences and might negatively affect their education satisfaction and study engagement. As low levels of education satisfaction and study engagement are risk factors for burnout and dropout, resources that mitigate these possible negative consequences of forced online education need to be identified. Therefore, the current study investigated 1) the associations of the amount of online education with education satisfaction and study engagement, and 2) whether quantitative (i.e., network size) and qualitative (i.e., perceived support) aspects of peer relationships can buffer the expected negative associations.

Methods

In a cross-sectional study, 372 undergraduate medical students from all eight Dutch medical schools (79.8% female; mean age: 20.4 years) completed an online survey assessing the relevant variables. Data were analysed using correlation and moderated mediation analyses.

Results

The amount of online education was significantly negatively related to education satisfaction and study engagement. Additionally, higher amounts of online education were indirectly associated with lower levels of study engagement through lower levels of education satisfaction. More importantly, both quantitative and qualitative aspects of peer relationships significantly buffered this negative indirect association. Specifically, among medical students with a large peer network or high levels of perceived peer support, the amount of online education was no longer significantly negatively related to education satisfaction and subsequently to study engagement.

Conclusions

The current study underlines the importance of peer relationships in the educational context, since our findings indicate that both the peer network size and the perceived peer support protect medical students’ education satisfaction and study engagement when confronted with study demands, such as forced online education during the COVID-19 pandemic. These findings may be translated into educational efforts that stimulate collaborative learning and the formation of formal peer networks.
Survey of the patients' perspectives and preferences in adopting telepharmacy versus in-person visits to the pharmacy: a feasibility study during the COVID-19 pandemic
Authors: Moulaei Khadijeh , Shanbehzadeh Mostafa , Bahaadinbeigy Kambiz , Kazemi-Arpanahi Hadi
Published: April 2022

Background

Following the coronavirus disease 2019 (COVID-19) pandemic, the health authorities recommended the implementation of strict social distancing and complete lockdown regulations to reduce disease spread. The pharmacists quickly adopted telemedicine (telepharmacy) as a solution against this crisis, but awareness about this technology is lacking. Therefore, the purpose of this research was to explore the patients' perspectives and preferences regarding telepharmacy instead of traditional in-person visits.

Methods

An electronic questionnaire was designed and sent to 313 patients who were eligible for the study (from March to April 2021). The questionnaire used five-point Likert scales to inquire about motivations for adopting telepharmacy and in-person visits, their perceived advantages and disadvantages, and the declining factors of telepharmacy. Finally, the results were descriptively analyzed using SPSS 22.

Results

Of all 313 respondents, a total of 241 (77%) preferred appointments via telepharmacy while 72 (23%) preferred in-person services. There was a significant difference between the selection percentage of telepharmacy and in-person services (chi-square 91.42; p < 0.0001). Preference bout the telepharmacy system versus in-person visits to the pharmacy was associated with factors such as "reducing the incidence of contagious disease" (4.41; ± 0.78), "spending less time receiving pharmaceutical services” (4.24; ± 0.86)), and “traveling a shorter distance for receiving pharmaceutical services" (4.25; ± 0.86). "Reducing costs" (90.87%), "saving time" (89.21%), and "reducing the incidence of contagious disease" (87.13%) were the most important reasons for choosing telepharmacy services. Also, “face-to-face communication with the pharmacist” (25%), “low internet bandwidth” (25%), and “reduction of patients' anxiety and the increase of their peace of mind” (23.61%) were the most important reasons for choosing in-person visits.

Conclusion

Survey data indicate that most participants are likely to prefer the use of telepharmacy, especially during crises such as the current COVID-19 pandemic. Telepharmacy can be applied as an important means and a crucial service to lessen the load on healthcare organizations and expand drug supply shelters in pharmacies. However, there are still substantial hurdles to overcome in order to successfully implement the telemedicine platform as part of mainstream practice.
“I do lack peace, and I’ve run out of answers”: primary caregivers’ perspectives on social and behaviour problems in cerebral malaria survivors in Blantyre, Malawi
Authors: Karmen-Tuohy Savannah , Mboma Sebastian M. , Langfitt John T. , Brim Rachel , Gladstone Melissa , Taylor Terrie E.
Published: April 2022

Background

Despite recent advances in treatment and prevention, the prevalence of cerebral malaria (CM) remains high globally, especially in children under 5 years old. As treatment improves, more children will survive episodes of CM with lasting neurodisabilities, such as social and behavioural issues. Behaviour problems in children who survive CM are poorly characterized, and the impact of caring for a child with post-CM behaviour issues has not been well-explored. Caregivers’ perceptions of and experiences with their child’s post-CM behaviour problems are reported here.

