bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses' and Families' perceptions and practices and factors influencing the implementation of family‐centred care for hospitalised children and their families
Authors: Wong Cho Lee , Phiri Patrick G. M. C. , Chan Carmen W. H. , Tse Mankei
Published: April 2023

Aims and Objectives

To explore the perceptions of family‐centred care among nurses and the family members of hospitalised children and investigate the facilitators of and barriers to the implementation of family‐centred care in Malawi.

Background

In Malawi, approximately 34% of children have long‐term illnesses that require hospitalisation. Family‐centred care ensures that the delivery of healthcare is grounded in partnerships between healthcare providers, patients and their families, which can improve the psychological well‐being of families. However, there is lack a good understanding of how families and nurses perceive this concept, its facilitators and the barriers.

Design

This was an exploratory qualitative study. Data were analysed deductively and inductively using the five‐step qualitative content analysis method.

Methods

Twenty‐nine nurses and 31 families were recruited. Data were collected through in‐depth, semi‐structured and face‐to‐face individual interviews. The study was reported using the COREQ checklist.

Results

Both nurses and families of hospitalised children recognised the importance of nurse–family partnerships in family‐centred care. Four themes emerged as follows: Perceptions of family‐centred care, elements of family‐centred care, facilitators of family‐centred care and barriers to family‐centred care. Specific information to families and the religious beliefs of families were identified as important facilitator and barrier to family‐centred care, respectively.

Conclusion

The implementation of family‐centred care is promising in Malawi, as it is positively perceived by nurses and families, and its implementation is consistent with the Institute for Patient and Family‐Centred Care Framework.

Relevance to clinical practice

Our findings present the best practices, gaps and challenges in the context of a low‐income country regrading implementation of family‐centred care. Education programmes on family‐centred care are crucial for sustaining the current gains.
Imaging biomarkers of cerebral edema automatically extracted from routine CT scans of large vessel occlusion strokes
Authors: Dhar Rajat , Kumar Atul , Chen Yasheng , Begunova Yelyzaveta , Olexa Madelynne , Prasad Ayush , Carey Grace , Gonzalez Isabella , Bhatia Kunal , Hamed Mohammad , Heitsch Laura , Mainali Shraddha , Petersen Nils , Lee Jin‐Moo
Published: April 2023

Background and Purpose

Volumetric and densitometric biomarkers have been proposed to better quantify cerebral edema after stroke, but their relative performance has not been rigorously evaluated.

Methods

Patients with large vessel occlusion stroke from three institutions were analyzed. An automated pipeline extracted brain, cerebrospinal fluid (CSF), and infarct volumes from serial CTs. Several biomarkers were measured: change in global CSF volume from baseline (ΔCSF); ratio of CSF volumes between hemispheres (CSF ratio); and relative density of infarct region compared with mirrored contralateral region (net water uptake [NWU]). These were compared to radiographic standards, midline shift and relative hemispheric volume (RHV) and malignant edema, defined as deterioration resulting in need for osmotic therapy, decompressive surgery, or death.

Results

We analyzed 255 patients with 210 baseline CTs, 255 24‐hour CTs, and 81 72‐hour CTs. Of these, 35 (14%) developed malignant edema and 63 (27%) midline shift. CSF metrics could be calculated for 310 (92%), while NWU could only be obtained from 193 (57%). Peak midline shift was correlated with baseline CSF ratio (ρ = –.22) and with CSF ratio and ΔCSF at 24 hours (ρ = –.55/.63) and 72 hours (ρ = –.66/.69), but not with NWU (ρ = .15/.25). Similarly, CSF ratio was correlated with RHV (ρ = –.69/–.78), while NWU was not. Adjusting for age, National Institutes of Health Stroke Scale, tissue plasminogen activator treatment, and Alberta Stroke Program Early CT Score, CSF ratio (odds ratio [OR]: 1.95 per 0.1, 95% confidence interval [CI]: 1.52‐2.59) and ΔCSF at 24 hours (OR: 1.87 per 10%, 95% CI: 1.47‐2.49) were associated with malignant edema.

Conclusion

CSF volumetric biomarkers can be automatically measured from almost all routine CTs and correlate better with standard edema endpoints than net water uptake.
Stress and suicidal ideation among first‐generation farmers: A cross‐sectional study with 1,288 farmers in Georgia
Authors: Montgomery Anne , Basey Stephanie , Baucom Lily , Scoggins Chris
Published: April 2023

Purpose

The suicide rate among farmers is higher than that of the overall working population. Literature on farmer mental health in Georgia (GA) has been scarce and mostly focused on suicide as a result. Literature on stressors or coping are mostly qualitative studies. This study looks at the influence of being a first‐generation farmer on farm‐related stressors and coping mechanisms.

Methods

This cross‐sectional study inventories mental well‐being, stressors, and coping mechanisms for different types of farmers in GA, USA. The online survey ran from January 2022 through April 2022. Participants (N = 1,288) were asked about demographics, work descriptors, health care access, specific stressors, stress levels, and coping mechanisms.

