bluuebunny/crossref_metadata_2025 huggingface dataset:
Supplemental Bacillus subtilis PB6 Improves Growth Performance and Gut Health in Broilers Challenged with Clostridium perfringens
Authors: Liu Yan , Zhang Song , Luo Zheng , Liu Dan
Published: October 2021

Clostridium perfringens (CP) is the principal pathogenic bacterium of chicken necrotic enteritis (NE), which causes substantial economic losses in poultry worldwide. Although probiotics are known to provide multiple benefits, little is known about the potential effects of Bacillus subtilis (B. subtilis) application in preventing CP-induced necrotic enteritis. In this study, 450 male Arbor Acres broilers were divided into 5 experimental treatments: A: basal diet (control group); B: basal diet and CP challenge (model group); C: CP challenge+10 mg/kg enramycin (positive control group); D: CP challenge+

4
×

10

7

 
CFU
/
kg

of feed B. subtilis PB6 (PB6 low-dosage group); and E: CP challenge+

6
×

10

7

 
CFU
/
kg

of feed B. subtilis PB6 (PB6 high-dosage group). There were 6 replicate pens per treatment with 15 broilers per pen. The present research examined the effect of Bacillus subtilis PB6 (B. subtilis PB6) on growth performance, mRNA expression of intestinal cytokines and tight junctions, and gut flora composition in broilers challenged with CP. The entire experiment was divided into two phases: the non-CP challenge phase (d0–18) and the CP challenge phase (d18–26). PB6 did not increase the growth performance during the first stage, but the PB6 high-dosage group was found to have larger body weight gain and ADFI during the CP challenge stage. Feed supplementation with PB6 reduced the lesion score of challenged chicks, with increased tight junction-related gene expression (occludin and ZO-1) and decreased TNF-α expression compared with CP-infected birds. A decrease in the abundance of Clostridium XI, Streptococcus, and Staphylococcus was observed after CP infection (

P
<
0.05

), while supplementation with PB6 restored the ileal microbial composition. In conclusion, administration of B. subtilis PB6 improved growth performance, enhanced intestinal barrier function, and mitigated intestinal inflammation/lesions, which might be due to its restoring effects on the ileal microbial composition in CP-challenged broilers.
Characterization of the Congestion Lemma on Layout Computation
Authors: Liu Jia-Bao , Shalini Arul Jeya , Arockiaraj Micheal , Delaila J. Nancy
Published: October 2021

An embedding of a guest network

G
N

into a host network

H
N

is to find a suitable bijective function between the vertices of the guest and the host such that each link of

G
N

is stretched to a path in

H
N

. The layout measure is attained by counting the length of paths in

H
N

corresponding to the links in

G
N

and with a complexity of finding the best possible function overall graph embedding. This measure can be computed by summing the minimum congestions on each link of

H
N

, called the congestion lemma. In the current study, we discuss and characterize the congestion lemma by considering the regularity and optimality of the guest network. The exact values of the layout are generally hard to find and were known for very restricted combinations of guest and host networks. In this series, we derive the correct layout measures of circulant networks by embedding them into the path- and cycle-of-complete graphs.
Genome-Wide Analysis of the Auxin/Indoleacetic Acid Gene Family and Response to Indole-3-Acetic Acid Stress in Tartary Buckwheat (Fagopyrum tataricum)
Authors: Yang Fan , Zhang Xiuxia , Tian Ruifeng , Zhu Liwei , Liu Fang , Chen Qingfu , Shi Xuanjie , Huo Dongao
Published: October 2021

Auxin/indoleacetic acid (Aux/IAA) family genes respond to the hormone auxin, which have been implicated in the regulation of multiple biological processes. In this study, all 25 Aux/IAA family genes were identified in Tartary buckwheat (Fagopyrum tataricum) by a reiterative database search and manual annotation. Our study provided comprehensive information of Aux/IAA family genes in buckwheat, including gene structures, chromosome locations, phylogenetic relationships, and expression patterns. Aux/IAA family genes were nonuniformly distributed in the buckwheat chromosomes and divided into seven groups by phylogenetic analysis. Aux/IAA family genes maintained a certain correlation and a certain species-specificity through evolutionary analysis with Arabidopsis and other grain crops. In addition, all Aux/IAA genes showed a complex response pattern under treatment of indole-3-acetic acid (IAA). These results provide valuable reference information for dissecting function and molecular mechanism of Aux/IAA family genes in buckwheat.
A Defense Strategy Selection Method Based on the Cyberspace Wargame Model
Authors: Zhu Yuwen , Yu Lei , He Houhua , Meng Yitong
Published: October 2021

Network defenders always face the problem of how to use limited resources to make the most reasonable decision. The network attack-defense game model is an effective means to solve this problem. However, existing network attack-defense game models usually assume that defenders will no longer change defense strategies after deploying them. However, in an advanced network attack-defense confrontation, defenders usually redeploy defense strategies for different attack situations. Therefore, the existing network attack-defense game models are challenging to accurately describe the advanced network attack-defense process. To address the above challenges, this paper proposes a defense strategy selection method based on the network attack-defense wargame model. We model the advanced network attack-defense confrontation process as a turn-based wargame in which both attackers and defenders can continuously adjust their strategies in response to the attack-defense posture and use the Monte Carlo tree search method to solve the optimal defense strategy. Finally, a network example is used to illustrate the effectiveness of the model and method in selecting the optimal defense strategy.
Comparison of the Wiener and Kirchhoff Indices of Random Pentachains
Authors: Wei Shouliu , Shiu Wai Chee , Ke Xiaoling , Huang Jianwu
Published: October 2021

