bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Psychological Readiness to Return to Sport After Primary Versus Revision Anterior Cruciate Ligament Reconstruction
Authors: Duncan Brian R. , Reid Matthew , Kleihege Jacquelyn , Higbie Steven , Gardner Emily P. , Lowe Walter , Bailey Lane
Published: May 2023

Background:

Rates of return to preinjury level of play after anterior cruciate ligament (ACL) reconstruction (ACLR) remain unsatisfactory, particularly for patients who undergo revision surgery. Psychological readiness is associated with successful return to sport (RTS) and self-perceived preinjury sport performance.

Purpose:

To compare psychological readiness at RTS between patients who underwent revision ACL autograft reconstruction and matched controls who underwent primary ACL autograft reconstruction.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Data were gathered using a single orthopaedic surgeon database of patients who underwent ACLR between 2015 and 2018. Patients who underwent revision ACLR and met the study criteria (N = 92) were matched by age, sex, graft type, and rehabilitation protocol to a control group of patients who underwent primary ACLR (n = 92). Functional assessment at release to play was examined using passive knee range of motion, single-leg squat, and single-leg hop testing. Self-reported outcomes included the International Knee Documentation Committee subjective function survey and the ACL–Return to Sport after Injury (ACL-RSI) psychological readiness scale. Time to release to play was recorded as the number of months needed to reach a ≥90% limb symmetry index from the date of the index ACLR. Data were assessed for normality using the Shapiro-Wilk test, and univariate general linear models were utilized with an alpha level of .05.

Results:

The overall mean patient age was 29.9 ± 10 years, and 40% of patients were women. No significant differences between groups were noted in any of the baseline patient characteristics or surgical findings. At RTS, the mean ACL-RSI score was significantly lower in the revision surgery group (77.4 ± 19.4 vs 85.3 ± 17.4; P = .011). In addition, the revision surgery group returned to play significantly later than the primary surgery group (9.4 ± 2 vs 8.1 ± 1.3 months, respectively; P < .001).

Conclusion:

When compared with primary ACL autograft reconstruction, revision reconstruction patients exhibited lower psychological readiness scores and a longer time to meet the objective criteria for RTS.

Registration:

NCT03704376 ( ClinicalTrials.gov identifier).
Reading, Writing, and Harassment: White–Latinx Test Score Disparities on the U.S.–Mexico Border
Authors: Carris Peggy Sue
Published: May 2023

The U.S.–Mexico Border region is typified by enhanced immigration enforcement and legal violence, which are known to reduce the educational achievement of Latinx children and youth. Using data from the Stanford Education Data Archive, I compare math and reading test score disparities between White and Latinx students in public school districts in the four states along the U.S.–Mexico Border—California, Arizona, New Mexico, and Texas—with districts outside of the Border region. I find that reading and math test score disparities widen with proximity to the Border. Results indicate that educational and family-income differences between White and Latinx adults explain the disparity in math test scores. However, the reading test score disparity on the Border remains net of school and community factors, suggesting legal violence and immigration enforcement may be impacting Latinx youth and, therefore, increasing the size of the test score disparity. Finally, I find the test score disparities between the Border region and interior districts do not vary significantly in size across the four Border states.
Exploring the Implications of Implementing Ungrading in Two Graduate-Level Global Health Courses
Authors: Kalbarczyk Anna , Miller Emily , Majidulla Arman , Tarazona-Meza Carla , Chatterjee Pranab , Sauer Molly , Closser Svea
Published: May 2023

The practice of assigning grades is a universal quality of educational institutions, but the effects of biases in grading as well as its potential to distract from actual learning can make grading particularly problematic in the context of global health education. Ungrading is an anti-oppressive strategy to teaching which seeks to promote students as the experts of their own learning. It de-emphasizes grades and focuses on improved student engagement over time facilitated through thoughtful instructor comments and ongoing conversations. We implemented ungrading in two graduate-level global health courses at the Johns Hopkins Bloomberg School of Public Health; this manuscript documents the implementation process, the teaching teams’ experience, and student evaluations related to ungrading. Overall, quantitative course reviews were much improved from previous year(s). Qualitative responses revealed that students across both courses felt that ungrading improved their ability to focus on learning course material without anxiety about GPAs. Ungrading also encouraged students to embrace comments for learning, take risks, and leverage their lived experiences in responses. The teaching team felt students put in more effort, not less, and enjoyed a transformation in interactions with students—away from grades and toward content. Ungrading is a promising approach in graduate global health education that can facilitate inclusive and reflexive learning spaces.
E-Learning Medical Education in Gaza During COVID-19: Students’ Experiences and Policy Recommendations
Authors: Ismail Alaa , Ismail Anas , Alazar Ameera , Saman Mosab , Abu-Elqomboz Ayham , Sharaf Fawzi Khalil
Published: May 2023

Objectives

We explored medical students’ perspectives on and experiences of e-learning in Gaza and proposed relevant policy recommendations.

Methods

We administered an online questionnaire to medical students in Gaza exploring (1) demographics, computer skills, and time spent on e-learning; (2) students’ perception and challenges of e-learning; and (3) students’ preferences of continuing medical e-learning in the future. Analysis was done using SPSS version 23.

