bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Progressive Muscle Relaxation Exercise on Anxiety among Nursing Students in Pediatric Clinical Training
Authors: Toqan Dalia , Ayed Ahmad , Amoudi Mosab , Alhalaiqa Fadwa , Alfuqaha Othman A. , ALBashtawy Mohammed
Published: March 2022

Introduction

Pediatric nursing students are expected to work hard to help children realize their full potential by giving care, knowing their growth process, and being responsive to their needs. Students should be able to communicate effectively and solve problems. Nurses who care for pediatric patients experience compassion fatigue as well as moderate to severe levels of work-related stress. The purpose of this study was to investigate the effect of progressive muscle relaxation exercise on anxiety among nursing students during pediatric nursing clinical training.

Methods

A quasi-experimental, pre-post study was conducted in the faculty of nursing at the Arab American University/Palestine. The sample of the study consists of 60 nursing students enrolled in the pediatric nursing course were selected through convenience sampling. This study was conducted on one group of nursing students that received Jacobson's progressive muscle relaxation exercise for five consecutive days per week for two weeks before entering the clinical environment. The S-anxiety scale (STAI Form Y-1) was applied to collect data before and after the intervention.

Results

The magnitude of anxiety after the progressive muscle relaxation exercise was greater reduced than before (t (59) = 21.1, P < 0.05). There was less anxiety post the program (M = 1.34 ± 0.36) than pre- program (M = 2.83 ± 0.35).

Conclusion

The study findings indicated the positive influence of progressive muscle relaxation exercise on nursing students’ anxiety levels in pediatric clinical settings. As a result, it is recommended that teaching programs on this approach be conducted for nursing students at nursing schools prior to the commencement of pediatric clinical practice in order to lessen anxiety.
Exploiting COVID-19 related traffic changes to evaluate flow dependency of an FCD-defined congestion measure
Authors: Bruwer Megan M , Andersen Simen J
Published: March 2022

Traffic congestion poses a significant problem in urban areas globally, and yet no measure of congestion is universally applied. Various studies have evaluated congestion measures, however, none have identified and demonstrated a best-practice congestion metric that can compare congestion between road segments, networks, and city zones. Furthermore, no studies have proven the link between a congestion metric and traffic flow, despite suggestion by Lomax et al. in their seminal 1997 Quantifying Congestion report that an appropriate congestion metric should vary predictably according to flow. This paper aims to address these gaps in traffic congestion literature. Various congestion measures are evaluated according to standard criteria. Although this process has been followed before, this paper adds a unique criterion that requires congestion to be quantifiable from commercial floating car data (FCD), due to its extensive availability and relative affordability. The most appropriate congestion measure is evaluated to be the speed reduction index (SRI). The application of the SRI to describe spatiotemporal congestion patterns and flow dependency is then demonstrated in a case-study analysis in South Africa. This analysis exploited traffic impacts of the COVID-19 pandemic in 2020 (particularly, the stepwise increase from severely reduced traffic flows as lockdown levels eased), to evaluate SRI. The wide range of flows enabled an unprecedented regression analysis comparing congestion level and flow. The results of the regression analysis are highly significant ( p < 0.001) indicating that SRI-based congestion measurement tracks flow variation. This study further identified that unidirectional congestion, quantified by the SRI, is impacted by high bi-directional flow along arterials. These findings confirm the appropriateness of the SRI quantified from commercial FCD to measure congestion.
Karnan: An Assertion of Dalit Identity
Authors: Premila Swamy D
Published: March 2022

Indian films, both mainstream Bollywood (Hindi cinema) and regional films have captured issues related to caste, class and gender disparities, and have enabled directors/producers to experiment with techniques so as to challenge stereotypical representations. Tamil cinema in this context has gone through a sea change in its representation of the subaltern class. From being silent and passive sufferers, the characters on screen now raise to speak for their community and assert their identity. This article explores the representation of Dalits on visual platform and how contemporary filmmakers seek to challenge and demystify the established narratives/canon. The article further analyses the recent Tamil cinema titled Karnan (April 2021) which challenges dominant ideologies that perpetuates discrimination, objectification, exclusion and silence to sustain its power. Using the Mahabharata mythical characters and employing cinematic techniques, the film resists and subverts dominant perception which aims to silence the other.
Reverse Shoulder Arthroplasty for Failed Operative Treatment of Proximal Humeral Fractures
Authors: Kokkalis Zinon T , Bavelou Aikaterini , Papanikos Efstratios , Kalavrytinos Dimitrios , Panagopoulos Andreas
Published: March 2022

Introduction

Failure after operative treatment of complex proximal humeral fractures (PHF) can prove challenging even for experienced surgeons. Reverse shoulder arthroplasty (RSA) seems to offer a satisfactory revision procedure with good clinical outcomes.

Materials and Methods

We present a case series of 14 patients, who were treated during a 3.5 years period (from 01/2016 until 06/2019). They all underwent revision surgery with RSA for failed operative treatment of PHF. Their mean age was 68 years (range, 51-84 years). 2 patients (14.3%) had been primarily treated with open reduction and internal fixation (ORIF), 5 patients (35.7%) with hemiarthroplasty, 3 patients (21.4%) with closed reduction and percutaneous fixation and 4 patients (28.6%) with transosseous suture fixation (TSF). We evaluated their absolute Constant score (CS), Visual Analogue Scale (VAS) score, and Range of Motion at their final follow-up, and we made a full clinical and radiological assessment to detect any postoperative complications.

