bluuebunny/crossref_metadata_2025 huggingface dataset:
Learner spoken output and teacher response in second versus foreign language classrooms
Authors: Vold Eva Thue
Published: January 2022

It is commonly agreed that learner target language output and spoken interaction are essential to communicative language learning. This video-based classroom observation study of five lower secondary schools in Norway investigated how second language (L2) English and third language (L3) French teachers responded to their students when they spoke the target language in class. Using categories and functions from classroom interaction research and corrective feedback research, L2 English and L3 French teachers’ response patterns to learner target language output were identified and compared. Findings indicated that L2 English teachers taught in a meaning- and fluency-oriented context, frequently ignoring errors and providing ample content-related responses, while L3 French teachers taught in a form-and-accuracy context, using varied strategies to correct errors and rarely engaging with the content of the learners’ utterances. The article discusses some consequences of this lack of context shifts within subjects and recommends an increased focus on contextual differences to facilitate mutual transfer of successful practices between contexts.
Emotional availability in dyads of nursing aide - resident with dementia: Old tool, new perspective
Authors: Cohen Liora , Sher-Censor Efrat , Oppenheim David , Dassa Ayelet , Ayalon Liat , Palgi Yuval
Published: January 2022

Objectives

This study examined the emotional availability of nursing aide-resident with dementia dyads in a long-term care-facility. Emotional availability refers to the nursing aide’s sensitivity toward the resident, structuring their interactions in a non-intrusive and non-hostile manner and the resident’s responsiveness to and involvement of the nursing aide. The study evaluated the reciprocity in the emotional availability of nursing aides and the residents and examined whether emotional availability varies with the level of difficulty of taking care of the residents and with the context of the interaction.

Method

The study was conducted in three wards in one long-term care-facility. Twenty nursing aides and 40 residents took part in the study. Each nursing aide was videotaped during feeding, structured and unstructured interactions, with two residents, one that was nominated by the head nurse as difficult to take care of and one that was nominated as easy to take care of. The interactions were coded using the emotional availability scales.

Results

Linear mixed-effect model analyses indicated that higher emotional availability of nursing aides was related to higher emotional availability of the residents. Nursing aides’ emotional availability did not vary between “difficult” and “easy” residents or across the three interaction contexts. “Difficult” residents involved their nursing aides less than “easy” residents.

Discussion

The study documented the reciprocal nature of the interaction between nursing aides and residents with dementia. It suggests that nursing aides have an important role in promoting residents’ responsiveness and involvement.
A Complex Intervention for Alcohol Misuse Among Conflict-Affected Populations in Uganda and Ukraine: Study Protocol for the Qualitative Components in the CHANGE Trial
Authors: Massazza Alessandro , Fuhr Daniela C. , Bogdanov Sergiy , Tol Wietse A. , Roberts Bayard , Nadkarni Abhijit , Akudrabo Geoffrey , Skovgaard Andersen Lena , Dumchev Kostyantyn , Karachevskyy Andriy , Kinyanda Eugene , Koss Kateryna , Moore Quincy , May Carl R.
Published: January 2022

Qualitative research is increasingly being integrated within the development and evaluation phases of trials of complex health interventions. Qualitative research can complement effectiveness data and provide insights around how context and implementation impact the results of the trial and to what extent interventions fit implementation contexts after evaluation. Several qualitative studies have been conducted at different stages of trials of mental health and psychosocial support interventions for populations affected by adversity such as armed conflict and disasters. However, these qualitative components are usually implemented as disjointed components within the trial. The current protocol aims to provide a shared framework detailing the qualitative components of the CHANGE project trial: a program of work to address alcohol misuse and associated mental health comorbidities among conflict-affected populations in Uganda and Ukraine. In particular, the objectives of the current protocol are (i) to identify the specific qualitative questions and methods that will be undertaken in CHANGE; (ii) characterize the different methodological approaches to analyzing the data; and (iii) explain how each qualitative component within the different work-packages will cumulatively add value to each other over the duration of the CHANGE project. The current protocol will represent a useful template for the integration of serial qualitative research components within complex health interventions in humanitarian settings. Each qualitative components described will undergo formal ethics approval by ethics boards in the United Kingdom, Uganda, and Ukraine. Multiple mechanisms will be in place to ensure rigor and trustworthiness of the research by meeting the criteria of credibility, transferability, dependability, and confirmability.
The Association of Blood Biomarkers and Body Mass Index in Knee Osteoarthritis: A Cross-Sectional Study
Authors: Schadler Paul , Lohberger Birgit , Thauerer Bettina , Faschingbauer Martin , Kullich Werner , Stradner Martin Helmut , Leithner Andreas , Ritschl Valentin , Omara Maisa , Steinecker-Frohnwieser Bibiane
Published: January 2022

Objective

Despite massive efforts, there are no diagnostic blood biomarkers for knee osteoarthritis (KOA). This study investigated several candidate diagnostic biomarkers and the metabolic phenotype in end-stage KOA in the context of obesity.