Results

Out of 1830 students invited, 470 responded, and 227 of them were basic-level students. More female students responded (58.3%, n = 256). Most participants ( n = 413, 87.9%) reported moderate to high computer skills allowing them to access e-learning. Before coronavirus disease-19 (COVID-19), over two-thirds ( n = 321, 68.3%) spent 0-3 hours on e-learning. After COVID-19, the majority shifted, and 306 students (65.1%) reported spending at least 7 hours on various e-learning sources. The challenges for clinical-level students were mainly related to lack of practical training in the hospital ( n = 196, 80%), followed by lack of interactions with real patients ( n = 167, 68.7%). As for basic-level students, a majority ( n = 120, 52.8%) reported lack of practical skills (eg, lab skills) as a challenge followed by unreliable internet access ( n = 119, 52.4%). Pre-recoded lectures, readily available educational videos were used more than live lectures. Less than a third of all students ( n = 147, 31.3%) wanted e-learning in the next term.

Conclusions

Medical students in Gaza don’t have a favourable experience with online medical education. There need to be actions to help overcome the challenges faced by students. This requires orchestrated actions by the government, universities, and local and international organizations.
Aneurysm treatment within 6 h versus 6–24 h after rupture in patients with subarachnoid hemorrhage
Authors: Vergouwen Mervyn DI , Germans Menno R , Post René , Tjerkstra Maud A , Coert Bert A , Rinkel Gabriel JE , Peter Vandertop William , Verbaan Dagmar
Published: May 2023

Background:

The risk of rebleeding after aneurysmal subarachnoid hemorrhage (aSAH) is the highest during the initial hours after rupture. Emergency aneurysm treatment may decrease this risk, but is a logistic challenge and economic burden. We aimed to investigate whether aneurysm treatment <6 h after rupture is associated with a decreased risk of poor functional outcome compared to aneurysm treatment 6–24 h after rupture.

Methods:

We used data of patients included in the ULTRA trial (NCT02684812). All patients in ULTRA were admitted within 24 h after aneurysm rupture. For the current study, we excluded patients in whom the aneurysm was not treated <24 h after rupture. We calculated crude and adjusted risk ratios (aRR) with 95% confidence intervals using Poisson regression analyses for poor functional outcome (death or dependency, assessed by the modified Rankin Scale) after aneurysm treatment <6 h versus 6–24 h after rupture. Adjustments were made for age, sex, clinical condition on admission (WFNS scale), amount of extravasated blood (Fisher score), aneurysm location, tranexamic acid treatment, and aneurysm treatment modality.

Results:

We included 497 patients. Poor outcome occurred in 63/110 (57%) patients treated within 6 h compared to 145/387 (37%) patients treated 6–24 h after rupture (crude RR: 1.53, 95% CI: 1.24–1.88; adjusted RR: 1.36, 95% CI: 1.11–1.66).

Conclusion:

Aneurysm treatment <6 h is not associated with better functional outcome than aneurysm treatment 6–24 h after rupture. Our results do not support a strategy aiming to treat every patient with a ruptured aneurysm <6 h after rupture.
First occurrence of the M2a2b2c polytype of argentopolybasite, [Ag6Sb2S7][Ag10S4]: Structural adjustments in the Cu-free member of the pearceite–polybasite group
Authors: Bindi Luca , Keutsch Frank N. , Topa Dan , Kolitsch Uwe , Morana Marta , Tait Kimberly T.
Published: May 2023

The chemistry and the crystal structure of the recently described mineral argentopolybasite are critically discussed based on the study of two new occurrences of the mineral: Gowganda, Timiskaming District, Ontario, Canada and IXL Mine, Silver Mountain mining district, Alpine County, California.

The crystal structure of argentopolybasite can be described as the sequence, along the c axis, of two alternating layers: a [Ag6Sb2S7]2–A layer and a [Ag10S4]2+B layer. In the B layer there are linearly-coordinated metal positions (B sites), which are usually occupied by copper in all members of the pearceite–polybasite group, resulting in a B-layer composition [Ag9CuS4]2+. In argentopolybasite, however, Ag fills all the metal sites in both A and B layers. By means of a multi-regression analysis on 67 samples of the pearceite–polybasite group, which were studied by electron microprobe and single-crystal X-ray diffraction, the effect of Ag, Sb and Se on the B sites of the B layer was modelled. Although the nomenclature rules for these minerals are based on chemical data only, we think this approach is useful to evaluate the goodness of the refinement of the structure (Ag/Cu disorder) and thus fundamental to discriminate different members of the pearceite–polybasite group.
Crystallisation of Ca-bearing nepheline in basanites from Kajishiyama, Tsuyama Basin, Southwest Japan
Authors: Yoneoka Keiya , Hamada Maki , Arai Shoji
Published: May 2023

Ca-bearing nepheline found in the Kajishiyama basanite, Tsuyama Basin, southwest Japan, was investigated to clarify its genesis in silica-undersaturated magmas. The basanite contains olivine and augite as phenocrysts and microphenocrysts, with Ca-bearing nepheline, olivine, augite, ulvöspinel, plagioclase, alkali feldspar, apatite and zeolites in the groundmass. Zeolites are more abundant in coarser-grained samples. The whole-rock composition of the basanite is characterised by low SiO2 and P2O5 contents and high total Fe, MgO, Na2O, K2O, Ba and Sr contents.

The Ca-bearing nepheline, ~20 μm in size, occurs in the mesostasis of the Kajishiyama basanite and contains up to 2.31 wt.% CaO and 16.75 wt.% Na2O, in contrast to nepheline from the Hamada nephelinite, southwest Japan. The approximate compositional formula of the Kajishiyama nepheline with the highest Ca content is (Ca0.467Ba0.013Na5.286K0.919□Total1.385)Σ8.070(Si0.912Al6.980Cr3+0.003Fe3+0.067 Mg0.017)Σ7.979Si8.000O32; i.e. Ne65.50Ks11.39Qxs11.22CaNe11.89.