Methods

Semi-structured interviews were conducted with 29 primary caregivers of children who survived CM with reported behaviour issues in Blantyre, Malawi. Interviews were conducted in Chicheŵa, audio-recorded, transcribed, and translated into English. Data were coded manually, utilizing inductive and deductive approaches. Identified codes were thematically analysed.

Results

Post-CM behaviours reported include externalizing, aggressive behaviours and learning difficulties. Variable timescales for behaviour change onset were noted, and most caregivers reported some evolution of their child’s behaviour over time. Caregivers experienced a variety of emotions connected to their child’s behaviour and to reactions of family and community members. Caregivers who experienced discrimination were more likely to describe negative emotions tied to their child’s behaviour changes, compared to caregivers who experienced support.

Conclusions

Caregiver perceptions of behaviour changes in post-CM survivors are variable, and caregiver experience is strongly impacted by family and community member responses. Future educational, rehabilitation, and support-based programmes should focus on the specific types of behaviour problems identified and the difficulties faced by caregivers and their communities.
Predicting 2-year survival in stage I-III non-small cell lung cancer: the development and validation of a scoring system from an Australian cohort
Authors: Lee Natalie Si-Yi , Shafiq Jesmin , Field Matthew , Fiddler Caroline , Varadarajan Suganthy , Gandhidasan Senthilkumar , Hau Eric , Vinod Shalini Kavita
Published: April 2022

Background

There are limited data on survival prediction models in contemporary inoperable non-small cell lung cancer (NSCLC) patients. The objective of this study was to develop and validate a survival prediction model in a cohort of inoperable stage I-III NSCLC patients treated with radiotherapy.

Methods

Data from inoperable stage I-III NSCLC patients diagnosed from 1/1/2016 to 31/12/2017 were collected from three radiation oncology clinics. Patient, tumour and treatment-related variables were selected for model inclusion using univariate and multivariate analysis. Cox proportional hazards regression was used to develop a 2-year overall survival prediction model, the South West Sydney Model (SWSM) in one clinic (n = 117) and validated in the other clinics (n = 144). Model performance, assessed internally and on one independent dataset, was expressed as Harrell’s concordance index (c-index).

Results

The SWSM contained five variables: Eastern Cooperative Oncology Group performance status, diffusing capacity of the lung for carbon monoxide, histological diagnosis, tumour lobe and equivalent dose in 2 Gy fractions. The SWSM yielded a c-index of 0.70 on internal validation and 0.72 on external validation. Survival probability could be stratified into three groups using a risk score derived from the model.

Conclusions

A 2-year survival model with good discrimination was developed. The model included tumour lobe as a novel variable and has the potential to guide treatment decisions. Further validation is needed in a larger patient cohort.
Increasing dominant follicular proportion negatively associated with good clinical outcomes in normal ovarian responders using the depot GnRH agonist protocol: a large-sample retrospective analysis
Authors: Su Houming , Lai Youhua , Li Jie , Liao Tingting , Ji Licheng , Hu Xinyao , Qian Kun
Published: April 2022

Background

Currently, there is no universal criteria for the trigger time of controlled ovarian hyperstimulation (COH), especially with the emerging depot GnRH agonist protocol. It is challenging to explore an indicator that is representative of target follicle cohort development as an alternative to the conventional approach of determining the trigger time based on a few leading follicles.

Methods

This was a large-sample retrospective analysis. Between January 2016 and January 2020, 1,925 young normal ovarian responders who underwent their first in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) cycle using the depot GnRH agonist protocol were included. They were divided into three groups based on the dominant follicular proportion (DFP, defined as the ratio of ≥ 18 mm dominant follicles/ ≥ 14 mm large follicles on the human chorionic gonadotropin (HCG) day; Group A: < 30%; Group B: 30%−60%; and Group C: ≥ 60%). The binary logistic regression and multivariate linear regression were used to assess whether the DFP was associated with clinical pregnancy, the number of frozen blastocysts, the blastocyst formation rate, and the low number of frozen blastocysts.

