bluuebunny/crossref_metadata_2025 huggingface dataset:
Animating and sustaining outrage: The place of crisis pregnancy centers in abortion justice
Authors: Thomsen Carly
Published: January 2022

In 2021, U.S. states enacted 106 different abortion restrictions, the highest number of any year since Roe v. Wade was decided in 1973. Inspiring the most public outcry is Texas's S.B. 8, which bans abortion after six weeks and allows private citizens to sue those performing abortions or aiding in this process. Abortion justice supporters should be enraged—but only in small part due to Texas’ ban, any of the other 105 enacted restrictions, or the likelihood that the Supreme Court soon will hand down a decision to overturn Roe v. Wade. We should be enraged because the anti-abortion movement has chipped away at the accessibility of abortion to the degree that the legal right to abortion means far less than it should. Key to this chipping away has been crisis pregnancy centers—religiously motivated, anti-abortion non-profit organizations that critics describe as “fake women's health clinics.” Today, there are 2500 crisis pregnancy centers and just 738 abortion clinics in the U.S., numbers that were reversed 30 years ago. And yet, countering crisis pregnancy centers has been less central to the work of abortion justice advocates than advancing crisis pregnancy centers has been to the anti-abortion movement. In this article, I argue that focusing on crisis pregnancy centers can provide new opportunities for both understanding the contemporary abortion landscape and also for advancing abortion justice activism. To put a finer point on it, I argue that centering crisis pregnancy centers in our development of what Sydney Calkin terms “the political geography of abortion” is one way to animate outrage among those who have not been involved in abortion justice work previously and to sustain outrage among feminist activists who have been worn down by decades of anti-abortion advancement.
Advances in pharmacotherapy for postpartum depression: a structured review of standard-of-care antidepressants and novel neuroactive steroid antidepressants
Authors: Kaufman Yardana , Carlini Sara V. , Deligiannidis Kristina M.
Published: January 2022

Postpartum depression is one of the most common morbidities of childbearing, yet it is underdiagnosed and undertreated with negative consequences for mother and offspring. Despite the widespread use of standard-of-care antidepressants as the mainstay of treatment for postpartum depression, there is limited evidence on their safety and efficacy due to their slow onset of action and suboptimal outcomes. The emergence of gamma-aminobutyric acidergic neuroactive steroids may offer faster response and remission times and improved patient outcomes. This article reviews the evidence base for the efficacy of standard-of-care antidepressants, hormonal therapeutics including progestins and estradiol, and gamma-aminobutyric acidergic neuroactive steroids in the treatment of postpartum depression, as well as the safety of infant exposure to these agents during lactation.
Brugada syndrome: should we be screening patients before prescribing psychotropic medication?
Authors: Attard Azizah , Stanniland Claire , Attard Stephen , Iles Andrew , Rajappan Kim
Published: January 2022

Brugada syndrome (BrS) presents with a characteristic electrocardiogram (ECG) and is associated with sudden cardiac death. Until now, prolongation of QTc interval and its association with Torsade de Pointe and possible fatal arrhythmia have been the focus of routine baseline ECGs before prescribing psychotropic medication. A semi-systematic literature review was conducted using PubMed. The terms ‘Brugada’, ‘Brugada Syndrome’ AND ‘psychotropic’ ‘antipsychotic’ ‘antidepressant’ ‘mood stabilisers’ ‘clozapine’ ‘Tricyclic Antidepressants’ ‘Lithium’ were searched. From a search that delivered over 200 articles, 82 articles were included. Those that included details around causative medication, doses of medication and where clear timeline on drug cause were included. Where clarification was needed, the manufacturer of the medication was contacted directly. Psychotropic medication can be associated with BrS, Brugada phenocopy or unmasking of BrS, in overdose or in normal doses. Our results include a table summarising a number of psychotropic overdoses that led to BrS unmasking. Routine screening for BrS in patients before prescribing psychotropic medication is a natural extension of the baseline ECG currently routinely done to rule out QTc prolongation. Psychiatrists need to invest in ensuring better skills in interpreting ECGs and work closer with cardiologists in interpreting ECGs.
Paediatric Dentistry and Orthodontics interface: When should we consider balancing and compensating extractions?
Authors: Jones Harriet , Nichol Rachael , Spencer R. James
Published: January 2022

The guidelines regarding balancing and compensating extractions, published by the Royal College of Surgeons of England,1 are based on relatively low-level evidence and it is highlighted in the guidance that further research into these areas is required. This paper aims to appraise the current evidence base regarding balancing and compensating extractions, to aid general dental practitioners in their decision making. General and clinical factors that should be considered in the treatment planning process are discussed throughout.
Replacement Resorption in Children: The Root of All Evil?
Authors: Warrilow Laura , Gohil Tanika , Casaus Abdullah
Published: January 2022

Replacement resorption is a common complicating factor in teeth that have been avulsed or intruded. Poor short- and long-term management of dental injuries in children can have a significant impact on a child’s dental function, aesthetics and ultimately their quality of life. This article aims to provide clarity on the physiological process of replacement resorption, the clinical presentation and an overview of interceptive treatment that is available.
When Less is More: Minimally Invasive, Evidence-Based Treatments for Dentine Caries in Primary Teeth – The Hall Technique and Silver Diamine Fluoride
Authors: Al-Yaseen Waraf , Seifo Nassar , Bhatia Shannu , Innes Nicola
Published: January 2022

Evidence supports minimally invasive dentistry, and we have a better understanding of dental caries as a biofilm-mediated disease. These factors, together with the current need to reduce aerosol generation, make treatment approaches such as the Hall Technique and the use of silver diamine fluoride (SDF) more relevant than ever.