Basanites are defined as being nepheline-normative, however they are high in normative plagioclase, the amount of which increases with fractionation of the magma. Nepheline crystallised after plagioclase, at the last stage of magmatic solidification is enriched in Ca. Such Ca-rich nepheline only forms from a magma which is high in normative plagioclase, as is the case in the Kajishiyama basanite. In contrast, Ca-poor nepheline is precipitated from nephelinitic magmas that crystallise melilite instead of plagioclase, even when Ca contents are high.
Vitamin D receptor antagonist activity in wastewater effluents—potential for endocrine disruption
Authors: Lundqvist Johan , Mandava Geeta , Oskarsson Agneta
Published: May 2023

Background

Endocrine disrupting chemicals have been identified for a number of human endocrine systems, but there are no reports on vitamin D-antagonistic activities in environmental samples.

Objectives

We have investigated if there are compounds present in the environment that can act as Vitamin D receptor (VDR) antagonists.

Methods

Water samples were collected of the influent and effluent water from five Swedish wastewater treatment facilities and concentrated with solid phase extraction. VDR antagonistic properties of the samples were tested with a cell-based in vitro assay responsive to vitamin D signaling. Cytotoxicity was monitored by three different assays.

Results

We observed a dose-dependent decrease in the VDR signaling in most studied samples, although the effect was overlapping with cytotoxicity for the influent samples. For effluent samples, we observed clear VDR antagonistic effects also in non-cytotoxic concentrations. The observed effects could not be explained by presence of natural organic matter or cadmium in the water.

Discussion

The vitamin D endocrine system regulates a broad range of physiological processes, and disruption of this system could be associated with serious health consequences. In this study, we report environmental presence of compounds with VDR antagonistic properties, compounds which constitute a new group of potential endocrine disruptors. The VDR antagonism was observed in wastewater treatment facility effluent waters, which are discharged into water systems used as raw water for drinking water production. The findings reported in this study may indicate a potential hazard to human health and aquatic life. Future research is needed to investigate the presence of VDR antagonists in the environment, identification of the causative compounds, and studies of exposure of humans and aquatic organisms to these compounds.
The role of the calcofluor white staining in the diagnosis of Acanthamoeba keratitis
Authors: Elhardt Carolin , Schweikert Romina , Hartmann Lennart Maximilian , Vounotrypidis Efstathios , Kilani Adnan , Wolf Armin , Wertheimer Christian Maximilian
Published: May 2023

Purpose

Acanthamoeba keratitis is often misdiagnosed at disease onset. This study presents data to confirm the diagnosis using calcofluor white (CFW) staining.

Methods

Forty three patients were retrospectively included who presented to the Department of Ophthalmology at the University Hospital Ulm with keratitis between 2000 and 2022. Condition positive cases were diagnosed based on the typical clinical presentation of Acanthamoeba keratitis with a positive polymerase chain reaction (PCR). Condition negative were patients with ulcers due to other causing pathogens with a negative Acanthamoeba PCR result. The condition was compared with the CFW test results.

Results

After symptom onset, time until presentation was 17 ± 12 days and until diagnosis 27 ± 13 days in the 15 condition positive patients. Among the 35 patients with additional CFW test, 7 patients were condition positive and 28 negative. 5 of the 7 patients were true positive, 2 were false negative. In the 28 condition negative patients, 1 was false positive. Sensitivity of CFW was 71% and specificity 96%. The positive PCR results were available 3.4 ± 2.3 days after corneal scraping, the positive CFW test results on the same day in each case.

Conclusion

Our data demonstrate that diagnosis of Acanthamoeba keratitis remains difficult and therapy is initiated late. A positive CFW test confirms the diagnosis as there are almost no false positive results and it was available faster than PCR. In case of a negative CFW test, Acanthamoeba keratitis cannot be ruled out because of a high false negative rate.
Investigation of hollow mesoporous NiFe2O4 nanospheres fabricated via a template-free solvothermal route as pH-responsive drug delivery system for potential anticancer application
Authors: Qi Qing , Zhang Hui , Liu Mengru , Qi Shujing , Huo Zhongchao , Ma Yingying , Zhang Zhongqiang , Lu Yongchang , Qi Xiongwei , Han Shuai , Wang Guangshuo
Published: May 2023