Let

G

be a connected (molecule) graph. The Wiener index

W

G

and Kirchhoff index

K
f

G

of

G

are defined as the sum of distances and the resistance distances between all unordered pairs of vertices in

G

, respectively. In this paper, explicit formulae for the expected values of the Wiener and Kirchhoff indices of random pentachains are derived by the difference equation and recursive method. Based on these formulae, we then make comparisons between the expected values of the Wiener index and the Kirchhoff index in random pentachains and present the average values of the Wiener and Kirchhoff indices with respect to the set of all random pentachains with

n

pentagons.
SACTNet: Spatial Attention Context Transformation Network for Cloud Removal
Authors: Liu Linlin , Hu Shaohui
Published: October 2021

Optical remote sensing image has the advantages of fast information acquisition, short update cycle, and dynamic monitoring. It plays an important role in many earth observation activities, such as ocean monitoring, meteorological observation, land planning, and crop yield investigation. However, in the process of image acquisition, an optical remote sensing system is often disturbed by clouds, resulting in low image clarity or even loss of ground information, affecting the acquisition of feature information and subsequent applications. We propose a spatial attention recurrent neural network model combined with a context transformation network to overcome the challenge of cloud occlusion. This model can obtain the core information in remote sensing images and consider the remote dependencies in the network. Furthermore, the network proposed in this paper has achieved excellent performance on the RICE1 and RICE2 datasets.
Engineered Magnetic Carbon-Based Adsorbents for the Removal of Water Priority Pollutants: An Overview
Authors: Reynel-Ávila H. E. , Camacho-Aguilar K. I. , Bonilla-Petriciolet A. , Mendoza-Castillo D. I. , González-Ponce H. A. , Trejo-Valencia R.
Published: October 2021

This review covers the preparation, characterization, and application of magnetic adsorbents obtained from carbon-based sources and their application in the adsorption of both inorganic and organic pollutants from water. Different preparation routes to obtain magnetic adsorbents from activated carbon, biochar, hydrochar, graphene, carbon dots, carbon nanotubes, and carbon nanocages, including the magnetic phase incorporated on the solid surface, are described and discussed. The performance of these adsorbents is analyzed for the removal of fluoride, arsenic, heavy metals, dyes, pesticides, pharmaceuticals, and other emerging and relevant water pollutants. Properties of these adsorbents and the corresponding adsorption mechanisms have been included in this review. Overall, this type of magnetic adsorbents offers an alternative for facing the operational problems associated to adsorption process in water treatment. However, some gaps have been identified in the proper physicochemical characterization of these adsorbents, the development of green and low-cost preparation methods for their industrial production and commercialization, the regeneration and final disposal of spent adsorbents, and their application in the multicomponent adsorption of water pollutants.
As Formações Santo Antônio do Bonito e Rocinha (Grupo Vazante, Minas Gerais): sedimentação gravitacional sin a pós-glacial e fosfogênese na transição Faixa Brasília-Cráton do São Francisco
Authors: Marques Carla Sofia de Sousa , Uhlein Alexandre , Uhlein Gabriel Jubé , Koester Edinei , Oliveira Eduardo Luís Carneiro de
Published: October 2021

As Formações Santo Antônio do Bonito e Rocinha, unidades basais do Grupo Vazante, compreendem diamictitos, arenitos, pelitos e raros carbonatos, originados de uma sedimentação gravitacional subaquosa, formando um sistema deposicional de slope-apron. Na região estudada, ao leste da cidade de Coromandel (Minas Gerais), no Vale do Rio Santo Antônio do Bonito, procedeu-se a mapeamento geológico, análise de fácies sedimentares, estudos isotópicos e comparação entre fosforitos sedimentares visando análise estratigráfica regional. Os dados geocronológicos U-Pb em zircão detrítico indicamidade deposicional máxima neoproterozoica para ambas as formações (idade concordante mais jovem de 934 ± 8 Ma), mas com proveniências ligeiramente diferentes entre as unidades. Dados isotópicos Sm-Nd mostram idades TDM e valores de εNd(t) diferentes entre as duas unidades, sugerindo, também, mudança nas áreas fontes. Os dados Sm-Nd também mostram grande semelhança entre as Formações Santo Antônio do Bonito e Jequitaí, cujas idades TDM são Paleoproterozoicas, com valores entre 1,8 e 2,1 Ga. Dados isotópicos Sm-Nd mostram, também, grande diferença entre pelitos da Formação Rocinha e pelitos do Grupo Bambuí (Formação Serra de Santa Helena). De leste para oeste, uma sedimentação glacial (Formação Jequitaí) é retrabalhada por processos gravitacionais, passando para um sistema de slope-apron na margem do paleocontinente São Francisco (Formações Santo Antônio do Bonito e Rocinha). Os depósitos fosfáticos do Grupo Vazante, nomeados de depósitos Coromandel (basal), Rocinha e Lagamar (topo), são comparados e, então, relacionados a um grande evento transgressivo fosfogênico pós-glacial de possível idade ediacarana. Esse enriquecimento em fosfato ocorre em ritmitos (fosfoarenitos ricos em intraclastos com granulometria de areia fina/média, fluorapatitas e matriz criptocritalina), enriquecidos, posteriormente, por processos supergênicos, formando wavellita nas fraturas.
Influência de projetos de reflorestamento de matas ciliares no controle/mitigação da erosão por ondas em reservatórios
Authors: Silva Paola de Oliveira , Leite Mariangela Garcia Praça , Costa Adivane Terezinha , Fujaco Maria Augusta Gonçalves
Published: October 2021