Design

In this cross-sectional study, adult patients undergoing knee arthroplasty were enrolled and KOA severity was assessed using the Lequesne index. Blood biomarkers with an important role in obesity, the metabolic syndrome, or KOA (oxidized form of low-density lipoprotein [oxLDL], advanced glycation end product [AGE], soluble AGE receptor [sRAGE], fatty acid binding protein 4 [FABP4], phospholipase A2 group IIA [PLA2G2A], fibroblast growth factor 23 [FGF-23], ghrelin, leptin, and resistin) were measured using enzyme-linked immunosorbent assay (ELISA; n = 70) or Luminex technique (subgroup of n = 35). H1-NMR spectroscopy was used for the quantification of metabolite levels (subgroup of n = 31). The hip-knee-ankle angle was assessed. Multivariable and multivariate regression analysis was used to examine the relationship of biomarkers with body mass index (BMI) and KOA severity in complete case and multiple imputation analysis.

Results

While most of the investigated biomarkers were not associated with KOA severity, FABP4 and leptin were found to correlate with BMI and gender. Resistin was associated with Lequesne index in complete case analysis. Using a targeted metabolomics approach, BMI-dependent changes in the metabolome were hardly visible.

Conclusions

Our findings confirm studies on FABP4, leptin, and resistin with regard to obesity and the metabolic syndrome. There was no association of the investigated biomarkers with KOA severity, most likely due to the patient selection (end-stage KOA patients). Based on this absence of BMI-dependent changes in the metabolome, we might assume that BMI is not correlated with KOA severity in this specific patient group.
Exploring Foot Care Conditions for People Experiencing Homelessness: A Community Participatory Approach
Authors: D’Souza Melba Sheila , O’Mahony Joyce , Achoba Alfred
Published: January 2022

Introduction:

People experiencing homelessness are faced with complex challenges and are at high risk of illness due to inequities and disparities in access to health care services.

Objective:

To explore the health and foot care problems related to people experiencing homelessness in British Columbia.

Methods:

A community participatory research approach was used with a sample of 65 people experiencing homelessness. Data were collected using a survey questionnaire and face-to-face semistructured interviews.

Results:

Thematic findings shows risk of foot injuries, lack of foot care resources, and absence of family support. Barriers to equitable access to services for most participants experiencing homelessness were lack of housing (76.92%), inability to work (72.31%), and inability to afford the cost of living on their own (63.08%).

Conclusions:

There is a pressing need for early screening and detection by health care professionals and enhanced foot care services to reduce foot problems and improve foot care wellness of homeless people. Addressing foot-related care are necessary steps in promoting health, preventing illness, and improving access to health services among people experiencing homelessness.
Immunometabolism in biofilm infection: lessons from cancer
Authors: Mirzaei Rasoul , Sabokroo Niloofar , Ahmadyousefi Yaghoub , Motamedi Hamid , Karampoor Sajad
Published: January 2022

Background

Biofilm is a community of bacteria embedded in an extracellular matrix, which can colonize different human cells and tissues and subvert the host immune reactions by preventing immune detection and polarizing the immune reactions towards an anti-inflammatory state, promoting the persistence of biofilm-embedded bacteria in the host.

Main body of the manuscript

It is now well established that the function of immune cells is ultimately mediated by cellular metabolism. The immune cells are stimulated to regulate their immune functions upon sensing danger signals. Recent studies have determined that immune cells often display distinct metabolic alterations that impair their immune responses when triggered. Such metabolic reprogramming and its physiological implications are well established in cancer situations. In bacterial infections, immuno-metabolic evaluations have primarily focused on macrophages and neutrophils in the planktonic growth mode.

Conclusion

Based on differences in inflammatory reactions of macrophages and neutrophils in planktonic- versus biofilm-associated bacterial infections, studies must also consider the metabolic functions of immune cells against biofilm infections. The profound characterization of the metabolic and immune cell reactions could offer exciting novel targets for antibiofilm therapy.
Eriodictyol ameliorates cognitive dysfunction in APP/PS1 mice by inhibiting ferroptosis via vitamin D receptor-mediated Nrf2 activation
Authors: Li Lin , Li Wen-Jun , Zheng Xiang-Ru , Liu Qing-Long , Du Qian , Lai Yu-Jie , Liu Song-Qing
Published: January 2022

Background

Alzheimer’s disease (AD) is the most common type of neurodegenerative disease in the contemporary era, and it is still clinically incurable. Eriodictyol, a natural flavonoid compound that is mainly present in citrus fruits and some Chinese herbal medicines, has been reported to exert anti-inflammatory, antioxidant, anticancer and neuroprotective effects. However, few studies have examined the anti-AD effect and molecular mechanism of eriodictyol.

Methods

APP/PS1 mice were treated with eriodictyol and the cognitive function of mice was assessed using behavioral tests. The level of amyloid-β (Aβ) aggregation and hyperphosphorylation of Tau in the mouse brain were detected by preforming a histological analysis and Western blotting. HT-22 cells induced by amyloid-β peptide (1–42) (Aβ1–42) oligomers were treated with eriodictyol, after which cell viability was determined and the production of p-Tau was tested using Western blotting. Then, the characteristics of ferroptosis, including iron aggregation, lipid peroxidation and the expression of glutathione peroxidase type 4 (GPX4), were determined both in vivo and in vitro using Fe straining, Western blotting and qPCR assays. Additionally, the expression level of vitamin D receptor (VDR) and the nuclear factor erythroid 2-related factor 2/heme oxygenase-1 (Nrf2/HO-1) signaling pathway were tested using Western blotting and qPCR assays. Afterward, HT-22 cells with VDR knockout were used to explore the potential mechanisms, and the relationship between VDR and Nrf2 was further assessed by performing a coimmunoprecipitation assay and bioinformatics analysis.

