bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of the RNA interference technique to Xenopus embryos: Specific reduction of the β‐catenin gene products by short double‐stranded RNA produced by recombinant human Dicer
Authors: Tagami Yuta , Nishiyama Takeshi , Omote Michiko , Watanabe Minoru
Published: November 2021

RNA interference (RNAi) is a technique for suppressing the function of specific genes and is widely used in many organisms, including yeast, nematodes, flies, plants, mice, and cultured mammalian cells. As of date, this technique has not been successfully applied to Xenopus laevis embryos. In this study, we applied RNAi to Xenopus embryos using β‐catenin as a model gene. Injection of long double‐stranded RNA (dsRNA) corresponding to the 3′‐untranslated region of β‐catenin mRNA into embryos induced embryonic lethality without any specific phenotype. However, injection of short dsRNA, generated from long dsRNA by treatment with recombinant human Dicer, into embryos resulted in decreased expression of endogenous β‐catenin mRNA and protein, as well as decreased Wnt signaling activity in the embryos. The decrease in β‐catenin mRNA and protein levels was observed only after mid‐blastula transition. Embryos injected with short dsRNA showed a characteristic phenotype of enlarged anterior structures and loss of posterior structures. These phenotypes, as well as the increased expression of the anterior gene and decreased expression of the posterior gene, suggest that RNAi against the β‐catenin gene suppresses the “late Wnt signaling” involved in proper anterior–posterior patterning of Xenopus embryos. The effect of RNAi on Xenopus embryos was also found to be sensitive to temperature. These results strongly suggest that the RNAi technique can be applied to Xenopus embryos using short dsRNAs, appropriate temperature control, and proper selection of target genes.
Humanitarian aid and local responses: the aftermath of the rebuilding effort on Tongoa island, Vanuatu
Authors: Calandra Maëlle
Published: November 2021

Cyclone Pam swept through the archipelago of Vanuatu on 13–14 March 2015, with wind speeds exceeding those recorded anywhere in the South Pacific since the 1980s. Southern and central parts of the country were particularly affected. Material damage on Tongoa, one of the most afflicted islands, was extensive, but no deaths were reported. During the storm, villagers found shelter in their kitchen, in what is considered locally as a ‘lifeboat’. The aftermath was managed and mitigated by international aid organisations. On Tongoa, this included a ‘Shelter Cluster’ programme, under which villagers were given house rebuilding kits. Elaborating upon extensive ethnographic investigations on site between 2011 and 2018, this paper explores and reveals the ways in which this aid generated confusion among the local population. In a larger context of regular disasters triggered by natural hazards, locals have found endogenous ways of dealing with such extreme climatic events, for the most part without any external assistance.
Unusual localization of vegetations in a native aortic valve infective endocarditis
Authors: Bruls Samuel , Dulgheru Raluca , Lancellotti Patrizio , Defraigne Jean‐Olivier
Published: November 2021

In case of valvular infective endocarditis, the infection is mainly localized on the flow side of the valves or at damaged valvular endothelium. We describe a rare case of an aortic valvular ineffective endocarditis with an aortic‐valve vegetation situated on the aortic side of the valve. We believe this is the first description of this unusual localization of vegetations in a native aortic valve.
Identification of diverse lipid‐binding modes in the groove of zinc α2 glycoprotein reveals its functional versatility
Authors: Zahid Henna , Lau Andy M. , Kelly Sharon M. , Karu Kersti , Gor Jayesh , Perkins Stephen J. , McDermott Lindsay C.
Published: November 2021

ZAG is a multifunctional glycoprotein with a class I MHC‐like protein fold and an α1‐α2 lipid‐binding groove. The intrinsic ZAG ligand is unknown. Our previous studies showed that ZAG binds the dansylated C11 fatty acid, DAUDA, differently to the boron dipyrromethane C16 fatty acid, C16‐BODIPY. Here, the molecular basis for this difference was elucidated. Multi‐wavelength analytical ultracentrifugation confirmed that DAUDA and C16‐BODIPY individually bind to ZAG and compete for the same binding site. Molecular docking of lipid‐binding in the structurally related Cluster of differentiation 1 proteins predicted nine conserved ligand contact residues in ZAG. Twelve mutants were accordingly created by alanine scanning site directed mutagenesis for characterisation. Mutation of Y12 caused ZAG to misfold. Mutation of K147, R157 and A158 abrogated C16‐BODIPY but not DAUDA binding. L69 and T169 increased the fluorescence emission intensity of C16‐BODIPY but not of DAUDA compared to wild‐type ZAG and showed that C16‐BODIPY binds close to T169 and L69. Distance measurements of the crystal structure revealed K147 forms a salt bridge with D83. A range of bioactive bulky lipids including phospholipids and sphingolipids displaced DAUDA from the ZAG binding site but unexpectedly did not displace C16‐BODIPY. We conclude that the ZAG α1‐α2 groove contains separate but overlapping sites for DAUDA and C16‐BODIPY and is involved in binding to a bulkier and wider repertoire of lipids than previously reported. This work suggested that the in vivo activity of ZAG may be dictated by its lipid ligand.
Campylobacter concisus gastritis masquerading as Helicobacter pylori on gastric biopsy
Authors: Ferreira Elizabeth O , Lagacé‐Wiens Philippe , Klein Julianne
Published: November 2021

Objective

Campylobacter concisus is a Gram‐negative rod closely related to Helicobacter pylori. We sought to identify gastric biopsies positive for C. concisus that had been misdiagnosed as H. pylori gastritis in our routine surgical pathology practice.

