bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between objectively measured physical activity, sedentary time, and cardiorespiratory fitness with inflammatory and oxidative stress markers and heart rate variability
Authors: Del Rosso Sebastian , Baraquet Lucía , Bergero Gastón , Muñoz Fabian , Mazzocco Yanina Luciana , Aoki Maria Pilar , Perovic Nilda Raquel
Published: June 2022

Background:

To assess the associations between physical activity (PA) and sedentary time (SEDT) with inflammatory and oxidative stress markers, heart rate variability (HRV) and post-exercise recovery (HRR) controlling for cardiorespiratory fitness (CRF) and potential confounders.

Design and methods:

The following data was collected from 44 participants during 2019 (age = 49.5 ± 6.4 years, 66% women): Plasma levels of C-reactive protein (CRP) and cytokines (IL-1β, INF-γ, TNF-α, MCP-1, IL-6, IL-8, IL-10, IL-18, IL-23); catalase (CAT) and glutathione peroxidase (GPX) activities; resting heart (HR) rate for HRV analysis, anthropometric measures, a submaximal cycling test to evaluate CRF with active recovery to assess and HRR (absolute and ΔHR), and 7-day accelerometry.

Results:

Women spent significantly more SEDT ( p = 0.035), had higher inflammatory markers (IL-6 and TNF) and lower HRV indices [SDNN, LF/HF, SD2 ( p > 0.05)]. Significant associations were found between SEDT and markers of inflammation [CRP, B = 0.006, p = 0.001; MCP-1, B = 0.003, p = 0.038]. HRV indices were significantly associated with inflammatory/oxidative stress markers [IL-10 ( p = 0.04), GPX ( p = 0.014), ln-IL 23 ( p = 0.036), CAT ( p = 0.026)] while HRR was positively associated with light PA [Δ3 ( B = 0.051, p = 0.043), Δ4 ( B = 0.062, p = 0.021)] and inversely related to catalase [Δ3 ( B = −54.7, p = 0.042), Δ4 ( B = −54.1, p = 0.021] and CRP [Δ5 ( B = −19.8, p = 0.033)]. Higher CRF showed lower values for TNF-α ( p = 0.02) and IL-10 ( p = 0.003) and better HRV/HRR indices [RMSSD, PNS, SampEn, SD1 ( p < 0.05)].

Conclusions:

SEDT had a higher impact on inflammation and autonomic balance, independently of PA levels with differences by sex and CRF. PA appears to be more important for a better HRR. Lower HRV and HRR could be indicative of inflammatory status.
The Burden of Plastic Surgery Related Disease in Canada: A Perspective Based on the 2019 Global Burden of Disease Study
Authors: Sardiwalla Yaeesh , Price Emma L. , Bridgman Alanna C. , Voineskos Sophocles
Published: June 2022

Purpose: Identifying the burden of disease related to plastic and reconstructive surgery in Canada will provide timely population-based data, inform policy, and generate support for research funding. Methods and Patients: Data on the burden of disease (ie, prevalence, incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years [DALYs]), were extracted from the Global Burden of Disease 2019 results tool for all available and relevant plastic surgery diseases. The economic burden of disease in Canadian dollars was calculated based on prior studies. Data are presented as either rates (per 100 000) or counts with the associated uncertainty interval. Results: In 2019, plastic surgery related conditions in Canada had an overall age-standardized DALY rate of 556 per 100 000 [463-664]. Of these conditions, breast cancer was responsible for approximately 50% of the overall burden of disease, with an age-standardized DALY rate of 268 per 100 000 [244-294] followed by squamous cell carcinoma (66 per 100 000 [45-94]) and thermal burns (61 per 100 000 [46-82]). Age-standardized incidence rates were highest for cellulitis (2654 per 100 000 [2502-2812]). Breast cancer had the highest age-standardized cost of care of all plastic surgery related diseases, at $5.1 billion, approximately half of the total age-standardized cost of $10.6 billion for included plastic surgery diseases. Conclusion: Plastic and reconstructive surgery related diseases, particularly breast cancer, thermal burns, and malignant melanoma, are responsible for a high burden of disease and significant cost to the Canadian healthcare system. These results will help guide national healthcare policy and should provide support to directing funding and research efforts toward impactful diseases facing the Canadian healthcare system.
The 1 Year Effect of COVID-19 on Plastic Surgery Trauma at a Level One Trauma Centre: A Retrospective Review
Authors: Mittermaier Peter , Oxley Paul J. , Mian Rizwan A. , Prince Jennifer M. , Lee Adrian T. , Murabit Amera , Ratanshi Imran , Bone Jeffrey
Published: June 2022