Results

Eriodictyol obviously ameliorated cognitive deficits in APP/PS1 mice, and suppressed Aβ aggregation and Tau phosphorylation in the brains of APP/PS1 mice. Moreover, eriodictyol inhibited Tau hyperphosphorylation and neurotoxicity in HT-22 cells induced by Aβ1–42 oligomer. Furthermore, eriodictyol exerted an antiferroptosis effect both in vivo and in vitro, and its mechanism may be associated with the activation of the Nrf2/HO-1 signaling pathway. Additionally, further experiments explained that the activation of Nrf2/HO-1 signaling pathway by eriodictyol treatment mediated by VDR.

Conclusions

Eriodictyol alleviated memory impairment and AD-like pathological changes by activating the Nrf2/HO-1 signaling pathway through a mechanism mediated by VDR, which provides a new possibility for the treatment of AD.
Cranial autonomic symptoms: prevalence, phenotype and laterality in migraine and two potentially new symptoms
Authors: Karsan Nazia , Nagaraj Karthik , Goadsby Peter J.
Published: January 2022

Background

Whilst cranial autonomic symptoms (CAS) are typically associated with trigeminal autonomic cephalalgias (TAC’s), they have also been reported in migraine. Identification and understanding of these symptoms in migraine is important to ensure timely diagnosis and effective management.

Methods

Migraineurs seen in a tertiary headache service between 2014 and 2018 (n = 340): cohort one, and a separate cohort of headache patients seen between 2014-May 2021 reporting voice change, or throat swelling, or both, as CAS were selected (n = 64): cohort two. We performed a service evaluation of our records regarding age, sex, diagnosis, headache and CAS frequency and laterality as acquired from the first consultation, during which a detailed headache history is taken by a headache trained physician.

Results

Cohort 1: Mean age 43 (range 14–94, SD 15). The most common diagnosis was chronic migraine (78%). Median monthly headache frequency was 26 days (IQR 15–75). At least one CAS was reported in 74%, with a median of two (IQR 0–3). The most common were nasal congestion (32%), lacrimation (31%) and aural fullness (25%). Most patients reported their most common headache as unilateral (80%) and with it strictly unilateral CAS (64%). There was a positive association between headache and CAS laterality (χ21 = 20.7, P < 0.001), with a positive correlation between baseline headache frequency and number of CAS reported (r = 0.11, P = 0.047). Cohort two: mean age 49 (range 23–83, SD 14). Diagnoses were chronic migraine (50%), chronic cluster headache (11%), undifferentiated continuous lateralised headache (9%), SUNCT/SUNA (8%), hemicrania continua (8%), episodic migraine (8%), episodic cluster headache (3%) and trigeminal neuropathies (3%). Most (89%) described trigeminal distribution pain; 25% involving all three divisions. Throat swelling was reported by 54, voice change by 17, and both by 7. The most common CAS reported were lacrimation (n = 47), facial swelling (n = 45) and rhinorrhoea (n = 37). There was significant agreement between the co-reporting of throat swelling (χ21 = 7.59, P = 0.013) and voice change (χ21 = 6.49, P = 0.02) with aural fullness.

Conclusions

CAS are common in migraine, are associated with increasing headache frequency and tend to lateralise with headache. Voice change and throat swelling should be recognized as possible parasympathetically-mediated CAS. They may be co-associated and associated with aural fullness, suggesting a broadly somatotopic endophenotype.
Raman spectroscopy biochemical characterisation of bladder cancer cisplatin resistance regulated by FDFT1: a review
Authors: Kanmalar M. , Abdul Sani Siti Fairus , Kamri Nur Izzahtul Nabilla B. , Said Nur Akmarina B. M. , Jamil Amirah Hajirah B. A. , Kuppusamy S. , Mun K. S. , Bradley D. A.
Published: January 2022

Bladder cancer is the fourth most common malignancy in males. It can present across the whole continuum of severity, from mild through well-differentiated disease to extremely malignant tumours with poor survival rates. As with other vital organ malignancies, proper clinical management involves accurate diagnosis and staging. Chemotherapy consisting of a cisplatin-based regimen is the mainstay in the management of muscle-invasive bladder cancers. Control via cisplatin-based chemotherapy is threatened by the development of chemoresistance. Intracellular cholesterol biosynthesis in bladder cancer cells is considered a contributory factor in determining the chemotherapy response. Farnesyl-diphosphate farnesyltransferase 1 (FDFT1), one of the main regulatory components in cholesterol biosynthesis, may play a role in determining sensitivity towards chemotherapy compounds in bladder cancer. FDFT1-associated molecular identification might serve as an alternative or appendage strategy for early prediction of potentially chemoresistant muscle-invasive bladder cancer tissues. This can be accomplished using Raman spectroscopy. Developments in the instrumentation have led to it becoming one of the most convenient forms of analysis, and there is a highly realistic chance that it will become an effective tool in the pathology lab. Chemosensitive bladder cancer tissues tend to have a higher lipid content, more protein genes and more cholesterol metabolites. These are believed to be associated with resistance towards bladder cancer chemotherapy. Herein, Raman peak assignments have been tabulated as an aid to indicating metabolic changes in bladder cancer tissues that are potentially correlated with FDFT1 expression.
Differences in caecal microbiota composition and Salmonella carriage between experimentally infected inbred lines of chickens
Authors: Cazals Anaïs , Estellé Jordi , Bruneau Nicolas , Coville Jean-Luc , Menanteau Pierrette , Rossignol Marie-Noëlle , Jardet Deborah , Bevilacqua Claudia , Rau Andrea , Bed’Hom Bertrand , Velge Philippe , Calenge Fanny
Published: January 2022

