bluuebunny/crossref_metadata_2025 huggingface dataset:
Manipulation of genes could inhibit SARS-CoV-2 infection that causes COVID-19 pandemics
Authors: Banerjee Arnab , Mukherjee Sandip , Maji Bithin K
Published: April 2021

The year 2020 witnessed an unpredictable pandemic situation due to novel coronavirus (COVID-19) outbreaks. This condition can be more severe if the patient has comorbidities. Failure of viable treatment for such viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is due to lack of identification. Thus, modern and productive biotechnology-based tools are being used to manipulate target genes by introducing the clustered regularly interspaced short palindromic repeats (CRISPR)/Cas (CRISPR-associated) system. Moreover, it has now been used as a tool to inhibit viral replication. Hence, it can be hypothesized that the CRISPR/Cas system can be a viable tool to target both the SARS-CoV-2 genome with specific target RNA sequence and host factors to destroy the SARS-CoV-2 community via inhibition of viral replication and infection. Moreover, comorbidities and COVID-19 escalate the rate of mortality globally, and as a result, we have faced this pandemic. CRISPR/Cas-mediated genetic manipulation to knockdown viral sequences may be a preventive strategy against such pandemic caused by SARS-CoV-2. Furthermore, prophylactic antiviral CRISPR in human cells (PAC-MAN) along with CRISPR/Cas13d efficiently degrades the specific RNA sequence to inhibit viral replication. Therefore, we suggest that CRISPR/Cas system with PAC-MAN could be a useful tool to fight against such a global pandemic caused by SARS-CoV-2. This is an alternative preventive approach of management against the pandemic to destroy the target sequence of RNA in SARS-CoV-2 by viral inhibition.
Vitamin E and Lactobacillus Provide Protective Effects Against Liver Injury Induced by HgCl2: Role of CHOP, GPR87, and mTOR Proteins
Authors: Alhusaini Ahlam , Alghilani Shahad , Alhuqbani Waad , Hasan Iman H.
Published: April 2021

Background and Objective:

Mercury is one of the most harmful heavy metals and its toxicity causes severe multi-organ dysfunction. This study was designed to explore novel molecular pathways involved in the hepatoprotective effect of vitamin E (Vit-E) and Lactobacillius plantarum (Lac-B) against mercury toxicity.[Formula: see text]

Method:

Acute hepatotoxicity was induced by administration of high dose of mercuric chloride (HgCl2) in male rats, Vit-E or/and Lac-B were given along with HgCl2 for 2 weeks. The effects of those antioxidants were studied focusing on their anti-apoptotic, anti-oxidative stress and anti-inflammatory eficacies. Histopathological examinations were also conducted.

Results:

The administration of HgCl2 induced liver injury which manifested by elevation in serum ALT and AST. Liver MDA, caspase-3 and TNF-α levels were markedly increased; whereas, GSH level and SOD activity were declined. HgCl2 significantly elevated the expressions of hepatic CHOP, GPR87, NF-κB and mTOR. Histopathological examination revealed massive hepatocyte degeneration following HgCl2 administration. Treatment with Vit-E or/and Lac-B restored the normal levels of the previously mentioned parameters, as well as improved hepatic architecture.

Conclusion:

Vit-E and Lac-B provided protective effect against HgCl2-induced hepatotoxicity via reduction of oxidative stress and inflammation, and downregulation of CHOP, GPR87, NF-κB and mTOR proteins’ expressions.
Comparison of ultrasound-accelerated versus conventional catheter-directed thrombolysis for deep vein thrombosis: A systematic review and meta-analysis
Authors: Farrokhi Mehrdad , Khurshid Maria , Mohammadi Sassan , Yarmohammadi Bardia , Bahramvand Yaser , Nasrollahi Elham , Taheri Fatemeh
Published: April 2021

Background

Recent in vitro and clinical studies have shown that ultrasound-accelerated catheter-directed thrombolysis (USACDT) can accelerate thrombolysis. Therefore, in this meta-analysis, we aimed to compare the efficacy and safety of USACDT with conventional catheter-directed thrombolysis in patients with deep vein thrombosis.

Methods

A systematic search of the following electronic databases was performed from their dates of inception to 20 June 2020: MEDLINE, Scopus, Google Scholar, CINAHL, Cochrane Library, and EMBASE. All randomized controlled trials that directly compared the complications and efficacy of USACDT and conventional catheter-directed thrombolysis in patients with deep vein thrombosis were identified. The statistical analysis was performed using comprehensive meta-analysis software.

Results

Finally, 18 studies with a total of 597 participants were included in our meta-analysis according to the eligibility criteria. Pooled proportion of USACDT success in patients with deep vein thrombosis was 87.8% (18 studies; 95% CI: 83.1–91.3). Success rate was significantly higher in USACDT treatment than in conventional catheter-directed thrombolysis treatment (seven studies; OR: 2.96; 95% CI: 1.69–5.16; P < 0.01)). Although the mean infusion time was higher in catheter-directed thrombolysis treatment compared to USACDT treatment, this difference was not statistically significant (three studies; MD: –1.46; 95% CI: –3.25–0.32; P = 0.10). Moreover, pooled rate of complications was lower in USACDT than catheter-directed thrombolysis which was not statistically significant (seven studies; OR: 0.49; 95% CI: 0.13–1.76; P = 0.27).