Findings

Two‐thirds of our sample were first‐generation farmers. First‐generation farmers had a higher stress score on average, as well as being more likely to feel depressed, and feel hopeless. They also showed less diverse coping mechanisms than generational farmers, with alcohol in their top 3 coping mechanisms. First‐generation farmers were also much more likely to experience suicidal ideation: 9% daily and 61% at least once in the past year (vs generational: 1% daily; 20% once in the past year). Binary logistic regression indicated that having more diverse coping mechanisms is a protective factor against suicidal ideation within the previous year. The same model indicated that being a farm owner or farm manager, being first‐generation, being unhappy with one's role, feeling sad or depressed, and feeling hopeless were all risk factors.

Conclusions

First‐generation farmers experience more stress and exhibit more risk factors for suicidal ideation than generational farmers.
Non‐traumatic hemorrhagic myelopathy in dogs
Authors: West Natalie , Butterfield Sarah , Rusbridge Clare , Fernandez Ana , Tabanez Joana , Rudolf Nichola Jane , Archer Simon , Whittaker Danielle
Published: April 2023

Background

Non‐traumatic spinal cord hemorrhage (NTSH) is an uncommon cause of myelopathy in dogs.

Objectives

Describe the clinical characteristics, concurrent medical conditions and underlying causes, magnetic resonance imaging (MRI) findings and outcome in dogs with NTSH.

Animals

Dogs diagnosed with NTSH using gradient echo T2‐weighted (GRE) sequences with or without histopathological confirmation of hemorrhage were included. Dogs with a traumatic cause were excluded, including those with compressive intervertebral disc extrusion.

Methods

Retrospective descriptive study; the databases of 2 referral hospitals were searched between 2013 and 2021.

Results

Twenty‐three dogs met inclusion criteria. The onset of signs was acute and progressive in 70% of cases; spinal hyperesthesia was variable (48%). Hemorrhage was identified in the thoracolumbar spinal segments in 65% of dogs. An underlying cause was identified in 65% of cases. Angiostrongylus vasorum represented 18% of the total cohort, followed by steroid‐responsive meningitis arteritis (SRMA; 13%). Overall, 64% of dogs had a good or excellent outcome, regardless of cause; which was increased to 100% for SRMA, 75% for A. vasorum and 75% for idiopathic NTSH. Outcome was not associated with neurological severity. Recovery rate was 67% and 50% for nociception‐intact and nociception‐negative dogs, respectively.

Conclusions

Larger prospective studies would be required to define prognostic factors for dogs with NTSH, but outcome appeared to be most influenced by the underlying cause, as opposed to neurological severity at presentation.
Subarachnoid hemorrhage and axonal degeneration after C1‐C2 cervical centesis in 2 horses
Authors: Luethy Daniela , Colmer Sarah , Jodzio Dayna , Bender Susan , Porter Erin , Hemmen Zena , Fultz Lisa , Craft William , Walker Randall , Johnson Amy , Holbrook Todd
Published: April 2023

Ultrasound‐guided cervical centesis has gained popularity as a method for collecting cerebrospinal fluid (CSF) from standing horses. There are anecdotal reports of neck stiffness, regional swelling, sensitivity to palpation, and fever after the procedure. We report 2 horses with complications that occurred within days of C1‐C2 centesis and ultimately resulted in euthanasia. Both C1‐C2 centesis were performed routinely, with CSF cytologic analysis providing no evidence of blood contamination. Post‐mortem examination revealed equine degenerative myeloencephalopathy as the primary disorder causing Horse 1's initial neurologic deficits, whereas Horse 2 did not have a distinct lesion explaining the horse's deficits. Both horses had evidence of subarachnoid hemorrhage at or near the centesis site with Wallerian axonal degeneration in the cranial cervical spinal cord. Although hemorrhage with associated axonal degeneration at the cervical centesis site appears to be rare, this complication of C1‐C2 centesis should be considered as this technique gains popularity.
Monitoring Reading Component Skills during a Word‐Level Intervention for Adolescents with Limited Reading Proficiency
Authors: Washburn Jocelyn
Published: April 2023

This study examined incremental change for several reading component skills while adolescents were actively learning a word‐level intervention and measured pre‐/postintervention change in skills. Six ninth graders in two different classes participated during the 2019–2020 academic year. Primary analysis was based on an A‐B single‐case design across behaviors and participants to observe change in skills proximal to the intervention. Visual analyses of baseline and intervention phase data indicated correlational relationships between the word‐level intervention and word identification of multisyllabic words and oral reading fluency. Specifically, an aggregate Tau‐U statistical calculation for prosody showed a moderate 0.70 effect size. Secondary analysis indicated a statistically significant group effect for improved strategy knowledge and skill with a 0.90 effect size but no statistically significant group effects for silent reading fluency or sentence comprehension. Discussion includes connections between progress monitoring and reading theory as well as limitations and implications for researchers and practitioners.
Resilience and vulnerabilities of urban food environments in the Asia‐Pacific region
Authors: Rousham Emily , Clark Martyn , Latham Michelle , Oo Swan Pyae , Read Sonja , Griffiths Paula , Blankenship Jessica , Goudet Sophie
Published: April 2023