Background

Salmonella Enteritidis (SE) is one of the major causes of human foodborne intoxication resulting from consumption of contaminated poultry products. Genetic selection of animals that are more resistant to Salmonella carriage and modulation of the gut microbiota are two promising ways to decrease individual Salmonella carriage. The aims of this study were to identify the main genetic and microbial factors that control the level of Salmonella carriage in chickens (Gallus gallus) under controlled experimental conditions. Two-hundred and forty animals from the White Leghorn inbred lines N and 61 were infected by SE at 7 days of age. After infection, animals were kept in isolators to reduce recontamination of birds by Salmonella. Caecal contents were sampled at 12 days post-infection and used for DNA extraction. Microbiota DNA was used to measure individual counts of SE by digital PCR and to determine the bacterial taxonomic composition, using a 16S rRNA gene high-throughput sequencing approach.

Results

Our results confirmed that the N line is more resistant to Salmonella carriage than the 61 line, and that intra-line variability is higher for the 61 line. Furthermore, the 16S analysis showed strong significant differences in microbiota taxonomic composition between the two lines. Among the 617 operational taxonomic units (OTU) observed, more than 390 were differentially abundant between the two lines. Furthermore, within the 61 line, we found a difference in the microbiota taxonomic composition between the high and low Salmonella carriers, with 39 differentially abundant OTU. Using metagenome functional prediction based on 16S data, several metabolic pathways that are potentially associated to microbiota taxonomic differences (e.g. short chain fatty acids pathways) were identified between high and low carriers.

Conclusions

Overall, our findings demonstrate that the caecal microbiota composition differs between genetic lines of chickens. This could be one of the reasons why the investigated lines differed in Salmonella carriage levels under experimental infection conditions.
Different paradigms of transcranial electrical stimulation improve motor function impairment and striatum tissue injuries in the collagenase-induced intracerebral hemorrhage rat model
Authors: Heidarzadegan Amir Reza , Zarifkar Asadollah , Sotoudeh Narges , Namavar Mohammad Reza , Zarifkar Amir Hossein
Published: January 2022

Background

In the horizon of therapeutic restrictions in intracerebral hemorrhage (ICH), recently, non-invasive transcranial electrical stimulation (tES) has achieved considerable prosperities. Translational studies have postulated that transcranial direct current stimulation (tDCS) and the other types of tES remain potentially a novel therapeutic option to reverse or stabilize cognitive and motor impairments.

Objective

The aim of this study was to comparatively evaluate the effects of the four main paradigms of tES, including tDCS, transcranial alternating (tACS), pulsed (tPCS), and random noise (tRNS) stimulations on collagenase-induced sensorimotor impairments and striatum tissue damage in male rats.

Methods

To induce ICH, 0.5 μl of collagenase was injected into the right striatum of male Sprague Dawley rats. One day after surgery, tES, was applied to the animals for seven consecutive days. Motor functions were appraised by neurological deficit score, rotarod, and wire hanging tests on the day before surgery and postoperative days 3, 7, and 14. After behavioral tests, brain tissue was prepared appropriately to perform the stereological evaluations.

Results

The results indicated that the application of the four tES paradigms (tDCS, tACS, tRNS, and tPCS) significantly reversed motor disorders in collagenase-induced ICH groups. Further, the motor function improvement of tACS and tRNS receiving rats in wire-hanging and rotarod tests were higher than the other two tES receiving groups. Structural changes and stereological assessments also confirmed the results of behavioral functions.

Conclusion

Our findings suggest that in addition to tDCS application in the treatment of ICH, other tES paradigms, especially tACS and tRNS may be considered as add-on therapeutic strategies in stroke.
Clinical characteristics and outcome in patients with ST-segment and non-ST-segment elevation myocardial infarction without obstructive coronary artery: an observation study from Chinese population
Authors: Li Menghuan , He Yuan , Cheang Iokfai , Zhang Zhiyong , Liu Yang , Wang Hui , Kong Xiangqing
Published: January 2022

Background

The disparity between ST-segment and non-ST-segment elevation myocardial infarction without obstructive coronary artery (STE-MINOCA and NSTE-MINOCA) are unclear. Our study aims to compare the clinical features and outcomes in patients with STE-MINOCA and NSTE-MINOCA.

Methods

This cross-sectional study consecutively enrolled patients diagnosed with acute myocardial infarction (AMI) from January 2013 to January 2020. MINOCA were identified as angiographic stenosis < 50%. Clinical characteristics, angiographic features, and clinical outcomes of STE-MINOCA and NSTE-MINCOA were documented. The primary endpoint was composite events in the different time periods.

Results

A total of 1966 AMI patients were screened, 107 (5.4%) were diagnosed as MINOCA. Among, there were 34 (31.8%) of STE-MINOCA and 73 (68.2%) of NSTE-MINOCA. STE-MINOCA group were younger, had lower N-terminal pro-brain natriuretic peptide (NT-proBNP), and smaller left atrial diameter (P < 0.05). Dual antiplatelet therapy (DAPT) was more likely to be prescribed to STE-MINOCA patients (P = 0.015). During median follow-up time of 24.5 months, STE-MINOCA group also demonstrated lower risks for primary endpoint and cardiovascular-related (CVS) rehospitalization. In univariate Cox regression analyses, NSTE-MINOCA showed an increased risk of long-term primary endpoint (HR 2.57, 95 CI%: 1.10–6.02) and CVS-related rehospitalization (HR 3.14, 95% CI: 1.16–8.48). After adjusting for NT-proBNP and DAPT, NSTE-MINOCA remained an independent risk factor for CVS-related rehospitalization in long-term follow-up (HR 2.78, 95% CI: 1.03–7.49).