Materials and Methods

We performed a retrospective review of gastric biopsies in our regional microbiology and pathology electronic records to identify cases that were submitted for H. pylori testing in which C. consicus was identified on culture and how many had concurrent biopsies sent to pathology for histologic assessment over a two‐year period (2017–2018). Pathologic findings in the gastric biopsies were reviewed and immunohistochemical staining for H. pylori was performed.

Results

50 of 2191 gastric biopsy specimens submitted to microbiology in 2017–18 grew C. concisus (2.3%), compared to 168 in which H. pylori was identified (7.7%). Twenty‐eight cases had concurrent histology. A total of four cases (three from 2017 and one from 2018) demonstrated organisms morphologically identical to H. pylori in the H&E sections, of which all were H. pylori immunoreactive.

Conclusions

Our case series is the first to demonstrate that C. concisus can mimic H. pylori gastritis in routine biopsy pathology.
Effects of an individualized training course on technical quality and periapical status of teeth treated endodontically by dentists in the Public Dental Service in Norway: An observational intervention study
Authors: Jordal Kristin , Skudutyte‐Rysstad Rasa , Sen Abhijit , Torgersen Gerald , Ørstavik Dag , Sunde Pia Titterud
Published: November 2021

Aim

To investigate the effect of a continuing education course on technical quality and treatment outcome for root filled permanent teeth in Møre and Romsdal County, Norway.

Methodology

Fifty‐two dentists employed in the Public Dental Service in Møre and Romsdal county, Norway, completed a two‐day continuing education course in root canal treatment. Periapical radiographs of root filled teeth treated before and after the course, with at least one‐year follow‐up were identified and scored for technical quality and periapical status. Technical root filling quality was assessed by density and length and the treatment outcome by PAI scores. Treatment information was achieved from the county's electronic dental record system. Information regarding the dental practitioners' background and treatment procedure routines was collected by a questionnaire. Descriptive statistics analyses and mixed‐effect logistic regression analyses were performed to evaluate the effect of the course.

Results

Radiographs were available for 224 teeth root filled before and for 221 teeth after the course. The proportion of teeth with adequate root filling quality was significantly lower after the course (p = .006), associated mainly with short root fillings (p < .001). No significant differences were observed in treatment outcome. There were, however, large differences in treatment outcome amongst subgroups of dentists. Further, there was evidence of effect modification by the continuing education course on periapical outcome by patient's age (pinteraction = .0023) suggesting that teeth in patients ≤18 years healed relatively better post‐course compared to patients >18 years.

Conclusions

A two‐day continuing education course in root canal treatment attended by Public Dental Service dentists in Norway did not improve the technical quality of root fillings or periapical status associated with root filled teeth.
The clinical characteristics and prognosis of Chinese acute myeloid leukemia patients with CSF3R mutations
Authors: Chen Xiuhua , Xu Jing , Fang Fang , Xu Zhifang , Tan Yanhong , Chang JianMei , Muyey Daniel Muteb , Wang Hongwei
Published: November 2021

Introduction

The colony‐stimulating factor 3 receptor (CSF3R) controls the proliferation of myeloid progenitors and differentiation into neutrophils. However, the clinical features and prognostic significance of CSF3R mutations in primary acute myeloid leukemia (AML) patients are still unclear.

Methods

158 newly diagnosed AML patients were retrospectively evaluated in our study. Amplicon‐based next‐generation sequencing (NGS) and multiplex‐nested reverse‐transcription polymerase chain reaction (RT‐PCR) were used to investigate the 34 genes and 43 fusion genes associated with leukemia. In addition, clinical features, mutation incidence, and survival outcomes were compared between patients with CSF3R mutation and patients with wild‐type CSF3R.

Results

In our study, CSF3R mutations were found in 7.6% (12/158) cases. The membrane‐proximal amino acid substitution T618I (58.3%) was the most frequent mutation. CSF3R mutations were associated with higher WBC counts (P = .035). CEBPA mutation, TET2 mutation, and RUNX1‐RUNX1T1 translocation were the most common co‐mutations of CSF3R. The CSF3R gene was mutually exclusive with signal transduction genes (P = .029), while positively associated with TET2 mutations (P = .014). CSF3R mutations had no effect on CR1 (P = .935), R (P = .625) and OS (P = .1172). Patients with CSF3R mutations had a worse DFS (P = .0352) than those with wild‐type CSF3R. Multivariate survival analysis showed that CSF3R mutation was an independent risk factor for DFS of primary AML patients (HR=2.048, 95%CI: 1.006‐4.170, P = .048).

