bluuebunny/crossref_metadata_2025 huggingface dataset:
Adherence to Antiretroviral Treatment and Associated Factors among Seropositive People Received Treatment in Jimma Town Public Health Facilities, Ethiopia
Authors: Demas Zenash , Gebremariam Abebe , Kebede Alemi , Ayele Lalisa
Published: August 2022

Background: Drug adherence is the most significant in the progression of diseases. Thus, this study aimed to assess adherence and associated factors among seropositive people received treatment. Methods: Facility-based cross-sectional study was conducted in Jimma town public health facility from March to April 2019 on 385 selected participants. Systematic sampling technique was used to select study participants. The data were entered using Epi-data version 4.1 and analyzed by SPSS version 20 software. Variables with p-value of less than 0.25 in binary logistic regression were entered into the multivariable logistic regression to control cofounding A significance level of less than 0.05 was used in the final model to judge statistical significance. Results: The magnitude of adherence to antiretroviral treatment was 69.4%. Food security (AOR = 1.75 (95% CI;(1.01-3.0), substance abuse (AOR = 0.55 (95% CI;(0.32-0.96), Didn’t take other medications (AOR = 2.11(95%CI;(1.15-3.87), Good relationship with providers (AOR = 3.35(95%CI;(1.55-7.2), and irregular appointment (AOR = 0.19(95%CI; (0.11-0.34) were significantly associated. Conclusion: The magnitude of adherence to Anti-retroviral therapy was low compare to WHO. Food security, substance abuse, use of other medication, relationship with the health care providers, and irregular appointment were the factors associated. Treatment. Therefore, it is recommended that patients and health care workers enhance Antiretroviral Treatment adherence.
Lift High the Cross: The Visual Message of Popular Chinese Christianity
Authors: Ireland Daryl R. , Li David
Published: August 2022

What does popular Chinese Christianity look like? Answers are elusive, because the materials that survive tend to be books and buildings—artifacts that tell us more about the elites who produced them than the average believers who used them. The Center for Global Christianity and Mission’s digitization of 700 Chinese Christian propaganda posters at ccposters.com offers a rare glimpse into the Christian ideas and images that circulated on the street. Produced between 1920 and 1950, these posters packaged Christianity for mass consumption, and what they offered China was not Jesus Christ but his cross. Popular Christianity was crucicentric, not Christocentric.
State-led stigmatisation of place and the politics of the exception
Authors: Olsen Sara Høier , Larsen Henrik Gutzon
Published: August 2022

Ghetto area’ has become an official categorisation in Danish housing policy. This article investigates how this stigmatising spatialisation of politics and policy has emerged through evolving storylines for particular housing estates, which gradually have come to structure political debate and become institutionalised in official policy. While political actors can draw on different storylines, it is argued that a range of storylines and associated quantifiable criteria combine to produce a generic ‘ghetto place’ in Danish politics. This scale-framing and objectification have enabled a politics of the exception, making it possible to apply extraordinary measures to particular places. This has significant effects for inhabitants in these places and the cities in which they are located, and it is proposed that, in the longer term, the politics of the exception could also become a battering ram against the collectively owned non-profit housing sector in Denmark.
Decolonizing conservation? Indigenous resurgence and buffalo restoration in the American West
Authors: Schneider Lindsey
Published: August 2022

There has been a recent surge of interest in “decolonizing” conservation and natural resource management fields. Most of this scholarship, however, speaks to colonialism on a global scale and does not address conservation within modern settler colonial states such as the United States and Canada. This project focuses on the reintroduction of buffalo (bison) in the American West as an example of how even conservation efforts that purport to include, value, and share Indigenous perspectives can ultimately uphold settler colonial relations of power. Using an Indigenous mixed-methodology approach, it interrogates the discursive construction of buffalo as “America's great conservation success story” and highlights the ways in which conservation has historically worked to support colonial projects of Indigenous erasure and dispossession. Some contemporary buffalo restoration projects seek to include Indigenous people as stakeholders and/or collaborators with unique cultural interests in buffalo, but these efforts do not always embody the material shift in power relations that Indigenous scholars have identified as a key component of decolonization. For Indigenous people, buffalo are more than a keystone species with cultural import; they are relatives whose well-being is deeply entwined with our own. For landscape-scale buffalo restoration projects to engage in decolonization, they must seek to not only repair the harm done to tribal nations through buffalo eradication but also work to support Indigenous resurgence by transforming structures of power.
Creating Meaningful Alerts and Reducing Alert Fatigue: Strategies Implemented by Informatics Pharmacists to Optimize Dose Range Checking Alerts in a Multihospital Health System
Authors: Choukroun Jonathan F. , Lee Kristina , Rey Aixa
Published: August 2022