Successful treatment planning depends on carious lesions being detected, their status accurately assessed, and a correct diagnosis made. Choosing the most appropriate treatment options for the tooth and child relies on marrying this with a precise history and an understanding of indications and contraindications for treatments.

This article outlines the optimal use of the Hall Technique and SDF, allowing dental practitioners and therapists to use these modalities as less invasive approaches to provide the highest quality treatment for children with dental caries; less is more.
Determinants of oral rehydration salt utilization among under-five children with diarrhea in Ethiopia: A multilevel mixed-effect analysis
Authors: Girma Desalegn , Abita Zinie , Wale Alemnew , Fetene Gossa
Published: January 2022

Background:

Oral rehydration salt therapy is a critical intervention to reduce mortality and morbidity of children with diarrheal diseases. However, it remains underused in low- and middle-income countries. In Ethiopia, only less than half of children with diarrheal diseases were treated with oral rehydration salt solution. Therefore, the objective of this study was to identify the determinants of oral rehydration salt utilization among children with diarrhea in Ethiopia.

Method:

A secondary data analysis was done using the 2016 Ethiopian Demographic and Health Survey. A weighted sample of 1227 children who had diarrhea in the last 2 weeks with their index mothers during the 5 years survey was included in the study. A multilevel mixed logistic regression model was fitted to identify factors associated with oral rehydration salt utilization. Finally, statistical significance was declared at p-value < 0.05.

Result:

The overall prevalence of oral rehydration salt utilization for children with diarrhea was 29.5%. In this study, age of mother ⩾35 (adjusted odds ratio = 1.66, 95% confidence interval = 1.05, 2.64), mothers with formal education (adjusted odds ratio = 1.52, 95% confidence interval = 1.09, 2.11), media exposure (adjusted odds ratio = 1.72, 95% confidence interval = 1.25, 2.38), living in Metropolitan regions (Addis Ababa and Dire Dawa (adjusted odds ratio = 1.76, 95% confidence interval = 1.14, 2.69)), and small peripheral regions (Afar, Gambela, Somalia, Benishangul-Gumuz (adjusted odds ratio = 1.69, 95% confidence interval = 1.22, 2.34)) were associated with higher odd of oral rehydration salt utilization for children with diarrhea.

Conclusion:

The study concludes that the age of mothers, educational status of the mother, media exposure, and regions of mothers were determinants of oral rehydration salt utilization for children with diarrhea. Therefore, media advertising regarding diarrhea management should be scaled up to increase oral rehydration salt utilization for children with diarrhea. Special attention to socio-cultural constraints or beliefs regarding diarrhea management should be given to mothers from large to center (Tigray, Amhara, Oromia, Southern Nations Nationalities, and People’s Region, and Harari) regions.
Comparison of the effectiveness of an e-health program versus a home rehabilitation program in patients with chronic low back pain: A double blind randomized controlled trial
Authors: Lara-Palomo Inmaculada Carmen , Antequera-Soler Eduardo , Matarán-Peñarrocha Guillermo A , Fernández-Sánchez Manuel , García-López Héctor , Castro-Sánchez Adelaida María , Aguilar-Ferrándiz María Encarnación
Published: January 2022

Objetive

We conducted a randomized double blind clinical trial, to compare the effectiveness of McKenzie exercises and electroanalgesia via an e-Health program versus a home rehabilitation program on functionality, pain, fear of movement and quality of life in patients with non-specific chronic low back pain.

Methods

Seventy-four participants with non-specific chronic low back pain were randomized to either the e- Health program group (n = 39) or the home rehabilitation program group (n = 35). The interventions consisted of the e-Health program group performing McKenzie exercises and received transcutaneous electrical nerve stimulation, while the home rehabilitation group attended an information session to explain the exercises, which they then performed at home with printed instructions. Both groups performed 3 weekly sessions for 8 weeks. The following were analyzed main measures: pain, disability, fear of movement, quality of life, trunk muscle endurance and trunk anteflexion motion were assessed at baseline and at 2 months.

Results

Independent samples Student’s t-tests showed that although the patients who followed the e-Health program showed significantly greater improvement than those who followed the home disability rehabilitation program in terms of intensity of pain, lumbar flexion mobility ( P < 0.001), and the following dimensions of quality of life ( P < 0.005), both groups improved significantly in the immediate post-treatment follow up compared with baseline scores.