A erosão por ondas em reservatórios está entre os processos que mais remodelam suas margens e promovem seu assoreamento. A continuidade destes processos causa inúmeros problemas não só ambientais, mas também econômicos. Infelizmente, poucos são os trabalhos e modelos que tratam do assunto e a maioria deles usa um número restrito de parâmetros em suas análises. Uma das variáveis menos utilizada é a presença/tipo de vegetação, provavelmente pela dificuldade em se estimar seu impacto direto. Para se avaliar a influência da existência de matas ciliares em diferentes estágios sucessionais sobre a erosão por ondas em reservatórios, quatro áreas com diferentes usos e idades de reflorestamento tiveram ventos e ondas monitorados durante um ano e meio, incluindo feições erosivas e recuos de margens medidos, além de solos e sedimentos caracterizados. Os dados obtidos apontaram para um processo complexo, com muitas variáveis correlacionadas. Os resultados mostraram que a área com projeto de revegetação mais antigo (29 anos), cuja mata ciliar já se encontra bem estabelecida, apresenta características de solo e erosão semelhantes à área com vegetação nativa preservada, o que ajudou a preservar suas margens da ação erosiva das ondas. Já a área com projeto de revegetação recente (19 anos), ainda sem uma mata ciliar plenamente desenvolvida, se assemelha às áreas de pastagem, apenas com gramíneas, com intensa perda de material das margens para o reservatório. Esforços devem ser feitos no sentido de modificar legislações e ampliar o número de projetos de reflorestamento no intuito de reduzir os problemas causados pela erosão por ondas em reservatórios e, desta forma, melhorar a qualidade de suas águas e aumentar seu tempo de vida útil.
School Administrators’ Intentions to Promote Adapted Physical Education
Authors: W T. McNamara Scott , Rizzo Terry , Townsley Matt
Published: October 2021

A survey, developed with the Theory of Planned Behavior, was used to assess school administrators’ intention to promote adapted physical education (APE). Survey results indicated that when school administrators’ attitudes and subjective norms were favorable, the intention to promote APE was subsequently higher. The results indicate that if we expect public school administrators to promote APE in schools, they must know the importance of high-quality physical education to students with disabilities.
Characteristics of tobacco consumption among cancer patients at a tertiary cancer hospital in South India—A cross-sectional study
Authors: Ramani Vinod K , V Ganesha D , Benny Neethu , Naik Radheshyam
Published: October 2021

Introduction

Cancer patients commonly present with antecedent addiction to tobacco consumption. Our study describes the characteristics of this substance use. Following the diagnosis of cancer, continued consumption of tobacco results in reduced tolerance to treatment, failure of treatment, tumor progression, other primary tumors, secondary cancers, and poor quality of life. The aim of our study is to enumerate the clinico-social aspects of tobacco consumption among cancer patients.

Methods

This cross-sectional study includes 100 cancer patients admitted to Healthcare Global cancer hospital, Bangalore, India. The study subjects were assessed for tobacco consumption, as well as other substance use such as intake of alcohol. We assessed various dimensions of exposure to tobacco consumption such as duration, intensity, and cumulative dose as independent risk factors for cancer.

Results

Among the study subjects, 46.2% were found to smoke filter cigarettes. The mean duration of tobacco consumption among beedi users was found to be longer (25.9 years, SD: 14.4). When stratified for exclusive consumption, the mean durations were as follows: beedis (29 ± 14.4 years), cigarettes (23.8 ± 13.3 years), and chewing (15.9 ± 9.6 years). Along with tobacco, a large proportion (59.3%) of patients consumed alcohol as well. After attempts to quit, 89.01% patients had reversal of tobacco substance use. The data did not show significance for duration, intensity, and cumulative dose of tobacco consumption.

Conclusion

The diagnosis of cancer is a life-altering event, which results in higher motivation to quit the use of tobacco. Smoking cessation initiatives can reduce the risk of developing tobacco-related malignancies.
The Lived Experiences of Caregivers of Lung Transplant Recipients
Authors: Glaze Joy A. , Brooten Dorothy , Youngblut Jo Anne , Hannan Jean , Page Timothy
Published: October 2021

Introduction

Lung transplantation is a treatment crucial for the survival of patients with end-stage lung diseases. An identified caregiver is obligatory for a patient to be eligible for a lung transplant and plays an essential role in the transplant recipient's care. Most caregiver research, however, has been on caregivers of persons with Alzheimer's disease or the elderly, with limited research on caregivers’ experiences caring for transplant recipients. This study examined the experiences of caregivers of recipient's pre- and post-lung transplantation.

Methods/Approach

Caregivers of lung transplant recipients were recruited using purposeful sampling. Audiotaped semi-structured open ended interviews were conducted until data saturation. Each interview was transcribed verbatim, and conventional content analysis performed to extract significant themes and subthemes.

