bluuebunny/crossref_metadata_2025 huggingface dataset:
Utility of POPVESL scoring system in the management of renal pseudoaneurysm: a retrospective study
Authors: Singh Shashank , Para Sajad Ahmad , Wani Mohammad Saleem , Manzar Faiz , Kumar Manjul
Published: September 2023

Background

We intended to assess the role of POPVESL scoring system in managing renal pseudoaneurysm at our institute which is a referral center in this region.

Methods

We retrospectively reviewed the records of all patients who were managed for renal pseudoaneurysm between January 2020 and December 2022. Data were collected from patient medical records and analyzed by using SPSS Statistics for Windows version 29.0. Data were expressed as mean ± standard deviation (SD) or median for continuous variables, whereas frequency and percentage were used to express qualitative data. Demographic data, type of procedure, operative data, post-procedure data of patients, management type, i.e., conservative or angioembolization were recorded and POPVESL score of individual patients was calculated. Data analysis was conducted among subgroups based on management type, i.e., conservative vs angioembolization. ROC curves were utilized to find the threshold value for predicting the need of angioembolization.

Results

Out of 55, pseudoaneurysm develops after USG guided PCN in 4 individuals, i.e., 7.3%; renal biopsy in 11, i.e., 20% and PCNL in 40, i.e., 72.7%. On statistical analysis, hemoglobin drop, number of PCV transfused, size of vascular lesion and interval of readmission showed significant differences among subgroups and were predictive of the need for angioembolization. There was a significant difference in POPVESL score between both subgroups. POPVESL score 11 and above is 100% specific and 90% sensitive for angioembolization.

Conclusion

Renal pseudoaneurysm with a low POPVESL (i.e., < 11) score can be managed conservatively. This scoring system has the potential to help in making bedside decision for managing intrarenal vascular bleeding.
Ecosystem restoration, regeneration and rewilding
Authors: Shackelford Nancy , McDougall Carmel
Published: September 2023

Anthropomorphic activities have caused major damage to ecosystems worldwide. Although documenting this damage is important, implementing measures to halt and reverse ecosystem decline is critical and is now being prioritised globally. To support global goals to protect and restore nature, BMC Ecology and Evolution has launched a new article collection to encourage contributions from the multifaceted ecosystem restoration community.
Genomic characterization and comparative genomic analysis of HS-associated Pasteurella multocida serotype B:2 strains from Pakistan
Authors: Mahboob Sadia , Ullah Nimat , Farhan Ul Haque Muhammad , Rauf Waqar , Iqbal Mazhar , Ali Amjad , Rahman Moazur
Published: September 2023

Background

Haemorrhagic septicaemia (HS) is a highly fatal and predominant disease in livestock, particularly cattle and buffalo in the tropical regions of the world. Pasteurella multocida (P. multocida), serotypes B:2 and E:2, are reported to be the main causes of HS wherein serotype B:2 is more common in Asian countries including Pakistan and costs heavy financial losses every year. As yet, very little molecular and genomic information related to the HS-associated serotypes of P. multocida isolated from Pakistan is available. Therefore, this study aimed to explore the characteristics of novel bovine isolates of P. multocida serotype B:2 at the genomic level and perform comparative genomic analysis of various P. multocida strains from Pakistan to better understand the genetic basis of pathogenesis and virulence.

Results

To understand the genomic variability and pathogenomics, we characterized three HS-associated P. multocida serotype B:2 strains isolated from the Faisalabad (PM1), Peshawar (PM2) and Okara (PM3) districts of Punjab, Pakistan. Together with the other nine publicly available Pakistani-origin P. multocida strains and a reference strain Pm70, a comparative genomic analysis was performed. The sequenced strains were characterized as serotype B and belong to ST-122. The strains contain no plasmids; however, each strain contains at least two complete prophages. The pan-genome analysis revealed a higher number of core genes indicating a close resemblance to the studied genomes and very few genes (1%) of the core genome serve as a part of virulence, disease, and defense mechanisms. We further identified that studied P. multocida B:2 strains harbor common antibiotic resistance genes, specifically PBP3 and EF-Tu. Remarkably, the distribution of virulence factors revealed that OmpH and plpE were not present in any P. multocida B:2 strains while the presence of these antigens was reported uniformly in all serotypes of P. multocida.

Conclusion

This study's findings indicate the absence of OmpH and PlpE in the analyzed P. multocida B:2 strains, which are known surface antigens and provide protective immunity against P. multocida infection. The availability of additional genomic data on P. multocida B:2 strains from Pakistan will facilitate the development of localized therapeutic agents and rapid diagnostic tools specifically targeting HS-associated P. multocida B:2 strains.
Sex differences in secondary preventive follow-up after coronary heart events
Authors: Kaldal Anete , Tonstad Serena , Jortveit Jarle
Published: September 2023

Background and aims

Some studies point to sex differences in cardiovascular preventive practices. The aim of this study was to investigate differences in achievement of secondary preventive targets and long-term outcome in men and women after a coronary heart event.