Conclusion

This meta-analysis revealed that USACDT significantly increased the success rate of thrombolysis compared to conventional catheter-directed thrombolysis. Furthermore, USACDT was associated with lower rate of complication and infusion time. Taken together, these findings confirm the superiority of this novel intervention over conventional catheter-directed thrombolysis in treatment of patients with deep vein thrombosis.
Functional performance status and risk of cardiovascular events and mortality following endovascular repair of thoracic and abdominal aortic pathology
Authors: Nadeswaran Pradeep , Ding Li , Singh Nikhil , Plotkin Anastasia , Magee Gregory A , Han Sukgu M , Garg Parveen K
Published: April 2021

Objective

To characterize the association of preoperative functional performance status based on Eastern Cooperative Oncology Group (ECOG) scoring with the risk of adverse cardiovascular events, vascular events, and mortality in patients undergoing EVAR and TEVAR.

Methods

Retrospective review of the Society for Vascular Surgery Vascular Quality Initiative, a large, multi-center, registry database was performed. All individuals undergoing EVAR ( n = 18,730) and TEVAR ( n = 6595) for non-ruptured aortic pathologies between 2014 and 2018 were eligible for analysis. Multivariable logistic regression was used to determine the association of pre-procedure ECOG functional performance status on risk of in-hospital adverse cardiovascular events, vascular events, and mortality.

Results

The number of operations complicated by adverse cardiovascular and vascular events was 480 (2.6%) and 190 (1.0%) for EVAR and 733 (11.1%) and 219 (3.3%) for TEVAR, respectively. There were 118 (0.6%) and 240 (3.6%) in-hospital deaths following EVAR and TEVAR, respectively. Patients with ECOG grades 3 or 4 undergoing EVAR were at increased risk of cardiovascular events (OR = 1.62; 95% CI = 1.09, 2.41) and one-year mortality (HR = 2.62; 95% CI = 1.92, 3.57) compared to those with ECOG grade 0. Patients undergoing TEVAR with ECOG grade 3 or 4 were at increased risk for both inpatient death (OR = 2.77; 95% CI = 1.56, 4.9) and one-year mortality (HR = 3.27, 95% CI = 2.06, 5.21). ECOG status was not associated with an increased risk of adverse vascular events following either EVAR or TEVAR.

Conclusions

Poor preoperative functional status as assessed by ECOG score is associated with an increased risk of adverse postoperative cardiovascular events following EVAR and a higher mortality risk following both EVAR and TEVAR. Functional status assessment may be useful for risk stratification and determining procedural candidacy prior to EVAR and TEVAR.
Health promotion interventions post-stroke for improving self-management: A systematic review
Authors: Taft Karenza , Laing Bobbi , Wensley Cynthia , Nielsen Lorraine , Slark Julia
Published: April 2021

Background

It is well-documented that women tend to be worse off post-stroke. They are often frailer, have less independence, lower functionality, increased rates of depression, and overall a lower quality of life. People who have had strokes benefit from rehabilitative support to increase their independence and reduce the risk of stroke reoccurrence. Despite the gender differences in the effects of stroke, interventions explicitly aimed at helping women have not been identified.

Purpose

This systematic review aimed to summarize the effectiveness of the health promoting behavioural interventions for reducing risk factors and improved self-management in women post-stroke, compared to usual care.

Method

Seven databases, Medline (Ovid), CINAHL, PsychInfo, Embase, PubMed, Scopus, and Google Scholar, were reviewed for randomized controlled trials covering post-stroke interventions. The following keywords were used: health promotion, secondary prevention, woman, women, female, sex difference, gender difference, after stroke, and post-stroke.

Results

Ten randomised controlled trials were found. These demonstrated common successful approaches for rehabilitation, but none specifically described health promotion strategies for women. Core components of successful programs appeared to be a structured approach, tailored to clientele and formalised support systems through their carer, family networks, or community engagement. Comprehensive reminder systems were successful for stroke risk reduction.

Conclusion

Women are disproportionately affected by stroke and are often in the frail category. Tailored structured health promotion programs with family and caregiver support combined with a comprehensive reminder system would appear to enable women post-stroke.
Developing Core Competence With Project-Based Learning: Voices From Chinese High School Students Serving Visually Impaired Students
Authors: Zhou (周林莉) Linli , Li (李佳) Jia
Published: April 2021

Highlights

This study explores the experiences of project-based learning (PBL) experimentation in Chinese high schools, especially the feedback that Chinese students have for better practicing PBL in China. We conducted a case study at two Chinese high schools in an intermediate city, Suzhou, which started their first PBL practice. The two high schools were chosen because of their unique initiative to mix visually impaired students (VIS) and ordinary students in a PBL course, which focuses on “designing accessible garbage bins for VIS.” Interviews and observations were conducted. All data are anonymized. After two rounds of thematic sorting and coding of the qualitative data, we found that the PBL course helped students develop two aspects of the civic participation dimension of core competence: social responsibility and problem-solving. Students learned to empathize with VIS to understand their needs and to build a more feasible and usable garbage bin. This study provides instructional recommendations in terms of how to better utilize the pedagogy of PBL in Chinese K-12 schools, particularly to support teachers to facilitate students' development of core competence and learning of inclusion, social responsibility, and sustainability by using the PBL technique.
Transition From Subsistence Agriculture to Rubber Plantations in Northern Laos: Analysis of Household Livelihood Strategies by Ethnicity and Gender
Authors: Kusakabe Kyoko , Chanthoumphone Chanthavisith
Published: April 2021

