bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of right ventricular dysfunction and pulmonary hypertension with adverse 30‐day outcomes in COVID‐19 patients
Authors: Wats Karan , Rodriguez Daniel , Prins Kurt W. , Sadiq Adnan , Fogel Joshua , Goldberger Mark , Moskovits Manfred , Tootkaboni Mahsa Pourabdollah , Shani Jacob , Jacob Jessen
Published: March 2021

Background

Cardiac manifestations in COVID‐19 are multifactorial and are associated with increased mortality. The clinical utility and prognostic value of echocardiography in COVID‐19 inpatients is not clearly defined. We aim to identify echocardiographic parameters that are associated with 30‐day clinical outcomes secondary to COVID‐19 hospitalization.

Methods

This retrospective cohort study was conducted in a large tertiary hospital in New York City during the COVID‐19 pandemic. It included 214 adult inpatients with a laboratory‐confirmed diagnosis of COVID‐19 by reverse transcriptase polymerase chain reaction assay (RT‐PCR) for SARS‐CoV‐2 on nasopharyngeal swab and had a transthoracic echocardiogram performed during the index hospitalization. Primary outcome was 30‐day all‐cause inpatient mortality. Secondary outcomes were 30‐day utilization of mechanical ventilator support, vasopressors, or renal replacement therapy.

Results

Mild right ventricular systolic dysfunction (odds ratio (OR): 3.51, 95% confidence interval (CI): 1.63–7.57, p = 0.001), moderate to severe right ventricular systolic dysfunction (OR: 7.30, 95% CI: 2.20–24.25, p = 0.001), pulmonary hypertension (OR: 5.39, 95% CI: 1.96–14.86, p = 0.001), and moderate to severe tricuspid regurgitation (OR: 3.92, 95% CI: 1.71–9.03, p = 0.001) were each associated with increased odds of 30‐day all‐cause inpatient mortality. Pulmonary hypertension and moderate to severe right ventricular dysfunction were each associated with increased odds of 30‐day utilization of mechanical ventilator support and vasopressors.

Conclusions

Right ventricular dysfunction, pulmonary hypertension, and moderate to severe tricuspid regurgitation were associated with increased odds for 30‐day inpatient mortality. This study highlights the importance of echocardiography and its clinical utility and prognostic value for evaluating hospitalized COVID‐19 patients.
Time trends of pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension
Authors: Hobohm Lukas , Keller Karsten , Münzel Thomas , Konstantinides Stavros V. , Lankeit Mareike
Published: March 2021

Chronic thromboembolic pulmonary hypertension is considered as a rare but severe complication after acute pulmonary embolism and is potentially curable by pulmonary endarterectomy. We aimed to evaluate, over an 11‐year period, time trends of in‐hospital outcomes of pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension patients and to investigate predictors of the in‐hospital course. We analyzed data on the characteristics, comorbidities, treatments, and in‐hospital outcomes for all chronic thromboembolic pulmonary hypertension patients treated with pulmonary endarterectomy in the German nationwide inpatient sample between 2006 and 2016. Overall, 1398 inpatients were included. Annual number of pulmonary endarterectomy increased from 67 in 2006 to 194 in 2016 (P < 0.001), in parallel with a significant decrease of in‐hospital mortality (10.9% in 2008 to 1.5% in 2016; P < 0.001). Patients’ characteristics shifted slightly toward older age and higher prevalence of chronic renal insufficiency and obesity over time, whereas duration of hospital stay decreased over time. Independent predictors of in‐hospital mortality were age (OR 1.03 (95%CI: 1.01–1.05); P = 0.001), right heart failure (2.55 (1.37–4.76); P = 0.003), in‐hospital complications such as ischemic stroke (6.87 (1.06–44.70); P = 0.044) and bleeding events like hemopneumothorax (24.93 (6.18–100.57); P < 0.001). Annual pulmonary endarterectomy volumes per center below 10 annual procedures were associated with higher rates of adverse in‐hospital outcomes. Annual numbers of chronic thromboembolic pulmonary hypertension patients treated with pulmonary endarterectomy increased markedly in Germany between 2006 and 2016, in parallel with a decrease of in‐hospital mortality. Our findings suggest that perioperative management of pulmonary endarterectomy, institutional experience, and patient selection is crucial and has improved over time.
Current Trend and Determinants of Intentions to Migrate: Evidence From China
Authors: Iqbal Kashif , Wang Yichu , Khurshaid Khurshaid , Haroon Shah Muhammad , Sohaib Muhammad
Published: March 2021

The increasing pace of globalization and competition for highly skilled professionals have accelerated the international mobility across national boundaries for knowledge exchange and economic reasons. The purpose of this study was to examine the current trend and determinants of migration intentions in China. For this purpose, we carried out a survey in China from 2021 respondents by using a probability sampling technique. For empirical estimation, we employed the logistic regression estimation technique to compute and evaluate the data. In the findings of this study, several push-and-pull factors have been identified for both inflow and outflow of skilled human capital in China. The findings of this study derived that high wages outside China and low wages within China are considered as the top reasons to leave China. In addition, more opportunities and a better lifestyle in the host countries are the key factors to push skilled human capital from China. The results also indicate that better education in the host countries has a positive correlation with migration intentions in China. Therefore, it can be argued that education, wages, more opportunities and better lifestyle are the significant push factors that determine why highly educated people emigrate from China.
Glenoid Bone Loss Is a Risk Factor for Poor Clinical Results After Coracoid Transfer in Rugby Players With Shoulder Dislocations
Authors: Shibuya Kenta , Kawasaki Takayuki , Hasegawa Yoshinori , Gonda Yoshinori , Itoigawa Yoshiaki , Sobue Shogo , Kaketa Takefumi , Ishijima Muneaki
Published: March 2021

Background:

Although surgical shoulder stabilization via coracoid transfer in collision athletes is effective and has a low reinjury rate, the factors affecting poor clinical results and the superiority of the 2 stabilization procedures (Bristow and Latarjet) remain unclear.