Methods

This study was a subanalysis from a randomized controlled trial of hospital-based versus primary care-based secondary preventive follow-up at Sorlandet Hospital, Norway, 2007–2022 and included both groups. The main outcome was achievement of treatment targets two years after the index event. Event-free survival was calculated based on the composite of mortality, coronary intervention, stroke, or myocardial infarction during follow-up. Participants were followed-up for up to 10 years after the index event through out-patient consultations.

Results

In total, 337 women and 1203 men were eligible for the study. Due to loss of follow-up during the first two years after the index coronary event 106 (7%) participants were excluded from further analysis (53% withdrawal of consent, 12% death, and 35% other causes) leaving 307 (21%) women and 1127 (79%) men. After two years of follow-up we found no differences between women and men in achievement of blood pressure targets (61% vs. 59%; p = 0.57), LDL-cholesterol goals (64% vs. 69%; p = 0.15), HbA1c-goal in patients with diabetes (49% vs. 45%; p = 0.57), non-smoking (79% vs. 81%; p = 0.34), healthy diets (14% vs. 13%, p = 0.89), physical activity (55% vs. 58%; p = 0.38), use of acetylsalicylic acid (93% vs. 94%; p = 0.39), and use of lipid lowering therapy (92% vs. 94%; p = 0.15). After a median follow-up time of 5.0 [SD 3.2] years there were no differences between women and men regarding composite endpoint (89 [30.0%] vs. 345 [30.6]; p = 0.58), and composite endpoint-free survival did not differ between women and men (hospital-based follow-up HR for women versus men, 0.87, 95% CI 0.62–1.23; p = 0.44 and primary care service HR for women versus men 0.95, 95% CI 0.69–1.31; p = 0.78).

Conclusions

The study show no sex differences in achievement of secondary preventive targets or composite endpoint after coronary heart events. However, many women and men did not achieve treatment goals, and further improvement in secondary prevention is needed.

Trial registration

The study is registered in ClinicalTrials.gov (NCT00679237).
Health-related quality of life and healthcare consultations among adult patients before and after diagnosis with rheumatic heart disease in Namibia
Authors: Shimanda Panduleni Penipawa , Söderberg Stefan , Iipinge Scholastika Ndatinda , Lindholm Lars , Shidhika Fenny Fiindje , Norström Fredrik
Published: September 2023

Background

Rheumatic Heart Disease (RHD) causes high morbidity and mortality rates among children and young adults, impacting negatively on their health-related quality of life (HRQoL). This study aimed to evaluate the HRQoL and healthcare consultations of adult patients with RHD in Namibia.

Methods

From June 2019 to March 2020, a questionnaire was administered to 83 RHD patients during routine follow-ups. The EQ-5D-5L instrument was used to assess the health-related quality of life before diagnosis and at the time of the survey. The Ethiopian value set for EQ-5D-5L was used to calculate Quality-Adjusted Life Years (QALY).

Results

Most respondents were women (77%), young adults below the age of 30 years (42%), and individuals who grew up in rural areas (87%). The mean QALY statistically significantly improved from 0.773 pre-diagnosis to 0.942 in the last 12 months (p < 0.001). Sixty-six patients who had surgery reported a better QALY. Healthcare visits statistically significantly increased from on average 1.6 pre-diagnosis to 2.7 days in the last 12 months (p < 0.001). The mean distance to the nearest facility was 55 km, mean cost of transport was N$65, and mean time spent at the clinic was 3.6 h. The median time from diagnosis to the survey was 7 years (quartiles 4 and 14 years).

Conclusion

Treatment and surgery can improve HRQoL substantially among RHD patients. Being diagnosed with RHD affects patients living in socioeconomically disadvantaged rural areas through cost and time for healthcare visits. It would be valuable with further research to understand differences between disease severities.
Construction of a novel signature based on immune-related lncRNA to identify high and low risk pancreatic adenocarcinoma patients
Authors: Li Na , Chen Jionghuang , Yu Weihua , Huang Xiaoling
Published: September 2023

Background

Pancreatic adenocarcinoma is one of the most lethal tumors in the world with a poor prognosis. Thus, an accurate prediction model, which identify patients within high risk of pancreatic adenocarcinoma is needed to adjust the treatment and elevate the prognosis of these patients.

Methods

We obtained RNAseq data of The Cancer Genome Atlas (TCGA) pancreatic adenocarcinoma (PAAD) from UCSC Xena database, identified immune-related lncRNAs (irlncRNAs) by correlation analysis, and identified differential expressed irlncRNAs (DEirlncRNAs) between pancreatic adenocarcinoma tissues from TCGA and normal pancreatic tissues from TCGA and Genotype-Tissue Expression (GTEx). Further univariate and lasso regression analysis were performed to construct prognostic signature model. Then, we calculated the areas under curve and identified the best cut-off value to identify high- and low-risk patients with pancreatic adenocarcinoma. The clinical characteristics, immune cell infiltration, immunosuppressive microenvironment, and chemoresistance were compared between high- and low-risk patients with pancreatic adenocarcinoma.

Results

We identified 20 DEirlncRNA pairs and grouped the patients by the best cut-off value. We proved that our prognostic signature model possesses a remarkable efficiency to predict prognosis of PAAD patients. The AUC for ROC curve was 0.905 for 1-year prediction, 0.942 for 2-year prediction, and 0.966 for 3-year prediction. Patients in high-risk group have poor survival rate and worse clinical characteristics. We also proved that patients in high-risk groups were in immunosuppressive status and may be resistant to immunotherapy. Anti-cancer drug evaluation was performed based on in-silico predated tool, such as paclitaxel, sorafenib, and erlotinib, may be suitable for PAAD patients in high-risk group.