Results

The logistic regression analysis showed that compared with Group A, the odds ratio (OR) for clinical pregnancy was 1.345 in Group B (P = 0.023), and there was no statistical difference between Group C and Group A (P = 0.216). The multivariate linear regression analysis showed that DFP was negatively associated with the number of frozen blastocysts (β ± SE: Group B vs. Group A = − 0.319 ± 0.115, P = 0.006; Group C vs. Group A = − 0.432 ± 0.154, P = 0.005) as well as the blastocyst formation rate (β ± SE: Group B vs. Group A = − 0.035 ± 0.016, P = 0.031; Group C vs. Group A = − 0.039 ± 0.021, P = 0.067). Furthermore, the OR for the low number of frozen blastocysts was 1.312 in Group B (P = 0.039) and 1.417 in Group C (P = 0.041) compared to Group A.

Conclusions

For young normal ovarian responders using the depot GnRH agonist protocol, increasing DFP might reduce the developmental potential of oocytes and reduce the number of available blastocysts, and this might result in a lower cumulative pregnancy rate. However, further confirmation using strict prospective randomised controlled studies is required.
Reflex BRCA1 and BRCA2 tumour genetic testing for high-grade serous ovarian cancer: streamlined for clinicians but what do patients think?
Authors: McCuaig Jeanna M. , Ferguson Sarah E. , Vicus Danielle , Ott Karen , Stockley Tracy L. , Kim Raymond H. , Metcalfe Kelly A.
Published: April 2022

Background

Reflex (automatic) BRCA1 and BRCA2 (BRCA1/2) genetic testing of tumour tissue is being completed for all newly diagnosed high-grade serous ovarian cancer (HGSOC) in the province of Ontario, Canada. The objective of this study was to measure the psychological impact of tumour genetic testing among individuals with a new diagnosis of HGSOC.

Methods

Participants had a new diagnosis of HGSOC and received reflex BRCA1/2 tumour genetic testing as a component of their care. Eligible individuals were recruited from two oncology centres in Toronto, Canada. One week after disclosure of tumour genetic test results, consenting participants were asked to complete a questionnaire that measured cancer-related distress, dispositional optimism, knowledge of hereditary breast/ovarian cancer, recall of tumour genetic test results, satisfaction, and the psychological impact of receiving tumour genetic test results. The Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire was used to measure the psychological impact of tumour genetic testing.

Results

76 individuals completed the study survey; 13 said they did not receive their tumour test results. Of the remaining 63 participants, the average MICRA score was 26.8 (SD = 16.3). Higher total MICRA scores were seen among those with children (p = 0.02), who received treatment with primary surgery (p = 0.02), and had higher reported cancer-related distress (p < 0.001). Higher dispositional optimism (p < 0.001) and increasing age (p = 0.03) were associated with lower total MICRA scores. Most (83.5%) participants reported being satisfied/highly satisfied with having tumour testing completed; however, 40.8% could not accurately recall their tumor test results.

Conclusions

This study is the first to assess psychological outcomes following reflex BRCA1/2 tumour genetic testing in women newly diagnosed with HGSOC. Increased dispositional optimism provided a protective effect, while increased cancer-related distress increased the psychological impact of tumour genetic testing. Educational resources are needed to help increase patient understanding and recall of tumour results, particularly when tumour genetic testing includes analysis of genes that may have implications for hereditary cancer risk. Additional research is required to better understand the patient experience of reflex tumour genetic testing.
Delineating the role of osteoprotegerin as a marker of breast cancer risk among women with a BRCA1 mutation
Authors: Park Sarah Sohyun , Uzelac Aleksandra , Kotsopoulos Joanne
Published: April 2022

Women with a pathogenic germline mutation in the BRCA1 gene face a very high lifetime risk of developing breast cancer, estimated at 72% by age 80. Prophylactic bilateral mastectomy is the only effective way to lower their risk; however, most women with a mutation opt for intensive screening with annual MRI and mammography. Given that the BRCA1 gene was identified over 20 years ago, there is a need to identify a novel non-surgical approach to hereditary breast cancer prevention. Here, we provide a review of the emerging preclinical and epidemiologic evidence implicating the dysregulation of progesterone-mediated receptor activator of nuclear factor κB (RANK) signaling in the pathogenesis of BRCA1-associated breast cancer. Experimental studies have demonstrated that RANK inhibition suppresses Brca1-mammary tumorigenesis, suggesting a potential target for prevention. Data from studies conducted among women with a BRCA1 mutation further support this pathway in BRCA1-associated breast cancer development. Progesterone-containing (but not estrogen-alone) hormone replacement therapy is associated with an increased risk of breast cancer in women with a BRCA1 mutation. Furthermore, BRCA1 mutation carriers have significantly lower levels of circulating osteoprotegerin (OPG), the decoy receptor for RANK-ligand (RANKL) and thus endogenous inhibitor of RANK signaling. OPG levels may be associated with the risk of disease, suggesting a role of this protein as a potential biomarker of breast cancer risk. This may improve upon current risk prediction models, stratifying women at the highest risk of developing the disease, and further identify those who may be targets for anti-RANKL chemoprevention. Collectively, the evidence supports therapeutic inhibition of the RANK pathway for the primary prevention of BRCA1-associated breast cancer, which may generate unique prevention strategies (without prophylactic surgery) and enhance quality of life.
Femur-tibia angle and patella-tibia angle: new indicators for diagnosing anterior cruciate ligament tears in magnetic resonance imaging
Authors: Li Zeng , Li Mengyuan , Du Yan , Zhang Mo , Jiang Hai , Zhang Ruiying , Ma Yuanchen , Zheng Qiujian
Published: April 2022