Purpose:

To explore the factor(s) affecting poor clinical results of coracoid transfer in a large cohort of rugby players and to compare postoperative function between the Bristow and Latarjet procedures.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This study included 169 consecutive shoulders of 154 competitive male rugby players who underwent shoulder stabilization surgery (Bankart repair with coracoid transfer) between 2014 and 2018 and had a mean follow-up of 2.7 years (minimum follow-up, 2 years). The Bristow procedure was performed in the first 92 shoulders (84 players), and the Latarjet procedure was performed in the latter 77 shoulders (70 players). A poor clinical result was defined as a postoperative Rowe score of <70 and a postoperative Western Ontario Shoulder Instability Index (WOSI) score of >630. Multiple logistic regression analysis was conducted to identify the factors affecting postoperative functional failure. The postoperative scores and complication rates were also compared between the 2 procedures.

Results:

In total, 92.3% of the rugby players returned to their preinjury competition level at a mean of 5.9 months postoperatively. The Rowe and WOSI scores showed that shoulder function was improved postoperatively compared with preoperatively. The number of rugby players with a poor clinical result was 18 (10.7%). Multiple logistic regression analysis demonstrated that a poor clinical result was associated with a preoperative glenoid bone defect of >20% of the glenoid width (odds ratio, 9.8), whereas the clinical result was unaffected by the type of coracoid transfer. There were no differences between the 2 procedures in any of the postoperative scores or complication rates.

Conclusion:

The present study indicated that the most effective predictor of postoperative functional scores was the degree of the glenoid bone defect and not the type of coracoid transfer. This information may be useful for the strategic treatment of shoulder dislocations in collision athletes.
Phospholipase A2 receptor antibody mediated membranous nephropathy associated with cemiplimab
Authors: Bonilla Marco , Maturostrakul Boonyanuth , Khan Neelofar , Bijol Vanesa , Jhaveri Kenar D , Wanchoo Rimda
Published: March 2021

Background:

Immune checkpoint inhibitors (ICI) are a fast growing therapy used in several types of malignancies. The majority of immune related adverse events observed in the kidney are due to acute interstitial nephritis. Glomerular diseases although less common have also been described.

Case Presentation:

We present a case of phospholipase A2 receptor positive membranous nephropathy triggered by ICI therapy cemiplimab (PD1 inhibitor) in a 88 year old man with no prior history of proteinuria or glomerular disease. The patient responded to steroid monotherapy with rapid clinical and immunological remission.

Conclusion:

While patients undergoing ICI therapy warrant close monitoring of systemic immune related adverse events, physicians should remain vigilant of kidney related events and obtain a kidney biopsy if clinically indicated.
Differential DNA Methylation by Hispanic Ethnicity Among Firefighters in the United States
Authors: Goodrich Jaclyn M , Furlong Melissa A , Caban-Martinez Alberto J , Jung Alesia M , Batai Ken , Jenkins Timothy , Beitel Shawn , Littau Sally , Gulotta John , Wallentine Darin , Hughes Jeff , Popp Charles , Calkins Miriam M , Burgess Jefferey L
Published: March 2021

Firefighters are exposed to a variety of environmental hazards and are at increased risk for multiple cancers. There is evidence that risks differ by ethnicity, yet the biological or environmental differences underlying these differences are not known. DNA methylation is one type of epigenetic regulation that is altered in cancers. In this pilot study, we profiled DNA methylation with the Infinium MethylationEPIC in blood leukocytes from 31 Hispanic white and 163 non-Hispanic white firefighters. We compared DNA methylation (1) at 12 xenobiotic metabolizing genes and (2) at all loci on the array (>740 000), adjusting for confounders. Five of the xenobiotic metabolizing genes were differentially methylated at a raw P-value <.05 when comparing the 2 ethnic groups, yet were not statistically significant at a 5% false discovery rate ( q-value <.05). In the epigenome-wide analysis, 76 loci exhibited DNA methylation differences at q < .05. Among these, 3 CpG sites in the promoter region of the biotransformation gene SULT1C2 had lower methylation in Hispanic compared to non-Hispanic firefighters. Other differentially methylated loci included genes that have been implicated in carcinogenesis in published studies ( FOXK2, GYLTL1B, ZBTB16, ARHGEF10, and more). In this pilot study, we report differential DNA methylation between Hispanic and non-Hispanic firefighters in xenobiotic metabolism genes and other genes with functions related to cancer. Epigenetic susceptibility by ethnicity merits further study as this may alter risk for cancers linked to toxic exposures.
Assessment of Knowledges, Attitudes, and Practices of Health Personnel with Regard to Hypertension During Pregnancy in Hospitals of Bujumbura
Authors: Ndirahisha Eugene , Nyandwi Joseph , Manirakiza Sebastien , Barasukana Patrice , Nahayo Hermenegilde , Baransaka Elysee
Published: March 2021

Objective:

To assess knowledges, attitudes, and practices of health personnel in Bujumbura hospitals with regard to hypertension during pregnancy.