Introduction: Since the onset of the COVID-19 pandemic, Canada has seen significant societal and health changes leading to the closures of many businesses and shifts in the daily activities of many Canadians. Despite these changes and a sharp drop in the number of patients attending emergency departments across British Columbia (BC), little change was noted in the use of protected plastic surgery trauma time at a level one trauma centre surveyed in BC. The purpose of this study was to analyze and compare the changes in plastic surgery-related trauma cases before and after the onset of the COVID-19 pandemic, both in etiology and case description. Methods: A retrospective medical chart review was performed, evaluating all of the participating surgeon's trauma slates in the year before and after April 1, 2020. Patient demographics, etiology, injury location, diagnosis, and surgical timing were all recorded and analyzed using an interrupted time-series statistical model. Results: No significant difference was observed in any of the recorded categories across the 2 time periods. Slight increases were noted in workplace injuries, assaults, and home-related machinery injuries. Conclusion: The lack of significant change in workplace injuries likely stemmed from the high number of factories and industrial plants present in our health region, as these jobs lacked the ability to work from home. The results of this study show that the demand for trauma-related plastic surgery care is independent of an overall decrease in hospital admissions and therefore should be planned and budgeted for accordingly.
A Sustainable Swedish School Intervention with Extra Aerobic Exercise—Its Organization and Effects on Physical Fitness and Academic Achievement
Authors: Seger Izabela , Lundvall Suzanne , Eklund Annika , Jamshidpey Ali , Takats Johnny , Stålman Cecilia , Tidén Anna , Andersson Eva A.
Published: June 2022

Objectives:

A large majority of Swedish children do not reach the recommended daily activity level. Some, but not all, studies show that extra physical activity may have positive effects on children’s school performance, physical fitness and health. The present aim was to offer pupils from the 7th to the 8th grade extra aerobic exercise led by physical education teachers and to evaluate the effects on aerobic fitness, muscle strength, school grades and health. The hypothesis was that extra aerobic exercise would improve physical fitness, school grades and health.

Methods:

In the two-year project, 122 pupils aged 13–14 years from three schools constituted an aerobic group with 30 min extra exercise sessions (≥70% maximal heart rate) twice weekly. A control group of 26 pupils was included. All 148 pupils also had regular 60 min physical education lessons (2/week). A moderate to large significant effect size (via partial eta-squared) of the interaction effect for the aerobic group compared to the control group over time was generally seen for aerobic fitness, the muscle strength test with push-ups, school grades in Swedish, English and physical education, and in average school grade for four school subjects combined, thus also including mathematics.

Results:

Within the aerobic group, significant improvements were also shown for aerobic fitness, endurance and strength of abdominal and leg muscles, and the total physical test index during the two-year project. The control group showed no corresponding improvement in these parameters. Improvements in school grades were generally seen among both sexes in the aerobic group, whereas improvements in physical capacity were distinctly more pronounced among boys and seldom among girls. A similar pattern with significant improvement in several school grades was noted in all three intervention schools, although one of the schools had a distinctly larger proportion of children who immigrated to Sweden. The aerobic group showed significantly higher ratings (with a small to moderate effect size) on several questions about physical self-perception than the control group at the end of the 8th grade.

Conclusion:

This teacher-led school intervention generated a sustainable project with improvements in physical fitness and school grades. The project might act as an inspiration for other schools to increase physical activity to improve physical fitness and possibly school grades.
Knowledge and Attitude Towards Short Birth Interval among Rural Women who Gave Birth in the Last Three Years at Dembecha District, Northwest Ethiopia, 2019
Authors: Aklil Mastewal Belayneh , Temesgan Wubedle Zelalem , Anteneh Kiber Temesgen , Debele Tibeb Zena
Published: June 2022

Background

A woman can have fewer children when intervals between consecutive births are optimal. This has great importance for the well-being of women, pregnancy outcomes, and the long-term health of children under the age of five. We can save 2millon of the 11 million deaths of children under the age of five per year by avoiding short birth intervals. It is affected by the knowledge and attitude of women, particularly rural women, who had a high fertility rate. To our deep review, this is the first study done in Ethiopia. Hence, this study aimed to assess knowledge and attitude towards short birth intervals and associated factors among rural women who gave birth in the last three years at Dembecha district, northwest Ethiopia.

Method

A community-based cross-sectional study was conducted from September 20 to October 20, 2019. A cluster sampling technique was employed to select the study participants and data were collected using a pre-tested, semi-structured, interviewer-administered questionnaire. Bivariable and multivariable logistic regression model was fitted to identify factors associated with knowledge and attitude towards short birth interval. The level of significant association was declared using the adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p-value of <0.05.

Result

From the total study participants, 66.4% (95% CI: 63.0–70.0) had good knowledge and 45.9% (95% CI: 42.3–49.8) had a positive attitude towards short birth intervals. In multivariable logistic regression: marital status, antenatal care follow-up, maternal occupation, and wealth status were significantly associated with knowledge. In addition, antenatal care follow-up and maternal occupation were significantly associated with attitude.