Background: Among the many clinical decision support (CDS) mechanisms available in electronic health record (EHR) systems, dose range checking (DRC) is one of the most impactful safeguard tools integrated within most computerized provider order entry (CPOE) workflows. Unfortunately, improper configurations and lack of resources to maintain and monitor CDS systems can hinder and even disrupt daily clinical operations. Objective: This article seeks to highlight the impact that informatics pharmacists can make by implementing different strategies to decrease nuisance alerts and create clinically meaningful DRC alerts that guide clinicians in their practice. Methods: Following the activation of the DRC application for 3623 medication groupers (ie, generic drugs and all their dosage form variations), informatics pharmacists implemented strategies to monitor DRC alert output and decrease the number of inappropriate alerts. Such strategies included weekly monitoring of alerts, modification of order sentences (including dose, route, and age/weight filters), update to the rule triggering the alerts, and modifications of the preference settings. Results: From July to September 2018, an average of 70 DRC tables were reviewed by informatics pharmacists, reducing the number of overridden DRC alerts to 4796 in the first week of September—a 63% decrease in a 3-month period. Conclusions: By reducing the number of DRC nuisance alerts and improving the clinical content of DRC alerts, informatics pharmacists can contribute to lowering alert fatigue and improving providers’ trust in CDS alerts.
New arsenate minerals from the Arsenatnaya fumarole, Tolbachik volcano, Kamchatka, Russia. XVIII. Khrenovite, Na3Fe3+2(AsO4)3, the member with the highest sodium in the alluaudite supergroup
Authors: Pekov Igor V. , Koshlyakova Natalia N. , Belakovskiy Dmitry I. , Vigasina Marina F. , Zubkova Natalia V. , Agakhanov Atali A. , Britvin Sergey N. , Sidorov Evgeny G. , Pushcharovsky Dmitry Yu.
Published: August 2022

The new alluaudite-group mineral khrenovite with the ideal, end-member formula Na3Fe3+2(AsO4)3 was found in the Arsenatnaya fumarole, Second scoria cone of the Northern Breakthrough of the Great Tolbachik Fissure Eruption, Tolbachik volcano, Kamchatka, Russia. It is associated with aphthitalite-group sulfates, badalovite, calciojohillerite, nickenichite, johillerite, tilasite, svabite, achyrophanite, ozerovaite, pansnerite, arsenatrotitanite, anhydrite, sanidine, hematite, cassiterite, rutile and pseudobrookite. Khrenovite occurs as coarse prismatic crystals up to 0.2 × 0.3 × 0.8 mm and their clusters up to 1 mm across. It is transparent, honey-coloured, red-, orange- or yellow-brown, with vitreous lustre. Khrenovite is brittle, cleavage was not observed. Dcalc is 4.257 g cm–3. Khrenovite is optically biaxial (+), α = 1.825(7), β = 1.834(7), γ = 1.845(7) and 2Vmeas. = 80(10)°. The chemical composition (wt.%, electron-microprobe) is: Na2O 11.47, K2O 1.23, CaO 0.18, MgO 0.01, MnO 4.10, CuO 4.27, ZnO 1.99, Al2O3 0.17, Fe2O3 21.12, SiO2 0.08, P2O5 0.01, V2O5 0.10, As2O5 56.03, SO3 0.02, total 100.78. The empirical formula calculated on the basis of 12 O apfu is (Na2.26K0.16Ca0.02Mn0.35Cu0.33Zn0.15Al0.02Fe3+1.62)Σ4.91(As2.98Si0.01V0.01)Σ3.00O12. Khrenovite is monoclinic, C2/c, a = 12.2394(7), b = 12.7967(5), c = 6.6589(4) Å, β = 112.953(7)°, V = 960.37(10) Å3 and Z = 4. The crystal structure was solved from single-crystal X-ray diffraction data with R1 = 0.0287. Khrenovite is isostructural with other alluaudite-group minerals. Its structural formula simplified to the species-defining constituents is A(1)NaA(2)’NaM(1)NaM(2)Fe3+2(TAsO4)3. The mineral is named in honour of the Russian volcanologist and geologist Anatoly Petrovich Khrenov (1946–2016).
Associations of influenza vaccination with severity of immune-related adverse events in patients with advanced thoracic cancers on immune checkpoint inhibitors
Authors: Lin Emily Pei-Ying , Huang Li-Ching , Whisenant Jennifer , York Sally , Osterman Travis , Lewis Jennifer , Iams Wade , Skotte Emily , Cass Amanda , Hsu Chih-Yuan , Shyr Yu , Horn Leora
Published: August 2022