Conclusions

Patients with chronic low back pain who followed an unsupervised home intervention supported by an individualized video exercise program showed greater post-treatment improvement than those who followed the same program with printed instructions.
Revolution in military affairs - The operation mole cricket 19 as a case study for the technological race during the cold war
Authors: Yogev Haim , Cohen Ronen A. , Lewin Eyal
Published: January 2022

The article reviews the development of the modern idea of Revolution in Military Affairs (RMA) whose buds appeared after the First World War, matured during the Cold War and demonstrated in 1982 in the First Lebanon War by the Israeli Air Force, and in 1991 in the Iraq War by the American Army. After analyzing the essence of RMA, with reference to the concept of both evolution and revolution of military technologies and doctrines, the article suggests that two types of revolutions should be distinguished. The first is a revolution in military affairs in the broadest sense in which a paradigm shift in the nature of war is occurred, and it is possible to apply it mainly by superpowers. The second, is a limited revolution that is essentially an approach of solving a military problem, suitable for small countries. The article examines these ideas and shows that Operation Mole Cricket 19, in which Syrian missile batteries made in the USSR were destroyed by the Israeli Air Force in 1982, is a revolution in military affairs of the second type.
A Tasquinomod-loaded dopamine-modified pH sensitive hydrogel is effective at inhibiting the proliferation of KRAS mutant lung cancer cells
Authors: Xu Jun , Zhang Chuxi , Cheng Chun , Yang Jun , Li Chenxi , Liu Xia , Sang Yi
Published: January 2022

Hydrogels can maintain a high local drug concentration during treatments and may be useful to local targeting diseased areas. We propose a pH sensitive hydrogel consisting of poly-vinylpyrrolidone (PVP) and chitosan as a new treatment method for KRAS mutant lung cancer. Addition of dopamine improved the drug loading and release effects of this hydrogel. We demonstrate that Tasquinimod-loading of this dopamine-modified pH sensitive hydrogel is more effective than Tasquinimod alone for inhibiting the proliferation of KRAS mutant lung cancer cells. Combination of conventional drugs with hydrogels may thus provide a new treatment modality for lung cancer.
End-of-Life Experiences for Cancer Patients Dying in Hospital with COVID-19
Authors: McFarlane Philippa , Halley Angela , Kano Yukie , Wade Nicola , Wilson Sophie , Droney Joanne
Published: January 2022

Despite a wealth of research regarding COVID-19, little evidence exists about cancer patients’ specific needs and experiences at end-of-life. This study retrospectively describes the care of 34 hospitalised cancer patients dying with COVID-19. The palliative care needs of patients were described. The main domains of end-of-life care service provision were evaluated including treatment of pain and other symptoms, communication and decision making at end-of-life and level of involvement of the palliative care team. Physical symptoms were managed with relatively low doses of end-of-life medications. High levels of patient and family anxiety, however, highlight the complexity of death from a stigmatised disease. Prompt acknowledgement of the vulnerability of advanced cancer patients with COVID-19 can facilitate proactive symptom management, anticipatory communication and enhance family support.
Perceived Self-Efficacy, Confidence, and Skill Among Factors of Adult Patient Participation in Transitional Care: A Systematic Review of Quantitative Studies
Authors: Bailey Andrea , Mallow Jennifer , Theeke Laurie
Published: January 2022

Introduction

An advancing healthcare system in which patients are often required to self-manage care needs across countless settings and clinicians is increasing focus on participation in care. Mismanagement of care during already risky care-transitions further increases adverse care outcomes. Understanding factors of patient participation in transitional care in an adult population can help guide ways to reduce this burden.

Methods

A systematic review of the literature guided by the PRISMA method was conducted to identify factors of patient participation in transitional care. Quantitative studies in which patient participation was measured as an outcome variable and related statistics reported, and data were collected from an adult sample, were included. Two authors independently reviewed, critiqued, and synthesized the articles, and later categorized study variables according to identified trends.

Results

Twelve studies across international and multidisciplinary backgrounds were identified. Across studies, efforts were largely based on understanding or improving patient self-management of care during transitions. The majority of studies were experimental and care interventions grounded in patient and healthcare team partnerships, delivered beyond the hospital setting. An array of measures was used to quantify patient participation. Factors of patient participation in transitional care included higher perceived levels of self-efficacy, confidence, and skills to participate in care.

Conclusion

The results of this study suggest patient participation in transitional care is largely based on perceptions of self-efficacy, confidence, and skill. Patient-centric transitional care interventions targeting these factors and delivered beyond the hospital setting may improve care outcomes. Implications and direction for further studies includes conceptual clarity, the study of a broader-reaching patient population demographic, and use of multidisciplinary interventions. Outcome variables should remain focused on patient perception of care involvement and participation and expanded to include variables such as functional abilities and social determinants of health.
“A culture of caring”: Leading differently in the twin pandemics
Authors: McCoy-Wilson Sonya
Published: January 2022

The twin pandemics of COVID-19 and systematic racism have ushered in a global reckoning. As much of the data indicates, COVID-19 has disproportionately impacted marginalized Black people and people of color. Simultaneously, police brutality and murders of Black people have escalated. Consequently, the movement for Black lives has moved like a wave of human solidarity across the world. These two global crises have disrupted and deconstructed systems. Although many colleges made decisions to return students and faculty to campuses in the fall of 2020, Urban Technical College (UTC) made the decision to keep operations and classes online for the remainder of 2020. The purpose of this paper is to illustrate, through a case study, how a predominantly Black, technical college in Atlanta, Georgia, used culturally responsive leadership to guide its campus community.
Proclamations and provocations: Decolonising curriculum in education research and professional practice
Authors: Race Richard , Gill Dalvir , Kaitell Emerick , Mahmud Arif , Thorpe Anthony , Wolfe Kelli
Published: January 2022