Conclusion

Although STE-MINOCA and NSTE-MINOCA patients showed similar clinical characteristics, NSTE-MINOCA group presented a worse long-term outcome mainly driven by CVS-related hospitalization which suggested that NSTE-MINOCA patients might also require prompt medical attention.
Successful percutaneous left atrial appendage occlusion for atrial fibrillation in a patient with mirror-image dextrocardia: a case report
Authors: Xu Jizhe , Jiang Gaxue , Zhang Lu , Chen Zixian , Wang Hao , Bai Ming , Zeng Jie
Published: January 2022

Background

Dextrocardia is a rare congenital condition (1/10,000–12,000) and AF is uncommon (1–2%). Therefore, the occurrence of the two conditions is rare. Percutaneous left atrial appendage occlusion (LAAO) is a treatment to prevent atrial fibrillation (AF)-associated thromboembolic events.

Case presentation

An 85-year-old female with known situs inversus totalis, persistent AF, and stroke was treated with oral anticoagulation, but she was suffering from constant gingival bleeding. Her CHA2DS2VASc score was 6 points (abnormal, ≥ 2), and her HAS-BLED score was 4 points (abnormal, ≥ 3). The transthoracic echocardiography (TTE) demonstrated left atrial (LA) enlargement (46 mm) and 50% of ejection fraction. She underwent percutaneous LAAO for stroke recurrence prevention using a Watchman occluder. The operation was successful but with technical differences compared with a standard case because of the dextrocardia.

Conclusion

This is the first reported case of a percutaneous LAAO in situs inversus dextrocardia. This case indicates the feasibility of LAAO in congenital cardiac malposition combined with AF.
Preventing COVID-19 outbreaks through surveillance testing in healthcare facilities: a modelling study
Authors: Litwin Tim , Timmer Jens , Berger Mathias , Wahl-Kordon Andreas , Müller Matthias J. , Kreutz Clemens
Published: January 2022

Background

Surveillance testing within healthcare facilities provides an opportunity to prevent severe outbreaks of coronavirus disease 2019 (COVID-19). However, the quantitative impact of different available surveillance strategies and their potential to decrease the frequency of outbreaks are not well-understood.

Methods

We establish an individual-based model representative of a mental health hospital yielding generalizable results. Attributes and features of this facility were derived from a prototypical hospital, which provides psychiatric, psychosomatic and psychotherapeutic treatment. We estimate the relative reduction of outbreak probability for three test strategies (entry test, once-weekly test and twice-weekly test) relative to a symptom-based baseline strategy. Based on our findings, we propose determinants of successful surveillance measures.

Results

Entry Testing reduced the outbreak probability by 26%, additionally testing once or twice weekly reduced the outbreak probability by 49% or 67% respectively. We found that fast diagnostic test results and adequate compliance of the clinic population are mandatory for conducting effective surveillance. The robustness of these results towards uncertainties is demonstrated via comprehensive sensitivity analyses.

Conclusions

We conclude that active testing in mental health hospitals and similar facilities considerably reduces the number of COVID-19 outbreaks compared to symptom-based surveillance only.
Decision tree model predicts live birth after surgery for moderate-to-severe intrauterine adhesions
Authors: Zhu Ru , Duan Hua , Xu Wenbin , Wang Sha , Gan Lu , Xu Qian , Li Jinjiao
Published: January 2022

Background

After treatment of intrauterine adhesions, the rate of re-adhesion is high and the pregnancy outcome unpredictable and unsatisfactory. This study established and verified a decision tree predictive model of live birth in patients after surgery for moderate-to-severe intrauterine adhesions (IUAs).

Methods

A retrospective observational study initially comprised 394 patients with moderate-to-severe IUAs diagnosed via hysteroscopy. The patients underwent hysteroscopic adhesiolysis from January 2013 to January 2017, in a university-affiliated hospital. Follow-ups to determine the rate of live birth were conducted by telephone for at least the first postoperative year. A classification and regression tree algorithm was applied to establish a decision tree model of live birth after surgery.

Results

Within the final population of 374 patients, the total live birth rate after treatment was 29.7%. The accuracy of the model was 83.8%, and the area under the receiver operating characteristic curve (AUC) was 0.870 (95% CI 7.699–0.989). The root node variable was postoperative menstrual pattern. The predictive accuracy of the multivariate logistic regression model was 70.3%, and the AUC was 0.835 (95% CI 0.667–0.962).

Conclusions

The decision tree predictive model is useful for predicting live birth after surgery for IUAs; postoperative menstrual pattern is a key factor in the model. This model will help clinicians make appropriate clinical decisions during patient consultations.
Gut microbiome profiles in Thai healthy pregnant women and its association with types of foods
Authors: Phoonlapdacha P. , Tangshewinsirikul C. , Phosuwattanakul J. , Kittisakmontri K. , Nitisinprasert S. , Nakayama J. , Prombutara P. , Suthutvoravut U. , Chongviriyaphan N.
Published: January 2022

Background

Gut microbiome colonization during early life is significant for immunological and physiological development. Maternal microbiome is associated with proper development of infants. The aim of this study was to determine the gut microbiome profiles among Thai healthy pregnant women and its associated factors.

