bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation of a pre-calving vaccination programme against rotavirus, coronavirus and enterotoxigenic Escherichia coli (F5) and association with dairy calf survival
Authors: Viidu Dagni-Alice , Mõtus Kerli
Published: January 2022

Background

Diarrhea is one of the most common diseases and causes of death in calves during the first month of life. Pre-calving vaccination programme (PVP) against the most common diarrhea-causing pathogens could help to avoid this threat if hyperimmune transition milk (TM) is fed to calves throughout the whole susceptibility period. The aim of this retrospective cohort study was to reveal the implementation practices of PVPs in large commercial dairy farms and to compare calf-level mortality hazards during the first year of vaccination (V+ period) and a year before implementing the vaccination programme (V- period). A questionnaire was filled out in 15 large-scale dairy farms in Estonia that used PVP. The farms were assigned into three groups based on compliance with the vaccine directions for use and TM feeding practices. Calf-level time-to-event data was analyzed with an observation period of 21 days and on-farm mortality due to diarrhea being the event of interest.

Results

During the V+ period, a significant decline in diarrhea-induced calf mortality was identified in three out of six herds that followed vaccination instructions and fed TM for at least 14 days. On average, calf mortality hazard due to diarrhea decreased among these herds (hazard rate ratio (HR) = 0.72, 95% confidence interval (CI) 0.63; 0.81). In the group of correctly vaccinating herds where TM was fed for less than 14 days, diarrhea-induced calf mortality decreased in two herds and remained unchanged in two herds with average diarrhea-induced calf mortality hazard declining significantly during the vaccination period (HR = 0.24, 95% CI 0.14; 0.41). Among the three farms that deviated from the vaccination instructions, the average calf mortality hazard increased in the V+ period (HR = 1.61, 95% CI 1.21; 2.14).

Conclusions

This study revealed that implementing a PVP might aid to reduce diarrhea-induced calf mortality in large commercial dairy farms. There is a need to increase veterinarians´ and farmers´ awareness about the importance of including pregnant heifers into the vaccination programme and emphasize the importance of prolonged feeding of hyperimmune TM to calves.
Patient-derived xenograft models in hepatopancreatobiliary cancer
Authors: Pan Binhua , Wei Xuyong , Xu Xiao
Published: January 2022

Animal models are crucial tools for evaluating the biological progress of human cancers and for the preclinical investigation of anticancer drugs and cancer prevention. Various animals are widely used in hepatopancreatobiliary cancer research, and mouse models are the most popular. Generally, genetic tools, graft transplantation, and chemical and physical measures are adopted to generate sundry mouse models of hepatopancreatobiliary cancer. Graft transplantation is commonly used to study tumour progression. Over the past few decades, subcutaneous or orthotopic cell-derived tumour xenograft models (CDX models) have been developed to simulate distinct tumours in patients. However, two major limitations exist in CDX models. One model poorly simulates the microenvironment of tumours in humans, such as the vascular, lymphatic and immune environments. The other model loses genetic heterogeneity compared with the corresponding primary tumour. Increased efforts have focused on developing better models for hepatopancreatobiliary cancer research. Hepatopancreatobiliary cancer is considered a tumour with high molecular heterogeneity, making precision medicine challenging in cancer treatment. Developing a new animal model that can better mimic tumour tissue and more accurately predict the efficacy of anticancer treatments is urgent. For the past several years, the patient-derived xenograft model (PDX model) has emerged as a promising tool for translational research. It can retain the genetic and histological stability of their originating tumour at limited passages and shed light on precision cancer medicine. In this review, we summarize the methodology, advantages/disadvantages and applications of PDX models in hepatopancreatobiliary cancer research.
Assessing equity in health, wealth, and civic engagement: a nationally representative survey, United States, 2020
Authors: Stopka Thomas J. , Feng Wenhui , Corlin Laura , King Erin , Mistry Jayanthi , Mansfield Wendy , Wang Ying , Levine Peter , Allen Jennifer D.
Published: January 2022

Background

The principle of equity is fundamental to many current debates about social issues and plays an important role in community and individual health. Traditional research has focused on singular dimensions of equity (e.g., wealth), and often lacks a comprehensive perspective. The goal of this study was to assess relationships among three domains of equity, health, wealth, and civic engagement, in a nationally representative sample of U.S. residents.

Methods

We developed a conceptual framework to guide our inquiry of equity across health, wealth, and civic engagement constructs to generate a broad but nuanced understanding of equity. Through Ipsos’ KnowledgePanel service, we conducted a cross-sectional, online survey between May 29–June 20, 2020 designed to be representative of the adult U.S. population. Based on our conceptual framework, we assessed the population-weighted prevalence of health outcomes and behaviors, as well as measures of wealth and civic engagement. We linked individual-level data with population-level environmental and social context variables. Using structural equation modeling, we developed latent constructs for wealth and civic engagement, to assess associations with a measured health variable.

Results

We found that the distribution of sociodemographic, health, and wealth measures in our sample (n = 1267) were comparable to those from other national surveys. Our quantitative illustration of the relationships among the domains of health, wealth, and civic engagement provided support for the interrelationships of constructs within our conceptual model. Latent constructs for wealth and civic engagement were significantly correlated (p = 0.013), and both constructs were used to predict self-reported health. Beta coefficients for all indicators of health, wealth, and civic engagement had the expected direction (positive or negative associations).