Findings

Four main themes and 12 sub-themes were identified. The former included (1) establishing the diagnosis, (2) caregiver roles, (3) caregiver psychological and psychosocial issues, and (4) support. Caregivers lacked basic knowledge related to lung transplantation. The caregivers’ roles necessitated rearranging priorities, lifestyle changes, and redirecting emotional and physical energy. Support played an important role in caregiving experiences.

Discussion

Each caregiver shared their unique caregiving experiences. Caregivers lack knowledge about transplantation, experience dramatic changes in their family life, social activities, employment, and often financial status. Healthcare providers can use the findings of this study in developing informational, and psychological interventions to alleviate caregivers’ stress and anxiety.
The significance of family reminiscing for children’s historical consciousness
Authors: Rantala Jukka
Published: October 2021

Ten years ago, I set out to study the ways in which Finnish children encounter the past. Back then, I found that parents and grandparents play an important role as sources of historical knowledge. In early 2020, I duplicated the same interview study with 78 children between 10 and 12 years of age. Despite the changes in media culture, looking at photographs and visiting historical sites together with family have retained their relevance as historical activities. Storytelling through family mementos is also commonplace. Although the historical discourse of families revolves around everyday topics, the Finnish wars of 1939–1945 are still strongly present in historical storytelling. Against the backdrop of their parents’ and grandparents’ lives, children perceive history as a progress narrative, which inspires them to believe in their nation’s and their own future success. In this article, I explore the significance of family reminiscing for children’s historical consciousness.
Population status and distribution of the critically endangered Indian Courser (Cursorius coromandelicus) on Delft Island, Sri Lanka
Authors: Aloysius Nitharsan , Madhushanka Shashi , Chandrika Chathuri
Published: October 2021

The critically endangered Indian Courser ( Cursorius coromandelicus) is a rare resident bird species in Sri Lanka. This bird species is restricted to the northern avifaunal region of Sri Lanka, and even there it has been recorded from only a few locations. Thus, it is identified as one of the rarest birds in Sri Lanka. A 1-year study was conducted to investigate Indian Courser population and their distribution within the Delft Island from 5th of January to 20th of December 2020. Ten (10) randomly selected points were investigated in this study. Of the 10 sampling points, the Indian Courser was observed within three (03) sampling points year around while several sightings were recorded in points 8, and 9 during 3 months of the year. Their abundance significantly varied among sampling locations (one-way ANOVA, F = 15.04, p < .05). The maximum number of individuals recorded was 18 ± 4.64 in December and the minimum number was 4 ± 4.64 during the non-migrant season. Although most of the area in the island is covered with dry grasslands, their distribution in Delft is largely confined to a few grassland patches where human activities are minimum. Hunting, egg collection, and trampling of their nest by the Delft ponies (feral horses) can be identified as the main threats of this species. It is of utmost importance to immediately implement holistic conservation measures to save this critically endangered bird as Delft is the only known location where a viable resident population of Indian Courser is found.
Rural Michigan Farmers’ Health Concerns and Experiences: A Focus Group Study
Authors: Wright Nathan , Scherdt Marylee , Aebersold Michelle L. , McCullagh Marjorie C. , Medvec Barbara R. , Ellimoottil Chad , Patel Minal R. , Shapiro Shoshana , Friese Christopher R.
Published: October 2021

Objectives:

Rural residents comprise approximately 15% of the United States population. They face challenges in accessing and using a health care system that is not structured to meet their unique needs. It is important to understand rural residents’ perceptions of health and experiences interacting with the health care system to identify gaps in care.

Methods:

Our team conducted focus groups with members of the Michigan Farm Bureau during their 2019 Annual Meeting. Topics explored included resources to manage health, barriers to virtual health care services, and desired changes to localized healthcare delivery. Surveys were used to capture demographic and internet access information.

Conclusion:

Analysis included data from 2 focus groups (n = 14). Participants represented a wide age range and a variety of Michigan counties. The majority were full-time farm owners with most—93% (n = 13)—reporting they had access to the internet in their homes and 86% (n = 12) reporting that their cellphones had internet capabilities. Participants identified challenges and opportunities in 4 categories: formal health care; health and well-being supports; health insurance experiences; and virtual health care.

Conclusion:

The findings from this study provide a useful framework for developing interventions to address the specific needs of rural farming residents. Despite the expressed challenges in access and use of health care services and resources, participants remained hopeful that innovative approaches, such as virtual health platforms, can address existing gaps in care. The study findings should inform the design and evaluation of interventions to address rural health disparities.
Hemophagocytic Lymphohistiocytosis for the Internist and Other Primary Care Providers
Authors: Pai Tanmayi Srinivas , Stancampiano Fernando F. , Rivera Candido
Published: October 2021

Hemophagocytic lymphohistiocytosis (HLH) syndrome is a hyperinflammatory state that leads to life-threatening, disproportionate activation of the immune system and may be confused for and concomitantly exist with sepsis. However, its treatment differs from sepsis, requiring early initiation of immunosuppressive treatment. While HLH syndrome is more commonly diagnosed in children, internists and other primary care providers must be familiar with the diagnosis and treatment of adult patients with HLH in the hospital and outpatient setting. In this article, we review the essentials that an internist and other primary care providers managing adult HLH patients should know.
Early Determinants of Length of Hospital Stay: A Case Control Survival Analysis among COVID-19 Patients admitted in a Tertiary Healthcare Facility of East India
Authors: Agarwal Neeraj , Biswas Bijit , Singh Chandramani , Nair Rathish , Mounica Gera , H Haripriya , Jha Amit Ranjan , Das Kumar M.
Published: October 2021

Background:

Length of hospital stay (LOS) for a disease is a vital estimate for healthcare logistics planning. The study aimed to illustrate the effect of factors elicited on arrival on LOS of the COVID-19 patients.

