bluuebunny/crossref_metadata_2025 huggingface dataset:
Routine health check-ups for adolescents in Mwanza City, Tanzania: stakeholders’ recommendations on its content, venue, and mode of delivery
Authors: Sedekia Yovitha , Mshana Gerry , Nsanya Mussa K. , Kohl Kid , Wambura Mwita , Grosskurth Heiner , Ross David A. , Kapiga Saidi
Published: May 2023

Background

Routine adolescent health screening aiming at the detection of unnoticed medical problems may increase awareness among policy makers and contribute to improved health in this population. Research is needed to inform the World Health Organization (WHO) and national health programs to provide evidence-based guidance on whether public health systems should offer comprehensive adolescent health screening, what should be included in different contexts, and how it should be delivered. We conducted formative research to define the content and delivery strategies for health check-ups to be performed in young (10–14 years) and older (15–19 years) adolescents, and to assess whether such services are likely to be acceptable and feasible in Tanzania.

Methods

As part of a collaborative research program coordinated by WHO in Chitungwiza, Zimbabwe; Mwanza City, Tanzania; and Cape Coast, Ghana a series of key informant interviews were conducted from April to July 2020, using a semi-structured guide with purposively selected stakeholders from government departments, non-governmental and community-based organisations, schools and health facilities. Data transcripts were coded using NVivo 12 software and thematic analysis was performed.

Results

We report results from 31 key informant interviews to address four main domains: proposed health conditions for routine health check-ups, health interventions to be combined with such check-ups, preferable venues, and the mode for delivering such screening activities. Stakeholders were supportive of introducing routine health check-ups among adolescents. They recommended focusing on non-communicable diseases, physical disabilities, common mental health problems, reproductive health problems, specific communicable diseases, and hygiene-related problems. They also recommended combining counselling and family planning information with these check-ups. Three venues were proposed: schools, community settings (to reach out-of-school adolescents), and youth-friendly health facilities (for conditions requiring a high level of confidentiality).

Conclusions

Stakeholders were supportive of the proposed routine health check-ups for adolescents, recommending specific health conditions to be screened for in both community and school settings. Based on the above, we plan to conduct implementation research to determine the number of new treatable conditions detected, and the costs of offering such services. In the longer term, evaluation of their health impact and cost-effectiveness will be required to guide policy.
Finite element analysis of the mechanical strength of a new hip Spacer
Authors: Ge Hao , Yan Hongsong , Liu Xianwang , Huang Yiwei , Zeng Jianchun
Published: May 2023

Background and objective

At present, the influence of the internal metallic endoskeleton of Spacer on the biomechanical strength of Spacer remains unclear. The aim of this study was to analyze the mechanical stability of a novel Spacer applying a annular skeleton that mimics the structure of trabecular bone using finite element methods.

Metheds

The femur models of three healthy individuals and skeletonless Spacer, K-Spacer, and AD-Spacer were assembled to create 15 3D models. Finite element analysis was performed in an Ansys Bench2022R1. Biomechanical parameters such as stress and strain of the Spacer, internal skeleton and femur were evaluated under three loads, which were applied with the maximum force borne by the hip joint (2100 N), standing on one leg (700 N), and standing on two legs (350 N). The mechanical properties of the new hip Spacer were evaluated.

Result

The stresses on the medial and lateral surfaces of the AD-Spacer and K-Spacer were smaller than the stresses in the state without skeletal support. The maximum stresses on the medial and lateral surfaces of the AD-Spacer were smaller than those of the inserted K-Spacer, and the difference gradually increased with the increase of force intensity. When the skeleton diameter was increased from 3 to 4 mm, the stresses in the medial and lateral sides of the AD-Spacer and K-Spacer necks decreased. The stress of both skeletons was concentrated at the neck, but the stress of the annular skeleton was evenly distributed on the medial and lateral sides of the skeleton. The mean stress in the proximal femur was higher in femurs with K-Spacer than in femurs with AD-Spacer.

Conclusions

AD-Spacer has lower stress and higher load-bearing capacity than K-Spacer, and the advantages of AD-Spacer are more obvious under the maximum load state of hip joint.
Use of the forgotten joint score (FJS)-12 to evaluate knee awareness after quadriceps tendon reconstruction
Authors: Sava Manuel P. , Schelker Benjamin L. , Khan Zainab A. , Amsler Felix , Hirschmann Michael T.
Published: May 2023

Background

Quadriceps tendon rupture (QTR) is a severe injury of the knee extensor apparatus. The study aims to validate the use of forgotten joint score (FJS-12) for functional outcome assessing after surgical treatment of QTR.

Methods

Fifty-seven patients who underwent surgery for QTR with transosseous suture reconstruction in a single orthopaedic surgery and traumatology center between 2015 and 2020 were eligible for enrolment in this retrospective case series. The demographic data and other pre-operative details such as age, gender, comorbidities and medication use also were extracted from the medical records. Patient reported outcome measures (PROMs) were gathered in the form of Western Ontario and McMaster Universities Arthritis Index Score (WOMAC), Tegner Activity Score (TAS), Lysholm Score and FJS-12 at a mean follow-up time of 49.84 months ± 20.64 months. The FJS-12 was validated by correlation with WOMAC, TAS and Lysholm Score.