Background

Femur-tibia angle (FTA) and patella-tibia angle (PTA) are two MRI measurements that reflect the rotation of the knee joint. The purposes of this study were to assess whether FTA and PTA are associated with ACL tear and to explore their roles in ACL tear diagnosis.

Methods

FTA, PTA, ACL angle and anterior tibial subluxation were compared between the two matched groups: ACL tear group and control group (each n = 20). Diagnostic performance was evaluated in a consecutive 120-patient cohort who underwent MR imaging of the knee and subsequently had arthroscopy. Different measurements were assessed by area under the curve (AUC) of receiver operating characteristic (ROC) curve.

Results

FTA and PTA increased significantly in ACL tears group when compared to the control group (4.79 and 7.36 degrees, respectively, p < 0.05). In distinguishing complete ACL tear, ACL angle had the highest AUC of 0.906 while AUC of PTA and FTA were 0.849 and 0.809. The cutoff of FTA was 80 degrees with a sensitivity of 82% and specificity of 68%, while the cutoff of PTA was 91 degrees with a sensitivity of 82% and specificity of 74%. In distinguishing partial ACL tear, FTA and PTA had the highest AUCs of 0.847 and 0.813, respectively. The calculated cutoff of FTA was 84 degrees with a sensitivity of 90% and specificity of 81%, while the cutoff of PTA was 92 degrees with a sensitivity of 80% and specificity of 77%.

Conclusion

FTA and PTA increased when ACL tears and they might be valuable in diagnosing ACL tears, especially in distinguishing partial ACL tear from intact ACL.
Use of WATCH antibiotics prior to presentation to the hospital in rural Burkina Faso
Authors: Valia Daniel , Ingelbeen Brecht , Kaboré Bérenger , Karama Ibrahima , Peeters Marjan , Lompo Palpouguini , Vlieghe Erika , Post Annelies , Cox Janneke , de Mast Quirijn , Robert Annie , van der Sande Marianne A. B. , Villalobos Hector Rodriguez , van der Ven Andre , Tinto Halidou , Jacobs Jan
Published: April 2022

Background

In low- and middle-income countries, the prevalence of antimicrobial resistance (AMR) is increasing. To control AMR, WHO recommends monitoring antibiotic use, in particular Watch antibiotics. These are critically important antibiotics, with restricted use because at risk of becoming ineffective due to increasing AMR. We investigated pre-hospital antibiotic use in rural Burkina Faso.

Methods

During 2016–2017, we collected data from patients aged > 3 months presenting with severe acute fever to the rural hospital of Nanoro Health District, Burkina Faso, including antibiotic use in the two weeks prior to consultation or hospitalization. We analysed reported antibiotic use by applying the WHO Access, Watch, Reserve classification.

Results

Of 920 febrile participants (63.0% ≤ 14 years), pre-hospital antibiotic use was reported by 363 (39.5%). Among these 363, microbiological diagnoses were available for 275 (75.8%) patients, of whom 162 (58.9%) were non-bacterial infections. Use of more than one antibiotic was reported by 58/363 (16.0%) participants. Of 491 self-referred patients who did not previously visit a primary health care center, 131 (26.7%) reported antibiotic use. Of 424 antibiotics reported, 265 (62.5%) were Access and 159 (37.5%) Watch antibiotics. Watch antibiotic use was more frequent among patients > 14 year olds (51.1%) compared to those 0–14 year old (30.7%,p < 0.001) and among referrals from the primary health care centers (42.2%) compared to self-referred patients (28.1%,p = 0.004). Most frequently reported Watch antibiotics were ceftriaxone (114, 71.7%) and ciprofloxacin (32, 20.1%).