Results

The mean absolute CS, VAS score, active anterior elevation, active abduction significantly improved compared with the preoperative status. Less significant difference was found in external rotation when comparing with the preoperative status ( P = .0304). No significant differences were found when comparing RSA for different failed primary techniques ( P > .05). No complications were detected following the revision surgeries of all patients.

Conclusion

RSA is an appropriate treatment as a revision technique for failed primary surgical treatment of PHFs. Though challenging it can offer good clinical results and pain relief.
Modernity, landscape conquest, and the mobility politics of stilt-walking in Landes region, France
Authors: Wickland Teo
Published: March 2022

Histories of stilt-walking in the Landes de Gascogne reveal intertwinements between mobility politics and landscape modernization. Reading these stories through a lens of “landscape conquest” centers the ongoing presence of coloniality in modernity, while highlighting the ways in which modernization produces homogeneity. This process of making every place more like anywhere else is more-than-physical. Universal landscape features, including universal mobility cultures, reproduce universal ways of thinking and relating. This depauperation enables the continual conquest of natural, cultural, epistemological, and phenomenological diversity. Conversely, landscape diversification, including the diversification of mobility cultures, could support abundant futures.
Controlled amnioreduction for twin-to-twin transfusion syndrome
Authors: Gordon Zoya , Fattal-Valevski Aviva , Elad David , Jaffa Ariel J.
Published: March 2022

Background:

Twin-to-twin transfusion syndrome (TTTS) is a severe condition causing preterm delivery, fetal death, and neurodevelopmental disorders. This study presents a data-based controlled amnioreduction (AR) protocol composed of sequential amniodrainage in treatment of TTTS.

Methods:

A total of 18 procedures were performed in 11 TTTS pregnancies at 17 to 34 weeks of gestation. The amniotic pressure was measured along with sequential removal of the amniotic fluid, 500 mL each step. The umbilical artery systolic/diastolic (S/D) ratio for each twin was measured pre- and post-AR. Long-term neurodevelopmental outcomes of all TTTS survivors were evaluated from parental answers to a phone survey.

Results:

The amniotic pressure decreased exponentially with the increased volume of removed amniotic fluid until a plateau was obtained. Changes of the S/D ratio between pre- and post-AR procedure did not reveal a clear tendency. The survival rate was 86.4% although 91% of all twins were at Quintero stage III. Long-term neurodevelopment outcomes in the 19 surviving twins were 68.4% optimal, 26.3% suboptimal, and 5.3% abnormal.

Conclusion:

The controlled AR procedure resulted in a relatively high rate of twin survival with favorable long-term neurodevelopment outcomes.
Derivation and validation of the UCAP-Q case-finding questionnaire to detect undiagnosed asthma and COPD
Authors: Huynh Chau , Whitmore G.A. , Vandemheen Katherine L. , FitzGerald J. Mark , Bergeron Celine , Boulet Louis-Philippe , Cote Andreanne , Field Stephen K. , Penz Erika , McIvor R. Andrew , Lemière Catherine , Gupta Samir , Mayers Irvin , Bhutani Mohit , Hernandez Paul , Lougheed M. Diane , Licskai Christopher J. , Azher Tanweer , Ainslie Martha , Fraser Ian , Mahdavian Masoud , Alvarez Gonzalo G. , Kendzerska Tetyana , Aaron Shawn D.
Published: March 2022

Background

Many people with asthma and COPD remain undiagnosed. We developed and validated a new case-finding questionnaire to identify symptomatic adults with undiagnosed obstructive lung disease.

Methods

Adults in the community with no prior history of physician-diagnosed lung disease who self-reported respiratory symptoms were contactedviarandom-digit dialling. Pre- and post-bronchodilator spirometry was used to confirm asthma or COPD. Predictive questions were selected using multinomial logistic regression with backward elimination. Questionnaire performance was assessed using sensitivity, predictive values and area under the receiver operating characteristic curve (AUC). The questionnaire was assessed for test–retest reliability, acceptability and readability. External validation was prospectively conducted in an independent sample and predictive performance re-evaluated.

Results

A 13-item Undiagnosed COPD and Asthma Population Questionnaire (UCAP-Q) case-finding questionnaire to predict undiagnosed asthma or COPD was developed. The most appropriate risk cut-off was determined to be 6% for either disease. Applied to the derivation sample (n=1615), the questionnaire yielded a sensitivity of 92% for asthma and 97% for COPD; specificity of 17%; and an AUC of 0.69 (95% CI 0.64–0.74) for asthma and 0.82 (95% CI 0.78–0.86) for COPD. Prospective validation using an independent sample (n=471) showed sensitivities of 93% and 92% for asthma and COPD, respectively; specificity of 19%; with AUCs of 0.70 (95% CI 0.62–0.79) for asthma and 0.81 (95% CI 0.74–0.87) for COPD. AUCs for UCAP-Q were higher compared to AUCs for currently recommended case-finding questionnaires for asthma or COPD.