Conclusion

Through development and assessment of our comprehensive equity framework, we found significant associations among key equity domains. Our conceptual framework and results can serve as a guide for future equity research, encouraging a more thorough assessment of equity.
Extracellular vesicle PD-L1 in reshaping tumor immune microenvironment: biological function and potential therapy strategies
Authors: Liu Jiaxing , Peng Xueqiang , Yang Shuo , Li Xinyu , Huang Mingyao , Wei Shibo , Zhang Sheng , He Guangpeng , Zheng Hongyu , Fan Qing , Yang Liang , Li Hangyu
Published: January 2022

Programmed cell death 1 ligand 1 (PD-L1) is the ligand for programmed death protein-1 (PD-1), is associated with immunosuppression. Signaling via PD-1/PD-L1 will transmits negative regulatory signals to T cells, inducing T-cell inhibition, reducing CD8+T-cell proliferation, or promoting T-cell apoptosis, which effectively reduces the immune response and leads to large-scale tumor growth. Accordingly, many antibody preparations targeting PD-1 or PD-L1 have been designed to block the binding of these two proteins and restore T-cell proliferation and cytotoxicity of T cells. However, these drugs are ineffective in clinical practice. Recently, numerous of studies have shown that, in addition to the surface of tumor cells, PD-L1 is also found on the surface of extracellular vesicles secreted by these cells. Extracellular vesicle PD-L1 can also interact with PD-1 on the surface of T cells, leading to immunosuppression, and has been proposed as a potential mechanism underlying PD-1/PD-L1-targeted drug resistance. Therefore, it is important to explore the production, regulation and tumor immunosuppression of PD-L1 on the surface of tumor cells and extracellular vesicles, as well as the potential clinical application of extracellular vesicle PD-L1 as tumor biomarkers and therapeutic targets.
The effects of national mental health plans on mental health services development in Chile: retrospective interrupted time series analyses of national databases between 1990 and 2017
Authors: Mundt Adrian P. , Martínez Pablo , Jaque Sebastián , Irarrázaval Matías
Published: January 2022

Aims

To describe changes in mental health services in Chile between 1990 and 2017, and to retrospectively assess the effects of national mental health plans (NMHPs) on mental health services development during this period.

Methods

Service data (beds in psychiatric hospitals, psychiatric beds in general hospitals, forensic psychiatric beds, beds in protected housing facilities, psychiatric day hospital places, and outpatient mental health care centers) were retrieved from government sources in Chile. Data were reported as rates per 100,000 population. We conducted interrupted time series analyses, using ordinary least-square regressions with Newey-West standard errors, to assess the effects of the 1993 and 2000 NMPHs on mental health services development.

Results

Rates of short- and long-stay beds in psychiatric hospitals (per 100,000 population) were reduced from 4.3 to 3.2 and from 19.0 to 2.0 over the entire time span, respectively. The strongest reduction of short- and long-stay beds in psychiatric hospitals was seen between the 1993 and 2000 NMHPs (annual removal of − 0.14 and − 1.03, respectively). We observed increased rates of psychiatric beds in general hospitals from 1.8 to 4.0, beds in protected housing facilities from 0.4 to 10.2, psychiatric day hospital places from 0.4 to 5.0, outpatient mental health care centers from 0.1 to 0.8 and forensic psychiatric beds from 0.3 to 1.1 over the entire time span. The strongest annual increase of rates of psychiatric beds in general hospitals (0.09), beds in protected housing facilities (0.50), psychiatric day hospital places (0.16) and outpatient mental health care centers (0.04) were observed after the 2000 NMHP. Forensic psychiatric beds increased in the year 2007 (0.58) due to the opening of a new facility.

Conclusions

The majority of acute care psychiatric beds in Chile now are based in general hospitals. The strong removal of short- and long-stay beds from psychiatric hospitals after the 1993 NMHP preceded substantial expansion of more modern mental health services in general hospitals and in the community. Only after the 2000 NMHP, the implementation of new mental health services gained momentum. Reiterative policies are needed to readjust mental health services development.
Effects of positive end-expiratory pressure on lung ultrasound patterns and their correlation with intracranial pressure in mechanically ventilated brain injured patients
Authors: Robba Chiara , Ball Lorenzo , Battaglini Denise , Iannuzzi Francesca , Brunetti Iole , Fiaschi Pietro , Zona Gianluigi , Taccone Fabio Silvio , Messina Antonio , Mongodi Silvia , Pelosi Paolo
Published: January 2022

Background

The effects of positive end-expiratory pressure (PEEP) on lung ultrasound (LUS) patterns, and their relationship with intracranial pressure (ICP) in brain injured patients have not been completely clarified. The primary aim of this study was to assess the effect of two levels of PEEP (5 and 15 cmH2O) on global (LUStot) and regional (anterior, lateral, and posterior areas) LUS scores and their correlation with changes of invasive ICP. Secondary aims included: the evaluation of the effect of PEEP on respiratory mechanics, arterial partial pressure of carbon dioxide (PaCO2) and hemodynamics; the correlation between changes in ICP and LUS as well as respiratory parameters; the identification of factors at baseline as potential predictors of ICP response to higher PEEP.

Methods

Prospective, observational study including adult mechanically ventilated patients with acute brain injury requiring invasive ICP. Total and regional LUS scores, ICP, respiratory mechanics, and arterial blood gases values were analyzed at PEEP 5 and 15 cmH2O.

