bluuebunny/crossref_metadata_2025 huggingface dataset:
Computed tomography findings and prognosis in older COVID-19 patients
Authors: Okoye Chukwuma , Finamore Panaiotis , Bellelli Giuseppe , Coin Alessandra , Del Signore Susanna , Fumagalli Stefano , Gareri Pietro , Malara Alba , Mossello Enrico , Trevisan Caterina , Volpato Stefano , Zia Gianluca , Monzani Fabio , Incalzi Raffaele Antonelli
Published: March 2022

Background

In older and multimorbid patients, chronic conditions may affect the prognostic validity of computed tomography (CT) findings in COVID-19. This study aims at assessing to which extent CT findings have prognostic implications in COVID-19 older patients.

Methods

Hospitalized COVID-19 patients aged 60 years or more enrolled in the multicenter, observational and longitudinal GeroCovid study who underwent chest CT were included. Patients were stratified by tertiles of age and pneumonia severity to compare CT findings. Hierarchical clustering based on CT findings was performed to identify CT-related classificatory constructs, if any. The hazard ratio (HR) of mortality was calculated for individual CT findings and for clusters, after adjusting for potential confounders.

Results

380 hospitalized COVID-19 patients, with a mean age of 78 (SD:9) years, underwent chest CT scan. Ground glass opacity (GGO), consolidation, and pleural effusion were the three most common CT findings, with GGO prevalence decreasing from younger to older patients and pleural effusion increasing. More severe the pneumonia more prevalent were GGO, consolidation and pleural effusion. HR of mortality was 1.94 (95%CI 1.24–3.06) for pleural effusion and 13 (95%CI 6.41–27) for cluster with a low prevalence of GGO and a high prevalence of pleural effusion (“LH”), respectively. Out of the three CT based clusters, “LH” was the only independent predictor in the multivariable model.

Conclusions

Pleural effusion qualifies as a distinctive prognostic marker in older COVID-19 patients. Research is needed to verify whether pleural effusion reflects COVID-19 severity or a coexisting chronic condition making the patient at special risk of death.

Trial registration

ClinicalTrials.gov: NCT04379440
Single-center experience with perioperative antibiotic prophylaxis and surgical site infections in kidney transplant recipients
Authors: Ostaszewska Agata , Domagała Piotr , Zawistowski Michał , Karpeta Edyta , Wszoła Michał
Published: March 2022

Background

Infections in kidney transplant recipients are particularly challenging owing to the immunosuppressive treatment, usually long history of chronic illness, comorbidities and prior exposures to antibiotics. Among the most common complications early after surgery are surgical site infections. The aim of this study was to identify risk factors and evaluate epidemiological data regarding surgical site infections. Moreover, we were able to compare the current results with historical data from our institution when different perioperative antibiotic prophylaxis was practiced.

Methods

We conducted a retrospective case–control study in a group of 254 deceased donor renal graft recipients transplanted in a single Central European institution. We evaluated epidemiological findings and resistance patterns of pathogens causing surgical site infections. We used multivariable logistic regression to determine risk factors for surgical site infections.

Results

We revealed no differences in baseline characteristics between patients with and without surgical site infections. Ten surgical site infections (3.9%) were diagnosed (six superficial incisional, two deep incisional, and two organ/space). Eight species (19 strains) were identified, most of which were multi-drug resistant (63%). The most common was extended-spectrum β-lactamase producing Klebsiella pneumoniae (26%). We showed that statistically significant differences were present between reoperated and non-reoperated patients (adjusted odds ratio: 6.963, 95% confidence interval 1.523–31.842, P = .012).

Conclusions

Reoperation is an individual risk factor for surgical site infection after kidney transplantation. According to our experience, cefazolin-based prophylaxis can be safe and is associated with relatively low prevalence of surgical site infections.
Metacognitions and brooding predict depressive symptoms in a community adolescent sample
Authors: Pedersen Helene , Grønnæss Ingrid , Bendixen Mons , Hagen Roger , Kennair Leif Edward Ottesen
Published: March 2022

Depressive symptoms are prevalent in adolescence, and girls have higher levels of depressive symptoms and depressive disorder than boys. Rumination and especially brooding, seem to be a central maintaining factor of depressive symptoms, where metacognitions about rumination play a prominent role in maintaining depressive rumination. There is a sex difference in adults in depressive disorder. The current investigation of a high school / community sample of adolescents aged 16–20 from Norway (N = 1198, 62.2% women) found that adolescent women had higher scores than men on all relevant measures: Depressive symptoms, negative and positive metacognitions, pondering, and brooding. A path model for predicting depressive symptoms showed that the major factors for both sexes were negative metacognitions and brooding. The predictors of depressive symptoms were invariant across sex and age groups, suggesting similar underlying mechanisms across these groups. The overall findings suggest that metacognitive therapy may be an efficient intervention for depressive symptoms among adolescents.
Capturing and analysing the working conditions of employees with disabilities in German social firms using focus groups
Authors: Efimov Ilona , Lengen Julia C. , Kordsmeyer Ann-Christin , Harth Volker , Mache Stefanie
Published: March 2022

Background

Social firms – a type of social enterprise – provide job opportunities to people with mental or intellectual, sensory, physical or multiple disabilities who are disadvantaged on the general labour market. Given the limited number of studies on working conditions of employees in inclusive workplaces, the aim of this study was to explore job demands and resources experienced by employees with disabilities in German social firms.