Conclusions

The UCAP-Q demonstrated high sensitivities and AUCs for identifying undiagnosed asthma or COPD. A web-based calculator allows for easy calculation of risk probabilities for each disease.
Heparan sulfate mimetic fucoidan restores the endothelial glycocalyx and protects against dysfunction induced by serum of COVID-19 patients in the intensive care unit
Authors: Yuan Lushun , Cheng Shuzhen , Sol Wendy M.P.J. , van der Velden Anouk I.M. , Vink Hans , Rabelink Ton J. , van den Berg Bernard M.
Published: March 2022

Accumulating evidence proves that endothelial dysfunction is involved in coronavirus disease 2019 (COVID-19) progression. We previously demonstrated that the endothelial surface glycocalyx has a critical role in maintenance of vascular integrity. Here, we hypothesised that serum factors of severe COVID-19 patients affect the glycocalyx and result in endothelial dysfunction.

We included blood samples of 32 COVID-19 hospitalised patients at the Leiden University Medical Center, of which 26 were hospitalised in an intensive care unit (ICU) and six on a non-ICU hospital floor; 18 of the samples were obtained from convalescent patients 6 weeks after hospital discharge, and 12 from age-matched healthy donors (control) during the first period of the outbreak. First, we determined endothelial (angiopoietin 2 (ANG2)) and glycocalyx degradation (soluble thrombomodulin (sTM) and syndecan-1 (sSDC1)) markers in plasma.

In the plasma of COVID-19 patients, circulating ANG2 and sTM were elevated in patients in the ICU. Primary lung microvascular endothelial cell (HPMEC) and human glomerular microvascular endothelial cell (GEnC) cultured in the presence of these sera led to endothelial cell glycocalyx degradation, barrier disruption, inflammation and increased coagulation on the endothelial surface, significantly different compared to healthy control and non-ICU patient sera. These changes could all be restored in the presence of fucoidan.

In conclusion, our data highlight the link between endothelial glycocalyx degradation, barrier failure and induction of a procoagulant surface in COVID-19 patients in ICU which could be targeted earlier in disease by the presence of heparan sulfate mimetics.
Ameliorative effect of aqueous Cissus populnea suspension on cotton seed-induced testicular damage in male Wistar rats
Authors: Olooto Wasiu Eniola , Fajobi Adeniyi Olugbenga , Adewole Omolara Oluwawemimo , Murtala Abdullahi Akanji , Aderinola Aderonke Adeyinka
Published: March 2022

Background

Testicular damage is an important etiological factor in male infertility. Despite reported decline in global incidence of infertility over the past years, pockets of cases are still ironically noticed to occur in developing countries due to limitation of accessibility to advanced management methods, hence their resort to alternative herbal therapy.

Methods

Testicular damage was induced using cotton seed. Cissus populnea was cut into chunks, air-dried, pulverized, powdered and suspended in water. Thirty-two (32) matured male Wistar rats were randomly divided into 4 groups (Group 1–4) designated as control, 100 mg/kg C. populnea (CP), cotton seed meal (CSM) and CSM + CP groups, each consisting of 8 rats. Group 1 was fed with normal rat chow, Group 2 was fed with 100 mg/kg CP, and Group 3 was fed with CSM for 8 weeks. Rats in Group 4 were fed with CSM for 8 weeks and dosed with 100 mg/kg aqueous C. populnea suspension for another 8 weeks. At the expiration of test period, the rats were sacrificed, blood sample collected, and plasma obtained for luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, estrogen, catalase, superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione (GSH) measurements. Semen was collected for analysis and testes harvested for histological studies.

Result

There is a significant decrease (p < 0.05) in plasma FSH, LH, testosterone, estrogen, GSH, catalase, SOD, and GPx in rats fed on CSM when compared with values obtained in the control and aqueous C. populnea suspension-fed rats. Seminal fluid analysis showed a significant reduction (p < 0.05) in the sperm count, motility, morphology, vitality, and non-vitality among rats fed with CSM when compared to control rats. The histologic features of the testes showed abnormal interstitial appearances and absent Leydig cells in many areas among cotton seed-fed rats. Improvements in reproductive hormones, sperm qualities, and histological features were observed to occur in CSM group following administration of aqueous C. populnea suspension.

Conclusion

Based on the findings from this study, it can be concluded that aqueous C. populnea suspension ameliorates cotton seed-induced hypothalamo-pituitary–testicular axis functional disruption and testicular damage.
Remnants of horizontal transfers of Wolbachia genes in a Wolbachia-free woodwasp
Authors: Queffelec Joséphine , Postma Alisa , Allison Jeremy D. , Slippers Bernard
Published: March 2022

Background

Wolbachia is a bacterial endosymbiont of many arthropod and nematode species. Due to its capacity to alter host biology, Wolbachia plays an important role in arthropod and nematode ecology and evolution. Sirex noctilio is a woodwasp causing economic loss in pine plantations of the Southern Hemisphere. An investigation into the genome of this wasp revealed the presence of Wolbachia sequences. Due to the potential impact of Wolbachia on the populations of this wasp, as well as its potential use as a biological control agent against invasive insects, this discovery warranted investigation.

Results

In this study we first investigated the presence of Wolbachia in S. noctilio and demonstrated that South African populations of the wasp are unlikely to be infected. We then screened the full genome of S. noctilio and found 12 Wolbachia pseudogenes. Most of these genes constitute building blocks of various transposable elements originating from the Wolbachia genome. Finally, we demonstrate that these genes are distributed in all South African populations of the wasp.

