bluuebunny/crossref_metadata_2025 huggingface dataset:
Preliminary testing of eye gaze interfaces for controlling a haptic system intended to support play in children with physical impairments: Attentive versus explicit interfaces
Authors: Castellanos-Cruz Javier L. , Gómez-Medina María F. , Tavakoli Mahdi , Pilarski Patrick , Adams Kim D
Published: February 2022

Introduction

Children with physical impairments may face challenges to play because of their motor impairments, which could lead to negative impacts in their development. The objective of this article was to compare two eye gaze interfaces that identified the desired toy a user wanted to reach with a haptic-enabled telerobotic system in a play activity.

Methods

One of the interfaces was an attentive user interface predicted the toy that children wanted to reach by observing where they incidentally focused their gaze. The other was an explicit eye input interface determined the toy after the child dwelled for 500 ms on a selection point. Five typically developing children, an adult with cerebral palsy (CP) and a child with CP participated in this study. They controlled the robotic system to play a whack-a-mole game.

Results

The prediction accuracy of the attentive interface was higher than 89% in average, for all participants. All participants did the activity faster with the attentive interface than with the explicit interface.

Conclusions

Overall, the attentive interface was faster and easier to use, especially for children. Children needed constant prompting and were not 100% successful at using the explicit interface.
Expanding Knowledge and Changing Attitudes About Poverty: An Interactive, Interprofessional Approach
Authors: Marrast Lyndonna M. , Chim Christine , Tocco Jack , Coletti Daniel J. , Nouryan Christian , Block Lauren , Martinez Johanna
Published: February 2022

Background:

Poverty negatively affects the lives and health of the poor. However, health professionals often have limited personal experience and receive little formal education on surviving under conditions of poverty in the United States, which may contribute to suboptimal patient care and outcomes.

Purpose:

We conducted a 3-h, interactive, experiential poverty simulation workshop with an interprofessional group of pre-professional health students to increase their comprehension about the realities of poverty.

Method:

As part of the evaluation, participants completed a self-assessment of their attitudes and skills using a Likert scale and open-ended questions; a reflection prompt about how the workshop might affect their professional practice; and a pre- and post-assessment questionnaire.

Discussion:

Participants’ attitudes about low-income patients became more favorable; they gained awareness and expressed empathy through the role-play experience. Our analysis revealed increased understanding of social determinants of health, of life challenges that patients face outside of healthcare, and that solutions must be collaborative as the challenges facing poor patients are multifactorial.

Conclusion:

The workshop allowed interprofessional students to learn from and with each other about the experiences of poor patients. Future sessions should emphasize interprofessional skill-building and action, potentially in virtual formats.
Examining the Relationships Between Frontline Bank Employees’ Job Demands and Job Satisfaction: A Mediated Moderation Model
Authors: Awwad Razan Ibrahim , Aljuhmani Hasan Yousef , Hamdan Sameer
Published: February 2022

This study aims to fill the previous research gap by examining the relationship between job stress, work-family conflict (WFC), and job satisfaction. It also investigates the mediating effect of job burnout, through which job demands influence job satisfaction, and examines the moderating effect of emotional intelligence (EI) on these relationships through the lens of the job demands-resources (JD-R) model. The data for this study was collected from 279 respondents who were frontline employees in 14 banks in Palestine. A cross-sectional research approach was performed using a partial least squares path modeling approach. The study finds that job demands (job stress and WFC) increase job burnout. Contrary to expectations, job demands have a negative but not significant direct effect on job satisfaction. Further, job burnout reduces frontline bank employees’ job satisfaction. Regarding the mediating effect, job burnout fully mediates the relationship between job demands and job satisfaction. The findings suggest that the relationship between job stress and job burnout is stronger when EI is comparatively low. The study thus extends prior research by investigating the conditional indirect effect of job stress on job satisfaction when job burnout acts as a mediator and EI is the moderator. It contributes to the JD-R literature by providing support from the Palestinian banking sector.
Thai EFL University Students’ Productions of the English Past Counterfactuals and Their Influences from Interlanguage Fossilization
Authors: Yossatorn Yossiri , Binali Theerapong , Chokthawikit Sirisira , Weng Cathy
Published: February 2022

The English past counterfactuality is difficult for non-native learners to learn and understand due to cross-language discrepancies. Oftentimes, individuals unavoidably develop the interlanguage and this language system becomes fossilized regardless of the amount of exposed time and input. The purpose of the study was twofold: (a) to examine 126 Thai EFL university students’ production of the English past counterfactuals through the grammar translation method (GT); (b) to qualitatively investigate how interlanguage fossilization exerts an influence on the students’ production. The results showed that their ability to use the English past counterfactuals was relatively low, whereas the errors of its structural elements could be found across the entire production. It was further observed from the interview that the low productive ability resulted from the L1 transfer and the training migration. The pedagogical implications for foreign language instructors are discussed.
The Mediating Role of Access to Financial Services in the Effect of Financial Literacy on Household Income: The Case of Rural Ghana
Authors: Twumasi Martinson Ankrah , Jiang Yuansheng , Ding Zhao , Wang Pengcheng , Abgenyo Wonder
Published: February 2022