Methods

A multicenter, open trial prospective study was performed at three hospitals in Northern, Central, and Northeastern regions of Thailand. Thai healthy pregnant women attending antenatal clinics were recruited. Fecal samples of subjects at the third trimester of pregnancy were collected with sterilized techniques. The gut microbiome profiles and bacterial diversity were assessed using 16Ss RNA gene sequencing. Demographic data, dietary intake, and anthropometric data were recorded and analyzed.

Results

There were 86 healthy pregnant women. The dominant of gut microbiome profiles were Bacteroidetes and Firmicutes. Pregnant women in the Central region had significantly higher of Ruminococcaceae and Lachnospiraceae than those in other regions (p < 0.001). Pregnant women in the Northern region significantly consumed more glutinous rice than those in other regions (p < 0.001). Glutinous rice intake was positively correlated with Bacteroidetes (rho = 0.405, p = 0.01) and negatively correlated with Firmicutes (rho = − 0.440, p = 0.001). Alpha diversity was not correlated with pre-pregnancy body mass index (BMI) or gestational weight gain.

Conclusions

The gut microbiome profiles mainly found in Thai healthy pregnant women were Bacteroidetes and Firmicutes. The gut microbiome profiles in pregnant women found in this study possibly depended on dietary patterns. Glutinous rice with high amylopectin is probably related to abundance of Bacteroidetes.
The experience of women with recent gestational diabetes during the COVID-19 lockdown: a qualitative study from Denmark
Authors: Jensen Nanna Husted , Nielsen Karoline Kragelund , Dahl-Petersen Inger Katrine , Maindal Helle Terkildsen
Published: January 2022

Background

Following COVID-19 and the lockdowns, maternity care and support for women after delivery have been temporary restructured. Studies show that COVID-19 adversely impacts pregnant and peripartum women in the general population, but experiences among women in the first year after delivery/in the wider postpartum period remain unexplored. Moreover, experiences among women with recent gestational diabetes mellitus (GDM) are lacking; though it is a group with a potential high need for support after delivery. The aim of our study was to investigate (i) how women with recent GDM experienced COVID-19 and the first lockdown in Denmark, and (ii) the women’s risk perception and health literacy in terms of interaction with the healthcare system in relation to COVID-19.

Methods

We performed a qualitative study among 11 women with recent GDM (infants aged 2-11 months old). Semi-structured interviews were conducted in April-May 2020 by telephone or Skype for Business, when Denmark was under lockdown. We analysed data using a thematic qualitative content analysis.

Results

Three themes emerged: i) Everyday life and family well-being, ii) Worries about COVID-19 and iii) Health literacy: Health information and access to healthcare. The women were generally not worried about their own or their infant’s risk of COVID-19. The lockdown had a negative impact on everyday life e.g. routines, loneliness, breastfeeding uncertainties and worries for the infant’s social well-being; but better family dynamics were also described. It was challenging to maintain healthy behaviours and thus the women described worries for the risk of type 2 diabetes and GDM in subsequent pregnancies. The women missed peer support and face-to-face visits from health visitors and found it difficult to navigate the restructured care with online/telephone set-ups.

Conclusions

COVID-19 and the lockdown affected everyday life among women with recent GDM both positively and negatively. Our findings suggest a need for care that are responsive to psychological and social aspects of health throughout the COVID-19 pandemic and support to limit worries about adaptation to motherhood and the infant’s social well-being. Communication focusing on the importance and relevance of contacting healthcare providers should also be strengthened.
Amisulpride withdrawal akathisia responding to aripiprazole with propranolol in first-onset psychosis: a case report
Authors: Yang Hae-Jung , Kim Seung-Gon , Seo Eun Hyun , Yoon Hyung-Jun
Published: January 2022

Background

Akathisia tends to develop as an early complication of antipsychotic treatment in a dose-dependent manner. Although withdrawal akathisia has been reported after the discontinuation or dose reduction of typical antipsychotic drugs, akathisia following atypical antipsychotic drug withdrawal remains a rare phenomenon.

Case presentation

A 24-year-old woman with an acute psychotic episode was admitted and initially treated with aripiprazole. The aripiprazole dose was titrated up to 30 mg/day over 9 days and maintained for the next 3 days; however, her psychotic symptoms persisted without change. She was switched to amisulpride, with the dose increased over 2 weeks to 1000 mg/day. Subsequently, although the patient’s psychotic episode subsided, her serum prolactin levels increased markedly. After discharge, the amisulpride dose was increased to 1200 mg/day owing to auditory hallucinations and was maintained with quetiapine (100–200 mg/day) and benztropine (1 mg/day) for 13 weeks. Given the potential for hyperprolactinemia as a side effect, the amisulpride dose was reduced to 800 mg/day concurrently with the discontinuation of benztropine; however, these changes resulted in severe restlessness without other extrapyramidal symptoms. The withdrawal akathisia disappeared over 2 weeks after switching to aripiprazole (10 mg/day) with propranolol (40 mg/day) and the patient’s prolactin levels had normalized after 6 months of aripiprazole monotherapy.

