bluuebunny/crossref_metadata_2025 huggingface dataset:
First Detection of Highly Pathogenic Avian Influenza Virus in Norway
Authors: Madslien Knut , Moldal Torfinn , Gjerset Britt , Gudmundsson Sveinn , Follestad Arne , Tronerud Ole-Herman , Dean Katharine , Åkerstedt Johan , Jørgensen Hannah , Neves Carlos das , Rømo Grim
Published: January 2021

Background: Several outbreaks of highly pathogenic avian influenza (HPAI) caused by influenza A virus of subtype H5N8 have been reported in wild birds and poultry in Europe during autumn 2020.Norway is one of the few countries in Europe that had not previously detected HPAI virus, despite widespread active monitoring of both domestic and wild birds since 2005.Results: We report detection of HPAI virus subtype H5N8 in a wild pink-footed goose (Anser brachyrhynchus), and several other geese, ducks and a gull, from south-western Norway in November and December 2020. Despite previous reports of low pathogenic avian influenza (LPAI), this constitutes the first detections of HPAI in Norway.Conclusions: The mode of introduction is unclear, but a northward migration of infected geese or gulls from Denmark or the Netherlands during the autumn of 2020 is currently our main hypothesis for the introduction of HPAI to Norway. Although HPAI of subtype H5N8 has been reported to have very low zoonotic potential, this is a reminder that HPAI with greater zoonotic potential in wild birds may pose a threat in the future.
Infectious Spondylodiscitis and Kyphosis Correction in an Infant: a Case Report and Review of the Literature
Authors: Romano Sara , Vittoria Francesca , Cataruzzi Elisabetta , Barbi Egidio , Carbone Marco
Published: January 2021

Background: neonatal infectious spondylodiscitis is a rare bony infection with atypical clinical presentation and non-specific systemic symptoms. Diagnosis and treatment are often delayed resulting in vertebral destruction and severe complications. We retrospectively reviewed the case of an infant with infectious spondylodiscitis resulting in T12 body destruction and marked angular kyphosis. Case-report: a four-week-old infant developed an infectious spondylodiscitis resulting in destruction of the T12 vertebral body and involvement of disc between T12 and L1. At 6 months of age, X-ray showed a marked thoracolumbar angular kyphosis above 50 Cobb degrees. Therefore, the patient underwent single time surgery with double anterior and posterior approach. At 9 years follow up, clinical and radiological findings show a stable correction with good aesthetic appearance. Conclusion: neonatal spondylodiscitis could lead to marked kyphosis similar to the congenital one. Since treatment with casts and tutors is often inefficacious, prompt surgery should be considered. The double anterior and posterior approach is the best option in this condition.
Thymosin β4 Protect Against LPS Induced Lung Injury and Inflammation and Subsequent Fibrosis in Mice
Authors: Tian Zhen , Yao Naijuan , Wu Yuchao , Wang Fei
Published: January 2021

Background: Inflammation plays a critical role in the progress ion of pulmonary fibrosis. Thymosin β4 (Tβ4) has antioxidant, anti-inflammatory and antifibrotic effects. Although the potent protective role of Tβ4 in bleomycin-induced pulmonary fibrosis has been validated, the mechanism is not clear, and its impact on LPS-induced lung injury/fibrosis has not been reported. Method: Expression of Tβ4 in fibrotic lung tissues was assessed by real-time quantitative reverse transcriptase PCR (RQ-PCR), immunohistochemistry (IHC) and Western Blotting. The effects of intraperitoneal adeno-associated virus-Tβ4 (AAV-Tβ4) on LPS-induced lung injury and fibrosis were observed through the evaluation of collagen deposition and α-SMA expression. In vitro tests with HPAEpiC and HLF-1 cells were performed to confirm the effects of Tβ4.Results: In this study, we evaluated the role of Tβ4 on pulmonary fibrosis and explored the possible underlying mechanisms. We found that Tβ4 was markedly upregulated in human or mouse fibrotic lung tissues. Adeno-associated virus-Tβ4 (AAV-Tβ4) markedly alleviated LPS-induced oxidative damage, lung injury, inflammation and fibrosis in mice. Our in vitro experiments also showed that LPS inhibited mitophagy and promoted inflammation via oxidative stress in HPAEpiC, and usage of Tβ4 significantly attenuated LPS-induced mitophagy inhibition, inflammasome activation and TGF-β1 induced epithelial-mesenchymal transition (EMT) in HPAEpiC. Moreover, we found that Tβ4 suppressed the proliferation and attenuated the TGF-β1-induced activation of HLF-1 cells. Conclusions: In conclusion, Tβ4 alleviated LPS-induced lung injury, inflammation, and subsequent fibrosis in mice, suggesting a protective role of Tβ4 in disease pathogenesis of pulmonary fibrosis (PF). Tβ4 may involve attenuating oxidative injury, promoting mitophagy, and then alleviating inflammation and fibrosis. Modulating of Tβ4 may be novel strategies for treating PF.
Epidemiological Characteristics and Mortality Risk Factors among COVID-19 Patients in Ardabil, Northwest of Iran
Authors: Adham Davoud , Habibzadeh Shahram , Ghobadi Hassan , jajin Shabnam Asghari , Abbasi-Ghahramanloo Abbas , Moradi-Asl Eslam
Published: January 2021