Conclusion

The reported frequent use of Watch group antibiotics among febrile patients prior to presentation to the hospital in rural Burkina Faso highlights the need to develop targeted interventions to improve antibiotic use in community settings as part of strengthening antibiotic stewardship in low- and middle-income countries. This should include facilitating referral, access to qualified prescribers and diagnostic tools in rural primary health care centers.

Trial registrationClinicalTrials.gov identifier: NCT02669823. Registration date was February 1, 2016.
Impacts of weaning weights and mycotoxin challenges on jejunal mucosa-associated microbiota, intestinal and systemic health, and growth performance of nursery pigs
Authors: Holanda D. M. , Kim S. W.
Published: April 2022

Background

This study aimed at investigating the effects of mycotoxin challenge on the growth and physiology of nursery pigs with different weaning weights.

Results

At weaning, 10 pigs were euthanized to collect jejunal mucosa and 90 pigs were assigned following a randomized complete block design in a 2 × 2 factorial arrangement of treatments with 3 pigs per pen. Factors were: weaning weight (light: body weight, BW < 7.5 kg or heavy: BW > 9.0 kg); and dietary mycotoxins (supplementation of 0.2 mg/kg aflatoxins, 2.0 mg/kg deoxynivalenol). All diets had titanium dioxide as an external marker at 0.5%. Growth performance and fecal score were recorded until pigs achieved 20 kg BW (light pigs average BW = 21.1 kg and heavy pigs average BW = 20.5 kg). Pigs were sampled for blood, ileal digesta, jejunal tissue and mucosa at 20 kg BW. Data were analyzed using the mixed procedure of SAS. At weaning, light pigs had decreased (P < 0.05) jejunal interleukin-8, increased (P < 0.05) tumor necrosis factor-α, and increased (P < 0.05) α-diversity indexes of jejunal mucosa-associated microbiota. At 20 kg of BW, light pigs had decreased (P < 0.05) average daily gain (ADG), average daily feed intake (ADFI), and gain to feed ratio (G/F). Mycotoxins decreased (P < 0.05) BW, ADG, ADFI, and G/F. Light pigs tended to have increased fecal score on d 0 (P = 0.080), d 10 (P = 0.069), and increased (P < 0.05) fecal score at 20 kg. Mycotoxins decreased the apparent ileal digestibility of nitrogen (P < 0.05). Light pigs had increased (P < 0.05) intestinal malondialdehydes and interleukin 8. Mycotoxins tended to increase (P = 0.060) intestinal tumor necrosis factor-α.

Conclusions

Nursery pigs with light weaning weight were more susceptible to jejunal inflammation and had impaired intestinal health due to weaning stress, whereas mycotoxins diminished the health and growth of nursery pigs regardless of weaning weight.
Pre-trained transformer-based language models for Sundanese
Authors: Wongso Wilson , Lucky Henry , Suhartono Derwin
Published: April 2022

The Sundanese language has over 32 million speakers worldwide, but the language has reaped little to no benefits from the recent advances in natural language understanding. Like other low-resource languages, the only alternative is to fine-tune existing multilingual models. In this paper, we pre-trained three monolingual Transformer-based language models on Sundanese data. When evaluated on a downstream text classification task, we found that most of our monolingual models outperformed larger multilingual models despite the smaller overall pre-training data. In the subsequent analyses, our models benefited strongly from the Sundanese pre-training corpus size and do not exhibit socially biased behavior. We released our models for other researchers and practitioners to use.
RETRACTED ARTICLE: Posterior chamber phakic intraocular lens implantation after laser in situ keratomileusis
Authors: Kamiya Kazutaka , Shimizu Kimiya , Igarashi Akihito , Kitazawa Yoshihiro , Kojima Takashi , Nakamura Tomoaki , Ichikawa Kazuo , Fukuoka Sachiko , Fujimoto Kahoko ,   the Japan ICL Study Group
Published: April 2022

Background

To assess the multicenter outcomes of posterior chamber phakic intraocular lens implantation with a central hole (EVO-ICL, STAAR Surgical) for patients undergoing previous laser in situ keratomileusis (LASIK).

Methods

This case series enrolled 31 eyes of 21 consecutive patients undergoing EVO-ICL implantation to correct residual refractive errors after LASIK at 7 nationwide major surgical sites. We investigated safety, efficacy, predictability, stability, and adverse events at 1 week, 1, 3, and 6 months postoperatively, and at the final visit.

