bluuebunny/crossref_metadata_2025 huggingface dataset:
A Multi-Site Evaluation of A National Employee Wellness Initiative at the Department of Veterans Affairs
Authors: Shah Freny , Sells Joanna R. , Werthman Jennifer , Abraham Corrine , Ali Asma M. , Callaway-Lane Carol
Published: March 2022

Background

The Department of Veterans Affairs (VA) seeks to transform its health care delivery from disease-centered, episodic care to a holistic and patient-centered model known as the Whole Health System (WHS) of care. Employee engagement and buy-in are crucial to this cultural transformation. The VA aspires to provide employees with opportunities to experience whole health in their personal and professional lives through a national Employee Whole Health (EWH) program. Although there are national recommendations, different local facilities may have unique strategies and challenges as they implement this program.

Objective

This study aimed to conduct a program evaluation of EWH at three different VA facilities across the United States in order to identify facilitators and barriers to the implementation of EWH.

Methods

The team used the RE-AIM framework to develop an interview guide to assess various domains of implementation. Quantitative data on whole health offerings at each site were gauged using a national employee education platform. Standardized employee-related metrics at each site were assessed using the annual, national VA employee survey.

Results

EWH has had variable implementation at the three sites. Sites noted main facilitators as employee interest as well as available skills and expertise for delivering complementary and integrative care to employees. Limited staffing for EWH and a lack of dedicated employee time were cited as barriers. The infrastructure to perform local program evaluations to demonstrate effectiveness and impact were missing.

Conclusion

Employee engagement in whole health activities has the potential to support the VA’s mission to transform its health care delivery model. Currently, the use of EWH and its potential impact are difficult to discern based on available information. Local sites need guidance to conduct program evaluations and find creative solutions to enhance employee participation. A robust measurement system to demonstrate effectiveness is paramount to ensure the success of this initiative.
Cemented Lateral Unicompartmental Knee Replacement: A retrospective single centre independent series
Authors: Hefny Mamdouh H. , Smith Nick A. , Waite Jon
Published: March 2022

Background

Unicompartmental knee replacement (UKR) has functional and economic benefits when compared with total knee replacement, however it is technically demanding and may be associated with higher failure rates. The primary aim of this independent series study was to evaluate the survival of lateral UKRs implanted in our institution and their clinical outcomes. The secondary outcome was to compare the results of mobile and fixed-bearing prostheses.

Methods

This is a retrospective series study of 183 cemented lateral UKRs implanted in 170 patients, for advanced isolated lateral compartment arthritis, under the care of two senior surgeons. Fixed or mobile-bearing prostheses were used according to the surgeon's preference. Kaplan Meier analysis was used to evaluate prosthesis survival with the endpoint being revision for any reason. A subgroup analysis of survival was also done for each bearing type. Functional outcomes were evaluated using the Oxford knee score (OKS) at final follow-up.

Results

This series included 103 Fixed-bearing and 80 mobile-bearing prostheses. Median follow-up was 6.9 years. 9 knees required revision. The commonest reason for revision was progression of arthritis to the medial compartment. Dislocation was the commonest cause of revision in the mobile-bearing group. Survival at 10 years was 91.9% with no significant difference ( p = 0.083) between bearing types (fixed-bearing 93.8% and mobile-bearing 90.6%). The OKS were comparable in both groups, the mean OKS was 44/48.

Conclusion

Good survival and functional outcomes can be achieved using cemented lateral UKRs with both bearing types. There was a trend towards superior outcomes in the fixed-bearing group.
A Meaningful Boost: Effects of Teachers’ Sense of Meaning at Work on Their Engagement, Burnout, and Stress
Authors: Lavy Shiri
Published: March 2022

The two studies presented here examine the effects of teachers’ enhanced sense of meaning at work (SOM) on their burnout and engagement. In the first study, 41 teachers in two Arab schools were randomly assigned to a meaning-induction group—in which they were prompted daily to acknowledge meaningful incidents at work for 2 weeks or to a control group. Qualitative analyses focused on teachers’ daily experiences of meaningful incidents, reflecting their contribution to others. In addition, one-way repeated measures analyses of variance indicated that teachers that acknowledged these incidents reported decreased burnout and increased engagement. In Study 2, the sample comprised 60 Arab and Jewish teachers who completed daily surveys for 12 workdays. Hierarchical linear modeling analyses showed that teachers’ daily SOM was associated with increased engagement on the following day and somewhat increased stress. Thus, the studies highlight teachers’ SOM as a resource that contributes to engagement and can be enhanced intentionally.
Squeezing flow analysis of time dependent AA7072 and AA7075 water-based nanofluids through parallel disks with velocity and thermal slip conditions
Authors: Bhatta DP , Mishra SR , Dash JK , Reddy M Gnaneswara
Published: March 2022