The study examined livelihood changes in eight villages in Luang Namtha province of northern Lao PDR following the expansion in rubber plantations and analyzed its impact on gender roles and relations. All study villages are engaged in rubber production, but the impact is shaped by the context and history of the particular location. The study has demonstrated the importance of feminist political ecologist approach in analyzing the conjuncture and intersectionality, as well as the location that shapes these conditions to better understand the gendered impact of the introduction of rubber production. The concept of social interface has helped us to identify the shock that women and men face and the changes in access to resources as a result of the shock and the agencies that the people exercised.
Barriers to Building More Effective Treatments: Negative Interactions Among Smoking-Intervention Components
Authors: Baker Timothy B. , Bolt Daniel M. , Smith Stevens S.
Published: April 2021

Meaningfully improved mental and behavioral health treatment is an unrealized dream. Across three factorial experiments, inferential tests in prior studies showed a pattern of negative interactions, suggesting that better clinical outcomes may be obtained when participants receive fewer rather than more intervention components. Furthermore, relatively few significant main effects were found in these experiments. Modeling suggested that negative interactions among components may account for these patterns. In this article, we evaluate factors that may contribute to such declining benefit: increased attentional or effort burden; components that produce their effects via the same capacity-limited mechanisms, making their effects subadditive; and a tipping-point phenomenon in which people near a hypothesized tipping point for change will benefit markedly from weak intervention and people far from the tipping point will benefit little from even strong intervention. New research should explore factors that cause negative interactions among components and constrain the development of more effective treatments.
Predictive Classification System for Low Back Pain Based on Unsupervised Clustering
Authors: Jin Lixia , Jiang Chang , Gu Lishu , Jiang Mengying , Shi Yuanlu , Qu Qixun , Shen Na , Shi Weibin , Cao Yuanwu , Chen Zixian , Jiang Chun , Feng Zhenzhou , Shen Linghao , Jiang Xiaoxing
Published: April 2021

Study Design:

Retrospective study.

Objective:

Lumbar magnetic resonance imaging (MRI) findings are believed to be associated with low back pain (LBP). This study sought to develop a new predictive classification system for low back pain.

Method:

Normal subjects with repeated lumbar MRI scans were retrospectively enrolled. A new classification system, based on the radiological features on MRI, was developed using an unsupervised clustering method.

Results:

One hundred and fifty-nine subjects were included. Three distinguishable clusters were identified with unsupervised clustering that were significantly correlated with LBP ( P = .017). The incidence of LBP was highest in cluster 3 (57.14%), nearly twice the incidence in cluster 1 (30.11%). There were obvious differences in the sagittal parameters among the 3 clusters. Cluster 3 had the smallest intervertebral height. Based on follow-up findings, 27% of subjects changed clusters. More subjects changed from cluster 1 to clusters 2 or 3 (14.5%) than changed from cluster 2 or cluster 3 to cluster 1 (5%). Participation in sport was more frequent in subjects who changed from cluster 3 to cluster 1.

Conclusion:

Using an unsupervised clustering method, we developed a new classification system comprising 3 clusters, which were significantly correlated with LBP. The prediction of LBP is independent of age and better than that based on individual sagittal parameters derived from MRI. A change in cluster during follow-up may partially predict lumbar degeneration. This study provides a new system for the prediction of LBP that should be useful for its diagnosis and treatment.
Arthroscopic Management of Scapulothoracic Bursitis: Clinical Outcomes and Assessment of Novel Bony Parameters on Magnetic Resonance Imaging
Authors: Zeng Gerald Joseph , Puah Ken Lee , Hao Ying , Lie Denny Tjiauw Tjoen
Published: April 2021

Background:

Scapulothoracic bursitis is a significant clinical condition that limits day-to-day function. Arthroscopic scapular debridement and resection have provided satisfactory outcomes; however, techniques, approaches, and recommendations remain varied. Novel bony parameters have also gained increasing interest owing to their value in preoperative planning.

Purpose:

To assess midterm clinical outcomes after the arthroscopic management of scapulothoracic bursitis and to identify and measure novel bony parameters on preoperative magnetic resonance imaging.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 8 patients underwent arthroscopic scapular debridement and bursectomy; 5 of the 8 patients underwent additional medial scapulectomy. There were 5 male (62.5%) and 3 female (37.5%) patients with a mean age of 30.1 ± 12.3 years (range, 19-58 years). Inclusion criteria for surgery were patients with symptomatic scapulothoracic bursitis for whom extensive nonoperative modalities had been utilized for at least 6 months but failed. Outcome measures included the Oxford Shoulder Score (OSS), University of California Los Angeles (UCLA) shoulder rating scale, Constant Shoulder Score (CSS), and visual analog scale (VAS) for pain. The bony parameters included scapular shape, anterior offset, costomedial angle, and medial scapular corpus angle (MSCA).

Results:

The follow-up duration was at least 2 years for all patients (mean follow-up, 25.0 ± 4.1 months [range, 24-35 months]). The majority of patients had a concave-shaped scapula (62.5%). The mean anterior offset was 24.3 ± 3.4 mm, and the mean costomedial angle was 132.3° ± 9.6°. Half the patients had a positive MSCA, while the other half had a negative MSCA. A statistically significant improvement was observed in the OSS, UCLA, CSS, and VAS scores from preoperatively to 2-year follow-up ( P < .001 for all). No complications were observed.