Background

Whether influenza vaccination (FV) is associated with the severity of immune-related adverse events (IRAEs) in patients with advanced thoracic cancer on immune checkpoint inhibitors (ICIs) is not fully understood.

Methods

Patients enrolled in this retrospective cohort study were identified from the Vanderbilt BioVU database and their medical records were reviewed. Patients with advanced thoracic cancer who received FV within 3 months prior to or during their ICI treatment period were enrolled in the FV-positive cohort and those who did not were enrolled in the FV-negative cohort. The primary objective was to detect whether FV is associated with decreased IRAE severity. The secondary objectives were to evaluate whether FV is associated with a decreased risk for grade 3–5 IRAEs and better survival times. Multivariable ordinal logistic regression was used for the primary analysis.

Results

A total of 142 and 105 patients were enrolled in the FV-positive and FV-negative cohorts, respectively. There was no statistically significant difference in patient demographics or cumulative incidences of IRAEs between the two cohorts. In the primary analysis, FV was inversely associated with the severity of IRAEs (OR 0.63; p=0.046). In the secondary analysis, FV was associated with a decreased risk for grade 3–5 IRAEs (OR 0.42; p=0.005). Multivariable Cox regression showed that FV was not associated with survival times.

Conclusions

Our study showed that FV does not increase toxicity for patients with advanced thoracic cancer on ICIs and is associated with a decreased risk for grade 3–5 IRAEs. No statistically significant survival differences were found between patients with and without FV.
Genetic control of neuronal activity enhances axonal growth only on permissive substrates
Authors: Mesquida-Veny Francina , Martínez-Torres Sara , Del Río José Antonio , Hervera Arnau
Published: August 2022

Background

Neural tissue has limited regenerative ability. To cope with that, in recent years a diverse set of novel tools has been used to tailor neurostimulation therapies and promote functional regeneration after axonal injuries.

Method

In this report, we explore cell-specific methods to modulate neuronal activity, including opto- and chemogenetics to assess the effect of specific neuronal stimulation in the promotion of axonal regeneration after injury.

Results

Opto- and chemogenetic stimulations of neuronal activity elicited increased in vitro neurite outgrowth in both sensory and cortical neurons, as well as in vivo regeneration in the sciatic nerve, but not after spinal cord injury. Mechanistically, inhibitory substrates such as chondroitin sulfate proteoglycans block the activity induced increase in axonal growth.

Conclusions

We found that genetic modulations of neuronal activity on both dorsal root ganglia and corticospinal motor neurons increase their axonal growth capacity but only on permissive environments.
Suitability of aquatic mosses for biomonitoring micro/meso plastics in freshwater ecosystems
Authors: Carrieri V. , Varela Z. , Aboal J. R. , De Nicola F. , Fernández J. A.
Published: August 2022

Background

Mesoplastics (5–25 mm) and microplastics (0.001–5 mm) are emerging pollutants of great concern. However, reliable methods of monitoring these types of plastic in river ecosystems have not yet been established. The goal of this work was to evaluate, for the first time, the suitability of Fontinalis antipyretica as a biomonitor of meso- and micro-plastics in rivers. With this aim, native samples of the moss and devitalized moss clones, held inside the bags, were compared for the uptake of fluorescent polystyrene particles under laboratory conditions, and for retention of plastic debris in the field, in sites close to wastewater treatment plants.