Methods

Three focus groups were conducted between September and October 2020 with 14 employees with disabilities from social firms in the catering and cleaning sector in Germany. The Job Demands-Resources model was used as a theoretical basis for developing the semi-structured interview guide. Audiotaped data were transcribed verbatim, analysed deductively and inductively using the qualitative content analysis according to Mayring.

Results

The results show that employees of social firms experience specific job demands and resources regarding work content, work organisation, social relations and work environment. Job demands were mainly reported with respect to work organisation, e.g. high workload, time pressure or challenges in collaboration, whereas social relationships with colleagues and supervisors were most frequently mentioned as important resources at the workplace.

Conclusion

First exploratory study results on the working conditions of employees in social firms in Germany were obtained. Given the pivotal importance of employment for people with disabilities, the identified job demands and resources of this study highlight the relevance of a healthy workplace, especially for employees in social firms. Future interventional research is needed regarding the development, implementation and evaluation of workplace health promotion measures in social firms.
Establishing CREATE: lessons learned in setting up a training environment for early-career researchers in respiratory medicine
Authors: Christian Katherine , Hey-Cunningham Alison , Corte Tamera , Goh Nicole , Jaffar Jade , Reynolds Paul , Teoh Alan , Troy Lauren
Published: March 2022

Background

The purpose of the National Health and Medical Research Council Centre of Research Excellence in Pulmonary Fibrosis (CRE-PF) is to improve and extend the lives of patients living with pulmonary fibrosis through the development of a comprehensive and integrated program of basic and clinical research and education across Australia. A key objective of the CRE-PF was establishment of a unique national training scheme, CREATE, for early-career researchers (ECRs) in respiratory research. CREATE ECRs are broadly drawn from two main fields of researchers: clinicians and scientists, where clinicians tend to be involved in part-time translational research and scientists are involved in broad scientific research including laboratory or genetic research, health economics or population research.

Methods

We describe the CREATE Program which, with limited budget and the assistance of key organisations, has provided funding opportunities (scholarships, fellowships, prizes, travel and collaboration grants), professional development (mentoring program, symposia, presentation opportunities and on-line training) and fostered a connected, supportive research community for respiratory ECRs.

Results

The CREATE program has successfully fostered the development of the supported researchers, contributing substantially to the future of pulmonary fibrosis research in Australia. During the life of the program the CRE-PF has offered 10 PhD scholarships and five postdoctoral fellowships, awarded 13 travel grants and three grants to promote collaboration between ECRs from different institutes. A mentoring program has been established and CREATE Symposia have been held in association with key meetings. During COVID-19 restrictions, a series of virtual research meetings has offered 12 CREATE ECRs from seven universities the opportunity to present their research to a national audience.

CREATE research-related achievements are impressive, including over 80 first-author publications by ECRs, and many conference presentations. Contributions to the research community, measured by committee membership, is also strong.

Conclusions

In spite of a very limited budget, wide geographic distribution of participants and the multi-disciplinary nature of the cohort, we have succeeded in providing a unique, supportive academic development environment for CREATE ECRs. Lessons learned in the process of developing this program include the importance of leveraging funding, being flexible, building networks and seeking and responding to ECR input.
Workshop with medical students on physicians’ earning opportunities, workload and job satisfaction increases the attractiveness of working self-employed and working in general practice
Authors: Heine Alexander , Geier Anne-Kathrin , Lippmann Stefan , Bleckwenn Markus , Frese Thomas , Deutsch Tobias
Published: March 2022

Background

Among the various factors identified as relevant for primary care career choice, financial considerations have been consistently shown to have an impact. In Germany, reliable and easily understandable information on physicians’ earning opportunities in self-employed settings is difficult to obtain for medical students, leading to substantial misperceptions that may negatively affect respective career considerations. This study investigated medical students’ evaluation of a 45-min evidence-based workshop on earning opportunities, workload and job satisfaction in different specialties and settings to examine its effect on the perceived attractiveness of working self-employed and working in general practice.

Methods

The workshop was implemented as part of a mandatory general practice clerkship in the fourth study year (of six). Post-hoc evaluations of all participants between October 2017 and September 2018 (one cohort) were analysed cross-sectionally including descriptive statistics, subgroup comparisons and qualitative analysis of free-text answers regarding students’ main insights.