Conclusion:

Arthroscopic scapular debridement and resection provided satisfactory midterm clinical outcomes for the treatment of scapulothoracic bursitis.
Indigenous Empowerment Through Community-Engaged Health Education Curriculum: Health Promotion in a Commercial Tobacco Cessation Campaign
Authors: Newman Carroll Sara , Mombourquette Annie , Boxer Majel , Williams Rexine , Brewer Sarah
Published: April 2021

Community-engaged classrooms offer advantages to both students and community-based organizations by creating an environment where students become agents of change and contribute to meeting communities’ health needs. However, most community-engaged classroom research is done in high-income contexts in advanced curriculums with graduate students. This article explores a community-engaged classroom project at a minority- and indigenous-serving undergraduate institution, focusing on indigenous student empowerment. Commercial tobacco use prevention is of particular importance to indigenous contexts and resulted in a college policy change to reflect indigenous values. Students designed, implemented, and evaluated a tobacco product education campaign to effect change using a community-engaged approach. The educational activities included (1) understanding the tobacco context, (2) health communication course design, (3) forming key partnerships, (4) facilitating student activities through behind-the-scenes work, (5) designing and implementing a campaign, and (6) student growth and empowerment. We illustrate how academic and state partnerships can align interests in implementing public health policies and providing students with real-world public health communication and health equity experience.
Gods and the Oppressed: A Study on Theyyam Performers of North Malabar
Authors: Gopi Anil
Published: April 2021

Caste and caste inequalities are existing as a factual reality in the present day too. In Kerala, irrespective of high development, literacy and secularism, caste is still a crucial matter in the social and cultural life of the people. Related to the caste system in the Hindu religion is hierarchy in status, prevailing inequalities in power and wealth as well as imbalances in the religious sphere. This study explores such a case in which the famous religious ritual of kaliyattam in Northern Kerala is subjected to an ethnographic investigation. What resulted is the understanding of the harsh realities existing in the society in terms of caste and ritual authorities and exploitation. The different communities in the region that are a part of the ritual have to follow strict customs, which are mostly exploitative economically and unjustifiable and inhumane socially.
Sonographic Features of TOA With Highly Elevated CA-125: A Case Series
Authors: Patel Priya R. , Crabtree-Burton Elizabeth
Published: April 2021

Given the significant morbidity and mortality associated with tubo-ovarian abscess (TOA), prompt diagnosis and initiation of treatment is critical. If a diagnosis is made early, medical management remains an option thereby improving the chance of conservation of reproductive organs. TOA is a sequalae of pelvic inflammatory disease (PID) and the diagnosis remains difficult due to the wide inclusion criteria for this condition, which should exclude other causes of pelvic pain. This case study presents two atypical cases of TOA in which neither patient met the diagnostic criteria for PID, on initial presentation and delayed diagnosis. Sonographic findings of enlarging, complex hyper-vascular masses and markedly elevated CA-125 levels instead raised concerns for malignancy influencing management decisions. In retrospect, utilizing these two predictive diagnostic tools may facilitate an earlier diagnosis of TOA therefore even without overt PID. This becomes more important when the clinical signs support a potential diagnosis of malignancy.
Advantages of using graph databases to explore chromatin conformation capture experiments
Authors: D’Agostino Daniele , Liò Pietro , Aldinucci Marco , Merelli Ivan
Published: April 2021

Background

High-throughput sequencing Chromosome Conformation Capture (Hi-C) allows the study of DNA interactions and 3D chromosome folding at the genome-wide scale. Usually, these data are represented as matrices describing the binary contacts among the different chromosome regions. On the other hand, a graph-based representation can be advantageous to describe the complex topology achieved by the DNA in the nucleus of eukaryotic cells.

Methods

Here we discuss the use of a graph database for storing and analysing data achieved by performing Hi-C experiments. The main issue is the size of the produced data and, working with a graph-based representation, the consequent necessity of adequately managing a large number of edges (contacts) connecting nodes (genes), which represents the sources of information. For this, currently available graph visualisation tools and libraries fall short with Hi-C data. The use of graph databases, instead, supports both the analysis and the visualisation of the spatial pattern present in Hi-C data, in particular for comparing different experiments or for re-mapping omics data in a space-aware context efficiently. In particular, the possibility of describing graphs through statistical indicators and, even more, the capability of correlating them through statistical distributions allows highlighting similarities and differences among different Hi-C experiments, in different cell conditions or different cell types.

Results

These concepts have been implemented in NeoHiC, an open-source and user-friendly web application for the progressive visualisation and analysis of Hi-C networks based on the use of the Neo4j graph database (version 3.5).

Conclusion

With the accumulation of more experiments, the tool will provide invaluable support to compare neighbours of genes across experiments and conditions, helping in highlighting changes in functional domains and identifying new co-organised genomic compartments.
A new Bayesian piecewise linear regression model for dynamic network reconstruction
Authors: Shafiee Kamalabad Mahdi , Grzegorczyk Marco
Published: April 2021

Background

Linear regression models are important tools for learning regulatory networks from gene expression time series. A conventional assumption for non-homogeneous regulatory processes on a short time scale is that the network structure stays constant across time, while the network parameters are time-dependent. The objective is then to learn the network structure along with changepoints that divide the time series into time segments. An uncoupled model learns the parameters separately for each segment, while a coupled model enforces the parameters of any segment to stay similar to those of the previous segment. In this paper, we propose a new consensus model that infers for each individual time segment whether it is coupled to (or uncoupled from) the previous segment.