The aim of alleviating poverty has a necessary implication on rural households’ economic development. The study investigates the mediating role of access to financial services (AFS) in the effect of financial literacy (FL) on household income using survey data collected from four regions in Ghana. Using the multi-stage sampling technique, 572 respondents were randomly selected for the study. The findings of this study reveal that financial literacy has a robust, increasing effect on household income. Again, the results depict that AFS mediates the positive effect of FL on household income. An interesting moderating effect of social networks is also revealed in the study. This study adds to the existing literature on rural development by exploring how financial education and inclusions contribute to poverty alleviation and provides policy implications to improve rural households’ well-being.
Patterns of Lumbar Spine Malalignment Leading to Revision Surgery for Proximal Junctional Kyphosis: A Cluster Analysis of Over- Versus Under-Correction
Authors: Lafage Renaud , Passias Peter , Sheikh Alshabab Basel , Bess Shay , Smith Justin S. , Klineberg Eric , Kim Han Jo , Elysee Jonathan , Shaffrey Christopher , Burton Douglas , Hostin Richard , Mundis Gregory , Schwab Frank , Lafage Virginie ,   On behalf of the International Spine Study Group
Published: February 2022

Study Design

Retrospective cohort study.

Objective

Investigate the patterns of fused lumbar alignment in patients requiring revision surgery for proximal junctional kyphosis (PJK).

Methods

Fifty patients (67.8 yo, 76% female) with existing thoraco-lumbar fusion (T10/12 to pelvis) and indicated for surgical correction for PJK were included. To investigate patterns of radiographic alignment prior to PJK revision, unsupervised 2-step cluster analysis was run on parameters describing the fused lumbar spine (PI-LL) to identify natural independent groups within the cohort. Clusters were compared in terms of demographics, pre-operative alignment, surgical parameters, and post-operative alignment. Associations between pre- and post-revision PJK angles were investigated using a Pearson correlation analysis.

Results

Analysis identified 2 distinct patterns: Under-corrected (UC, n = 12, 32%) vs over-corrected (OC, n = 34, 68%) with a silhouette of .5. The comparison demonstrated similar pelvic incidence (PI) and PJK angle but significantly greater deformity for the UC vs OC group in terms of PI-LL, PI-LL offset, pelvic tilt, and sagittal vertebral axis. The surgical strategy for PJK correction did not differ between the 2 groups in terms of approach, American Society of Anesthesiologists grade, decompression, use of osteotomy, interbody fusion, or fusion length. The post-revision PJK angle significantly correlated with the amount of PJK correction within the OC group but not within the UC group.

Conclusions

This study identified 2 patterns of lumbar malalignment associated with severe PJK: over vs under corrected. Despite the difference in PJK etiology, both patterns underwent the same revision strategy. Future analysis should look at the effect of correcting focal deformity alone vs correcting focal deformity and underlying malalignment simultaneously on recurrent PJK rate.
Acute Myocardial Infarction Associated With a Mobile Left Ventricular Thrombi
Authors: Del Rio-Pertuz Gaspar , Morataya Cristina , Iskandir Marina , Argueta-Sosa Erwin
Published: February 2022

The majority of acute coronary syndromes are caused by coronary artery thrombotic occlusions secondary to atherosclerotic plaque erosion or rupture. Coronary embolism is an important yet forgotten underlying cause of acute coronary syndrome. We present a case of a young patient who presented with ST elevation myocardial infarction suspected to be secondary to coronary embolization originating from a left ventricular thrombus.
Psychological Resilience and Cognitive Function Among Older Military Veterans
Authors: McDaniel Justin T. , Hascup Erin R. , Hascup Kevin N. , Trivedi Mehul , Henson Harvey , Rados Robert , York Mary , Albright David L. , Weatherly Taryn , Frick Kaitlyn
Published: February 2022

The purpose of this study was to explore the association between psychological resilience and cognitive function in military veterans. We obtained public-use data from the Health and Retirement Study (HRS) for this cross-sectional study of military veterans aged 52 to 101 years ( n = 150). We estimated a multivariable linear regression model in which cognitive function served as the dependent variable and psychological resilience served as the independent variable. After controlling for demographics, health conditions, and health behaviors, veterans who had higher psychological resilience scores had better cognitive function (b = 0.22, p = 0.03). Our findings suggest that psychological resilience may be associated with cognitive function among veterans. These findings highlight the importance of assessing psychological resilience in gerontological social work practice.
Ganglion Cyst in the Elbow: A Case Study With a Rare Presentation
Authors: Winther Susan
Published: February 2022

Ganglion cysts are a common, often asymptomatic, finding in the wrist although they may also be found in other joints. This is a case study of a rare presentation of a ganglion cyst in the anterior aspect of the elbow, the antecubital fossa (ACF). Sonography played a primary role in the diagnosis of this unusual injury with magnetic resonance imaging (MRI) confirming the site of origin and surgical intervention resolving the patient’s symptoms.
Introduction to a review series on megakaryopoiesis and platelet production
Authors: Crispino John D.
Published: February 2022