Results

The mean age of all patients were 69.2 ± 13.6 years with 51 (89.5%) males and 6 (10.5%) females. The mean time from injury to surgery was 3.39 ± 5.46 days. All patients reported satisfactory functional outcomes after surgery on FJS-12, WOMAC and Lysholm scores, except the TAS, which decreased slightly from pre-operative level. There was a high negative correlation between WOMAC and FJS-12, but moderate positive correlations between FJS-12 and TAS and Lysholm scores. The Cronbach’s alpha value was 0.96 for 12 items in FJS-12.

Conclusion

This study has found that FJS-12 is a reliable and easy to assess tool for functional outcomes after QTR reconstruction. It has shown moderate to strong correlation with other commonly used outcome measures (WOMAC, TAS and Lysholm).
Influence of surface treatment on repair bond strength of CAD/CAM long-term provisional restorative materials: an in vitro study
Authors: Soliman Tarek Ahmed , Robaian Ali , Al-Gerny Youssef , Hussein Eman Mohamed Raffat
Published: May 2023

Background

The surface treatment to improve the repair bond strength may vary because CAD/CAM provisional restoration polymers exhibit a variety of microstructures. This study was conducted to evaluate the effect of surface treatments on the repairability of three different CAD/CAM polymers for long-term provisional restorations.

Methods

Thirty specimens from each provisional restorative materials (CAD-Temp, Everest C-Temp, and PEEK) were divided into three groups: C: surfaces received no treatment; SB: surfaces were airborne particle abraded with 50 μm aluminum oxide; SB-T: surfaces received the same conditions as group SB in addition to thermocycling before and after treatment. Primer and nanohybrid repair resin composite were applied to the prepared CAD /CAM surfaces. The shear bond strength and the mode of failure were assessed. ANOVA and Tukey’s significant difference tests were used to evaluate the data.

Results

The SB group had significantly higher repair SBS values (p < .001) compared to the other groups (C and SB-T). Everest C-Temp significantly recorded the highest repair SBS (17.84 ± 0.19 MPa) in group SB, while the lowest repair SBS values (5.51 ± 1.14 MPa) for CAD-Temp were recorded in group C. PEEK significantly recorded the second highest repair SBS (15.96 ± 0.18) in the SB group.

Conclusions

Everest C-Temp had the highest repair SBS after an airborne abrasion particle. Thermocycling had no significant effect on the repair SBS for PEEK. Everest C-Temp and PEEK are recommended as long-term durable provisional materials for clinical use.
Evaluation of recurrence, mortality and treatment complications of oral squamous cell carcinoma in public health centers in Shiraz during 2010 to 2020
Authors: Rezazadeh Fahimeh , Andisheh-Tadbir Azadeh , Malek Mansouri Zahra , Khademi Bijan , Bayat Pourya , Sedarat Hossein , Tabesh Amir , Tayebi Khorami Elham
Published: May 2023

Introduction

Oral Squamous cell Carcinoma (OSCC) is the most common oral cancer and is treated with surgery, radiotherapy and chemotherapy. Various complications of treatment include xerostomia, mucositis, and trismus, which affect patients’ quality of life. The aim of this study is to evaluate the mortality, recurrence rate and prevalence of oral complications in treated patients.

Method and materials

This cross-sectional study reviewed 326 cases of patients with OSCC who were referred to public health centers in Shiraz (Khalili Hospital and Dental School) from 2010 to 2020. All patients were contacted, and the survivors were called and examined by an oral physician. A medical record was created for them, including demographic information, location of the lesion, type of treatment, history of recurrence, metastasis and oral complications.

Results

53.5% of patients were male and 46.5% were female. The mean age of patients was 58.68 years. Mortality and recurrence rate was respectively 49.8% and 17.8%. The most common location of the lesion was tongue (64%). Surgery was done for all patients. 97.4% of patients complained of xerostomia, 46.2% of mucositis and 44.3% of trismus.

Conclusion

The most common complications of treatment are xerostomia, mucositis, and trismus, respectively. Frequent and regular follow-ups and supportive therapies reduce these complications and improve patients’ quality of life.
Telemedicine consultation for emergency patients’ attention: a clinical experience from a high complex university hospital from Latin America
Authors: Libreros-Peña Laura , Quintero Jaime A. , Gelves Arnold , Alarcón Juliana , Morales Sergio , Escobar María Fernanda , Valencia Andres M. , Guzmán Sara , Diez-Sepulveda Julio
Published: May 2023

Introduction

As a result of the new coronavirus pandemic, a highly complex academic hospital in Latin America implemented a telemedicine service for the care of obstetric, pediatric, and adult patients. In 2020, regional emergency services collapsed due to the increase in demand for care, generating the need to open expansion services and seek strategies to provide timely care to consulting patients.

Objective

We retrospectively describe the clinical experience of patients who consulted the emergency department via telemedicine across a videoconference tool using digital platforms.

Methods

A descriptive study with retrospective data collection was conducted to describe the implementation of the teleconsultation care model for patients. We constructed the clinical process indicators to evaluate the model.