Results

The results show that the new consensus model is superior to the uncoupled and the coupled model, as well as superior to a recently proposed generalized coupled model.

Conclusions

The newly proposed model has the uncoupled and the coupled model as limiting cases, and it is able to infer the best trade-off between them from the data.
The physiological and molecular mechanisms of N transfer in Eucalyptus and Dalbergia odorifera intercropping systems using root proteomics
Authors: Yao Xianyu , Liao Liangning , Huang Yongzhen , Fan Ge , Yang Mei , Ye Shaoming
Published: April 2021

Background

The mixing of Eucalyptus with N2-fixing trees species (NFTs) is a frequently successful and sustainable cropping practice. In this study, we evaluated nitrogen (N) transfer and conducted a proteomic analysis of the seedlings of Eucalyptus urophylla × E. grandis (Eucalyptus) and an NFT, Dalbergia (D.) odorifera, from intercropping and monocropping systems to elucidate the physiological effects and molecular mechanisms of N transfer in mixed Eucalyptus and D. odorifera systems.

Results

N transfer occurred from D. odorifera to Eucalyptus at a rate of 14.61% in the intercropping system, which increased N uptake and growth in Eucalyptus but inhibited growth in D. odorifera. There were 285 and 288 differentially expressed proteins by greater than 1.5-fold in Eucalyptus and D. odorifera roots with intercropping vs monoculture, respectively. Introduction of D. odorifera increased the stress resistance ability of Eucalyptus, while D. odorifera stress resistance was increased by increasing levels of jasmonic acid (JA). Additionally, the differentially expressed proteins of N metabolism, such as glutamine synthetase nodule isozyme (GS), were upregulated to enhance N competition in Eucalyptus. Importantly, more proteins were involved in synthetic pathways than in metabolic pathways in Eucalyptus because of the benefit of N transfer, and the two groups of N compound transporters were found in Eucalyptus; however, more functional proteins were involved in metabolic degradation in D. odorifera; specifically, the molecular mechanism of the transfer of N from D. odorifera to Eucalyptus was explained by proteomics.

Conclusions

Our study suggests that N transfer occurred from D. odorifera to Eucalyptus and was affected by the variations in the differentially expressed proteins. We anticipate that these results can be verified in field experiments for the sustainable development of Eucalyptus plantations.
Coronary microvascular dysfunction is associated with degree of anaemia in end‐stage renal disease
Authors: Radhakrishnan Ashwin , Pickup Luke C. , Price Anna M. , Law Jonathan P. , McGee Kirsty C. , Fabritz Larissa , Senior Roxy , Steeds Richard P. , Ferro Charles J. , Townend Jonathan N.
Published: April 2021

Background

Coronary microvascular dysfunction (CMD) is common in end-stage renal disease (ESRD) and is an adverse prognostic marker. Coronary flow velocity reserve (CFVR) is a measure of coronary microvascular function and can be assessed using Doppler echocardiography. Reduced CFVR in ESRD has been attributed to factors such as diabetes, hypertension and left ventricular hypertrophy. The contributory role of other mediators important in the development of cardiovascular disease in ESRD has not been studied. The aim of this study was to examine the prevalence of CMD in a cohort of kidney transplant candidates and to look for associations of CMD with markers of anaemia, bone mineral metabolism and chronic inflammation.

Methods

Twenty-two kidney transplant candidates with ESRD were studied with myocardial contrast echocardiography, Doppler CFVR assessment and serum multiplex immunoassay analysis. Individuals with diabetes, uncontrolled hypertension or ischaemic heart disease were excluded.

Results

7/22 subjects had CMD (defined as CFVR < 2). Demographic, laboratory and echocardiographic parameters and serum biomarkers were similar between subjects with and without CMD. Subjects with CMD had significantly lower haemoglobin than subjects without CMD (102 g/L ± 12 vs. 117 g/L ± 11, p = 0.008). There was a positive correlation between haemoglobin and CFVR (r = 0.7, p = 0.001). Similar results were seen for haematocrit. In regression analyses, haemoglobin was an independent predictor of CFVR (β = 0.041 95% confidence interval 0.012–0.071, p = 0.009) and of CFVR < 2 (odds ratio 0.85 95% confidence interval 0.74–0.98, p = 0.022).

Conclusions

Among kidney transplant candidates with ESRD, there is a high prevalence of CMD, despite the absence of traditional risk factors. Anaemia may be a potential driver of microvascular dysfunction in this population and requires further investigation.
Effect of cardiopulmonary bypass reoxygenation on myocardial dysfunction following pediatric tetralogy of Fallot repair
Authors: Yang Ji-nong , Zhang Xiao-ming , Ma Lu-yao , Lu Zhan-jie , Zheng Si-qiang , Hamzah Al-Wajih , Shao Yong-feng , Liu Hong , Liu Gao-li
Published: April 2021

Background

Little is known regarding the effect of cardiopulmonary bypass (CPB) reoxygenation on cardiac function following tetralogy of Fallot repair. We hypothesized that hyperoxic reoxygenation would be more strongly associated with myocardial dysfunction in children with tetralogy of Fallot.