Materials and Methods:

It was a retrospective, record based, unmatched, case control study using hospital records of 334 COVID-19 patients admitted in an East Indian tertiary healthcare facility during May to October 2020. Discharge from the hospital (cases/survivors) was considered as an event while death (control/non-survivors) as right censoring in the case-control survival analysis using cox proportional hazard model.

Results:

Overall, we found the median LOS for the survivors to be 8 days [interquartile range (IQR): 7-10 days] while the same for the non-survivors was 6 days [IQR: 2-11 days]. In the multivariable cox-proportional hazard model; travel distance (>16 km) [adjusted hazard ratio (aHR): 0.69, 95% CI: (0.50-0.95)], mode of transport to the hospital (ambulance) [aHR: 0.62, 95% CI: (0.45-0.85)], breathlessness (yes) [aHR: 0.56, 95% CI: (0.40-0.77)], number of co-morbidities (1-2) [aHR: 0.66, 95% CI: (0.47-0.93)] (≥3) [aHR: 0.16, 95% CI: (0.04-0.65)], COPD/asthma (yes) [ [aHR: 0.11, 95% CI: (0.01-0.79)], DBP (<60/≥90) [aHR: 0.55, 95% CI: (0.35-0.86)] and qSOFA score (≥2) [aHR: 0.33, 95% CI: (0.12-0.92)] were the significant attributes affecting LOS of the COVID-19 patients.

Conclusion:

Factors elicited on arrival were found to be significantly associated with LOS. A scoring system inculcating these factors may be developed to predict LOS of the COVID-19 patients.
ANAT 3.0: a framework for elucidating functional protein subnetworks using graph-theoretic and machine learning approaches
Authors: Signorini L. F. , Almozlino T. , Sharan R.
Published: October 2021

Background

ANAT is a Cytoscape plugin for the inference of functional protein–protein interaction networks in yeast and human. It is a flexible graphical tool for scientists to explore and elucidate the protein–protein interaction pathways of a process under study.

Results

Here we present ANAT3.0, which comes with updated PPI network databases of 544,455 (human) and 155,504 (yeast) interactions, and a new machine-learning layer for refined network elucidation. Together they improve network reconstruction to more than twofold increase in the quality of reconstructing known signaling pathways from KEGG.

Conclusions

ANAT3.0 includes improved network reconstruction algorithms and more comprehensive protein–protein interaction networks than previous versions. ANAT is available for download on the Cytoscape Appstore and at https://www.cs.tau.ac.il/~bnet/ANAT/.
Spatial data analysis of malnutrition among children under-five years in Ethiopia
Authors: Fenta Haile Mekonnen , Zewotir Temesgen , Muluneh Essey Kebede
Published: October 2021

Background

Childhood malnutrition is a major cause of child mortality under the age of 5 in the sub-Saharan Africa region. This study sought to identify the risk factors and spatial distribution of the composite index of anthropometric failure (CIAF).

Methods

Secondary data from 2000, 2005, 2011, and 2016 Ethiopian Health and Demographic Survey (EDHS) were used. The generalized geo-additive mixed model was adopted via the Integrated Nested Laplace Approximation (INLA) with a binomial family and logit link function.

Results

The CIAF status of children was found to be positively associated with the male gender, the potency of contracting a disease, and multiple births. However, it was negatively associated with family wealth quartiles, parental level of education, place of residence, unemployment status of mothers, improved sanitation, media exposure, and survey years. Moreover, the study revealed significant spatial variations on the level of CIAF among administrative zones.

Conclusions

The generalized geo-additive mixed-effects model results identified gender of the child, presence of comorbidity, size of child at birth, dietary diversity, birth type, place of residence, age of the child, parental level of education, wealth index, sanitation facilities, and media exposure as main drivers of CIAF. The results would help decision-makers to develop and carry out target-oriented programs.
High-dose versus low-dose iron sucrose in individuals undergoing maintenance haemodialysis: a retrospective study
Authors: Liu Luojin , Cheng Huihui , Lv Yukai , Yu Weiguang , Liu Qilong , Wu Yanqing , Xu Bo
Published: October 2021

Background

Intravenous iron sucrose is becoming a prevailing treatment for individuals undergoing maintenance haemodialysis, but comparisons of dosing regimens are lacking. The aim of this retrospective review was to evaluate the safety and efficacy of proactively administered high-dose iron sucrose versus reactively administered low-dose iron sucrose in patients undergoing maintenance haemodialysis.

Methods

We analysed the data of 1500 individuals with maintenance haemodialysis who were treated with either high-dose iron sucrose that was proactively administered (Group HD) or low-dose iron sucrose that was reactively administered (Group LD) at the First Affiliated Hospital of Chongqing Medical University from Jan 1, 2008, to Dec 31, 2020. The primary endpoints were the cumulative doses of iron and erythropoiesis-stimulating agent; the secondary endpoints were the events of nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, infection rate, and death from any cause.