Background: Coronavirus disease highly contagious, is prevalent in all age and sex groups infecting the respiratory system. The present study seeks to investigate the epidemiology and effective factors in mortality of patients with COVID-19 in Ardabil province, northwestern of Iran.Methods: In a retrospective study, the hospitalized patients with laboratory diagnosed COVID-19 between February to August, 2020 were enrolled. Data registration portal was designated according to WHO recommendation. In this portal, demographic information, clinical presentation, laboratorial and imaging data were registered for patients in all hospitals in the same format. The Hosmer-Lemeshow guideline was used for variable selection in a multiple model.Results: Of the patients involved 2812(50.3%) were male and 150 (2.7%) had a contact with a confirmed case of COVID-19 in the last 14 days. Pre-existing morbidity was reported in 1310 (23.4%) patients. Of all patients 477(8.5%) died due to COVID 19. The hospitalization in ICU had significant correlation with fever or chills, shortness of breath, aches and pains, runny nose and chest pain.Conclusions: Hospitalization had the strongest effect on mortality followed by hospitalization in ICU, and higher age. This study showed that having some symptoms like aches and pains and headache can serve as preventive factors of mortality.
Predicting Surgical Resource Consumption and In-hospital Mortality in Resource-scarce Conflict Settings: A Retrospective Database Study
Authors: Muhrbeck Måns , Osman Zaher , Von Schreeb Johan , Wladis Andreas , Andersson Peter
Published: January 2021

Background: In armed conflicts, civilian health care struggles to cope. Being able to predict what resources are needed is therefore vital. The International Committee of the Red Cross ICRC) implemented in the 1990s the Red Cross Wound Score (RCWS) for assessment of penetrating injuries. It is unknown to what extent RCWS or the established trauma scores ampala trauma Score (KTS) and revised trauma score (RTS) can be used to predict surgical resource consumption and in-hospital mortality.Methods: A retrospective study of routinely collected data on weapon-injured adults admitted to ICRC’s hospitals in Peshawar, 2009–2012 and Goma, 2012–2014. High resource consumption was defined as ≥3 surgical procedures, ≥3 blood-transfusions and/or amputation. The relationship between RCWS, KTS, RTS and resource consumption, in-hospital mortality was evaluated with logistic regression and adjusted receiver operating characteristic curves (AUC). The impact of missing data was assessed with imputation. Model fit was compared with Akaike Information Criterion (AIC).Results: A total of 1564 patients were included, of these 834 patients had complete data. For high resource consumption AUC was significantly higher for RCWS (0.76) than for KTS (0.53) and RTS (0.51). Additionally, RCWS had lower AIC, indicating a better model fit. For in-hospital mortality AUC was significantly higher for RCWS (0.79) than for KTS (0.71) and RTS (0.70) for all patients, but not for patients with complete data.Conclusion: RCWS appears to predict surgical resource consumption better than KTS and RTS. RCWS may be a promising tool for planning and monitoring surgical care in resource-scarce conflict settings.
Primary stability of the Activ L® intervertebral disc prosthesis in cadaver bone and comparison of the keel and spike anchoring concept
Authors: Pellengahr Christoph von Schulze , Teske Wolfram , Kapoor Saurabh , Klein Alexander , Wegener Bernd , Büttner Andreas , Lahner Matthias
Published: January 2021

Background: High primary stability is the key prerequisite for safe osseointegration of cementless intervertebral disc prosthesis. The aim of our study was to determine the primary stability of intervertebral disc prosthesis with two different anchoring concepts – keel and spike anchoring. Methods: 10 ActivL intervertebral disc prosthesis (5 x keel anchoring, 5 x spike anchoring) implanted in human cadaver lumbar spine specimens were tested in a spine movement simulator. Under axial load flexion, extension, left and right bending and axial rotation were applied on the lumbar spine specimens through a defined three-dimensional movement program as per ISO 2631 and ISO/CD 18192-1.3 standards. Micromotion of the implants covering every single movement axis were measured for both anchor types and compared using Student’s T-test for significance after calculating 95% confidence intervals. Results: In the transverse axis, the keel anchoring concept showed lower statistically significant (p<0.05) mean values of micromotion compared to spike anchoring concept. The highest micromotion values for both types were observed in the longitudinal axis. The data achieved the threshold of primary stability (150-200 μm).Conclusions: Both fixation systems fulfil the required criteria of primary stability. Independent of the selected anchorage type an immediate postoperative active mobilization doesn’t compromise the stability of the prostheses.
Shared Decision-making between health care providers and patients at a Tertiary Hospital Diabetic Clinic in Tanzania  
Authors: Vedasto Osward , Morris Baraka , Furia Francis Fredrick
Published: January 2021