Conclusion

Majority of the participants had poor knowledge and a positive attitude towards short birth intervals. Hence, interventions should be done to optimize women's knowledge and attitude towards short birth intervals by enhancing antenatal care utilization.
Connecting across difference in environmental governance: Beyond rights, recognition, and participation
Authors: Arney Rachel N , Henderson Maya B , DeLoach Haley R , Lichtenstein Gabrielle , German Laura A
Published: June 2022

This paper explores the significance of current paradigms for connecting across difference in environmental governance, with a focus on dominant practices and the erasures that occur in the process. It focuses on three core concepts and corresponding practices: rights (adhering to both persons and property, procedural, and substantive); recognition (of harms done, of those harmed, or of those deserving of special recognition); and participation (in which information, decision authority, and/or benefits are shared with affected populations). The paper begins with a literature review on the history and purported benefits of each of these concepts, the environmental arenas where they occur, and the critiques that are leveraged against them. To envision what it might look like to connect across difference differently, we situate these critiques in the literature on coloniality and use this to develop a conceptual framework for evaluating efforts to connect across difference in environmental governance. We then illustrate the application of this framework in the environmental arenas of biodiversity conservation and extractivism to crystalize through lived experiences what it means to operate inside of these paradigms and to move beyond them. The paper highlights how current paradigms for connecting across difference are deeply situated in (settler) colonial logics of hierarchies of value, state sovereignty, and Indigenous erasure. We conclude with a vision of how environmental governance can move beyond its current colonial hegemony by centering decolonial and abolition ecologies scholarship that decenters settler ontologies in favor of more radical alternatives for relating with the so-called “natural” world.
Down syndrome: a review of ocular manifestations
Authors: Haseeb Abid , Huynh Elisah , ElSheikh Reem H. , ElHawary Ahmed S. , Scelfo Christina , Ledoux Danielle M. , Maidana Daniel E. , Elhusseiny Abdelrahman M.
Published: June 2022

Down syndrome is the most common genetically mediated intellectual disability. Although many physiologic and pathologic features of Down syndrome are discussed at length in the literature, the ocular manifestations of Down syndrome have seldom been discussed in a comprehensive fashion. Given that Down syndrome has ocular manifestations from the front to the back of the eye, it is important for physicians to become familiar with these manifestations, especially given the prevalence of Down syndrome. This review aims to discuss the varied ophthalmologic manifestations of Down syndrome – including strabismus, amblyopia, nystagmus, accommodation deficits, nasolacrimal duct obstruction, keratoconus, optic nerve pathology, neoplastic disease, and retinal pathology – to facilitate better care and visual outcomes in this important patient population.
‘57 Chocolate: Entrepreneurial Initiatives to Revive Ghana’s Chocolate Market
Authors: Ahmed Jashim Uddin , Talukder Niza , Khan Md. Muinuddin , Ahmed Asma
Published: June 2022

Ghana, one of the largest suppliers of cocoa in the global market, is widely known for its cocoa beans but not chocolate. A new wave of entrepreneurs emerging from across the African continent are now addressing this issue through efforts to grow the domestic chocolate industry. The case of ‘57 Chocolate presents an entrepreneurial initiative of two African women who are on a mission to revolutionize the chocolate industry using cocoa beans from Ghana. The case unfolds with a duo of Pan African sisters, Kimberly and Priscilla Addison, passionately using local cocoa to make premium African chocolates that are now available in both local and global markets. In addition to discussing how the brand is standing out in the chocolate market, the case identifies the competitors and goes on to evaluate how the entrepreneurial spirit of the founders is uplifting the image of Ghana.
Towards a New Paradigm: Employee Development through OD
Authors: Ramamoorthy Sankarasubramanyan
Published: June 2022

Employee development is focused on training, education, coaching and on-the-job learning experiences for strengthening the competencies and improving the confidence of employees to deliver the needs of organisations. Organisation development (OD) is a planned process of organisation change based on the current situation and the desired future.

Employee development has been significantly impacted by the VUCA (volatile, uncertain, complex and ambiguous) world created by the pandemic, remote working, and a significant reduction in training budgets. This is further amplified by the changing nature of employer–employee relationships.

Hence, it is important to redefine the vision, strategy and approach to employee development and situate it in the reality of the current context. The author recommends that employee development should be seen through an OD perspective rather than as a standalone function. The focus should be on building a learning culture and envisioning employee development as a subset of the OD process.
Employee Development in the Conceptual Age: Moving from Left to Right to Create a Whole
Authors: Kumar S. Senthil
Published: June 2022

Employees increasingly feel that their work is dread, drudgery, and not passion-driven and purposeful. Organisations need to find the right ways to retain and engage them. The factors instrumental in every phase of industrial growth in global economies change. The 21st century’s conceptual age is shaped by increased affluence, digital technologies, unmet self-actualisation needs among the workforce and customers and sustainability priorities. Organisations in the conceptual age can stay relevant and purposeful by providing engaging work, sustainable operations and life-satisfying experiences to employees and customers. Traditionally organisations mastered and leveraged the left-brain oriented competencies such as logic, focus, utility and efficiency. However, in the conceptual age, high-concept and high-touch approaches leveraging the six right-brain oriented competencies–design, symphony, story, empathy, meaning, play are crucial in developing such value propositions.
Employee Development: New Paradigms
Authors: Sachdev Anil
Published: June 2022