Conclusions

Our results provide evidence that S. noctilio might be compatible with a Wolbachia infection and that the bacteria could potentially be used in the future to regulate invasive populations of the wasp. Understanding the mechanisms that led to a loss of Wolbachia infection in S. noctilio could indicate which host species or host population should be sampled to find a Wolbachia strain that could be used as a biological control against S. noctilio.
Phylogeographic relationships and the evolutionary history of the Carassius auratus complex with a newly born homodiploid raw fish (2nNCRC)
Authors: Gu Qianhong , Wang Shi , Zhong Hui , Yuan Hui , Yang Junliu , Yang Conghui , Huang Xuexue , Xu Xiaowei , Wang Yude , Wei Zehong , Wang Jing , Liu Shaojun
Published: March 2022

Background

An important aspect of studying evolution is to understand how new species are formed and their uniqueness is maintained. Hybridization can lead to the formation of new species through reorganization of the adaptive system and significant changes in phenotype. Interestingly, eight stable strains of 2nNCRC derived from interspecies hybridization have been established in our laboratory. To examine the phylogeographical pattern of the widely distributed genusCarassiusacross Eurasia and investigate the possible homoploid hybrid origin of theCarassius auratuscomplex lineage in light of past climatic events, the mitochondrial genome (mtDNA) and one nuclear DNA were used to reconstruct the phylogenetic relationship between theC. auratuscomplex and 2nNCRC and to assess how demographic history, dispersal and barriers to gene flow have led to the current distribution of theC. auratuscomplex.

Results

As expected, 2nNCRC had a very close relationship with theC. auratuscomplex and similar morphological characteristics to those of theC. auratuscomplex, which is genetically distinct from the other three species ofCarassius. The estimation of divergence time and ancestral state demonstrated that theC. auratuscomplex possibly originated from the Yangtze River basin in China. There were seven sublineages of theC. auratuscomplex across Eurasia and at least four mtDNA lineages endemic to particular geographical regions in China. The primary colonization route from China to Mongolia and the Far East (Russia) occurred during the Late Pliocene, and the diversification of other sublineages of theC. auratuscomplex specifically coincided with the interglacial stage during the Early and Mid-Pleistocene in China.

Conclusion

Our results support the origin of theC. auratuscomplex in China, and its wide distribution across Eurasia was mainly due to natural Pleistocene dispersal and recent anthropogenic translocation. The sympatric distribution of the ancestral area for both parents of 2nNCRC and theC. auratuscomplex, as well as the significant changes in the structure of pharyngeal teeth and morphological characteristics between 2nNCRC and its parents, imply that homoploid hybrid speciation (HHS) forC. auratuscould likely have occurred in nature. The diversification pattern indicated an independent evolutionary history of theC. auratuscomplex, which was not separated from the most recent common ancestor ofC. carassiusorC. cuvieri. Considering that the paleoclimate oscillation and the development of an eastward-flowing drainage system during the Pliocene and Pleistocene in China provided an opportunity for hybridization between divergent lineages, the formation of 2nNCRC in our laboratory could be a good candidate for explaining the HHS ofC. auratusin nature.
Pedigree reconstruction and spatial analysis for genetic testing and selection in a Larix kaempferi (Lamb.) Carrière plantation
Authors: Lee Kyungmi , Kim In-Sik , Kang Kyu-Suk
Published: March 2022

Background

Larix kaempferiis one of the major timber species in Northeast Asia. Demand for the reforestation of the species is rising in South Korea due to an increase in large timber production and utilization. However, progeny trials for the species have not been explored, making it challenging to foster advanced generations of tree improvement. In the present study, genetic testing and selection for diameter growth were conducted using pedigree reconstruction and phenotypic spatial distribution analysis in a plantation ofL. kaempferi. The aim of the present study was to select the superior larch individuals using the pedigree reconstruction and phenotypic spatial distribution to substitute progeny trials. The plantation of seed orchard crops was established in 1990 and one-hundred and eighty-eight trees were selected as the study material. Genetic variation was investigated first to validate its adequacy as breeding material. Genetic testing was carried out using a model considering pedigree information and spatial autoregression of the phenotypes.

Results

The expected heterozygosity of the mother trees and offspring were 0.672 and 0.681 presenting the corresponding level of genetic variation between two groups. The pedigree reconstruction using maternity analysis assigned one to six progenies to ninety-two candidate mothers. The accuracy of genetic testing was exceedingly increased with the animal model considering AR1 ⊗ AR1 structure compared to the animal model only. The estimated genetic variance of the former was 9.086 whereas that of the latter was 4.9E-5 for DBH. The predicted breeding values of the offspring for DBH were ranged from -5.937 cm to 5.655 cm and the estimated heritability of diameter growth was 0.344.

Conclusions

The genetic testing approach based on pedigree reconstruction and phenotypic spatial distribution analysis was considered a useful analytical scheme that could replace or supplement progeny trials.
The potential of foliar application of nano-chitosan-encapsulated nano-silicon donor in amelioration the adverse effect of salinity in the wheat plant
Authors: Hajihashemi Shokoofeh , Kazemi Shadi
Published: March 2022

Background

Nano-materials ameliorate the adverse effect of salinity stress on the physiological and biochemical processes in plants. The present investigation was designed to evaluate the physiological mechanisms through which a nano-chitosan-encapsulated nano-silicon fertilizer (NC-NS) can ameliorate the adverse effect of salinity stress on the wheat plants, and compare it with nano-chitosan (NC) and nano-silicon (NS) application. Nano-silicon was encapsulated with a chitosan-tripolyphosphate (TPP) nano-matrix by ionic gelation method for its slow release. The wheat plants were exposed to foliar application of distilled water, NC, NS, and NC-NS with two NaCl irrigation levels at 0 (distilled water) and 100 mM.