Results

In the laboratory experiment, the moss retained smaller microplastics, and a higher number of polystyrene meso and microplastics was counted in the moss bags than in the native moss.

In the field study, the moss retained plastic debris chiefly in the form of fibres regardless of the capacity and flow rate of the wastewater treatment plants affecting each sampling site. The uniform morphology of moss clone seems to affect the retention of this type of pollutant. The FTIR analysis confirmed the particles entrapped by the moss bags as plastic, specifically polyethylene and polyamide type 6, among the most common plastic polymers detected in rivers.

Conclusions

The study findings highlighted the value of using uniform material, as the clone exhibited a greater accumulation efficiency with respect to the native moss. The mesh bags could act as selective filters and/or prevent the loss of adhering plastics. In the field, the bags favour plastic fibres retention despite the river flow. Finally, although FTIR is useful for the identification of plastic type, it is not very sensitive when small quantities of ground samples are used.
Semi-supervised COVID-19 CT image segmentation using deep generative models
Authors: Zammit Judah , Fung Daryl L. X. , Liu Qian , Leung Carson Kai-Sang , Hu Pingzhao
Published: August 2022

Background

A recurring problem in image segmentation is a lack of labelled data. This problem is especially acute in the segmentation of lung computed tomography (CT) of patients with Coronavirus Disease 2019 (COVID-19). The reason for this is simple: the disease has not been prevalent long enough to generate a great number of labels. Semi-supervised learning promises a way to learn from data that is unlabelled and has seen tremendous advancements in recent years. However, due to the complexity of its label space, those advancements cannot be applied to image segmentation. That being said, it is this same complexity that makes it extremely expensive to obtain pixel-level labels, making semi-supervised learning all the more appealing. This study seeks to bridge this gap by proposing a novel model that utilizes the image segmentation abilities of deep convolution networks and the semi-supervised learning abilities of generative models for chest CT images of patients with the COVID-19.

Results

We propose a novel generative model called the shared variational autoencoder (SVAE). The SVAE utilizes a five-layer deep hierarchy of latent variables and deep convolutional mappings between them, resulting in a generative model that is well suited for lung CT images. Then, we add a novel component to the final layer of the SVAE which forces the model to reconstruct the input image using a segmentation that must match the ground truth segmentation whenever it is present. We name this final model StitchNet.

Conclusion

We compare StitchNet to other image segmentation models on a high-quality dataset of CT images from COVID-19 patients. We show that our model has comparable performance to the other segmentation models. We also explore the potential limitations and advantages in our proposed algorithm and propose some potential future research directions for this challenging issue.
Low-cost and clinically applicable copy number profiling using repeat DNA
Authors: Abujudeh Sam , Zeki Sebastian S. , van Lanschot Meta C.J. , Pusung Mark , Weaver Jamie M.J. , Li Xiaodun , Noorani Ayesha , Metz Andrew J. , Bornschein Jan , Bower Lawrence , Miremadi Ahmad , Fitzgerald Rebecca C. , Morrissey Edward R. , Lynch Andy G.
Published: August 2022

Background

Somatic copy number alterations (SCNAs) are an important class of genomic alteration in cancer. They are frequently observed in cancer samples, with studies showing that, on average, SCNAs affect 34% of a cancer cell’s genome. Furthermore, SCNAs have been shown to be major drivers of tumour development and have been associated with response to therapy and prognosis. Large-scale cancer genome studies suggest that tumours are driven by somatic copy number alterations (SCNAs) or single-nucleotide variants (SNVs). Despite the frequency of SCNAs and their clinical relevance, the use of genomics assays in the clinic is biased towards targeted gene panels, which identify SNVs but provide limited scope to detect SCNAs throughout the genome. There is a need for a comparably low-cost and simple method for high-resolution SCNA profiling.