Results

A total of 4652 teleconsultations were registered. Telemedicine consultation was above 50% in the country and department and above 90% in Cali city. The average waiting time for care was estimated to be 1:59:52 h. A total of 275 patients were transferred to the emergency room after consultation. The principal reasons for consultation in the institutional telemedicine program were respiratory and gastrointestinal symptoms. Teleconsultations related to SARS-COV 2 infections reported 3775 patients (3127 with unidentified virus and 648 with the identified virus).

Conclusions

Telemedicine is a tool that provides support and guidance to patients who consult emergency departments, reducing barriers to access health care and decreasing emergency department collapse.
Identification of founder and novel mutations that cause congenital insensitivity to pain (CIP) in palestinian patients
Authors: Khaled Boushra , Alzahayqa Mahmoud , Jaffal Ahmad , Sallam Husam , Thawabta Rua’a , Mansour Mamoun , Alian Akram , Salah Zaidoun
Published: May 2023

Background

Congenital insensitivity to pain (CIP) is a rare autosomal recessive disorder characterized primarily by an inability to perceive physical pain from birth, resulting in the accumulation of bruising, inflammation, and fractures that affect patient’s life expectancy. CIP has different forms including CIP and CIPA. CIP with Anhidrosis (CIPA) is the most common type of CIP, which is caused mainly by mutations in NTRK1 and NGF genes, and is characterized by mental retardation and the inability to sweat (Anhidrosis). Because of high consanguinity rates in Palestine, this rare disease appears to have a higher frequency than in other communities. However, there were no systematic studies to address the genetic factors that cause CIP in the Palestinian community.

Methods

In our study, we used Sanger and Whole exome sequencing to genotype members of five CIP-affected Palestinian families.

Results

Our results confirm the presence of the founder c.1860-1861insT mutation in the NTRK1 gene of Palestinian Bedouin CIPA patients. Furthermore, one CIPA family carried a missense c.2170 G > A (G724 S) mutation in exon 16 of the NTRK1 gene. Finally, a novel nonsense c.901 A > T mutation (K301*) was detected in exon 7 of the SCN9A gene in CIP without anhidrosis family.

Conclusions

Our study revealed three mutations that cause CIP and CIPA in the Palestinian community, which can help in improving the process of diagnosis and genetic counseling and establishing protocols for the diagnosis and follow-up for the affected individuals. This is especially important given that early diagnosis and medical care interference can prevent unpleasant CIP and CIPA complications.
Prenatal diagnosis of genetic aberrations in fetuses with pulmonary stenosis in southern China: a retrospective analysis
Authors: Cai Meiying , Guo Nan , Fu Meimei , Chen Yuqing , Liang Bin , Que Yanting , Ji Qingqiang , Huang Hailong , Xu Liangpu , Lin Na
Published: May 2023

Background

The genetic etiology of congenital pulmonary stenosis (PS) in fetuses remains inadequately studied. We used karyotype analysis and chromosomal microarray analysis (CMA) to investigate the genetic aberrations associated with PS in human fetuses.

Methods

A retrospective analysis was performed on 84 fetuses with congenital PS in southern China. Fetal amniotic fluid and umbilical cord blood samples were obtained for chromosomal karyotype analysis and CMA.

Results

The rate of pathogenic copy number variation (CNV) was 15.5% (13/84) after karyotyping and CMA. An abnormal karyotype was detected in five cases (6.0%, 5/84) via karyotyping, whereas pathogenic CNVs were detected in 13 cases (15.5%, 13/84) via CMA. In addition to the five abnormal karyotypes detected using karyotype analysis, eight additional chromosomal microduplications and microdeletions were detected using CMA, comprising three cases of 22q11.21 microdeletion; two cases of 16p11.2 microdeletion; one case of simultaneous 18q23 microdeletion and 22q13.33 microduplication; one case of 15q24.1q24.2 microdeletion; and one case of 1q21.1q21.2 microduplication. The rate of pathogenic CNV occurrence was 11.5% in fetuses with isolated PS and 17.2% in fetuses with PS combined with other ultrasound abnormalities. This difference between the two experimental groups was statistically significant. Among 84 fetuses with PS, 39 pregnancies were terminated, and five were lost to follow-up.

Conclusions

CMA was not only conducive to detect PS-related pathogenic genomic abnormalities but also to accurately evaluate fetal prognosis in genetic counseling. The early detection of PS and genomic abnormalities will exerta positive impact on fetal intervention and the related prognosis of PS in perinatal infants.
Evidence for a lack of inotropic and chronotropic effects of glucagon and glucagon receptors in the human heart
Authors: Aranda-Domene Ramón , Orenes-Piñero Esteban , Arribas-Leal José María , Canovas-Lopez Sergio , Hernández-Cascales Jesús
Published: May 2023

Background

Glucagon is thought to increase heart rate and contractility by stimulating glucagon receptors and increasing 3′,5′-cyclic adenosine monophosphate (cAMP) production in the myocardium. This has been confirmed in animal studies but not in the human heart. The cardiostimulatory effects of glucagon have been correlated with the degree of cardiac dysfunction, as well as with the enzymatic activity of phosphodiesterase (PDE), which hydrolyses cAMP. In this study, the presence of glucagon receptors in the human heart and the inotropic and chronotropic effects of glucagon in samples of failing and nonfailing (NF) human hearts were investigated.