Results

The mean observation period was 1.6 ± 1.8 years. Uncorrected and corrected visual acuities were − 0.14 ± 0.11 and − 0.22 ± 0.09 logMAR at 6 months postoperatively. At 6 months postoperatively, 81% and 100% of eyes were within ± 0.5 D and ± 1.0 D, respectively, of the targeted correction. We found neither significant manifest refraction changes of 0.05 ± 0.38 D from 1 week to 6 months nor apparent intraoperative or postoperative complications in any case.

Conclusions

Our multicenter study confirmed that the EVO-ICL provided good outcomes in safety, efficacy, predictability, and stability, even in post-LASIK eyes. Therefore, EVO-ICL implantation may be a viable surgical option, even for correcting residual refractive errors after LASIK.

Trial registration University Hospital Medical Information Network Clinical Trial Registry (000045295).
In vitro comparative analysis of scanning accuracy of intraoral and laboratory scanners in measuring the distance between multiple implants
Authors: Natsubori Reiji , Fukazawa Shota , Chiba Toyokazu , Tanabe Norimasa , Kihara Hidemichi , Kondo Hisatomo
Published: April 2022

Background

The purpose of this study was to evaluate the accuracy of intraoral scanners by comparing the trueness and precision of several types of scanners in measuring the distance between the ball abutments on pairs of multiple implants.

Methods

Seven implants were placed on a fully edentulous upper jaw model. After ball abutments were attached to the implants on the master model, the three-dimensional (3D) shape of the model was evaluated using a computer numerical control 3D coordinate-measuring machine. Subsequently, the 3D shape-related data of the model were obtained using two types of intraoral scanners (3M True Definition Scanner [TDS] and 3Shape Trios3 [TR3]) and two types of laboratory scanners (KaVo ARCTICA Auto Scan [KA] and Identica Hybrid [IH]). Using the obtained 3D shape-related data, the trueness and precision in measuring the distance between the balls within seven pairs of ball abutments were compared among the scanners using 3D analysis software.

Results

Intraoral scanners produced significantly greater errors in trueness and precision than laboratory scanners in measuring the distances between the ball abutments in all the dental regions. Between the intraoral scanners, powder-requiring TDS produced significantly lower errors at inflection points than powder-free TR3.

Conclusions

These results indicate that an optical impression technique using an intraoral scanner is suitable for dental implant treatment in patients with a few missing teeth.
Beneficial effects of pumpkin seed soft extract on lower urinary tract symptoms and quality of life in men with benign prostatic hyperplasia: a meta-analysis of two randomized, placebo-controlled trials over 12 months
Authors: Vahlensieck Winfried , Heim Stefan , Patz Brigitte , Sahin Kurtulus
Published: April 2022

Background

In clinical practice, plant extracts are an option to treat mild-to-moderate lower urinary tract symptoms suggestive of benign prostate hyperplasia (LUTS/BPH). However, only a few herbal extracts have been investigated in long-term placebo-controlled studies. The safety and efficacy of a well-tolerated proprietary pumpkin seed soft extract (PSE) were investigated in two randomized placebo-controlled 12-month studies (Bach and GRANU study). Both trials studied LUTS/BPH patients with an International Prostate Symptom Score (IPSS) ≥13 points at baseline. The Bach study demonstrated positive effects of PSE compared to placebo, but no difference between treatments was observed in the GRANU study. We aimed to assess the efficacy of PSE in a meta-analysis using the patient-level data of these two studies.

Methods

Pooled analysis was performed in the intention-to-treat set using last-observation-carried-forward (ITT-LOCF). An IPSS improvement of ≥5 points after 12 months of therapy was the predefined response criterion. Logistic regression and ANCOVA models included the covariables treatment group, study, center size, and baseline IPSS. Each analysis was repeated for the per-protocol (PP) set.

Results

The ITT/PP analysis sets consisted of 687/485 and 702/488 patients in the PSE and placebo groups, respectively. At the 12-month follow-up, the response rates in the PSE group were 3% (ITT) and 5% (PP) higher than those in the placebo group. The odds ratio of response obtained by logistic regression analysis for comparing PSE versus placebo was 1.2 (95% CI 0.9, 1.5), favoring PSE (ITT- LOCF). For the IPSS change from baseline to 12 months, the ANCOVA estimated difference between the treatment groups was 0.7 points (95% CI 0.1, 1.2) in favor of PSE. The variables study, baseline IPSS, and center size had a relevant influence on treatment response.