Conclusions

Overall, our study constructed a novel prognostic risk model based on pairing irlncRNAs, exhibited a promising prediction value in patients with pancreatic adenocarcinoma. Our prognostic risk model may help distinguish PAAD patients suitable for medical treatments.
Application of machine learning approaches in predicting clinical outcomes in older adults – a systematic review and meta-analysis
Authors: Olender Robert T. , Roy Sandipan , Nishtala Prasad S.
Published: September 2023

Background

Machine learning-based prediction models have the potential to have a considerable positive impact on geriatric care.

Design

Systematic review and meta-analyses.

Participants

Older adults (≥ 65 years) in any setting.

Intervention

Machine learning models for predicting clinical outcomes in older adults were evaluated. A random-effects meta-analysis was conducted in two grouped cohorts, where the predictive models were compared based on their performance in predicting mortality i) under and including 6 months ii) over 6 months.

Outcome measures

Studies were grouped into two groups by the clinical outcome, and the models were compared based on the area under the receiver operating characteristic curve metric.

Results

Thirty-seven studies that satisfied the systematic review criteria were appraised, and eight studies predicting a mortality outcome were included in the meta-analyses. We could only pool studies by mortality as there were inconsistent definitions and sparse data to pool studies for other clinical outcomes. The area under the receiver operating characteristic curve from the meta-analysis yielded a summary estimate of 0.80 (95% CI: 0.76 – 0.84) for mortality within 6 months and 0.81 (95% CI: 0.76 – 0.86) for mortality over 6 months, signifying good discriminatory power.

Conclusion

The meta-analysis indicates that machine learning models display good discriminatory power in predicting mortality. However, more large-scale validation studies are necessary. As electronic healthcare databases grow larger and more comprehensive, the available computational power increases and machine learning models become more sophisticated; there should be an effort to integrate these models into a larger research setting to predict various clinical outcomes.
The effects of psychosocial interventions using generic photos on social interaction, mood and quality of life of persons with dementia: a systematic review
Authors: Tan Josephine Rose Orejana , Boersma Petra , Ettema Teake P. , Planting Caroline H. M. , Clark Soraya , Gobbens Robbert J. J. , Dröes Rose-Marie
Published: September 2023

Background

Although family photos are often used in the psychosocial care for people with dementia, little is known about the use and effectiveness of generic photos. This systematic literature review explored psychosocial interventions using generic photos for people with dementia, and the effects they have on their social interaction and/or mood and/or quality of life. In addition, it was investigated whether these interventions made use of technology in its implementation.

Methods

A systematic search on the following databases was performed: PubMed, Embase, APA PsychInfo, Cinahl, Web of Science, Scopus and Cochrane Central. Inclusion and exclusion criteria were based on the PICO model (Population, Intervention, Comparison, Outcome), and quality assessment was undertaken using the Weight of Evidence Framework. Narrative synthesis was undertaken to summarize study characteristics- settings and designs, type of psychosocial interventions identified, type of photos and technology used, outcome measures, and results.

Results

A total of 2,035 results were found, however after title, abstract and full-text screening, a total of 8 studies were included. The most common psychosocial intervention using generic photos was found to be reminiscence therapy, followed by art-viewing activities. In studies that used technology, it was reported that viewing digitalized photos were either similar or better to conventional printed photos. Despite photos being generic, it was found that generic photos could still hold personal significance to the person with dementia. Some positive and significant effects were found for the outcomes social interaction, mood and quality of life, though no study evaluated all three outcomes. Two studies were rated as having high overall quality, 4 were rated as fair, and 2 studies had a low quality assessment rating.

Conclusion

Studies found using generic photos were limited, showing varying outcomes and methodological quality. Firm conclusions on the effectiveness of interventions using generic photos are not possible. However, the use of generic photos in psychosocial interventions is a promising area for future research. Researchers should consider studies with better methodological quality and larger samples; and qualitative studies where the intention is to get better insight into successful implementation and impact mechanisms of such psychosocial interventions.

Trial registration

n/a.
Bleeding due to successive duodenal and rectal ulcers in an 81-year-old patient with severe COVID-19: a case report
Authors: Liu Guanlin , Meng Qiang , Li Yunwei , Li Yiling , Jiao Taiwei , Zhao Hongwen , Dai Bing
Published: September 2023

Background

In the early stages of the coronavirus disease 2019 (COVID-19) outbreak, the most widely recognised symptoms of the disease were fever, cough, shortness of breath, myalgia, and fatigue. However, in addition to these symptoms, COVID-19 can cause systemic symptoms outside the lungs. Older patients with severe COVID-19 often require admission to the intensive care unit (ICU). Acute rectal ulcer bleeding, characterised by painless, profuse haematochezia, caused by solitary or multiple rectal ulcers, is one of the main causes of severe haematochezia in patients with COVID-19 in the ICU. However, recurrent duodenal ulcer bleeding followed by rectal ulcer bleeding has not previously been reported in older patients during ICU treatment for severe COVID-19.