Methods

Concentration‒response curves for glucagon in the absence and presence of the PDE inhibitor IBMX were performed on samples obtained from the right (RA) and left atria (LA), the right (RV) and left ventricles (LV), and the sinoatrial nodes (SNs) of failing and NF human hearts. The expression of glucagon receptors was also investigated. Furthermore, the inotropic and chronotropic effects of glucagon were examined in rat hearts.

Results

In tissues obtained from failing and NF human hearts, glucagon did not exert inotropic or chronotropic effects in the absence or presence of IBMX. IBMX (30 µM) induced a marked increase in contractility in NF hearts (RA: 83 ± 28% (n = 5), LA: 80 ± 20% (n = 5), RV: 75 ± 12% (n = 5), and LV: 40 ± 8% (n = 5), weaker inotropic responses in the ventricular myocardium of failing hearts (RV: 25 ± 10% (n = 5) and LV: 10 ± 5% (n = 5) and no inotropic responses in the atrial myocardium of failing hearts. IBMX (30 µM) increased the SN rate in failing and NF human hearts (27.4 ± 3.0 beats min−1, n = 10). In rat hearts, glucagon induced contractile and chronotropic responses, but only contractility was enhanced by 30 µM IBMX (maximal inotropic effect of glucagon 40 ± 8% vs. 75 ± 10%, in the absence or presence of IBMX, n = 5, P < 0.05; maximal chronotropic response 77.7 ± 6.4 beats min−1 vs. 73 ± 11 beats min−1, in the absence or presence of IBMX, n = 5, P > 0.05). Glucagon receptors were not detected in the human heart samples.

Conclusions

Our results conflict with the view that glucagon induces inotropic and chronotropic effects and that glucagon receptors are expressed in the human heart.
Cost of image-guided percutaneous nephrostomy among cervical cancer patients at Muhimbili National Hospital in Tanzania
Authors: Mori Amani Thomas , Nyabakari Cecilia J.
Published: May 2023

Background

Most cervical cancer patients in developing countries seek care in health facilities with an advanced disease, often characterized by obstructive uropathy. This study aims to estimate the cost of an image-guided percutaneous nephrostomy (PCN), which was recently introduced at Muhimbili National Hospital to manage obstructive uropathy.

Methods

This was a cross-sectional study that was conducted between February and June 2021, from the provider’s perspective. The study involved forty-eight (n = 48) cervical cancer patients with obstructive uropathy. A micro-costing approach was used to identify, quantify and value both capital and recurrent cost items consumed by the patients. Cost data were collected in Tanzanian shillings and converted to USD with the relevant exchange rate. Analysis was performed in Microsoft Excel (Microsoft Excel®, Microsoft Corporation).

Results

The unit cost of image-guided PCN at Muhimbili National Hospital was estimated at 380.4 USD. The main cost drivers were the single-use Nephrostomy catheters, Amplatz guide wire, and Micro-puncture set. The estimated unit cost is higher than the reimbursement price of 237.4 USD charged by the National Health Insurance Fund, and the 259.4 USD and 172.9 USD charged by the hospital for private and public patients, respectively.

Conclusion

Image-guided PCN for cervical cancer patients costs three times the minimum monthly government wage. The study underscores the importance of conducting costing studies to inform pricing and reimbursement decisions in Tanzania.
Cellular crosstalk in atherosclerotic plaque microenvironment
Authors: Mahdinia Elmira , Shokri Nafiseh , Taheri Abdolkarim Talebi , Asgharzadeh Sahar , Elahimanesh Mohammad , Najafi Mohammad
Published: May 2023

Atherosclerosis is an underlying pathology of many vascular diseases as a result of cellular, structural and molecular dysfunctions within the sub-endothelial space. This review deals with the events involved in the formation, growth and remodeling of plaque, including the cell recruitment, cell polarization, and cell fat droplets. It also describes cross talking between endothelial cells, macrophages, and vascular smooth muscle cells, as well as the cellular pathways involved in plaque development in the plaque microenvironment. Finally, it describes the plaque structural components and the role of factors involved in the rupture and erosion of plaques in the vessel.
Analysis of the microglia transcriptome across the human lifespan using single cell RNA sequencing
Authors: Yaqubi Moein , Groh Adam M. R. , Dorion Marie-France , Afanasiev Elia , Luo Julia Xiao Xuan , Hashemi Hadi , Sinha Sarthak , Kieran Nicholas W. , Blain Manon , Cui Qiao-Ling , Biernaskie Jeff , Srour Myriam , Dudley Roy , Hall Jeffery A. , Sonnen Joshua A. , Arbour Nathalie , Prat Alexandre , Stratton Jo Anne , Antel Jack , Healy Luke M.
Published: May 2023

Background

Microglia are tissue resident macrophages with a wide range of critically important functions in central nervous system development and homeostasis.