Rapid urbanisation in the Asia‐Pacific region is associated with complex changes to urban food environments. The impact of changing food environments on food purchasing and consumption and the diets and nutritional status of vulnerable groups, especially women and young children, is not well researched in low‐ and middle‐income country cities. This paper aimed to examine: the risks and opportunities for healthy diets for low income populations offered by modernising urban centres; the concept of food deserts in relation to urban food environments in the Asia‐Pacific region and how these could be mitigated; and measures to strengthen the resilience of food environments in the region using a case study of the impact of COVID‐19 on informal food vendors. Our findings indicate that the dynamic changes in urban food environments in the Asia‐ Pacific region need to be understood by examining not only modern retail food outlets but also wet markets and informal food outlets, including street foods. Efforts should be made to ensure both modern and traditional outlets provide complementary platforms for convenient, affordable and accessible nutritious foods for urban populations. The resilience of urban food environments to environmental, physical and socio‐economic shocks can be strengthened by shortening food supply chains and maximising food production in cities. Support mechanisms targeting urban informal food outlets and street vendors can also strengthen resilience and improve food security. Further research is needed on the impact of urbanising food environments on consumer choices, preferences, diets and health outcomes.
Determining the Good and Human Culpability: Catholic Catechesis on Overcoming the Anxiety of Sin
Authors: Goodey Daniel J.
Published: April 2023

This article focuses on the implications of modernity for human culpability and moral responsibility. Although the sacrament of Penance and Reconciliation is most often approached theologically and pastorally, this article is intended as an answer to Pope Benedict XVI's call to explore catechesis through new lenses by adopting a psychological therapeutic approach. As such, this article will examine how the rejection of religious ascription to God for defining and determining the good and re-ascribing it to humanity leads to a rupture and the psychological conditions of anxiety, depression, and melancholia. The article will go on to argue for a Lacanian reading of Thomas Aquinas’ definition of the good and how the Thomistic understanding provides a more comprehensive approach to determining culpability and overcoming the associated fear which leads to anxiety, depression, and melancholia.
An Alternative Perspective on the Changing Relationships between Fertility and Replacement Level in European Countries
Authors: Parr Nick
Published: April 2023

This paper brings a new perspective to the population growth implications of the low fertility levels of European countries. For years between 2009 and 2018, whether constant fertility, mortality, and net migration would generate long‐run population growth or population decrease is indicated simply and visually by comparison of the total fertility rate (TFR) to a migration‐adjusted replacement level. The results show that, when considered in combination with concurrent net migration and mortality, the population growth implication of low fertility varies between countries and over time. For Sweden, Luxembourg, Belgium, and the United Kingdom for all the years considered the fertility–mortality–migration combination is coherent with long‐run population growth. For the former two countries, long‐run population growth would be sustained by net migration at current levels even if fertility were to fall to very low levels. In contrast, for every Eastern European country and year considered, unchanged fertility–mortality–migration combination would lead to population decrease. The need for an alternative view of low fertility in terms of whether the TFR is above or below a migration‐adjusted replacement level and the need for a migration context‐specific view, as distinct from a universal best view, of the desirability of fertility level are discussed.
The SCL30a SR protein regulates ABA‐dependent seed traits and germination under stress
Authors: Laloum Tom , Carvalho Sofia D. , Martín Guiomar , Richardson Dale N. , Cruz Tiago M. D. , Carvalho Raquel F. , Stecca Kevin L. , Kinney Anthony J. , Zeidler Mathias , Barbosa Inês C. R. , Duque Paula
Published: April 2023

SR proteins are conserved RNA‐binding proteins best known as splicing regulators that have also been implicated in other steps of gene expression. Despite mounting evidence for a role in plant development and stress responses, the molecular pathways underlying SR protein regulation of these processes remain poorly understood. Here we show that the plant‐specific SCL30a SR protein negatively regulates ABA signaling to control seed traits and stress responses during germination in Arabidopsis. Transcriptome‐wide analyses revealed that loss of SCL30a function barely affects splicing, but largely induces ABA‐responsive gene expression and genes repressed during germination. Accordingly, scl30a mutant seeds display delayed germination and hypersensitivity to ABA and high salinity, while transgenic plants overexpressing SCL30a exhibit reduced ABA and salt stress sensitivity. An ABA biosynthesis inhibitor rescues the enhanced mutant seed stress sensitivity, and epistatic analyses confirm that this hypersensitivity requires a functional ABA pathway. Finally, seed ABA levels are unchanged by altered SCL30a expression, indicating that the gene promotes seed germination under stress by reducing sensitivity to the phytohormone. Our results reveal a new player in ABA‐mediated control of early development and stress response.
An evaluation of conventional and deep learning‐based image‐matching methods on diverse datasets
Authors: Ji Shunping , Zeng Chang , Zhang Yongjun , Duan Yulin
Published: April 2023