Results

Thirty patients were included; 19 of them (63.3%) were male, with median age of 65 years [interquartile range (IQR) = 66.7–76.0]. PEEP from 5 to 15 cmH2O reduced LUS score in the posterior regions (LUSp, median value from 7 [5–8] to 4.5 [3.7–6],p = 0.002). Changes in ICP were significantly correlated with changes in LUStot (rho = 0.631,p = 0.0002), LUSp (rho = 0.663,p < 0.0001), respiratory system compliance (rho = − 0.599,p < 0.0001), mean arterial pressure (rho = − 0.833,p < 0.0001) and PaCO2(rho = 0.819,p < 0.0001). Baseline LUStot score predicted the increase of ICP with PEEP.

Conclusions

LUS-together with the evaluation of respiratory and clinical variables-can assist the clinicians in the bedside assessment and prediction of the effect of PEEP on ICP in patients with acute brain injury.
Third-generation cognitive behavioral therapy versus treatment-as-usual for attention deficit and hyperactivity disorder: a multicenter randomized controlled trial
Authors: Crouzet Laetitia , Gramond Anne , Suehs Carey , Fabbro-Peray Pascale , Abbar Mocrane , Lopez-Castroman Jorge
Published: January 2022

Background

This study aims to compare improvements in attention deficit and hyperactivity disorder (ADHD) symptom severity between a group of ADHD children and parents undergoing a new therapeutic program based on third-generation cognitive behavioral therapy (Hyper-mCBT) and a similar group undergoing treatment-as-usual with the Barkley program.

Methods

Two hundred forty-eight children diagnosed with ADHD will be randomly assigned to either a Hyper-mCBT program or a Barkley program. This is a multicenter randomized (1:1), 2 parallel-group, superiority trial with evaluator blinding and stratification according to center and methylphenidate treatment. The Hyper-mCBT program consists in a series of 16 simultaneous-but-separate therapy sessions for parents and for children.

Discussion

More effective psychotherapeutic approaches are needed for ADHD children. Pharmacotherapy seems to be more effective in reducing ADHD symptoms but it is not always helpful, it carries side effects, and it is rejected by many parents/professionals. Results for psychotherapy programs for ADHD are inconsistent although several studies have shown clinical improvements. This trial will substantiate encouraging preliminary results of an innovative psychotherapy program for both parents and children.

Trial registration

ClinicalTrials.gov NCT03437772. Registered on February 19, 2018. Sponsor number: PHRC-N/2016/JLC-01. RCB identification: 2017-A01349-44
Assessment of subclinical left ventricle myocardial dysfunction using global myocardial work in type 2 diabetes mellitus patients with preserved left ventricle ejection fraction
Authors: Wang Tao , Li Li , Huang Jun , Fan Li
Published: January 2022

Background

The purpose of this study was to assess subclinical left ventricle (LV) myocardial dysfunction using global myocardial work (MW) in type 2 diabetes mellitus (T2DM) patients with preserved left ventricle ejection fraction (LVEF).

Methods

Sixty T2DM patients and 60 normal controls were enrolled in the study. Apical 4-, 3- and 2-chamber views were acquired by two-dimensional echocardiography. Peak systolic myocardial global longitudinal strain (GLS), global myocardial work index (GWI), global constructive work (GCW), global wasted work (GWW), and myocardial work efficiency (GWE) were determined by speckle-tracking echocardiography (STE).

Results

The GLS values in the T2DM patients were significantly lower than those in normal controls (p < 0.001). The GWW in T2DM patients was significantly greater than that in normal controls, while GWI, GCW and GWE was significantly lower (p < 0.001). Receiver operating characteristic (ROC) analysis showed there were no significant different difference between GWW, GWE and GLS in the area under the curves (AUCs). In T2DM patients, fasting plasma glucose was positively correlated with GWW but negatively correlated with GWE, and GLS was negatively correlated with GWI and GCW.

Conclusion

From the research, we found that global MW as new technique could detect the subclinical LV myocardial dysfunction and confirm that the impaired LV function in T2DM patients with preserved LV systolic function.
Adiponectin levels and its relation with insulin secretion and insulin sensitivity in a group of sub-Saharan African women with polycystic ovary syndrome
Authors: Momo Audrey Synthia , Ama Moor Vicky Jocélyne , Tankeu Aurel T. , Amazia Falmata , Sadeu Wafeu Guy , Guewo-Fokeng Magellan , Mbono Samba Esther Astrid , Nkeck Jan réné , Djieka Yannick , Chemaga Nkonpawa Christelle , Djapa Tofeun Floriane , Guifo Serge , Dohbit Sama Julius , Choukem Siméon Pierre
Published: January 2022

Objectives

Low levels of adiponectin have been reported in Polycystic Ovary Syndrome (PCOS). In sub-Saharan Africa, little data are available on the topic. We aimed to investigate the levels of adiponectin and its relation with insulin secretion and insulin sensitivity in women with PCOS in Yaoundé, Cameroon. A comparative cross-sectional study was conducted in 32 women presenting PCOS and 32 controls matched for age and Body Mass Index. For each participant, adiponectin levels were measured. We estimated insulin sensitivity using Homeostasis model index (HOMA-IR) and insulin secretion with C-peptide levels.