Method

In this study, we aimed to characterize the transcriptional landscape of ex vivo human microglia across different developmental ages using cells derived from pre-natal, pediatric, adolescent, and adult brain samples. We further confirmed our transcriptional observations using ELISA and RNAscope.

Results

We showed that pre-natal microglia have a distinct transcriptional and regulatory signature relative to their post-natal counterparts that includes an upregulation of phagocytic pathways. We confirmed upregulation of CD36, a positive regulator of phagocytosis, in pre-natal samples compared to adult samples in situ. Moreover, we showed adult microglia have more pro-inflammatory signature compared to microglia from other developmental ages. We indicated that adult microglia are more immune responsive by secreting increased levels of pro-inflammatory cytokines in response to LPS treatment compared to the pre-natal microglia. We further validated in situ up-regulation of IL18 and CXCR4 in human adult brain section compared to the pre-natal brain section. Finally, trajectory analysis indicated that the transcriptional signatures adopted by microglia throughout development are in response to a changing brain microenvironment and do not reflect predetermined developmental states.

Conclusion

In all, this study provides unique insight into the development of human microglia and a useful reference for understanding microglial contribution to developmental and age-related human disease.
miRNA 548a-3p as biomarker of NEDA-3 at 2 years in multiple sclerosis patients treated with fingolimod
Authors: Gonzalez-Martinez Alicia , Patel Rohit , Healy Brian C. , Lokhande Hrishikesh , Paul Anu , Saxena Shrishti , Polgar-Turcsanyi Mariann , Weiner Howard L. , Chitnis Tanuja
Published: May 2023

Background

Multiple sclerosis (MS) is a disabling autoimmune demyelinating disorder affecting young people and causing significant disability. In the last decade, different microRNA (miRNA) expression patterns have been associated to several treatment response therapies such as interferon and glatiramer acetate. Nowadays, there is increasing interest in the potential role of miRNA as treatment response biomarkers to the most recent oral and intravenous treatments. In this study, we aimed to evaluate serum miRNAs as biomarkers of No Evidence of Disease Activity (NEDA-3) at 2 years in patients with relapsing remitting MS (RRMS) treated with fingolimod.

Main body

A Discovery cohort of 31 RRMS patients treated with fingolimod were identified from the CLIMB study and classified as No Evidence of Disease Activity (NEDA-3) or Evidence of Disease Activity (EDA-3) after 2 years on treatment. Levels of miRNA expression were measured at 6 months using human serum miRNA panels and compared in EDA-3 and NEDA-3 groups using the Wilcoxon rank sum test. A set of differentially expressed miRNA was further validated in an independent cohort of 22 fingolimod-treated patients. We found that 548a-3p serum levels were higher levels in fingolimod-treated patients classified as NEDA-3, compared to the EDA-3 group in both the Discovery (n = 31; p = 0.04) and Validation (n = 22; p = 0.03) cohorts 6 months after treatment initiation; miR-548a-3p provided an AUC of 0.882 discriminating patients with NEDA-3 at 2 years in the Validation cohort.

Conclusion

Our results show differences in miR-548a-3p expression at 6 months after fingolimod start in patients with MS with NEDA-3 at 2 years. These results provide class III evidence of the use of miR-548a-3p as biomarker of NEDA-3 in patients with fingolimod.
Exosomal miR-214-3p from senescent osteoblasts accelerates endothelial cell senescence
Authors: Guo Zhen , Li Jing , Tan Jiyong , Sun Sainan , Yan Qing , Qin Hao
Published: May 2023

Background

Osteoporosis is a common systemic bone disease that leads to bone fragility and increases the risk of fracture. However, the pathogenesis of osteoporosis is considered to be highly complex. The exosomes can regulate the communication between cells. The specific mechanism of information transmission between osteoblasts and endothelial cells is worthy of further study.

Methods

Exosomes were isolated and verified from senescent osteoblasts. The source and properties of exosomes were determined by TEM, particle size analysis and western blot. We established the co-culture model of endothelial cells and senescent osteoblasts. We used qRT-PCR to identify differentially expressed miRNAs. The functional changes of vascular endothelial cells were verified by cell transfection. β-Galactosidase cell senescence assay, Hoechst cell apoptosis assay, Ki67 cell proliferation assay and Transwell migration assay were used to verify cell senescence, apoptosis, proliferation, and migration. The potential target gene of miRNA was detected by bio-informatics pathway and double luciferase report.

Results

We discovered that senescent osteoblasts could promote the senescence and apoptosis of vascular endothelial cells and inhibit their proliferation and migration. miR-214-3p was upregulated in senescent osteoblast-derived exosomes. miR-214-3p could effectively promote senescence and apoptosis of endothelial cells and inhibit proliferation and migration ability. L1CAM is a miR-214-3p direct target gene determined by bio-informatics and double luciferase report.