Employees are the life of any organisation. The success or failure of the organisation depends on employee engagement, motivation and performance. Organisations are investing huge amounts of time, money and resources on employee development. This paper analyses and shares some frameworks and models related to employee development with various live examples of B-school programmes, executive learning strategies and organisational initiatives. It refers to the mega trends shaping the world due to the COVID-19 pandemic and develops a model for creating meaningful and competent teams for development needs and the potential identification and proper execution of employee development strategies. This article also talks about how technology can be used for development needs identification and capability building. The article suggests that we should look at various dimensions like conceptual skills, technical and functional skills, human skills, curiosity, self-awareness and corporate citizenship, while designing employee development programmes.
Perspectives on the Changing Face of Employee Development
Authors: Nath Pramath
Published: June 2022

Employee development is arguably the most critical variable impacting organisational effectiveness. It has a direct correlation with the culture of the organisation. It thrives in farsighted organisations whose credo is to develop talent and help them grow. Traditionally, the responsibility of the employer has been to deploy appropriate interventions for developing the skills and shaping the behaviours of the employees. Of late, the paradigm has shifted. It is increasingly becoming incumbent upon the employees to take control of their development and career. The paradigm has shifted from training programmes designed to suit employers’ interests to the contemporary period where they encompass employee wellness.
Employee Development: The Road Ahead
Authors: Vasudevan A.
Published: June 2022

Employee development has come a long way in the past six decades as physical work has given way to knowledge work. The pandemic has changed the paradigm significantly. Today, HR leaders must figure out how to enable employee development as job roles and employee aspirations and needs keep changing rapidly. They should learn lessons from history and look ahead to see what might happen in view of the emerging trends.
Cancer rehabilitation and palliative care for socially vulnerable patients in Denmark: an exploration of practices and conceptualisations
Authors: Nissen Nina , Rossau Henriette Knold , Pilegaard Marc Sampedro , la Cour Karen
Published: June 2022

Background:

Despite a tax-funded, needs-based organisation of the Danish health system, social inequality in cancer rehabilitation and palliative care (PC) has been noted repeatedly. Little is known about how best to improve access and participation in cancer rehabilitation and PC for socio-economically disadvantaged and socially vulnerable patients.

Aim:

To gather, synthesise and describe practice-orientated development studies presented in Danish-language publications and examine the underpinning conceptualisations of social inequality and vulnerability; explore related views of stakeholders working in the field.

Methods:

The study comprised a narrative review of Danish-language literature on practice-orientated development studies which address social inequality and vulnerability in cancer rehabilitation and PC and an online stakeholder consultation workshop with Danish professionals and academics working in the field.

Results:

Two themes characterise the included publications ( n = 8): types of interventions; conceptualisations of social inequality and vulnerability; three themes were identified in the workshop data: focus and type of interventions; organisation of cancer care; and vulnerability of the healthcare system. The publications and the workshop participants ( n = 12) favoured approaches which provide additional individualised resources throughout the cancer trajectory for this patient group. The terms social inequality and social vulnerability are largely used interchangeably, and associated with low income and no or little education yet qualified with multiple descriptors, which reflect the diverse socio-economic situations professionals encounter in cancer patients and their psychosocial needs.

Conclusion:

Addressing social inequality and vulnerability in cancer rehabilitation and PC in Denmark entails practical and conceptual challenges. Of importance is individualised support and the integration of rehabilitation and PC into standardised care pathways. To conceive of social vulnerability as a layered, dynamic, relational and contextual concept reflects current practice in identifying the diversity of cancer patients who may benefit from additional support in accessing and participating in rehabilitation and PC.
Flexural performance of RC beams externally strengthened with a single-layer of basalt fiber reinforced polymer sheets
Authors: Kadhim Sara , Özakça Mustafa
Published: June 2022

Basalt Fiber Reinforced Polymer (BFRP) is an environment friendly strengthening material that can be used in several engineering applications. In this research, an experimental program was directed to investigate the BFRP strengthening adequacy of reinforced concrete beams. Eight simple-span beams were tested under the four-point bending test and were all made from the same concrete mixture. One layer of BFRP was applied on the soffit of B1, while this layer was wrapped partially along the sides of beams B2, B3, and B4 with vertical side extensions of 25, 75, and 105 mm, respectively, to evaluate the effect of vertical extension of the bottom BFRP layer on the flexural behavior of the strengthened beams. The beams B5 and B6 were strengthened with three BFRP U-strips along the flexural span without and with a bottom layer of BFRP sheet, respectively. On the other hand, the bottom and side surfaces of B7 were fully wrapped with a layer of BFRP, while B0 was kept without strengthening as a reference beam. The test results showed that strengthening with BFRP can noticeably improve the beam load capacity at cracking, yield, and ultimate stages. The ductility of strengthened beams was less than B0 by up to 33% for partial side strengthening and 45% for full side strengthening, while the toughness of all strengthened beams was higher than that of reference beam by 8–78%. The results also showed that increasing the vertical side extension of the bottom BFRP layer leads to significant load capacity increase.
Time as a resource in mathematics education: Teachers’ perspectives
Authors: Gracin Dubravka Glasnović , Trupčević Goran
Published: June 2022