Results

Response rate was 98.1% (307/313). Participants were on average 25.0 years old, and 68.3% were women. Based on a ten-point scale ranging from 1 = ’no influence’ to 10 = ’very big influence’, 91.9% confirmed at least some (> = 2) and 57.3% a rather high (> = 5) influence of earning expectations on their career choice process. Regarding the workshop, 86.1% were overall satisfied, and 89.5% indicated they had gained new insights, primarily regarding earning opportunities in different specialties and work settings, and frequently regarding job satisfaction, workload and the structure of revenues and expenditures in a doctor’s office (according to qualitative analysis). In the opinion of 89.8% of students, the provided learning content should be part of the undergraduate curriculum. More than half of participants reported an increase regarding the attractiveness of working self-employed and working as a general practitioner, most frequently regarding earning opportunities, but also in general and in respect to job satisfaction, cost–benefit ratio and workload. This increase was significantly higher among students favouring or at least considering a general practice career.

Conclusions

The workshop and its content were appreciated by the students and showed clear potential to usefully complement undergraduate curricula aiming at increasing or reinforcing students’ interest in working self-employed and working in general practice.
Building a country-wide Fistula Treatment Network in Kenya: results from the first six years (2014-2020)
Authors: Pollaczek Lindsey , El Ayadi Alison M. , Mohamed Habiba C.
Published: March 2022

It is estimated that one million women worldwide live with untreated fistula, a devastating injury primarily caused by prolonged obstructed labor when women do not have access to timely emergency obstetric care. Women with fistula are incontinent of urine and/or feces and often suffer severe social and psychological consequences, such as profound stigma and depression. Obstetric fistula affects economically vulnerable women and garners little attention on the global health stage. Exact figures on fistula incidence and prevalence are not known. In Kenya, results from a 2014 population-based survey suggest that 1% of reproductive-aged women have experienced fistula-like symptoms.

In collaboration with key stakeholders, Fistula Foundation launched the Fistula Treatment Network (initially known as Action on Fistula) in 2014 to increase access to timely, quality fistula treatment and comprehensive post-operative care for women with fistula in Kenya. The integrated model built linkages between the community and the health system to support women through all parts of their treatment journey and to build capacity of healthcare providers and community leaders who care for these women. Fistula Foundation and its donors provided the program’s funding. Seed funding, representing about 30% of the program budget, was provided by Astellas Pharma EMEA.

Over the six-year period from 2014 to 2020, the network supported 6,223 surgeries at seven hospitals, established a fistula training center, trained eleven surgeons and 424 Community Health Volunteers, conducted extensive community outreach, and contributed to the National Strategic Framework to End Female Genital Fistula. At 12 months post fistula repair, 96% of women in a community setting reported that they were not experiencing any incontinence and the proportion of women reporting normal functioning increased from 18% at baseline to 85% at twelve-months.

The Fistula Treatment Network facilitated collaboration across hospital and community actors to enhance long-term outcomes for women living with fistula. This model improved awareness and reduced stigma, increased access to surgery, strengthened the fistula workforce, and facilitated post-operative follow-up and reintegration support for women. This integrated approach is an effective and replicable model for building capacity to deliver comprehensive fistula care services in other countries where the burden of fistula is high.
Recommendations related to occupational infection prevention and control training to protect healthcare workers from infectious diseases: a scoping review of infection prevention and control guidelines
Authors: Qureshi Mohammed O. , Chughtai Abrar A. , Seale Holly
Published: March 2022

Background

Events such as the COVID-19 pandemic remind us of the heightened risk that healthcare workers (HCWs) have from acquiring infectious diseases at work. Reducing the risk requires a multimodal approach, ensuring that staff have the opportunity to undertake occupational infection prevention and control (OIPC) training. While studies have been done within countries to look at availability and delivery of OIPC training opportunities for HCWs, there has been less focus given to whether their infection prevention and control (IPC) guidelines adhere to recommended best practices.

Objectives

To examine national IPC guidelines for the inclusion of key recommendations on OIPC training for HCWs to protect them from infectious diseases at work and to report on areas of inconsistencies and gaps.

Methods

We applied a scoping review method and reviewed guidelines published in the last twenty years (2000–2020) including the IPC guidelines of World Health Organization and the United States Centers for Disease Control and Prevention. These two guidelines were used as a baseline to compare the inclusion of key elements related to OIPC training with IPC guidelines of four high-income countries /regions i.e., Gulf Cooperation Council, Australia, Canada, United Kingdom and four low-, and middle-income countries (LMIC) i.e. India, Indonesia, Pakistan and, Philippines.

Results

Except for the Filipino IPC guideline, all the other guidelines were developed in the last five years. Only two guidelines discussed the need for delivery of OIPC training at undergraduate and/or post graduate level and at workplace induction. Only two acknowledged that training should be based on adult learning principles. None of the LMIC guidelines included recommendations about evaluating training programs. Lastly the mode of delivery and curriculum differed across the guidelines.