BackgroundPatients’ participation in decision making regarding their treatment is defined in ethical, legal and human rights standards in the provision of care that concerns health providers and the entire community. This study was conducted to document experiences of patients and health care providers on shared decision making.Methods: This study employed a phenomenological study design using in-depth interview technique. Study participants were diabetic patients visiting the clinic and healthcare providers working at Muhimbili National Hospital. Data was collected using the semi-structured interview guide with open-ended questions using an audio digital recorder. Content analysis method was used during analysis whereby categories were reached through the process of coding assisted by Nvivo 12 software. ResultsParticipants in this study expressed the role of shared decision-making in the care of patients with diabetes, with report of engagement of patients by health care providers in making treatment decisions. Participants reported no use of decision-making aids; however, health education tools were reported by participants to be used for educating patients. Limited time, patient beliefs and literacy were documented as barriers of effective engagement of patients in decision making by their healthcare providers. Conclusion Engagement of patients in decision-making was noted in this study as experienced by participants of this study. Time, patient beliefs and patient literacy were documented as barriers for patients engagement, therefore diabetic clinic at Muhimbili National Hospital need to devise mechanisms for ensuring patients involvement in treatment decisions.
A Serological Survey of Brucellosis in Wildlife in Four Major National Parks of Uganda
Authors: Aruho Robert , MacLeod Ewan T. , Manirakiza Leonard , Rwego Innocent Bidason
Published: January 2021

Background: Brucellosis is a contagious zoonotic disease of great public health and economic significance especially in developing countries. The disease affects humans and several species of livestock and wildlife. Studies on Brucellosis in wildlife in Uganda have been limited to single populations particularly in Queen Elizabeth National Park. This study aimed at estimating the percentage of positive samples of Brucella spp. in wildlife in four major national parks of Uganda. This was a retrospective survey which utilized archived samples collected from wildlife during the annual disease surveillance activities between 2013 and 2017. Results: A total of 241 samples from seven species namely African buffalo (Syncerus caffer, n = 109), African elephant (Loxodonta africana, n = 22), giraffe (Giraffa camelopardalis rothschildi, n = 41), Uganda kob (Kobus kob thomasi, n = 36), lion (Panthera leo, n = 6), plain zebra (Equus quagga, n = 25), and bushbuck (Tragelaphus scriptus, n = 2), were tested for antibodies using the Rose Bengal Plate Test. The overall percentage of positive samples in the four national parks was 31.1% (75/241; 95% CI: 25.6 - 37.2). Kidepo Valley National Park had a significantly higher percentage of positive samples of 55.9% (19/34; 95% CI: 39.5 - 71.1) compared to other sampled national parks (p < 0.05). Lions had significantly higher percentage of positive samples at 66.7% (4/6) than African buffalo at 48.6% (53/109; p < 0.0001). There were no antibodies for Brucella spp. detected in African elephant and bushbuck. Conclusion: This study shows variations in percentage of positive samples with Brucella spp. between species and across national parks and notably a high percentage with Brucella spp. in wildlife in Uganda than that recorded elsewhere in sub-Saharan region of Africa. Potential for transmission to other wildlife and spill over to livestock is high especially in national parks with high livestock-wildlife interaction.
Candida tropicalis distribution and drug resistance is correlated with ERG11 and UPC2 expression
Authors: Wang Dan , An Na , Yang Yuwei , Yang Xianggui , Fan Yingzi , Feng Jiafu
Published: January 2021

Background: Candida tropicalis (C. tropicalis) is an important opportunistic pathogenic Candida species that can cause nosocomial infection. In this study, we analyzed the distribution and drug susceptibility of C. tropicalis and the relationship between ERG11 and UPC2 expression and resistance to azole antifungal agents.Methods: C. tropicalis was cultured and identified by Sabouraud Agar Medium, CHROM Agar Candida and ATB tests (Bio-Mérieux, France). Total RNA was extracted from the collected strains, and the ERG11 and UPC2 mRNA expression levels were analyzed by quantitative real-time PCR. Results: In total, 2872 clinical isolates of Candida, including 319 strains of C. tropicalis, were analyzed herein; they were mainly obtained from the Departments of Respiratory Medicine and ICU. The strains were predominantly isolated from airway secretion samples, and the detection trend in four years was mainly related to the type of department and specimens. The resistance rates of C. tropicalis to fluconazole, itraconazole and voriconazole had been increasing year by year. The mRNA expression levels of ERG11 and UPC2 in the fluconazole-resistant group were significantly higher than they were in the susceptible group. In addition, there was a significant positive linear correlation between these two genes in the fluconazole-resistant group.Conclusions: Overexpression of the ERG11 and UPC2 genes in C. tropicalis could increase resistance to azole antifungal drugs. The routine testing for ERG11 and UPC2 in high-risk patients in key departments would provide a theoretical basis for the rational application of azole antifungal drugs.
Medical education too: sexual harassment within the educational context of medicine – insights from undergraduates
Authors: Schoenefeld Eva , Marschall Bernhard , Paul Berit , Ahrens Helmut , Sensmeier Janina , Coles Jan , Pfleiderer Bettina
Published: January 2021