A novel magnetic-targeted pH-responsive intelligent drug carrier based on hollow mesoporous structured NiFe2O4 nanospheres was designed and developed for potential anticancer treatment in the present study. The hollow mesoporous NiFe2O4 nanospheres were fabricated through a template-free solvothermal approach and the possible formation mechanism of this structure was proposed. The products were investigated comprehensively for their morphology, microstructure, composition and magnetic properties using a wide series of characterization methods. The NiFe2O4 nanospheres were demonstrated to possess a well-defined spherical morphology, homogeneous particle size distribution, large hollow cavities and abundant mesopores, unique superparamagnetic behavior, high saturation magnetization as well as good biocompatibility. Due to these desirable physicochemical properties, the hollow mesoporous NiFe2O4 nanospheres were expected to be employed as a potential vehicle for loading and delivering anticancer drug of doxorubicin hydrochloride (DOX). Drug release behavior was evidenced to be controllable and pH-responsive with effective DOX release of 73.1% and 58.8% in acidic conditions (pH 4.0 and 5.5), whereas insufficient drug release of 44.7% at a neutral atmosphere (pH 7.4) within 48 h. More importantly, the DOX-loaded NiFe2O4 nanospheres displayed significant anti-proliferation and apoptosis effects on human breast cancer cells (MCF-7), which further indicated the promising potential application of constructed drug delivery nanocarriers in the field of cancer therapy.
HostSeq: a Canadian whole genome sequencing and clinical data resource
Authors: Yoo S , Garg E , Elliott LT , Hung RJ , Halevy AR , Brooks JD , Bull SB , Gagnon F , Greenwood CMT , Lawless JF , Paterson AD , Sun L , Zawati MH , Lerner-Ellis J , Abraham RJS , Birol I , Bourque G , Garant J-M , Gosselin C , Li J , Whitney J , Thiruvahindrapuram B , Herbrick J-A , Lorenti M , Reuter MS , Adeoye OO , Liu S , Allen U , Bernier FP , Biggs CM , Cheung AM , Cowan J , Herridge M , Maslove DM , Modi BP , Mooser V , Morris SK , Ostrowski M , Parekh RS , Pfeffer G , Suchowersky O , Taher J , Upton J , Warren RL , Yeung RSM , Aziz N , Turvey SE , Knoppers BM , Lathrop M , Jones SJM , Scherer SW , Strug LJ
Published: May 2023

HostSeq was launched in April 2020 as a national initiative to integrate whole genome sequencing data from 10,000 Canadians infected with SARS-CoV-2 with clinical information related to their disease experience. The mandate of HostSeq is to support the Canadian and international research communities in their efforts to understand the risk factors for disease and associated health outcomes and support the development of interventions such as vaccines and therapeutics. HostSeq is a collaboration among 13 independent epidemiological studies of SARS-CoV-2 across five provinces in Canada. Aggregated data collected by HostSeq are made available to the public through two data portals: a phenotype portal showing summaries of major variables and their distributions, and a variant search portal enabling queries in a genomic region. Individual-level data is available to the global research community for health research through a Data Access Agreement and Data Access Compliance Office approval. Here we provide an overview of the collective project design along with summary level information for HostSeq. We highlight several statistical considerations for researchers using the HostSeq platform regarding data aggregation, sampling mechanism, covariate adjustment, and X chromosome analysis. In addition to serving as a rich data source, the diversity of study designs, sample sizes, and research objectives among the participating studies provides unique opportunities for the research community.
An optimized graph-based structure for single-cell RNA-seq cell-type classification based on non-linear dimension reduction
Authors: Abadi Saeedeh Akbari Rokn , Laghaee Seyed Pouria , Koohi Somayyeh
Published: May 2023

Background

It is now possible to analyze cellular heterogeneity at the single-cell level thanks to the rapid developments in single-cell sequencing technologies. The clustering of cells is a fundamental and common step in heterogeneity analysis. Even so, accurate cell clustering remains a challenge due to the high levels of noise, the high dimensions, and the high sparsity of data.

Results

Here, we present SCEA, a clustering approach for scRNA-seq data. Using two consecutive units, an encoder based on MLP and a graph attention auto-encoder, to obtain cell embedding and gene embedding, SCEA can simultaneously achieve cell low-dimensional representation and clustering performing various examinations to obtain the optimal value for each parameter, the presented result is in its most optimal form. To evaluate the performance of SCEA, we performed it on several real scRNA-seq datasets for clustering and visualization analysis.

Conclusions

The experimental results show that SCEA generally outperforms several popular single-cell analysis methods. As a result of using all available datasets, SCEA, in average, improves clustering accuracy by 4.4% in ARI Parameters over the well-known method scGAC. Also, the accuracy improvement of 11.65% is achieved by SCEA, compared to the Seurat model.
Determinants of referral for suspected coronary artery disease: a qualitative study based on decision thresholds
Authors: Winkler Katja , Gerlach Navina , Donner-Banzhoff Norbert , Berberich Anika , Jung-Henrich Jutta , Schlößler Kathrin
Published: May 2023

Background

Chest pain is a frequent consultation issue in primary care, with coronary artery disease (CAD) being a serious potential cause. Primary care physicians (PCPs) assess the probability for CAD and refer patients to secondary care if necessary. Our aim was to explore PCPs’ referral decisions, and to investigate determinants which influenced those decisions.

Methods

PCPs working in Hesse, Germany, were interviewed in a qualitative study. We used ‘stimulated recall’ with participants to discuss patients with suspected CAD. With a sample size of 26 cases from nine practices we reached inductive thematic saturation. Interviews were audio-recorded, transcribed verbatim and analyzed by inductive-deductive thematic content analysis. For the final interpretation of the material, we used the concept of decision thresholds proposed by Pauker and Kassirer.

Results

PCPs reflected on their decisions for or against a referral. Aside from patient characteristics determining disease probability, we identified general factors which can be understood as influencing the referral threshold. These factors relate to the practice environment, to PCPs themselves and to non-diagnostic patient characteristics. Proximity of specialist practice, relationship with specialist colleagues, and trust played a role. PCPs sometimes felt that invasive procedures were performed too easily. They tried to steer their patients through the system with the intent to avoid over-treatment. Most PCPs were unaware of guidelines but relied on informal local consensus, largely influenced by specialists. As a result, PCPs gatekeeping role was limited.