Conclusions

Developing a culture of learning in healthcare organizations by incorporating and evaluating OIPC training at different stages of HCWs career path, along with incorporating adult learning principles into national IPC guidelines may help standardize guidance for the development of OIPC training programs. Sustainability of this discourse could be achieved by first updating the national IPC guidelines. Further work is needed to ensure that all relevant healthcare organisations are delivering a package of OIPC training that includes the identified best practice elements.
Effect of informal care on health care utilisation for the elderly in urban and rural China: evidence from China health and retirement longitudinal study (CHARLS)
Authors: Chen Xinlan , Su Dai , Chen Xinlin , Chen Yingchun
Published: March 2022

Background

Receiving informal care from family members is the mainstream way of care for the elderly in China because of the influence of the culture of filial piety. However, the relationship between informal care and health care use in urban and rural areas needs to be further explored. This study aimed to understand the association between informal care and health care utilisation for the elderly and explore how this effect may differ between urban and rural China.

Method

A total of 5704 residents aged 65 years and above were selected from wave 3 (2015) and wave 4 (2018) of the China Health and Retirement Longitudinal Study, which is a nationally representative survey. A negative binomial regression model for the panel data was used to explore the relationship between informal care and health care utilisation. A fixed-effect binary choice model for panel data was used for the sensitivity test.

Result

The elderly who received informal care had increased in outpatient and inpatient visits compared with those who did not receive informal care. The inpatient visits of the elderly who received 15–29 days of informal care was higher than the elderly who did not receive informal care (incidence rate ratio [IRR] = 2.082, P < 0.05). Moreover, the elderly who received informal care for more than 30 days had 39.6% more inpatient visits (IRR = 1.396, P < 0.01) and 37.4% more outpatient visits than the elderly who did not receive informal care (IRR = 1.374, P < 0.05). For urban respondents, receiving informal care can facilitate outpatient use of the elderly, but for rural respondents, receiving informal care can predict an increase in outpatient and inpatient visits.

Conclusion

Informal care was associated with higher use of health services. The association between informal care and health care utilisation varies between rural and urban residents. These findings indicate the role of informal care and remind that relevant departments should pay attention to the differences in medical service utilisation levels amongst different elderly groups.
TFE3-associated perivascular epithelioid cell tumor with complete response to mTOR inhibitor therapy: report of first case and literature review
Authors: Purwar Roli , Soni Kishan , Shukla Mridula , Verma Ashish , Kumar Tarun , Pandey Manoj
Published: March 2022

Background

Perivascular epitheloid cell tumor (PEComas) are characterized by expression of both muscles, most often smooth muscle actin (in ~80% of cases) and melanocytic markers (mainly HMB-45 and Melan A). TFE 3-associated PEComas are new variant which are poorly defined due to their limited reports in literature. These tumors lack response to targeted mTOR inhibitor therapy due to lack of mutation in TSC gene. Hereby, we are reporting a case of TFE3 associated pelvic PEComa showing excellent response to Everolimus.

Case presentation

A 45-year-old female presented with complaint of abdominal mass and bleeding per vaginum for 4 months. She had a history of total abdominal hysterectomy 3 years back in view of abnormal uterine bleeding and exploratory laprotomy 7 months back to remove some pelvic mass. Imaging suggested of ill-defined heterogenous mass of 9.3 x 9.2 x 16 cm involving the uterus, cervix, and upper 1/3 vagina. Multiple omental and peritoneal deposits were also seen, making probable diagnosis of carcinoma endometrium. USG guided biopsy showed cores of fibrous tissue with the presence of cells in sheets with granular eosinophillic cytoplasm; IHC showed positivity for TFE-3, H Caldesmon, GATA-3, and Melan A- and HMB-45; and Ki 67 index was 35%. The basis of above diagnosis of PEComa was made and she was started on Everolimus; repeat imaging after 3 months of therapy showed complete response.

Conclusion

We are reporting first case of malignant pelvic TFE 3 PEComa showing response to mTOR therapy. Identification of TFE 3 PEComa is important because they showed different biologic behavior then their conventional PEComa.
Naples prognostic score, a novel prognostic score for patients with high- and intermediate-risk gastrointestinal stromal tumours after surgical resection
Authors: Wu Hao , Fu Mengdi , Xie Xiaozhou , Yang Jianqiao , Liu Yang , Du Fengying , Fang Zhen , Shang Liang , Li Leping
Published: March 2022

Background

A novel multidimensional inflammatory and nutritional assessment system named the Naples prognostic score could serve as an independent prognostic indicator. However, its significance in patients with high- and intermediate-risk gastrointestinal stromal tumours remains unclear.

Methods

We performed this retrospective cohort study based on a prospectively collected database of gastrointestinal stromal tumours (GISTs) between March 2010 and December 2019. The Kaplan–Meier method and log-rank test were used for survival analyses. Least absolute shrinkage and selection operator (LASSO) and Cox proportional hazards regression analysis was used for univariate and multivariate analyses. Time-dependent receiver operating characteristic curves were generated to evaluate the discriminatory ability of the prognostic scoring systems. Differences in the areas under the curve were further compared.