Background: Assessment of the presence and the characteristics of sexual harassment in academic medicine is a global issue. Only limited international data are available so far.Methods: Aim: To assess the extent of sexual harassment and to identify the perpetrators in the student population of the medical school of Münster, Germany.A survey was undertaken, using the Medical Womens’ International Association sexual harassment questionnaire translated into German. The anonymous online questionnaire was sent as a link to all medical undergraduates at Münster Medical School via a mailing list between 1st October and the 30th November 2018. Identifying and potentially identifying data was not collected.Data were analyzed by descriptive statistical methods such as categorical variables. Baseline characteristics, e.g. answers by male or female medical students, were correlated with their individual sexual harassing experiences and perpetrator groups by means of univariate analysis. Results: A total of 2162 medical students were asked to participate: 623 (28.8%) completed the survey. Sexual harassment is a significant issue among medical students at Münster, over half (58.9%) of all undergraduates were exposed to sexually harassing behavior: 31.8 % of all participants reported to have experienced unwanted physical sexual contact such as e.g. unwanted physical touch; 87.6% of the victims were female. 41.3 % of all students did personally experience verbal sexual harassment of which 87.4 % were female. 8.5% of all undergraduates faced forced sexual contact e.g. such as oral, anal or vaginal penetration, intercourse and rape; all victims were female. Perpetrators in these cases were mostly male medical superiors (7.0%) and male patients (18.3%). In general, the majority of perpetrators were patients, followed by medical superiors and educators, and less frequently by colleagues.Conclusions: Sexual harassment in medical education and the medical working place are a significant problem in a German medical school. The majority of students experiencing sexual harassment are females. Female students also experience the more serious forms of sexual harassment more often.
Effect of adding a psychological intervention to routine care of common mental disorders in a specialized mental healthcare facility in Pakistan: a randomized controlled trial
Authors: Hamdani Syed Usman , Huma Zill-e- , Masood Aqsa , Zhou Kiana , Ahmed Zainab , Nazir Huma , Amin Hania , Akhtar Parveen , Bryant Richard , Dawson Katie , Ommeren Mark van , Wang Duolao , Rahman Atif , Minhas Fareed Aslam
Published: January 2021

Background: In many low resource settings, the provision of government mental health care services is limited to specialized psychiatry units in urban hospital care facilities, where the most common treatment for common mental disorders (CMDs) is pharmacotherapy, occasionally with adjunct nonspecific psychological support. We aimed to evaluate the effectiveness of adding a low intensity, psychological intervention, Problem Management Plus (PM+) for CMDs into routine care in a specialized mental health care facility in Pakistan. Methods: A two arm, single-blind individual randomized controlled trial (RCT) was carried out with adults (N=192), referred for psychological support by psychiatrists. The study participants were randomized (1:1) to PM+ plus Treatment as Usual (TAU) (n = 96) or TAU only (n = 96). The primary outcomes were symptoms of anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS) and functional impairment as measured by WHO Disability Assessment Schedule (WHODAS 2.0) at 20 weeks after baseline. Results: The analysis was done on intention-to-treat principle. The linear mixed model analysis showed that at 20 weeks after baseline, there was a significant reduction in symptoms of anxiety and depression (mean [SD], 16.23 [8.81] vs 19.79 [7.77]; AMD, -3.10; 95% CI, −0.26 to −5.76); p=0.03 and improvement in functioning (mean [SD], 22.94 [9.37] vs 27.37 [8.36]; AMD, -4.35; 95% CI, -1.45 to -7.24); p=0.004 in PM+ plus TAU versus TAU arm. The follow-up rate was 67% at primary end-point. Conclusions: Specialized care facilities in LMICs may consider adding brief, evidence-based psychological treatments for CMDs to their routine care.
Comparison of ‘Mental training’ and physical practice in the mediation of a structured facial examination: A quasi randomized, blinded and controlled study 
Authors: Nelskamp Arne , Schnurr Benedikt , Germanyuk Alexandra , Sterz Jasmina , Lorenz Jonas , Sader Robert , Rüsseler Miriam , Seifert Lukas Benedikt
Published: January 2021

Background: The correct performance of a structured facial examination presents a fundamental clinical skill to detect facial pathologies. However, many students are not adequately prepared in this basic clinical skill. Many argue that the traditional ‘See One, Do One’ approach is not sufficient to fully master a clinical skill. ‘Mental Training’ has successfully been used to train psychomotor and technical skills in sports and other surgical fields, but its use in Oral and Maxillofacial Surgery is not described. We conducted a quasi-experimental to determine if ‘Mental Training’ was effective in teaching a structured facial examination. Methods: 67 students were randomly assigned to a ‘Mental Training’ and ‘See One, Do One’ group. Both groups received standardized video instruction on how to perform a structured facial examination. The ‘See One, Do One’ group then received 60 minutes of guided physical practice while the ‘Mental Training’ group actively developed a detailed, stepwise sequence of the performance of a structured facial examination and visualized this sequence subvocally before practicing the skill. Student performance was measured shortly after (T1) and five to ten weeks (T2) after the training by two blinded examiners (E1 and E2) using a validated checklist. Results: Groups did not differ in gender, age or in experience. The ‘Mental Training’ group averaged significantly more points in T1 (pE1 = 0.00012; pE2 = 0.004; dE1 = 0.86; dE2 = 0.66) and T2 (pE1 = 0.04; pE2 = 0.008, dE1 = 0.37; dE2 = 0.64) than the ‘See One, Do One’ group. The intragroup comparison showed a significant (pE1 = 0.0002; pE2 = 0.06, dE1 = 1.07; dE2 = 0.50) increase in clinical examination skills in the ‘See One, Do One’ group, while the ‘Mental Training’ group maintained an already high level of clinical examination skills between T1 and T2.Discussion: ‘Mental Training’ is an efficient tool to teach and maintain basic clinical skills. In this study ‘Mental Training’ was shown to be superior to the commonly used ‘See One, Do One’ approach in learning how to perform a structured facial examination and should therefore be considered more often to teach physical examination skills.
Impact of career choice motivation on academic burnout in senior dental students: A cross-sectional study
Authors: Mohebbi Simin Z. , Gholami Mahdia , Chegini Mostafa , Ghoreyshi Younes , Gorter Ronald C. , Bahramian Hoda
Published: January 2021