Conclusion

AML patients with CSF3R mutations had unique clinical features and gene co‐mutation spectrum. CSF3R mutation was an independent risk factor for DFS and could be a potential prognostic marker and therapeutic target for Chinese primary AML patients.
“Ethno-microbiology” of ethnic Indian fermented foods and alcoholic beverages
Authors: Tamang Jyoti Prakash
Published: November 2021

The concept of “ethno-microbiology” is to understand the indigenous knowledge of the Indian people for production of culturally and organoleptically acceptable fermented foods by natural fermentation. About 1000 types of common, uncommon, rare, exotic and artisan fermented foods and beverages are prepared and consumed in different geographical regions by multi-ethnic communities in India. Indian fermented foods are mostly acidic and some are alkaline, along with various types of alcoholic beverages. A colossal diversity of microorganisms comprising bacteria mostly belongs to phylum Firmicutes, filamentous moulds and enzyme- and alcohol-producing yeasts under phyla Ascomycota and Mucoromycota, and few bacteriophages and archaea have been reported from Indian fermented foods. Some microorganisms associated with fermented foods have functionalities and health promoting benefits. “Ethno-microbiology” of ethnic Indian people has exhibited the proper utilisation of substrates either singly or in combination such as fermented cereal-legume mixture (idli, dosa and dhokla) in South and West India, sticky fermented soybean food (kinema and related foods), fermented perishable leafy vegetable (gundruk and related foods), fermented bamboo shoots (soibum and related foods) and fermented fish (ngari and others) in North East India, and fermented meat and sausage-like products in the Indian Himalayas, fermented coconut beverage (toddy) in coastal regions, and various types of naturally fermented milk products (dahi and related products) in different regions of India. This review has also highlighted the “ethno-microbiology” knowledge of the people involving the consortia of essential microorganisms in traditionally prepared amylolytic starters for production of cereal-based alcoholic beverages. The novelty of this review is the interpretation of ethno-microbiological knowledge innovated by ethnic Indian people on the use of beneficial microorganisms for food fermentation to obtain the desired fermented food products for consumption.
Why did (some) consumers buy toilet papers? A cross‐cultural examination of panic buying as a maladaptive coping response to COVID‐19
Authors: Im Hyunjoo , Kim Naeun Lauren , Lee Ha Kyung
Published: November 2021

The high uncertainty around the COVID‐19 pandemic elicited an unprecedented level of panic buying during the early months. Using the framework of stress and coping, the current study conceptualized and tested a theoretical model that predicts individuals' panic buying in two countries. A survey of US (n = 311) and Korean consumers (n = 347) revealed that negative emotions (loneliness and anxiety) contributed to panic buying, yet two important coping resources, resilience and social support, were effective in protecting consumers from engaging in a maladaptive coping strategy. The hypothesis that collectivism (vs. individualism) would make consumers rely on social (vs. personal) coping resources was partially supported. The results highlight the unique circumstance of the global pandemic in which social support works as both a resource for healthy coping and a source to increase negative emotions, and call for future investigation of the complex role of social support in the context of stress and coping theory.
Risk factors for oral alterations in intensive care unit patients: A pilot cohort study
Authors: Martins Hélder Domiciano Dantas , Sales Roberta Correia , Medeiros Domingos Sávio Barbalho de , de Aquino Martins Ana Rafaela Luz , Lopes Maria Luiza Diniz de Sousa , Lima Kenio Costa , Silveira Éricka Janine Dantas da
Published: November 2021

Background

Several studies evidenced the presence of oral alterations in ICU patient. However, data about identification of their risk factors in ICU patients is scarce, especially due to the lack of longitudinal prospective studies. Here, we evaluate the risk factors for the development of oral alterations in a group of ICU patients through a prospective longitudinal cohort.

Methods

During May‐December 2019, 43 ICU patients in a tertiary hospital in Brazil were evaluated. Medical record reviews and oral examinations of each patient were made by 3 dentists in five distinct moments.

Results

Among all patients, 53.5% (n = 23) were female, with a mean age of 59.8 years (±17.4). The incidence of oral alterations was 51.2% (35.6%–66.8%) and among these (n = 22), hyposalivation (n = 9; 40.9%), and lingual biofilm accumulation (n = 9; 40.9%) were the most common. The mean age of the group with oral alterations (66.9 years) was higher compared to the group without alterations (52.3 years). Furthermore, male patients (p = 0.02), older than 60 years (p = 0.004) and treated with mechanical ventilator (p = 0.03) had a higher risk of oral alterations.

Conclusions

Systemic parameters, as age and mechanical ventilator, could influence the oral environment of ICU patients.
Intrahepatic immune infiltrate in chronic hepatitis B and chronic hepatitis C: Similar but not the same
Authors: Giadans Cecilia Graciela , Ríos Daniela Alejandra , Ameigeiras Beatriz , Haddad Leila , De Matteo Elena Noemí , Valva Pamela , Preciado María Victoria
Published: November 2021