Conclusions

In conclusion, senescent osteoblast-derived exosomes can accelerate endothelial cell senescence through miR-214-3p/L1CAM pathway. Our experiments reveal the role of exosomes in the skeletal microenvironment.
Perilous medicine in Tigray: a systematic review
Authors: Gesesew Hailay , Kebede Hafte , Berhe Kenfe , Fauk Nelsensius , Ward Paul
Published: May 2023

Background

The war in Tigray, North Ethiopia which started in November 2020, has destroyed decades of the region’s healthcare success. There is some emerging published evidence on attacks on health care in the region, and we synthesized the available evidence on ‘perilous medicine’ in Tigray to understand the data source, subjects and content covered, and what gaps exist.

Methods

We employed a systematic review and performed a systematic search of MEDLINE, PubMed, CINHAL, Web of Science and Scopus. We included English written documents published from 4 November 2020 to 18–19 October 2022 and updated the search on 23 January 2023. HG and NF independently performed title, abstract and full-text screening. We used Joanna Briggs Institute (JBI) tools to appraise and extract data, and applied content synthesis to analyze. The PROSPERO registration number is CRD42022364964.

Results

Our systematic review search yielded 8,039 documents, and we finally found 41 documents on conflict and health in Tigray. The areas were: (1) attacks on infrastructure, health or aid workers, patients, ambulances or aid trucks identified in 29 documents—the documents reported targeted attacks on health infrastructure and personnel; (2) interruption of health or social services in 31 documents—the documents reported medical and humanitarian siege; (3) outcomes and direct or indirect impacts in 33 documents—the documents reported increased magnitude of illnesses, and catastrophic humanitarian crises including the use of food, medicine and rape as tools of war; and (4) responses, rebuilding strategies, and recommendations in 21 documents—the documents reported improvisation of services, and calling to seize fire, accountability and allow humanitarian.

Conclusions

Despite promising studies on conflict and health in Tigray, the documents lack quality of designs and data sources, and depth and diversity of subjects and contents covered; calling further primary studies on a prioritized future research agenda.
Inferring cell-type-specific causal gene regulatory networks during human neurogenesis
Authors: Aygün Nil , Liang Dan , Crouse Wesley L. , Keele Gregory R. , Love Michael I. , Stein Jason L.
Published: May 2023

Background

Genetic variation influences both chromatin accessibility, assessed in chromatin accessibility quantitative trait loci (caQTL) studies, and gene expression, assessed in expression QTL (eQTL) studies. Genetic variants can impact either nearby genes (cis-eQTLs) or distal genes (trans-eQTLs). Colocalization between caQTL and eQTL, or cis- and trans-eQTLs suggests that they share causal variants. However, pairwise colocalization between these molecular QTLs does not guarantee a causal relationship. Mediation analysis can be applied to assess the evidence supporting causality versus independence between molecular QTLs. Given that the function of QTLs can be cell-type-specific, we performed mediation analyses to find epigenetic and distal regulatory causal pathways for genes within two major cell types of the developing human cortex, progenitors and neurons.

Results

We find that the expression of 168 and 38 genes is mediated by chromatin accessibility in progenitors and neurons, respectively. We also find that the expression of 11 and 12 downstream genes is mediated by upstream genes in progenitors and neurons. Moreover, we discover that a genetic locus associated with inter-individual differences in brain structure shows evidence for mediation of SLC26A7 through chromatin accessibility, identifying molecular mechanisms of a common variant association to a brain trait.

Conclusions

In this study, we identify cell-type-specific causal gene regulatory networks whereby the impacts of variants on gene expression were mediated by chromatin accessibility or distal gene expression. Identification of these causal paths will enable identifying and prioritizing actionable regulatory targets perturbing these key processes during neurodevelopment.
Genomic and epigenomic determinants of heat stress-induced transcriptional memory in Arabidopsis
Authors: Kappel Christian , Friedrich Thomas , Oberkofler Vicky , Jiang Li , Crawford Tim , Lenhard Michael , Bäurle Isabel
Published: May 2023

Background

Transcriptional regulation is a key aspect of environmental stress responses. Heat stress induces transcriptional memory, i.e., sustained induction or enhanced re-induction of transcription, that allows plants to respond more efficiently to a recurrent HS. In light of more frequent temperature extremes due to climate change, improving heat tolerance in crop plants is an important breeding goal. However, not all heat stress-inducible genes show transcriptional memory, and it is unclear what distinguishes memory from non-memory genes. To address this issue and understand the genome and epigenome architecture of transcriptional memory after heat stress, we identify the global target genes of two key memory heat shock transcription factors, HSFA2 and HSFA3, using time course ChIP-seq.

Results

HSFA2 and HSFA3 show near identical binding patterns. In vitro and in vivo binding strength is highly correlated, indicating the importance of DNA sequence elements. In particular, genes with transcriptional memory are strongly enriched for a tripartite heat shock element, and are hallmarked by several features: low expression levels in the absence of heat stress, accessible chromatin environment, and heat stress-induced enrichment of H3K4 trimethylation. These results are confirmed by an orthogonal transcriptomic data set using both de novo clustering and an established definition of memory genes.