Results

A total of 405 patients with regular follow-up were included and analysed in this study. Significant differences in progression-free survival and overall survival were observed between the groups (P< 0.001). Multivariate analysis demonstrated that the NPS was a significant predictor of poor progression-free survival (1 vs 0,HR= 4.622,P= 0.001; 2 vs 0,HR= 12.770,P< 0.001) and overall survival (2 vs 0,HR= 5.535,P= 0.002). Furthermore, time-dependent AUC analyses showed that the NPS was more accurate than other haematologic prognostic systems.

Conclusions

The present study demonstrates that the NPS could independently predict disease progression and survival among patients with high- and intermediate-risk GISTs. The NPS might be regarded and applied as one of the most convenient and effective preoperative risk stratification tools in the future, which should be validated by large-scale multicentre prospective cohort studies.
3.0 T MRI is more recommended to detect acetabular labral tears than MR Arthrography: an updated meta-analysis of diagnostic accuracy
Authors: Zhang Peng , Li Chunbao , Wang Wenliang , Zhang Baiqing , Miao Weicheng , Liu Yujie
Published: March 2022

Background

This meta-analysis aimed to evaluate the current evidence on the diagnostic performance of MRI/MRA for detecting acetabular labral tears (ALT).

Methods

We systematically searched the PubMed, Embase, and Cochrane library until February 5, 2021, to identify original research studies reporting the diagnostic performance of MRI/MRA for the detection of ALT. Study methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. The summary sensitivity (Se) and specificity (Sp) of the studies were estimated using a bivariate model. We calculated the post-test probability to assess the clinical utility of MRI/MRA. Univariate meta-regression and subgroup analyses were performed to assess between-study heterogeneity.

Results

We included 22 studies (n = 1670 patients). The meta-analytic summary Se and Sp for MRI were 0.8 (95% CI 0.51–0.94) and 0.77 (95% CI 0.68–0.84), respectively, while for MRA they were 0.89 (95% CI 0.82–0.93) and 0.69 (95% CI 0.56–0.80). MRA showed a higher area under the summary receiver operating curve (SROC) (0.87 vs. 0.80) than MRI. MRI could increase the post-test probability to 0.78 and could decrease the post-test probability to 0.21, MRA could increase the post-test probability to 0.74 and could decrease the post-test probability to 0.14. Meta-regression analysis showed two significant factors affecting study heterogeneity: MR field strength and reference standard. After dividing the studies into two subgroups based on the MR field strength, we found that the Se values of 3.0 T MRI were very close to MRA (0.87 vs. 0.89), the Sp values of 3.0 T MRI were superior to MRA (0.77 vs. 0.69).

Conclusions

Given that 3.0 T MRI could provide a non-invasive, fast and convenient method to recognize suspicious ALT cases, 3.0 T MRI is more recommended than MRA.
The validity of the residuals approach to measuring resilience to adverse childhood experiences
Authors: Cahill Stephanie , Hager Reinmar , Chandola Tarani
Published: March 2022

Background

Resilience is broadly defined as the ability to maintain or regain functioning in the face of adversity. Recent work to harmonise the quantification and definition of resilience quantifies resilience as the residual variance in psychosocial functioning that remains after accounting for adversity exposure. However, there have been no published studies that have formally investigated the validity of this approach. Considering this, we examine the construct and predictive validity of the residuals approach using participants from the Avon Longitudinal Study of Parents and Children (ALSPAC), a multigenerational, longitudinal cohort study.

Methods

We regressed exposures of adolescent adversity on adolescent psychopathology scores using the Strength and Difficulties Questionnaire and obtained the residual variance. We investigated construct validity by analysing whether previously identified demographic and resilience factors significantly predicted resilience. Predictive validity of resilience was investigated by comparing the predictive power of resilience with other determinants of psychosocial functioning on two developmental outcomes: depressive symptoms at 18 years, measured by the Short Moods and Feelings Questionnaire, and NEET (Not in Employment, Education or Training) status at 17 and 23 years. The associations between depressive symptoms at 18, resilience, ACEs and covariates were tested using multiple linear regression. NEET status at 17 and 23 were run as separate binary multiple logistic regression models to test associations with resilience and known demographics previously associated with NEET status.

Results

Seven previously identified protective factors, including self-esteem, positive sibling relationship, temperament, and positive perception of school, significantly predicted resilience to adolescent psychopathology, thus providing strong construct validity. Resilience significantly predicted a reduction in depressive symptoms at 18 years, and significantly decreased the likelihood of having NEET status at both 17 years and 23 years, even after taking into account early childhood adversity and other risk factors. None of the socioeconomic factors were significantly associated with resilience.

Conclusions

Our study demonstrates that the residuals method of operationalising resilience has good construct and predictive validity yet recommend replication studies. It has the potential to advance research into the mechanisms and modifiability of resilience.