Given the current resurgence of interest in decolonisation in education and the wider social sciences, this article aims to bring an original contribution to an evolving and important discussion. The methodology of this work is possibly unique in the sense that it allows a range of academics from an English university to voice their decolonising proclamations. The authors of the article are a combination of white, black, Asian and mixed raced colleagues who have come together as part of a support group entitled: ‘Beyond the Threshold: dismantling racism together’. They draw upon their research and apply professional practice in relation to differing aspects of generally decolonising education and specifically decolonising curricula. We believe as a group that the notion of decolonising applies to all sections of education and not only schools, but nurseries, colleges and universities. The objective of this paper is to proclaim our advocacy for the need to decolonise and provoke the reader into reflecting and thinking about her/his feelings, views and experiences on decolonising. We hope this will encourage more research within education contexts into the complexity of decolonising the curriculum, as well as increasing equity in education and society.
School leaders leading curriculum inclusion: Re-culturing pedagogy, re-imagining the student experience
Authors: Miller Paul , Lane James , Jaeggi Karen
Published: January 2022

There has been widespread discussion within and outside educational institutions on the relevance and suitability of the curriculum provided to students in the United Kingdom. In North London, at the beginning of the school year 2019/2020, 11 primary school leaders, representing nine primary schools’ came together as a group, to begin to identify and examine ways they could improve their schools’ curriculum offer and ultimately the experience of students in their schools.

The research produced four main findings. First, school leaders need targeted continuing professional development (CPD) to provide the knowledge and skills required to lead whole school change involving this level of complexity. Second, school leaders need well organised CPD. Third, school leaders learning should support an entire school community. Fourth, leaders can take charge of their own learning. That participants formed the group and contacted the consultancy for the training is an important point of note. That is, school leaders can (and do) take charge of their own learning for they know what they ‘lack’ or what they do not know, and they (have demonstrated they) possess the agency to seek out support.
Analysis of SGLT2 Inhibitor Therapy and Other Potential Risk Factors for the Development of Bacteremia in Patients With Urosepsis
Authors: Covington Elizabeth W. , Slaten Kelly , Harnden Adam
Published: January 2022

Background: Risk factors for the development of bacteremia in patients with urosepsis are not well-defined in the current literature. Objective: To assess potential risk factors, including receipt of SGLT2 inhibitor therapy (SGLT2-I), for the development of bacteremia in patients with urosepsis. Methods: A retrospective case control study was performed on patients admitted to a community hospital. Patients were included if they had a positive urine culture and met criteria for urosepsis. Exclusion criteria included proven source of infection outside of the urogenital tract, age less than or equal to 18 years old, and pregnancy. Included patients were placed into 1 of 2 groups: bacteremia or non-bacteremia. The primary endpoint was the percentage of patients taking an SGLT2-I in the bacteremia versus the non-bacteremia group. Secondary endpoints included an assessment of potential risk factors for the development of bacteremia in patients with urosepsis via univariate and multivariate regression analysis and comparison of clinical outcomes in patients receiving SGLT2-I prior to admission versus those not receiving SGLT2-I. Results: There was no difference in the proportion of patients within the bacteremia and non-bacteremia groups who were receiving an SGLT2-I (12% vs. 19%, P = 0.277). Binary multivariate regression analysis identified 2 variables associated with increased risk of bacteremia: male gender and cirrhosis. Conclusion: Within this study, there was no difference in the proportion of patients receiving an SGLT2-I in bacteremia and non-bacteremia groups. Potential risk factors for the development of bacteremia identified included male gender and cirrhosis. However, results from our study should be confirmed in larger scale studies.
The Wombat Hole Prospect, Benambra, Victoria, Australia: a Cu–Bi–(Te) exoskarn with unusual supergene mineralogy
Authors: Henry Dermot A. , Birch William D.
Published: January 2022

The Wombat Hole Prospect is a small copper–bismuth–(tellurium) exoskarn cropping out in the Morass Creek gorge, near Benambra, in eastern Victoria, Australia. Its main primary sulfide constituent is bornite in a grossular‒vesuvianite matrix. The skarn formed in a megaclast of Lower Silurian limestone from metal-bearing fluids accompanying the high-level emplacement of the Late Silurian–Lower Devonian Silver Flat Porphyry. Though the primary bornite mineralisation has been nearly obliterated by weathering, there are small relict patches containing exsolved grains of wittichenite (Cu3BiS3) and chalcopyrite, as well as inclusions of bismuth tellurides in the tetradymite group, namely sulphotsumoite (Bi3Te2S) and hedleyite (Bi7Te3). Joséite-A (Bi4TeS2), a mineral with a formula Bi3(Te,S)4, several unnamed Cu–Bi‒Te phases and minute grains of native bismuth have also been detected. Pervasive veining by chrysocolla throughout the garnet‒vesuvianite host contains a range of unusual secondary bismuth minerals that have crystallised at various times. These include mrázekite, namibite, pucherite, schumacherite and eulytine. Other secondary minerals present include wulfenite, bismutite, azurite, malachite and a poorly-crystalline bismuth oxide containing several weight percent tellurium. Rare grains of gold (electrum) containing up to 23 wt.% Ag are also present. The assemblage of grossular–vesuvianite with minor diopside is indicative of formation in a low-${\rm X}_{{\rm C}{\rm O}_ 2}$environment under fluid-buffered conditions. A temperature range between ~650°C and as low as ~150°C can be estimated from the exsolution of wittichenite and chalcopyrite from the bornite. The tetradymite-group inclusions formed first under low values of$f_{{\rm S}_ 2}$/$f_{{\rm T}{\rm e}_ 2}$, with bornite crystallising as values increased. The primary Cu‒Bi‒Te mineralogy and the unusual secondary mineral assemblage makes the Wombat Hole skarn unique in southeastern Australia. The deposit provides scope for studying the mobility of elements such as Bi and Te over short distances during weathering of hypogene ore minerals.
Disrupting the adult globin promoter alleviates promoter competition and reactivates fetal globin gene expression
Authors: Topfer Sarah K. , Feng Ruopeng , Huang Peng , Ly Lana C. , Martyn Gabriella E. , Blobel Gerd A. , Weiss Mitchell J. , Quinlan Kate G. R. , Crossley Merlin
Published: January 2022