Methodology:

This study has been conducted on health personnel of gynecology and obstetrics department of three national referral hospitals in Bujumbura. It is a descriptive cross-sectional study to assess knowledge, attitudes, and practices. Data were collected by a questionnaire and analyzed by Epi Info 7.2.

Results:

In a total of ninety-seven health workers participated in our study and 78.3% were paramedics with 53.6% of nurses and 24.7% of midwives. Medical doctors represented 21.6% of the participants. The sex ratio was 1.4 in favor of women. The professional experience was more than 5 years for 64.9% of participants. Concerning knowledge about hypertension; 74.2% of participants correctly defined hypertension during pregnancy. Despite this, only 48.4% respected conditions about its measurement. concerning attitude toword hypertension; 94.8% of participants informed their patients about the risks linked to hypertension in pregnancy before any therapeutic strategy. The antihypertensive drugs contraindicated during pregnancy were known by 54.6% of participants. To prevent preeclampsia, low doses of aspirin and calcium were prescribed by 42.2% of participants.

Conclusion:

Hypertension during pregnancy is a worrying situation for health personnel, which still has many theoretical and practical gaps.
Recovery from COVID-19: a sprint or marathon? 6-month follow-up data from online long COVID-19 support group members
Authors: Vaes Anouk W. , Goërtz Yvonne M.J. , Van Herck Maarten , Machado Felipe V.C. , Meys Roy , Delbressine Jeannet M. , Houben-Wilke Sarah , Gaffron Swetlana , Maier Dieter , Burtin Chris , Posthuma Rein , van Loon Nicole P.H. , Franssen Frits M.E. , Hajian Bita , Simons Sami O. , van Boven Job F.M. , Klok Frederikus A. , Spaetgens Bart , Pinxt Claire M.H. , Liu Limmie Y.L. , Wesseling Geertjan , Spies Yvonne , Vijlbrief Herman , van ’t Hul Alex J. , Janssen Daisy J.A. , Spruit Martijn A.
Published: March 2021

Background

It remains unknown whether and to what extent members of online “long COVID” peer support groups remain symptomatic and limited over time. Therefore, we aimed to evaluate symptoms in members of online long COVID peer support groups up to 6 months after the onset of coronavirus disease 2019 (COVID-19)-related symptoms.

Methods

Demographics, symptoms, health status, work productivity, functional status and health-related quality of life were assessed about 3 and 6 months after the onset of COVID-19-related symptoms in members of online long COVID peer support groups.

Results

Data from 239 patients with a confirmed COVID-19 diagnosis (83% women; median (interquartile range) age 50 (39–56) years) were analysed. During the infection, a median (interquartile range) of 15 (11–18) symptoms was reported, which was significantly lower 3 and 6 months later: 6 (4–9) and 6 (3–8), respectively (p<0.05). From 3 to 6 months follow-up, the proportion of patients without symptoms increased from 1.3% to only 5.4% (p<0.001). Patients also reported a significantly improved work productivity (work absenteeism and presenteeism: 73%versus52% and 66%versus60%, respectively), self-reported good health (9.2%versus16.7%), functional status (mean±sdPost-COVID-19 Functional Status scale: 2.4±0.9versus2.2±1.0) and health-related quality of life (all p<0.05).

Conclusion

Although patients with confirmed COVID-19, who were all members of online long COVID peer support groups, reported significant improvements in work productivity, functional status and quality of life between 3 and 6 months follow-up, these data clearly highlight the long-term impact of COVID-19, as approximately 6 months after the onset of COVID-19-related symptoms a large proportion still experienced persistent symptoms, a moderate-to-poor health, moderate-to-severe functional limitations, considerable loss in work productivity, and/or an impaired quality of life. Action is needed to improve the management and healthcare of these patients.
Accompaniedversusunaccompanied walking for continuous oxygen saturation measurement during 6-min walk test in COPD: a randomised crossover study
Authors: Riegler Thomas F. , Frei Anja , Haile Sarah R. , Radtke Thomas
Published: March 2021

The aim of this study was to determine if there is a difference in 6-min walk test (6MWT) distance when the assessor accompanies the patient to continuously measure peripheral oxygen saturation (SpO2) compared to the patient walking unaccompanied.

 We conducted a randomised crossover study to evaluate the impact of the assessor walking with the patient during the 6MWT (6MWTwith)versusthe patient walking alone (6MWTwithout). At the end of a pulmonary rehabilitation programme, each patient performed two 6MWTs in random order and separated by a 30-min rest.

 49 patients with chronic obstructive pulmonary disease (COPD) (Global Initiative for Obstructive Lung Disease classification II–IV) were included. In a regression model adjusting for period and subject, accompanying the patient resulted in a lower walking distance (mean difference −9.1 m, 95% CI −13.9– −4.3, p=0.0004). Notably, six patients walked more than 30 m farther (minimal important difference) in one of the two conditions (6MWTwith: n=1, 6MWTwithout: n=5). There were no between-sequence-group differences in heart rate, dyspnoea, leg fatigue andSpO2. The median (interquartile range) number and duration ofSpO2signal artefacts were high but not different between the experimental conditions (6MWTwith: 17 (4–24), 34 s (7–113 s); 6 MWTwithout: 11 (3–26), 24 s (4–62 s)).