Results

We present conliga, a fully probabilistic method that infers SCNA profiles from a low-cost, simple, and clinically-relevant assay (FAST-SeqS). When applied to 11 high-purity oesophageal adenocarcinoma samples, we obtain good agreement (Spearman’s rank correlation coefficient, rs=0.94) between conliga’s inferred SCNA profiles using FAST-SeqS data (approximately £14 per sample) and those inferred by ASCAT using high-coverage WGS (gold-standard). We find that conliga outperforms CNVkit (rs=0.89), also applied to FAST-SeqS data, and is comparable to QDNAseq (rs=0.96) applied to low-coverage WGS, which is approximately four-fold more expensive, more laborious and less clinically-relevant. By performing an in silico dilution series experiment, we find that conliga is particularly suited to detecting SCNAs in low tumour purity samples. At two million reads per sample, conliga is able to detect SCNAs in all nine samples at 3% tumour purity and as low as 0.5% purity in one sample. Crucially, we show that conliga’s hidden state information can be used to decide when a sample is abnormal or normal, whereas CNVkit and QDNAseq cannot provide this critical information.

Conclusions

We show that conliga provides high-resolution SCNA profiles using a convenient, low-cost assay. We believe conliga makes FAST-SeqS a more clinically valuable assay as well as a useful research tool, enabling inexpensive and fast copy number profiling of pre-malignant and cancer samples.
Fungal diversity in the gut microbiome of young South African children
Authors: Nel Van Zyl K , Whitelaw A. C. , Hesseling A. C. , Seddon J. A. , Demers A-M , Newton-Foot M.
Published: August 2022

Background

The fungal microbiome, or mycobiome, is a poorly described component of the gut ecosystem and little is known about its structure and development in children. In South Africa, there have been no culture-independent evaluations of the child gut mycobiota. This study aimed to characterise the gut mycobiota and explore the relationships between fungi and bacteria in the gut microbiome of children from Cape Town communities.

Methods

Stool samples were collected from children enrolled in the TB-CHAMP clinical trial. Internal transcribed spacer 1 (ITS1) gene sequencing was performed on a total of 115 stool samples using the Illumina MiSeq platform. Differences in fungal diversity and composition in relation to demographic, clinical, and environmental factors were investigated, and correlations between fungi and previously described bacterial populations in the same samples were described.

Results

Taxa from the genera Candida and Saccharomyces were detected in all participants. Differential abundance analysis showed that Candida spp. were significantly more abundant in children younger than 2 years compared to older children. The gut mycobiota was less diverse than the bacterial microbiota of the same participants, consistent with the findings of other human microbiome studies. The variation in richness and evenness of fungi was substantial, even between individuals of the same age. There was significant association between vitamin A supplementation and higher fungal alpha diversity (p = 0.047), and girls were shown to have lower fungal alpha diversity (p = 0.003). Co-occurrence between several bacterial taxa and Candida albicans was observed.

Conclusions

The dominant fungal taxa in our study population were similar to those reported in other paediatric studies; however, it remains difficult to identify the true core gut mycobiota due to the challenges set by the low abundance of gut fungi and the lack of true gut colonising species. The connection between the microbiota, vitamin A supplementation, and growth and immunity warrants exploration, especially in populations at risk for micronutrient deficiencies. While we were able to provide insight into the gut mycobiota of young South African children, further functional studies are necessary to explain the role of the mycobiota and the correlations between bacteria and fungi in human health.
The constricting effect of reduced coronary artery compliance on the left ventricle is an important cause of reduced diastolic function in patients with coronary heart disease
Authors: Lv Liang , Ma Xianghe , Xu Yannan , Zhang Qiong , Kan Shanshan , Chen Xiaoming , Liu Huajin , Wang Hongwei , Wang Changhua , Ma Jiangwei
Published: August 2022

Background

Previous studies of left ventricular diastolic function (LVDF) have focused on the decrease in active and passive diastolic function due to ischemic factors but have not investigated if the decrease in compliance of the coronary arteries that bypass the surface of the heart and travel between the myocardium could cause a constricting effect on the ventricular wall like that caused by myocardial fibrosis.

Methods and Results

581 patients diagnosed with coronary heart disease (CHD) were divided into A group (patients are the control group), B group (patients with less than 50% coronary artery stenosis), C group (patients with coronary artery stenosis between 50 and 75%), D group (patients with coronary artery stenosis greater than 75%) according to the degree of coronary stenosis. The diastolic function of the ventricle is reflected by applying the relaxation time constant T value, which refers to the time between peak dp/dt and end-diastolic pressure in the left ventricle. It was concluded that there was a statistical difference in Gensini scores between patients in groups B, C and D (P < 0.001). And multiple linear regression analysis showed that T was correlated with Gensini score and C-dp/dtmax (R = 0.711, P < 0.001). Grouping according to the site of stent implantation and the number of stents implanted, it was found out that the changes in T values before and after left anterior descending artery (LAD) stent implantation were greater than left circumflex artery (LCX) and right coronary artery (RCA) (P < 0.001). And multiple linear regression revealed a correlation between T values and stent length, ventricular stiffness, and C-dp/dtmax (P = 0.001).