Hematologists have long been fascinated by how platelet production occurs, and our understanding continues to evolve as technology advances and as more and more genetic causes for thrombocytopenia are discovered. In this Review Series on megakaryopoiesis and platelet production edited by Associate Editor John Crispino, experts in the field discuss the latest insights into megakaryopoiesis in fetal and adult life, the varied roles that megakaryocytes are now recognized to play, the mechanics of platelet creation, and how all of this new knowledge underpins clinical disorders requiring diagnosis and management.
Genome variation in tick infestation and cryptic divergence in Tunisian indigenous sheep
Authors: Ahbara Abulgasim M. , Khbou Médiha Khamassi , Rhomdhane Rihab , Sassi Limam , Gharbi Mohamed , Haile Aynalem , Rekik Mourad , Rischkowsky Barbara , Mwacharo Joram M.
Published: February 2022

Background

Ticks are obligate haematophagous ectoparasites considered second to mosquitos as vectors and reservoirs of multiple pathogens of global concern. Individual variation in tick infestation has been reported in indigenous sheep, but its genetic control remains unknown.

Results

Here, we report 397 genome-wide signatures of selection overlapping 991 genes from the analysis, using ROH, LR-GWAS, XP-EHH, and FST, of 600 K SNP genotype data from 165 Tunisian sheep showing high and low levels of tick infestations and piroplasm infections. We consider 45 signatures that are detected by consensus results of at least two methods as high-confidence selection regions. These spanned 104 genes which included immune system function genes, solute carriers and chemokine receptor. One region spanned STX5, that has been associated with tick resistance in cattle, implicating it as a prime candidate in sheep. We also observed RAB6B and TF in a high confidence candidate region that has been associated with growth traits suggesting natural selection is enhancing growth and developmental stability under tick challenge. The analysis also revealed fine-scale genome structure indicative of cryptic divergence in Tunisian sheep.

Conclusions

Our findings provide a genomic reference that can enhance the understanding of the genetic architecture of tick resistance and cryptic divergence in indigenous African sheep.
Analysis of global Aeromonas veronii genomes provides novel information on source of infection and virulence in human gastrointestinal diseases
Authors: Liu Fang , Yuwono Christopher , Tay Alfred Chin Yen , Wehrhahn Michael C. , Riordan Stephen M. , Zhang Li
Published: February 2022

Background

Aeromonas veronii is a Gram-negative rod-shaped motile bacterium that inhabits mainly freshwater environments. A. veronii is a pathogen of aquatic animals, causing diseases in fish. A. veronii is also an emerging human enteric pathogen, causing mainly gastroenteritis with various severities and also often being detected in patients with inflammatory bowel disease. Currently, limited information is available on the genomic information of A. veronii strains that cause human gastrointestinal diseases.

Here we sequenced, assembled and analysed 25 genomes (one complete genome and 24 draft genomes) of A. veronii strains isolated from patients with gastrointestinal diseases using combine sequencing technologies from Illumina and Oxford Nanopore. We also conducted comparative analysis of genomes of 168 global A. veronii strains isolated from different sources.

Results

We found that most of the A. veronii strains isolated from patients with gastrointestinal diseases were closely related to each other, and the remaining were closely related to strains from other sources. Nearly 300 putative virulence factors were identified. Aerolysin, microbial collagenase and multiple hemolysins were present in all strains isolated from patients with gastrointestinal diseases. Type III Secretory System (T3SS) in A. veronii was in AVI-1 genomic island identified in this study, most likely acquired via horizontal transfer from other Aeromonas species. T3SS was significantly less present in A. veronii strains isolated from patients with gastrointestinal diseases as compared to strains isolated from fish and domestic animals.

Conclusions

This study provides novel information on source of infection and virulence of A. veronii in human gastrointestinal diseases.
Out of hospital cardiac arrest in Western Sydney—an analysis of outcomes and estimation of future eCPR eligibility
Authors: Chandru Pramod , Mitra Tatum Priyambada , Dhanekula Nitesh Dutt , Dennis Mark , Eslick Adam , Kruit Natalie , Coggins Andrew
Published: February 2022

Background

Refractory out of hospital cardiac arrest (OHCA) is associated with extremely poor outcomes. However, in selected patients extracorporeal cardiopulmonary resuscitation (eCPR) may be an effective rescue therapy, allowing time treat reversible causes. The primary goal was to estimate the potential future caseload of eCPR at historically 'low-volume' extracorporeal membrane oxygenation (ECMO) centres.

Methods

A 3-year observational study of OHCA presenting to the Emergency Department (ED of an urban referral centre without historical protocolised use of eCPR. Demographics and standard Utstein outcomes are reported. Further, an a priori analysis of each case for potential eCPR eligibility was conducted. A current eCPR selection criteria (from the 2-CHEER study) was used to determine eligibly.

Results

In the study window 248 eligible cardiac arrest cases were included in the OHCA registry. 30-day survival was 23.4% (n = 58). The mean age of survivors was 55.4 years. 17 (6.8%) cases were deemed true refractory arrests and fulfilled the 2-CHEER eligibility criteria. The majority of these cases presented within “office hours” and no case obtained a return of spontaneous circulation standard advanced life support.