 At a study population level, we observed a statistically significant difference in 6MWT distance between the two experimental conditions; however, the magnitude of difference was small and may not be clinically relevant. Nevertheless, in a clinical setting, unaccompanied walking resulted in a substantially higher walking distance in individual patients, pointing towards strictly standardised testing methodology, in particular in pre–post study designs.
Rapid systemic surge of IL-33 after severe human trauma: a prospective observational study
Authors: Sundnes Olav , Ottestad William , Schjalm Camilla , Lundbäck Peter , la Cour Poulsen Lars , Mollnes Tom Eirik , Haraldsen Guttorm , Eken Torsten
Published: March 2021

Background

Alarmins are considered proximal mediators of the immune response after tissue injury. Understanding their biology could pave the way for development of new therapeutic targets and biomarkers in human disease, including multiple trauma. In this study we explored high-resolution concentration kinetics of the alarmin interleukin-33 (IL-33) early after human trauma.

Methods

Plasma samples were serially collected from 136 trauma patients immediately after hospital admission, 2, 4, 6, and 8 h thereafter, and every morning in the ICU. Levels of IL-33 and its decoy receptor sST2 were measured by immunoassays.

Results

We observed a rapid and transient surge of IL-33 in a subset of critically injured patients. These patients had more widespread tissue injuries and a greater degree of early coagulopathy. IL-33 half-life (t1/2) was 1.4 h (95% CI 1.2–1.6). sST2 displayed a distinctly different pattern with low initial levels but massive increase at later time points.

Conclusions

We describe for the first time early high-resolution IL-33 concentration kinetics in individual patients after trauma and correlate systemic IL-33 release to clinical data. These findings provide insight into a potentially important axis of danger signaling in humans.
Identification of virulence associated milRNAs and their bidirectional targets in Rhizoctonia solani and maize during infection
Authors: Meng Hongxu , Wang Shaoli , Yang Wei , Ding Xinhua , Li Ning , Chu Zhaohui , Li Xiaoming
Published: March 2021

Background

Anastomosis group 1 IA (AG1-IA) of Rhizoctonia solani is the major agent of banded leaf and sheath blight (BLSB) disease that causes severe yield loss in many worldwide crops. MicroRNAs (miRNAs) are ~ 22 nt non-coding RNAs that negatively regulate gene expression levels by mRNA degradation or translation inhibition. A better understanding of miRNA function during AG1-IA infection can expedite to elucidate the molecular mechanisms of fungi-host interactions.

Results

In this study, we sequenced three small RNA libraries obtained from the mycelium of AG1-IA isolate, non-infected maize sheath and mixed maize sheath 3 days after inoculation. In total, 137 conserved and 34 novel microRNA-like small RNAs (milRNAs) were identified from the pathogen. Among these, one novel and 17 conserved milRNAs were identified as potential virulence-associated (VA) milRNAs. Subsequently, the prediction of target genes for these milRNAs was performed in both AG1-IA and maize, while functional annotation of these targets suggested a link to pathogenesis-related biological processes. Further, expression patterns of these virulence-associated milRNAs demonstrated that theyparticipate in the virulence of AG1-IA. Finally, regulation of one maize targeting gene, GRMZM2G412674 for Rhi-milRNA-9829-5p, was validated by dual-luciferase assay and identified to play a positive role in BLSB resistance in two maize mutants. These results suggest the global differentially expressed milRNAs of R. solani AG1-IA that participate in the regulation of target genes in both AG1-IA and maize to reinforce its pathogenicity.

Conclusions

Our data have provided a comprehensive overview of the VA-milRNAs of R. solani and identified that they are probably the virulence factors by directly interfered in host targeting genes. These results offer new insights on the molecular mechanisms of R.solani-maize interactions during the process of infection.
Birthweight measurement processes and perceived value: qualitative research in one EN-BIRTH study hospital in Tanzania
Authors:   EN-BIRTH Study Group, Gladstone Miriam E. , Salim Nahya , Ogillo Karama , Shamba Donat , Gore-Langton Georgia R. , Day Louise T. , Blencowe Hannah , Lawn Joy E.
Published: March 2021

Background

Globally an estimated 20.5 million liveborn babies are low birthweight (LBW) each year, weighing less than 2500 g. LBW babies have increased risk of mortality even beyond the neonatal period, with an ongoing risk of stunting and non-communicable diseases. LBW is a priority global health indicator. Now almost 80% of births are in facilities, yet birthweight data are lacking in most high-mortality burden countries and are of poor quality, notably with heaping especially on values ending in 00. We aimed to undertake qualitative research in a regional hospital in Dar es Salaam, Tanzania, observing birthweight weighing scales, exploring barriers and enablers to weighing at birth as well as perceived value of birthweight data to health workers, women and stakeholders.

Methods

Observations were undertaken on type of birthweight scale availability in hospital wards. In-depth semi-structured interviews (n = 21) were conducted with three groups: women in postnatal and kangaroo mother care wards, health workers involved in birthweight measurement and recording, and stakeholders involved in data aggregation in Temeke Hospital, Tanzania, a site in the EN-BIRTH study. An inductive thematic analysis was undertaken of translated interview transcripts.