Conclusions

The decrease in compliance of the coronary arteries bypassing the surface of the heart and travelling between the myocardium would cause a constricting effect on the ventricular wall like that caused by myocardial fibrosis.
Clinical effectiveness and safety of self-expandable implantable bulking agents for faecal incontinence: a systematic review
Authors: Gassner Lucia , Wild Claudia , Walter Melanie
Published: August 2022

Purpose

The purpose of this systematic review is to evaluate whether self-expandable implantable vs non-self-expandable injectable bulking agents (second-line therapies) are equal/superior in terms of effectiveness (severity, quality of life [QoL]) and safety (adverse events) for faecal incontinence (FI).

Methods

A systematic review was conducted, and five databases were searched (Medline via Ovid, Embase, Cochrane Library, University of York Centre for Reviews and Dissemination, and International Network of Agencies for Health Technology database). In-/exclusion criteria were predefined according to the PICOS scheme. The Institute of Health Economics risk of bias (RoB) tool assessed studies' internal validity. According to the Grading of Recommendations, Assessment, Development and Evaluation approach, the strength of evidence for safety outcomes was rated. A qualitative synthesis of the evidence was used to analyse the data.

Results

The evidence consists of eight prospective single-arm, before-after studies (166 patients) fulfilling the inclusion criteria for assessing clinical effectiveness and safety of implantable bulking agents. FI severity statistically significantly improved in five of seven studies rated by the Cleveland Clinic FI Score and in three of five studies measured by the Vaizey score. Statistically significant improved disease-related QoL was found in one of five studies measured by the FI QoL Score and in one of two studies rated by the American Medical Systems score. Procedure-related adverse events occurred in 16 of 166 patients (i.e., intraoperative complications, anal discomfort and pain). Device-related adverse events occurred in 48 of 166 patients, including prostheses’ dislodgement and removed/extruded prostheses. Studies were judged with moderate/high RoB. The strength of evidence for safety was judged to be very low.

Conclusion

Implantable bulking agents might be an effective and safe minimally invasive option in FI treatment if conservative therapies fail. FI severity significantly improved, however, effects on QoL need to be explored in further studies. Due to the uncontrolled nature of the case series, comparative studies need to be awaited.
Systematic literature review and meta-analysis of the prevalence of secondary progressive multiple sclerosis in the USA, Europe, Canada, Australia, and Brazil
Authors: Vasanthaprasad Vijayalakshmi , Khurana Vivek , Vadapalle Sreelatha , Palace Jackie , Adlard Nicholas
Published: August 2022

Background

Secondary progressive multiple sclerosis (SPMS) is a subtype of multiple sclerosis (MS), which is a chronic neurological disease, characterised by inflammation of the central nervous system. Most of MS patients eventually progress to SPMS. This study estimates the prevalence of SPMS in the United States of America, Europe, Canada, Australia, and Brazil.

Methods

A systematic literature search of the Medline and Embase databases was performed using the OVID™ SP platform to identify MS epidemiological studies published in English from database inception to September 22, 2020. Studies reporting the prevalence of MS and proportion of SPMS patients in the included population were selected. The pooled prevalence of SPMS was calculated based on the proportion of SPMS patients. The Loney quality assessment checklist was used for quality grading. A meta-analysis of the proportions was conducted in RStudio.

Results

A total of 4754 articles were retrieved, and prevalence was calculated from 97 relevant studies. Overall, 86 medium- and high-quality studies were included in the meta-analysis. Most studies were conducted in European countries (84 studies). The estimated pooled prevalence of SPMS was 22.42 (99% confidence interval: 18.30, 26.95)/100,000. The prevalence of SPMS was more in the North European countries, highest in Sweden and lowest in Brazil. A decline in SPMS prevalence was observed since the availability of oral disease-modifying therapies. We also observed a regional variation of higher SPMS prevalence in urban areas compared with rural areas.