Cases presentation

Herein, we report the case of an 81-year-old woman admitted to the emergency department due to severe COVID-19 and transferred to the ICU 2 days later for treatment. During treatment in the ICU, the patient developed recurrent duodenal ulcer bleeding and underwent endoscopic electrocoagulation haemostasis and gastroduodenal artery embolisation. However, the night after the final haemostatic operation, due to rectal ulcer bleeding, the patient discharged bloody stools intermittently, which was effectively controlled using endoscopic electrocoagulation, topical medication, blood transfusion, and haemostatic drugs.

Conclusions

To the best of our knowledge, this is the first report of duodenal ulcer bleeding followed by rectal ulcer bleeding in an older patient with severe COVID-19 infection. This report creates awareness for clinicians about the multiple and complex gastrointestinal symptoms that may occur during COVID-19 treatment.
Extra-urogenital infection by Mycoplasma hominis in transplant patients: two case reports and literature review
Authors: Ahamad Afrinash , Zervou Fainareti N. , Aguero-Rosenfeld Maria E.
Published: September 2023

Background

Mycoplasma hominis is a facultative anaerobic bacterium commonly present in the urogenital tract. In recent years, M. hominis has increasingly been associated with extra-urogenital tract infections, particularly in immunosuppressed patients. Detecting M. hominis in a diagnostic laboratory can be challenging due to its slow growth rate, absence of a cell wall, and the requirements of specialized media and conditions for optimal growth. Consequently, it is necessary to establish guidelines for the detection of this microorganism and to request the appropriate microbiological work-up of immunosuppressed patients.

Case Presentation

We hereby present two cases of solid organ transplant patients who developed M. hominis infection. Microscopic examination of the bronchial lavage and pleural fluid showed no microorganisms. However, upon inoculating the specimens onto routine microbiology media, the organism was successfully identified and confirmation was performed using 16S rDNA sequencing. Both patients received appropriate treatment resulting in the resolution of M. hominis infection.

Conclusions

The prompt detection of M. hominis in a clinical specimen can have a significant impact on patient care by allowing for early intervention and ultimately resulting in more favorable clinical outcomes, especially in transplant patients.
Efficacy of comprehensive group-based education in lowering body weight, uric acid levels, and diuretic use in patients with chronic kidney disease: a retrospective study
Authors: Hotta Azumi , Iwatani Hirotsugu
Published: September 2023

Background

Patient education for the management of chronic kidney disease (CKD) is attracting attention. Therefore, this study aimed to analyze changes in body weight, uric acid, and estimated-glomerular filtration rate (eGFR) in patients with CKD after a group-based education during admission.

Methods

Overall, 157 patients with CKD, who were discharged from the nephrology department of our hospital between January 2015 and October 2019, received group-based education or individual-based education by nurses at admission. Deltas of body weight, uric acid, and eGFR, 6 months from baseline, were compared between group- and individual-based education using the Wilcoxon rank sum test.

Results

In total, 60 patients receiving group-based education (G group, n =35) or individual-based education (I group, n =25) during admission were included in this retrospective study. The patient characteristics at baseline were as follows: age mean, 72 ± SD 9; 16 females and 44 males; body weight, 62 ± 17 kg; eGFR median, 21 (IQR: 14, 29) mL/min/1.73 m2; UA, 7 (6.1, 7.5) mg/dL; and estimated intake of salt 6.9 (6.2, 8.4) g/day. Delta eGFR (mL/min/1.73 m2) was -1 (-3, 3) for G group and -1 (-2.5, 2) for I group (p = 0.8039). Delta body weight (kg) was -0.4 (-1.6, 0) for G group and 0 (-0.45, 0.95) for I group (p = 0.0597). Delta uric acid (mg/dL) was -1.1 (-1.6, 0.1) for G group and -0.2 (-1.1, 0.5) for I group (p = 0.0567).

In patients with higher sodium intake (≥ 117.4 mEq/day), delta body weight was significantly lower in the group-based education group than in the individual-based education group (p = 0.0398).

Conclusions

A comprehensive group-based education in patients with CKD may effectively suppress body weight and uric acid in 6 months along with less frequent diuretic use.
Endoscopy-assisted pars plana vitrectomy in retinal detachments associated with anterior proliferative vitreoretinopathy and epiciliary membranes
Authors: Ajlan Radwan S. , Pfannenstiel Matthew , Kam Yong , Sciulli Harrison
Published: September 2023

Background

Proliferative vitreoretinopathy (PVR) is the leading cause of recurrent retinal detachment. Anterior PVR can contribute to recurrent retinal detachment and is often difficult to remove during conventional pars plana vitrectomy. The purpose of this study is to report surgical outcomes of single endoscopy-assisted pars plana vitrectomy (E-PPV) in patients with tractional retinal detachments associated with anterior proliferative vitreoretinopathy and epiciliary membranes.

Methods

Retrospective review of E-PPV between 2017 and 2021 at a tertiary referral center. Inclusion criteria involved adult patients who underwent E-PPV for tractional retinal detachment with anterior PVR and epiciliary membranes. Data collection included patients’ demographics, ophthalmic exam findings, and surgical outcomes. A series of independent sample tests of proportion were conducted using a p-value of 0.05 as the threshold for statistical significance.