Image matching plays an important role in photogrammetry, computer vision and remote sensing. Modern deep learning‐based methods have been proposed for image matching; however, whether they will surpass and take the place of the conventional handcrafted methods in the remote sensing field still remains unclear. A comprehensive evaluation on stereo remote sensing images is also lacking. This paper comprehensively evaluates the performance of conventional and deep learning‐based image‐matching methods by dividing the matching process into feature point extraction, description and similarity measure on various datasets, including images captured from close‐range indoor and outdoor scenarios, unmanned aerial vehicles (UAVs) and satellite platforms. Different combinations of the three steps are evaluated. The experimental results reveal that, first, the performance of the different combinations varies between individual datasets, and it is difficult to determine the best combination. Second, by using more comprehensive indicators on all of the datasets, that is, the average rank and absolute rank, the combination of scale‐invariant feature transform (SIFT), ContextDesc and the nearest neighbour distance ratio (NNDR), and also the original SIFT, achieve the best results, and are recommended for use in remote sensing. Third, the deep learning‐based Sub‐SuperPoint extractor obtains a good performance, and is second only to SIFT. The learning based ContextDesc descriptor is as effective as the SIFT descriptor, and the learning based SuperGlue matcher is not as stable as NNDR, but leads to a few top‐performing combinations. Finally, the handcrafted methods are generally faster than the deep learning‐based methods, but the efficiency of the latter is acceptable. We conclude that although a full deep learning‐based method/combination has not yet beaten the conventional methods, there is still much room for improvement with the deep learning‐based methods because large‐scale aerial and satellite training datasets remain to be constructed, and specific methods for remote sensing images remain to be developed. The performance of the different combinations of feature extractor, descriptor and similarity measure varies between individual datasets. The combination of SIFT, ContextDesc and NNDR, and also the original SIFT, achieve the best results when using more comprehensive indicators on all the datasets. For extractor, the learning based Sub‐SuperPoint is second only to SIFT; for descriptor, learning‐based ContextDesc is as effective as the SIFT descriptor; and for matcher, learning‐based SuperGlue is not as stable as NNDR.
Global supply chains and cross‐border financing
Authors: Hertzel Michael , Peng Jie , Wu Jing , Zhang Yu
Published: April 2023

This paper provides evidence that the formation of global supply chain partnerships leads to an increased usage of cross‐border financing. The findings are detected in all three major financing markets—equities, syndicated loans, and public debt. Difference‐in‐differences tests allow us to draw a causal interpretation of our main findings, which also holds in several robustness tests. Our findings suggest that increased cross‐border financing reflects greater ability to access global financial markets, due to enhanced firm visibility and investor attention, as well as operational forces that arise when establishing new global supply chain partnerships. Specifically, we provide evidence that firms that are small, held less by institutional investors, and followed by fewer analysts have more benefits in cross‐border financing from the formation of the global supply chain. Our findings have important implications for firms attempting to integrate into the global supply chain network. More broadly, our findings suggest that the information generated by operational activities can have significant effects on subsequent financing activities.
Barriers of Women in Acquiring Leadership Positions in Agricultural Cooperatives: The Case of Cambodia☆
Authors: Huot Sovanneary , Jensen Leif , Bates Ricky , Ader David
Published: April 2023

Gender inequality in agriculture remains a global concern. Cambodia is marked by a lack of women representatives in leadership and decision‐making positions at every level, a problem that is clearly seen in agriculture. Previous research suggests a need to focus on financial and time constraints for women in acquiring leadership positions. Therefore, we study the barriers that women face in acquiring and continuing in leadership roles within two farmer cooperatives in Battambang and Siem Reap Provinces, Cambodia. Qualitative data were gathered through key informant interviews and focus group discussions with smallholder farmers. We find that women in these two cooperatives do have leadership opportunities, and some do acquire leadership roles. However, they face challenges in this regard. Obstacles include domestic work burden that limits time for activities off the farm, low education that inhibits capacity and the confidence to serve as leaders, and lack of proper compensation for leadership positions. If government agencies, policymakers, donors, NGOs, and others want women to play a greater leadership role, they need to reduce the interrelated constraints of time poverty, lack of capacity, and insufficient compensation.
The optimal input‐independent baseline for binary classification: The Dutch Draw
Authors: Pries Joris , van de Bijl Etienne , Klein Jan , Bhulai Sandjai , van der Mei Rob
Published: April 2023

Before any binary classification model is taken into practice, it is important to validate its performance on a proper test set. Without a frame of reference given by a baseline method, it is impossible to determine if a score is “good” or “bad.” The goal of this paper is to examine all baseline methods that are independent of feature values and determine which model is the “best” and why. By identifying which baseline models are optimal, a crucial selection decision in the evaluation process is simplified. We prove that the recently proposed Dutch Draw baseline is the best input‐independent classifier (independent of feature values) for all order‐invariant measures (independent of sequence order) assuming that the samples are randomly shuffled. This means that the Dutch Draw baseline is the optimal baseline under these intuitive requirements and should therefore be used in practice.
Rethinking the regularity in mobility patterns of personal vehicle drivers: A multi‐city comparison using a feature engineering approach
Authors: Ji Yuhan , Gao Song , Huynh Tam , Scheele Chris , Triveri James , Kruse Jacob , Bennett Collin , Wen Yicheng
Published: April 2023

Large‐scale trajectory data offer a finer lens into the regularity in individual mobility choices. Previous studies have exerted efforts to measure the regularity in people's location visiting patterns. However, the complexity of travel behavior at different spatial and temporal scales has not been adequately considered. To capture regularity in a more comprehensive manner, we construct human mobility profiles with interpretable features at three levels, that is, location, motif, and route, on personal vehicle drivers. A feature engineering approach is designed to analyze the extent to which individuals exhibit multi‐level regularity. The analysis pipeline includes feature selection, user segmentation and profiling, and feature importance evaluation. Our empirical study analyzed over 4 million trips of 3743 personal vehicle drivers collected over a month in six metropolitan areas in the United States. The weak correlations between features confirm the validity of quantifying regularity from different aspects. We discovered five clusters of drivers (i.e., gig drivers, homebodies, movers, typical drivers, and work‐focused commuters) that differ in their regularity to commute to the workplace and the inclination to participate in non‐work activities. A similar driver segmentation and profiling pattern is found in all of the studied metro areas. The minor differences are interpreted from the distribution of mobility features and urban features. The proposed method using multi‐level feature engineering provides a generic framework to study regularity and can be readily adapted to other mobility data sources by customizing the features. The improved understanding of mobility patterns within the built environment is valuable for innovating urban transportation solutions.
Screening for Zika virus in US armed services blood program donors: An opportunity to compare emerging infectious disease risk between the general US population and military donors
Authors: Fedyk Chriselda G. , Shahin George M. , Hill Ronnie , Cap Andrew P. ,   DoD Zika IND Investigators
Published: April 2023