Present investigation based on the axisymmetric squeezing flow of various alloy nanofluids between parallel disks embedding with porous medium. To enhance the heat transfer properties we have considered two special type of alloy nanoparticles such as AA7072 which contains 98% of Aluminum (Al), 1% of Zink (Zn), rest Silica (Si), Iron (Fe), Copper (Cu), and AA7075 contains 90% of Al, 5%–6% of Zn, 3% of manganese (Mg), 1%–2% of Cu with additive Si, Fe, and Mn. The effects of velocity slip and temperature jump boundary conditions are also considered. Suitable similarity transformation along with Maxwell model physical properties for nanofluid are use to formulate the dimensionless governing ordinary differential equations. Physical significance of characterizing parameters are presented graphically and discussed. The numerical computations for engineering coefficients are shown in tabular form. In a comparative study, the current result shows a good correlation with the earlier established result that confirms the convergence of the solution methodology. Further, the major outcomes are laid down as: The velocity is more prominent for AA7075-water nanofluid in the first region for applied magnetic field whereas reverse impact is observed in the second region. The fluid temperature retards when there is a rise in thermal slip parameter. The shear rate of AA7072-water based nanofluid is higher than other nanofluid AA7075.
The urban political never sleeps: A framework for tracing emergent counter-responses to depoliticisation
Authors: Saleh Mohamed , Rauws Ward
Published: March 2022

Responding to contemporary mechanisms of depoliticisation, some marginalised groups create political arenas independent from the State. The paper analyses how these groups utilise ‘cracks’ in the political landscape to forge counter-publics which transform unequal power structures. Positing that depoliticisation is always incomplete, an analytical framework is presented for understanding how ‘the political’ emerges and evolves in unexpected spaces of everyday life. The framework serves as a means to overcome some of the limitations of Rancière’s political ontology to operationalise in empirical research through integrating his notions with an understanding of self-organisation based on complexity science. Drawing on empirical research in Egypt, the paper demonstrates how the fusion between public spaces and online networks created a precondition for counter-publics to gradually revitalise local urban politics. The paper concludes with analytical considerations for inclusive city-makers who aim to engage productively with the transformative potential of such emergent counter-publics.
Patient-Specific Implants in Maxillofacial Reconstruction: A Case Report
Authors: Mukul Sailesh Kumar , Mishra Madan , Singh Gaurav , Singh Abhishek , Das Manthan Kumar
Published: March 2022

Background

The surgical repair and reconstruction of defects in the craniomaxillofacial region can be exigent because of complex anatomy, sensitivity of the involved systems, and uniqueness of each defect. The need to reconstruct the defect in the most precise way for the surgical procedure is of crucial importance to surgeons for enhancing patient outcomes and well-being. Autogenous grafts are considered the gold standard for reconstruction but are associated with an unpredictable resorption and donor site morbidity. The introduction of 3-dimensional printing in the biomedical field has led to the utilization of patient-specific implants (PSIs) in the surgical repair of maxillofacial defects, which occur congenitally, posttraumatically, or postsurgically. PSI fit quickly with greater accuracy with the added benefit of shorter rehabilitation time.

Material and Method

A 21-year-old male with a history of left zygomatico–orbital–maxillary complex fracture presented complaining of secondary deformity as a result of facial trauma. He underwent zygomatic osteotomy and repositioning followed by PSI reconstruction of the left zygoma, left orbital floor with titanium implants. A hemicoronal, subcilliary, and maxillary vestibular approaches were used.

Result

Good esthetic results with no postoperative complications are obtained.

Conclusion

The use of PSI for the reconstruction of oral and craniomaxillofacial defects should be considered an accurate alternative to noncustom-made implants. Automation allows for the application of safe, time-effective procedures not requiring specialized, and software-specific knowledge. The major drawback of PSI is its high cost, but many advantages of using PSI outweigh this disadvantage.
CAR T cells as a second-line therapy for large B-cell lymphoma: a paradigm shift?
Authors: Westin Jason , Sehn Laurie H.
Published: March 2022

The standard of care treatment strategy for patients with relapsed or refractory large B-cell lymphoma (LBCL) has been high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) if chemotherapy sensitive in suitable patients. Because of treatment intensity, this approach has only been feasible in half of patients and because of chemotherapy resistance has only been successful in a quarter of transplant-eligible patients. Chimeric antigen receptor (CAR) T-cell therapy, using genetically modified autologous T cells targeting CD19, has been approved for third-line therapy of LBCL and has been associated with durable remissions in a proportion of patients. In this review, we interpret the design and results of 3 randomized phase 3 trials comparing CAR T-cell therapy and ASCT and their implications for CAR T-cell therapy as a potential new standard of care for second-line treatment in appropriate patients with refractory or early relapsing LBCL.
Innovative computational approaches shed light on genetic mechanisms underlying cognitive impairment among children born extremely preterm
Authors: Liu Weifang , Sun Quan , Huang Le , Bhattacharya Arjun , Wang Geoffery W. , Tan Xianming , Kuban Karl C. K. , Joseph Robert M. , O’Shea T. Michael , Fry Rebecca C. , Li Yun , Santos Hudson P.
Published: March 2022

Background

Although survival rates for infants born extremely preterm (gestation < 28 weeks) have improved significantly in recent decades, neurodevelopmental impairment remains a major concern. Children born extremely preterm remain at high risk for cognitive impairment from early childhood to adulthood. However, there is limited evidence on genetic factors associated with cognitive impairment in this population.

Methods

First, we used a latent profile analysis (LPA) approach to characterize neurocognitive function at age 10 for children born extremely preterm. Children were classified into two groups: (1) no or low cognitive impairment, and (2) moderate-to-severe cognitive impairment. Second, we performed TOPMed-based genotype imputation on samples with genotype array data (n = 528). Third, we then conducted a genome-wide association study (GWAS) for LPA-inferred cognitive impairment. Finally, computational analysis was conducted to explore potential mechanisms underlying the variant x LPA association.