Results

The foliar application of NC, NS, and NC-NS induced a significant increase in the function of enzymatic and non-enzymatic antioxidant systems of the wheat plants to equilibrate cellular redox homeostasis by balancing H2O2content in the leaves and roots, as compared with salt-stressed plants without treatment. The plant's foliar-sprayed with NC, NS, and NC-NS solution exhibited a significant increase in the molecules with osmotic adjustment potentials such as proline, free amino acids, glycine betaine, and sugars to protect cells against osmotic stress-induced by salinity. The observed increase in the antioxidant power and osmoregulatory at NC, NS, and NC-NS application was accompanied by the protection of lipid membrane, proteins and photosynthetic apparatus against salinity stress.

Conclusion

In the present study, the beneficial role of NC, NS, and NC-NS application, particularly NC-NS, in alleviating the adverse effect of salinity stress on antioxidant systems and osmotic adjustment in wheat is well documented. An overview of the result of present study assists researchers in providing a potential solution for this increasing salinization threat in crops.

Graphical abstract
Association of ALDH2 rs671 and MTHFR rs1801133 polymorphisms with hypertension among Hakka people in Southern China
Authors: Wu Heming , Huang Qingyan , Yu Zhikang , Zhong Zhixiong
Published: March 2022

Background

Genetic factors play an important role in susceptibility to hypertension. Herein, the association between acetaldehyde dehydrogenase 2 (ALDH2) and methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and hypertension was analyzed among Hakka population in southern China.

Methods

A total of 3057 hypertensive patients and 2215 controls were enrolled. The ALDH2 rs671 and MTHFR rs1801133 genotyping were analyzed using gene chip. Relevant information and medical records of these subjects were collected.

Results

Hypertensive patients with ALDH2 rs671 G/A heterozygous had lower systolic blood pressure (SBP) than other genotypes (P < 0.001), while hypertensive patients with A allele had lower diastolic blood pressure (DBP) than patients with G allele (P < 0.001). The level of plasma homocysteine (Hcy) in patients with MTHFR CC, CT and TT genotypes showed an increasing trend (P < 0.001). The ALDH2 G/A genotype in the co-dominant model (adjusted OR 1.251, 95% CI 1.024–1.528, P = 0.028) and ALDH2 A/A genotype in the recessive model (adjusted OR 1.221, 95% CI 1.008–1.478, P = 0.041) were significant risk factors for the presence of hypertension. The MTHFR C/T genotype in the co-dominant model (adjusted OR 1.307, 95% CI 1.039–1.643, P = 0.022) and MTHFR C/T and T/T genotypes in the dominant model (adjusted OR 1.281, 95% CI 1.146–1.430, P < 0.001) were significant risk factors for the presence of hypertension. Further, logistic regression analysis showed that age, smoking, alcohol consumption, hyperhomocysteinemia, and high level of serum TG, Apo-A1, Apo-B were significant risks for hypertension.

Conclusions

In summary, ALDH2 rs671 G/A, A/A genotypes and MTHFR rs1801133 C/T, T/T genotypes may be risk factors for hypertension in this Chinese Hakka population.
Physically active primary care doctors are more likely to offer exercise counselling to patients with cardiovascular diseases: a cross-sectional study
Authors: Selvaraj Christine Shamala , Abdullah Nurdiana
Published: March 2022

Background

Regular physical activity had been shown to reduce morbidity and mortality from chronic diseases such as cardiovascular diseases, hypertension, type 2 diabetes mellitus, dyslipidaemia, obesity/metabolic syndrome, osteoarthritis, osteoporosis, bronchial asthma and chronic obstructive pulmonary disease. Research had shown that physically active doctors were more likely to offer exercise counselling to patients. However, few studies looked into this association with counselling practices to patients with specific chronic diseases. This study aims to determine the association between physical activity levels of primary care doctors (PCDs) in Malaysian private practice with physical activity counselling to patients with chronic diseases.

Methodology

A cross-sectional study involving PCDs in private practice in 3 states was done. Participants were recruited from members of the Malaysian Academy of Family Physicians and attendees of a conference. A self-administered questionnaire obtained information on sociodemography, initiation of exercise counselling to patients with chronic diseases as well as physical activity levels using the International Physical Activity Questionnaire (IPAQ).

Results

The response rate was 32.3% (272/842). 47.1% of the respondents were post-graduate holders. 50% of participants had a moderate level of physical activity and 24.3% a high level. Most respondents answered ‘always’ or ‘often’ for initiation of exercise counselling to patients with cardiovascular diseases (59.9%), hypertension (72.8%), type 2 diabetes mellitus (78.6%), obesity/metabolic syndrome (86.4%), dyslipidaemia (81.6%), osteoarthritis/osteoporosis (41.9%) and bronchial asthma/COPD (29.5%). PCDs being physically active and non-smokers were associated with a higher initiation of exercise counselling to patients with cardiovascular diseases. Doctors with post-graduate degrees were more likely to offer exercise counselling to hypertensive patients.