Conclusions

We could identify a large number of factors that impact referral for suspected CAD. Several of these factors offer possibilities to improve care at the clinical and system level. The threshold model proposed by Pauker and Kassirer was a useful framework for this kind of data analysis.
Functional outcomes following knee replacement in community-dwelling older adults
Authors: Wang Yuanyuan , Owen Alice , Franks Angus , Ackerman Ilana , Fitzgerald Sharyn M. , Liew Susan , Woods Robyn L. , Wluka Anita E. , McNeil John J. , Cicuttini Flavia M.
Published: May 2023

Background

Knee replacements are increasingly performed in older adults but uncertainty remains regarding their benefits in the context of age-related decline in physical function and other comorbidities. This study aimed to examine (1) the effect of knee replacement on functional outcomes in the context of age-related decline in physical function and (2) the factors associated with minimal important improvement in physical function after knee replacement in community-dwelling older adults aged ≥ 70 years.

Methods

This cohort study was performed within the ASPREE trial, with 889 participants undergoing knee replacement during the trial and 858 age- and sex-matched controls without knee or hip replacement identified from 16,703 Australian participants aged ≥ 70 years. Health-related quality of life was assessed annually using the SF-12, including its physical and mental component summary (PCS and MCS). Gait speed was measured biennially. Multiple linear regression and analysis of covariance were used to adjust for potential confounders.

Results

Participants with knee replacement had significantly lower pre- and post-replacement PCS scores and gait speed compared with age- and sex-matched controls. Participants with knee replacement had significant improvement in PCS score following knee replacement (mean change 3.6, 95% CI 2.9–4.3) while PCS score remaining unchanged in age- and sex-matched controls (-0.02, 95% CI -0.6 to 0.6) during follow-up period. The greatest improvements were observed for bodily pain and physical function. Following knee replacement, 53% of participants experienced minimal important improvement in PCS score (increased by ≥ 2.7), while 24% experienced worsened PCS score (reduced by > 2.7). Participants experiencing improved PCS score postoperatively had significantly lower PCS and higher MCS scores pre-surgery.

Conclusions

Although community-based older adults experienced a significant improvement in PCS scores after knee replacement, their postoperative physical functional status remained significantly lower than age- and sex-matched controls. The degree of preoperative physical function impairment was a strong predictor of functional improvement, suggesting that this could be an important consideration when identifying older people most likely to benefit from knee replacement surgery.
Previous antibiotic therapy as independent risk factor for the presence of vancomycin-resistant enterococci in surgical inpatients. Results from a matched case-control study
Authors: MacKenzie Philip , Färber Jacqueline , Post Marius , Esser Torben , Bechmann Lukas , Kropf Siegfried , Croner Roland , Geginat Gernot
Published: May 2023

Background

Investigation of risk factors for the presence of vancomycin-resistant enterococci (VRE) in inpatients on surgical wards and associated intensive care units of a German tertiary care hospital.

Methods

A single-centre retrospective matched case-control study was performed with surgical inpatients admitted between July 2013 and December 2016. Patients with in-hospital detection of VRE later than 48 h after admission were included and comprised 116 VRE-positive cases and 116 VRE-negative matched controls. VRE isolates of cases were typed by multi-locus sequence typing.

Results

ST117 was identified as the dominant VRE sequence type. Next to length of stay in hospital or on an intensive care unit and previous dialysis the case-control study revealed previous antibiotic therapy as a risk factor for the in-hospital detection of VRE. The antibiotics piperacillin/tazobactam, meropenem, and vancomycin were associated with the highest risks. After taking into account length of stay in hospital as possible confounder other potential contact-related risk factors such as previous sonography, radiology, central venous catheter, and endoscopy were not significant.

Conclusions

Previous dialysis and previous antibiotic therapy were identified as independent risk factors for the presence of VRE in surgical inpatients.
Pregnancy- and lactation-induced osteoporosis: a social-media-based survey
Authors: Peltz-Sinvani Naama , Raz Hadar Milloh , Klein Pinchas , Ish-Shalom Sophia , Vered Iris , Tripto-Shkolnik Liana
Published: May 2023

Background

Pregnancy- and lactation-induced osteoporosis (PLO) presenting as spinal fractures is rare, and the spectrum of clinical presentation, risk factors and pathophysiology are incompletely understood. The aim of this study was to delineate clinical parameters, risk factors and osteoporosis-related quality of life (QOL) of women with PLO.

Methods

Participants of a social-media (WhatsApp) PLO group and mothers of a parents’ WhatsApp group (control group) were offered to fill a questionnaire, including an osteoporosis-related QOL section. The groups were compared using the independent Students t test for numerical variables, and the Chi-square test or Fisher’s exact test for categorical variables.

Results

Twenty-seven women with PLO and 43 in the control group (aged 36.2 ± 4.7 and 38.8 ± 4.3 years, respectively, p = 0.04) participated. Among women with PLO, more than 5 vertebrae were involved in 13 (48%), 4 vertebrae in 6 (22%), and 3 or fewer vertebrae in 8 (30%). Among the 24 women with relevant data, 21 (88%) had nontraumatic fractures; 3 (13%) women had fractures during pregnancy, and the remaining during the early postpartum period. Diagnosis was delayed for over 16 weeks for 11 (41%) women; 16 (67%) received teriparatide. Significantly lower proportions of women in the PLO group engaged in physical activity over 2 hours/week, before and during pregnancy (37 vs. 67%, p < 0.015 and 11 vs. 44%, p < 0.003, respectively). A lower proportion of the PLO than the control group reported calcium supplementation during pregnancy (7% vs. 30%, p = 0.03) and a higher proportion reported treatment with low-molecular-weight-heparin during pregnancy (p = 0.03). Eighteen (67%) of the PLO group expressed fear of fractures and 15 (56%) fear of falls, compared to none and 2%, respectively, of the control group (p < 0.00001 for both).