Results

We identified two loci reaching genome-wide significance (p value < 5e-8): TEA domain transcription factor 4 (TEAD4 at rs11829294, p value = 2.40e-8) and syntaxin 18 (STX18 at rs79453226, p value = 1.91e-8). Integrative analysis with brain expression quantitative trait loci (eQTL), chromatin conformation, and epigenomic annotations suggests tetraspanin 9 (TSPAN9) and protein arginine methyltransferase 8 (PRMT8) as potential functional genes underlying the GWAS signal at the TEAD4 locus.

Conclusions

We conducted a novel computational analysis by utilizing an LPA-inferred phenotype with genetics data for the first time. This study suggests that rs11829294 and its LD buddies have potential regulatory roles on genes that could impact neurocognitive impairment for extreme preterm born children.
Comparative chromosome maps between the stone curlew and three ciconiiform species (the grey heron, little egret and crested ibis)
Authors: Wang Jinhuan , Su Weiting , Hu Yi , Li Shengbin , O’Brien Patricia C. M. , Ferguson-Smith Malcolm A. , Yang Fengtang , Nie Wenhui
Published: March 2022

Background

Previous cytogenetic studies show that the karyotypes of species in Ciconiiformes vary considerably, from 2n = 52 to 78. Their karyotypes include different numbers of small to minute bi-armed chromosomes that have evolved probably by fusions of two ancestral microchromosomes, besides macrochromosomes and dot-like microchromosomes. However, it is impossible to define the inter-species homologies of such small-sized bi-armed chromosomes based on chromosome morphology and banding characteristics. Although painting probes from the chicken (Gallus gallus, GGA) chromosomes 1–9 and Z have been widely used to investigate avian chromosome homologies, GGA microchromosome probes are rarely used in these studies because most GGA microchromosome probes generated by flow sorting often contain multiple GGA microchromosomes. In contrast, the stone curlew (Burhinus oedicnemus, BOE, Charadriiformes) has an atypical low diploid chromosome number (42) karyotype and only 4 pairs of dot-like microchromosomes; a set of chromosome-specific painting probes that cover all BOE chromosomes has been generated. To get a genome-wide view of evolutionary chromosomal rearrangements in different lineages of Ciconiiformes, we used BOE painting probes instead of GGA painting probes to analyze the karyotypes of three ciconiiform species belonging to two different families: the eastern grey heron (Ardea cinerea, ACI, 2n = 64, Ardeidae), the little egret (Egretta garzetta, EGA, 2n = 64, Ardeidae) and the crested ibis (Nipponia nippon, NNI, 2n = 68, Threskiornithidae).

Results

BOE painting probes display the same hybridization pattern on chromosomes of ACI and EGA, while a different hybridization pattern is observed on chromosomes of NNI. BOE autosome probes detected 21 conserved homologous segments and 5 fusions on the sixteen pairs of recognizable chromosomes of ACI and EGA, while 16 conserved homologous segments and 4 fusions were found on the twelve pairs of recognizable chromosomes of NNI. Only a portion of smaller bi-armed chromosomes in the karyotypes of the ciconiiform species could have evolved from fusions of ancestral microchromosomes. In particular BOE 5, which is the result of a fusion between two segments homologous to GGA 7 and 8 respectively, was retained also as either a single chromosome in ACI (ACI 5) and EGA (EGA 5) or had fused with a part of the BOE 10 equivalent in NNI (NNI 5).

Conclusion

Our painting results indicate that different chromosome rearrangements occur in different ciconiiform lineages. Some of the small-sized bi-armed chromosomes in ACI, EGA and NNI are derived from the fusions of two microchromosomes, indicating that microchromosome fusions play an important role in ciconiiform chromosome evolution. The fusion segment homologous to GGA 7 and 8 is a potential cytogenetic signature that unites Ardeidae and Threskiornithidae.
Comparative genomics of plant pathogenic Diaporthe species and transcriptomics of Diaporthe caulivora during host infection reveal insights into pathogenic strategies of the genus
Authors: Mena Eilyn , Garaycochea Silvia , Stewart Silvina , Montesano Marcos , Ponce De León Inés
Published: March 2022

Background

Diaporthe caulivora is a fungal pathogen causing stem canker in soybean worldwide. The generation of genomic and transcriptomic information of this ascomycete, together with a comparative genomic approach with other pathogens of this genus, will contribute to get insights into the molecular basis of pathogenicity strategies used by D. caulivora and other Diaporthe species.

Results

In the present work, the nuclear genome of D. caulivora isolate (D57) was resolved, and a comprehensive annotation based on gene expression and genomic analysis is provided. Diaporthe caulivora D57 has an estimated size of 57,86 Mb and contains 18,385 predicted protein-coding genes, from which 1501 encode predicted secreted proteins. A large array of D. caulivora genes encoding secreted pathogenicity-related proteins was identified, including carbohydrate-active enzymes (CAZymes), necrosis-inducing proteins, oxidoreductases, proteases and effector candidates. Comparative genomics with other plant pathogenic Diaporthe species revealed a core secretome present in all Diaporthe species as well as Diaporthe-specific and D. caulivora-specific secreted proteins. Transcriptional profiling during early soybean infection stages showed differential expression of 2659 D. caulivora genes. Expression patterns of upregulated genes and gene ontology enrichment analysis revealed that host infection strategies depends on plant cell wall degradation and modification, detoxification of compounds, transporter activities and toxin production. Increased expression of effectors candidates suggests that D. caulivora pathogenicity also rely on plant defense evasion. A high proportion of the upregulated genes correspond to the core secretome and are represented in the pathogen-host interaction (PHI) database, which is consistent with their potential roles in pathogenic strategies of the genus Diaporthe.