Conclusion

Although the Bach and the GRANU study showed contradictory results, the analysis in a pooled form still pointed towards an advantage of PSE; namely, more patients in the PSE group showed an IPSS improvement of at least 5 points after 12 months. Therefore, the results of this meta-analysis suggest that patients with moderate LUTS/BPH may benefit from PSE treatment in terms of symptomatic relief.
Investigation of presenteeism, physical function, and exercise habits in workers with CKD: three case reports with literature review
Authors: Tabata Aki , Yabe Hiroki , Katogi Takehide , Yamaguchi Tomoya , Mitake Yuya , Shirai Tomohiro , Fujii Takayuki
Published: April 2022

Management of presenteeism in the context of chronic kidney disease (CKD) is essential for disease management, ensuring the workforce’s availability, and reducing health-related costs. The purpose of this case study was to investigate presenteeism, physical function, and exercise habits in three working patients with CKD and discuss their effects. Case 1 was a 71-year-old male security guard; Case 2 was a 72-year-old male agricultural worker; and Case 3 was an 83-year-old male civil engineering employee. Presenteeism was measured using the work functioning impairment scale (WFun), and physical function was measured using grip strength, skeletal muscle mass index, 10 m walk test, short physical performance battery, and exercise habits. The WFun assessment showed that only Case 3 had moderate presenteeism, and the barrier to employment was fatigue. Each value of physical function was higher than the reference value, but Case 3 had the lowest physical function values. All three patients had no exercise habits and were in the interest stage of behavior change. This case report indicates the existence of workers with CKD who need care for presenteeism, even if they have no problems with physical function or activities of daily living. To ensure work productivity in workers with CKD, clinicians may need to evaluate presenteeism, physical function, and exercise habits in addition to popular treatment and care.
Patient and provider perspectives on using goal attainment scaling in care planning for older adults with complex needs
Authors: Clair Catherine A. , Sandberg Shana F. , Scholle Sarah H. , Willits Jacqueline , Jennings Lee A. , Giovannetti Erin R.
Published: April 2022

Background

Assess the feasibility of using goal attainment scaling (GAS) in care planning for older adults with complex needs. GAS is an individualized approach to goal setting and follow up using a quantified scale. To date, little is known about the feasibility of GAS among this population.

Methods

We conducted a qualitative study with a sample of 28 older adults and 23 providers from diverse settings to evaluate the value and challenges of this approach. We conducted semi-structured interviews and iteratively coded and analyzed interview transcripts for themes related to value, challenges, and implementation.

Results

Most older adults and providers reported that the GAS approach added value to the care encounter. GAS supported collaboration and patient accountability for their goals, though it could be demotivating to some patients. Some older adults and providers noted that GAS could be confusing and that it was uncomfortable to talk about negative outcomes (i.e., the − 2 and − 1 boxes of the scale). Factors that facilitated implementation included using visual copies of the GAS forms, having an established patient-provider relationship, practicing the approach, and having previous goal-related clinical training.

Conclusions

GAS was feasible to implement across diverse settings, and, despite challenges, both older adults and providers reported that it added value to care planning encounters with the potential to improve delivery of person-centered care. Further efforts to demonstrate the applicability and benefit of this method for older adults are warranted, particularly to address implementation of the approach.
Analyzing sentiments and themes on cannabis in Canada using 2018 to 2020 Twitter data
Authors: Najafizada Maisam , Rahman Arifur , Donnan Jennifer , Dong Zhihao , Bishop Lisa
Published: April 2022

Introduction

The Canadian Cannabis Act came into effect on October 17, 2018, which allowed Canadian adults to consume cannabis for non-medical purposes (Government of Canada, Cannabis regulations (SOR/2018-144). Cannabis Act, (2018a); Parliament of Canada, C-45: an Act respecting cannabis and to amend the Controlled Drugs and Substances Act, the Criminal Code and other Acts, 2018). With this major policy change, it is unknown how the attitude of the public changed and how information on cannabis changed. Social media platforms, including Twitter, are significant venues for studying emerging patterns in social issues such as cannabis legalization. This study aimed to examine sentiments, themes and contents of cannabis-related tweets by suppliers (both licensed and unlicensed) and general tweets in Canada. To our knowledge, this is the first analysis that mixes sentiment analysis and thematic analysis of Canadians’ cannabis-related Twitter data.

Method

A sample of Canadian cannabis-related tweets was collected from January 2018 to August 2020 through the Twitter Application Programming Interface (API). Using a standard access token and the Twitter Standard Search API, tweets were extracted based on Twitter handles to capture the content of both licensed and unlicensed cannabis retailers in Canada, as well as relevant cannabis-related keywords to capture public content. We conducted sentiment and positive polarity analyses, and content analysis to identify attitudes and themes around cannabis use in Canada.