Conclusions

Most of the women with PLO who responded to our survey reported spinal fractures involving multiple vertebrae, delayed diagnosis, and treatment with teriparatide. Compared to a control group, they reported less physical activity and impaired QOL. For this uncommon yet severe condition, a multidisciplinary effort should be exerted for early identification and treatment, to alleviate back pain, prevent subsequent fractures and improve QOL.
Changes in emergency department utilisation in Germany before and during different phases of the COVID-19 pandemic, using data from a national surveillance system up to June 2021
Authors: Schranz Madlen , Boender T. Sonia , Greiner Timo , Kocher Theresa , Wagner Birte , Greiner Felix , Bienzeisler Jonas , Diercke Michaela , Grabenhenrich Linus ,   AKTIN-Research Group, Brokmann Jörg , Mach Carsten , Wehler Markus , Blaschke Sabine , Esslinger Katrin , Schunk Domagoj , Wolfrum Sebastian , Hofmann Tobias , Lucas Benjamin , Klein Matthias , Peschel Thomas , Grupp Caroline , Wenderoth Hardy , Horn Oliver , Wrede Christian , Hoeger-Schmidt Heike , Dormann Harald , Ullrich Greta , Habbinga Kirsten , Henke Thomas , Schilling Tobias , Erdmann Bernadett , Wetzel Eckart , Baacke Markus , Grashey Rupert , Röhrig Rainer , Majeed Raphael , Kombeiz Alexander , Triefenbach Lucas , Walcher Felix , Schirrmeister Wiebke , Otto Ronny , Drynda Susanne , Aigner Annette , Ullrich Alexander
Published: May 2023

Background

During the COVID-19 pandemic and associated public health and social measures, decreasing patient numbers have been described in various healthcare settings in Germany, including emergency care. This could be explained by changes in disease burden, e.g. due to contact restrictions, but could also be a result of changes in utilisation behaviour of the population. To better understand those dynamics, we analysed routine data from emergency departments to quantify changes in consultation numbers, age distribution, disease acuity and day and hour of the day during different phases of the COVID-19 pandemic.

Methods

We used interrupted time series analyses to estimate relative changes for consultation numbers of 20 emergency departments spread throughout Germany. For the pandemic period (16-03-2020 – 13-06-2021) four different phases of the COVID-19 pandemic were defined as interruption points, the pre-pandemic period (06-03-2017 – 09-03-2020) was used as the reference.

Results

The most pronounced decreases were visible in the first and second wave of the pandemic, with changes of − 30.0% (95%CI: − 32.2%; − 27.7%) and − 25.7% (95%CI: − 27.4%; − 23.9%) for overall consultations, respectively. The decrease was even stronger for the age group of 0–19 years, with − 39.4% in the first and − 35.0% in the second wave. Regarding acuity levels, consultations assessed as urgent, standard, and non-urgent showed the largest decrease, while the most severe cases showed the smallest decrease.

Conclusions

The number of emergency department consultations decreased rapidly during the COVID-19 pandemic, without extensive variation in the distribution of patient characteristics. Smallest changes were observed for the most severe consultations and older age groups, which is especially reassuring regarding concerns of possible long-term complications due to patients avoiding urgent emergency care during the pandemic.
Complete childhood vaccination and associated factors among children aged 12–23 months in Dabat demographic and health survey site, Ethiopia, 2022
Authors: Gelagay Abebaw Addis , Worku Abebaw Gebeyehu , Bashah Debrework Tesgera , Tebeje Nigusie Birhan , Gebrie Mignote Hailu , Yeshita Hedija Yenus , Cherkose Endeshaw Adimasu , Ayana Birhanu Abera , Lakew Ayenew Molla , Bitew Desalegn Anmut , Asmamaw Desale Bihonegn , Negash Wubshet Debebe , Belachew Tadele Biresaw , Fentie Elsa Awoke
Published: May 2023

Introduction

Childhood immunization is one of the most cost-effective public health strategies to prevent children’s mortality and morbidity from infectious diseases, but the Covid-19 pandemic and associated disruptions have strained health systems, and worldwide 25 million children missing out on vaccination in 2021. Of the 25 million, more than 60% of these children live in 10 countries including Ethiopia. Therefore, this study aimed to assess complete childhood vaccination coverage and associated factors in the Dabat district.

Method

A community-based cross-sectional study was conducted from December 10/2020 to January 10/2021Gregorian Calendar. The data for this study was extracted from information collected for the assessment of maternal, Neonatal, and Child Health and health services utilization in the Dabat demographic and health survey site. Vaccine-related data were collected using an interviewer-administered questionnaire. An adjusted odds ratio with a 95% confidence interval was used to identify the presence and the direction of the association.

Results

Based on vaccination cards and mothers/caretakers’ recall 30.9% (95%CI: 27.9-34.1%) of children aged 12–23 months in the Dabat district were completely immunized. Urban residency [AOR 1.813, 95% CI: (1.143, 2.878)], delivered in the health facility [AOR = 5.925, 95% CI: (3.680, 9.540)], ANC follow-up during their pregnancy [AOR 2.023, 95% CI: (1.352, 3.027)], rich wealth index [AOR = 2.392, 95% CI: (1.296, 4.415)], and parity [AOR 2.737, 95% CI: (1.664, 4.500)] were significantly associated with complete child vaccination.