Conclusions

The present case highlights the potential for the development of withdrawal akathisia when the dose of amisulpride is tapered abruptly. Thus, a slow tapering and careful monitoring are recommended when switching from amisulpride to other antipsychotic drugs. Furthermore, this case suggests that changing the regimen to aripiprazole with propranolol may be a potential option for amisulpride withdrawal akathisia superimposed on pre-existing hyperprolactinemia.
Operational challenges of engaging development partners in district health planning in Tanzania
Authors: Kiologwe James C. , Kusirye Ukio , Hoffman Axel , Kalolo Albino
Published: January 2022

Background

Development Assistance for Health (DAH) represents an important source of health financing in many low and middle-income countries. However, there are few accounts on how priorities funded through DAH are integrated with district health priorities. This study is aimed at understanding the operational challenges of engaging development partners in district health planning in Tanzania.

Methods

This explanatory mixed-methods study was conducted in Kinondoni and Bahi districts, representing urban and rural settings of the country. Data collection took place between November and December 2015. The quantitative tools (mapping checklist, district questionnaire and Development partners (DPs) questionnaire) mapped the DPs and their activities and gauged the strength of DP engagement in district health planning. The qualitative tool, a semi-structured in-depth interview guide administered to 20 key informants (the council health planning team members and the development partners) explained the barriers and facilitators of engagement. Descriptive and thematic analysis was utilized for quantitative and qualitative data analysis respectively.

Results

Eighty-six per cent (85%) of the development partners delivering aid in the studied districts were Non-Governmental Organizations. Twenty percent (20%) of the interventions were HIV/AIDS interventions. We found that only four (4) representing 25 % (25%) DPs had an MOU with the District Council, 56 % (56%) had submitted their plans in writing to be integrated into the 2014/15 CCHP. Six (6) representing 38 % (38%) respondents had received at least one document (guidelines, policies and other planning tools) from the district for them to use in developing their organization activity plans. Eighty-seven point 5 % (87.5%) from Bahi had partial or substantial participation, in the planning process while sixty-two point 5 % (62.5%) from Kinondoni had not participated at all (zero participation). The operational challenges to engagements included differences in planning cycles between the government and donors, uncertainties in funding from the prime donors, lack of transparency, limited skills of district planning teams, technical practicalities on planning tools and processes, inadequate knowledge on planning guidelines among DPs and, poor donor coordination at the district level.

Conclusions

We found low engagement of Development Partners in planning. To be resolved are operational challenges related to differences in planning cycles, articulations and communication of local priorities, donor coordination, and technical skills on planning and stakeholder engagement.
Burden of malaria, impact of interventions and climate variability in Western Ethiopia: an area with large irrigation based farming
Authors: Haileselassie Werissaw , Parker Daniel M. , Taye Behailu , David Randy E. , Zemene Endalew , Lee Ming-Chieh , Zhong Daibin , Zhou Guofa , Alemu Tesfahun , Tadele Getnet , Kazura James W. , Koepfli Cristian , Deressa Wakgari , Yewhalaw Delenasaw , Yan Guiyun
Published: January 2022

Background

Land use change has increasingly been expanding throughout the world in the past decades. It can have profound effects on the spatial and temporal distribution of vector borne diseases like malaria through ecological and habitat change. Understanding malaria disease occurrence and the impact of prevention interventions under this intense environmental modification is important for effective and efficient malaria control strategy.

Methods

A descriptive ecological study was conducted by reviewing health service records at Abobo district health office. The records were reviewed to extract data on malaria morbidity, mortality, and prevention and control methods. Moreover, Meteorological data were obtained from Gambella region Meteorology Service Center and National Meteorology Authority head office. Univariate, bivariate and multivariate analysis techniques were used to analyze the data.

Results

For the twelve-year time period, the mean annual total malaria case count in the district was 7369.58. The peak monthly malaria incidence was about 57 cases per 1000 people. Only in 2009 and 2015 that zero death due to malaria was recorded over the past 12 years. Fluctuating pattern of impatient malaria cases occurrence was seen over the past twelve years with an average number of 225.5 inpatient cases. The data showed that there is a high burden of malaria in the district. Plasmodium falciparum (Pf) was a predominant parasite species in the district with the maximum percentage of about 90. There was no statistically significant association between season and total malaria case number (F3,8: 1.982, P:0.195). However, the inter-annual total case count difference was statistically significant (F11,132: 36.305, p < 0001). Total malaria case count had shown two months lagged carry on effect. Moreover, 3 months lagged humidity had significant positive effect on total malaria cases. Malaria prevention interventions and meteorological factors showed statistically significant association with total malaria cases.

Conclusion

Malaria was and will remain to be a major public health problem in the area. The social and economic impact of the disease on the local community is clearly pronounced as it is the leading cause of health facility visit and admission including the mortality associated with it. Scale up of effective interventions is quite important. Continuous monitoring of the performance of the vector control tools needs to be done.
Flu-IV score: a predictive tool for assessing the risk of invasive mechanical ventilation in patients with influenza-related pneumonia
Authors: Chen Liang , Han Xiudi , Li YanLi , Zhang Chunxiao , Xing Xiqian
Published: January 2022

Background

The need for invasive mechanical ventilation (IMV) is linked to significant morbidity and mortality in patients with influenza-related pneumonia (Flu-p). We aimed to develop an assessment tool to predict IMV among Flu-p patients within 14 days of admission.