Background

The U.S. Department of Defense (DoD) collects blood from volunteer DoD donors in U.S. Food and Drug Administration (FDA)‐regulated centers, and from emergency donor panels in overseas operations. Emerging infectious diseases could reduce DoD access to blood products. In August 2016, FDA determined that Zika virus was transfusion‐transmitted and advised that donated blood should be screened for Zika utilizing one of two investigational new drug (IND) applications. The Armed Services Blood Program (ASBP) tested blood using its own protocol concurrently with the IND study sponsored by Roche Molecular Systems, Inc., titled “A Prospective Study to Evaluate the Specificity of the cobas Zika test for use on the cobas 6800/8800 System for Screening of Blood Donations for the Presence of Zika virus RNA.”

Study Design and Methods

This prospective clinical trial (September 2016–August 2017) evaluated the specificity of the cobas Zika 6800/8800 System. Consenting volunteers were screened for Zika by participating reference labs. Participants with positive screens were offered a follow‐up study using alternative PCR and serology assays.

Results

92,618 DoD donors enrolled; four tested positive on screening (0.0043%; CI 0.001176896%, 0.01105894%). Three enrolled in follow‐up testing and none were positive. These results were comparable to all U.S. donors: 3,858,114 enrolled (excluding Puerto Rico) with 459 positive screens (0.0119%; CI 0.01083582%, 0.01303962%).

Conclusion

The study demonstrated the effectiveness of the cobas Zika test. DoD donors, who are included in emergency donor panels during military operations, were at no higher risk for Zika than the overall U.S. donor population.
Arakelov–Milnor inequalities and maximal variations of Hodge structure
Authors: Biquard Olivier , Collier Brian , García-Prada Oscar , Toledo Domingo
Published: April 2023

In this paper we study the $\mathbb {C}^*$-fixed points in moduli spaces of Higgs bundles over a compact Riemann surface for a complex semisimple Lie group and its real forms. These fixed points are called Hodge bundles and correspond to complex variations of Hodge structure. We introduce a topological invariant for Hodge bundles that generalizes the Toledo invariant appearing for Hermitian Lie groups. An important result of this paper is a bound on this invariant which generalizes the Milnor–Wood inequality for a Hodge bundle in the Hermitian case, and is analogous to the Arakelov inequalities of classical variations of Hodge structure. When the generalized Toledo invariant is maximal, we establish rigidity results for the associated variations of Hodge structure which generalize known rigidity results for maximal Higgs bundles and their associated maximal representations in the Hermitian case.
Scoping Review of Population-Based Physical Activity and Sedentary Behavior in Saudi Arabia
Authors: Evenson Kelly R. , Alhusseini Noara , Moore Christopher C. , Hamza Mariam M. , Al-Qunaibet Ada , Rakic Severin , Alsukait Reem F. , Herbst Christopher H. , AlAhmed Reem , Al-Hazzaa Hazzaa M. , Alqahtani Saleh A.
Published: April 2023

Background: Saudi Arabia is experiencing rapid development of the built environment and implementing policy changes to promote physical activity (PA) and reduce sedentary behavior (SB) among its population. In light of these developments, this scoping review systematically summarized population levels of PA/SB in Saudi Arabia. Methods: The authors searched 6 databases on December 13, 2021, for articles published in English or Arabic from 2018 to the search date. Studies using population-based sampling in Saudi Arabia and measuring PA/SB were included. Results: Of the 1272 records found, 797 were screened, and 19 studies (9 on children/adolescents age 6–19 y and 10 on adults age 15–75 y) were included. All studies were cross-sectional in design, and 18 studies collected data at only one point in time, ranging from 2009 to 2020. A total of 18 studies relied on self-reporting to assess PA/SB using a variety of questionnaires. Among children/adolescents, approximately 80% to 90% did not attain at least 60 minutes per day of moderate to vigorous PA and 50% to 80% engaged in ≥2 hours per day of screen time or SB. Among adults, approximately 50% to 95% had low or insufficient PA (eg, less than meeting PA guidelines) and about half had a sitting time of ≥5 hours per day. Population-based studies were not found among children <10 years and adults >75 years. Conclusions: A high proportion of participants in the reviewed studies did not meet PA recommendations and spent excessive time in SB. Ongoing surveillance efforts for all ages may help identify target populations for interventions and prioritize the national strategy on PA/SB in Saudi Arabia.
Retrospective Multicenter Evaluation of the VirClia Galactomannan Antigen Assay for the Diagnosis of Pulmonary Aspergillosis with Bronchoalveolar Lavage Fluid Samples from Patients with Hematological Disease
Authors: Buil Jochem B. , Huygens Sammy , Dunbar Albert , Schauwvlieghe Alexander , Reynders Marijke , Langerak Diana , van Dijk Karin , Bruns Anke , Haas Pieter-Jan , Postma Douwe F. , Biemond Bart , Delma Fatima Zohra , de Kort Elizabeth , Melchers Willem J. G. , Verweij Paul E. , Rijnders Bart
Published: April 2023