Methods

We investigated the association of perfusate oxygenation (PpO2) associated with myocardial dysfunction among children aged 6–72 months who underwent complete repair of tetralogy of Fallot in 2012–2018. Patients were divided into two groups: lower PpO2 group (≤ 250 mmHg) and higher PpO2 (> 250 mmHg) group based on the highest value of PpO2 during aortic occlusion. The odd ratio (ORs) and 95% confidence intervals (CIs) were estimated by logistic regression models.

Results

This study included 163 patients perfused with lower PpO2 and 213 with higher PpO2, with median age at surgery 23.3 (interquartile range [IQR] 12.5–39.4) months, 164 female (43.6%), and median body mass index 15.59 (IQR 14.3–16.9) kg/m2. After adjustment for baseline, clinical and procedural variables, patients with higher PpO2 were associated with higher risk of myocardial dysfunction than those with lower PpO2 (OR 1.770; 95% CI 1.040–3.012, P = 0.035). Higher PpO2, lower SpO2, lower pulmonary annular Z-score, and longer CPB time were independent risk factors for myocardial dysfunction.

Conclusions

Association exists between higher PpO2 and myocardial dysfunction risk in patients with tetralogy of Fallot, highlighting the modulation of reoxygenation during aortic occlusion to reduce cardiovascular damage following tetralogy of Fallot repair.

Trial registration

Clinical Trials. gov number NCT03568357. June 26, 2018
Factors associated with health facility deliveries among mothers living in hospital catchment areas in Rukungiri and Kanungu districts, Uganda
Authors: Mugambe Richard K. , Yakubu Habib , Wafula Solomon T. , Ssekamatte Tonny , Kasasa Simon , Isunju John Bosco , Halage Abdullah Ali , Osuret Jimmy , Bwire Constance , Ssempebwa John C. , Wang Yuke , McGriff Joanne A. , Moe Christine L.
Published: April 2021

Background

Health facility deliveries are generally associated with improved maternal and child health outcomes. However, in Uganda, little is known about factors that influence use of health facilities for delivery especially in rural areas. In this study, we assessed the factors associated with health facility deliveries among mothers living within the catchment areas of major health facilities in Rukungiri and Kanungu districts, Uganda.

Methods

Cross-sectional data were collected from 894 randomly-sampled mothers within the catchment of two private hospitals in Rukungiri and Kanungu districts. Data were collected on the place of delivery for the most recent child, mothers’ sociodemographic and economic characteristics, and health facility water, sanitation and hygiene (WASH) status. Modified Poisson regression was used to estimate prevalence ratios (PRs) for the determinants of health facility deliveries as well as factors associated with private versus public utilization of health facilities for childbirth.

Results

The majority of mothers (90.2%, 806/894) delivered in health facilities. Non-facility deliveries were attributed to faster progression of labour (77.3%, 68/88), lack of transport (31.8%, 28/88), and high cost of hospital delivery (12.5%, 11/88). Being a business-woman [APR = 1.06, 95% CI (1.01–1.11)] and belonging to the highest wealth quintile [APR = 1.09, 95% CI (1.02–1.17)] favoured facility delivery while a higher parity of 3–4 [APR = 0.93, 95% CI (0.88–0.99)] was inversely associated with health facility delivery as compared to parity of 1–2. Factors associated with delivery in a private facility compared to a public facility included availability of highly skilled health workers [APR = 1.15, 95% CI (1.05–1.26)], perceived higher quality of WASH services [APR = 1.11, 95% CI (1.04–1.17)], cost of the delivery [APR = 0.85, 95% CI (0.78–0.92)], and availability of caesarean services [APR = 1.13, 95% CI (1.08–1.19)].

Conclusion

Health facility delivery service utilization was high, and associated with engaging in business, belonging to wealthiest quintile and having higher parity. Factors associated with delivery in private facilities included health facility WASH status, cost of services, and availability of skilled workforce and caesarean services.
Screening for antenatal depression and its determinants among pregnant women in Qatar: revisiting the biopsychosocial model
Authors: Naja Sarah , Al Kubaisi Noora , Singh Rajvir , Abdalla Hiba , Bougmiza Iheb
Published: April 2021

Background

Screening for antenatal depression and its determinants is highly recommended. However, there is no consensus on a standard conceptual framework to approach pregnant women in a primary health care setting. The prevalence of antenatal depression and significant determinants are unknown in Qatar, a gap that we propose to fill.

Methods

An analytical cross-sectional study with a probability sampling technique was employed. Enrolling eight-hundred participants from primary health care centers. The screening was performed through a valid and reliable screening instrument ‘Edinburgh Postpartum Depression Scale.’ In addition to the proposed Comprehensive Biopsychosocial Model, participants were asked about their predisposing profile, biological risk, and other suggested modifiable variables.

Results

Twenty-one percent reported minor depressive episodes (n = 167, 20.9%) at a 95% confidence interval [18.2–23.8]. Previous use of mental health medications, fear of giving birth, concern about appearance, low perceived social support, and low resilience level showed to be associated with antenatal depression. The logistic regression analyses revealed that the Comprehensive Biopsychosocial model forecast 89% of antenatal depression predictors provided Area Under the Receiver Operating Characteristic Curve of 0.89 at a 95% confidence interval [0.85 to 0.92].