Conclusions

In this contemporary OHCA registry a significant number of refractory cases were deemed potential eCPR candidates reflecting a need for future interdisciplinary work to support delivery of this therapy.
The association between continuous renal replacement therapy as treatment for sepsis-associated acute kidney injury and trend of lactate trajectory as risk factor of 28-day mortality in intensive care units
Authors: Wang Zichen , Zhang Luming , Xu Fengshuo , Han Didi , Lyu Jun
Published: February 2022

Background

Sepsis has high incidence and fatality rates in intensive care units, often leading to renal failure. The effectiveness of continuous renal replacement therapy (CRRT) in sepsis-associated acute kidney injury (S-AKI) patients is currently uncertain.

Aim

Joint model was used to determine the association between CRRT and the lactate trajectory trend and how it correlated to 28-day mortality for S-AKI patient in ICU.

Methods

A retrospective study was applied to patients with sepsis and AKI, which were extracted from the MIMIC-III public database, with the endpoint being 28-day mortality. Every lactate level measurement within 28 days was observed and calculated using logarithms. Joint model combined the longitudinal analysis of the natural logarithm of the lactate level [log(lactate)] in longitudinal submodel and Cox regression by trajectory function, demonstrating the effects of CRRT on 28-day survival and log(lactate) changes, and its final relationship with the event status.

Results

Among the 717 S-AKI patients, 157 received CRRT. CRRT was not associated with 28-day mortality. After adjustments, the relationship between CRRT use and log(lactate) elevation was statistically significant. The parameter estimation of CRRT and log(lactate) indicated that using CRRT will increase log(lactate) by 0.041 in S-AKI patients. The joint model also instigated a fixed association between changes in the lactate level and the event result, revealing an exp value of (0.755) = 2.12, indicating that an increase of one unit in log(lactate) will increase the risk of 28-day mortality 2.12-times.

Conclusion

There was no significant association between CRRT use and 28-day survival in S-AKI patients, and JM showed that CRRT use might be associated with elevation of longitudinal lactate levels. Therefore, additional attention should be paid to other treatments to control lactate levels when providing renal support for patients with S-AKI.
Danish feasibility study of a new innovation for treating alcohol disorders in primary care: the 15-method
Authors: Schøler Peter Næsborg , Søndergaard Jens , Barfod Sverre , Nielsen Anette Søgaard
Published: February 2022

Background

The 15-method: a new brief intervention tool for alcohol problems in primary care has shown promising results in Sweden for mild to moderate alcohol use disorders. The present study evaluated the 15-method’s usability, organizational integration, and overall implementation feasibility in Danish general practice in preparation for a large-scale evaluation of the method’s effectiveness in identifying and treating alcohol problems in general practice.

Methods

Five general practices in the Central and Southern Region of Denmark participated: seven general practitioners (GPs), eight nurses. Participants received a half day of training in the 15-method. Testing of implementation strategies and overall applicability ran for 2 months. A focus group interview and two individual interviews with participating GPs along with five individual patient interviews concluded the study period.

Results

Results indicate that implementation of the 15-method is feasible in Danish general practice. The healthcare professionals and patients were positive about the method and its possibilities. The method was considered a new patient centered treatment offer and provided structure to a challenging topic. An interdisciplinary approach was much welcomed. Results indicate that the method is ready for large scale evaluation.

Conclusions

Implementation of the 15-method is considered feasible in Danish general practice and large-scale evaluation is currently being planned.
Functional dentition is a modifier of the association between vitamin D and the frailty index among Chinese older adults: a population-based longitudinal study
Authors: Dai Miao , Yue Jirong , Zhang Jingyi , Wang Hui , Wu Chenkai
Published: February 2022

Backgrounds

Although vitamin D and dentition status are each associated with frailty, their combined effects on frailty have not been studied. This study aimed to evaluate the combined effects of vitamin D and dentition status on frailty in old Chinese adults.

Methods

Baseline data were obtained from the 2011–2012 wave of the Chinese Longitudinal Healthy Longevity Survey. A total of 1074 participants ≥65 years who were non-frail or prefrail at baseline were included; follow-up was conducted in the 2014 wave. Frailty was assessed by a 40-item frailty index (FI) and classified into frail (FI > 0.21), prefrail (FI: 0.1–0.21), and non-frail (FI ≤0.1). Vitamin D was assessed by 25-Hydroxyvitamin D (25(OH)D) and categorized into quartiles and dichotomies (normal: ≥50 nmol/L vs. low: < 50 nmol/L). The presence of ≥20 natural teeth was defined as functional dentition, otherwise as non-functional dentition. We used bivariate logistic regression and restricted cubic splines to examine the association between vitamin D, dentition status, and frailty. We created a multiplicative interaction between vitamin D and dentition status to test for their combined effect.

Results

A total of 205 (19.1%) incident frailty were identified during the 3-year follow-up. Participants with the lowest quartile of plasma 25(OH) D were more likely to be frail (odds ratio [OR] 2.45, 95% confidence interval [CI]: 1.38 to 4.35) than those in the highest quartile. Older adults with the lowest quartile of 25(OH) D and non-functional dentition had the highest odds of frailty (OR = 3.67, 95% CI: 1.02 to 13.12). We also observed that a lower vitamin D level was associated with an increased risk of frailty with a threshold of 40.37 nmol/L using restricted cubic spline models. However, vitamin D levels were not significantly associated with frailty among participants with functional dentition.