Conclusions

Our findings provide an integrated view of HSF-dependent transcriptional memory and shed light on its sequence and chromatin determinants, enabling the prediction and engineering of genes with transcriptional memory behavior.
Simultaneous acromioclavicular dislocation, proximal humeral fracture, and reverse Hill–Sachs lesion: a case report
Authors: Barati Hasan , Afzal Sina
Published: May 2023

Background

In cases with injuries to the shoulder region, the combination of acromioclavicular joint dislocation, reverse Hill–Sachs lesion, and proximal humeral fracture is a very rare condition.

Case presentation

This study described a 38-year-old male Persian patient with simultaneous acromioclavicular joint dislocation, proximal humeral fracture, and reverse Hill–Sachs lesion due to motor vehicle crash injury who underwent arthroscopic acromioclavicular joint fixation using tight rope technique. In the 7-month follow-up period following the surgical fixation, range of motion was approximately normal. Reduction and hardware were intact, no dislocation or apprehension to dislocation was observed. Patient only had minor shoulder pain at the end of range of motion and a dull pain on the site of incision over the clavicle in deep touch. Our findings showed acceptable arthroscopic outcomes in the management of such complex case.

Conclusion

Our experience on this case showed acceptable outcomes of the arthroscopic treatment of the acromioclavicular joint dislocation in the management of such a complex case with associated injuries to the shoulder region.
Unsupervised deep learning techniques for automatic detection of plant diseases: reducing the need of manual labelling of plant images
Authors: Benfenati Alessandro , Causin Paola , Oberti Roberto , Stefanello Giovanni
Published: May 2023

Crop protection from diseases through applications of plant protection products is crucial to secure worldwide food production. Nevertheless, sustainable management of plant diseases is an open challenge with a major role in the economic and environmental impact of agricultural activities. A primary contribution is expected to come from precision crop protection approaches, with treatments tailored to spatial and time-specific needs of the crop, in contrast to the current practice of applying treatments uniformly to fields. In view of this, image-based automatic detection of early disease symptoms is considered a key enabling technology for high throughput scouting of the crop, in order to timely target the treatments on emerging infection spots. Thanks to the unprecedented performance in image-recognition problems, Deep Learning (DL) methods based on Convolutional Neural Networks (CNNs) have recently entered the domain of plant disease detection. This work develops two DL approaches for automatic recognition of powdery mildew disease on cucumber leaves, with a specific focus on exploring unsupervised techniques to overcome the need of large training set of manually labelled images. To this aim, autoencoder networks were implemented for unsupervised detection of disease symptoms through: i) clusterization of features in a compressed space; ii) anomaly detection. The two proposed approaches were applied to multispectral images acquired during in-vivo experiments, and the obtained results were assessed by quantitative indices. The clusterization approach showed only partially capability to provide accurate disease detection, even if it gathered some relevant information. Anomaly detection showed instead to possess a significant potential of discrimination which could be further exploited as a prior step to train more powerful supervised architectures with a very limited number of labelled samples.
Integration and adoption of climate resilient management practices for enhanced productivity of sheep and goats in pastoral communities of Northern Kenya
Authors: Ojango Julie M. K. , Gitau Jennifer , Ndiwa Nicholas , Recha John W. , Gachora Judy , Muigai Anne W. T.
Published: May 2023

Interventions to improve productivity in pastoral livestock systems of northern Kenya focus on the management of the rangeland resources and grazing areas with few initiatives on changes related to the livestock assets. However, changing climatic conditions with high frequencies of droughts have increased the vulnerability of pastoral communities and necessitate prompt interventions in animal management practices. In 2018, the Ministry of Agriculture, Livestock, Fisheries and Irrigation in collaboration with the International Livestock Research Institute commenced a programme to build the resilience of pastoral holdings using their animal assets rather than depending on humanitarian emergency responses. Interventions necessitated changes in management practices related to sheep and goat production. Core innovation groups (CIG) each comprising 30 pastoral households in select communities were established to model new practices for wider adoption using participatory processes in Isiolo, Marsabit and Turkana Counties. CIG members went through a 3-year phased training programme on animal management practices for more efficient, resilient and productive animals. The adoption of new practices in CIG flocks was monitored by extension personnel. Data were analysed using logistic regression techniques to assess household-level adoption of livestock breed improvement, feeding and disease control interventions. The 3 years of the programme (2018–2021) were relatively satisfactory in terms of pasture availability; hence, communities pursued strategies to enhance their flocks. All CIG adopted more than one of the introduced technologies concurrently. Prevention of diseases was the most readily adopted, followed by crossbreeding using indigenous breeds of sheep and goats from other arid areas of Kenya. Turkana County had the lowest probability of adopting any of the technologies as previous devastating droughts have resulted in an increased emphasis on animals for survival rather than productivity. The study shows that pastoral communities are open to technological interventions for animal productivity. Adoption of the technologies was enhanced by the experiential capacity development activities adapted to the education level of the different communities.
Separate and joint associations of chronic pain, multisite pain and mental health with sickness absence among younger employees: a register based longitudinal study
Authors: Fagerlund Pi , Shiri Rahman , Suur-Uski Johanna , Kaartinen Sara , Rahkonen Ossi , Lallukka Tea
Published: May 2023

Background

Pain conditions and poorer mental health are associated with work disability. However, few studies have examined the association of concurrent pain and poorer mental health with sickness absence among younger employees. We examined separate and joint associations of chronic pain, multisite pain, and mental health with total and long-term all-cause sickness absence days among younger Finnish municipal employees.