Galactomannan (GM) testing of bronchoalveolar lavage (BAL) fluid samples has become an essential tool to diagnose invasive pulmonary aspergillosis (IPA) and is part of diagnostic guidelines. Enzyme-linked immunosorbent assays (ELISAs) (enzyme immunoassays [EIAs]) are commonly used, but they have a long turnaround time. In this study, we evaluated the performance of an automated chemiluminescence immunoassay (CLIA) with BAL fluid samples.
Human Cytomegalovirus IE1 Impairs Neuronal Migration by Downregulating Connexin 43
Authors: Huang Sheng-Nan , Pan Yu-Ting , Zhou Yue-Peng , Wang Xian-Zhang , Mei Meng-Jie , Yang Bo , Li Dong , Zeng Wen-Bo , Cheng Shuang , Sun Jin-Yan , Cheng Han , Zhao Fei , Luo Min-Hua
Published: April 2023

Congenital CMV (cCMV) infection causes neurological sequelae in newborns. Recent studies of cCMV pathogenesis in animal models reveal ventriculomegaly and cortical atrophy associated with impaired neural progenitor cell (NPC) proliferation and migration.
Nutrient Limitation Mimics Artemisinin Tolerance in Malaria
Authors: Brown Audrey C. , Warthan Michelle D. , Aryal Anush , Liu Shiwei , Guler Jennifer L.
Published: April 2023

There is a dire need for effective treatments against microbial pathogens. Yet, the continuing emergence of drug resistance necessitates a deeper knowledge of how pathogens respond to treatments.
Isolation and Characteristics of a Novel Aichivirus D from Yak
Authors: Yan Nan , Yue Hua , Liu Quan , Wang Gang , Tang Cheng , Liao Ming
Published: April 2023

In this study, we identified and successfully isolated a novel genotype of AiV-D from yaks. Animal infection confirmed that this virus can cause diarrhea, intestinal bleeding, and inflammation in yak calves via oral inoculation. The virus was distributed in the ileum, jejunum, cecum, duodenum, colon, and rectum.
Optimization and Improvement of qPCR Detection Sensitivity of SARS-CoV-2 in Saliva
Authors: Ko Hui-Ying , Li Yao-Tsun , Li Ya-Yuan , Chiang Ming-Tsai , Lee Yi-Ling , Liu Wen-Chun , Liao Chun-Che , Chang Chih-Shin , Lin Yi-Ling
Published: April 2023

The primary method for detection of SARS-CoV-2 is using nasopharyngeal swabs, but a shortage of trained health professionals has hindered its large-scale implementation. Saliva-based nucleic acid detection is a widely adopted alternative, due to its convenience and minimally invasive nature, but the detection limit and direct impact of saliva on viral RNA remain poorly understood.
Effect of a Geometric Potential on the Eigenfunction and Eigenvalue of the Energy of State in a Twisted Graphene Nanoribbon
Authors: Sadykov N. R. , Petrova Yu. A. , Pilipenko I. A. , Khrabrov R. S. , Skryabin S. N.
Published: April 2023

An expression is obtained for an effective geometric potential based on a coordinate system for a nanoribbon twisted in the form of a helicoid. The effective geometric potential for a Schrödinger equation is used to study a graphene nanoribbon of finite length with “armchair” edges under the action of an external electric field parallel to them. Solutions are calculated for the energy levels and wave functions of electrons in the vicinity of the Dirac point. It is shown there is only one state in the transverse direction.
Diagnostic dilemma and challenges in management: Hirschsprung’s disease, anal stenosis and reduced interstitial cells of Cajal enteric mesenchymopathy
Authors: Chan Esther Ern Hwei , Merchant Khurshid , Othman Mohd Yusran , Laksmi Narasimhan Kannan
Published: April 2023

Hirschsprung’s disease (HD) is one of the most well-known gastrointestinal motility disorders. Diagnosis and management of other lesser-known motility disorders are often challenging and tedious. We describe a teenager who was severely constipated from birth and needed intensive care admissions for life-threatening enterocolitis. She also had concomitant anal stenosis. Several rectal biopsies were unable to yield a conclusive diagnosis. Surgical level of resection had to be identified based on the motility of the bowel as determined by transit studies using oral ingestion of a milk feed labelled with Technetium-99m colloid. After completion of all operative stages, histopathological examination of the excised specimens concluded that she had short-segment HD associated with reduced interstitial cells of Cajal in the large bowel. She is currently continent, evacuating voluntarily approximately four times a day and is relieved of all her symptoms.
Reconstruction of multiple fingertip crush injuries with full-thickness skin grafting
Authors: Kholinne Erica , Santosa Claudia , Anestessia Ira Juliet , Muchtar
Published: April 2023