Conclusions

Antenatal depression is common among pregnant women in Qatar, and preventive interventions must target the determinants revealed. From a clinical perspective, the use of the proposed model may aid in the standardization of the screening process.
Scale development and an educational program to reduce the stigma of schizophrenia among community pharmacists: a randomized controlled trial
Authors: Fujii Tomoo , Hanya Manako , Murotani Kenta , Kamei Hiroyuki
Published: April 2021

Background

Stigma associated with mental disorders is rooted among many pharmacists, and represents a major barrier to patient support in community-based psychiatry. We developed an assessment scale that is specifically designed to assess the level of stigma that pharmacists may have toward schizophrenia, and then examined the effects of reducing stigma with an educational program that focuses on communication with patients diagnosed with schizophrenia (PDS) using the newly developed Stigma Scale towards Schizophrenia for Community Pharmacists (SSCP).

Methods

SSCP was developed by exploratory factor analysis with promax rotation based on responses from 822 randomly selected community pharmacists. Furthermore, a randomized controlled trial was conducted for 115 community pharmacists to clarify the effects of reducing the stigma of schizophrenia using an educational program for them with a focus on communication with PDS. Participants were individually allocated to two groups: educational lecture group (56; only attending a lecture on schizophrenia) or contact-based intervention group (59; communicating with PDS and attending the lecture). The stigma assessment using SSCP was conducted immediately before and after the educational intervention.

Results

A total of 4 factors and 27 items were extracted from the exploratory factor analysis to comprise the SSCP. Cronbach’s α of SSCP, social distance at professional pharmacy service (factor I), attitudes towards PDS (factor II), self-disclosure (factor III), and social distance in personal (factor IV) were 0.89, 0.88, 0.76, 0.62, and 0.62, respectively. Educational program-related changes of the median (interquartile range) total SSCP score from baseline were − 9.0 (− 16.0 – − 5.0) in the contact-based intervention group and − 3.0 (− 7.0–1.0) in the educational lecture group, reflecting a significant reduction of stigma levels in the contact-based intervention group. On examining the SSCP subscales, scores for factor I and factor II significantly improved. The educational program was more effective for pharmacists aged 20–39 years or with negligible experience of communicating with PDS at work and/or in private life.

Conclusions

SSCP and the educational program for community pharmacists that focuses on communication with PDS were useful for assessing and reducing, respectively, the stigma attached by these pharmacists to schizophrenia.

Trial registration

UMIN Clinical Trials Registry (UMIN000043189, registered on January 30, 2021), Retrospectively registered.
Study protocol: evaluation of sheds for life (SFL): a community-based men’s health initiative designed “for shedders by shedders” in Irish Men’s sheds using a hybrid effectiveness-implementation design
Authors: McGrath Aisling , Murphy Niamh , Richardson Noel
Published: April 2021

Background

Men’s Sheds (“Sheds”) offer a unique opportunity to reach a captive audience of “hard-to-reach” men. However, attempts to engage Sheds in structured health promotion programmes must respect the ethos of Sheds as highly variable, autonomous, non-structured spaces. This paper captures the key methodologies used in “Sheds for Life’ (SFL), a men’s health initiative tailored to the Shed setting.

Methods

A hybrid effectiveness-implementation study design is used to test effectiveness and implementation outcomes across multiple levels (participant, provider, organisational and systems levels). A dynamic, iterative and collaborative process seeks to address barriers and translation into the real world context. Using a community-based participatory research approach and guided by established implementation frameworks, Shed members (‘Shedders’) assume the role of key decision makers throughout the evaluation process to promote the systematic uptake of SFL across Shed settings. The protocols pertaining to the development, design and implementation of SFL and the evaluation of impact on participants’ health and wellbeing outcomes up to 12 months are outlined.

Conclusions

There is a dynamic interplay between the intervention characteristics of SFL and the need to assess and understand the diverse contexts of Sheds and the wider implementation environment. A pragmatic and context-specific design is therefore favoured over a tightly controlled efficacy trial. Documenting the protocols used to evaluate and implement a complex multi-level co-developed intervention such as SFL helps to inform gender-specific, community-based men’s health promotion and translational research more broadly.

Trial registration

This study has been retrospectively registered with the ‘International Standard Randomised Controlled Trial Number’ registry (ISRCTN79921361) as of the 5th of March 2021.
Urban social environment and low birth weight in 360 Latin American cities
Authors: Rodríguez López Santiago , Tumas Natalia , Ortigoza Ana , de Lima Friche Amélia Augusta , Diez-Roux Ana V.
Published: April 2021

Objective

Using data compiled by the SALURBAL project (Urban Health in Latin America; ‘Salud Urbana en América Latina’) we quantified variability in low birth weight (LBW) across cities in Latin America, and evaluated the associations of socio-economic characteristics at various levels (maternal, sub-city and city) with the prevalence of LBW.

Methods

The sample included 8 countries, 360 cities, 1321 administrative areas within cities (sub-city units) and birth registers of more than 4.5 million births for the year 2014. We linked maternal education from birth registers to data on socioeconomic characteristics of sub-cities and cities using the closest available national population census in each country. We applied linear and Poisson random-intercept multilevel models for aggregated data.