Conclusions

Our findings give novel and relevant insights into the molecular traits involved in pathogenicity of D. caulivora towards soybean plants. Some of these traits are in common with other Diaporthe pathogens with different host specificity, while others are species-specific. Our analyses also highlight the importance to have a deeper understanding of pathogenicity functions among Diaporthe pathogens and their interference with plant defense activation.
Transjugular intrahepatic portosystemic shunt for the treatment of portal hypertensive biliopathy with cavernous transformation of the portal vein: a case report
Authors: Zhao Ming , Wang Xiaoze , Liu Bangxi , Luo Xuefeng
Published: March 2022

Background

Portal hypertensive biliopathy (PHB) was caused by anatomical and functional abnormalities in the intrahepatic and extrahepatic bile ducts secondary to portal hypertension. Currently, there is no consensus regarding to the optimal treatment for PHB. Transjugular intrahepatic portosystemic shunt (TIPS) is the treatment choice for the management of symptomatic PHB, however, it could be very difficult in patients with PHB and cavernous transformation of portal vein.

Case presentation

We report a case of PHB, successfully managed with TIPS. A 23-year-old man with liver cirrhosis presented with jaundice. Magnetic resonance cholangiopancreatography (MRCP) showed multiple tortuous hepatopetal collateral vessels compressing the common bile duct (CBD) and leading to the dilated proximal bile duct. He was diagnosed with PHB and treated with TIPS. A guidewire was inserted into the appropriate collateral vessel through transsplenic approach to guide intrahepatic puncture and TIPS was performed successfully. After the operation, portal vein pressure decreased and the symptoms of biliary obstruction were relieved significantly. In addition, the patient showed no jaundice at a follow-up of one year.

Conclusions

For PHB patients presenting for cavernous transformation of the portal vein, which precludes the technical feasibility of TIPS, a combined transjugular/transsplenic approach could be an alternative option.
Submucosal oesophageal squamous cell carcinoma with lymph node metastasis: a case report and literature review
Authors: Jia Yuting , Zhang Quanmao , Li Erfeng , Zhang Zhen , Chen Xing
Published: March 2022

Background

Submucosal oesophageal squamous cell carcinoma is a quite infrequent and special type of oesophageal cancer. Its endoscopic manifestations are similar to those of submucosal oesophageal lesions, so it is easily ignored or misdiagnosed. Thus, the exact and timely diagnosis of oesophageal subepithelial lesions (SELs) is crucial. Endoscopic submucosal dissection (ESD) improves the diagnosis rate of malignant SELs without specific endoscopic presentations.

Case presentation

We report a 63-year-old patient with submucosal lesions of the oesophagus under endoscopy, but CT suggested mediastinal lymphadenectasis. Thus, there was a contradiction between them. After multidisciplinary consultation, endoscopic submucosal dissection (ESD) resection was finally recommended. The lesion was completely resected by endoscopic submucosal dissection. Postoperative pathology reported poorly differentiated squamous cell carcinoma, and subsequent PET-CT examination provided clarity, revealing mediastinal lymph node metastasis.

Conclusions

Not all oesophageal SELs are benign, and a small number of SELs can be malignant. Submucosal oesophageal squamous cell carcinoma is a rare disease that may be characterized by oesophageal subepithelial lesions (SELs). Therefore, the precise and timely diagnosis of SELs is essential. If it is necessary to obtain lesion tissue for a definite diagnosis, ESD with less invasiveness is an excellent choice.
Public assistance program and depressive symptoms of the recipient: a cross-sectional Japan Gerontological Evaluation Study
Authors: Kino Shiho , Nishioka Daisuke , Ueno Keiko , Haseda Maho , Kondo Naoki
Published: March 2022

Background

Mental health conditions among older recipients of public assistance should be considered because it has been reported that public assistance recipients tend to have higher risks of morbidity than non-recipients, and mental health is strongly related to frailty. We aimed to examine whether older recipients of public assistance were more likely to have depressive symptoms compared to non-recipients.

Methods

Data were obtained from the Japan Gerontological Evaluation Study, a 2016 community-based study of older adults. Poisson regression analyses with a robust error variance using fixed effects were conducted to examine the relationship between receiving public assistance and depressive symptoms controlling for sociodemographic factors. Depressive symptoms were assessed by the Geriatric Depression Scale 15.

Results

We found that the older recipients of public assistance were 1.57 times (95% confidence interval [CI]: 1.47, 1.67) more likely to have depressive symptoms compared to non-recipients. We also found that, when additionally adjusting for indicators of social participation, this relationship was slightly attenuated; however, the recipients still had worse mental health issues (Prevalence ratio: 1.33; 95% CI: 1.25, 1.42).