The benign condition hereditary persistence of fetal hemoglobin (HPFH) is known to ameliorate symptoms of co-inherited β-hemoglobinopathies, such as sickle cell disease and β-thalassemia. The condition is sometimes associated with point mutations in the fetal globin promoters that disrupt the binding of the repressors BCL11A or ZBTB7A/LRF, which have been extensively studied. HPFH is also associated with a range of deletions within the β-globin locus that all reside downstream of the fetal HBG2 gene. These deletional forms of HPFH are poorly understood and are the focus of this study. Numerous different mechanisms have been proposed to explain how downstream deletions can boost the expression of the fetal globin genes, including the deletion of silencer elements, of genes encoding noncoding RNA, and bringing downstream enhancer elements into proximity with the fetal globin gene promoters. Here we systematically analyze the deletions associated with both HPFH and a related condition known as δβ-thalassemia and propose a unifying mechanism. In all cases where fetal globin is upregulated, the proximal adult β-globin (HBB) promoter is deleted. We use clustered regularly interspaced short palindromic repeats-mediated gene editing to delete or disrupt elements within the promoter and find that virtually all mutations that reduce ΗΒΒ promoter activity result in elevated fetal globin expression. These results fit with previous models where the fetal and adult globin genes compete for the distal locus control region and suggest that targeting the ΗΒΒ promoter might be explored to elevate fetal globin and reduce sickle globin expression as a treatment of β-hemoglobinopathies.
Underwater Laser Welding/Cladding for High-performance Repair of Marine Metal Materials: A Review
Authors: Sun Guifang , Wang Zhandong , Lu Yi , Chen Mingzhi , Yang Kun , Ni Zhonghua
Published: January 2022

With the rapid developments of marine resource exploitation, mounts of marine engineering equipment are settled on the ocean. When it is not possible to move the damaged equipment into a dry dock, welding operations must be performed in underwater environments. The underwater laser welding/cladding technique is a promising and advanced technique which could be widely applied to the maintenance of the damaged equipment. The present review paper aims to present a critical analysis and engineering overview of the underwater laser welding/cladding technique. First, we elaborated recent advances and key issues of drainage nozzles all over the world. Next, we presented the underwater laser processing and microstructural-mechanical behavior of repaired marine materials. Then, the newly developed powder-feeding based and wire-feeding based underwater laser direct metal deposition techniques were reviewed. The differences between the convection, conduction, and the metallurgical kinetics in the melt pools during underwater laser direct metal deposition and in-air laser direct metal deposition were illustrated. After that, several challenges that need to be overcame to achieve the full potential of the underwater laser welding/cladding technique are proposed. Finally, suggestions for future directions to aid the development of underwater laser welding/cladding technology and underwater metallurgical theory are provided. The present review will not only enrich the knowledge in the underwater repair technology, but also provide important guidance for the potential applications of the technology on the marine engineering.
Peripheral venous lactate levels substitute arterial lactate levels in the emergency department
Authors: Oi Yasufumi , Mori Kosuke , Yamagata Hidehiro , Nogaki Ayako , Takeda Tomoaki , Watanabe Chikara , Sakaguchi Yusuke , Ogawa Fumihiro , Abe Takeru , Imaki Shouhei , Takeuchi Ichiro
Published: January 2022

Background

Arterial lactate (AL) level is an important predictor of patient prognosis. AL and peripheral venous lactate (PVL) in blood gas analysis have a low concordance rate, and PVL cannot be used as a substitute for AL. However, if the AL range can be predicted from PVL, PVL may be an alternative method for predicting patient prognosis, and the risk of arterial puncture complications with AL may be reduced. This could be a safe and rapid test method.

Methods

This was a retrospective observational study of 125 cases in which blood gas analysis was performed on both arterial and venous blood with an infectious disease in an emergency department. Spearman’s rank correlation coefficient (r) and Bland–Altman analyses were performed. Sensitivity, specificity, and area under the curve (AUC) were calculated for PVL to predict AL < 2 mmol/L or < 4 mmol/L.