Recommendation and conclusion

Complete vaccination coverage among children aged 12–23 months in the Dabat district was lower than the Global vaccine plan and Ethiopian ministry of health goal in 2020. Therefore, Health care providers and other stakeholders should mobilize the community to improve mothers’ health-seeking behavior toward pregnancy follow-up and health facility delivery to improve childhood vaccination. Besides, expanding the service to remote areas are necessary to increase the immunization access.
Trends of a decade in risk factors of patient delay among pulmonary tuberculosis patients during fast aging and urbanization - analysis of surveillance data from 2008 to 2017 in Wuhan, China
Authors: Wang Xiaojun , Li Yuehua , Fu Qian , Zhou Meilan
Published: May 2023

Background

Tuberculosis (TB) is a leading infectious cause of morbidity and mortality worldwide. However, delay in health care seeking has remained unacceptably high. The aim of this study was to clarify the trend of patient delay and its associated risk factors during rapid aging and urbanization in Wuhan, China from 2008 to 2017.

Methods

A total of 63,720 TB patients registered at Wuhan TB Information Management System from January 2008 to December 2017 were included. Long patient delay (LPD) was defined as patient delay longer than 14 days. Independent associations of area and household identity with LPD, as well their interaction effect, were tested by logistic regression models.

Results

Among 63,720 pulmonary TB patients, 71.3% were males, the mean age was 45.5 ± 18.8 years. The median patient delay was 10 days (IQR, 3–28). A total of 26,360 (41.3%) patients delayed for more than 14 days. The proportion of LPD decreased from 44.8% in 2008 to 38.3% in 2017. Similar trends were observed in all the subgroups by gender, age and household, except for living area. The proportion of LPD decreased from 46.3 to 32.8% in patients living near downtown and increased from 43.2 to 45.2% in patients living far from downtown. Further interaction effect analysis showed that among patients living far from downtown, the risk of LPD for local patients increased with age, while decreased with age for migrant patients.

Conclusion

Although the overall LPD among pulmonary TB patients declined in the past decade, the extent of reduction varied in different subgroups. The elderly local and young migrant patients living far from downtown are the most vulnerable groups to LPD in Wuhan, China.
Association between periodontitis and osteoporosis in United States adults from the National Health and Nutrition Examination Survey: a cross-sectional analysis
Authors: Peng Jing , Chen Jianming , Liu Yucheng , Lyu Jun , Zhang Bin
Published: May 2023

Objective

This cross-sectional study aimed to investigate the association between periodontitis and osteoporosis among US adults as well as the subgroup of menopausal women.

Background

Periodontitis and osteoporosis are both chronic inflammatory diseases characterized by local or systemic bone resorption. Since they share many risk factors, and the significant decrease in estrogen along with menopause is unfavorable for both diseases, it’s reasonable to assume that there exists some links between the two diseases, especially during the menopause.

Methods

We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2009–2010 and 2013–2014. Periodontitis (defined according to the CDC/AAP definition) and osteoporosis (assessed by the dual-energy radiation absorptiometry) data were available for 5736 participants, and 519 subjects were enrolled in the subgroup of menopausal women aged 45–60 years old. We used binary logistic regression analysis to examine the association between the two diseases both in crude and fully adjusted model.

Results

In the fully adjusted model, osteoporosis was significantly associated with an increased risk of periodontal disease (OR:1.66, 95% CI: 1.00–2.77) in the whole population. As to the subgroup of menopausal women, osteoporosis group had an adjusted OR of 9.66 (95% CI: 1.13–82.38) for developing severe periodontitis in the fully adjusted model.

Conclusions

Osteoporosis is significantly associated with periodontitis and the association is even more pronounced in menopausal women with severe periodontitis.
Cytotoxic activity of essential oil from Leaves of Myrcia splendens against A549 Lung Cancer cells
Authors: Montalvão Monalisa Martins , Felix Franciel Batista , Propheta dos Santos Edmilson William , Santos Jileno Ferreira , de Lucca Júnior Waldecy , Farias Atenilton Santos , de Souza Ribeiro Adauto , Cavaleiro Carlos , Machado Samísia Maria Fernandes , Scher Ricardo , Corrêa Cristiane Bani
Published: May 2023

Background

Plants of the Myrcia genus have been widely used in folk medicine to treat various diseases, including cancer. Myrcia splendens species has a diverse chemical constitution, but the biological activities of its essential oil have not been well investigated. In this study to out the chemistry characterization of essential oil (EO) from the leaves of the species M. splendens from Brazil and evaluate cytotoxic effect in A549 lung cancer cells.

Methods

M. splendens EO was obtained by hydrodistillation and analyzed by Gas Chromatography-Mass Spectrometry (GC-MS). EO was isolated and evaluated for cellular viability in tumor cell lines by MTT assay. The evaluation of the formation of clones and the migratory capacity of the A549 cells treated with EO was done by the clonogenic assay and the wound healing assay. Morphological changes were observed in A549 cells by fluorescence using Phalloidin/FITC and DAPI.

Results

22 compounds were identified in the chemical analysis of EO, corresponding to 88% of the sample. Major compounds were the sesquiterpenic hydrocarbons bicyclogermacrene (15.4%), germacrene D (8.9%) and E-caryophyllene (10.1%). The biological analysis of the EO showed high cytotoxic activity with an IC50 below 20 µg/ml in the THP-1, A549 and B16-F10 tumor cells. The treatment with EO reduced colony formation and inhibited the migratory capacity of A549 cells. Furthermore, apoptotic morphological changes in the nucleus and cytoplasm of A549 cells was observed after of treatment with EO.