Results

Women with PCOS had higher insulin secretion levels than controls (C-peptide: 4.98 ± 3.83 vs 3.25 ± 1.62 mUI/l; p = 0.02). Also, the HOMA-IR index was higher compared to that of women without PCOS (1.15 ± 0.90 vs 0.77 ± 0.38; p = 0.03) suggesting greater insulin resistance. The median [25th–75th percentile] values of adiponectin concentrations were similar between the two groups (22.68 [21.72–23.41] μg/ml vs 22.03 [21.40–22.93] μg/ml; p = 0.1). There was no association between insulin sensitivity and adiponectin levels in the PCOS group. PCOS is not associated with changes in adiponectin in a population of sub-Saharan African women. Further studies are needed to shed more light on this condition.
The effect of tax incentives practices on the sustainability of micro, small and medium enterprises in Ethiopia during the outbreak of corona virus pandemic
Authors: Deyganto Kanbiro Orkaido
Published: January 2022

Purpose

This study was aimed to identify the effect of tax incentive practices on the sustainability of MSMEs during an outbreak of coronavirus pandemic in Ethiopia.

Design/methodology/approach

To achieve this objective, the researcher has employed a quantitative research approach with an explanatory research design in which six hypotheses have been tested. The primary data were collected from 300 MSMEs owners/operators using structured questionnaires. A multiple regression model was employed to study the effect of tax incentives parameters on the sustainability of MSMEs.

Findings

According to the regression analysis, this paper revealed that tax holiday, tax allowance, reduction in the tax rate, accelerated depreciation, loss carry forward, and tax exemption have a positive and statistically significant effect on the sustainability of the MSMEs.

Research limitations

The current study was geographically focused on Ethiopia by considering the MSMEs sector. The subject wise was focused on the effect of the tax incentives on the sustainability of MSMEs. The primary data were limited to the year 2020. It might be improved in the future if other researchers incorporate large firms in the country and use secondary data for the analysis of multiple years. Also, future researchers will improve the same study by considering both monetary and non-monetary incentives as study variables.

Practical implications

To survive during the COVID-19 pandemic, MSMEs need support from the government in the form of tax incentives. The tax incentives play a great role in enhancing the growth and the sustainability of MSMEs as well as the economy as a whole. So the owners of MSMEs have to ask the government to obtain necessary support in the form of monetary and non-monetary incentives to be sustainable in economic activity. Also, the findings and recommendations of the current study might serve as an ingredient and be informative to the policymakers on the MSMEs sector. The governments have to continue to shape tax incentives policies to support the MSMEs’ sustainability by providing tax and non-tax incentives.

Originality/value

This study contributes to empirical evidence about the effect of tax incentives practices on the sustainability of MSMEs during the outbreak of COVID-19 in Ethiopia by considering six tax incentive practices in terms of tax holiday, tax allowance, reduction in the tax rate, accelerated depreciation, loss carried forward, and tax exemption.
Brain macrophages acquire distinct transcriptomes in multiple sclerosis lesions and normal appearing white matter
Authors: Miedema Anneke , Gerrits Emma , Brouwer Nieske , Jiang Qiong , Kracht Laura , Meijer Michel , Nutma Erik , Peferoen-Baert Regina , Pijnacker Anna T. E. , Wesseling Evelyn M. , Wijering Marion H. C. , Gabius Hans-Joachim , Amor Sandra , Eggen Bart J. L. , Kooistra Susanne M.
Published: January 2022

Multiple sclerosis (MS) is a disease of the central nervous system that is characterized by inflammation and focal areas of demyelination, ultimately resulting in axonal degradation and neuronal loss. Several lines of evidence point towards a role for microglia and other brain macrophages in disease initiation and progression, but exactly how lesion formation is triggered is currently unknown. Here, we characterized early changes in MS brain tissue through transcriptomic analysis of normal appearing white matter (NAWM). We found that NAWM was characterized by enriched expression of genes associated with inflammation and cellular stress derived from brain macrophages. Single cell RNA sequencing confirmed a stress response in brain macrophages in NAWM and identified specific microglia and macrophage subsets at different stages of demyelinating lesions. We identified both phagocytic/activated microglia and CAM clusters that were associated with various MS lesion types. These overall changes in microglia and macrophages associated with lesion development in MS brain tissue may provide therapeutic targets to limit lesion progression and demyelination.
Community perceptions of enrolment of indigents into the National Health Insurance Scheme in Ghana: a case study of the Livelihood Empowerment against Poverty Programme
Authors: Akweongo Patricia , Voetagbe Edmund , Tediosi Fabrizio , Gadeka Dominic Dormenyo , Salari Paola , Aikins Moses
Published: January 2022

Background

The Livelihood Empowerment against Poverty (LEAP) programme in Ghana as part of its beneficiary programme, identifies the poor/indigents for exemptions from premium payments in the National Health Insurance Scheme (NHIS). This paper sought to understand community perceptions of enrolling the poor in the NHIS through LEAP in order to inform policy.

Methods

The study adopted a descriptive cross-sectional study design by using a qualitative approach. The study was conducted in three geographical regions of Ghana: Greater Accra, Brong-Ahafo and Northern region representing the three ecological zones of Ghana between October 2017 and February 2018. The study population included community members, health workers, NHIS staff and social welfare officers/social development officers. Eighty-one in-depth interviews and 23 Focus Group Discussions were conducted across the three regions. Data were analysed thematically and verbatim quotes from participants were used to support the views of participants.