In chronic hepatitis B (CHB) and C (CHC) infections, the composition of the immune cell microenvironment at the site of infection is poorly understood. Thus, our aim was to characterize and compare liver infiltrates to identify shared and exclusive hepatic immune components. Immunohistochemistry was performed on 26 CHB and 42 CHC liver biopsies to determine Th (CD4+), Th1 (T‐bet+), Th17 (IL‐17A+), Treg (Foxp3+) and CTL (CD8+) cells frequency in portal/periportal and intralobular areas and relate them to liver damage. CHB and CHC cases shared a portal/periportal CD4+ lymphocyte predominance and a lobular CD8+ lymphocyte majority. However, CHC exhibited a concomitant lobular T‐bet+ cell dominance while in CHB FoxP3+ cells prevail. CHC disclosed higher frequencies of P/P FoxP3+, IL‐17A+ and T‐bet+ cells and intralobular CD4+, IL‐17A+ and T‐bet+ lymphocytes. HBeAg+ chronic hepatitis and CHC cell frequencies were similar except for lobular T‐bet+ that remained higher among CHC cases. Comparison among cases with less severe liver disease revealed lower lymphocyte frequencies in CHB samples, while no differences were observed between patients with more severe stages. Interestingly, in CHB portal/periportal CD4+ and lobular CD4+, CD8+ and IL‐17A+ cells were associated with severe hepatitis. Even when all studied populations were identified in both infections preferential lymphocyte frequencies and prevalence at different areas along with their association with liver damage highlighted that CHB and CHC immune responses are not the same.
Contextual and individual factors associated with knowledge, awareness and attitude on liver diseases: A large‐scale Asian study
Authors: Lee Mei Hsuan , Ahn Sang Hoon , Chan Henry L. Y. , Choudhry Asad , Alvani Gani Rino , Mohamed Rosmawati , Ong Janus P. , Shukla Akash , Tan Chee Kiat , Tanwandee Tawesak , Thuy Pham Thi Thu , Neo Boon Leong , Tsang Venus , Youn Jin , Singh Shikha
Published: November 2021

There are limited data to provide better understanding of the knowledge/awareness of general population towards liver health in Asia. We sought to identify the knowledge gaps and attitudes towards liver health and liver diseases as well as evaluate associated individual‐level and macro‐level factors based on contextual analysis. An online survey assessing knowledge, awareness and attitudes towards liver health and disease was conducted among 7500 respondents across 11 countries/territories in Asia. A liver index was created to measure the respondents’ knowledge level and the degree of awareness and attitudes. Multilevel logistic regression was performed to identify individual factors and contextual effects that were associated with liver index. The overall liver index (0–100‐point scale) was 62.4 with 6 countries/territories’ liver indices greater than this. In the multilevel model, the inclusion of geographical information could explain for 9.6% of the variation. Residing in a country/territory with higher HBV prevalence (80% IOR: 1.20–2.79) or higher HCV death rate (80% IOR: 1.35–3.13) increased the individual probability of obtaining a high overall liver index. Individual factors like age, gender, education, household income, disease history and health screening behaviour were also associated with liver index (all p‐values<0.001). The overall liver index was positively associated with the two macro‐level factors viz. HBV prevalence and HCV death rate. There is a need to formulate policies especially in regions of lower HBV prevalence and HCV death rate to further improve the knowledge, awareness and attitudes of the general public towards liver diseases.
Feasibility, effectiveness and cost of a decentralized HCV care model among the general population in Delhi, India
Authors: Markby Jessica , Gupta Ekta , Soni Divya , Sarin Sanjay , Murya Mugil , Katapur Preetishirin , Tewatia Navneet , Ramachandran Babu Entoor , Ruiz Ryan Jose , Gaeddert Mary , Tyshkovskiy Alexander , Adee Madeline , Chhatwal Jagpreet , Miglani Sundeep , Easterbrook Philippa , Sarin Shiv K. , Shilton Sonjelle
Published: November 2021

Background and aims

India has a significant burden of hepatitis C virus (HCV) infection and has committed to achieving national elimination by 2030. This will require a substantial scale‐up in testing and treatment. The “HEAD‐Start Project Delhi” aimed to enhance HCV diagnosis and treatment pathways among the general population.

Methods

A prospective study was conducted at 5 district hospitals (Arm 1: one‐stop shop), 15 polyclinics (Arm 2: referral for viral load (VL) testing and treatment) and 62 screening camps (Arm 3: referral for treatment). HCV prevalence, retention in the HCV care cascade, and turn‐around time were measured.

Results

Between January and September 2019, 37 425 participants were screened for HCV. The median (IQR) age of participants was 35 (26‐48) years, with 50.4% male and 49.6% female. A significantly higher proportion of participants in Arm 1 (93.7%) and Arm 3 (90.3%) received a VL test compared with Arm 2 (52.5%, P < .001). Of those confirmed positive, treatment was initiated at significantly higher rates for participants in both Arms 1 (85.6%) and 2 (73.7%) compared to Arm 3 (41.8%, P < .001). Arm 1 was found to be a cost‐saving strategy compared to Arm 2, Arm 3, and no action.

Conclusions

Delivery of all services at a single site (district hospitals) resulted in a higher yield of HCV seropositive cases and retention compared with sites where participants were referred elsewhere for VL testing and/or treatment. The highest level of retention in the care cascade was also associated with the shortest turn‐around times.
Small RNAs that target G‐rich sequences are generated by diverse biogenesis pathways in Epsilonproteobacteria
Authors: Svensson Sarah L. , Sharma Cynthia M.
Published: November 2021