Conclusions

Low vitamin D levels were associated with an increased risk of frailty in older adults. Functional dentition modified the association of vitamin D with frailty.
Factors associated with in-hospital mortality in adult sepsis with Escherichia coli infection
Authors: Song Kun , Guo Cuirong , Zeng Zhao , Li Changluo , Ding Ning
Published: February 2022

Background

Escherichia coli (E. coli) is an important pathogen in sepsis. This study aimed to explore the factors which were associated with in-hospital mortality in adult sepsis with E. coli infection based on a public database.

Methods

All sepsis patients with E. coli infection in MIMIC-III were included in this study. Clinical characteristics between the survivor and non-survivor groups were analyzed. Factors associated with in-hospital mortality were identified by multivariate logistic regression.

Results

A total of 199 patients were eventually included and divided into two groups: a survivor group (n = 167) and a non-survivor group (n = 32). RDW and HCT were identified as the factors with clinical outcomes. The area under the ROC curve (AUC) were 0.633 and 0.579, respectively. When combined RDW and HCT for predicting in-hospital mortality, the AUC was 0.772, which was significantly superior to SOFA and APACHEII scores.

Conclusion

RDW and HCT were identified as factors associated with in-hospital mortality in adult sepsis patients with E. coli infection. Our findings will be of help in early and effective evaluation of clinical outcomes in those patients.
Development and validation of the Health Education Adherence Scale for Stroke Patients: a cross-sectional study
Authors: Ding Weiwei , Chen Junya , Liu Jing , Lin Beibei , Li Shihen , Li Fengzhen , Guo Junyi , Li Yun , Li Jufang
Published: February 2022

Background

Due to the lack of health education adherence assessment tools for stroke patients, the assessment of health education adherence in this population is insufficient, which hinders the prevention and rehabilitation of stroke. This study aims to develop and validate a Health Education Adherence Scale for Stroke Patients (HEAS-SP).

Methods

A cross-sectional design with a purposive sampling method was used for this study. Six hundred and fifty-four eligible participants completed the demographic questionnaire and the HEAS-SP. The data collection lasted for 7 months, from March 1stto September 30th in 2019. Item analysis and exploratory and confirmatory factor analysis were employed to develop and validate the HEAS-SP.

Results

The item analysis, exploratory and confirmatory factor analysis resulted in a 20-item HEAS-SP with 4 domains: medication adherence, diet adherence, rehabilitation exercise adherence, and healthy lifestyle adherence. The four-domain model demonstrated acceptable model fit indexes and the 20-item HEAS-SP demonstrated acceptable reliability and validity.

Conclusion

The 20-item HEAS-SP was shown to have acceptable reliability and validity for assessing health education adherence with respect to diet, medication, rehabilitation exercise and healthy lifestyle in stroke patients, making it a potential basis for developing targeted interventions for stroke patients.
Prognostic utility of systemic inflammatory markers and chronic hepatitis C virus infection status in hepatocellular carcinoma patients treated with local ablation
Authors: Ali Mohamed Abdulwahab Mohamed , Harmsen William Scott , Morsy Khairy Hammam , Galal Ghada Moustapha Kamal , Therneau Terry M. , Roberts Lewis Rowland
Published: February 2022

Background

Hepatocellular carcinoma (HCC) has high incidence and mortality worldwide. Local ablation using radiofrequency ablation (RFA) or microwave ablation (MWA) is potentially curative for early-stage HCC with outcomes comparable to surgical resection. We explored the influence of demographic, clinical, and laboratory factors on outcomes of HCC patients receiving ablation.

Methods

This retrospective cohort study included 221 HCC patients receiving local ablation at Mayo Clinic between January 2000 and October 2018, comprising 140 RFA and 81 MWA. Prognostic factors determining overall survival (OS) and disease-free survival (DFS) were identified using multivariate analysis.

Results

There was no clinically significant difference in OS or DFS between RFA and MWA. In multivariate analysis of OS, pre-ablation lymphocyte-monocyte ratio [Hazard ratio (HR) 0.7, 95% confidence interval (CI) 0.58–0.84, P = 0.0001], MELD score [HR 1.12, 95%CI 1.068–1.17, P <  0.0001], tumor number [HR 1.23, 95%CI 1.041–1.46, P = 0.015] and tumor size [HR 1.18, 95%CI 1.015–1.37, P = 0.031] were clinically-significant prognostic factors. Among HCC patients with chronic hepatitis C (HCV) infection, positive HCV PCR at HCC diagnosis was associated with 1.4-fold higher hazard of death, with 5-year survival of 32.8% vs 53.6% in HCV PCR-negative patients. Regarding DFS, pre-ablation lymphocyte-monocyte ratio [HR 0.77, 95%CI 0.66–0.9, P = 0.001], MELD score [HR 1.06, 95%CI 1.022–1.11, P = 0.002], Log2 AFP [HR 1.11, 95%CI 1.033–1.2, P = 0.005], tumor number [HR 1.29, 95%CI 1.078–1.53, P = 0.005] and tumor size [HR 1.25, 95%CI 1.043–1.51 P = 0.016] were independently prognostic.