Results

Eighteen out of 55 patients who underwent E-PPV met the inclusion criteria. There were six females (33%) and 12 males (p-value = 0.096). Age ranged between 27 and 82 years old (mean age 52.1 ± 17.3 years). Nine patients (50%) had a history of ipsilateral retinal detachment repair. Single E-PPV success rate was 100% after three months, and 94.4% at the latest follow up visit. Recurrent retinal detachment with posterior PVR occurred in one patient four months after surgery. Cataract progressed in 57% (8/14) of phakic patients, with 63% (5/8) undergoing cataract extraction surgery within the first postoperative year.

Conclusion

E-PPV enabled epiciliary membrane and anterior PVR visualization and removal. The single E-PPV success rate remained high at the latest follow up visit. E-PPV enabled the preservation of the phakic lens in all study patients. Larger prospective studies are needed on the role of E-PPV in retina surgeries.
Factors associated with the adoption of extreme weight control behavior by non-obese adolescents: a secondary analysis
Authors: Jeong Eunha
Published: September 2023

Background

Misperceptions about obesity is common among adolescents. Adolescents who overestimate their body size tend to indulge in extreme weight control behaviors. However, little is known about the factors involved in the adoption of extreme weight control behavior (EWCB) by non-obese adolescents who are mistaken for being overweight. This study identified factors associated with unhealthy behaviors among normal/underweight high school students who overestimate their body image and attempt to lose weight.

Design

A secondary analysis of nationally representative data from the Korea Youth Risk Behavior Survey focused on adolescents who attended vocational and academically oriented high schools.

Methods

The analysis included data from 4,286 non-obese respondents (15–18 years) who overestimated their body weight. Of them, 2,887 were girls (66.5%), while 1,399 were boys (33.5%). Multiple logistic regression was used to investigate risk factors for EWCB by sex. A statistical analysis reflecting strata, clusters, and weights of the complex sampling design was adopted.

Results

Of the respondents, 674 (23.3%) girls and 162 (11.5%) boys reported EWCB. For both sexes, vocational high school attendance and depression were significantly influenced by EWCB. EWCB was linked to perceived stress in girls and living in a big city in boys.

Conclusions

The findings suggest the importance of providing quality health education, including that for non-obese adolescents, in school obesity prevention programs along with the expansion of tailored intervention programs based on sex, following a consideration of the characteristics of high schools as well as individuals.
Prediction of postoperative hypokalemia in patients with oral cancer undergoing en bloc cancer resection: a retrospective cohort study
Authors: Bao Qilin , Song Lei , Ma Liyuan , Wang Meng , Hou Zhaohuan , Lin Jie , Li Chunjie
Published: September 2023

Background

The factors associated with postoperative hypokalemia in patients with oral cancer remain unclear. We determined the preoperative factors associated with postoperative hypokalemia in patients with oral cancer following en bloc cancer resection and established a nomogram for postoperative hypokalemia prediction.

Methods

Data from 381 patients with oral cancer who underwent en bloc cancer resection were retrospectively analyzed. Univariate and multivariate analyses were performed to identify the risk factors for postoperative hypokalemia. We used receiver operating characteristic (ROC) curves to quantify the factors’ effectiveness. A nomogram was created to show each predictor’s relative weight and the likelihood of postoperative hypokalemia development. The multinomial regression model’s effectiveness was also evaluated.

Results

Preoperative factors, including sex, preoperative serum potassium level, and preoperative platelet-to-lymphocyte ratio (PLR), were significantly associated with postoperative hypokalemia. Based on the ROC curve, the preoperative serum potassium and PLR cut-off levels were 3.98 mmol/L and 117, respectively. Further multivariate analysis indicated that female sex, preoperative serum potassium level < 3.98 mmol/L, and preoperative PLR ≥ 117 were independently associated with postoperative hypokalemia. We constructed a predictive nomogram with all these factors for the risk of postoperative hypokalemia with good discrimination and internal validation.

Conclusions

The predictive nomogram for postoperative hypokalemia risk constructed with these factors had good discrimination and internal validation. The developed nomogram will add value to these independent risk factors that can be identified at admission in order to predict postoperative hypokalemia.
Health professional’s perception of a smoking cessation intervention among disadvantaged patients participating in a pragmatic randomized trial
Authors: Manns Aurélia , Mahdjoub Sarah , Ibanez Gladys , Jarrier Emilie , Daeipour Ava , Melchior Maria , El-Khoury Fabienne
Published: September 2023

Introduction

Individuals who have a low socio-economic position (SEP) are more likely to smoke and face greater barriers to quitting tobacco. However, the effectiveness of tailored interventions has been limited probably due to specific challenges relative to this population. We conducted a mixed-method study to better understand health professionals’ perceptions and barriers when implementing a preference-based smoking cessation (SC) intervention among disadvantaged smokers.

Methods

A self-administered online questionnaire was sent to health professionals (doctors’ and other health professionals specialized in SC) participating in “STOP” a pragmatic multicentre randomized controlled trial. Perceptions regarding patient eligibility, the doctor-patient relationship, general study organization, and satisfaction were measured.