Background: Motivation triggers all human activities including learning and lack of career motivation can lead to decreased efficiency. This study assessed the association between academic burnout and career choice motivation in senior dental students.Methods: This cross-sectional study was performed on senior dental students of all four dental schools in Tehran in 2017. Dental students voluntarily filled out a 33-item questionnaire that comprised three sections. The first section included the Burnout Clinical Subtype Questionnaire (BCSQ-SS) with 12 questions addressing academic burnout. The second section consisted of 8 questions about career choice motivation, and the third section concentrated on 13 questions dealing with demographics. The individual scores of each section and the total scores were reported. The factor analysis of 8 questions about dental career choice motivation yielded 3 factors of social status and security, altruism, and others’ advice motivations. The data were analyzed using regression test. Results: Totally, 131 students filled out the questionnaire (response rate = 86%). The total score of academic burnout was 38.89% ± 1.13%. The highest and the lowest burnout scores belonged to the domains of “overload” (46.69%± 1.46%) and “neglect” (31.98%± 1.32%), respectively. The most and the least frequently mentioned source of motivation for choosing dentistry were high income and failing to enter other fields, respectively. The burnout score was higher in students with altruism motivations (P=0.007) and lower in students with others’ advice motivations (P=0.004). The burnout score was higher in students with inadequate or moderate financial support from the family and lower in students whose mothers’ educational level was high-school diploma or lower. Conclusion: Senior dental students in Tehran encountered different levels of academic burnout. In the present study, low financial support and altruism as career choice motivations were associated with higher level of academic burnout.
Family achievements in struggling with schizophrenia: life experiences in a qualitative content analysis study in Iran
Authors: Darban Fatemeh , Mehdipour_Rabori Roghayeh , Farokhzadian Jamileh , Nouhi Esmat , Sabzevari Sakineh
Published: January 2021

Background: The challenges of living with and taking care of a patient with schizophrenia can lead to positive changes depending on the experiences and reactions of family caregivers. Such changes may directly affect the family performance and the patient's recovery stage. Present study aimed to explain the positive experiences reported by family caregivers of patients with schizophrenia.Methods: The present study is a qualitative study of content analysis. Data were collected using semi-structured and in-depth interviews with 15 family caregivers of patients with schizophrenia referring to one of the psychiatric hospitals in Zahedan, Southeast part of Iran. Purposive sampling method was applied and data analysis was conducted using conventional content analysis proposed by Graneheim and Lundman. Results: Data analysis created a theme entitled “family achievements in struggling with schizophrenia”. This theme included four categories including Developing positive personality traits in family members, Strengthening family ties, developing insight into the life, and social mobility.Conclusions: The results provided insights that the experience of taking care of patients with schizophrenia led to positive consequences for family caregivers. Thus, it is recommended that psychiatrists or consultants help families rely on positive experiences and share these experiences with families with a newly-suffered patient.
Vaccination concerns, beliefs and practices among Ukrainian migrants in Poland: A qualitative study
Authors: Ganczak Maria , Bielecki Klaudia , Drozd-Dąbrowska Marzena , Topczewska Katarzyna , Biesiada Daniel , Molas-Biesiada Agnieszka , Dubiel Paulina , Gorman Dermot
Published: January 2021

Background: Ukrainians numbering approximately 1.2 million are the largest migrant group in Poland. Data on vaccination coverage among migrants are not collected in EU, including Poland. Therefore, this qualitative study aimed to identify vaccination practices in this migrant group, to explore facilitators and barriers to vaccination and related access to Polish healthcare services.Methods: In September 2019, a qualitative study of Ukrainian migrants (UMs) living in Szczecin, Poland, and recruited through a snowball sampling method, was conducted. Using a semi-structured topic guide, four focus groups were held with 22 UMs aged 18-45. Participants were asked about their attitudes towards vaccination in general with comparison between services in Poland and Ukraine. Following transcription and translation, a thematic analysis was conducted.Results: Respondents were distrustful of Ukrainian vaccination policy, medical personnel and individual vaccines, however, they often returned to Ukraine for dental and gynaecological appoint-ments. While critical with regards to registering with Polish GPs practices, UMs were confident in health professionals, as well as vaccine delivery. Vaccines were perceived as safer and of better quality than in Ukraine. Difficulties in translating vaccination records were rarely reported, verbal communi-cation was not problematic due to language similarities. All UM parents reported vaccinating their children according to the Polish schedule. However, a significant number of adult UMs have not completed mandatory vaccinations, although they may have obtained false immunization certificates; according to UMs those can be obtained by bribing. Participants reported lower acceptance of the influenza vaccine, mainly due to perceptions around its importance; none had been vaccinated against influenza. None of UMs had heard of the HPV vaccine. UMs experienced challenges in accessing credible online vaccination information in Ukrainian, no official local health authority vaccination material existed either, except for information about measles.Conclusions: This study pinpointed positive UM attitudes and practices regarding child vaccination in the Polish healthcare system and identified issues for improvement, such as adult vaccination. Health communication should be more tailored within UMs information delivery systems to enable migrants to make informed choices about vaccination. Further research is needed to better assess factors affecting vaccine uptake identified in this study.
Cytokine Profile During Occult Hepatitis B Virus Infection in Chronic Hepatitis C Patients
Authors: Ribeiro Camilla Rodrigues de Almeida , de Almeida Nathalia Alves Araújo , Martinelli Katrini Guidolini , Pires Marcia Amendola , Mello Carlos Eduardo Brandao , Barros José J. , De Paula Vanessa Salete
Published: January 2021