Conclusions

Even after controlling for sociodemographic factors, older recipients of public assistance tended to be more depressed than non-recipients. However, our findings also indicated that social participation could slightly attenuate the negative relationship between receiving public assistance and depressive symptoms. Therefore, the public assistance program needs to consider the inclusion of mental healthcare support in addition to financial support.
Severe Post-COVID-19 dysautonomia: a case report
Authors: Bosco Joan , Titano Ruwanthi
Published: March 2022

Background

The emergence of dysautonomia as a consequence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; or COVID-19) is becoming more prevalent. We have seen evidence in several post-COVID patients and in the literature of varying degrees of autonomic dysfunction. Symptoms, among others, include inappropriate tachycardia, sweating, anxiety, insomnia and blood pressure variability from the effects of excessive catecholamine, as well as cognitive impairment, fatigue, headaches and orthostatic intolerance from decreased brain perfusion.

Case presentation

We present a case of severe dysautonomia in a previously healthy 27-year-old runner. About five weeks after her initial mild COVID-19 infection, the patient began to develop weakness, which progressed into severe post-exertional fatigue, slowed cognition, headaches, blurred vision and generalized body aches. She also endorsed palpitations, especially when getting up from a seated or lying position as well as with mild exertion. She became reliant on her husband for help with her activities of daily living. Exam was significant for orthostasis; laboratory workup unremarkable. Over the following months, the patient’s symptoms have improved slowly with fluid and sodium intake, compression stockings and participating in a graduated exercise program.

Conclusions

Dysautonomia as a consequence of infection with COVID-19 is becoming increasingly discussed, especially as more patients recover from COVID-19. This is a case of a non-hospitalized patient with a mild initial presentation and significant, debilitating dysautonomia symptoms. More research on its pathophysiology, especially in relation to a precedent viral insult, as well as its treatment, is needed.
Fetal heart rate evolution patterns in cerebral palsy associated with umbilical cord complications: a nationwide study
Authors: Hasegawa Junichi , Nakao Masahiro , Ikeda Tomoaki , Toyokawa Satoshi , Jojima Emi , Satoh Shoji , Ichizuka Kiyotake , Tamiya Nanako , Nakai Akihito , Fujimori Keiya , Maeda Tsugio , Takeda Satoru , Suzuki Hideaki , Ueda Shigeru , Iwashita Mitsutoshi , Ikenoue Tsuyomu
Published: March 2022

Background

The aim of the present study was to clarify fetal heart rate (FHR) evolution patterns in infants with cerebral palsy (CP) according to different types of umbilical cord complications.

Methods

This case–control study included children born: with a birth weight   ≥2000 g, at gestational age   ≥33 weeks, with disability due to CP, and between 2009 and 2014. Obstetric characteristics and FHR patterns were compared among patients with CP associated with (126 cases) and without (594 controls) umbilical cord complications.

Results

There were 32 umbilical cord prolapse cases and 94 cases with coexistent antenatal umbilical cord complications. Compared with the control group, the persistent non-reassuring pattern was more frequent in cases with coexistent antenatal umbilical cord complications (p = 0.012). A reassuring FHR pattern was observed on admission, but resulted in prolonged deceleration, especially during the first stage of labor, and was significantly identified in 69% of cases with umbilical cord prolapse and 35% of cases with antenatal cord complications, compared to 17% of control cases (p < 0.001).

Conclusion

Hypercoiled cord and abnormal placental umbilical cord insertion, may be associated with CP due to acute hypoxic-ischemic injury as well as sub-acute or chronic adverse events during pregnancy, while umbilical cord prolapse may be characterized by acute hypoxic-ischemic injury during delivery.
Incidence of anemia and predictors among Human Immunodeficiency Virus-infected children on antiretroviral therapy at public health facilities of Bahir Dar City, Northwest Ethiopia: multicenter retrospective follow up study
Authors: Kerebeh Gashaw , Ayalew Yeneneh , Kefale Demewoz , Chanie Ermias Sisay , Misganaw Natnael Moges , Feleke Dejen Getaneh , Kassaw Amare , Tigabu Agimasie , Bantie Berihun , Tamirat Mahlet , Mengesha Teshale , Azmeraw Molla , Endalamaw Aklilu
Published: March 2022

Background

Anemia is one of the common hematological problems among HIV-infected children. It impairs physical functioning, affects the quality of life, increases HIV progression, and decreases survival of HIV-infected children. In Ethiopia, limited studies were conducted on the incidence and predictors of anemia among HIV-infected children on antiretroviral therapy (ART). Therefore, this study aims to assess the incidence of anemia and predictors among HIV- infected children on ART at public health facilities of Bahir Dar City, Northwest Ethiopia.

Methods

An institution-based retrospective follow-up study was conducted among 403 HIV- infected children who have followed at ART clinics in public health facilities of Bahir Dar City from 2010 to 2020. A simple random sampling technique was employed to select the study units. Data was entered using Epi-data version 4.6 and analyzed using STATA 14.0. Cox proportional hazard model assumption was checked graphically and by scaled Schoenfeld residual test. Bivariable Cox-proportional hazards regression model was employed for each explanatory variable to check the association with the outcome variable. Variables with a p-value of < 0.2 in the bivariable analysis were candidates to the multivariable proportional hazard model. Cox proportional hazards model was used at a 5% level of significance to identify predictors of anemia.