Results

The study shows that participants were aware of the existence of LEAP and its benefits. There was, however, a general belief that the process of LEAP had been politicized and therefore favours only people who were sympathizers of the ruling government as they got enrolled into the NHIS. Participants held the view that the process of selecting beneficiaries lacked transparency, thus, they were not satisfied with the selection process. However, the study shows the ability of the community to identify the poor. The study reports varying concepts of poverty and its identification across the three ecological zones of Ghana.

Conclusion

There is a general perception of politicization and lack of transparency of the selection of the poor into the NHIS through the LEAP programme in Ghana. Community-based approaches in the selection of the indigent are recommended to safeguard the NHIS-LEAP beneficiary process.
Influence of aqueous chloride and bromide ions on bisphenol A degradation efficiency with zinc oxide nanoparticles
Authors: Yang Yi-Chen , Sahu Rama Shanker , Shih Yang-hsin
Published: January 2022

Zinc oxide (ZnO) nanoparticles (NPs) have been widely investigated for applications in photocatalytic degradation of organic pollutants in wastewater. Despite the advantages of robust ZnO material, its photocatalytic activity is greatly affected by environmental factors. Halogen ions are commonly found in wastewater, which directly affect the pollutant aggregation and sedimentation, therefore it is necessary to discuss their effect on the photocatalytic degradation. The current study assesses the halogen ions effect on the photocatalytic degradation of bisphenol A (BPA) using different dosage of sodium chloride (NaCl) and sodium bromide (NaBr). The microstructural characterization of ZnO NPs was conducted by transmission electron microscopy and hydrodynamic size was analyzed through dynamic light scattering. The effective BPA degradation with ZnO NPs was observed and pseudo-first-order kinetics was calculated. The increase of ZnO NPs dosage from 10 to 100 mg L− 1 enhanced the degradation rate constant of BPA up to 0.089 min− 1 (14.8 folds). In order to evaluate the role halogen ions to degrade BPA, NaBr and NaCl were used. The degradation rate was reduced to 0.0034 min− 1 after the addition of NaBr due to the increase in hydrodynamic particle size, thereby restricting the light adsorption capacity. Noteworthy, upon addition of NaCl up to 500 mM concentration, only a slight decrease on BPA degradation rate was observed. Therefore, this study unveils the role of chloride ions as an effective medium for BPA degradation by ZnO NPs, without aggregation, and provides a novel platform for the treatment of organic pollutants in saline water.
Past, present, and future of cartilage restoration: from localized defect to arthritis
Authors: Lee Dong Hwan , Kim Seok Jung , Kim Seon Ae , Ju Gang-ik
Published: January 2022

Background

Osteoarthritis, one of the most common joint diseases, is characterized by the loss of joint function due to articular cartilage destruction. Herein, we review current and previous research involving the clinical applications of arthritis therapy and suggest potential therapeutic options for osteoarthritis in the future.

Past, present, and future treatment

The arthroscopic cartilage regeneration procedure or realignment osteotomy has been performed as a joint-conserving procedure in cases where conservative treatment for damaged articular cartilage and early osteoarthritis failed. If cartilage regeneration is ineffective or if the joint damage progresses, arthroplasty is the main treatment option. The need for biological arthritis treatment has expanded as the healthy lifespan of the global population has increased. Accordingly, minimally invasive surgical treatment has been developed for the treatment of damaged cartilage and early osteoarthritis. However, patients generally prefer to avoid all types of surgery, including minimally invasive surgery. Therefore, in the future, the treatment of osteoarthritis will likely involve injection or medication.

Conclusion

Currently, arthritis management primarily involves the surgical application of therapeutic agents to the joints. However, nonsurgical or prophylactic methods are expected to become mainstream arthritis therapies in the future.
A pragmatic approach to identifying implementation barriers and facilitators for a novel pre-exposure prophylaxis (PrEP) delivery model at public facilities in urban Uganda
Authors: Thomas Dorothy , Mujugira Andrew , Ortblad Katrina , Namanda Sylvia , Kibuuka Joseph , Nakitende Mai , Nambi Florence , Nakabugo Lylianne , Scoville Caitlin , Muwonge Timothy , Heffron Renee
Published: January 2022

Background

Scalable HIV pre-exposure prophylaxis (PrEP) delivery models for resource-limited settings are critical for improving PrEP coverage and interrupting HIV transmission. This research uses technical assistance (TA) reports to evaluate implementation barriers and facilitators for a novel delivery model integrating PrEP and antiretroviral therapy (ART) delivery for HIV sero-different couples in public health facilities in Kampala, Uganda.

Methods

We used data from the Partners PrEP Program (PPP)—a stepped-wedge cluster randomized trial that is launching PrEP delivery through an integrated model of oral PrEP and antiretroviral therapy (ART) delivery for HIV sero-different couples at public health facilities in Kampala and Wakiso, Uganda (NCT03586128). Technical assistance teams, comprised of PPP program staff, conducted monthly TA visits to implementing facilities where they identified and addressed implementation challenges in collaboration with health facility staff. Findings were recorded in TA reports, a standardized form structured using the Consolidated Framework for Implementation Research (CFIR). We used a conceptual content analysis approach to evaluate TA reports completed from January to December 2019 and identify implementation barriers and facilitators.