Conclusion

The association between PCDs’ physical activity levels and their physical activity counselling varies between different types of chronic diseases. Primary care doctors with higher physical activity levels were more likely to initiate physical activity counselling in patients with cardiovascular disease during chronic disease follow up visits.
Pneumatosis cystoides intestinalis associated with etoposide in hematological malignancies: a case report and a literature review
Authors: Yang Liqing , Zhong Xi , Yang Hao , Wu Qin , Gong Yuping , Wang Bo
Published: March 2022

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of air collection within the subserosa and/or submucosa of the gastrointestinal wall. Due to the lack of specific symptoms, PCI is likely to be misdiagnosed or missed without the use of imaging techniques or gastrointestinal endoscopy. Here, we report a patient who complained of abdominal distention and constipation after chemotherapy for hematological malignancies, and was diagnosed with secondary PCI via computed tomography (CT) and exploratory laparotomy. Pneumoperitoneum was no longer observed after two weeks of conservative treatments. Notably, the possibility of intra-abdominal pressure (IAP) as a predictor for surgical intervention was proposed. Furthermore, we conducted a literature review on PCI after chemotherapy in hematological malignancies to raise awareness of etoposide-related PCI, while whether PCI could be identified as an adverse event of etoposide requires more evidence.
CD63-positive extracellular vesicles are potential diagnostic biomarkers of pancreatic ductal adenocarcinoma
Authors: Odaka Haruki , Hiemori Keiko , Shimoda Asako , Akiyoshi Kazunari , Tateno Hiroaki
Published: March 2022

Background

Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest gastrointestinal cancers with a 5-year survival rate of less than 10%. Biomarkers for early PDAC detection are useful in treating patients with PDAC. Extracellular vesicles (EVs) are lipid-bound vesicles that are potential biomarkers of various diseases such as PDAC. In this study, we quantitatively measured the serum levels of EVs (CD63+-EVs) or platelet-derived EVs (CD41+- and CD61+-EVs) and evaluated their potential use as biomarkers of PDAC.

Methods

We measured the serum levels of CD63+-, CD41+-, CD61+-EVs using sandwich enzyme-linked immunosorbent assay based on Tim4 with specificity for phosphatidylserine on EVs in age- and sex-matched healthy controls (HCs, n = 39) and patients with PDAC (n = 39). We also examined the effect of tumor burden on the serum EV levels after surgical resection (n = 28). CA19-9, a clinical PDAC biomarker, was also measured for comparison.

Results

Serum levels of CD63+-EVs, CD41+-EVs, and CD61+-EVs were significantly increased in patients with PDAC compared to HCs. Receiver operating characteristic analysis revealed that CD63+-EVs exhibited the highest diagnostic performance to discriminate patients with PDAC from HCs (area under the curve (AUC): 0.846), which was comparable to CA19-9 (AUC: 0.842). CA19-9 showed lower AUC values in early stages (I–II, AUC: 0.814) than in late stages (III–IV, AUC: 0.883) PDAC. Conversely, CD63+-EVs, CD41+-EVs, and CD61+-EVs showed comparable AUCs between early- and late-stage PDAC. The combined use of CA19-9 and CD63+-EVs showed a higher diagnostic performance for early-stage PDAC (AUC: 0.903) than CA19-9. The serum levels of CD63+-EVs, CD41+-EVs, CD61+-EVs, and CA19-9 decreased significantly after surgical resection, demonstrating that EVs are increased in sera of patients depending on the tumor burden.

Conclusions

The serum levels of CD63+-EVs and platelet-derived EVs (CD41+-EVs, CD61+-EVs) are increased in patients with PDAC than HCs. Since CD63+-EVs showed a high AUC to discriminate patients with PDAC from HCs; they might be useful as potential biomarkers for PDAC.
An assessment of Veterans attitudes and willingness to receiving the COVID-19 vaccine: a mixed methods study
Authors: Gardner Jessica , Brown Gabriel , Vargas-Correa Jadisha , Weaver Frances , Rubinstein Israel , Gordon Howard S.
Published: March 2022

Background

While several safe and effective COVID-19 vaccines have been available since December 2020, many eligible individuals choose to remain unvaccinated. This vaccine hesitancy is an important factor affecting our ability to combat the COVID-19 pandemic.

Methods

The objective of the study was to examine the attitudes and willingness among US Veterans toward receiving COVID-19 vaccination. The study used a quantitative qualitative mixed methods design with a telephone survey and then in-depth interviews in a subset of those surveyed. Participants were unvaccinated Veterans (N = 184) selected randomly from a registry of patients who had received VA healthcare during the pandemic and had a diagnostic test for COVID-19. The primary outcome was willingness to accept COVID-19 vaccination. Survey data collection and in-depth interviews were conducted by telephone. Analyses of the survey data compared the primary outcome with demographics, clinical data, and survey responses using bivariate and multiple regression analyses. A subset (N = 10) of those surveyed, participated in an in-depth interview. Interview transcripts were analyzed to derive themes using qualitative content analysis.

Results

Almost 40% of participants disagreed they would receive a COVID-19 vaccine. Participants who were younger, female, and had fewer comorbid conditions were more likely (P < 0.05) to disagree with COVID-19 vaccination. In multiple regression analysis, willingness to accept vaccination was associated with reliance on a doctor or family member’s recommendation and with a belief that vaccines are effective. In-depth interviews revealed several barriers to COVID-19 vaccination, including lack of trust in the government and vaccine manufacturers, concerns about the speed of vaccine development, fear of side effects, and fear the vaccine was a tool of racism.