Different kinds of resources, material and non-material, are used and developed with the aim of being part of an effective mathematics education. As a non-material resource, time seems to be of great importance to teachers and students. The aim of the present study is to focus on teachers’ views about time as a resource and its interactions with other resources in mathematics education. For this purpose, a large-scale examination of teachers’ opinions was undertaken, combining qualitative and quantitative methods, and involving teachers from different school levels. The results show that teachers highly value time as a resource, although with clear differences among primary, middle, and higher grade teachers. The participants of all levels complained to a great extent about not having as much time as they need for geometry topics, problem solving, and teamwork. On the other hand, the results show that textbooks and technology as material resources save teachers and students time, making lesson preparation and enactment more efficient, particularly in lower grades. The insight gained into teachers’ views about time, together with the literature review, indicate the importance of non-material resources within the discussion of resources.
Assessing needs for linguistic interpretation in hospital settings: A retrospective analysis of ad hoc interpreter requests
Authors: Bhambra Nishaant , Gold Morgan Spencer , Naumova Darya , Abdelhamid Kenzy , Lessard David , Lebouché Bertrand
Published: June 2022

Background:

In Canada, healthcare professionals often rely on ad hoc interpreters, who are untrained volunteers recruited via intercom hospital announcements to interpret for patients with language barriers. This study analyzed the frequency of ad hoc interpreter requests via intercom announcements to estimate hospital interpretation needs.

Methods:

A retrospective cohort analysis from intercom requests for medical interpretation collected from five hospitals of the McGill University Health Center. Requests included date, time, language requested, hospital location, and extension for who placed the request.

Results:

A total of 1265 intercom requests were placed for 48 languages, with the top five languages being Mandarin (17.8%), Punjabi (10.1%), Inuktitut (9.8%), Arabic (7.3%), and Cantonese (6.4%). Almost 69.8% of requests were made during working hours, 13.2% on workday evenings, and 14.8% on weekends. Requests came from urgent care (42.3%), outpatient (29.5%), and inpatient (23.3%) settings.

Conclusion:

This is the first published study that measures interpretation needs via intercom requests. We propose that our method can be replicated to inform implementation of professional medical interpretation services. We conclude that linguistic interpretation needs are significant in the Montreal area, and likely in Canada in general and pose a barrier to effective medical care.
Reduced-dose WBRT as consolidation treatment for patients with primary CNS lymphoma: an LOC network study
Authors: Lesueur Paul , Damaj Gandhi , Hoang-Xuan Khê , Roland Virginie , Schmitt Anna , Chinot Olivier , Fabbro Michel , Agapé Philippe , Moluçon-Chabrot Cécile , Chebrek Safia , Alentorn Agusti , Feuvret Loic , Delgadillo Daniel , Stefan Dinu , Choquet Sylvain , Nichelli Lucia , Mokhtari Karima , Mathon Bertrand , Dureau Sylvain , Soussain Carole , Houillier Caroline
Published: June 2022

The optimal consolidation strategy for primary central nervous system lymphoma (PCNSL) remains controversial. Preventing radio-induced neurotoxicity of consolidation treatment through reduced-dose whole-brain radiotherapy (rdWBRT) at a dose of 23.4 Gy is an interesting alternative to conventional WBRT in patients aged <60 years. From the LOC Network (Network for Oculo-cerebral Lymphomas) database, we retrospectively selected patients with PCNSL aged <60 years who showed complete (CR) or unconfirmed CR after high-dose methotrexate–based chemotherapy and had received consolidation rdWBRT as the first-line treatment. If available, prospective neuropsychological follow-ups were reported. Twenty-nine patients diagnosed between 2013 and 2018 met the study selection criteria. Nine (31%) patients experienced relapse during the follow-up, with a median time from radiotherapy to recurrence of 8.7 months (interquartile range, 4-11.5). Five of those patients received salvage treatment and consolidation with intensive chemotherapy and autologous stem cell transplantation. Progression-free survival rates were 89% (95% confidence interval [CI] 79%-100%), 72% (95% CI, 56%-88%), and 69% (95% CI, 52%-85%) at 1, 2, and 5 years, respectively. Overall survival rates were 100%, 89% (95% CI, 79%-100%), and 86% (95% CI, 74%-99%) at 1, 2, and 5 years, respectively, and were consistent with those observed for standard-dose WBRT (sdWBRT). No prognostic factor was identified. The results of the 36-month neuropsychological follow-up for a subset of patients appeared reassuring, with most patients exhibiting maintenance of or improvements in their baseline conditions. Our results, combined with phase 2 study results, support the use of rdWBRT instead of sdWBRT as a consolidation treatment in <60-year-old patients showing CR after induction treatment.
Development and validation of an interstitial lung disease exposure questionnaire for sub-Saharan Africa
Authors: Jackson Peter , Padalkar Roma , Katagira Winceslaus , Mortimer Kevin , Rykiel Natalie A. , Robertson Nicole M. , Pollard Suzanne L. , Alupo Patricia , Checkley William , Kirenga Bruce , Siddharthan Trishul
Published: June 2022

Background

American Thoracic Society/European Respiratory Society guidelines recommend context-specific exposure assessments to diagnose interstitial lung disease (ILD). In sub-Saharan Africa, ILD diagnoses are rare, and locally validated ILD exposure questionnaires are not used.