Results

Of the 2124 individuals, 624 individuals were excluded because they met one or more of the exclusion criteria, thus resulting in 1500 individuals who were eligible for inclusion in the study (Group HD, n = 760 and Group LD, n = 740). The median follow-up for the two cohorts was 32 months (range: 25–36). A significant median difference was detected in the monthly iron dose between the groups (1121 mg [range: 800–1274] in the HD group vs. 366 mg [range: 310–690] in the LD group; p < 0.05). The median dose of an erythropoiesis-stimulating agent was 26,323 IU/month (range: 17,596-44,712) in the HD group and 37,934 IU/month (range: 22,402-59,380) in the LD group (median difference: − 7901 IU/month; 95% CI: − 9632--5013; p = 0.000). A significant difference was detected in the secondary endpoints (266 events in 320 cases in the HD group vs. 344 events in 385 cases in the LD group) (HR: 0.62; 95% CI: 0.51–0.79; p < 0.001). A significant difference was not observed in death from any cause (HR: 0.57; 95% CI: 0.48–1.00; p = 0.361).

Conclusions

For individuals undergoing maintenance haemodialysis, high-dose iron sucrose that was proactively administered may be superior to low-dose iron sucrose that was reactively administered with low doses of erythropoiesis-stimulating agent.
Correction to: FXTAS is difficult to differentiate from neuronal intranuclear inclusion disease through skin biopsy: a case report
Authors: Toko Megumi , Ohshita Tomohiko , Kurashige Takashi , Morino Hiroyuki , Kume Kodai , Yamashita Hiroshi , Sobue Gen , Iwasaki Yasushi , Sone Jun , Kawakami Hideshi , Maruyama Hirofumi
Published: October 2021

An amendment to this paper has been published and can be accessed via the original article.
The effect of self-care counseling on health practices of adolescent pregnant women: a randomized controlled trial
Authors: Rezaie Ronya , Mohammad-Alizadeh-Charandabi Sakineh , Nemati Fatemeh , Mirghafourvand Mojgan
Published: October 2021

Background

Pregnancy and childbirth at an early age are associated with potential risks and complications for adolescent mothers. Health practices are behaviors that can positively affect maternal and fetal health. This study aimed to investigate the effects of self-care counseling on health practices (main outcome), attitudes towards motherhood and pregnancy, and pregnancy symptoms (secondary outcomes) in adolescent pregnant women.

Methods

In this randomized controlled trial, 54 adolescent pregnant women admitted to the health centers of Bukan, Iran in 2020 were enrolled. Using randomized block design, the participants were randomly assigned to the counseling (n=27) and control (n=27) groups. Those in the intervention group attended 6 self-care group counseling sessions. The Health Practices Questionnaire-II (HPQ-II), Attitudes towards Motherhood and Pregnancy Questionnaire (PRE-MAMA), and Pregnancy Symptoms Inventory (PSI) were completed before and 4 weeks after the intervention.

Results

Based on the results of ANCOVA with controlled baseline values, after the intervention the mean health practices score of the participants in the intervention group was significantly higher than those in the control group (adjusted mean difference (AMD): 36.34; 95% CI: 34.69 to 37.98; P<0.001). The mean attitude towards motherhood score of the participants in the intervention group was significantly higher than those in the control group (AMD: 1.01; 95% CI: 0.06 to 1.96; P= 0.038). However, the mean pregnancy symptoms score of the participants in the intervention group was partially lower than those in the control group (AMD: -1.37; 95% CI: -4.32 to 1.58; P= 0.354).

Conclusion

Self-care counseling sessions can improve the health practices of adolescent pregnant women and enhance their attitudes towards maternal role and pregnancy. Therefore, planners are recommended to organize self-care counseling programs for all pregnant women, especially for adolescent pregnant women.

Trial registration

Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N54. Date of registration: 2/3/2020. URL: https://en.irct.ir/user/trial/42571/view; Date of first registration: February 3, 2020.
Associations between accessibility to health care service, social support, and Korean Americans’ mental health status amid the COVID-19 pandemic
Authors: Min Jihyun Jane , Choi Shinwoo , Park Hyejoon
Published: October 2021

Background

While previous studies have examined the relationships between social support and health care accessibility among ethnic minority populations, studies on Korean Americans remain scarce. Therefore, this study aims to assess the relationship between Korean Americans’ mental health, accessibility to health care, and how they perceive the level of social support during the COVID-19 pandemic.

Method/result

We distributed online surveys to Korean Americans from May 24, 2020, to June 14, 2020, generating 790 responses from participants residing in 42 states. Binary Logistic and Ordinary Least Square regression analyses revealed that poor mental health was associated with language barriers inhibiting Korean Americans’ access to COVID-19-related information. Their perceived social support from family members and close friends was positively associated with mental health.

Conclusion

Our findings recommend that equipping community health care services with translators or interpreters is necessary. Additionally, health practitioners and staff should be trained to utilize telehealth tools to effectively treat individuals with mental health problems. American policymakers and health care professionals need to understand and address the unique hardships Korean Americans experience amid COVID-19.
Is it worth it? Cost-effectiveness analysis of a commercial physical activity app
Authors: Rondina Renante , Hong Michael , Sarma Sisira , Mitchell Marc
Published: October 2021

Background

Government interest in investing in commercial physical activity apps has increased with little evidence of their cost-effectiveness. This is the first study to our knowledge to examine the cost-effectiveness of a commercial physical activity app (Carrot Rewards) despite there being over 100,000 in the major app stores.