Bacterial small RNAs (sRNAs) are widespread post‐transcriptional regulators that control bacterial stress responses and virulence. Nevertheless, little is known about how they arise and evolve. Homologs can be difficult to identify beyond the strain level using sequence‐based approaches, and similar functionalities can arise by convergent evolution. Here, we found that the virulence‐associated CJnc190 sRNA of the foodborne pathogen Campylobacter jejuni resembles the RepG sRNA from the gastric pathogen Helicobacter pylori. However, while both sRNAs bind G‐rich sites in their target mRNAs using a C/U‐rich loop, they largely differ in their biogenesis. RepG is transcribed from a stand‐alone gene and does not require processing, whereas CJnc190 is transcribed from two promoters as precursors that are processed by RNase III and also has a cis‐encoded antagonist, CJnc180. By comparing CJnc190 homologs in diverse Campylobacter species, we show that RNase III‐dependent processing of CJnc190 appears to be a conserved feature even outside of C. jejuni. We also demonstrate the CJnc180 antisense partner is expressed in C. coli, yet here might be derived from the 3’UTR (untranslated region) of an upstream flagella‐related gene. Our analysis of G‐tract targeting sRNAs in Epsilonproteobacteria demonstrates that similar sRNAs can have markedly different biogenesis pathways.
Global analysis of trait–trait relationships within and between species
Authors: Zhou Jianhong , Cieraad Ellen , van Bodegom Peter M.
Published: November 2021

Some commonly reported trait–trait relationships between species, including the leaf economic spectrum (LES), are regarded as important plant strategies but whether these relationships represent plant strategies in reality remains unclear.

We propose a novel approach to distinguish trait–trait relationships between species that may represent plant strategies vs those relationships that are the result of common drivers, by comparing the direction and strength of intraspecific trait variation (ITV) vs interspecific trait variation. We applied this framework using a unique global ITV database that we compiled, which included 11 traits related to LES, size and roots, and observations from 2064 species occurring in 1068 communities across 19 countries.

Generally, compared to between species, trait–trait relationships within species were much weaker or totally disappeared. Almost only within the LES traits, the between‐species trait–trait relationships were translated into positive relationships within species, which suggests that they may represent plant strategies.

Moreover, the frequent coincidental trait–trait relationships between species, driven by co‐varying common drivers, imply that in future research, decoupling of trait–trait relationships should be considered seriously in model projections of ecosystem functioning. Our study emphasizes the importance of describing the mechanisms behind trait–trait relationships, both between and within species, for deepening our understanding of general plant strategies.
Public health and COVID‐19: Leaky bodies and regulated borders
Authors: Lovell Sarah A.
Published: November 2021

The adoption of border restrictions is a political act that situates bodies relative to the nation state. Despite its lauded pandemic response, Aotearoa/New Zealand deviated from WHO recommendations in its use of strict border control measures. This commentary seeks to critically situate Aotearoa's adoption of border restrictions within the context of quarantine historically and global policy advice. Informed by discourse analysis of WHO COVID‐19 technical guidance and travel advisories, it is argued that in situating COVID‐19 as a global health problem requiring multilateral action WHO advice failed to reflect the needs of nation states, such as Aotearoa/New Zealand, which were poorly prepared to respond to a pandemic.
Impact of Variations in Water Concentration on the Nanomechanical Behavior of Type I Collagen Microfibrils in Annulus Fibrosus
Authors: Bhattacharya Shambo , Dubey Devendra K.
Published: November 2021

Radial variation in water concentration from outer to inner lamellae is one of the characteristic features of annulus fibrosus (AF). In addition, water concentration changes are also associated with intervertebral disc (IVD) degeneration. Such changes alter the chemo-mechanical interactions among the biomolecular constituents at molecular level, affecting the load-bearing nature of IVD. This study investigates mechanistic impacts of water concentration on the collagen type I microfibrils in AF using molecular dynamics simulations. Results show, in axial tension, that increase in water concentration (WC) from 0% to 50% increases the elastic modulus from 2.7 GPa to 3.9 GPa. This is attributed to combination of shift in deformation from backbone straightening to combined backbone stretching– intermolecular sliding and subsequent strengthening of tropocollagen–water (TC-water-TC) interfaces through water bridges and intermolecular electrostatic attractions. Further increase in WC to 75% reduces the modulus to 1.8 GPa due to shift in deformation to polypeptide straightening and weakening of TC-water-TC interface due to reduced electrostatic attraction and increase in the number of water molecules in a water bridge. During axial compression, increase in WC to 50% results in increase in modulus from 0.8 GPa to 4.5 GPa. This is attributed to the combination of the development of hydrostatic pressure and strengthening of the TC-water-TC interface. Further increase in WC to 75% shifts load-bearing characteristic from collagen to water, resulting in a decrease in elastic modulus to 2.8 GPa. Such water-mediated alteration in load-bearing properties acts as foundations toward AF mechanics and provides insights toward understanding degeneration-mediated altered spinal stiffness.
Internal Load of Male Varsity Ice Hockey Players During Training and Games Throughout an Entire Season
Authors: Bigg Jessica L. , Gamble Alexander S.D. , Spriet Lawrence L.
Published: November 2021