Methods

A physician-administered ILD exposure questionnaire was developed using a four-step mixed-methods modified Delphi approach. First, ILD questionnaires from high-income countries and data from Pneumotox were reviewed, compiled and face-validated. Second, a local pilot group of ILD experts ranked item relevance using a Likert scale and suggested additions. Third, the questionnaire format and pilot rankings were addressed in a focus group discussion that was analysed using grounded theory. Finally, following focus group discussion modifications, the resulting items (with three duplicate item groups for evaluation of internal consistency) were ranked for importance by members of the Pan-African Thoracic Society (PATS).

Results

Face validation resulted in 82 items in four categories: “Smoking and Drugs”, “Environmental Exposures”, “Occupations” and “Medications”. Pilot group (n=10) ranking revealed 27 outliers and 30 novel suggestions. Focus group (n=12) discussion resulted in 10 item deletions, 14 additions and 22 re-wordings; themes included desire for extensive questionnaires and stigma sensitivity. Final validation involved 58 PATS members (mean±sdage 46±10.6  years, 76% male, from 17 countries) ranking 84 items derived from previous steps and three duplicate question groups. The questionnaire was internally consistent (Cronbach's α >0.80) and ultimately included 73 items.

Conclusion

This mixed-methods study included experts from 17 countries in sub-Saharan Africa and successfully developed a 73-item ILD exposure questionnaire for sub-Saharan Africa. African pulmonary experts valued region-specific additions and ranked several items from existing ILD questionnaires as unimportant.
Bronchodilator responsiveness and dysanapsis in bronchopulmonary dysplasia
Authors: Nelin Leif D. , Kielt Matthew J. , Jebbia Maria , Jadcherla Sudarshan , Shepherd Edward G.
Published: June 2022

Background

The incidence of bronchopulmonary dysplasia (BPD) following preterm birth is increasing. Bronchodilators are often used to treat patients with BPD with little evidence to guide therapy. The aim of this study was to test the hypothesis that there are infant pulmonary function test (iPFT) parameters that can predict subsequent bronchodilator response in infants with BPD.

Methods

Subjects in this study were part of a patient group in which we reported three BPD phenotypes (obstructive, restrictive and mixed) based on iPFT data. From that group, a cohort of 93 patients with iPFT data including bronchodilator response was eligible for this study.

Results

Bronchodilator responsiveness was found in 59 people (63%) in the cohort. There were no differences in demographics between the responders and non-responders. There was no difference in forced vital capacity (FVC) between the two groups. Responders had significantly lower forced expiratory volume in 0.5 s (FEV0.5) and FEV0.5/FVC (p<0.005) and greater indices of hyperinflation than did non-responders (p<0.005). Logistic regression modelling found that pre-bronchodilator FEV0.5and functional residual capacity/total lung capacity were significantly associated with bronchodilator response. The magnitude of response to bronchodilators was negatively correlated (R= −0.49, R2= 0.24, p<0.001) with the FEV0.5. The median dysanapsis ratio in responders (0.08, 95% CI 0.05–0.19) was significantly (p=0.005) smaller than in non-responders (0.18, 95% CI 0.06–0.38).

Conclusion

These findings demonstrate that there are pulmonary function test parameters associated with bronchodilator response. Responders had evidence of greater dysanaptic lung growth than non-responders.
Identification of risk factors for delirium, cognitive decline, and dementia after cardiac surgery (FINDERI—find delirium risk factors): a study protocol of a prospective observational study
Authors: Sadlonova Monika , Vogelgsang Jonathan , Lange Claudia , Günther Irina , Wiesent Adriana , Eberhard Charlotte , Ehrentraut Julia , Kirsch Mareike , Hansen Niels , Esselmann Hermann , Timäus Charles , Asendorf Thomas , Breitling Benedict , Chebbok Mohammed , Heinemann Stephanie , Celano Christopher , Kutschka Ingo , Wiltfang Jens , Baraki Hassina , von Arnim Christine A. F.
Published: June 2022

Background

Postoperative delirium is a common complication of cardiac surgery associated with higher morbidity, longer hospital stay, risk of cognitive decline, dementia, and mortality. Geriatric patients, patients undergoing cardiac surgery, and intensive care patients are at a high risk of developing postoperative delirium. Gold standard assessments or biomarkers to predict risk factors for delirium, cognitive decline, and dementia in patients undergoing cardiac surgery are not yet available.