Results

Among 39 reports from the 8 implementing facilities (~ 5 per facility), we identified 11 CFIR constructs. Key implementation facilitators included sensitizing and educating facility staff about PrEP (knowledge and beliefs about the innovation); establishing formal and informal feedback and accountability mechanisms (reflecting and evaluating); and empowering facility staff to address implementation challenges (self-efficacy). Key implementation barriers were related to ineffective recruitment and referral of sero-different couples to and from nearby facilities (cosmopolitanism) as well as stockouts of laboratory resources and testing supplies (available resources).

Conclusions

This analysis featured a robust implementation science framework to assess the relationship between early implementation determinants and outcomes of this innovative PrEP delivery model. Further, we have provided important descriptions of early implementation barriers and facilitators that will inform scale-up efforts for PrEP delivery within and beyond Uganda. Future work will refine the analysis of pragmatic program data, qualitatively investigate the identified key themes, and explore strategies for addressing implementation barriers.
To what extent AstraZeneca ChAdOx1 nCoV-19 vaccine is safe and effective? Rapid systematic review
Authors: Mohamed Hussein Aliae A. R. , Ibrahim Islam H. , Mahmoud Islam A. , Amary Marwa , Sayad Reem
Published: January 2022

Until now, there are more than two hundred million confirmed cases of COVID-19 including more than seven million deaths. Clinical trials of all three vaccines authorized for use in the UK (Pfizer–BioNTech, Oxford–AstraZeneca, and Moderna) have reported high vaccine efficacy. This rapid systematic review was initiated because no systematic review had been conducted to determine the safety and efficacy of AstraZeneca ChAdOx1 nCoV-19 vaccine. Evidence acquisition: A systematic search in the following platforms: PubMed, Google Scholar, Scopus, WOS, and MEDLINE databases for all articles in the English language regarding safety and efficacy of SARS-CoV-2 vaccine ChAdOx1 nCoV-19 was performed. Papers published up to end of June were included. Evidence synthesis: Out of 477 retrieved articles, fifteen are included. All the selected articles are concerned with evaluation of AstraZeneca ChAdOx1 nCoV-19 vaccine. Three of them discussed the effectiveness of ChAdOx1 nCoV-19 vaccine, while thirteen (one is common with the group of the effectiveness) measured the adverse effects associated with the vaccine. Because thrombosis was recorded as a serious adverse effect developed after ChAdOx1 nCoV-19 vaccination, it was emphasized in a special group to be analyzed separately. In conclusion: the main message of selected papers was that the value of ChAdOx1 nCoV-19 vaccination to provide critical protection should be considered higher compared to the significant worldwide burden of the emerging COVID-19 infection. No causal relations were found to link cases- having thrombotic adverse reactions to the vaccine.
Polymer-based dampening layer application to improve the operating shock tolerance of hard disk drive
Authors: Djamari Djati Wibowo , Yap Fook Fah , Budiman Bentang Arief , Triawan Farid
Published: January 2022

This paper discusses a passive vibration control method to improve the shock tolerance of hard disk drives (HDDs) in operating condition (op-shock tolerance). Past works in improving the HDDs’ op-shock tolerance includes (i) parking the head when shock is detected, (ii) installing a lift-off limiter, (iii) structural modification of the suspension, and (iv) installing an external vibration isolation. Methods (i) and (iv) have practical issues, method (ii) works only on single shock direction, and method (iii) requires major engineering design/manufacturing work. Compared to these works, this paper proposes a method which has no practical issues and without requiring major engineering design/manufacturing work. The proposed method is to apply a polymer-based dampening layer on the backside of the baseplate with the purpose of increasing the damping ratio of the 1st bending mode of the baseplate. The location of the dampening layer on the baseplate is first determined by modal analysis and then fine-tuned by non-op-shock tests. The op-shock tolerance improvement is confirmed by op-shock tests where 2.5″ HDD with the dampening layer on the baseplate can withstand a 300G 0.5-ms shock without failure while unmodified HDD can only withstand 250G 0.5-ms shock without failure.
The unseen pandemic: treatment delays and loss to follow-up due to fear of COVID
Authors: Einav Sharon , Tankel James
Published: January 2022

Background

Fear of contracting SARS-CoV-2 has transformed public interaction with healthcare professionals and hospitals alike. In turn, this has resulted in a collateral impact on patients’ health across medical and surgical paradigms. Understanding the causative factors of this fear, and tackling it head on, is vital to return to pre-pandemic levels of healthcare.

Main body

In this editorial, we explore the evidence base behind the fear of healthcare professionals and facilities that has developed during the course of the SARS-CoV-2pandemic. We also reflect on the ways in which these fears have affected the general public. In so doing, we review a recent article from Montalto et al. that has explored fear of SARS-CoV-2 among patients undergoing surgery in Italy.

Conclusion

While fear of SARS-CoV-2 is uncommon among surgical patients, there are still those who delay or avoiding seeking medical care due to fear of transmission. Physicians must lead the fight against this fear in a hope to regain the trust of the public.
Oral Glucose Tolerance Test-based Measures of Insulin Secretory Response in Pregnancy
Authors: Powe Camille E , Locascio Joseph J , Gordesky Larraine Huston , Florez Jose C , Catalano Patrick M
Published: January 2022

Background

Oral glucose tolerance test (OGTT)-based measures of insulin secretory response have not been validated in pregnancy.