Trial Registration: Not applicable.
TADA—a machine learning tool for functional annotation-based prioritisation of pathogenic CNVs
Authors: Hertzberg Jakob , Mundlos Stefan , Vingron Martin , Gallone Giuseppe
Published: March 2022

Few methods have been developed to investigate copy number variants (CNVs) based on their predicted pathogenicity. We introduce TADA, a method to prioritise pathogenic CNVs through assisted manual filtering and automated classification, based on an extensive catalogue of functional annotation supported by rigourous enrichment analysis. We demonstrate that our classifiers are able to accurately predict pathogenic CNVs, outperforming current alternative methods, and produce a well-calibrated pathogenicity score. Our results suggest that functional annotation-based prioritisation of pathogenic CNVs is a promising approach to support clinical diagnostics and to further the understanding of mechanisms controlling the disease impact of larger genomic alterations.
Comprehensive Anaemia Programme and Personalized Therapies (CAPPT): protocol for a cluster-randomised controlled trial testing the effect women’s groups, home counselling and iron supplementation on haemoglobin in pregnancy in southern Nepal
Authors: Saville Naomi M. , Kharel Chandani , Morrison Joanna , Harris-Fry Helen , James Philip , Copas Andrew , Giri Santosh , Arjyal Abriti , Beard B. James , Haghparast-Bidgoli Hassan , Skordis Jolene , Richter Adam , Baral Sushil , Hillman Sara
Published: March 2022

Background

Anaemia in pregnancy remains prevalent in Nepal and causes severe adverse health outcomes.

Methods

This non-blinded cluster-randomised controlled trial in the plains of Nepal has two study arms: (1) Control: routine antenatal care (ANC); (2) Home visiting, iron supplementation, Participatory Learning and Action (PLA) groups, plus routine ANC. Participants, including women in 54 non-contiguous clusters (mean 2582; range 1299–4865 population) in Southern Kapilbastu district, are eligible if they consent to menstrual monitoring, are resident, married, aged 13–49 years and able to respond to questions. After 1–2 missed menses and a positive pregnancy test, consenting women < 20 weeks’ gestation, who plan to reside locally for most of the pregnancy, enrol into trial follow-up. Interventions comprise two home-counselling visits (at 12–21 and 22–26 weeks’ gestation) with iron folic acid (IFA) supplement dosage tailored to women’s haemoglobin concentration, plus monthly PLA women’s group meetings using a dialogical problem-solving approach to engage pregnant women and their families. Home visits and PLA meetings will be facilitated by auxiliary nurse midwives. The hypothesis is as follows: Haemoglobin of women at 30 ± 2 weeks’ gestation is ≥ 0.4 g/dL higher in the intervention arm than in the control. A sample of 842 women (421 per arm, average 15.6 per cluster) will provide 88% power, assuming SD 1.2, ICC 0.09 and CV of cluster size 0.27.

Outcomes are captured at 30 ± 2 weeks gestation. Primary outcome is haemoglobin concentration (g/dL). Secondary outcomes are as follows: anaemia prevalence (%), mid-upper arm circumference (cm), mean probability of micronutrient adequacy (MPA) and number of ANC visits at a health facility. Indicators to assess pathways to impact include number of IFA tablets consumed during pregnancy, intake of energy (kcal/day) and dietary iron (mg/day), a score of bioavailability-enhancing behaviours and recall of one nutrition knowledge indicator. Costs and cost-effectiveness of the intervention will be estimated from a provider perspective. Using constrained randomisation, we allocated clusters to study arms, ensuring similarity with respect to cluster size, ethnicity, religion and distance to a health facility. Analysis is by intention-to-treat at the individual level, using mixed-effects regression.

Discussion

Findings will inform Nepal government policy on approaches to increase adherence to IFA, improve diets and reduce anaemia in pregnancy.

Trial registration

ISRCTN 12272130.
Physical and technical demands of offence, defence, and contested phases of play in Australian Football
Authors: Wing Christopher , Hart Nicolas H. , Ma’ayah Fadi , Nosaka Kazunori
Published: March 2022

Background

This study compared the physical demands and effect of field location for different phases of play (offence, defence and contested), and examined the physical and technical demands of successful and unsuccessful phases of play during Australian Football matches.

Methods

Global positioning system (GPS) and technical performance data were collected from 32 male Australian Football players in one club over 19 games in the 2019 season. The GPS data was aligned with phases of play acquired using Champion Data. Linear mixed models were used to detect differences between phases of play and field location which were further contextualized using Cohen’s d effect size.

Results

Physical demands were greatest (p < 0.001) in defensive phases for backs (ES 0.61 to 1.42), and offensive phases for midfielders (ES 0.65 to 0.96) and forwards (ES 0.84 to 1.94). Additionally, distance and high-speed running were lowest in contested phases irrespective of playing position. Distance and high-speed running were greatest in larger field locations (e.g., full ground). No pattern was evident for accelerations or decelerations. Successful offensive plays demonstrated greater physical and technical outputs for midfielders and forwards, whereas the opposite was found for backs. Physical output was largely greater in unsuccessful defensive plays for all positions; however, the rate of tackles and marks was greater during successful defence.