Methods

A cost-effectiveness analysis was performed to calculate the incremental cost-effectiveness ratio (ICER) of the app compared to a no-intervention reference scenario using a five-year time horizon. Primary data was collected between 2016 and 2017. Data synthesis, model creation, and statistical analyses were conducted between 2019 and 2020. An age-, sex-, and geography-dependent Markov model was developed assuming a public healthcare payer perspective. A closed cohort (n = 38,452) representing the population reached by Carrot Rewards in two Canadian provinces (British Columbia, Newfoundland & Labrador) at the time of a 12-month prospective study was used. Costs and effects were both discounted at 1.5% and expressed in 2015 Canadian dollars. Subgroup analyses were conducted to compare ICERs between provinces, sexes, age groups, and engagement levels.

Results

Carrot Rewards had an ICER of $11,113 CAD per quality adjusted life year (QALY), well below a $50,000 CAD per QALY willingness-to-pay (WTP) threshold. Subgroup analyses revealed that the app had lower ICERs for British Columbians, females, highly engaged users, and adults aged 35-64 yrs., and was dominant for older adults (65 + yrs). Deterministic sensitivity analyses revealed that the ICER was most influenced by the relative risk of diabetes. Probabilistic sensitivity analyses revealed varying parameter estimates predominantly resulted in ICERs below the WTP threshold.

Conclusions

The Carrot Rewards app was cost-effective, and dominant for older adults. These results provide, for the first time, rigorous health economic evidence for a commercial physical activity app as part of public health programming.
Self-management of overactive bladder at home using transcutaneous tibial nerve stimulation: a qualitative study of women’s experiences
Authors: Daly Ciara M. E. , Loi Lynette , Booth Jo , Saidan Dalia , Guerrero Karen , Tyagi Veenu
Published: October 2021

Background

Transcutaneous tibial nerve stimulation (TTNS) has been used to treat overactive bladder (OAB), however patient experiences and views of this treatment are lacking. The aim of this study was to explore women’s experiences of OAB and TTNS treatment and the perceived factors influencing participation and adherence.

Methods

Semi-structured, individual interviews conducted as part of a mixed-methods, randomised, feasibility trial of self-managed versus HCP-led TTNS. Interviews were audio recorded and transcribed verbatim. Reflexive thematic analysis was undertaken using Booth et al. (Neurourol Urodynam. 2017;37:528–41) approach.

Results

16 women were interviewed, 8 self-managing TTNS at home and 8 receiving TTNS in twice-weekly hospital clinic appointments. Women self-managing OAB considered TTNS easy to administer, flexible and favourably ‘convenient’, especially when the participant was bound by work and other life commitments. In contrast to OAB symptoms ‘dominating life’, self-managing bladder treatment was empowering and fitted around home life demands. Flexibility and control engendered by self-management, facilitated women’s willingness to participate in TTNS. Women attending a hospital clinic for TTNS enjoyed the social aspects but found the routine appointments constrained their lives. Motivation to continue TTNS in the longer term was dependent on perception of benefit.

Conclusions

This study provides novel insights into women’s experiences of self-managing their OAB using TTNS compared to HCP-led management in the clinical setting. It highlights positive experiences self-managing TTNS at home and a willingness to continue in the longer term, facilitated by ease of use and convenience.

Trial Registration 1/11/2018: ClinicalTrials.gov Identifier: NCT03727711.
A collaborative escape room as gamification strategy to increase learning motivation and develop curricular skills of occupational therapy students
Authors: Dugnol-Menéndez Julia , Jiménez-Arberas Estíbaliz , Ruiz-Fernández María Luisa , Fernández-Valera David , Mok Allen , Merayo-Lloves Jesús
Published: October 2021

Background

This study presents an experiment regarding the introduction of gamification strategies in occupational therapy courses. Based on previous studies, the objective is to adapt the idea of recreational escape rooms to educational environments of health sciences like occupational therapy to increase student motivation and promote game-based learning and key skills, such as teamwork.

Methods

Computer software was created for a collaborative escape room which allows on-line simultaneous play of up to 24–30 students. It was tested three times in an occupational therapy degree program with 75 students and it was based on two different subjects, although it can be adapted to others. The escape room was evaluated using feedback surveys and comparing students’ performances before and after the game. Descriptive exploratory statistical analysis was performed using SPSS version 24.

Results

An appropriate use of educational escape rooms can have significant positive impacts on students’ engagement and learning. Students were found to prefer using gamification tools in their learning. Their degrees of satisfaction exceeded their expectations.

Conclusions

Educational escape rooms may have a positive impact on students’ motivation and a statistically significant improvement of test scores after playing was found. Comments from the feedback surveys were used to improve successive versions of the software and design of the game.

Trial registration

T.F.G. n° 2020.038 (Research Ethics Committee of the Principality of Asturias).
The association between perceived hospital ethical climate and self-evaluated care quality for COVID-19 patients: the mediating role of ethical sensitivity among Chinese anti-pandemic nurses
Authors: Jiang Wenjing , Zhao Xing’e , Jiang Jia , Zhang Huilin , Sun Shujuan , Li Xianhong
Published: October 2021

Background

The COVID-19 pandemic called for a new ethical climate in the designated hospitals and imposed challenges on care quality for anti-pandemic nurses. Less was known about whether hospital ethical climate and nurses’ ethical sensitivity were associated with care quality. This study examined the association between the perceived hospital ethical climate and self-evaluated quality of care for COVID-19 patients among anti-pandemic nurses, and explored the mediating role of ethical sensitivity in this relationship.