Results

The median [interquartile range] AL and PVL were 1.82 [1.25–2.46] vs. 2.08 [1.57–3.28], respectively, r was 0.93 (p < 0.0001), and a strong correlation was observed; however, Bland–Altman analysis showed disagreement. When AL < 2 mmol/L was used as the outcome, AUC was 0.970, the PVL cutoff value was 2.55 mmol/L, sensitivity was 85.71%, and specificity was 96.05%. If PVL < 2 mmol/L was the outcome, the sensitivity for AL < 2mmol/L was 100%, and for PVL levels ≥ 3 mmol/L, the specificity was 100%. When AL < 4 mmol/L was used as the outcome, AUC was 0.967, the PVL cutoff value was 3.4 mmol/L, sensitivity was 100%, and specificity was 85.84%. When PVL < 3.5 mmol/L was the outcome, the sensitivity for AL < 4 mmol/L was 100%, and for PVL levels ≥ 4 mmol/L, the specificity was 93.81%.

Conclusions

This study revealed that PVL and AL levels in the same critically ill patients did not perfectly agree with each other but were strongly correlated. Furthermore, the high accuracy for predicting AL ranges from PVL levels explains why PVL levels could be used as a substitute for AL level ranges.
Characteristics of emergency department admissions with congestive heart failure in the United States: a Nationwide cross-sectional study
Authors: Zhang Xingyu , Qiu Peilin , Prushinskaya Anna , Jiang Yun , Fan Hui , Yang Sheng
Published: January 2022

Background

To understand the characteristics and clinical presentation of patients with Congestive Heart Failure (CHF) visiting the emergency department (ED), and to examine the factors associated with clinical outcomes and medical resource utilization amongst the studied population.

Methods

We analyzed the 2014–2016 ED visit data collected by the National Hospital Ambulatory Medical Care Survey Emergency Department Subfile. We described patients’ characteristics and clinical outcomes after ED visits with CHF vs. without CHF. Logistic regression models were used to estimate the association between these characteristics and CHF.

Results

ED visits with CHF visits represented 3.9% of annual ED visits (3,647,113 out of 92,899,685). ED patients with CHF were mostly non-Hispanic White (69.9%). Compared with other ED patients, those with CHF were older, including 71.2% that were were older than 60. ED patients with CHF were more likely to be admitted to the hospital (aOR: 2.56; 95% CI: 2.28–2.87) and intensive care unit (ICU) (aOR: 2.19; 95% CI: 1.77–2.71).

Conclusions

This study describes the demographic, socioeconic, and clinical characteristics of patients who present to the ED with CHF through analysis of a comprehensive national survey. These patients require a higher level of emergency care due to their higher chance of admittance to the hospital and ICU.
Postoperative survival effect of the number of examined lymph nodes on esophageal squamous cell carcinoma with pathological stage T1–3N0M0
Authors: Wu Lei-Lei , Zhong Jiu-Di , Zhu Jia-Li , Kang Lu , Huang Yang-Yu , Lin Peng , Long Hao , Zhang Lan-Jun , Ma Qi-Long , Qiu Li-Hong , Ma Guo-Wei
Published: January 2022

Background

The postoperative survival effect of the number of examined lymph nodes on patients of R0-resected esophageal squamous cell carcinoma with pathological stage T1–3N0M0 is still unclear.

Methods

Patients diagnosed with pathological stage T1–3N0M0 esophageal squamous cell carcinoma from two cancer databases—our cancer center (N = 707), and Surveillance Epidemiology and End Results (N = 151). The primary clinical endpoint was overall survival. The X-tile software was used to determine the optimal cutoff value of the number of examined lymph nodes, and propensity score matching was conducted to reduce selection bias according to the results of X-tile software. The cohort of 151 patients from another database was used for validation.

Results

X-tile software provided an optimal cutoff value of 15 examined lymph nodes based on 707 patients, and 231 pairs of matched patients were included. In the unmatched cohort, Cox proportional hazard regression analysis revealed better overall survival in patients with more than 15 examined lymph nodes (adjusted hazard ratio, 0.566, 95% confidence interval, 0.445–0.720; p < 0.001) compared with patients with 15 or fewer examined lymph nodes. In the validation cohort, patients with more than 15 examined lymph nodes also had better overall survival (adjusted hazard ratio 0.665, p = 0.047).

Conclusions

The number of examined lymph nodes is a significant prognostic factor in esophageal squamous cell carcinoma patients with pathological stage T1–3N0M0, and more than 15 examined lymph nodes are associated with better overall survival. Although the difference is not significant, the survival curve of patients with examined lymph nodes > 30 is better than those with examined lymph nodes 15–30. We believe that the number of examined lymph nodes can provide prognostic guidance for those patients, and the more examined lymph nodes cause lesser occult lymph nodes metastasis and lead to a better prognosis. Therefore, surgeons and pathologists should try to examine as many lymph nodes as possible to evaluate the pathological stage precisely. However, we need more validation from other studies.
Prevalence and predictors of depression among emergency physicians: a national cross-sectional study
Authors: Chen Yueming , Shen Xin , Feng Jing , Lei Zihui , Zhang Weixin , Song Xingyue , Lv Chuanzhu
Published: January 2022

Background

Physicians' depression can damage their physical and mental health and can also lead to prescribing errors and reduced quality of health care. Emergency physicians are a potentially high-risk community, but there have been no large-sample studies on the prevalence and predictors of depression among this population.