Results

Twenty-eight STOP study investigators responded. Health professionals prioritize smoking cessation for disadvantaged patients, but face challenges in approaching and following them. A research intervention providing cessation tools based on preference was deemed useful but generally undermined by time constraints. Health professionals’ preconceptions regarding patients in low SEP having other “pressing problems” which might be exacerbated by quitting smoking were also identified. Further, participation in a research intervention was perceived as not satisfactory due to workload and lack of time.

Conclusion

Our results highlight general barriers inherent to implementing pragmatic trials. They also present specific challenges in smoking cessation trials among disadvantaged population, essential to advance equity in tobacco control.
Experiences and needs of welfare benefit recipients regarding their welfare-to-work services and case workers
Authors: Oude Geerdink Esmee , Sewdas Ranu , van Kempen Hetty , van Weeghel Jaap , Anema Johannes R. , Huysmans Maaike A.
Published: September 2023

Background

This study aimed to explore the experiences and needs of (ex-)welfare benefit recipients from a large urban municipality in the Netherlands regarding their welfare-to-work services and their case workers.

Methods

Quantitative data from a client satisfaction survey that was filled out by 213 people (response rate 11%) who received welfare-to-work services was combined with results from four group interviews with a total of 15 people receiving welfare-to-work services. Verbatim transcripts from the interviews were analysed using inductive thematic analysis.

Results

The survey results showed that most clients were reasonably satisfied with the welfare-to-work services they received. Four main themes emerged from the interviews: (1) experiences and needs related to the interactions between case workers and benefit recipients; (2) the need for tailored services; (3) the complicating role of the system the case workers operate within; and (4) the existence of differences between case workers regarding how strict they followed the rules and to what extent they connected with their clients on a personal level.

Conclusions

Our findings show that clients were reasonably satisfied with the welfare-to-work services provided by their municipality but that there is still room for improvement. Case workers should have good social skills to build a trusting relationship with the client, welfare-to-work services should be tailored to the individual, and clear concise information should be given to welfare benefit recipients, especially with regard to what benefit recipients can expect of the municipality and the case workers, given their dual role in supporting (re-)integration to work and monitoring benefit eligibility.
Surveillance of wild animals carrying infectious agents based on high-throughput screening platform in the Republic of Korea
Authors: Kim Myeongsu , Bae Jieun , Oh Byungkwan , Rhim Haerin , Yang Myeon-Sik , Yang Somyeong , Kim Bumseok , Han Jae-Ik
Published: September 2023

Background

Infectious diseases transmitted by wild animals are major threats to public health. This study aimed to investigate the potential of rescued wild animals that died of unknown causes as reservoirs of infectious agents. From 2018 to 2019, 121 dead wild animals (55 birds and 66 mammals) were included in this study. All wild animals died during treatment after anthropogenic events. After deaths of animals, necropsies were performed and trachea, lungs, large intestine (including stool), and spleen were collected to determine causes of deaths. A high-throughput screening (HTS) quantitative polymerase chain reaction (qPCR) designed to detect 19 pathogens simultaneously against 48 samples in duplicate was performed using nucleic acids extracted from pooled tissues and peripheral blood samples. If positive, singleplex real-time PCR was performed for individual organs or blood samples.

Results

The HTS qPCR showed positive results for Campylobacter jejuni (10/121, 8.3%), Campylobacter coli (1/121, 0.8%), Mycoplasma spp. (78/121, 64.5%), and Plasmodium spp. (7/121, 5.7%). Singleplex real-time PCR confirmed that C. jejuni was detected in the large intestine but not in the blood. C. coli was only detected in the large intestine. Mycoplasma spp. were detected in all organs, having the highest proportion in the large intestine and lowest in the blood. Plasmodium spp. was also detected in all organs, with proportions being were similar among organs.

Conclusions

This study shows that wild animals can become carriers of infectious agents without showing any clinical symptoms.
Co-infection of Plasmodium falciparum and Schistosoma mansoni is associated with anaemia
Authors: Dassah Sylvester Donne , Nyaah Kingsley Enock , Senoo Dodzi Kwaku Jnr , Ziem Juventus B. , Aniweh Yaw , Amenga-Etego Lucas , Awandare Gordon A. , Abugri James
Published: September 2023

Background

Malaria and schistosomiasis persist as major public health challenge in sub-Saharan Africa. These infections have independently and also in polyparasitic infection been implicated in anaemia and nutritional deficiencies. This study aimed at assessing asymptomatic malaria, intestinal Schistosoma infections and the risk of anaemia among school children in the Tono irrigation area in the Kassena Nankana East Municipal (KNEM) in the Upper East Region of Northern Ghana.

Methods

A cross sectional survey of 326 school children was conducted in the KNEM. Kato Katz technique was used to detect Schistosoma eggs in stool. Finger-prick capillary blood sample was used for the estimation of haemoglobin (Hb) concentration and blood smear for malaria parasite detection by microscopy.