Conclusion

The findings of this study suggest that the M. splendens EO has cytotoxic compounds for the A549 lung cancer cells. Treatment with the EO decreased the colony formation and reduced the ability of lung cancer cells to migrate. Future studies may be used to isolate compounds from the EO for the study of lung cancer.
From expert to novice and back: a qualitative study of interprofessional collaboration and the experiences of frontline healthcare professionals during the first wave of COVID-19
Authors: Heiden Malin , Bernild Camilla , Berg Selina Kikkenborg , Dagyaran Ilkay , Missel Malene , Christensen Signe Westh , Risom Signe Stelling , Højskov Ida Elisabeth
Published: May 2023

Background

The global coronavirus disease 2019 pandemic put extreme pressure on healthcare systems worldwide, forcing a heavy workload on healthcare professionals. Frontline treatment and care for patients with coronavirus disease 2019 compelled healthcare professionals to rapidly adapt to new working conditions. This study explores the experiences of frontline healthcare professionals to learn more about how frontline work affects their learning and skills development but also interprofessional collaboration during a pandemic.

Methods

In-depth, one-to-one semi-structured interviews were conducted with 22 healthcare professionals. A broad interdisciplinary group, the participants were employed in public hospitals in four of Denmark’s five regions. Using a reflexive methodology for the data analysis allowed reflexive interpretation when interpreting subjects and interpreting the interpretation.

Results

The study identified two empirical themes: into the unknown and in the same boat, which we critically interpreted using learning theory and theory on interprofessionalism. The study found that the healthcare professionals moved from being experts in their own fields to being novices in the frontline of the pandemic, and then back to being experts based on interprofessional collaboration that included shared reflection. Working in the frontline was imbued with a unique atmosphere in which workers were equals and functioned interdependently, the barriers normally obstructing interprofessional collaboration set aside to focus on combating the pandemic.

Conclusions

This study reveals new insights regarding knowledge on frontline healthcare professionals in terms of learning and developing new skills, as well as the importance of interprofessional collaboration. The insights contributed to the understanding of the importance of shared reflection and how the development of expertise was a socially embedded process where discussions were possible without fear of being ridiculed and healthcare professionals were willing to share their knowledge.
The degree of cortisol secretion is associated with diabetes mellitus and hypertension in patients with nonfunctioning adrenal tumors
Authors: Favero Vittoria , Aresta Carmen , Parazzoli Chiara , Cairoli Elisa , Eller-Vainicher Cristina , Palmieri Serena , Salcuni Antonio Stefano , Arosio Maura , Persani Luca , Scillitani Alfredo , Morelli Valentina , Chiodini Iacopo
Published: May 2023

Background

Similarly to cortisol-secreting adrenal tumors, also non-functioning adrenal tumors (NFAT) may be associated with an increased cardiovascular risk. We assessed in NFAT patients: (i) the association between hypertension (HT), diabetes mellitus (DM), obesity (OB), dyslipidemia (DL) and cardiovascular events (CVE) and cortisol secretion; (ii) the cut-off of the cortisol secretion parameters for identifying NFAT patients with a worse cardiometabolic profile.

Patients and methods

In 615 NFAT patients (with cortisol levels after 1 mg overnight dexamethasone suppression test, F-1mgDST < 1.8 µg/dL [50 nmol/L]) F-1mgDST and adrenocorticotroph hormone (ACTH) levels and data on HT, DM, OB, DL and CVEs prevalence were retrospectively collected.

Results

HT, DM and HT plus DM were associated with F-1mgDST levels (area under the ROC curve: 0.588 ± 0.023, 0.610 ± 0.028, 0.611 ± 0.033, respectively, p < 0.001 for all comparisons) but not with ACTH. The cut-off for identifying patients with either HT or DM or HT plus DM was set at ≥ 1.2 µg/dL (33 nmol/L). As compared with patients with F-1mgDST < 1.2 µg/dL (n = 289), patients with F-1mgDST 1.2–1.79 µg/dL (33–49.4 nmol/L) (n = 326) had lower ACTH levels (17.7 ± 11.9 vs 15.3 ± 10.1 pg/mL, respectively, p = 0.008), older age (57.5 ± 12.3 vs 62.5 ± 10.9 years, respectively, p < 0.001), and higher prevalence of HT (38.1% vs 52.5% respectively p < 0.001), DM (13.1% vs 23.3%, respectively, p = 0.001), HT plus DM (8.3% vs 16.9%, respectively, p < 0.002) and CVE (3.2% vs 7.3%, respectively, p = 0.028). F-1mgDST 1.2–1.79 µg/dL was associated with either HT (odd ratio, OR, 1.55, 95% confidence interval, 95% CI 1.08–2.23, p = 0.018) or DM (OR 1.60, 95% CI 1.01–2.57, p = 0.045) after adjusting for age, gender, OB, DL, and DM (for HT) or HT (for DM), and with the presence of HT plus DM (OR 1.96, 95% CI 1.12–3.41, p = 0.018) after adjusting for age, gender, OB and DL.

Conclusions

In NFAT patients, F-1mgDST 1.2–1.79 µg/dL seems to be associated with a higher prevalence of HT and DM and a worse cardiometabolic profile, even if the poor accuracy of these associations suggests caution in interpreting these results.