Methods

In a secondary analysis of a longitudinal study, participants were studied prepregnancy (n = 40), in early pregnancy (n = 36; 12-14 weeks’ gestation), and in late pregnancy (n = 36; 34-36 weeks’ gestation). Participants underwent an OGTT, an intravenous glucose tolerance test (IVGTT), and a hyperinsulinemic-euglycemic clamp at each timepoint. We calculated homeostatic model assessment of beta-cell function (HOMA-2B), insulinogenic index (IGI), corrected insulin response (CIR), ratio of the area under the insulin curve and the area under the glucose curve (AUCins/AUCglu), and Stumvoll first-phase estimate (Stumvoll) from OGTT insulin and glucose levels. We used Pearson correlation to compare measures from OGTT and IVGTT. We used mixed effects models to examine longitudinal changes in insulin secretory response.

Results

Stumvoll was the only OGTT-based measure that was significantly correlated with first-phase insulin response prior to and across gestation (prepregnancy: r = 0.44, P = 0.01; early pregnancy: r = 0.67, P = 0.0001; late pregnancy: r = 0.67, P = 0.0001). In early and late pregnancy, AUCins/AUCglu had the strongest correlation with first-phase insulin response (early pregnancy: r = 0.79, P < 0.0001; late pregnancy: r = 0.69, P < 0.0001) but was not significantly correlated prepregnancy. IGI and CIR were significantly correlated with first-phase insulin response prepregnancy (IGI: r = 0.50, P = 0.005; CIR r = 0.47, P = 0.008) and in late pregnancy (IGI: r = 0.68, P = 0.0001; CIR r = 0.57, P = 0.002) but not in early pregnancy. HOMA-2B was the weakest correlate of first-phase insulin response. Stumvoll and AUCins/AUCglu recapitulated the longitudinal changes in insulin secretory response observed by IVGTT.

Conclusions

Stumvoll and AUCins/AUCglu are valid OGTT-based insulin secretory response measures for pregnancy studies.
Spinal Versus General Anesthesia for Cesarean Delivery in Pregnant Women With Moyamoya Disease: A Retrospective Observational Study
Authors: Kim Hee Jung , Choi Seung Ho , Kwon Hayan , Park Eun Kyung , Kwon Ja-Young , Yang Hyukjin , Kim Seung Hyun
Published: January 2022

BACKGROUND:

Moyamoya disease, a rare chronic cerebrovascular disease with a fragile vascular network at the base of the brain, can cause ischemic or hemorrhagic strokes or seizures. Precise blood pressure control and adequate analgesia are important for patients with moyamoya disease to prevent neurological events such as ischemia and hemorrhage. This study aimed to compare the intraoperative mean arterial pressure of pregnant women with moyamoya disease according to the mode of anesthesia (general anesthesia versus spinal anesthesia) used during cesarean delivery.

METHODS:

We retrospectively reviewed the medical records of 87 cesarean deliveries in 74 patients who had been diagnosed with moyamoya disease before cesarean delivery. The primary outcome, intraoperative maximum mean arterial pressure during anesthesia, was compared according to the type of anesthesia administered (general versus spinal anesthesia). Other perioperative hemodynamic data (lowest mean arterial pressure, incidence of hypotension, vasopressor use, and antihypertensive agent use), maternal neurologic symptoms, neonatal outcomes (Apgar scores <7, ventilatory support, and intensive care unit admission), maternal and neonatal length of stay, postoperative pain scores, and rescue analgesic use were assessed as secondary outcomes.

RESULTS:

While the lowest blood pressure during anesthesia and incidence of hypotension did not differ between the 2 groups, the maximum mean arterial pressure during anesthesia was lower in the spinal anesthesia group than that in the general anesthesia group (104.8 ± 2.5 vs 122.0 ± 4.6; P = .002). Study data did not support the claim that maternal neurologic symptoms differ according to the type of anesthesia used (5.6% vs 9.3%; P = .628); all patients recovered without any sequelae. The postoperative pain scores were lower, and fewer rescue analgesics were used in the spinal anesthesia group than in the general anesthesia group. Other maternal and neonatal outcomes were not different between the 2 groups.

CONCLUSIONS:

Compared with general anesthesia, spinal anesthesia mitigated the maximum arterial blood pressure during cesarean delivery and improved postoperative pain in patients with moyamoya disease.
The Legal and Socioeconomic Considerations in Spine Telemedicine
Authors: Perez-Roman Roberto J. , Trenchfield Delano R. , Perez-Roman Nayda I. , Wang Michael Y.
Published: January 2022

Telemedicine has become indispensable in today's health care because of the recent ongoing COVID-19 crisis. Although it has been beneficial in coping with the pandemic, there is still much uncertainty as to whether it will have a permanent role in treating spine patients. Some of the ongoing legal challenges include patient confidentiality, liability coverage for treating healthcare workers, and financial reimbursements by insurance companies. One of the impediments of telemedicine is its lack of a standard legal framework. Telehealth is currently regulated through a state-based system with each state having its own policy regarding this practice. In addition, each of the components of a virtual visit represent a potential area for legal concerns. Nonetheless, telemedicine has the ability to provide convenient and effective health care to patients. However, the spine surgeon, as well as other physicians, must consider the legal issues along with some socioeconomic factors identified herein. Moreover, without parity and uniformity, the incentive to offer telehealth services decreases. There may be a need for modifications in the law, insurance policies, and medical malpractice coverage to strengthen their support to telemedicine usage. As spine surgeons become more familiarized with the telemedicine framework, its role in patient care will likely expand.
A single-cell atlas of de novo β-cell regeneration reveals the contribution of hybrid β/δ-cells to diabetes recovery in zebrafish
Authors: Singh Sumeet Pal , Chawla Prateek , Hnatiuk Alisa , Kamel Margrit , Silva Luis Delgadillo , Spanjaard Bastiaan , Eski Sema Elif , Janjuha Sharan , Olivares-Chauvet Pedro , Kayisoglu Oezge , Rost Fabian , Bläsche Juliane , Kränkel Annekathrin , Petzold Andreas , Kurth Thomas , Reinhardt Susanne , Junker Jan Philipp , Ninov Nikolay
Published: January 2022