Methods

The FINDERI trial (FINd DElirium RIsk factors) is a prospective, single-center, observational study. In total, 500 patients aged ≥ 50 years undergoing cardiac surgery at the Department of Cardiovascular and Thoracic Surgery of the University of Göttingen Medical Center will be recruited. Our primary aim is to validate a delirium risk assessment in context of cardiac surgery. Our secondary aims are to identify specific preoperative and perioperative factors associated with delirium, cognitive decline, and accelerated dementia after cardiac surgery, and to identify blood-based biomarkers that predict the incidence of postoperative delirium, cognitive decline, or dementia in patients undergoing cardiac surgery.

Discussion

This prospective, observational study might help to identify patients at high risk for delirium prior to cardiac surgery, and to identify important biological mechanisms by which cardiac surgery is associated with delirium. The predictive value of a delirium screening questionnaire in cardiac surgery might be revealed. Finally, the identification of specific blood biomarkers might help to predict delirium, cognitive decline, and dementia in patients undergoing cardiac surgery.

Trial registration: Ethics approval for this study was obtained from the IRB of the University of Göttingen Medical Center. The investigators registered this study in the German Clinical Trials Register (DRKS; https://www.drks.de) (DRKS00025095) on April 19th, 2021.
Accuracy of echocardiography and ultrasound protocol to identify shock etiology in emergency department
Authors: Ramadan Asmaa , Abdallah Tamer , Abdelsalam Hassan , Mokhtar Ahmed , Razek Assem Abdel
Published: June 2022

Background

Early diagnosis and appropriate management of shock aimed at prevention of prolonged hypoperfusion has shown to decrease morbidity and mortality in patients with undifferentiated shock. However, there is often a challenge in emergency department (ED) – where diagnosis is mainly based on clinical signs and standard monitoring parameters. Early use of point of care ultrasound could reduce the diagnostic time and improve diagnostic accuracy.

Purpose

The aim of this study is to investigate the accuracy of echocardiography - ultrasound protocol to identify the cause of shock in ED.

Method

The study was conducted on 150 shocked patients admitted to emergency department of Alexandria Main University Hospital from December 2018 to December 2020. The study was conducted to reach initial impression about shock etiology which was then compared to final diagnosis to determine accuracy, agreement, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).

Results

One hundred forty patients were included in the study (10 patients were excluded). The protocol was 100% accurate for diagnosing cases with obstructive and mixed obstructive distributive shock. It showed excellent rule- out characteristics for cardiogenic shock (sensitivity and NPV = 100%). There was almost perfect agreement between provisional and final shock type for mixed distributive cardiogenic shock (kappa 0.915). Echo- US protocol had lowest agreement and PPV for patients with hypovolemic shock Kappa 0.48 and 35% respectively.

Conclusion

The Echo- US protocol showed a high accuracy in identifying shock etiology in ED and is likely a promising diagnostic tool in emergency care.
Investigating the burden of disease dimensions (time-dependent, developmental, physical, social and emotional) among family caregivers with COVID-19 patients in Iran
Authors: Sheikhbardsiri Hojjat , Tavan Asghar , Afshar Parya Jangipour , Salahi Sahar , Heidari-Jamebozorgi Majid
Published: June 2022

Background

The caregivers of patients with covid-19 face constant responsibilities such as providing personal, health, and social care to family, which can be physically, and emotionally exhausting resulting in a considerable stress burden. Therefore, given the importance of the subject, this study aimed to investigate the burden of disease dimensions (time-dependent, developmental, physical, social and emotional) among family caregivers with covid-19 patients in Iran.

Methods

This cross-sectional study was conducted one year after the onset of the Covid-19 outbreak in Iran. Family caregivers of Covid-19 patients discharged from the hospitals in Kerman city, Iran, were chosen by simple randomization (n = 1500). Data were collected utilizing a demographic characteristics inventory created by the researcher as well as the Novak and Guest Caregiver Burden Inventory. Descriptive statistics such as mean and standard deviations, frequency, and percentages and analytical statistics such as Kolmogorov–Smirnov, T-test, ANOVA, and Multivariate Linear Regression were used for data analysis using the 20, SPSS Inc., Chicago, IL Software at the level of P < 0.05.

Results

The results demonstrated that the mean score of family caregiver burden was 2.61±0.6 and the severity of this burden was in a moderate range. The finding showed a statistical difference was seen between the family caregiver burden mean score of participants in terms of gender, duration of treatment, age and employed status. The multivariable linear regression model showed demographic variables of caregivers included (female, married, employed, elderly, low income and poor education) had a beneficial influence on family caregiver burden.

Conclusion

The findings of this study can increase the awareness of health managers, about the level of burden of disease among family caregivers from the covid-19 patients and can help to provide economic, social and psychological support programs for improvement and reducing the burden of disease of caregivers during the covid-19 outbreaks.
Personalized neurorehabilitative precision medicine: from data to therapies (MWKNeuroReha) – a multi-centre prospective observational clinical trial to predict long-term outcome of patients with acute motor stroke
Authors: Blum Corinna , Baur David , Achauer Lars-Christian , Berens Philipp , Biergans Stephanie , Erb Michael , Hömberg Volker , Huang Ziwei , Kohlbacher Oliver , Liepert Joachim , Lindig Tobias , Lohmann Gabriele , Macke Jakob H. , Römhild Jörg , Rösinger-Hein Christine , Zrenner Brigitte , Ziemann Ulf
Published: June 2022

Background

Stroke is one of the most frequent diseases, and half of the stroke survivors are left with permanent impairment. Prediction of individual outcome is still difficult. Many but not all patients with stroke improve by approximately 1.7 times the initial impairment, that has been termed proportional recovery rule. The present study aims at identifying factors predicting motor outcome after stroke more accurately than before, and observe associations of rehabilitation treatment with outcome.