Conclusions

This study illustrates the complexity of patients’ deliberation about COVID-19 vaccination and may help physicians and other health care providers understand patients’ perspectives about COVID-19 vaccination. The results highlight the importance of patients’ trust in physicians, healthcare organizations, pharmaceutical manufacturers and the government when making health decisions.
Incidence of acute otitis media in children in the United States before and after the introduction of 7- and 13-valent pneumococcal conjugate vaccines during 1998–2018
Authors: Hu Tianyan , Done Nicolae , Petigara Tanaz , Mohanty Salini , Song Yan , Liu Qing , Lemus-Wirtz Esteban , Signorovitch James , Sarpong Eric , Weiss Thomas
Published: March 2022

Background

Acute otitis media (AOM) is a leading cause of office visits and antibiotic prescriptions in children. Pneumococcal conjugate vaccines were introduced in the USA in 2000 (7-valent, PCV7) and 2010 (13-valent, PCV13). Expanded valency PCVs are currently under development. To describe the impact of PCVs and quantify the residual burden of AOM, this study estimated annual incidence rates (IRs) of AOM and AOM-related complications and surgical procedures in children < 18 years in the USA before and after the introduction of PCV7 and PCV13.

Methods

AOM episodes were identified in the IBM MarketScan® Commercial and Medicaid databases using diagnosis codes (ICD-9-CM: 382.x; ICD-10-CM: H66.xx and H67.xx). Annual IRs were calculated as the number of episodes per 1000 person-years (PYs) for all children < 18 years and by age group (< 2, 2–4, and 5–17 years). National estimates of annual AOM IRs were extrapolated using Census Bureau data. Interrupted time series analyses were used to assess immediate and gradual changes in monthly AOM IRs, controlling for seasonality.

Results

In the commercially insured population, AOM IRs declined between the pre-PCV7 period (1998–1999) and the late PCV13 period (2014–2018) from 1170.1 to 768.8 episodes per 1000 PY for children < 2 years, from 547.4 to 410.3 episodes per 1000 PY in children 2–4 years, and from 115.6 to 91.8 episodes per 1000 PY in children 5–17 years. The interrupted time series analyses indicated significant immediate or gradual decreases in the early PCV7 period (2001–2005), and gradual increases in the late PCV7 period (2006–2009) in children < 2 years; however, crude IRs trended downward in all time periods. In older children, IRs decreased in the early PCV7 and early PCV13 period (2011–2013), but gradually increased in the late PCV7 period. IRs of AOM-related surgical procedures decreased, and IRs of AOM-related complications increased during the study timeframe.

Conclusions

AOM disease burden remains high in children of all ages despite overall reductions in AOM IRs during 1998–2018 following the introduction of PCV7 and PCV13. The impact of investigational PCVs on the disease burden of AOM will likely depend on AOM etiology and circulating pneumococcal serotypes.
Effect of gender, age and vaccine on reactogenicity and incapacity to work after COVID-19 vaccination: a survey among health care workers
Authors: Nachtigall Irit , Bonsignore Marzia , Hohenstein Sven , Bollmann Andreas , Günther Rosita , Kodde Cathrin , Englisch Martin , Ahmad-Nejad Parviz , Schröder Alexander , Glenz Corinna , Kuhlen Ralf , Thürmann Petra , Meier-Hellmann Andreas
Published: March 2022

Background

The aim of our study was to assess the impact the impact of gender and age on reactogenicity to three COVID-19 vaccine products: Biontech/Pfizer (BNT162b2), Moderna (mRNA-1273) and AstraZeneca (ChAdOx). Additional analyses focused on the reduction in working capacity after vaccination and the influence of the time of day when vaccines were administered.

Methods

We conducted a survey on COVID-19 vaccinations and eventual reactions among 73,000 employees of 89 hospitals of the Helios Group. On May 19th, 2021 all employees received an email, inviting all employees who received at least 1 dose of a COVID-19 to participate using an attached link. Additionally, the invitation was posted in the group’s intranet page. Participation was voluntary and non-traceable. The survey was closed on June 21st, 2021.

Results

8375 participants reported on 16,727 vaccinations. Reactogenicity was reported after 74.6% of COVID-19 vaccinations. After 23.0% vaccinations the capacity to work was affected. ChAdOx induced impairing reactogenicity mainly after the prime vaccination (70.5%), while mRNA-1273 led to more pronounced reactions after the second dose (71.6%). Heterologous prime-booster vaccinations with ChAdOx followed by either mRNA-1273 or BNT162b2 were associated with the highest risk for impairment (81.4%). Multivariable analyses identified the factors older age, male gender and vaccine BNT162b as independently associated with lower odds ratio for both, impairing reactogenicity and incapacity to work. In the comparison of vaccine schedules, the heterologous combination ChAdOx + BNT162b or mRNA-1273 was associated with the highest and the homologue prime-booster vaccination with BNT162b with the lowest odds ratios. The time of vaccination had no significant influence.

Conclusions

Around 75% of the COVID-19 vaccinations led to reactogenicity and nearly 25% of them led to one or more days of work loss. Major risk factors were female gender, younger age and the administration of a vaccine other than BNT162b2. When vaccinating a large part of a workforce against COVID-19, especially in professions with a higher proportion of young and women such as health care, employers and employees must be prepared for a noticeable amount of absenteeism. Assuming vaccine effectiveness to be equivalent across the vaccine combinations, to minimize reactogenicity, employees at risk should receive a homologous prime-booster immunisation with BNT162b2.