Results

The overall follow up time was 1587 person–years. The overall incidence density of anemia was 6.87 with 95% confidence interval (CI) = (5.60, 8.16) per 100 person-years. The independent predictors show an association were child age from 0.25 to 5 years adjusted hazard ratio (AHR) = (1.83; 95% CI = 1.22, 2.77), World health organization clinical stage III and IV (AHR = 1.80; 95% CI = 1.22, 2.67), being underweight (AHR = 1.5; 95% CI = 1.01, 2.26), having fair/poor adherence to anti-retroviral therapy (AHR = 1.75; 95% CI = 1.08, 2.85) and zidovidine based anti -retroviral therapy regimen (AHR = 1.72; 95% CI = 1.12, 2.64).

Conclusion

The overall incidence rate of anemia was high compared to other country reports. Age, clinical, and ART-related variables provoked the incidence of anemia. Therefore, a need to emphasize the younger age group, prevent and manage opportunistic infections of WHO clinical stage III and IV, and select and monitor appropriate ART regimen types.
The prevalence of long-term rehabilitation following motor-vehicle crashes in Saudi Arabia: a multicenter study
Authors: Alghnam Suliman , Alghamdi Mashael , Alzahrani Sarah , Alzomai Sufyan , Alghannam Abdullah , Albabtain Ibrahim , Alsheikh Khalid , Bajowaiber Miasem , Alghamdi Ali , Alibrahim Fatimah , Aldibasi Omar
Published: March 2022

Introduction

In Saudi Arabia, motor-vehicle crashes (MVC) are the leading cause of disability-adjusted life years (DALYs). There is limited information locally on the magnitude and need for rehabilitation following MVC. This study examined the prevalence of MVC patients requiring long-term rehabilitation and the epidemiology of associated injuries.

Methods

A retrospective study was conducted at four hospitals of the National Guard Hospitals Affairs from January 2016 to March 2019. The study used data from an institutional trauma registry of all MVC admissions. Chi-square tests, bivariate and multivariate analyses were conducted to compare patients requiring long-term and short-term rehabilitation.

Results

The study included 506 patients. The study population was relatively young, with an average age was 32.8 ± 15.5 years, and the majority were males. Over two-thirds (71.3%) of patients required long-term rehabilitation. Half the patients sustained multiple fractures, and 17.0% sustained traumatic brain injuries. Overall, 53.1 and 61.8% of patients required occupational and physiotherapy, respectively. Those admitted to the intensive care unit were four times more likely to need long-term rehabilitation.

Conclusions

We found a significant burden of long-term rehabilitation following MVC. Patients were relatively young, thus posing a significant burden on future healthcare utilization. Policymakers should use these findings to guide primary, secondary, and tertiary prevention to improve health outcomes.
Benefits of early application of pelvic circumferential compression device to reduce bleeding in pelvic fractures
Authors: Rungsinaporn Visit , Akkarawanit Pawin , Kongmalai Pinkawas
Published: March 2022

Background

To study of efficacy of early pelvic circumferential compression device using in patients with suspected pelvic trauma, compared with conventional stepwise approach.

Methods

Traumatic injury and at least one of the following criteria are required for inclusion: loss of consciousness or a Glasgow coma score (GCS) of less than 13; systolic blood pressure less than 90 mmHg; falling from more than 6 m; injury to several important organs; and a positive pelvic compression test. Patients who satisfied the inclusion criteria for the experimental group were given an early application of a commercial pelvic sling beginning in July 2019. The control group consisted of cases who got the device after clinical or radiological confirmation of a pelvic fracture in the previous year. Gender, age, mechanism of injury, GCS, hospital stay, amount of packed red blood cell transfusion, hematocrit in emergency room, and hematocrit 24 h after application of pelvic binder were all assessed and compared.

Results

The study had a total of 30 participants, with 15 in each group. The number of packed red blood cell transfusions in the early pelvic binder group (0.80 ± 1.42) is considerably lower than in the control group (2.4 ± 2.32) (P = 0.008), although the hematocrit change is not statistically different between the groups (2.1 VS 0.7) (P = 0.191). The time it took to install a pelvic binder was considerably shorter in the early pelvic binder group (16.40 ± 5.45) than in the control group (40.40 ± 13.64) (P = 0.001). There were no problems associated to soft tissue and skin necrosis in either group of patients.

Conclusions

The use of the PCCD for 24 h prior to clinical and radiographic confirmation has significantly reduced the rate of packed red blood cell transfusion in any pelvic fracture patient without device-related complications.

Trial registration

The study was entered into the Thai Clinical Trials Registry (TCTR20210809007).
Salivary fluoride concentration following toothbrushing with and without rinsing: a randomised controlled trial
Authors: Albahrani Marwah M. , Alyahya Asma , Qudeimat Muawia A. , Toumba K. Jack
Published: March 2022

Background

Caries prevalence has declined significantly since the introduction of fluoridated toothpaste. There have been several developments regarding specific active fluoride ingredients but not enough evidence to support one over the other. The purpose of this double-blind randomized controlled trial was to compare salivary fluoride concentrations of different fluoride formulations in the form of toothpaste with and without post-brushing water rinsing in adults.