Fingertip crush injuries are commonly encountered as a result of workplace accidents causing significant morbidity. The primary goal of reconstruction is to restore function and sensibility, as well as a faster return to work. We reported a patient with multiple fingertip injuries presented 5 days following the initial injury. Copious irrigation and excisional debridement were performed, followed by a full-thickness skin graft harvested from the volar wrist. At the 4-month follow-up, all of the reconstructed fingertips achieved good functionality without any pain or sensory impairment. The length was well preserved and static two-point discrimination was comparable with the contralateral side. Full-thickness skin grafts may provide an excellent alternative reconstruction option in the management of multiple fingertip crush injuries.
Pituitary apoplexy and cerebral infarction
Authors: Brás-Cruz Rute , Cruz Isabel , Camões Sara
Published: April 2023

Pituitary apoplexy (PA) is a possible complication of pituitary adenoma but is rarely followed by cerebral infarction. The mechanism by which this occurs is not totally understood but is believed to have multiple aetiologies such as arterial compression due to mass effect, vasospasm induced by the presence of blood or by vasoactive agents. In this report, we present a man in his 80s with known pituitary adenoma with a sudden onset of left central facial palsy, left hemiparesis, paresis of the VI left pair and previously unrecognised atrial fibrillation in the ECG. At first, the signs of haemorrhage on imaging were unnoticed, which led to a diagnosis of ischaemic stroke that was submitted to thrombolysis. Due to complications during hospitalisation, the team suspected of PA with panhypopituitarism, confirmed by brain MRI and blood tests. The patient underwent conservative management with glucocorticoids with resolution of the acute adrenal insufficiency related symptoms.
Engaging pregnant individuals and healthcare professionals in an international mixed methods study to develop a core outcome set for studies on placenta accreta spectrum disorder (COPAS): a study protocol
Authors: O’Rinn Susan E , Barrett Jon F R , Parsons Janet A , Kingdom John C , D’Souza Rohan
Published: April 2023

Introduction

Placenta accreta spectrum (PAS) disorder is a life-threatening condition that may result in serious maternal complications, including mortality. The placenta which is pathologically adherent to the uterine wall, places individuals at high risk of major haemorrhage during the third stage of labour. Current research reports on PAS disorder outcomes have highly variable levels of information, which is therefore difficult for investigators to aggregate to inform practice. There is an urgent need to harmonise data collection in prospective studies to identify and implement best practices for management. One approach to standardise outcomes across any health area via the use of core outcome sets (COSs), which are consensus-derived standardised sets of outcomes that all studies for a particular condition should measure and report. This protocol outlines the steps for developing a COS for PAS disorder (COPAS).

Methods and analysis

This protocol outlines steps for the creation of COPAS. The first step, a systematic review, will identify all reported outcomes in the scientific literature. The second step will use qualitative one-on-one interviews to identify additional outcomes identified as important by patients and healthcare professionals that are not reported in the published literature. Outcomes from the first two steps will be combined to form an outcome inventory. This outcome inventory will inform the third step which is a Delphi survey that encourages agreement between patients and healthcare professionals on which outcomes are most important for inclusion in the COS. The fourth step, a consensus group meeting of representative participants, will finalise outcomes for inclusion in the PAS disorder COS.

Ethics and dissemination

This study has obtained Research Ethics Board approval from Sunnybrook Health Sciences Centre (#2338, #1488). We will aim to publish the study findings in an international peer-reviewed OBGYN journal.

Registration details

COMET Core Outcome Set Registration:https://www.comet-initiative.org/Studies/Details/1127.

PROSPERO registration number

CRD42020173426.
Clinical and economic burden of low back pain in low- and middle-income countries: a systematic review
Authors: Fatoye Francis , Gebrye Tadesse , Mbada Chidozie Emmanuel , Useh Ushotanefe
Published: April 2023

Objectives

Low back pain (LBP) is the leading cause of disability and work absenteeism globally, and it poses significant clinical and economic burden to individuals, health systems and the society. This study aimed to synthesise the clinical and economic burden of LBP in low-income and middle-income countries (LMICs).

Methods

A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. PubMed, Medline, CINAHL, PsycINFO, AMED, Embase and Scopus databases were systematically searched for studies that examined the clinical and economic burden of LBP in LMICs, published from inception to 10 December 2021. Only studies with clearly stated methodologies and published in English were eligible for review.

Results

Nine studies met the inclusion criteria and were reviewed. Of these, three of them were clinical burden studies. The mean Newcastle–Ottawa Quality Assessment Scale (NOS) score of the included studies was 4, with an average from 3 to 6. The included studies were conducted in Argentina, Brazil, China, Ethiopia, Nigeria and Republic of Serbia. The rates of hospitalisation due to LBP ranged between 13.4% and 18.7%. Due to variation of methodological approaches, the reported cost estimates were inconsistent across the studies. A total cost of US$2.2 billion per population and US$1226.25 per patient were reported annually due to LBP.

Conclusion

This systematic literature review suggests that LBP is associated with significantly high rates of hospitalisation and costs. As LBP is an important threat to the population, health professionals and policymakers are to put in place appropriate programmes to reduce the clinical and economic burden associated with LBP and improve the health outcomes of individuals with this condition in LMICs.