Purpose: The purpose of this study was to quantify the internal load of male varsity ice hockey players, using both sessional rating of perceived exertion (sRPE) and the heart rate–derived physiological measure of training impulse (TRIMP), during training sessions and competitions throughout an entire season. Methods: Twenty-seven male varsity ice hockey players (22.1 [1.1] y, 85.9 [5.4] kg, 181.3 [5.1] cm) were included in this longitudinal prospective cohort study. Results: The internal load was significantly higher (P < .001) for games (sRPE: 403 [184] arbitrary units [AU], TRIMP: 98 [59] AU) compared with training sessions (sRPE: 281 [130] AU, TRIMP: 71 [35] AU). The regular season had the highest internal load compared with the preseason and postseason. There was evidence of microcycle periodization with training sessions several days prior to game days having the highest internal load (both sRPE and TRIMP) and tapering down as the subsequent training sessions approached game day. For positional comparisons, the goalies had higher sRPE (346 [151] AU, P < .001) and TRIMP (99 [64] AU, P < .001) compared with defense (sRPE: 295 [130] AU, TRIMP: 65 [29] AU) and forwards (sRPE: 264 [123] AU, TRIMP: 70 [30] AU) for training sessions, but no significant differences were present for competitions. Finally, there was an overall moderate and statistically significant relationship between the sRPE and TRIMP internal load measures (r = .434, P < .001). Conclusions: Internal load was greater during competitions versus training sessions in male varsity ice hockey players, and the microcycle assessment demonstrated that training sessions were tailored to game day. Mesocycle assessment revealed the highest internal loads during the regular season due to dense game scheduling and a short season.
The Influence of Chronic Pain and Catastrophizing on Patient Outcomes in an Athletic Therapy Setting
Authors: Hindle Meaghan , Aldinger Katherine , Dover Geoff
Published: November 2021

Context: Chronic pain is a challenge for Athletic Trainers and Athletic Therapists working in a clinical or university setting. The fear avoidance model, including catastrophizing, is well established in other health professions but is not established in Athletic Training and Athletic Therapy and may affect rehabilitation outcomes. Objective: To measure the influence of catastrophizing on rehabilitation outcomes of patients being treated in an Athletic Therapy setting. Design: Prospective single group pre–post design. Setting: Student Athletic Therapy clinic. Patients: A total of 92 patients were evaluated at initial assessment, and 49 were evaluated at follow-up. Intervention: All participants completed self-reported function questionnaires to assess level of injury and then received individualized treatments for a variety of musculoskeletal injuries. All measures were completed at initial assessment and at follow-up approximately 6 weeks later. Main Outcome Measures: The authors measured function using a variety of patient self-reported functional questionnaires: the Disability of the Arm, Shoulder, and Hand; Lower Extremity Functional Scale; the Neck Disability Index; and the Oswestry Disability Index depending on injury site. Catastrophizing was measured using the Pain Catastrophizing Scale. Results: Function significantly improved from the initial assessment to the follow-up (P > .001). Patients with acute pain experienced a significantly greater improvement in function between the initial assessment and follow-up compared with participants with chronic pain (P = .050). Those with high catastrophizing presented with lower levels of function at initial assessment (66.8%) and follow-up (72.1%) compared with those with low catastrophizing (80.8% and 87.0%, respectively). Conclusion: Similar to other studies in other professions, the function of patients with chronic pain does not improve as much compared with patients recovering from acute pain in an Athletic Therapy setting. It is important to measure patient-reported outcomes to evaluate patient rehabilitation progress. Rehabilitating patients with chronic pain is a challenge, and pain catastrophizing should be evaluated at the initial assessment since catastrophizing is associated with worse function.
Hints of lepton flavor universality violations
Authors: Crivellin Andreas , Hoferichter Martin
Published: November 2021

Mounting evidence shows where the standard model may be incomplete
Community policing in the developing world
Authors: Tobón Santiago
Published: November 2021

Community policing did not improve trust or reduce crime
As cancer grows old
Authors: Baez-Ortega Adrian
Published: November 2021

Mutations trace the evolution of an ancient tumor lineage
In Other Journals
Authors: Yiu Yuen , Hurtley Stella M. , Sugden Andrew M. , Ash Caroline , Suleymanov Yury , Wible Brad , Purnell Beverly A.
Published: November 2021

Editors’ selections from the current scientific literature
200,000 whole genomes made available for biomedical studies
Authors: Kaiser Jocelyn
Published: November 2021

UK Biobank offers easy access to genomic database for researchers around the world
Discordant and inappropriate discordant recommendations in consensus and evidence based guidelines: empirical analysis
Authors: Yao Liang , Ahmed Muhammad Muneeb , Guyatt Gordon H , Yan Peijing , Hui Xu , Wang Qi , Yang Kehu , Tian Jinhui , Djulbegovic Benjamin
Published: November 2021

Objective

To investigate whether alignment of strength of recommendations with quality of evidence differs in consensus based versus evidence based guidelines.

Design

Empirical analysis.

Data source

Guidelines developed by the American College of Cardiology and the American Heart Association (ACC/AHA) and the American Society of Clinical Oncology (ASCO) up to 27 March 2021.

Study selection

Recommendations were clearly categorised as consensus or evidence based, were separated from the remainder of the text, and included both the quality of evidence and the strength of the recommendations.

Data extraction

Paired authors independently extracted the recommendation characteristics, including type of recommendation (consensus or evidence based), grading system used for developing recommendations, strength of the recommendation, and quality of evidence. The study team also calculated the number of discordant recommendations (strong recommendations with low quality evidence) and inappropriate discordant recommendations (those that did not meet grading of recommendations assessment, development, and evaluation criteria of appropriateness).