Results

This study gathered and analyzed a total of 44,970 tweets in the sentiment analysis and a total of 1035 tweets in the thematic analysis. Descriptive analysis showed that monthly tweets peaked prior to legalization in October 2018 and again during the initial wave of the COVID-19 pandemic in February and March 2020. The data showed an overall positive sentiment polarity with a high of + 0.24 in April 2019 and a low of + 0.14 in March 2020.

Thematic analysis revealed the themes: (i) education/information, (ii) uses of cannabis, (iii) cannabis products including packing, quality, price, types, and sources, (iv) cannabis policies including regulations and public safety, (v) access, (vi) social issues include gender and stigma, and (vii) COVID-19 impact.

Conclusion

This study combined the power of big data collection and analysis with manual coding and analysis methods to extract rich content from large data using social media communications on issues related to cannabis in Canada. The findings of this study may inform policies on advertising cannabis products and highlighted some patterns related to education, access, and safety that deserve further investigation.
The diagnostic utility of cystoscopy in assessing patients with persistent microscopic abnormalities of urinalysis
Authors: Zainal Bahren Zulfadhly Murtadha Afiq
Published: April 2022

Background

Microscopic abnormalities are common findings on routine urinalysis performed for various clinical reasons. As a small proportion of these may indicate an underlying malignancy, a large number of patients with these abnormalities are referred for further investigations, which includes a cystoscopy. We aim to investigate the diagnostic utility of cystoscopy in detecting malignancy in this group of patients.

Methods

A retrospective review of patients who underwent standard diagnostic workup for microscopic abnormalities of urinalysis (microscopic haematuria, sterile pyuria and bacteriuria) between January 2013 and December 2018 was performed. Patients with macroscopic haematuria, concurrent UTI, recent kidney stone passage, dysmorphic red cells, proteinuria and casts on urinalysis were excluded. Demographic information, age at diagnosis, smoking status and final diagnosis were extracted.

Results

In total, 552 patients identified. 58% of the patients are males (319 patients). The mean age was 61 years with 35% patients having a history of smoking. 94% of the patients underwent pre-cystoscopy imaging. Twelve (2%) patients had a final diagnosis of genitourinary malignancy. Out of the 12 patients diagnosed with malignancy, pre-cystoscopy imaging detected a bladder lesion in 11 (92%) patients.

Conclusions

The incidence of genitourinary malignancy in patients with persistent microscopic abnormalities of urinalysis is low at 2%. In our cohort, flexible cystoscopy demonstrated little additional diagnostic value with only 1 malignancy (0.2%) detected by flexible cystoscopy alone. Hence, we may have to reconsider our current threshold in investigating this group of patients.
Could anakinra outmatch dexamethasone/tocilizumab in COVID-19?
Authors: Gupta Rahul
Published: April 2022

The hyperinflammatory state leading to an aberrant cytokine production, culminating in acute respiratory distress syndrome, sepsis and multi-organ dysfunction contribute much to the pathophysiologies of severe COVID-19. These severe patients have similar clinical manifestations with patients suffering from certain auto-inflammatory disorders and cytokine storm syndromes. Interestingly, anakinra (blocking both IL-1α and IL-1β) has shown promises in treating these patients with hyperinflammatory disorders, sepsis with multiorgan failures. Another inflammasome, AIM2, involved in production of IL-1 has also been found to be implicated in COVID-19. IL-1β, a known procoagulant, causes induction of tissue factor with increasing vascular endothelial permeability loss ensuing in hypercoagulability-one of the cardinal features of the disease. Hence, anakinra a 17kD recombinant human IL-1 receptor antagonist, used widely in Rheumatoid Arthritis treatments might prove efficacious in attenuating the hyperinflammatory state of the disease. Indeed, some of the controlled clinical trials have shown anakinra to effectively decrease mortality and hospital stay. Targeted cytokine blocking are always preferable in comparison with non-specific blocking (steroids) as it is more restrained with the chances of dampening of systemic immune system being much less. Early cell death and neutrophil migration have been one of the pivotal events in COVID-19 pathogenesis. Hence, suPAR levels which measures IL-1α (necroptosis) and S100A8/A9 (neutrophil migration) can perhaps be a good early biomarker predicting the disease progression. Lastly and importantly, as the vaccines are raised against spike protein and the different variants of concern are known to evade the neutralizing antibodies by varying degrees, it will be deserving to assess anakinra, against the variants of concern as an immunomodulatory drug.