Methods

The study included 120 participants who were randomly assigned to one of 12 groups (10 participants/group). The toothpaste formulas investigated included (1) fluoride-free (0 ppmF); (2) sodium fluoride (1450 ppmF); (3) sodium monofluorophosphate (1450 ppmF); (4) sodium fluoride and monofluorophosphate combined (1450 ppmF); (5) stannous fluoride and sodium fluoride combined (1450 ppmF); and (6) amine fluoride (1400 ppmF). Block randomisation was used to assign each participant to one of the 12 groups. Participants brushed with 1.0 g of one of the six different toothpaste formulations either with or without post-brushing water rinsing. Saliva was collected at six different times (baseline and at 1, 15, 30, 60, and 90 min/s post-brushing). Samples were analysed using a fluoride ion-specific sensitive electrode connected to an ion analyser.

Results

The demographic characteristics of the participants were not significantly different among the groups (P > 0.05). Time, toothpaste formulation, and post-brushing rinsing routines had significant effects on saliva fluoride retention (P < 0.05). Amine fluoride-containing toothpaste was the only formula that showed statistically significantly higher concentrations of salivary fluoride at 90 min in both the rinsing and non-rinsing groups. Sodium monofluorophosphate toothpaste did not result in a significant difference compared to the control group at any time point, in both rinsing and non-rinsing groups.

Conclusions

Based on the results from this study, no rinsing after toothbrushing in adults can be recommended when sodium monofluorophosphate containing toothpaste formula is used. It also concludes that amine fluoride resulted in a significantly higher saliva fluoride concentration at 90 min in both the rinsing and non-rinsing groups compared to other fluoride toothpaste formulations.

Registry: Protocol Registration and Results System (ClinicalTrials.gov).

Clinical trial registration number: NCT02740803 (15/04/2016).
Parent satisfaction with sustained home visiting care for mothers and children: an integrative review
Authors: Kanda Kie , Blythe Stacy , Grace Rebekah , Kemp Lynn
Published: March 2022

Aim

To synthesise and analyse the existing literature regarding parent satisfaction with sustained home visiting care for mothers and children.

Background

Sustained home visiting is a service delivery mechanism of both prevention and intervention, in which people receive structured support services within their home environment over an extended period of months or years. For the purposes of this paper, sustained home visiting refers to in-home nursing support to address health inequities for mothers and young children. Sustained home visiting programs have been found to support improved health, wellbeing, and developmental outcomes for children and families. However, there is limited knowledge with regards to the level of parent satisfaction with care provided at home, and the factors and elements of care parents perceive to be critical to their satisfaction. It is important for healthcare practitioners to understand what practices and process parents consider to be a priority in securing their ongoing engagement.

Design

Integrative review.

Data sources

PubMed/Medline, CINAHL, Embase, and PsycINFO.

Methods

A multi-step approach was used to search and retrieve peer-reviewed studies from the databases. Study selection, data extraction, data synthesis and critical appraisal were undertaken by two independent researchers.

Results

A total of 13 studies met the inclusion criteria, including nine quantitative and four qualitative studies. The review found that parents provided with home visiting interventions had higher levels of satisfaction with care than those who received routine or facility-based care. Service dose was a factor associated with parent satisfaction, however, the direction of impact on parent satisfaction was mixed. Other elements of care parents perceived as important to service satisfaction included the nurse-client relationship, being treated with respect, empowerment, and emotional support.

Conclusion

While it is critically important that home visiting practitioners provide evidence-based care and interventions, it is equally important that services are delivered in the context of positive and empowering relationships. Further research is recommended to understand the care process and mechanisms that enhance parent satisfaction and positive experiences, providing optimal quality of care.
Lack of food intake during shift work alters the heart transcriptome and leads to cardiac tissue fibrosis and inflammation in rats
Authors: Trott Alexandra J. , Greenwell Ben J. , Karhadkar Tejas R. , Guerrero-Vargas Natali N. , Escobar Carolina , Buijs Ruud M. , Menet Jerome S.
Published: March 2022

Background

Many epidemiological studies revealed that shift work is associated with an increased risk of a number of pathologies, including cardiovascular diseases. An experimental model of shift work in rats has additionally been shown to recapitulate aspects of metabolic disorders observed in human shift workers, including increased fat content and impaired glucose tolerance, and used to demonstrate that restricting food consumption outside working hours prevents shift work-associated obesity and metabolic disturbance. However, the way distinct shift work parameters, such as type of work, quantity, and duration, affect cardiovascular function and the underlying mechanisms, remains poorly understood. Here, we used the rat as a model to characterize the effects of shift work in the heart and determine whether they can be modulated by restricting food intake during the normal active phase.

Results

We show that experimental shift work reprograms the heart cycling transcriptome independently of food consumption. While phases of rhythmic gene expression are distributed across the 24-h day in control rats, they are clustered towards discrete times in shift workers. Additionally, preventing food intake during shift work affects the expression level of hundreds of genes in the heart, including genes encoding components of the extracellular matrix and inflammatory markers found in transcriptional signatures associated with pressure overload and cardiac hypertrophy. Consistent with this, the heart of shift worker rats not eating during work hours, but having access to food outside of shift work, exhibits increased collagen 1 deposition and displays increased infiltration by immune cells. While maintaining food access during shift work has less effects on gene expression, genes found in transcriptional signatures of cardiac hypertrophy remain affected, and the heart of shift worker rats exhibits fibrosis without inflammation.