Conclusions

Pre-ablation systemic inflammation represented by lymphocyte-monocyte ratio is significantly associated with OS and DFS in HCC patients treated with local ablation. HCV viremia is associated with poor OS. Tumor biology represented by tumor number and size are strongly prognostic for OS and DFS while AFP is significantly associated with DFS only.
Association of annexin A10 expression with poor prognosis of intrahepatic cholangiocarcinoma
Authors: Shao Yu-Yun , Kuo Hung-Yang , Jeng Yung-Ming , Wu Yao-Ming , Wang Hsiu-Po , Hsu Chiun , Hsu Chih-Hung , Hsu Hey-Chi , Cheng Ann-Lii , Lin Zhong-Zhe
Published: February 2022

Background

Annexin A10 expression influences the prognosis of several gastrointestinal cancers. We explored the association of annexin A10 expression with the overall survival (OS) of patients who underwent curative surgery for cholangiocarcinoma.

Methods

Patients who underwent curative surgery for cholangiocarcinoma (except gallbladder cancer) and had pathological stage T1-3N0M0 disease were enrolled. Annexin A10 expression was examined by performing immunohistochemical staining. Patient demographics and survival outcome data were retrieved from medical records.

Results

In total, 185 patients were enrolled. The primary tumor location was intrahepatic and extrahepatic (including the perihilar region) for 89% and 11% of patients, respectively. Positive annexin A10 staining was detected for 61 (33%) patients and associated with extrahepatic or perihilar cholangiocarcinoma (p = 0.001) and lower histological grade (p < 0.001). Patients with positive annexin A10 staining exhibited significantly poorer survival relative to patients with negative staining results (median OS, 2.5 vs. 4.9 years,p = 0.025). In the multivariate analysis adjusting for age, sex, tumor location, tumor grade, hepatitis infection, and disease stage, positive annexin A10 remained an independent predictor of poor OS (hazard ratio 1.572,p = 0.034). In the subgroup analysis, the association between annexin A10 and prognosis was restricted to intrahepatic cholangiocarcinoma. Among patients with intrahepatic cholangiocarcinoma, patients with positive annexin A10 staining exhibited significantly poorer survival compared with patients with negative annexin A10 staining (median OS, 2.3 vs. 4.9 years,p = 0.008).

Conclusion

Positive annexin A10 expression was associated with poor prognosis of intrahepatic cholangiocarcinoma.
Effects of Kinesio taping on skin deformation during knee flexion and extension: a preliminary study
Authors: He Fei , Wang Xiaoxuan , Yu Menglian , Chen Yiyi , Yu Bo , Lu Jianqiang
Published: February 2022

Background

Kinesio Taping (KT) is proved useful to many musculoskeletal disorders. But the mechanism remains unclear. The kinesio tape works by sticking to the skin surface. So exploring the interaction between the tape and the skin and analyzing its biomechanical influence may be an effective way to explore the mechanism of the tape.

Objectives

This study aimed to investigate the effect of Kinesio taping and taping methods on skin deformation during knee joint flexion and extension motion and further explore its possible functional mechanisms.

Methods

Ten healthy and pain-free subjects (4 males, 6 females) were recruited in this study. The skin observation area on the anterior side of the right thigh of the subjects was divided into 11 segments by 12 reflective marker points for distance measurement, from the distal knee to the proximal knee, the length of the interval was L1 to L11, and the total length was L0. Subjects were treated with no KT (NT), resting positive taping (RPT), resting negative taping (RNT), stretching positive taping (SPT), and stretching negative taping (SNT). A Qualisys infrared high-speed three-dimensional spatial coordinate capture system was used to observe changes in the length of the observed skin surface on the right anterior thigh during right knee flexion and extension in the sitting position.

Results

During right knee flexion and extension in the seated position in 10 subjects, all skin segment deformations produced significant differences between intervention groups (P < 0.05), except for L1 during flexion (P = 0.07). During right knee flexion and extension, total length, L0, and spacing lengths, L1, L6, and L11, were longer in the NT group than in all other groups. L0 and L1 were both longer in the stretched position than in the rest position; L11 also showed this trend.

Conclusions

The usage of the KT had an effect on the biomechanical changes of the skin, resulting in changes in skin deformation. I-tape, natural tension taping can shorten the skin distance between the two ends of the tape. Limb position during taping may influence the KT’s effects. However, the change in taping direction showed no significant effects on skin deformation during exercise. KT may apply a pre-stress in the biomechanics of the skin.
Elevated blood urea nitrogen-to-creatinine ratio increased the risk of Coronary Artery Disease in patients living with type 2 diabetes mellitus
Authors: Liu Feng , Ma Guanhui , Tong Chao , Zhang Shan , Yang Xinghua , Xu Cong , Yang Weihao , Xia Guobao , Li Mingliang
Published: February 2022

Background

High Blood Urea Nitrogen (BUN) and high Serum Creatinine (SCr) levels are risk factors for Coronary Artery Disease (CAD). However, the relationship between the Blood Urea Nitrogen to Creatinine (BUN/SCr) ratio (UCR) and the risk of CAD in patients living with new-onset diabetes is unclear. This study aimed to examine the relationship between blood UCR and the risk of CAD in patients living with new-onset type 2 diabetes mellitus (T2DM).