Methods

A cross-sectional study was conducted through an online survey. A total of 399 anti-pandemic nurses from ten designated hospitals in three provinces of China were recruited to fill out an online survey. Multiple linear regression analysis and a bootstrap test were used to examine the relationships between ethical climate, ethical sensitivity and care quality.

Results

Nurses reported mean scores of 4.43 ± 0.577 (out of 5) for hospital ethical climate, 45.00 ± 7.085 (out of 54) for ethical sensitivity, and 5.35 ± 0.661 (out of 6) for self-evaluated care quality. After controlling for covariates, perceived hospital ethical climate was positively associated with self-evaluated care quality (direct effect = 0.710, 95% confidence interval [CI] 0.628, 0.792), and was partly mediated by ethical sensitivity (indirect effect = 0.078, 95% confidence interval [CI] 0.002, 0.145).

Conclusions

Chinese nurses who cared for COVID-19 patients perceived high levels of hospital ethical climate, ethical sensitivity, and self-evaluated care quality. Positive perceptions of hospital ethical climate were both directly associated with a higher level of self-evaluated care quality and indirectly associated, through the mediation effect of ethical sensitivity among anti-pandemic nurses.
Barriers to reporting clinical errors in operating theatres and intensive care units of a university hospital: a qualitative study
Authors: Ghobadian Sedighe , Zahiri Mansour , Dindamal Behnaz , Dargahi Hossein , Faraji-Khiavi Farzad
Published: October 2021

Background

Clinical errors are one of the challenges of health care in different countries, and obtaining accurate statistics regarding clinical errors in most countries is a difficult process which varies from one study to another. The current study was conducted to identify barriers to reporting clinical errors in the operating theatre and the intensive care unit of a university hospital.

Methods

This qualitative study was conducted in the operating theatre and intensive care unit of a university hospital. Data collection was conducted through semi-structured interviews with health care staff, senior doctors, and surgical assistants. Data analysis was carried out through listening to the recorded interviews and developing transcripts of the interviews. Meaning units were identified and codified based on the type of discussion. Then, codes which had a common concept were grouped under one category. Finally, the codes and designated categories were analysed, discussed and confirmed by a panel of four experts of qualitative content analysis, and the main existing problems were identified and derived.

Results

Barriers to reporting clinical errors were extracted in two themes: individual problems and organizational problems. Individual problems included 4 categories and 12 codes and organizational problems included 6 categories and 17 codes. The results showed that in the majority of cases, nurses expressed their desire to change the current prevailing attitudes in the workplace while doctors expected the officials to implement reform policies regarding clinical errors in university hospitals.

Conclusion

In order to alleviate the barriers to reporting clinical errors, both individual and organizational problems should be addressed and resolved. At an individual level, training nursing and medical teams on error recognition is recommended. In order to solve organizational problems, on the other hand, the process of reporting clinical errors should be improved as far as the nursing team is concerned, but when it comes to the medical team, addressing legal loopholes should be given full consideration.
Phenotypic and molecular spectra of patients with switch/sucrose nonfermenting complex-related intellectual disability disorders in Korea
Authors: Lee Yena , Choi Yunha , Seo Go Hun , Kim Gu-Hwan , Keum Changwon , Kim Yoo-Mi , Do Hyo-Sang , Choi Jeongmin , Choi In Hee , Yoo Han-Wook , Lee Beom Hee
Published: October 2021

Background

The switch/sucrose nonfermenting (SWI/SNF) complex is an adenosine triphosphate-dependent chromatin-remodeling complex associated with the regulation of DNA accessibility. Germline mutations in the components of the SWI/SNF complex are related to human developmental disorders, including the Coffin–Siris syndrome (CSS), Nicolaides–Baraitser syndrome (NCBRS), and nonsyndromic intellectual disability. These disorders are collectively referred to as SWI/SNF complex-related intellectual disability disorders (SSRIDDs).

Methods

Whole-exome sequencing was performed in 564 Korean patients with neurodevelopmental disorders. Twelve patients with SSRIDDs (2.1%) were identified and their medical records were retrospectively analyzed.

Results

ARID1B, found in eight patients, was the most frequently altered gene. Four patients harbored pathogenic variants in SMARCA4, SMARCB1, ARID2, and SMARCA2. Ten patients were diagnosed with CSS, and one patient without a typical phenotype was diagnosed with ARID1B-related nonsyndromic intellectual disability. Another patient harboring the SMARCA2 pathogenic variant was diagnosed with NCBRS. All pathogenic variants in ARID1B were truncating, whereas variants in SMARCA2, SMARCB1, and SMARCA4 were nontruncating (missense). Frequently observed phenotypes were thick eyebrows (10/12), hypertrichosis (8/12), coarse face (8/12), thick lips (8/12), and long eyelashes (8/12). Developmental delay was observed in all patients, and profound speech delay was also characteristic. Agenesis or hypoplasia of the corpus callosum was observed in half of the patients (6/12).

Conclusions

SSRIDDs have a broad disease spectrum, including NCBRS, CSS, and ARID1B-related nonsyndromic intellectual disability. Thus, SSRIDDs should be considered as a small but important cause of human developmental disorders.