Results

Of five wards that were expected to have scales, three had functional scales, and only one of the functional scales was digital. The labour ward weighed the most newborns using an analogue scale that was not consistently zeroed. Hospital birthweight data were aggregated monthly for reporting into the health management information system. Birthweight measurement was highly valued by all respondents, notably families and healthcare workers, and local use of data was considered an enabler. Perceived barriers to high quality birthweight data included: gaps in availability of precise weighing devices, adequate health workers and imprecise measurement practices.

Conclusion

Birthweight measurement is valued by families and health workers. There are opportunities to close the gap between the percentage of babies born in facilities and the percentage accurately weighed at birth by providing accurate scales, improving skills training and increasing local use of data. More accurate birthweight data are vitally important for all babies and specifically to track progress in preventing and improving immediate and long-term care for low birthweight children.
Respectful maternal and newborn care: measurement in one EN-BIRTH study hospital in Nepal
Authors:   EN-BIRTH Study Group, Gurung Rejina , Ruysen Harriet , Sunny Avinash K. , Day Louise T. , Penn-Kekana Loveday , Målqvist Mats , Ghimire Binda , Singh Dela , Basnet Omkar , Sharma Srijana , Shaver Theresa , Moran Allisyn C. , Lawn Joy E. , KC Ashish
Published: March 2021

Background

Respectful maternal and newborn care (RMNC) is an important component of high-quality care but progress is impeded by critical measurement gaps for women and newborns. The Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study was an observational study with mixed methods assessing measurement validity for coverage and quality of maternal and newborn indicators. This paper reports results regarding the measurement of respectful care for women and newborns.

Methods

At one EN-BIRTH study site in Pokhara, Nepal, we included additional questions during exit-survey interviews with women about their experiences (July 2017–July 2018). The questionnaire was based on seven mistreatment typologies: Physical; Sexual; or Verbal abuse; Stigma/discrimination; Failure to meet professional standards of care; Poor rapport between women and providers; and Health care denied due to inability to pay. We calculated associations between these typologies and potential determinants of health – ethnicity, age, sex, mode of birth – as possible predictors for reporting poor care.

Results

Among 4296 women interviewed, none reported physical, sexual, or verbal abuse. 15.7% of women were dissatisfied with privacy, and 13.0% of women reported their birth experience did not meet their religious and cultural needs. In descriptive analysis, adjusted odds ratios and multivariate analysis showed primiparous women were less likely to report respectful care (β = 0.23, p-value < 0.0001). Women from Madeshi (a disadvantaged ethnic group) were more likely to report poor care (β = − 0.34; p-value 0.037) than women identifying as Chettri/Brahmin. Women who had caesarean section were less likely to report poor care during childbirth (β = − 0.42; p-value < 0.0001) than women with a vaginal birth. However, babies born by caesarean had a 98% decrease in the odds (aOR = 0.02, 95% CI, 0.01–0.05) of receiving skin-to-skin contact than those with vaginal births.

Conclusions

Measurement of respectful care at exit interview after hospital birth is challenging, and women generally reported 100% respectful care for themselves and their baby. Specific questions, with stratification by mode of birth, women’s age and ethnicity, are important to identify those mistreated during care and to prioritise action. More research is needed to develop evidence-based measures to track experience of care, including zero separation for the mother-newborn pair, and to improve monitoring.
Prevalence and associated factors of adolescent pregnancy (15–19 years) in East Africa: a multilevel analysis
Authors: Worku Misganaw Gebrie , Tessema Zemenu Tadesse , Teshale Achamyeleh Birhanu , Tesema Getayeneh Antehunegn , Yeshaw Yigizie
Published: March 2021

Background

Adolescent pregnancy is a major public health problem both in developed and developing countries with huge consequences to maternal health and pregnancy outcomes. However, there is limited evidence on the prevalence and associated factors of adolescent pregnancy in East Africa. Therefore, this study aimed to investigate the prevalence and associated factors of adolescent pregnancy in Eastern Africa.

Method

The most recent Demographic and Health Survey (DHS) datasets of the 12 East African countries were used. A total weighted sample of 17, 234 adolescent girls who ever had sex was included. A multilevel binary logistic regression analysis was fitted to identify the significantly associated factors of adolescent pregnancy. Finally, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the factors that are significantly associated with adolescent pregnancy.

Results

The overall prevalence of adolescent pregnancy in East Africa was 54.6% (95%CI: 53.85, 55.34%). In the multivariable multilevel analysis; being age 18–19 years [AOR = 3.06; 95%CI: 2.83, 3.31], using contraceptive [AOR = 1.41; 95%CI: 1.28, 1.55], being employed girls [AOR = 1.11; 95%CI: 1.03, 1.19], being spouse/head within the family [AOR = 1.62; 95% CI: 1.45, 1.82], and being from higher community level contraceptive utilization [AOR = 1.10; 95%CI:1.02, 1.19] were associated with higher odds of adolescent pregnancy. While adolescent girls attained secondary education and higher [AOR = 0.78; 95%CI: 0.68, 0.91], initiation of sex at age of 15 to 14 years [AOR = 0.69; 95%CI: 0.63, 0.75] and 18 to 19 years [AOR = 0.31; 95%CI: 0.27, 0.35], being unmarried [AOR = 0.25; 95%CI: 0.23, 0.28], having media exposure [AOR = 0.85; 95%CI: 0.78, 0.92], and being girls from rich household [AOR = 0.64; 95%CI: 0.58, 0.71] were associated with lower odds of adolescent pregnancy.