Methods

The Young Helsinki Health-study data were collected in 2017 from 19–39-year-old employees of the City of Helsinki, Finland. Chronic (≥ 3 months) and multisite (≥ 2 body sites) pain and mental health (RAND-36 emotional wellbeing subscale dichotomized by median score) were self-reported (n = 3911). Chronic pain, multisite pain and mental health were analyzed separately and combined. Register data on total (≥ 1 workdays) and long-term (≥ 11 workdays) sickness absence days during the following year were obtained. Negative binomial regression analyses were performed with sociodemographic, socioeconomic, and health-related factors as confounders. Gender interaction and synergistic indices were examined.

Results

Chronic multisite pain was associated with long-term sickness absence days (rate ratio [RR] 2.51, 95% CI 1.17–5.42). Chronic pain (RR 5.04, 95% CI 2.14–11.87) and multisite pain (RR 4.88, 95% CI 2.30–10.33) were associated with long-term sickness absence days among employees with poorer mental health. There was a synergistic interaction between gender and multisite pain for total sickness absence days (synergy index 1.80, 95% CI 1.27–2.54), with stronger associations among women.

Conclusions

Chronic and multisite pain are associated with long-term sickness absence among younger employees, particularly among women and employees with concurrent poorer mental health. Consideration of this knowledge at workplaces and in healthcare could help to identify and support employees at increased risk of later sickness absence.
Enablers and inhibitors of digital startup evolution: a multi-case study of Swedish business incubators
Authors: Page Andrew , Holmström Jonny
Published: May 2023

Global advances in digital technology are facilitating corresponding rises in digital entrepreneurship and its startup manifestation. There are many uncertainties on the road to digital startup evolution, some of which may be successfully navigated with the assistance of business incubators. While these organisations provide valuable guidance and support to the startup community, their efforts are at least partly constrained by the lack of a consistent, coherent roadmap to guide both them and their incubatees. T0 help efforts to develop such a map, this paper seeks to identify factors that influence digital startup evolution within an incubator setting through a multiple-case study focusing on digital startups under the umbrella of three business incubators in the Swedish city Umeå. Sets of enabling and inhibitory factors are identified through literature searches and the case studies. The latter may include inertia and possibly attitudes towards failure. In addition, present the Ideation Dynamics Model as a guide for both incubators and digital startups is proposed.
APSIC guide for prevention of catheter associated urinary tract infections (CAUTIs)
Authors: Ling Moi Lin , Ching P. , Apisarnthanarak A. , Jaggi N. , Harrington G. , Fong S. M.
Published: May 2023

Background

The Asia Pacific Society of Infection Control launched the APSIC guide for prevention of catheter associated urinary tract infections in July 2022. It aims to highlight practical recommendations in a concise format designed to assist healthcare facilities in the Asia Pacific region to achieve high standards in infection prevention and control practices during the management and care of patients with a urinary catheter.

Methods

The guidelines were developed by an appointed workgroup comprising experts in the Asia Pacific region, following reviews of previously published guidelines and recommendations relevant to each section.

Results

It recommends that healthcare institutions have a catheter associated urinary tract infection prevention program that includes surveillance and the use of the insertion and maintenance bundles. Implementation of the bundles is best done using a quality improvement approach with a multidisciplinary team.

Conclusions

Healthcare facilities should aim for excellence in care of patients with urinary catheters. It is recommended that healthcare facilities have a catheter associated urinary tract infection prevention program as part of their Infection Prevention and Control program.
Utility of indium-111 platelet scintigraphy for understanding the mechanism of thrombocytopenia associated with myelodysplastic syndromes and chronic myelomonocytic leukemia
Authors: Durand Pauline , Pottier Valérie , Mesguich Charles , Debordeaux Frédéric , Lazaro Estibaliz , Viallard Jean-François , Rivière Etienne
Published: May 2023

Background

Thrombocytopenia occurs in 60% of patients with myelodysplastic syndromes (MDS), increasing the risk of life-threatening haemorrhage in this population of mainly old patients with comorbidities. However, data are scare regarding immune thrombocytopenia (ITP) secondary to MDS.

Aim

We analyzed the utility of indium-111 platelet scintigraphy (IPS) to better characterize the mechanisms of thrombocytopenia in 21 adult patients with MDS.

Methods

Adult patients with a definite diagnosis of MDS according to the international criteria who underwent IPS between 2009 and 2018 because of an increased bleeding risk were retrospectively selected. Autologous 111Indium platelet labelling was performed with a technique similar to that described previously using a standardized method.

Results

Platelet lifespan ≤ 6 days identified patients with peripheral platelet destruction. Taking into account the response to ITP-directed therapies after IPS, the sensitivity, specificity, and positive and negative predictive values of IPS were 100%, 84.6%, 80%, and 100%, respectively.

Conclusion

We show that IPS can be a useful tool to identify the mechanism and guide treatment of a chronic thrombocytopenia increasing the bleeding risk in patients with MDS.