Results

The average age and Hb concentration were 10.9 years (standard deviation, SD: ± 2.29) and 11.2 g/dl (SD: ± 1.39) respectively with 58.9% (n = 192) being females. The overall prevalence of infection with any of the parasites (single or coinfection) was 49.4% (n = 161, 95% confidence interval, CI [44.0–54.8]). The prevalence of malaria parasite species or Schistosoma mansoni was 32.0% (n = 104) and 25.2% (n = 82), respectively with 7.7% (n = 25) coinfection. The prevalence of anaemia in the cohort was 40.5% (95%CI [35.3–45.9]), of which 44.4% harboured at least one of the parasites. The prevalence of anaemia in malaria parasite spp or S. mansoni mono-infections was 41.8% and 38.6%, respectively and 64.0% in coinfections. There was no statistically significant difference in the odds of being anaemic in mono-infection with malaria (OR = 1.22, 95% CI 0.71–2.11, p = 0.47) or S. mansoni (OR = 1.07, 95% CI 0.58–1.99, p = 0.83) compared to those with no infection. However, the odds of being anaemic and coinfected with malaria parasite species and S. mansoni was 3.03 times higher compared to those with no infection (OR = 3.03, 95% CI 1.26–7.28, p = 0.013).

Conclusion

The data show a high burden of malaria, S. mansoni infection and anaemia among school children in the irrigation communities. The risk of anaemia was exacerbated by coinfections with malaria parasite(s) and S. mansoni. Targeted integrated interventions are recommended in this focal area of KNEM.
“Asthma is a very bully disease” – patient experiences of living with chronic respiratory diseases in Cape Town, South Africa
Authors: Stolbrink Marie , Streicher Chantel , Mcimeli Khanyisa , Allwood Brian , Mortimer Kevin , Chinouya Martha
Published: September 2023

Background

Chronic respiratory diseases are common in Cape Town, South Africa. Yet the experiences of how adults with these conditions, such as asthma or COPD (chronic obstructive pulmonary disease), negotiate the health system are poorly understood. Qualitative methodology lends itself to investigate this question.

Aim of study

To explore the “emic” experiences of adults with CRDs in Cape Town when they were negotiating the health system using semi-structured interviews.

Methods

Interviews were conducted following informed consent with purposively sampled adults who had attended public hospitals in Cape Town with chronic respiratory disease flare-ups. This work was nested in the quantitative “Diagnosing Airways Disease” study. The topic guide explored patients’ experiences of accessing healthcare including receiving and interpretations of the diagnosis and management, and impacts on daily life. Interviews were conducted in Afrikaans, isiXhosa, or English; transcribed, and translated into English and thematically analysed until saturation.

Results

Thirty-two interviews (16 in Afrikaans, 8 in isiXhosa, 8 in English) were completed in 2022. 17 women and 15 men participated. Most participants were older than 50 years (25/32), and most were unemployed (13/32) or retired (11/32).

The identified themes were: Perceived causes of illness; experiences of healthcare; perceived risks and barriers when accessing healthcare; and impact on earnings. The perceived causes of their illness and risks were structural, and included air pollution, poor quality housing, occupational exposures, limited healthcare services, and fear of violence. These factors led to self-treatment, sharing of medicines, and delay in receiving a diagnosis. Many paid privately for treatments or services to overcome identified shortcomings of the public healthcare system, and many reported additional significant indirect costs. Being ill had a profound impact on income. The identified themes were explored through the lens of “structural violence”, where “social structures stop individuals … from reaching their full potential” (Galtung, 1969).

Conclusion

In Cape Town structural elements such as stretched healthcare professionals, insufficiently enforced policies on e.g., housing or work-place exposures, poverty and crime made it difficult for participants to successfully navigate their illness experience. It forced some to pay out of pocket to receive perceived better healthcare privately.
Why meta-regulation matters for public health: the case of the EU better regulation agenda
Authors: Lauber Kathrin , Brooks Eleanor
Published: September 2023

Meta-regulation – the rules that govern how individual policies are developed and reviewed – has not received much attention in the study of health policy. We argue that these rules, far from value-free and objective, have significant potential to shape policy outputs and, as such, health outcomes. Channelling and operationalising wider paradigms like neoliberalism, they determine, for instance, what is considered ‘good’ policy, how decisions are made, based on which evidence, and whose voices matter. Exploring an archetypal example of meta-regulation, the European Union’s Better Regulation agenda, we illustrate why meta-regulatory tools such as impact assessment, stakeholder consultation, and evaluation – and the norms that underlie their application – matter for health. In so doing, we concentrate especially on the ways in which Better Regulation may affect interest groups’ ability to exert influence and, conversely, how actors have sought to shape Better Regulation. We argue that attention to meta-regulation contributes to counter-balancing the focus on agency within debates at the intersection of globalisation and health, and notably those on regulatory practices and coordination. Whilst research has noted, for instance, the origins of frameworks like Better Regulation and the increasing inclusion of 'good regulatory practice' provisions within trade and investment agreements, less attention is directed to the role that these frameworks play once institutionalised. Yet, as we illustrate, there is considerable scope for meta-regulation to enhance our understanding of the forces shaping health policy via, for instance, conceptualisations of the (social, economic, political, commercial) determinants of health. As such, we call for increased attention to the role of meta-regulation in research and practice aimed at improving human and planetary health.
Knowledge of handling medical emergencies among general dental practitioners pan India: a cross-sectional survery
Authors: Gupta Shubhangi , Mishra Stuti , Behl Shubhangi , Srikant N. , Mascarenhas Roma
Published: September 2023