PROSPERO registration number

CRD42020196335.
Willingness to pay for diabetic retinopathy screening in Qujiang District, rural Guangdong, southern China: a cross-sectional study
Authors: Xiao Baixiang , Gu Xuejun , Jin Ling , Chan Ving Fai , Li Yanping , Price-Sanchez Carlos , Liu Yuanping , Wang Yanfang , Fu Haoxiang , Li Dongfeng , Congdon Nathan
Published: April 2023

Objective

To determine willingness to pay for a diabetic retinopathy screening, and its determinants, among people with diabetes mellitus in Qujiang District of Shaoguan City, rural Guangdong, southern China.

Design

This cross-sectional study was conducted through a large-scale screening programme in 2019. We randomly selected 575 (21.5%) among 2677 people over 18 years old with known diabetes who attended the screening. Participants elected to pay nothing or RMB10–RMB120 (US$1.6–US$18.8), in RMB10 intervals, displayed on printed cards. One trained interviewer collected all the data.

Setting

Ten primary health centres in Qujiang District of Shaoguan City, Guangdong.

Participants

545 from the 575 randomly selected people (94.8%) agreed to participate in the study.

Outcome measures

Proportion of participants willing to pay anything for screening, mean amount they were willing to pay and determinants of these figures.

Results

Among 545 participants (mean age 64.6 years (SD±10.4), 40.7% men), 327 (60.0%) were willing to pay something for screening, of whom 273 (83.5%) would pay RMB10–RMB30 (US$1.6–US$4.7). People living in rural areas and those from lower-income families were more likely to be willing to pay anything, while men, urban residents and those covered by employer-linked insurance were willing to pay larger sums (p<0.05 for all).

Conclusion

Nearly two-thirds of participants were willing to pay for screening in this screening programme organised at the primary care level in rural China. This finding offers the potential that such activities can be sustained and scaled up through user fees.
Estimating the cost-effectiveness and return on investment of the Victorian Cardiac Outcomes Registry in Australia: a minimum threshold analysis
Authors: Lee Peter , Brennan Angela L , Stub Dion , Dinh Diem T , Lefkovits Jeffrey , Reid Christopher M , Zomer Ella , Liew Danny
Published: April 2023

Objectives

We sought to establish the minimum level of clinical benefit attributable to the Victorian Cardiac Outcomes Registry (VCOR) for the registry to be cost-effective.

Design

A modelled cost-effectiveness study of VCOR was conducted from the Australian healthcare system and societal perspectives.

Setting

Observed deaths and costs attributed to coronary heart disease (CHD) over a 5-year period (2014–2018) were compared with deaths and costs arising from a hypothetical situation which assumed that VCOR did not exist. Data from the Australian Bureau of Statistics and published sources were used to construct a decision analytic life table model to simulate the follow-up of Victorians aged ≥25 years for 5 years, or until death. The assumed contribution of VCOR to the proportional change in CHD mortality trend observed over the study period was varied to quantify the minimum level of clinical benefits required for the registry to be cost-effective. The marginal costs of VCOR operation and years of life saved (YoLS) were estimated.

Primary outcome measures

The return on investment (ROI) ratio and the incremental cost-effectiveness ratio (ICER).

Results

The minimum proportional change in CHD mortality attributed to VCOR required for the registry to be considered cost-effective was 0.125%. Assuming this clinical benefit, a net return of $A4.30 for every dollar invested in VCOR was estimated (ROI ratio over 5 years: 4.3 (95% CI 3.6 to 5.0)). The ICER estimated for VCOR was $A49 616 (95% CI $A42 228 to $A59 608) per YoLS. Sensitivity analyses found that the model was sensitive to the time horizon assumed and the extent of registry contribution to CHD mortality trends.

Conclusions

VCOR is likely cost-effective and represents a sound investment for the Victorian healthcare system. Our evaluation highlights the value of clinical quality registries in Australia.
Efficacy of continuous intravenous remimazolam versus midazolam in the extraction of impacted wisdom teeth: protocol of a randomised controlled trial
Authors: Wang Lejunzi , Jing Quan , Pei Lijian , Li Mohan , Ruan Xia , Chen Shaohui , Zhang Yuelun , Wan Kuo , Huang Yuguang
Published: April 2023

Introduction

Benzodiazepines such as midazolam are widely used to moderately sedate patients during impacted wisdom tooth extraction to reduce anxiety in outpatient surgery. This present protocol was designed to determine whether continuous intravenous remimazolam, a new ultrashort-acting benzodiazepine, produces superior postoperative recovery quality to that of midazolam in patients undergoing extraction of impacted wisdom teeth.

Methods and analysis

This study is a multicentre randomised controlled trial conducted at Peking Union Medical College Hospital, Beijing Anzhen Hospital and Beijing Shijitan Hospital in China. Approximately 150 participants undergoing extraction of impacted mandibular wisdom teeth will be randomly allocated to two groups (remimazolam and midazolam). The participants will be administered standard interventions to ensure they achieve a sedation level of III on the Ramsay sedation scale during the treatment. Preoperative and anaesthesia management and surgical techniques will be standardised for all participants. The primary outcome is recovery time for complete alertness and the secondary outcomes are anterograde amnesia during and after surgery, and interruption during operation for poor compliance or safety concerns.

Ethics and dissemination

This study has been approved by the Ethics Review Committee of Peking Union Medical College Hospital (approval number: ZS-3142), Beijing Anzhen Hospital (approval number: KS2022082) and Beijing Shijitan Hospital (approval number: 2023-4).

Trial registration number

NCT05350085.