Methods

A nationally representative cross-sectional survey of 15,243 emergency physicians was conducted in 31 provinces across China between July and September 2019. Multivariable logistic regression analysis was performed to identify predictors of depression.

Results

A total of 35.59% of emergency physicians suffered from depression. Emergency physicians who were male (OR=0.91) and older [>37 and ≤43 (OR=0.83) or >43 (OR=0.71)], had high (OR=0.63) or middle (OR=0.70) level income, and participated in physical inactivity (OR=0.85) were not more likely to suffer depression. Meanwhile, those who were unmarried (OR=1.13) and smokers (OR=1.12) had higher education levels [Bachelor’s degree (OR=1.57) or Master’s degree or higher (OR=1.82)], long work tenure [>6 and ≤11 (OR=1.15) or >11;11 (OR=1.19)], poorer health status [fair (OR=1.67) or poor (OR=3.79)] and sleep quality [fair (OR=2.23) or poor (OR=4.94)], a history of hypertension (OR=1.13) and coronary heart disease (OR=1.57) and experienced shift work (OR=1.91) and violence (OR=4.94)].

Conclusion

Nearly one third of emergency physicians in China suffered from depression. Targeted measures should be taken to reduce the prevalence of depression to avoid a decline in health care quality and adversely impact the supply of emergency medical services.
Effects of the COVID-19 pandemic on sexual functioning and activity: a systematic review and meta-analysis
Authors: Masoudi Mojgan , Maasoumi Raziyeh , Bragazzi Nicola Luigi
Published: January 2022

Background

Since December 2019, when it was first reported in Wuhan, province of Hubei, China, the new virus SARS-CoV-2 has spread rapidly around the world and has become a global pandemic. During the COVID-19 pandemic, due to the public health measures implemented, people’s sexual activity has also been affected. Restrictions on people’s activities, reduced sports activities, economic issues, increased psychological stress, and reduced entertainment have, indeed, dramatically impacted sexual activity and functioning. The purpose of this study was tosystematically identify, collect and summarize the existing body of evidence from published studies on the effects of COVID-19 pandemic on sexual activity and functioning.

Methods

Several scholarly databases, namely MEDLINE (via PubMed interface), Web of Science (WOS), Embase, CINAHL, the Cochrane Library, Scopus, and PsycINFO databases, were mined from December 2019 to the end of January 2021. We utilized a random-effect meta-analytical model to analyze all the data. More in detail, the Standardized Mean Difference (SMD) was used in order to estimate and evaluate the effects of the COVID-19 pandemic on sexual activity and functioning.

Results

Twenty-one studies were included in the present study. In total, 2454 women and 3765 men were evaluated. In the present meta-analysis, sexual functioning and activity were assessed by means of two standardized and reliable tools, namely the “Female Sexual Function Index” (FSFI) and the “International Index of Erectile Function-5 items” (IIEF-5). A total of 5 studies reported the FSFI score before and after the COVID-19 pandemic in female participants. Based on the random-effect model, the SMD was computed to be − 4.26 [95% confidence interval or CI: − 7.26, − 1.25], being statistically significant. A total of 3 studies reported the IIEF-5 score before and after the COVID-19 pandemic in male participants. Based on the random-effect model, the SMD was computed to be − 0.66 [CI 95%: − 0.99, − 0.33], being statistically significant. In the majority of these studies, participants reported a reduction in the number of sexual relations and an increase in the frequency of solo sex activity, especially masturbation, compared to the time prior to the COVID-19 pandemic.

Conclusion

The results of the present study showed that COVID-19 related restrictions were correlated with higher rates of sexual dysfunction and reduced sexual activity; however, results of the current meta-analytical study show that this change in sexual functioning was greater in women compared to men. Sex is one of the dimensions of every person’s life; therefore, researchers should identify the factors that lead to sexual dysfunction due to COVID-19 pandemic in their community. In this regard, sexologists should design and implement effective programs to reduce the heterogeneous causes affecting sexual functioning, given the psychological strain that the COVID-19 pandemic puts on individuals.
Rationale and study protocol for a randomized controlled trial to determine the effectiveness of a culturally relevant, stress management enhanced behavioral weight loss intervention on weight loss outcomes of black women
Authors: Buro Acadia W. , Baskin Monica , Miller Darci , Ward Tayler , West Delia Smith , Gore L. Robert , Gwede Clement K. , Epel Elissa , Carson Tiffany L.
Published: January 2022

Background

Obesity is a persistent public health concern and a risk factor for many chronic diseases including at least 13 different cancers. Adult Black females have the highest prevalence of obesity (57%) compared to other racial/gender groups in the U.S. Although behavioral weight loss (BWL) interventions have demonstrated effectiveness, Black females tend to lose less weight than White counterparts. The higher prevalence of chronic psychological stress reported by Black females may contribute to their disproportionate prevalence of obesity and observed suboptimal weight loss. This study will examine the effectiveness of a 12-month culturally-targeted, stress management-enhanced BWL intervention on weight loss and stress reduction among Black females in a fully-powered randomized, controlled trial.