Conclusion

These findings enable a greater understanding of the demands of Australian Football matches, and can be utilized to inform both representative training design, and the evaluation of player performance.
Iatrogenic calcinosis cutis in 9-month-old baby boy: a case report
Authors: Alghaith Eman Ahmed , AlQahtani Ghada Abdullah , Omer Jamal Ahmed
Published: March 2022

Background

Calcinosis cutis is a rare condition, characterized by an accumulation of calcium salts in the skin and subcutaneous tissue. There are several types of this condition, including dystrophic, metastatic, idiopathic, calciphylaxis, and iatrogenic calcinosis cutis. The type related to our case is iatrogenic calcinosis cutis, and one its possible causes is calcium intravenous infusion. Physicians should be aware of this condition when giving calcium infusion.

Case presentation

Here we report the case of a 9-month-old Arabic - Saudi baby boy, who presented with abnormal movement for 1 day. Upon further investigation, his abnormal movement was found to be a manifestation of hypocalcemia and vitamin D deficiency. He was treated with intravenous calcium gluconate. Later, he had a treatment-related complication of intravenous calcium at the site of venipuncture causing swelling, which was initially soft but progressed to hard, over the left hand. Eventually, he was diagnosed with a case of iatrogenic calcinosis cutis due to intravenous calcium treatment.

Conclusion

There are multiple differential diagnoses of calcinosis cutis, as it resembles many other conditions. Careful history-taking, physical examination, and other investigations, such as radiological investigations, will aid in reaching a more accurate diagnosis and, thus, early treatment and intervention. Frequently checking the intravenous line and diluting the intravenous calcium may help reduce the occurrence of iatrogenic calcinosis cutis.
Coronavirus disease 2019 on routine testing in eclampsia: a case report
Authors: Kalsar Pradip , Datta Shreya , Kalsar Arbabasu , Kanyike Andrew Marvin
Published: March 2022

Background

Coronavirus disease 2019 has been associated with adverse pregnancy outcomes, including preeclampsia. Coronavirus disease 2019 and preeclampsia have overlapping clinical features and are therefore challenging to differentiate. Since pregnant women are not routinely tested for coronavirus disease 2019, it is prudent to test for it among patients presenting with preeclampsia or eclampsia.

Case presentation

A 23-year-old female, a Munda, gravida 1 para 0, at 36 weeks and 5 days of amenorrhea presented to Mal Super Specialty Hospital as a referral in a semiconscious state after a severe attack of tonic–clonic seizures. Detailed history from the husband was insignificant except for a persistent cough for the last 7 days. She had denied any visual changes, headaches, or vaginal discharge. Physical examination revealed tachycardia (150 beats per minute), elevated blood pressure (187/111 mmHg), tachypnea (36 breaths per minute), and oxygen saturation of 94% on room air. Routine coronavirus disease 2019 rapid test was positive, and urine dipstick was +3. Additional tests revealed leukocytosis and elevated liver enzymes. Chest radiograph revealed prominent interstitial markings, and a bedside transabdominal ultrasonography showed a live single intrauterine fetus in cephalic presentation with normal cardiac activity and movements. A diagnosis of a prime gravida with eclampsia and coronavirus disease 2019 was made. She was managed with intravenous labetalol; she had already received a loading dose of intravenous magnesium sulfate, and we administered two maintenance doses during monitoring. Within an hour of admission, she had a spontaneous rupture of the amniotic membranes, with meconium-stained liquor (grade 2), and the fetal heart rate (148 beats per minute) was reassuring. She had an uncomplicated vaginal delivery of a live male newborn. Shortly after delivery, she developed slight respiratory distress and significant fluid overload that was managed with furosemide. Coronavirus disease 2019 reverse-transcription polymerase chain reaction test came back negative for the neonate and positive for the mother. She was shifted to the coronavirus disease 2019 treatment unit, and her contact with the child was limited. She was kept on a course of tablets ivermectin, zinc, vitamin C, montelukast, azithromycin, metronidazole, and injectable pantoprazole. The mother and child were discharged on day 15 after recovery with negative COVID nasopharyngeal swab.

Conclusion

A diagnosis of preeclampsia or eclampsia should prompt testing for coronavirus disease 2019.
Current status of herbal medicine research for respiratory diseases induced by particulate matter: a protocol for a scoping review
Authors: Leem Jungtae , Kim Yohwan , Kim Kwan-Il
Published: March 2022

Background

Particulate matter (PM) is an important environmental risk factor for the initiation and exacerbation of respiratory disease. Various herbal medicines have exhibited a reduction in symptoms of respiratory diseases induced by PM in animal models. However, the types and characteristics of studies on herbal medicine for respiratory diseases by PM have not been reviewed. This scoping review will focus on the currents status and research gap of herbal medicines for respiratory diseases caused by PM.