Results

The study included 12 ACC/AHA guidelines that generated 1434 recommendations and 69 ASCO guidelines that generated 1094 recommendations. Of the 504 ACC/AHA recommendations based on low quality evidence, 200 (40%) proved to be consensus based versus 304 (60%) evidence based; of the 404 ASCO recommendations based on low quality evidence, 292 (72%) were consensus based versus 112 (28%) that were evidence based. In both ACC/AHA and ASCO guidelines, the consensus approach yielded more discordant recommendations (ACC/AHA: odds ratio 2.1, 95% confidence interval 1.5 to 3.1; ASCO: 2.9, 1.1 to 7.8) and inappropriate discordant recommendations (ACC/AHA: 2.6, 1.7 to 3.7; ASCO: 5.1, 1.6 to 16.0) than the evidence based approach.

Conclusion

Consensus based guidelines produce more recommendations violating the evidence based medicine principles than evidence based guidelines. Ensuring appropriate alignment of quality of evidence with the strength of recommendations is key to the development of “trustworthy” guidelines.
Elapsed time since BNT162b2 vaccine and risk of SARS-CoV-2 infection: test negative design study
Authors: Israel Ariel , Merzon Eugene , Schäffer Alejandro A , Shenhar Yotam , Green Ilan , Golan-Cohen Avivit , Ruppin Eytan , Magen Eli , Vinker Shlomo
Published: November 2021

Objectives

To determine whether time elapsed since the second injection of the Pfizer-BioNTech BNT162b2 mRNA vaccine was significantly associated with the risk of covid-19 infection after vaccination in people who received two vaccine injections.

Design

Test negative design study.

Setting

Electronic health records of a large state mandated healthcare organisation, Israel.

Participants

Adults aged ≥18 years who had received a reverse transcription polymerase chain reaction (RT-PCR) test between 15 May 2021 and 17 September 2021, at least three weeks after their second vaccine injection, had not received a third vaccine injection, and had no history of covid-19 infection.

Main outcome measures

Positive result for the RT-PCR test. Individuals who tested positive for SARS-CoV-2 and controls were matched for week of testing, age category, and demographic group (ultra-orthodox Jews, individuals of Arab ancestry, and the general population). Conditional logistic regression was adjusted for age, sex, socioeconomic status, and comorbid conditions.

Results

83 057 adults received an RT-PCR test for SARS-CoV-2 during the study period and 9.6% had a positive result. Time elapsed since the vaccine injection was significantly longer in individuals who tested positive (P<0.001). Adjusted odds ratio for infection at time intervals >90 days since vaccination were significantly increased compared with the reference of <90 days: 2.37 (95% confidence interval 1.67 to 3.36) for 90-119 days, 2.66 (1.94 to 3.66) for 120-149 days, 2.82 (2.07 to 3.84) for 150-179 days, and 2.82 (2.07 to 3.85) for ≥180 days (P<0.001 for each 30 day interval).

Conclusions

In this large population of adults tested for SARS-CoV-2 by RT-PCR after two doses of mRNA BNT162b2 vaccine, a gradual increase in the risk of infection was seen for individuals who received their second vaccine dose after at least 90 days.
The impact of pulse oximetry on diagnosis, management and outcomes of acute febrile illness in low-income and middle-income countries: a systematic review
Authors: Chew Rusheng , Zhang Meiwen , Chandna Arjun , Lubell Yoel
Published: November 2021

Background

Acute fever is a common presenting symptom in low/middle-income countries (LMICs) and is strongly associated with sepsis. Hypoxaemia predicts disease severity in such patients but is poorly detected by clinical examination. Therefore, including pulse oximetry in the assessment of acutely febrile patients may improve clinical outcomes in LMIC settings.

Methods

We systematically reviewed studies of any design comparing one group where pulse oximetry was used and at least one group where it was not. The target population was patients of any age presenting with acute febrile illness or associated syndromes in LMICs. Studies were obtained from searching PubMed, EMBASE, CABI Global Health, Global Index Medicus, CINAHL, Cochrane CENTRAL, Web of Science and DARE. Further studies were identified through searches of non-governmental organisation websites, snowballing and input from a Technical Advisory Panel. Outcomes of interest were diagnosis, management and patient outcomes. Study quality was assessed using the Cochrane Risk of Bias 2 tool for Cluster Randomised Trials and Risk of Bias in Non-randomized Studies of Interventions tools, as appropriate.

Results

Ten of 4898 studies were eligible for inclusion. Their small number and heterogeneity prevented formal meta-analysis. All studies were in children, eight only recruited patients with pneumonia, and nine were conducted in Africa or Australasia. Six were at serious risk of bias. There was moderately strong evidence for the utility of pulse oximetry in diagnosing pneumonia and identifying severe disease requiring hospital referral. Pulse oximetry used as part of a quality-assured facility-wide package of interventions may reduce pneumonia mortality, but studies assessing this endpoint were at serious risk of bias.

Conclusions

Very few studies addressed this important question. In LMICs, pulse oximetry may assist clinicians in diagnosing and managing paediatric pneumonia, but for the greatest impact on patient outcomes should be implemented as part of a health systems approach. The evidence for these conclusions is not widely generalisable and is of poor quality.
Patient and public engagement in decision-making regarding infectious disease outbreak management: an integrative review
Authors: Kemper Sophie , Bongers MEJ , Slok ENE , Schoonmade LJ , Kupper JFH , Timen A
Published: November 2021

Introduction

Worldwide, people experience the effects of infectious disease outbreaks on a regular basis. These effects vary from direct impact of the virus on health, to indirect impact of control measures on day-to-day life. Yet, incorporating the experiences, views and ideas of patients and the public in decision-making in managing outbreaks does not take place on a structural basis. However, this might be beneficial. We examined the current incorporation of patient and public engagement (PPE) in decision-making regarding outbreak management (OM).