Regeneration-competent species possess the ability to reverse the progression of severe diseases by restoring the function of the damaged tissue. However, the cellular dynamics underlying this capability remain unexplored. Here, we have used single-cell transcriptomics to map de novo β-cell regeneration during induction and recovery from diabetes in zebrafish. We show that the zebrafish has evolved two distinct types of somatostatin-producing δ-cells, which we term δ1- and δ2-cells. Moreover, we characterize a small population of glucose-responsive islet cells, which share the hormones and fate-determinants of both β- and δ1-cells. The transcriptomic analysis of β-cell regeneration reveals that β/δ hybrid cells provide a prominent source of insulin expression during diabetes recovery. Using in vivo calcium imaging and cell tracking, we further show that the hybrid cells form de novo and acquire glucose-responsiveness in the course of regeneration. The overexpression of dkk3, a gene enriched in hybrid cells, increases their formation in the absence of β-cell injury. Finally, interspecies comparison shows that plastic δ1-cells are partially related to PP cells in the human pancreas. Our work provides an atlas of β-cell regeneration and indicates that the rapid formation of glucose-responsive hybrid cells contributes to the resolution of diabetes in zebrafish
Synthesis and Resolution of a Chiral Open-Chain Host Having a Partial Structure of p-tert-Butylsulfinylcalix[4]arene
Authors: Sakamoto Atsuya , Budiutama Gekko Patria , Takayama Yoshihiro , Morohashi Naoya , Hattori Tetsutaro
Published: January 2022

An open-chain carboxylic acid host with a chiral sulfinyl group (4) was synthesized from 3,3′-thiobis[(5-tert-butyl-2-hydroxyphenyl)acetic acid] (2) by oxidation of the epithio linkage with mCPBA, followed by acid-catalyzed monoesterification with propan-1-ol. The monoester was resolved via diastereomeric salt formation using quinidine as a resolving agent. The absolute configuration of (+)-4 was assigned to be (R) by X-ray analysis.
A Satellite Account for Health in the United States
Authors: Cutler David M. , Ghosh Kaushik , Messer Kassandra L. , Raghunathan Trivellore , Rosen Allison B. , Stewart Susan T.
Published: January 2022

This paper develops a satellite account for the US health sector and measures productivity growth in health care for the elderly population between 1999 and 2012. We measure the change in medical spending and health outcomes for a comprehensive set of 80 conditions. Medical care has positive productivity growth over the time period, with aggregate productivity growth of 1.5 percent per year. However, there is significant heterogeneity in productivity growth. Care for cardiovascular disease has had very high productivity growth. In contrast, care for people with musculoskeletal conditions has been costly but has not led to improved outcomes. (JEL E01, H51, I10)
Economic burden of out-of-pocket expenditure, productivity cost during pregnancy and COVID-19 impact on household economy in a cohort of pregnant women in Anuradhapura District, Sri Lanka; A study protocol
Authors: Gunarathne Sajaan Praveena , Wickramasinghe Nuwan Darshana , Agampodi Thilini Chanchala , Prasanna Indika Ruwan , Agampodi Suneth Buddhika
Published: January 2022

Background: Investigating the out-of-pocket expenditure (OOPE) associated with maternal health is important since OOPE directly affects the affordability of health services. Global evidence suggests the importance of capturing the productivity cost during pregnancy in terms of absenteeism and presenteeism. Furthermore, the impact of the ongoing COVID-19 pandemic on the household economy needs to be further evaluated as pregnant women are one of the most vulnerable groups. This study aims at determining the economic burden of OOPE, productivity cost, and COVID-19 impact on pregnant women's household economy in a cohort of pregnant women in Anuradhapura District, Sri Lanka.

Methods: The study setting is all 22 Medical Officer of Health (MOH) areas in Anuradhapura district, Sri Lanka. The study has three components; a follow-up study of a cohort of pregnant women to assess the magnitude and associated factors of OOPE and to assess the productivity cost (Component 1), a qualitative case study to explore the impact and causes of the OOPE under free health services (Component 2) and a cross-sectional study to describe the effects of COVID-19 outbreak on household economy (Component 3). The study samples consist of 1,393 and 1,460 participants for components one and three, respectively, and 25 pregnant women will be recruited for component two. The data will be analyzed using descriptive, parametric, and non-parametric statistics for the first and third components and thematic analysis for the second component.

Discussion: With the lack of evidence on OOPE, productivity loss/cost in terms of maternal health, and COVID-19 impact on household economy in Sri Lanka, the evidence generated from this study would be valuable for policymakers, health care administrators, and health care practitioners globally, regionally, and locally to plan for future measures for reducing the OOPE, productivity loss/cost, and minimizing the economic hardship of the COVID-19 outbreak during pregnancy.