Methods

Adult Black females with obesity (n = 340) will be randomized to either a culturally targeted stress management-enhanced BWL intervention (BWL-Stress) or the same BWL intervention alone (BWL-alone). The primary outcome is weight change at month 6. Secondary outcomes will include changes in stress measures (e.g., perceived stress, cortisol), energy intake, and physical activity at month 6. We will also assess process measures (e.g., treatment adherence, treatment burden). Each outcome will also be evaluated at month 12 to assess longer-term effects of the intervention.

Discussion

This novel approach for enhancing an evidence-based BWL program with culturally-targeted stress management strategies for Black females addresses an understudied barrier to effective weight management among a population at high risk for obesity and obesity-related chronic diseases. This study will potentially elucidate psychological or behavioral mechanisms linking our novel intervention to study outcomes. If the intervention is proven to be effective, this study will have significant clinical and public health implications for weight management among Black females.

Trial registration

This study was registered on ClinicalTrials.gov, identifier NCT04335799t, on April 6, 2020.
The role of counselling in tuberculosis diagnostic evaluation and contact tracing: scoping review and stakeholder consultation of knowledge and research gaps
Authors: Foster Isabel , Sullivan Amanda , Makanda Goodman , Schoeman Ingrid , Tisile Phumeza , van der Westhuizen Helene-Mari , Theron Grant , Nathavitharana Ruvandhi R.
Published: January 2022

Background

Tuberculosis (TB) care cascade analyses show large gaps at early stages, including care-seeking and diagnostic evaluation, where promising interventions to decrease attrition are urgently needed. Person-centered care is prioritized in the World Health Organization’s End TB strategy; yet little is known about how it is delivered and can be optimized. Recommendations for counselling, a core component of person-centered care, are largely limited to its role in improving TB treatment adherence. The role of counselling to close key diagnostic gaps in the care cascade is poorly understood.

Methods

We conducted a scoping review to identify evidence on the use of counselling at TB diagnosis, for both people with presumptive TB and index patients to promote patient retention and contact tracing. Using search terms for TB, diagnosis and counselling, we systematically searched PubMed, EMBASE and Web of Science. Two independent reviewers screened all abstracts, full-texts, extracted data and conducted a quality assessment. We used thematic analysis to identify key themes.

Results

After screening 1785 articles, we extracted data from 15 studies and determined that the major themes best corresponded to the following gaps in the TB care cascade: care-seeking, pre-diagnosis, and pre-treatment. Studies were conducted across varied settings including pharmacies, primary health centres, and clinics, primarily in high TB incidence countries. No study directly evaluated the impact of counselling on outcomes such as treatment initiation or retention in care. Included studies suggested counselling may play an important role in improving the uptake of diagnostic testing and contact tracing. Barriers to counselling included time and personnel requirements. Stakeholder consultation emphasized the importance of high-quality counselling as a core tenet of TB care.

Conclusion

Data on the impact of counselling to improve TB case detection are absent from the literature. The shift towards person-centred care for TB presents an opportunity to incorporate counselling during earlier stages of the TB care cascade; however, evidence-based approaches are needed. Implementation research is needed to operationalize and evaluate counselling to strengthen high-quality TB care delivery.
Sagittal imbalance of the spine is associated with poor sitting posture among primary and secondary school students in China: a cross-sectional study
Authors: Li Chaoqun , Zhao Yuqi , Yu Zhenghui , Han Xu , Lin Xiang , Wen Li
Published: January 2022

Background

Long-term poor posture may affect the morphological development of the spine. However, there is no definite answer as to how writing posture affects students’ spine. This study attempted to compare the sagittal curvature of the spine between sitting and standing postures in adolescents to reveal the variation rule of spinal sagittal curvature of students with learning posture, and to discover the key factors that may affect students’ spinal health.

Methods

1138 participants (male, 604; female, 534; age range, 6–18 years) from three schools in Tianjin, China, including 570 primary school students and 568 secondary school students. This study used SpineScan and PA200 Station Posture Assessment System to assess the sagittal curvature of the spine for three postures: sitting on a chair in upright position, seated at a desk while reading/writing, and standing in natural relaxed position. Analyze the difference between spine angle of the three postures and the correlation between the sagittal plane angle of the spine and body posture.

Results

The mean sagittal angle of the spine changed when the participants were in reading/writing position compared to standing position, with the lumbar lordosis angle significantly decreased (p < 0.05) and the thoracic kyphosis angle significantly increased (p < 0.05). The TKA and LLA angles were abnormal in 33 and 52% of students in reading/writing posture respectively. There was a significant correlation between sitting posture and standing spinal Angle and were positively correlated with the height of the teenager (p < 0.05). By contrast, a higher percentage of TKA and LLA subjects in the standard reading/writing posture reference range maintained normal spinal shape while standing.

Conclusions

The angle of thoracic kyphosis significantly increased from standing posture to upright sitting, reading/writing posture, while lumbar lordosis significantly decreased or even disappeared. There was a significant correlation between sagittal angle of spine in different postures. The poor sitting posture associated with sagittal angle abnormalities impact the shape of the spine such that sagittal imbalance was also observed when students in natural standing posture. Height is an important factor affecting the sitting spine shape of students.