Methods

In total, 1107 Flu-p patients from five teaching hospitals were retrospectively enrolled from January 2012 to December 2019, including 895 patients in the derivation cohort and 212 patients in the validation cohort. The predictive model was established based on independent risk factors for IMV in the Flu-p patients from the derivation cohort.

Results

Overall, 10.6% (117/1107) of patients underwent IMV within 14 days of admission. Multivariate regression analyses revealed that the following factors were associated with IMV: early neuraminidase inhibitor use (− 3 points), lymphocytes < 0.8 × 109/L (1 point), multi-lobar infiltrates (1 point), systemic corticosteroid use (1 point), age ≥ 65 years old (1 points), PaO2/FiO2 < 300 mmHg (2 points), respiratory rate ≥ 30 breaths/min (3 points), and arterial PH < 7.35 (4 points). A total score of five points was used to identify patients at risk of IMV. This model had a sensitivity of 85.5%, a specificity of 88.8%, and exhibited better predictive performance than the ROX index (AUROC = 0.909 vs. 0.594, p = 0.004), modified ROX index (AUROC = 0.909 vs. 0.633, p = 0.012), and HACOR scale (AUROC = 0.909 vs. 0.622, p < 0.001) using the validation cohort.

Conclusions

Flu-IV score is a valuable prediction rule for 14-day IMV rates in Flu-p patients. However, it should be validated in a prospective study before implementation.
Risk factors and management strategies for cerebrospinal fluid leakage following lumbar posterior surgery
Authors: Tang Jin , Lu Qilin , Li Ying , Wu Congjun , Li Xugui , Gan Xuewen , Xie Wei
Published: January 2022

Objective

To analyze the risk factors of cerebrospinal fluid leakage (CSFL) following lumbar posterior surgery and summarize the related management strategies.

Methods

A retrospective analysis was performed on 3179 patients with CSFL strategies lumbar posterior surgery in our hospital from January 2019 to December 2020. There were 807 cases of lumbar disc hemiation (LDH), 1143 cases of lumbar spinal stenosi (LSS), 1122 cases of lumbar spondylolisthesis(LS), 93 cases of lumbar degenerative scoliosis(LDS),14 cases of lumbar spinal benign tumor (LST). Data of gender, age, body mass index(BMI), duration of disease, diabete, smoking history, preoperative epidural steroid injection, number of surgical levels, surgical methods (total laminar decompression, fenestration decompression), revision surgery, drainage tube removal time, suture removal time, and complications were recorded.

Results

The incidence of 115 cases with cerebrospinal fluid leakage, was 3.6% (115/3179).One-way ANOVA showed that gender, body mass index (BMI), smoking history, combined with type 2 diabetes and surgical method had no significant effect on CSFL (P > 0.05). Age, type of disease, duration of disease, preoperative epidural steroid injection, number of surgical levels and revision surgery had effects on CSFL (P < 0.05). Multivariate Logistic regression analysis showed that type of disease, preoperative epidural steroid injection, number of surgical levels and revision surgery were significantly affected CSFL (P < 0.05).Drainage tube removal time of CSFL patients ranged from 7 to 11 days, with an average of 7.1 ± 0.5 days, drainage tube removal time of patients without CSFL was 1–3 days, with an average of 2.0 ± 0.1 days, and there was a statistical difference between the two groups (P < 0.05).The removal time of CSFL patients was 12–14 days, with an average of 13.1 ± 2.7 days, and the removal time of patients without CSFL was 10–14 days, with an average of 12.9 ± 2.2 days, there was no statistically significant difference between the two groups (P > 0.05).

Conclusion

Type of disease, preoperative epidural steroid injection, number of surgical levels and revision surgery were the risk factors for CSFL. Effective prevention were the key to CSFL in lumbar surgery. Once appear, CSFL can also be effectively dealt without obvious adverse reactions after intraoperative effectively repair dural, head down, adequate drainage after operation, the high position, rehydration treatment, and other treatments.
Breast conserving therapy for central breast cancer in the United States
Authors: Liu Jiameng , Zheng Xiaobin , Lin Shunguo , Han Hui , Xu Chunsen
Published: January 2022

Introduction

Although central breast cancer is not a contraindication to breast conserving, most surgeons still choose to perform total mastectomy. The safety of breast conserving treatment for central breast cancer is still unclear. The purpose of this study is to evaluate the long-term survival outcome of central breast cancer.

Materials and methods

Using SEER database to explore the trend of surgical procedures for patients with central breast cancer. The patients were divided into breast conserving group and non-breast conserving group. Multivariate logistic regression was used to evaluate predictors of breast conserving surgery in central breast cancer. The clinicopathological variables were adjusted through the multivariable Cox risk model, and the stage and T stage were stratified to compare survival results.

Results

A total of 8702 patients with central breast cancer underwent surgical treatment from 2010 to 2015. There were 3870 patients in the breast conserving group and 4832 patients in the non-breast conserving group. The breast preservation rate was 44.4%, which rose from 39.9% in 2010 to 51% in 2015. Elderly patients (p < 0.001) and low tumor malignancy were predictors of breast conserving therapy. In the 1:1 matched case–control analysis, breast cancer-specific survival (BCSS) (p < 0.001) and overall survival (OS) (p < 0.001) in breast conserving therapy group were still higher than those of non-breast conserving. In the subgroup analysis of T staging and stage, the breast conserving therapy group still had higher OS and BCSS.

Conclusion

In central breast cancer, breast-conserving therapy is safe and optional.