Methods

The study is designed as a multi-centre prospective clinical observational trial. An extensive primary data set of clinical, neuroimaging, electrophysiological, and laboratory data will be collected within 96 h of stroke onset from patients with relevant upper extremity deficit, as indexed by a Fugl-Meyer-Upper Extremity (FM-UE) score ≤ 50. At least 200 patients will be recruited. Clinical scores will include the FM-UE score (range 0–66, unimpaired function is indicated by a score of 66), Action Research Arm Test, modified Rankin Scale, Barthel Index and Stroke-Specific Quality of Life Scale. Follow-up clinical scores and applied types and amount of rehabilitation treatment will be documented in the rehabilitation hospitals. Final follow-up clinical scoring will be performed 90 days after the stroke event. The primary endpoint is the change in FM-UE defined as 90 days FM-UE minus initial FM-UE, divided by initial FM-UE impairment. Changes in the other clinical scores serve as secondary endpoints. Machine learning methods will be employed to analyze the data and predict primary and secondary endpoints based on the primary data set and the different rehabilitation treatments.

Discussion

If successful, outcome and relation to rehabilitation treatment in patients with acute motor stroke will be predictable more reliably than currently possible, leading to personalized neurorehabilitation. An important regulatory aspect of this trial is the first-time implementation of systematic patient data transfer between emergency and rehabilitation hospitals, which are divided institutions in Germany.

Trial registration

This study was registered atClinicalTrials.gov(NCT04688970) on 30 December 2020.
“One time I fell, but I didn’t have to cry.” A qualitative study on everyday physical complaints in children
Authors: van der Ziel Sterre , Gol Janna M. , van Vliet Michel J. , Rosmalen Judith G. M.
Published: June 2022

Objective

Young children experience physical complaints, like abdominal pain or minor injuries from playing, almost every day. These experiences may shape how they deal with health issues later in life. While models exist to explain illness perception in adults, information is lacking on the perspective of young children. This qualitative study aimed to explore important themes in the experience of everyday physical complaints in four- and five-year-old children, using children as informants.

Study design

30 semi-structured interviews were performed in which four- and five-year-old children were questioned about their experiences with everyday physical complaints. The interviews were double coded using Atlas.ti and subsequently qualitative content analysis was used to define themes.

Results

All participating children were able to elaborate on their experiences with physical complaints. Three themes emerged from the interviews: causes of complaints, appraisal of complaints, and implications of complaints. In their appraisal of complaints, four- and five-year-old children made a distinction between visible and invisible complaints and real or pretended complaints.

Conclusion

Four- and five-year-old children can already give details about their experiences with everyday physical complaints. They have developed ideas about the causes and implications of complaints and try to make an appraisal.
A comparison of rural Australian First Nations and Non-First Nations survey responses to COVID-19 risks and impacts: implications for health communications
Authors: Allan Julaine , Kleinschafer Jodie , Saksena Teesta , Rahman Azizur , Lawrence Jayne , Lock Mark
Published: June 2022

Introduction

This study investigated differences between rural Australian First Nations and non-First Nations survey respondents’ perceptions of COVID-19-related risks and analysed other variables that could predict an exacerbation of anxiety related to COVID-19 harms.

Methods

A cross-sectional online and paper survey of rural residents from the western regions of NSW, Australia, was conducted. Descriptive and multivariate statistical analyses were used to assess links between First Nations status and demographic measures including postcode, age, gender, education, rural or town/village location, proximity to medical services and living situation. The analysis included five items related to perceptions about COVID-19: perceived likelihood of contracting COVID-19 in the next 12 months, perceived harmfulness of the virus, how often people felt afraid, perception about respondents’ ability to do something about the virus and perceived economic impacts of the pandemic.

Results

There were significant differences between First Nations (n=60) and non-First Nations (n= 639) respondents across all sociodemographic categories. The results reflect a significantly higher level of anxiety among the First Nations Australians in the sample: they felt afraid more often, felt it was highly likely they would catch the virus and if they did catch the virus perceived that it would be very harmful. Living with children under eighteen years of age and in small rural towns were key factors linked to feeling afraid of COVID-19 and First Nations status.

Conclusion

Health risk communication in pandemic response should include an equitable focus on rural areas, recognising that First Nations Australians are a significant proportion of the rural population with different risk factors and concerns than those of non-First Nations Australians. This principle of First Nations-led design is critical to all health policy and planning. The Australian Government should include rural areas in planning pandemic responses, recognising that First Nations populations are a significant proportion of the rural population creating syndemic conditions.