Results

The median prevalence of city LBW by country ranged from a high of 13% in Guatemala to a low of 5% in Peru (median across all cities was 7.8%). Most of the LBW variability across sub-cities was between countries, but there were also significant proportions between cities within a country, and within cities. Low maternal education was associated with higher prevalence of LBW (Prevalence rate ratios (PRR) for less than primary vs. completed secondary or more 1.12 95% CI 1.10, 1.13) in the fully adjusted model. In contrast, higher sub-city education and a better city social environment index were independently associated with higher LBW prevalence after adjustment for maternal education and age, city population size and city gross domestic product (PRR 1.04 95% CI 1.03, 1.04 per SD higher sub-city education and PRR 1.02 95% CI 1.00, 1.04 per SD higher SEI). Larger city size was associated with a higher prevalence of LBW (PRR 1.06; 95% CI 1.01, 1.12).

Conclusion

Our findings highlight the presence of heterogeneity in the distribution of LBW and the importance of maternal education, local and broader social environments in shaping LBW in urban settings of Latin America. Implementing context-sensitive interventions guided to improve women’s education is recommended to tackle LBW in the region.
Joint hypermobility in athletes is associated with shoulder injuries: a systematic review and meta-analysis
Authors: Liaghat Behnam , Pedersen Julie Rønne , Young James J. , Thorlund Jonas Bloch , Juul-Kristensen Birgit , Juhl Carsten Bogh
Published: April 2021

Background

Joint hypermobility in athletes is associated with increased risk of knee injuries, but its role in relation to shoulder injuries has not been scrutinized. Therefore, our aim was to synthesize the evidence on the association between joint hypermobility and shoulder injuries in athletes.

Methods

Data sources were MEDLINE, CINAHL, EMBASE, and SPORTDiscus from inception to 27th February 2021. Eligibility criteria were observational studies of athletes (including military personnel), mean age ≥ 16 years, and with a transparent grouping of those with and without joint hypermobility. A broad definition of joint hypermobility as the exposure was accepted (i.e., generalised joint hypermobility (GJH), shoulder joint hypermobility including joint instability). Shoulder injuries included acute and overuse injuries, and self-reported pain was accepted as a proxy for shoulder injuries. The Odds Ratios (OR) for having shoulder injuries in exposed compared with non-exposed athletes were estimated using a random effects meta-analysis. Subgroup analyses were performed to explore the effect of sex, activity type, sports level, study type, risk of bias, and exposure definition. Risk of bias and the overall quality of evidence were assessed using, respectively, the Newcastle–Ottawa Scale and the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results

Among 6207 records, six studies were included with 2335 (range 118–718) participants (34.1% females; athlete mean age 19.9 years). Athletes with joint hypermobility were more likely to have shoulder injuries compared with athletes without joint hypermobility (OR = 3.25, 95% CI 1.64, 6.43, I2 = 75.3%; p = 0.001). Exposure definition (GJH, OR = 1.97, 95% CI 1.32, 2.94; shoulder joint hypermobility, OR = 8.23, 95% CI 3.63, 18.66; p = 0.002) and risk of bias (low, OR = 5.25, 95% CI 2.56, 10.8; high, OR = 1.6, 95% CI 0.78, 3.29; p = 0.024) had large impacts on estimates, while the remaining subgroup analyses showed no differences. The overall quality of evidence was low.

Conclusion

Joint hypermobility in athletes is associated with a threefold higher odds of having shoulder injuries, highlighting the need for prevention strategies in this population. However, due to low quality of evidence, future research will likely change the estimated strength of the association.

Protocol registration

Open Science Framework registration osf.io/3wrn9.
Effectiveness of interactive augmented reality-based telerehabilitation in patients with adhesive capsulitis: protocol for a multi-center randomized controlled trial
Authors: Yeo Seung Mi , Lim Ji Young , Do Jong Geol , Lim Jae-Young , In Lee Jong , Hwang Ji Hye
Published: April 2021

Background

As the primary treatment for adhesive capsulitis, intensive and accurate home exercise is as important as physical therapy in hospitals. Augmented reality (AR)-based telerehabilitation has been implemented recently in various musculoskeletal conditions to increase patient compliance and enable patients to exercise with the correct posture. The objective of this study is to present a protocol for investigating the additive effect of interactive AR-based telerehabilitation in comparison with the usual care for patients with adhesive capsulitis.

Methods

This study presents the protocol of a prospective, multi-center, single-blinded, two-armed randomized controlled trial (RCT). One hundred patients with stage I or II adhesive capsulitis will be recruited at the physical medicine and rehabilitation clinic. Patients will be randomly divided into two groups with 1:1 allocation. The intervention group will receive 3 months of hospital-based physical therapy in conjunction with home-based telerehabilitation. The control group will receive 3 months of hospital-based physical therapy in conjunction with a home-based exercise described in a brochure provided by the hospital. The primary outcome will be the change in passive range of motion (ROM) of the affected shoulder joint from baseline to 12 weeks after baseline assessment. The secondary outcomes will be active ROM, pain measured with the numeric rating scale, shoulder pain and disability index, 36-Item Short Form Survey, EuroQoL-5D-5L, and Canadian Occupational Performance Measure.

Discussion

This will be the first RCT study protocol to investigate the effect of telerehabilitation in patients with adhesive capsulitis. The result of this RCT will determine whether AR-based telerehabilitation is more effective than a brochure-based home exercise program and will provide evidence of the usefulness of “telerehabilitation” using hardware (IoT) and software (monitoring platform) technologies to develop “digital therapeutics” for the future.

Trial registration

This trial was retrospectively registered at the Clinicaltrials.gov website on 20 March 2020, with the identifier NCT04316130.