Conclusion

This study found that adolescent pregnancy remains a common health care problem in East Africa. Age, contraceptive utilization, marital status, working status, household wealth status, community-level contraceptive utilization, age at initiation of sex, media exposure, educational level and relation to the household head were associated with adolescent pregnancy. Therefore, designing public health interventions targeting higher risk adolescent girls such as those from the poorest household through enhancing maternal education and empowerment is vital to reduce adolescent pregnancy and its complications.
The influence of exercise during pregnancy on racial/ethnic health disparities and birth outcomes
Authors: Raper Madigan J. , McDonald Samantha , Johnston Carol , Isler Christy , Newton Edward , Kuehn Devon , Collier David , Broskey Nicholas T. , Muldrow Adrienne , May Linda E.
Published: March 2021

Background

Non-Hispanic black (NHB) pregnant women disproportionately experience adverse birth outcomes compared to Non-Hispanic white (NHW) pregnant women. The positive effects of prenatal exercise on maternal and neonatal health may mitigate these disparities. This study evaluated the influence of prenatal exercise on racial/ethnic disparities in gestational age (GA), birthweight (BW), and risks of preterm birth (PTB), cesarean section (CS), and low-birthweight (LBW) neonates.

Methods

This study performed a secondary data analysis using data from a 24-week, two-arm exercise intervention trial (ENHANCED by Mom). Women with singleton pregnancies (< 16 weeks), aged 18–40 years, BMI between 18.5–34.99 kg/m2, and no preexisting health conditions were eligible. The aerobic exercisers (EX) participated in 150 min of moderate-intensity weekly exercise while non-exercising controls (CON) attended low-intensity stretching/breathing sessions. Data on GA, PTB (< 37 weeks), BW, LBW (< 2.5 kg), and delivery mode were collected. Poisson, median and linear regressions were performed.

Results

Participants with complete data (n = 125) were eligible for analyses (EX: n = 58, CON: n = 67). NHB pregnant women delivered lighter neonates (β = − 0.43 kg, 95% CI: − 0.68, − 0.18, p = 0.001). After adjusting for prenatal exercise, racial/ethnic disparities in BW were reduced (β = − 0.39 kg, 95% CI: − 0.65, − 0.13, p = 0.004). Prenatal exercise reduced borderline significant racial/ethnic disparities in PTB (p = 0.053) and GA (p = 0.07) with no effects found for CS and LBW.

Conclusions

The findings of this study demonstrate that prenatal exercise may attenuate the racial/ethnic disparities observed in neonatal BW, and possibly GA and PTB. Larger, diverse samples and inclusion of maternal biomarkers (e.g., cytokines) are encouraged to further evaluate these relationships.
Effect of perinatal depression on risk of adverse infant health outcomes in mother-infant dyads in Gondar town: a causal analysis
Authors: Dadi Abel Fekadu , Miller Emma R. , Woodman Richard J. , Azale Telake , Mwanri Lillian
Published: March 2021

Background

Approximately one-third of pregnant and postnatal women in Ethiopia experience depression posing a substantial health burden for these women and their families. Although associations between postnatal depression and worse infant health have been observed, there have been no studies to date assessing the causal effects of perinatal depression on infant health in Ethiopia. We applied longitudinal data and recently developed causal inference methods that reduce the risk of bias to estimate associations between perinatal depression and infant diarrhea, Acute Respiratory Infection (ARI), and malnutrition in Gondar Town, Ethiopia.

Methods

A cohort of 866 mother-infant dyads were followed from infant birth for 6 months and the cumulative incidence of ARI, diarrhea, and malnutrition were assessed. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the presence of maternal depression, the Integrated Management of Newborn and Childhood Illnesses (IMNCI) guidelines were used to identify infant ARI and diarrhea, and the mid upper arm circumference (MUAC) was used to identify infant malnutrition. The risk difference (RD) due to maternal depression for each outcome was estimated using targeted maximum likelihood estimation (TMLE), a doubly robust causal inference method used to reduce bias in observational studies.

Results

The cumulative incidence of diarrhea, ARI and malnutrition during 6-month follow-up was 17.0% (95%CI: 14.5, 19.6), 21.6% (95%CI: 18.89, 24.49), and 14.4% (95%CI: 12.2, 16.9), respectively. There was no association between antenatal depression and ARI (RD = − 1.3%; 95%CI: − 21.0, 18.5), diarrhea (RD = 0.8%; 95%CI: − 9.2, 10.9), or malnutrition (RD = -7.3%; 95%CI: − 22.0, 21.8). Similarly, postnatal depression was not associated with diarrhea (RD = -2.4%; 95%CI: − 9.6, 4.9), ARI (RD = − 3.2%; 95%CI: − 12.4, 5.9), or malnutrition (RD = 0.9%; 95%CI: − 7.6, 9.5).

Conclusion

There was no evidence for an association between perinatal depression and the risk of infant diarrhea, ARI, and malnutrition amongst women in Gondar Town. Previous reports suggesting increased risks resulting from maternal depression may be due to unobserved confounding.
Heterotopic ossification in the post cruciate ligament of the knee: a case report and literature review
Authors: Li Cun , Huang Zonggui , Anil K. C. , Lao Chendeng , Wu Qianghua , Jiang Hongmian
Published: March 2021

Background

Heterotopic ossification (HO) is noted most frequently in periarticular muscles and has not yet been reported in the cruciate ligaments of the knee. We present a rare case of symptomatic ossification of the posterior cruciate ligament (PCL).