Background: The hepatitis B virus (HBV) is one of the leading causes of acute, chronic and occult hepatitis (OBI) representing a serious public health threat. Cytokines are known to be important chemical mediators that regulate the differentiation, proliferation and function of immune cells. Accumulating evidence indicate that the inadequate immune responses are responsible for HBV persistency. The aim of this study were to investigate the cytokines IFN-γ, TNF-α, IL-2, IL-4, IL-6, IL-10 and IL-17A in patients with OBI and verify if there is an association between the levels of these cytokines with the determination of clinical courses during HBV occult infection.Methods: 114 patients with chronic hepatitis C were investigated through serological and molecular tests, the OBI coinfected patients were subjected to the test for cytokines using the commercial human CBA kit. As controls, ten healthy donors with no history of liver disease and 10 chronic HBV monoinfected patients of similar age to OBI patients were selected.Results: Among 114 HCV patients investigated, 11 individuals had occult hepatitis B. The levels of cytokines were heterogeneous between the groups, most of the cytokines showed higher levels of production detection among OBI/HCV individuals when compared to control group and HBV monoinfected patients. We found a high level of IL-17A in the HBV monoinfected group, high levels of TNF-α, IL-10, IL-6, IL-4 and IL-2 in OBI/HCV patients.Conclusion: These cytokines could be involved in the persistence of HBV DNA in hepatocytes triggers a constant immune response, inducing continuous liver inflammation, which can accelerate liver damage and favor the development of liver cirrhosis in other chronic liver diseases.
Dietary Intake, Intestinal Infection, and Safe Drinking Water Among Children with Anemia in Peru: A Cross-Sectional Analysis
Authors: Westgard Christopher M , Orrego-Ferreyros Luis A. , Calderón Liz Franco , Rogers Alexandra M.
Published: January 2021

Anemia is a major public health concern that is present in 41.7% of children under 5 worldwide. The prevalence of anemia in Peru was 43.6% in 2017, a decrease by only 6.8% in 8 years. Despite great efforts made by the government to reduce anemia by distributing free multi-micronutrient supplements and promote the consumption of iron rich foods, progress has been slow. The current study sought to better understand why the prevalence remains high by analyzing the dietary intake, incidence of intestinal infectious disease, and access to safe drinking water by children with anemia in Peru. METHODS A cross-sectional analysis was conducted using data from two national surveys that were combined by child ID. Descriptive statistics was analyzed to understand the experience of children with anemia in comparison to child without anemia. Logistic multivariate regression analyses were conducted to test the associations between anemia and dietary intake, intestinal infection, and access to safe drinking water. RESULTS The sample included 586 children between 6 and 35 months. The prevalence of anemia in this population was 53%. The portion of children that consumed sufficient iron to meet the recommendation for their age was 62%. Of the children with anemia, 52% consumed sufficient iron to meet their recommendation, vs. 72% of children without anemia (p<0.001). The children with anemia were more likely to have an intestinal infection during the previous year (35% vs. 26%, p=0.057) and less likely to have access to safe drinking water (77% vs. 86%, p=0.002) than those without anemia. The logistic analysis revealed that having an intestinal infection increased the odds of having anemia (OR=1.64, CI 95% [1.041-2.584]), and having access to safe drinking waters decreased the odds of having anemia (OR=0.578, [0.334-0.998]). CONCLUSIONS More than half of the children with anemia in Peru already consume sufficient iron to meet their daily requirement. However, they continue to have anemia, likely due to intestinal infection, such as diarrhea and parasites, from a lack of access to safe drinking water and hygienic practices.
Dopaminergic stimulation leads B-cell infiltration into the central nervous system upon autoimmunity
Authors: Prado Carolina , Osorio-Barrios Francisco , Espinoza Alexandra , Saez Juan J , Yuseff María I , Pacheco Rodrigo
Published: January 2021