Methods

A systematic search was executed in PubMed, Embase, APA PsycInfo, Web of Science, Scopus and other literature sources. Papers describing PPE in decision-making regarding OM on a collective level (group-level) were included. Relevant information about study characteristics, methods, impact and embedment of PPE in decision-making in OM was collected.

Results

The search yielded 4186 papers of which 13 were included. The papers varied in study context and design. Remarkably, no substantial patient engagement was identified. Overall, public engagement (PE) in decision-making regarding OM was mostly executed by a mix of methods, for example, workshops, interviews and surveys. Knowledge and idea sharing between the public and experts was deemed beneficial for establishing well-informed discussions. The efforts resulted in either direct implications for practice or recommendations in policy papers. Most papers described their efforts as a first step. No structural embedment of collective PE in decision-making regarding OM was identified. Furthermore, the quality of most papers was low to moderate due to insufficient description.

Conclusion

Overall, various practices for PE can be potentially valuable, but structural embedment in OM decision-making on a collective level was low. Before PPE can be permanently embedded in OM, more evidence on its impact needs to be collected. Furthermore, reporting on the engagement process and used terminology needs to be harmonised to ensure reproducibility and transparency.
Natural history and associated early life factors of childhood asthma: a population registry-based cohort study in Denmark
Authors: Chen Qian , Chen Ji , Zhou Yingchun , Huang Lisu , Tang Yincai , Li Jiong , Zhang Jun
Published: November 2021

Objective

Asthma is a common chronic disease that imposes a substantial burden on individuals and society. However, the natural history of childhood asthma in a large population remained to be studied. This study aimed to describe the natural course of childhood asthma and examine the association between early life factors and childhood asthma.

Design

A population-based cohort study.

Setting

This study was based on the national registry data in Denmark.

Participants

All liveborn singletons in Denmark during 1995–1997 were identified and followed them till the end of 2009. Finally, 193 673 children were eligible for our study.

Exposures

The following characteristics were examined as potential early life factors associated with childhood asthma, including parity, maternal asthma history, maternal smoking during pregnancy, maternal social status, delivery method and gender.

Main outcomes and measures

Asthma cases were identified on the basis of hospitalisation for asthma and prescriptions for antiasthmatic medications. Asthma remission was defined as no hospitalisation or prescription recorded for 2 years. Cox proportional hazards’ regression and logistic regression were used to evaluate the association between early life factors and the occurrence and remission of childhood asthma.

Results

The cumulative occurrence rate of asthma in children aged 3–14 years was 13.3% and the remission rate was 44.1%. The occurrence rate decreased with age. Being female had a lower risk of asthma (HR: 0.72, 95% CI 0.70 to 0.74) and higher remission rate of asthma (HR: 1.18, 1.13 to 1.22), while maternal asthma was associated with a higher risk of asthma (HR: 2.15, 2.04 to 2.26) and decreased remission rate of asthma (HR: 0.79, 0.73 to 0.85). These patterns remained the same for early onset asthma.

Conclusions

Female gender had a lower risk of asthma and a better chance of remission, while maternal asthma history had an opposite effect. The early life factors may influence the natural course of childhood asthma.
Towards universal health coverage for people with stroke in South Africa: a scoping review
Authors: van Niekerk Sjan-Mari , Kamalakannan Sureshkumar , Inglis-Jassiem Gakeemah , Charumbira Maria Yvonne , Fernandes Silke , Webster Jayne , English Rene , Louw Quinette A , Smythe Tracey
Published: November 2021

Objectives

To explore the opportunities and challenges within the health system to facilitate the achievement of universal health coverage (UHC) for people with stroke (PWS) in South Africa (SA).

Setting

SA.

Design

Scoping review.

Search methods

We conducted a scoping review of opportunities and challenges to achieve UHC for PWS in SA. Global and Africa-specific databases and grey literature were searched in July 2020. We included studies of all designs that described the healthcare system for PWS. Two frameworks, the Health Systems Dynamics Framework and WHO Framework, were used to map data on governance and regulation, resources, service delivery, context, reorientation of care and community engagement. A narrative approach was used to synthesise results.

Results

Fifty-nine articles were included in the review. Over half (n=31, 52.5%) were conducted in Western Cape province and most (n=41, 69.4%) were conducted in urban areas. Studies evaluated a diverse range of health system categories and various outcomes. The most common reported component was service delivery (n=46, 77.9%), and only four studies (6.7%) evaluated governance and regulation. Service delivery factors for stroke care were frequently reported as poor and compounded by context-related limiting factors. Governance and regulations for stroke care in terms of government support, investment in policy, treatment guidelines, resource distribution and commitment to evidence-based solutions were limited. Promising supporting factors included adequately equipped and staffed urban tertiary facilities, the emergence of Stroke units, prompt assessment by health professionals, positive staff attitudes and care, two clinical care guidelines and educational and information resources being available.

Conclusion

This review fills a gap in the literature by providing the range of opportunities and challenges to achieve health for all PWS in SA. It highlights some health system areas that show encouraging trends to improve service delivery including comprehensiveness, quality and perceptions of care.