Methods

We will follow the scoping review framework developed by Arksey and O’Malley. MEDLINE (via PubMed), EMBASE, and the Cochrane Central Register of Controlled Trials will be searched for relevant English-language publications, and only peer-reviewed, controlled comparative in vivo/in-vitro/human studies examining the effects of herbs on respiratory disease induced by PM will be included. The basic characteristics, research methods, detailed regimens, possible mechanisms, outcomes, and results will be extracted using a predefined standardized data extraction form. Outcomes will be presented in the following categories: pulmonary function, inflammatory markers, reactive oxygen species, histology and mechanisms, and adverse events. Two researchers will independently perform the study selection, data extraction, and quality assessment. We will also present the research map and implications for further study.

Ethics and dissemination

Ethical approval is not required because individual patient data will not be included. The findings will be disseminated through peer-reviewed publications or conference presentations.

Systematic review registration

This review protocol has been registered with the Open Science Framework on February 12, 2021 (https://osf.io/s7uvk/)
Baseline study of growers’ constraints in the production of apple (Malus domestica) in Plateau State Nigeria
Authors: Osadebamwen U. G. , Adekoya A. E. , Akintunde E. A.
Published: March 2022

Background

Including temperate fruits like apples in her production and export line is one of the many ways Nigeria, particularly, Plateau State, can diversify her economy and consequently address the issues of poverty, malnutrition, and hunger. However, there are constraints confronting the industry. This research was carried out as a baseline study of growers’ constraints in the production of apple in Plateau State, Nigeria.

Method and result

Multi-stage sampling procedure was used to select the respondents for this study. Plateau State has 17 local government areas (LGAs) out of which four LGAs, namely, Jos South, Jos North, Barki Ladi and Riyom were purposively selected because of the prevalence of apple growers in these areas. Furthermore, the snowball sampling technique was used to achieve an enumeration of 30 apple growers, which were used for the study (total sampling). A well-structured interview schedule was used to collect both quantitative and qualitative data from respondents and the former was subjected to statistical analysis using descriptive statistics (means and percentages) while the latter was done using focused group discussions (FGDs) and analysed using qualitative tools such as Problem Tree Analysis (PTA) and Paired Needs Priority Ranking (PNPR). Research findings revealed that lack of extension services ($$\overline{x }$$

x
¯

 = 1.93), inadequate finance/credit facilities ($$\overline{x }$$

x
¯

 = 1.90) and high cost of farm inputs ($$\overline{x }$$

x
¯

 = 1.83) were the most severe constraints to apple production in the study area. Using the PTA of low apple production in the study area, participants viewed lack of extension services, high cost of seedlings, inadequate/inaccessible credit facilities amongst others, as causes (roots) of the problem while high dependency ratio, low wages, loss of foreign exchange, etc., as the effects (fruits) of low apple production output. Furthermore, the PNPR revealed that subsidised farm inputs (especially cost of apple seedlings), extension services and credit facilities were the priority needs of the apple producers while receiving of market reports was their least prioritised need.

Conclusion

The study concludes that lack of extension services, inadequate finance/credit facilities and high cost of farm inputs were the most severe constraints to apple production in Plateau State, Nigeria. The study culminates with a list of suitable recommendations.
The core root microbiome of Spartina alterniflora is predominated by sulfur-oxidizing and sulfate-reducing bacteria in Georgia salt marshes, USA
Authors: Rolando Jose L. , Kolton Max , Song Tianze , Kostka Joel E.
Published: March 2022

Background

Salt marshes are dominated by the smooth cordgrass Spartina alterniflora on the US Atlantic and Gulf of Mexico coastlines. Although soil microorganisms are well known to mediate important biogeochemical cycles in salt marshes, little is known about the role of root microbiomes in supporting the health and productivity of marsh plant hosts. Leveraging in situ gradients in aboveground plant biomass as a natural laboratory, we investigated the relationships between S. alterniflora primary productivity, sediment redox potential, and the physiological ecology of bulk sediment, rhizosphere, and root microbial communities at two Georgia barrier islands over two growing seasons.

Results

A marked decrease in prokaryotic alpha diversity with high abundance and increased phylogenetic dispersion was found in the S. alterniflora root microbiome. Significantly higher rates of enzymatic organic matter decomposition, as well as the relative abundances of putative sulfur (S)-oxidizing, sulfate-reducing, and nitrifying prokaryotes correlated with plant productivity. Moreover, these functional guilds were overrepresented in the S. alterniflora rhizosphere and root core microbiomes. Core microbiome bacteria from the Candidatus Thiodiazotropha genus, with the metabolic potential to couple S oxidation with C and N fixation, were shown to be highly abundant in the root and rhizosphere of S. alterniflora.

Conclusions

The S. alterniflora root microbiome is dominated by highly active and competitive species taking advantage of available carbon substrates in the oxidized root zone. Two microbially mediated mechanisms are proposed to stimulate S. alterniflora primary productivity: (i) enhanced microbial activity replenishes nutrients and terminal electron acceptors in higher biomass stands, and (ii) coupling of chemolithotrophic S oxidation with carbon (C) and nitrogen (N) fixation by root- and rhizosphere-associated prokaryotes detoxifies sulfide in the root zone while potentially transferring fixed C and N to the host plant.