Multiple sclerosis (MS) involves a CD4+ T-cell-driven autoimmune response to central nervous system (CNS) derived antigens. Previous evidence has suggested that B-cells play a fundamental role as antigen-presenting cells (APC) in mouse models of MS re-stimulating CD4+ T-cells in the CNS as well as regulating the T-cell response by mean of inflammatory or anti-inflammatory cytokines. Despite an important dopaminergic regulation of T-cells has been previously described in MS, the effects of dopaminergic signalling in B-cells in this pathology remains unexplored. Here we addressed the role of the dopamine receptor D3 (DRD3), which display the highest affinity for dopamine, in B-cells in animal models of MS. Experimental autoimmune encephalomyelitis (EAE) was induced in mice harbouring Drd3-deficient or Drd3-suficient B-cells. Our data shows that, by promoting the expression of the chemokine receptor CXCR3 in autoreactive B-cells, DRD3-stimulation favours the CNS-tropism in a subset of B-cells that act as APC in the CNS, which is fundamental for disease development. Furthermore, we found that DRD3-stimulation induced the expression of the CNS-homing molecule CD49d in a B-cell subset with anti-inflammatory features, thus attenuating EAE manifestation in a CNS-autoimmunity model independent of the APC function of B-cells. Our findings demonstrate that DRD3-stimulation in B-cells exerts a dual role in CNS-autoimmunity, favouring CNS-tropism of pro-inflammatory B-cells with APC function, and also promoting CNS-homing of B-cells with anti-inflammatory features. Thus, these results show DRD3-stimulation in B-cells as a key regulator of CNS-autoimmunity.
Exercise-therapy and education for individuals one year after anterior cruciate ligament reconstruction: a pilot randomised controlled trial
Authors: Patterson Brooke , Barton Christian , Culvenor Adam , Cooper Randall , Crossley Kay
Published: January 2021

Background: Guided rehabilitation beyond 6-months is rare following anterior cruciate ligament reconstruction (ACLR), despite high prevalence of unacceptable symptoms and quality of life (QoL). Our primary aim was to determine the feasibility of a randomised controlled trial (RCT) evaluating a physiotherapist-guided intervention for individuals 1-year post-ACLR with persistent symptoms. Our secondary aim was to determine if a worthwhile treatment effect could be observed for the lower-limb focussed intervention (compared to the trunk-focussed intervention), for improvement in knee-related QoL, symptoms, and function. Design: Participant- and assessor-blinded, pilot feasibility RCT.Methods: Participant eligibility criteria: i) 12-15 months post-ACLR; ii) <87.5/100 on the Knee injury and Osteoarthritis Outcome Score (KOOS) QoL subscale; and either a one-leg rise test <22 repetitions, single-hop <90% limb symmetry; or Anterior Knee Pain Scale <87/100. Participants were randomised to lower-limb or trunk-focussed focussed exercise and education.. Both interventions involved 8 face-to-face physiotherapy sessions over 16-weeks. Feasibility was assessed by eligibility rate (>1 in 3 screened), recruitment rate (> 4 participants/month), retention (<20% drop-out), physiotherapy attendance and unsupervised exercise adherence (>80%). Between-group differences for knee-related QoL (KOOS-QoL, ACL-QoL), symptoms (KOOS-Pain, KOOS-Symptoms), and function (KOOS-Sport, functional performance tests) were used to verify that the worthwhile effect (greater than the minimal detectable change for each measure) was contained within the 95% confidence interval. Results: 47% of those screened were eligible, and 27 participants (3 participants/month; 48% men, 34±12 years) were randomised. Two did not commence treatment, and two were lost to follow-up (16% drop-out). Physiotherapy attendance was >80% for both groups but reported adherence to unsupervised exercise was low (<55%). Both interventions had potentially worthwhile effects for KOOS-QoL and ACL-QoL, while the lower-limb focussed intervention had potentially greater effects for KOOS-Sport, KOOS-Pain, and functional performance.Conclusions: A larger-scale RCT is warranted. All feasibility criteria were met, or reasonable recommendations could be made to achieve the criteria in future trials. Strategies to increase recruitment rate and exercise adherence are required. The potential worthwhile effects for knee-related QoL, symptoms, and function indicates a fully-powered RCT may detect a clinically meaningful effect.Trial Registration: Prospectively registered (ACTRN12616000564459).
Age-related changes in postural control in older women: transitional tasks in step initiation
Authors: Michalska Justyna , Kamieniarz Anna , Sobota Grzegorz , Stania Magdalena , Juras Grzegorz , Słomka Kajetan J
Published: January 2021

Background: Aging, being a natural process, involves many functional and structural changes within the body. Identifying the age-related postural changes will provide insight into the role of aging on postural control during locomotion. The aim of this study was to identify age-related postural changes during a transitional task under different conditions.Methods: Sixty healthy females divided into three age groups: A (50-60 y/o), B (60-70 y/o), and C (70-80 y/o). The transitional task was measured by two force platforms. The procedure consisted of three phases: quiet standing, transfer onto a second platform, and quiet standing on the second platform. Four different conditions were applied: unperturbed transfer, obstacle crossing, step-up, and step-down. Double-support time, transit time, and stability time before and after the step task were analyzed.Results: The transit time was longer by 30% for subjects over 70 y/o. The double-support time was longer by 11% among adults 60-70 y/o, while in people over 70 y/o it was longer by almost 50% compared to the 50-60 y/o subjects. The stability time before the transitional task was longer by 17% among adults over 60 y/o compared to middle-age subjects. The stability times before and after the transitional task were longer for adults in the 50-60 y/o category. Conclusion: The proposed procedure is adequate for assessing age-related changes in postural control while undergoing a transitional task. An analysis of the double-support time and stability time before and after the step task enabled the detection of early signs of balance changes in middle-age adults. Independent of age, the transitional task parameters changed with the increasing difficulty of the tasks.
An Investigation into the Cause of Road Failure Along Sagamu-Papalanto Highway Southwestern Nigeria
Authors: UBIDO OYEM EMMANUEL , Ogbonnaya Igwe , Ukah Bernadette Uche
Published: January 2021