Trial registration: The study was approved by the Ethic Committee of the Aerztekammer Berlin on May 27th, 2021 (Eth-37/21) and registered in the German Clinical Trials Register (DRKS 00025745). The study was supported by the Helios research grant HCRI-ID 2021-0272.
Cerebral nocardiosis in a patient treated with pembrolizumab: a first case report
Authors: Petitgas Paul , Lesouhaitier Mathieu , Boukthir Sarrah , Cattoir Vincent , Tattevin Pierre , Bénézit François
Published: March 2022

Background

Checkpoints inhibitors (CPIs) are increasingly used for the treatment of several malignancies. The most common side effects are Immune Related Adverse Events, while infectious complications are rare, especially cerebral nocardiosis.

Case presentation

Here, we report the first clinical case of a cerebral nocardiosis revealed after seizure in a patient treated by pembrolizumab for a metastatic lung cancer, in the absence of any additional immunosuppressive therapy or risk factors for cerebral nocardiosis. The extended evaluation including a brain CT-scan did not reveal any lesion before pembrolizumab. Nevertheless, the 3-month delay between the start of Pembrolizumab and the diagnosis of cerebral nocardiosis suggests that the infection occurred prior to the CPI. Unfortunately, the patient died during treatment for cerebral nocardiosis, while the lung cancer tumor mass had decreased by 80% after the sixth cycle of pembrolizumab.

Conclusions

This case report emphasizes that clinicians should consider diagnoses other than metastasis in a patient with a brain mass and metastatic cancer treated with CPI, such as opportunistic infections or IRAE.
Recipient and donor PTX3 rs2305619 polymorphisms increase the susceptibility to invasive fungal disease following haploidentical stem cell transplantation: a prospective study
Authors: Zhao Chen , Zhao Xiao-Su , Xu Lan-Ping , Zhang Xiao-Hui , Huang Xiao-Jun , Sun Yu-Qian
Published: March 2022

Background

Invasive fungal disease (IFD) is a severe complication after haploidentical stem cell transplantation (haplo-HSCT) and has a poor prognosis. It has been shown that genetic polymorphism may be one possible reason for the increased risk of IFD. This study aimed to assess the role of genetic polymorphism in the level of susceptibility to IFD after haplo-HSCT.

Methods

In this study, we prospectively enrolled 251 patients who received haplo-HSCT at the Peking University Institute of Hematology from 2016 to 2018. Forty-three single nucleotide polymorphisms (SNPs) of the genomic DNA were genotyped in blood samples from both recipient and donor.

Results

Twenty-two patients (8.8%) were diagnosed with proven or probable IFD. The independent risk factors for IFD were grades 3–4 acute graft-versus-host disease, cytomegalovirus reactivation, and recipient and donor rs2305619 (PTX3) (P < 0.05) in multivariate analysis. Meanwhile, we combined the variables to develop the IFD risk scoring system and stratified patients into low- (0–2) and high-risk (3–4) groups. The 30-day and 100-day cumulative incidence of IFD in the low- and high-risk groups were 2.1% and 10.2%, 4.2% and 20.3%, respectively (P = 0.015).

Conclusions

PTX3 rs2305619 polymorphism increase the susceptibility of IFD after haplo-HSCT in the Chinese Han population, and the IFD scoring system could be useful in risk stratification for IFD after HSCT.
Three-dimensional evaluation of soft tissues in hyperdivergent skeletal class II females in Guangdong
Authors: Zhang Xueqin , Zheng Jinxuan , Deng Jianqing , Wen Zhaoxiang , Chen Zhengyuan , Gan Liyi , Wu Liping
Published: March 2022

Objectives

To establish the three-dimensional facial soft tissue morphology of adolescent and adult females in the Guangdong population and to study the morphological characteristics of hyperdivergent skeletal class II females in Guangdong compared with that of normodivergent class I groups.

Materials and methods

The 3dMDface system was used to capture face scans of 160 patients, including 45 normal and 35 hyperdivergent skeletal class II adolescents (aged 11–14 years old) and 45 normal and 35 hyperdivergent skeletal class II adults (aged 18–30 years old). Thirty-two soft tissue landmarks were mapped, and 21 linear, 10 angular and 17 ratio measurements were obtained by 3dMDvultus analysis software. Data were assessed with a t-test of two independent samples between the normal adolescent and adult groups and between the normal and hyperdivergent skeletal class II groups.

Results

The linear measurements of the Guangdong adult females were larger than those of the adolescents in both Class I and Class II groups. However, the angular and ratio measurements had no significant difference. The vertical linear measurements were higher and the sagittal and transverse linear measurements were smaller in the hyperdivergent class II group (p < 0.05). The soft tissue ANB angle, chin-lip angle, and mandibular angle were significantly larger and the soft tissue facial convexity angle and nasal convexity angle were significantly smaller in the hyperdivergent class II group (p < 0.05). Additionally, there were significant differences in the ratio measurements between the hyperdivergent class II groups and the control groups (p < 0.05).

Conclusions

The three-dimensional facial morphology of Guangdong adolescent and adult females was acquired. The facial soft tissue measurements of the adults were higher in the three dimensions except for the facial convexity and proportional relationships which were similar, suggesting that the growth pattern remained the same. The three-dimensional facial soft tissue features of hyperdivergent skeletal class II were characterized by the terms “long, convex, and narrow”. Three-dimensional facial measurements can reflect intrinsic hard tissue characteristics.