Methods

We analyzed the data from the cohort of 12,299 patients living with type 2 diabetes mellitus. Primary endpoints were the events of CAD. The ANOVA test (continuous indicators) and χ2 test (categorical indicators) were used to assess the differences of baseline characteristics across the groups of UCR. In order to understand the correlation between variables, we performed correlation analysis on variables that have significant differences between CAD group and non-CAD group. Multivariate-adjusted Cox proportional hazard regression models were applied to estimate the association of the blood UCR with the risk of CAD in patients living with T2DM. The Kaplan–Meier survival function plotting and the log-rank test were used to evaluate the event-free survival according to the groups of UCR. The restricted cubic spline model was used to show the adjusted association between blood UCR and risk of CAD in patients living with T2DM.

Results

During a median follow-up of 2.66 years, 1173 CAD were recorded with an event rate of 28.49 events per 1000 person-years. In multivariate-adjusted Cox regression models, elevated blood urea nitrogen to creatinine ratio (UCR) was associated with higher risk of CAD in patients living with T2DM [hazard ratio (HR), 1.782; 95% confidence interval (CI), 1.237–2.567]. The Kaplan–Meier survival curves indicated that the high group of UCR tended to have a lower event-free survival than the low group and medium group. There was a nonlinear trend toward increasing risk of CAD across the groups of UCR. And cubic spline function graph suggested that the influence of UCR level on HR for CAD increased significantly at UCR levels above 6.67.

Conclusions

An elevated UCR was significantly associated with an increased risk for CAD in patients living with T2DM.
Screening the components of Saussurea involucrata for novel targets for the treatment of NSCLC using network pharmacology
Authors: Zhang Dongdong , Zhang Tieying , Zhang Yao , Li Zhongqing , Li He , Zhang Yueyang , Liu Chenggong , Han Zichao , Li Jin , Zhu Jianbo
Published: February 2022

Background

Saussurea involucrata (SAIN), also known as Snow lotus (SI), is mainly distributed in high-altitude areas such as Tibet and Xinjiang in China. To identify novel targets for the prevention or treatment of lung adenocarcinoma and lung squamous cell carcinoma (LUAD&LUSC), and to facilitate better alternative new drug discovery as well as clinical application services, the therapeutic effects of SAIN on LUAD&LUSC were evaluated by gene differential analysis of clinical samples, compound target molecular docking, and GROMACS molecular dynamics simulation.

Results

Through data screening, alignment, analysis, and validation it was confirmed that three of the major active ingredients in SAIN, namely quercetin (Q), luteolin (L), and kaempferol (K), mainly act on six protein targets, which mainly regulate signaling pathways in cancer, transcriptional misregulation in cancer, EGFR tyrosine kinase inhibitor resistance, adherens junction, IL-17 signaling pathway, melanoma, and non-small cell lung cancer. In addition, microRNAs in cancer exert preventive or therapeutic effects on LUAD&LUSC. Molecular dynamics (MD) simulations of Q, L, or K in complex with EGFR, MET, MMP1, or MMP3 revealed the presence of Q in a very stable tertiary structure in the human body.

Conclusion

There are three active compounds of Q, L, and K in SAIN, which play a role in the treatment and prevention of non-small cell lung cancer (NSCLC) by directly or indirectly regulating the expression of genes such as MMP1, MMP3, and EGFR.
Factors associated with burnout among Chinese nurses during COVID-19 epidemic: a cross-sectional study
Authors: Wan Zhiying , Lian Mengfei , Ma Hui , Cai Zhongxiang , Xianyu Yunyan
Published: February 2022

Background

The coronavirus disease 2019 (COVID-19) epidemic has broken out and even spread globally. The healthcare system worldwide faces enormous challenges, and nurses are at the highest risk as one of the leading forces. It's worth paying attention to nurses' anxiety and job burnout. This study aimed to investigate nurses' levels of burnout and anxiety during the epidemic of COVID-19 and to analyze influencing factors of burnout.

Methods

A cross-sectional survey was conducted from 19 to 25 February 2020. Questionnaires such as the basic information questionnaire, Maslach Burnout Inventory-General Survey (MBI-GS), and State-Trait Anxiety Inventory (STAI) were used among 1011 nurses in Wuhan tertiary hospitals via the online survey. The final number of valid questionnaires was 885. The effective response rate was 87.5%.

Results

The average score of MBI-GS was 11.50, 6.02, 24.47, respectively. The average score for state anxiety was 45.52 and trait anxiety, 43.78. Anxiety was positively associated with emotional exhaustion and cynicism, and negatively related to personal accomplishment. The protective factors of burnout were personnel agency, five years or less work experience, living in hospital dormitory, Wuhan medical team, working time exceeding 9 h, and the best knowledge of COVID-19. The absence of siblings, median job title, working in isolation wards, three or more night shifts per week, living in hotels, and being surrounded by confirmed or suspected medical staff were all negative factors.