Investigation into the cause of road failure has been carried out along a 60km long Sagamu –Papalanto highway southwestern Nigeria. Geochemical, mineralogical, geotechnical and geophysical analyses were conducted to evaluate the cause of failure along the study area. The results of the laboratory tests showed that the percentage amount of fines ranges from 12-61.3%, natural moisture content from 6.8 to 19.7%, liquid limit in the range of 25.1-52.2%, linear shrinkage between 3.96 to 12.71%, plastic limit ranges from 18.2-35%, plasticity index ranges from 5.2 to 24.6%, free swell in the range from 5.17 – 43.9%, maximum dry density ranges from 1.51 -1.74g /cm3, specific gravity ranges from 2.52-2.64 and CBR between 3-12%. The Cone Penetrometer Test (CPT) shows a resistance value of 20-138 kgf/cm2. The major clay mineral that is predominant in the studied soil is kaolinite. The major oxides present are SiO2, Al2O3, Fe2O3, K2O, Na2O, MgO and CaO. The result of the 2D Electrical Resistivity Imaging revealed a low resistivity values for profile 2 and 3 ranging from 100 Ωm – 300 Ωm, between a distance of 20m – 240 m along the profile to a depth of 7.60m and a low resistivity value ranging from 50 Ωm – 111Ωm, between a distance of 80 m –120 m along the profile to a depth of 15m. It was concluded that the low CBR, low MDD and the class of subsoils namely A-26, A-7, A-2-7 (clayey soils) which were identified are responsible for the cause of failure experienced in the study area. These makes the soils unsuitable as road construction materials and hence, there is need for stabilization during the reconstruction and rehabilitation of the road.
Rapid water parcel transport across the Kuroshio Extension in the lower thermocline from dissolved oxygen measurements by Seaglider
Authors: Hosoda Shigeki , Inoue Ryuichiro , Nonaka Masami , Sasaki Hideharu , Sasai Yoshikazu , Hirano Mizue
Published: January 2021

Small water parcels, which are characterized by a low salinity and high dissolved oxygen (DO) are observed by Seaglider in the main thermocline (26.0–27.0 sq) south of the Kuroshio Extension (KE), have horizontal and vertical scales of a few ten kilometers and a few ten meters, respectively. Water mass analyses revealed larger negative salinity anomalies (<−0.05) and positive DO anomalies (>15 μmol kg−1) than those of the surrounding water. The characteristics are similar to those of water mass with low salinity and high DO in the subpolar Northwestern Pacific Ocean. Additionally, higher DO anomaly water parcels appear in the upper layer (<26.7 σθ) while low salinity parcels appear in the lower layer (>26.7 sq). Oxygen consumption rates from the apparent oxygen utility suggest that the small water parcels consume less oxygen than the surrounding water, implying that they migrate in a shorter time across the KE after subduction and their characteristics may reflect the sea surface temperature, salinity, and DO in the subduction region. Similar small water parcels represented by high-resolution numerical simulations indicate that they pass through the KE in one month. The simulations support the oxygen consumption rate from the Seaglider observations. The existence of a fast process for water mass migration via meso- and submesoscale subduction processes across the KE affects the amount, subduction, and exchange process of water mass. Our study indicates a small water mass contributes to the exchange process across the KE rapidly, which had not been identified in previous studies. Consequently, detailed observations using multiple Seagliders should capture detailed spatial and temporal variability of the water mass exchange process.
An ADePT evaluation for incorporating the TIPPS periodontal health intervention into primary care ante-natal programmes to enhance infant birthweight in Palestine: a feasibility study.
Authors: Abuhaloob Lamis , Helles Nahla , Mossey Peter , Freeman Ruth
Published: January 2021

Background: A feasibility study was conducted to implement the T alk, I nstruct, P ractice, P lan and S upport (TIPPS) intervention for pregnant women to enhance infant birthweight in a conflict area in L ow and M iddle I ncome C ountries ( LMIC). The decision tool, A process for De cision-making after P ilot and feasibility T rials (ADePT) examines the methodological factors identified in a feasibility study, that may require modification for a full trial. Objectives: To use the ADePT decision tool to evaluate if the feasibility study had achieved its objectives and to identify the need for intervention, clinical context and trial design modification. Basic research design: Feasibility study: a one-arm, pre-test-post-test design. The ADePT framework was applied to evaluate the findings from the feasibility study. Clinical setting: Primary healthcare clinic located in Gaza City, Palestine. Participants: 25 pregnant women in their first trimester and clinic staff. Interventions: The TIPPS periodontal health intervention delivered by ante-natal nurses. Main outcome measures: ADePT checklist: sample size estimation, recruitment, consent, intervention adherence, intervention acceptability, costs and duration, completion and appropriateness of outcome assessments, retention, logistics and synergy between protocol components. Results: 25 pregnant women (aged 16-35 years old) attended the baseline and 22 (88%) completed the second follow-up appointment. This intervention significantly reduced (P<0.001) the mean percentage of plaque and bleeding scores from the baseline to Time 2. The participants stated the value of the intervention. The clinic staff voiced concerns regarding time and the cost of nurses providing the TIPPS intervention. This allowed suggestions to be made regarding the modification of trial design and context of implementation. Conclusions: The ADePT evaluation showed it was possible to progress to full trial with modifications in the trial design.