Conclusions

Together, our findings unraveled differential effects of food consumption on remodeled transcriptional profiles of the heart in shift worker rats. They also provide insights into how shift work affects cardiac function and suggest that some interventions aiming at mitigating metabolic disorders in shift workers may have adverse effects on cardiovascular diseases.
Promoting deceased organ and tissue donation registration in family physician waiting rooms (RegisterNow-1): a pragmatic stepped-wedge, cluster randomized controlled registry trial
Authors: Li Alvin Ho-ting , Garg Amit X. , Grimshaw Jeremy M. , Prakash Versha , Dunnett Alexie J. , Dixon Stephanie N. , Taljaard Monica , Mitchell Joanna , Naylor Kyla L. , Faulds Cathy , Bevan Rachel , Getchell Leah , Knoll Greg , Kim S. Joseph , Sontrop Jessica , Tong Allison , Bjerre Lise M. , Hyjek Karyn , Currie Donna , Edwards Susan , Sullivan Mike , Harvey-Rioux Linda , Presseau Justin
Published: March 2022

Background

The shortage of available organs for life-saving transplants persists worldwide. While a majority support donating their organs or tissue when they die, many have not registered their wish to do so. When registered, next of kin are much more likely to follow-through with the decision to donate. In many countries, most people visit their family physician office each year and this setting is a promising, yet underused, site where more people could register for deceased organ donation. Our primary aim was to evaluate the effectiveness of an intervention to promote organ donation registration in family physician’s offices.

Methods

We developed an intervention to address barriers and enablers to organ donation registration that involved physician office reception staff inviting patients to register on a tablet in the waiting room while they waited for their appointment. We conducted a cross-sectional stepped-wedge cluster randomized controlled registry trial to evaluate the intervention. We recruited six family physician offices in Canada. All offices began with usual care and then every two weeks, one office (randomly assigned) started the intervention until all offices delivered the intervention. The primary outcome was registration for deceased organ donation in the provincial organ registration registry, assessed within the 7 days of the physician visit. At the end of the trial, we also conducted interviews with clinic staff to assess any barriers and enablers to delivering the intervention.

Results

The trial involved 24,616 patient visits by 13,562 unique patients: 12,484 visits in the intervention period and 12,132 in the control period. There was no statistically significant difference in the percentage of patients registered for deceased organ donation in the intervention versus control period (48.0% vs 46.2%; absolute difference after accounting for the secular trend: 0.12%; 95% CI: − 2.30, 2.54; p=0.92). Interviews with clinic staff indicated location of the tablet within a waiting room, patient rapport, existing registration, confidence and motivation to deliver the intervention and competing priorities as barriers and enablers to delivery.

Conclusions

Our intervention did not increase donor registration. Nonetheless, family physician offices may still remain a promising setting to develop and evaluate better interventions to increase organ donation registration.

Trial registration

NCT03213171
Human serum from SARS-CoV-2-vaccinated and COVID-19 patients shows reduced binding to the RBD of SARS-CoV-2 Omicron variant
Authors: Schubert Maren , Bertoglio Federico , Steinke Stephan , Heine Philip Alexander , Ynga-Durand Mario Alberto , Maass Henrike , Sammartino Josè Camilla , Cassaniti Irene , Zuo Fanglei , Du Likun , Korn Janin , Milošević Marko , Wenzel Esther Veronika , Krstanović Fran , Polten Saskia , Pribanić-Matešić Marina , Brizić Ilija , Baldanti Fausto , Hammarström Lennart , Dübel Stefan , Šustić Alan , Marcotte Harold , Strengert Monika , Protić Alen , Piralla Antonio , Pan-Hammarström Qiang , Čičin-Šain Luka , Hust Michael
Published: March 2022

Background

The COVID-19 pandemic is caused by the betacoronavirus SARS-CoV-2. In November 2021, the Omicron variant was discovered and immediately classified as a variant of concern (VOC), since it shows substantially more mutations in the spike protein than any previous variant, especially in the receptor-binding domain (RBD). We analyzed the binding of the Omicron RBD to the human angiotensin-converting enzyme-2 receptor (ACE2) and the ability of human sera from COVID-19 patients or vaccinees in comparison to Wuhan, Beta, or Delta RBD variants.

Methods

All RBDs were produced in insect cells. RBD binding to ACE2 was analyzed by ELISA and microscale thermophoresis (MST). Similarly, sera from 27 COVID-19 patients, 81 vaccinated individuals, and 34 booster recipients were titrated by ELISA on RBDs from the original Wuhan strain, Beta, Delta, and Omicron VOCs. In addition, the neutralization efficacy of authentic SARS-CoV-2 wild type (D614G), Delta, and Omicron by sera from 2× or 3× BNT162b2-vaccinated persons was analyzed.

Results

Surprisingly, the Omicron RBD showed a somewhat weaker binding to ACE2 compared to Beta and Delta, arguing that improved ACE2 binding is not a likely driver of Omicron evolution. Serum antibody titers were significantly lower against Omicron RBD compared to the original Wuhan strain. A 2.6× reduction in Omicron RBD binding was observed for serum of 2× BNT162b2-vaccinated persons. Neutralization of Omicron SARS-CoV-2 was completely diminished in our setup.

Conclusion

These results indicate an immune escape focused on neutralizing antibodies. Nevertheless, a boost vaccination increased the level of anti-RBD antibodies against Omicron, and neutralization of authentic Omicron SARS-CoV-2 was at least partially restored. This study adds evidence that current vaccination protocols may be less efficient against the Omicron variant.