Conclusions

Nurses had high anxiety levels during the COVID-19 period, but the level of burnout was mild to moderate. Managers should continue to pay attention to nurses' psychological state and related factors and intervene to stabilize the nursing team.
Implications of national tax policy on local pharmaceutical production in a southwestern state nigeria – qualitative research for the intersection of national pharmaceutical policy on health systems development
Authors: Obembe Taiwo A. , Adenipekun Adebisi B. , Morakinyo Oyewale M. , Odebunmi Kehinde O.
Published: February 2022

Background

Universal access to quality and affordable medicines is one of the targets of the Sustainable Development Goals (SDGs). Access to essential medicines is defined as the availability of medicine at an affordable price in public and private health institutions including retail pharmacies in the proximity of less than an hour from the home of the population. The dependence on importation to meet the drug needs of an expanding population has implications on the growth of the local pharmaceutical industry, availability, and affordability of essential medicines in the country. This study aims to understand the dynamics of tariffs and tax policy on local drug production in the pharmaceutical industry in Nigeria.

Methods

This was a qualitative study involving the use of Key Informant Interviews (KIIs). A total of 15 stakeholders were interviewed. Interviews conducted were analysed thematically. The data generated were analysed using Atlas.Ti version 8.2.

Results

Assessment of the pharmaceutical industry sub-sector underscores myriads of challenges facing the industry and explains why the pharmaceutical industries in Nigeria are performing sub-optimally. Key stakeholders in the sector expressed concern about the fact that substantial percentage of drugs consumed in Nigeria are imported. Local manufacturers are underperforming due to several factors. Some highlighted factors were unfriendly tax environment, high cost of production, infrastructural deficit, low patronage from the government, and lack of access to low-interest rate loans. However, tax incentives and tax cuts are proven strategies to encourage and facilitate the growth of entrepreneurs in the pharmaceutical industry.

Conclusions

Stakeholders’ perspective of implications of the tax environment on the pharmaceutical sector of Nigeria revealed the unfriendliness of the government policy to local manufacturers. Although the checklist for availability and prices of essential medicines in Osun state, Nigeria revealed that the pre-selected drugs were available in the facilities, the observed prices further affirmed the relative difficulty that is experienced by local manufacturers to compete with imported brands of the same drugs.
Factors associated with health insurance enrolment among Ghanaian children under the five years: analysis of secondary data from a national survey
Authors: Anaba Emmanuel Anongeba , Tandoh Akua , Sesay Foday Robert , Fokukora Theopista
Published: February 2022

Background

Health insurance enrolment provides financial access to health care and reduces the risk of catastrophic healthcare expenditure. Therefore, the objective of this study was to assess the prevalence and correlates of health insurance enrolment among Ghanaian children under five years.

Methods

We analysed secondary data from the 2017/18 Ghana Multiple Indicator Cluster Survey. The survey was a nationally representative weighted sample comprising 8,874 children under five years and employed Computer Assisted Personal Interviewing to collect data from the participants. In addition, Chi-square and Logistic Regression analyses were conducted to determine factors associated with health insurance enrolment.

Results

The results showed that a majority (58.4%) of the participants were insured. Health insurance enrollment was associated with child age, maternal educational status, wealth index, place of residence and geographical region (p < 0.05). Children born to mothers with higher educational status (AOR = 2.14; 95% CI: 1.39–3.30) and mothers in the richest wealth quintile (AOR = 2.82; 95% CI: 2.00–3.98) had a higher likelihood of being insured compared with their counterparts. Also, children residing in rural areas (AOR = 0.75; 95% CI: 0.61–0.91) were less likely to be insured than children in urban areas.

Conclusion

This study revealed that more than half of the participants were insured. Health insurance enrolment was influenced by the child's age, mother's educational status, wealth index, residence, ethnicity and geographical region. Therefore, interventions aimed at increasing health insurance coverage among children should focus on children from low socio-economic backgrounds. Stakeholders can leverage these findings to help improve health insurance coverage among Ghanaian children under five years.
Basics for the potential use of saliva to evaluate stress, inflammation, immune system, and redox homeostasis in pigs
Authors: Cerón J. J. , Contreras-Aguilar M. D. , Escribano D. , Martínez-Miró S. , López-Martínez M. J. , Ortín-Bustillo A. , Franco-Martínez L. , Rubio C. P. , Muñoz-Prieto A. , Tvarijonaviciute A. , López-Arjona M. , Martínez-Subiela S. , Tecles F.
Published: February 2022

The use of saliva as a biological sample has many advantages, being especially relevant in pigs where the blood collection is highly stressful and painful, both for the animal and the staff in charge of the sampling. Currently one of the main uses of saliva is for diagnosis and detection of infectious diseases, but the saliva can also be used to measure biomarkers that can provide information of stress, inflammation, immune response and redox homeostasis. This review will be focused on the analytes that can be used for such evaluations. Emphasis will be given in providing data of practical use about their physiological basis, how they can be measured, and their interpretation. In addition, some general rules regarding sampling and saliva storage are provided and the concept of sialochemistry will be addressed. There is still a need for more data and knowledge for most of these biomarkers to optimize their use, application, and interpretation. However, this review provides updated data to illustrate that besides the detection of pathogens in saliva, additional interesting applicative information regarding pigs´ welfare and health can be obtained from this fluid. Information that can potentially be applied to other animal species as well as to humans.