Background

Medical emergency situations in dental clinics have been contemplated to be an issue in most of the countries by reason of dentist’s lack of knowledge and preparedness to attend emergency situations in dental offices. The aim of this paper is to observe the knowledge, attitude, and perceived confidence of the general dental practitioners regarding emergency medical care and its practical application. Questionnaire on knowledge assessment was circulated among 500 dentists using printed questionnaire formats and various social media platforms. The questionnaire included details on treating hypertensive patients, cardiopulmonary resuscitation training, accessibility of medical emergency equipments in the dental clinics, prevalence of medical emergency cases in the dental office and the self-assessed competence to handle medical emergency situations in the dental clinics. Data was surveyed and scrutinized using the Statistical Package for Social Sciences (SPSS), version 17 (SPSS Inc., Chicago IL). Descriptive statistics was tabulated and Chi square tests was applied.

Findings

500 general dental practitioners pan India were involved in the study (294 were females and 207 were males). They were grouped into different age groups (20–30 yrs, 30–40 yrs, 40–50 yrs, 50 and above) and experience (0–5 yrs, 5–10 yrs and more than 10 years). 279 participants did not attend any medical emergency training whereas, 222 participants from all groups attended training program. It was observed that with increased experience in the field, the knowledge, awareness and confidence to treat medical emergency situation in the dental clinics was better. Dentists should update themselves from time-to-time with the latest technologies in the field and need to attend training programs to handle any medical emergency situations in the dental offices. Medical emergencies in a dental clinic can be encountered at any point of time and the clinician should have apt knowledge in handling such situations. Majority of the dentists feel subdued in managing medical situations in dental offices. Training and workshops for handling medical situations in the dental offices should be mandated at the undergraduate and postgraduate levels. This will help the dentist to shape one’s confidence in managing such situations without apprehension. Availability of proper infrastructure and equipments is recommended in every dental clinics so as to ease the handling of the situation.

Conclusion

This paper enlightens the need of basic life support training on regular basis among the dentists to improve the competence among them and to improve the confidence in handling such situations.
Lifting of the 1,000 wheat exome project SNPs from Triticum aestivum cv. Chinese Spring assembly RefSeq v1.0 to RefSeq v2.1
Authors: Vasudevan Akshaya , Cloutier Sylvie
Published: September 2023

Objective

The 1,000 wheat exome project captured the single nucleotide variants in the coding regions of a diverse set of 890 wheat accessions to analyse the contribution of introgression to adaptation of wheat. However, this highly useful single nucleotide polymorphism (SNP) dataset is based on RefSeq v1.0 of the International Wheat Genome Sequencing Consortium (IWGSC) assembly of the bread wheat genome of Chinese Spring. This reference sequence has recently been updated using optical maps and long-read sequencing to produce the improved RefSeq v2.1. Our objective was to develop a reliable high-density SNP dataset positioned onto RefSeq v2.1 because it is the current standard reference sequence used by wheat researchers.

Results

The 3,039,822 SNPs originally positioned on RefSeq v1.0 were projected to v2.1 using Liftoff with four different flanking regions, and 2,946,536 SNPs were consistently lifted to the same location irrespective of the flanking region lengths. Of these, 2,799,166 were located on the ‘+’ ve strand. The distribution of the SNPs across the 21 chromosomes on RefSeq v2.1 was similar to that of RefSeq v1.0. Among the SNPs that were based on unanchored scaffolds in RefSeq v1.0, 11,938 were projected to one of the 21 pseudomolecules in the upgraded assembly. This SNP dataset constitutes a much-needed standardized resource for the wheat research community.
Variations in preservation of exceptional fossils within concretions
Authors: Saleh Farid , Clements Thomas , Perrier Vincent , Daley Allison C. , Antcliffe Jonathan B.
Published: September 2023

Concretions are an interesting mode of preservation that can occasionally yield fossils with soft tissues. To properly interpret these fossils, an understanding of their fossilization is required. Probabilistic models are useful tools to identify variations between different Konservat-Lagerstätten that are separated spatially and temporally. However, the application of probabilistic modeling has been limited to Early Paleozoic Konservat-Lagerstätten preserved in shales. In this paper, the patterns of preservation of three concretionary Konservat-Lagerstätten—the Carboniferous Mazon Creek (USA) and Montceau-les-Mines (France), and the Silurian Herefordshire Lagerstätte (UK)—are analyzed using a statistical approach. It is demonstrated that the degree of biotic involvement, i.e., the degree to which a carcass dictates its own preservation, is connected to internal organ conditional probabilities—the probabilities of finding an internal organ associated with another structure such as biomineralized, sclerotized, cuticularized, or cellular body walls. In concretions that are externally forced with little biological mediation (e.g., Herefordshire), all internal organ conditional probabilities are uniform. As biological mediation in concretion formation becomes more pronounced, heterogeneities in conditional probabilities are introduced (e.g., Montceau-les-Mines and Mazon Creek). The three concretionary sites were also compared with previously investigated Konservat-Lagerstätten preserving fossils in shales to demonstrate how the developed probability framework aids in understanding the broad-scale functioning of preservation in Konservat-Lagerstätten.