Case presentation

A 59-year-old woman had a 2-year history of knee pain that was getting worse during knee motion and had restricted knee motion for 1 year. X-rays could not show the lesion clearly. Multi-planar computed tomography demonstrated ossification within the PCL with mild osteoarthritic changes and excluded any other intra-articular pathology. The patient underwent arthroscopic debridement and then experienced immediate relief of pain and complete recovery of range of motion.

Conclusion

This is the first report of HO in the PCL as a possible cause of knee pain and restricted knee motion. On the basis of literature review, this case elaborates the difference between HO and calcification in the ligaments, the related factors inducing HO and the undefined pathogenesis, and favorable prognosis after adequate treatment.
Green synthesis of metal nanoparticles using microorganisms and their application in the agrifood sector
Authors: Bahrulolum Howra , Nooraei Saghi , Javanshir Nahid , Tarrahimofrad Hossein , Mirbagheri Vasighe Sadat , Easton Andrew J. , Ahmadian Gholamreza
Published: March 2021

The agricultural sector is currently facing many global challenges, such as climate change, and environmental problems such as the release of pesticides and fertilizers, which will be exacerbated in the face of population growth and food shortages. Therefore, the need to change traditional farming methods and replace them with new technologies is essential, and the application of nanotechnology, especially green technology offers considerable promise in alleviating these problems. Nanotechnology has led to changes and advances in many technologies and has the potential to transform various fields of the agricultural sector, including biosensors, pesticides, fertilizers, food packaging and other areas of the agricultural industry. Due to their unique properties, nanomaterials are considered as suitable carriers for stabilizing fertilizers and pesticides, as well as facilitating controlled nutrient transfer and increasing crop protection. The production of nanoparticles by physical and chemical methods requires the use of hazardous materials, advanced equipment, and has a negative impact on the environment. Thus, over the last decade, research activities in the context of nanotechnology have shifted towards environmentally friendly and economically viable ‘green’ synthesis to support the increasing use of nanoparticles in various industries. Green synthesis, as part of bio-inspired protocols, provides reliable and sustainable methods for the biosynthesis of nanoparticles by a wide range of microorganisms rather than current synthetic processes. Therefore, this field is developing rapidly and new methods in this field are constantly being invented to improve the properties of nanoparticles. In this review, we consider the latest advances and innovations in the production of metal nanoparticles using green synthesis by different groups of microorganisms and the application of these nanoparticles in various agricultural sectors to achieve food security, improve crop production and reduce the use of pesticides. In addition, the mechanism of synthesis of metal nanoparticles by different microorganisms and their advantages and disadvantages compared to other common methods are presented.
Combining respondent-driven sampling with a community-based participatory action study of people who smoke drugs in two cities in British Columbia, Canada
Authors: Elkhalifa Sulaf , Jozaghi Ehsan , Marsh Samona , Thomson Erica , Gregg Delilah , Buxton Jane , Jolly Ann
Published: March 2021

Background

The smoking of illicit drugs presents a serious social and economic burden in Canada. People who smoke drugs (PWSD) are at increased risk of contracting multiple infections through risky drug practices. Peer-led harm reduction activities, and the resulting social networks that form around them, can potentially minimize the dangers associated with the smoking illicit drugs.

Goal

The goals of this study were to pilot test the combined approaches of respondent driven sampling with community based participatory action research in these settings and compare the attributes and social networks of PWSD in two British Columbia cities with different harm reduction programs.

Methods

Using community-based participatory action research (CBPAR) and respondent-driven sampling (RDS), individuals with lived drug experiences were employed from communities in Abbotsford and Vancouver as peer researchers to interview ten contacts from their social networks. Contacts completed a questionnaire about their harm reduction behaviours and interactions.

Results

We found that PWSD residing in Abbotsford were more likely to report engaging in harm-promoting behaviours, such as sharing, reusing, or borrowing crack pipes. However, PWSD in the Downtown East side Community of Vancouver were more likely to report engaging in harm-reducing activities, such as being trained in naloxone use and CPR. We found no differences in network sizes between the two communities, despite the population differences and harm reduction programs

Conclusion

The high participation rates and interactions between researchers, and peer researchers enriched the study implementation and successfully informed our results. The fact that there were no differences in network size suggests that people have similar support in Vancouver as in Abbotsford, and that drug use practices differ mainly due to availability of harm reduction programming and resources.
Identification of 4 immune cells and a 5-lncRNA risk signature with prognosis for early-stage lung adenocarcinoma
Authors: Mu Lan , Ding Ke , Tu Ranran , Yang Wei
Published: March 2021

Background

Lung cancer is the most common cancer and cause of cancer‐related mortality worldwide, increasing evidence indicated that there was a significant correlation between tumors and the long non‐coding RNAs (lncRNAs), as well as tumor immune infiltration, but their role in early lung adenocarcinoma (LUAD) are still unclear.

Methods

Gene expression data and corresponding clinical data of early-stage LUAD patients were downloaded from GEO and TCGA databases. 24 kinds of tumor-infiltrating immune cells were analyzed by quantity analysis and univariate cox regression analysis, we divided patients into two subgroups using consensus clustering, recognized the differentially expressed genes (DEGs) in the subgroups, then, established lncRNA risk signature by least absolute shrinkage and selection operator (LASSO) regression.

Results

A total of 718 patients were enrolled in this study, including 246 from GSE31210 dataset, 127 from GSE50081 dataset and 345 from TCGA-LUAD. We identified that Th2 cells, TFH, NK CD56dim cells and Mast cells were prognosis-related(p < 0.05), then established a 5-lncRNA risk signature (risk score = 0.374600616* LINC00857 + 0.173825706* LINC01116 + (− 0.021398903)* DRAIC + (− 0.113658256)* LINC01140 + (− 0.008403702)* XIST), and draw a nomogram showed that the signature had a well prediction accuracy and discrimination.

Conclusions

We identified 4 immune infiltrating cells related to the prognosis of early-stage LUAD, and established a novel 5 immune-related lncRNA signature for predicting patients’ prognosis.
Clinical characteristics and sociodemographic features of psychotic major depression
Authors: Wang Meng-qi , Wang Ran-ran , Hao Yu , Xiong Wei-feng , Han Ling , Qiao Dong-dong , He Juan
Published: March 2021

Background

Psychotic major depression (PMD) is a subtype of depression with a poor prognosis. Previous studies have failed to find many differences between patients with PMD and those with non-psychotic major depression (NMD) or schizophrenia (SZ). We compared sociodemographic factors (including season of conception) and clinical characteristics between patients with PMD, NMD, and schizophrenia. Our aim was to provide data to help inform clinical diagnoses and future etiology research.

Methods

This study used data of all patients admitted to Shandong Mental Health Center from June 1, 2016 to December 31, 2017. We analyzed cases who had experienced an episode of PMD (International Classification of Diseases, Tenth Revision codes F32.3, F33.3), NMD (F32.0–2/9, F33.0–2/9), and SZ (F20–20.9). Data on sex, main discharge diagnosis, date of birth, ethnicity, family history of psychiatric diseases, marital status, age at first onset, education, allergy history, and presence of trigger events were collected. Odds ratios (OR) were calculated using logistic regression analyses. Missing values were filled using the k-nearest neighbor method.

Results

PMD patients were more likely to have a family history of psychiatric diseases in their first-, second-, and third-degree relatives ([OR] 1.701, 95% confidence interval [CI] 1.019–2.804) and to have obtained a higher level of education (OR 1.451, 95% CI 1.168–1.808) compared with depression patients without psychotic features. Compared to PMD patients, schizophrenia patients had lower education (OR 0.604, 95% CI 0.492–0.741), were more often divorced (OR 3.087, 95% CI 1.168–10.096), had a younger age of onset (OR 0.934, 95% CI 0.914–0.954), less likely to have a history of allergies (OR 0.604, 95% CI 0.492–0.741), and less likely to have experienced a trigger event 1 year before first onset (OR 0.420, 95% CI 0.267–0.661). Season of conception, ethnicity, and sex did not differ significantly between PMD and NMD or schizophrenia and PMD.

Conclusions

PMD patients have more similarities with NMD patients than SZ patients in terms of demographic and clinical characteristics. The differences found between PMD and SZ, and PMD and NMD correlated with specificity of the diseases. Furthermore, allergy history should be considered in future epidemiological studies of psychotic disorders.
MR-guided stereotactic body radiation therapy for primary cardiac sarcomas
Authors: Corradini Stefanie , von Bestenbostel Rieke , Romano Angela , Curta Adrian , Di Gioia Dorit , Placidi Lorenzo , Niyazi Maximilian , Boldrini Luca
Published: March 2021

Background

Primary cardiac tumors are an extremely rare disease with limited prognosis. The treatment of choice is surgery. Other treatment options include chemotherapy and radiation therapy, which historically represented a palliative approach in patients who were not eligible for surgery. The development of hybrid MR-guided radiation therapy makes it possible to better visualize cardiac lesions and to apply high doses per fraction in sensible organs such as the heart.

Case presentation

Patients affected by inoperable primary cardiac sarcomas and treated at two different institutions were considered for this analysis and retrospectively analyzed. All patients were treated using a 0.35 T hybrid MR Linac system (MRIdian, ViewRay Inc., Mountain View, CA). In the present study we investigated the feasibility, early outcome and toxicity of MR-guided RT in primary cardiac sarcomas. Four consecutive non-metastasized patients who were treated between 05–09/2020 were analyzed. The cardiac sarcomas were mostly located in the right atrium (50%) and one patient presented with 3 epicardial lesions. All patients received MRgRT as a salvage treatment for recurrent cardiac sarcoma after initial surgery, after a mean interval of 12 months (range 1–29 months). Regarding the treatment characteristics, the mean GTV size was 22.9 cc (range 2.5–56.9 cc) and patients were treated with a mean GTV dose of 38.9 Gy (range 30.1–41.1 Gy) in 5 fractions. Regarding feasibility, all treatments were completed as planned and all patients tolerated the treatment very well and showed only mild grade 1 or 2 symptoms like fatigue, dyspnea or mild chest pain at early follow-up.

Conclusion

To the best of our knowledge, in this retrospective analysis we present the first and largest series of patients presenting with primary cardiac sarcomas treated with online adaptive MRgRT. However, further studies are needed to evaluate the impact of this new methodology on the outcome of this very rare disease.