Conclusion

High variability was observed in the estimated SPMS prevalence, and the quality of the studies conducted. The influence of latitude and other factors known to affect overall MS prevalence did not fully explain the wide range of inter-country and intra-country variability identified in the results.
Preventing the adverse cardiovascular consequences of allogeneic stem cell transplantation with a multi-faceted exercise intervention: the ALLO-Active trial protocol
Authors: Dillon Hayley T. , Saner Nicholas J. , Ilsley Tegan , Kliman David , Spencer Andrew , Avery Sharon , Dunstan David W. , Daly Robin M. , Fraser Steve F. , Owen Neville , Lynch Brigid M. , Kingwell Bronwyn A. , La Gerche Andre , Howden Erin J.
Published: August 2022

Background

Allogeneic stem cell transplantation (allo-SCT) is a potentially lifesaving treatment for high-risk hematological malignancy, but survivors experience markedly elevated rates of cardiovascular disease and associated functional impairment. Mounting evidence suggests regular exercise, combined with a reduction in sedentary time through replacement with light exercise may be a useful therapeutic strategy for the prevention of cardiovascular comorbidities. However, this type of intervention has yet to be evaluated in patients undergoing allo-SCT. The ALLO-Active study will evaluate the efficacy of a ~ 4 month multi-faceted exercise intervention, commenced upon admission for allo-SCT, to preserve peak oxygen uptake (VO2peak) and peak cardiac output, compared with usual care. The study will also evaluate the effect of the intervention on functional independence, quality of life, and symptoms of fatigue.

Methods

Sixty adults with hematological malignancy scheduled for allo-SCT will be randomly assigned to usual care (n = 30) or the exercise and sedentary behaviour intervention (n = 30). Participants assigned to the intervention will complete a thrice weekly aerobic and progressive resistance training program and concomitantly aim to reduce daily sedentary time by 30 min with short, frequent, light-intensity exercise bouts. Participants will undergo testing prior to, immediately after inpatient discharge, and 12 weeks after discharge. To address aim 1, VO2peak and peak cardiac output (multiple primary outcomes, p < 0.025) will be assessed via cardiopulmonary exercise testing and exercise cardiac magnetic resonance imaging, respectively. Secondary outcomes include functional independence (defined as VO2peak ≥ 18.mL.kg−1.min−1), quality of life, and fatigue (assessed via validated questionnaire). Exploratory outcomes will include indices of resting cardiac, vascular, and skeletal muscle structure and function, cardiovascular biomarkers, anxiety and depression, transplant outcomes (e.g., engraftment, graft-versus-host disease), and habitual physical activity, sedentary time, and sleep.

Discussion

Multi-faceted exercise programs are a promising approach for ameliorating the cardiovascular consequences of allo-SCT. If this intervention proves to be effective, it will contribute to the development of evidence-based exercise guidelines for patients undergoing allo-SCT and assist with optimising the balance between acute cancer management and long-term health.

Trial Registration

Australian New Zealand Clinical Trials Registry (ANZCTR), ID: 12619000741189. Registered 17 May 2019.
Effects of globalization, energy consumption and ICT on health status in Australia: the role of financial development and education
Authors: Rahman Mohammad Mafizur , Alam Khosrul
Published: August 2022

Background

The outbreak of COVID-19 has alerted governments around the world, including Australia, to think seriously about the health issues. Life expectancy is one of such issues. Therefore, this study tries to reveal the effects of globalization, energy consumption, information and communication technology, financial development, education rate, and economic growth on life expectancy at birth in Australia.

Methods

Using the data period of 1990–2018, a series of econometric techniques: the Dickey-Fuller generalized least square test, Autoregressive Distributive Lag bounds test, fully modified ordinary least square method and the pairwise Granger causality test, are applied.

Results

The findings disclose that globalization, renewable energy use, information and communication technology, per capita gross domestic product, education rate, and financial development increased during this period but non-renewable energy use reduced life expectancy at birth. Unidirectional causal associations of the studied variables with life expectancy at birth are also revealed.

Conclusions

All the outcomes are relevant and useful for articulating an innovative policy in the health sector. The prime policy implication of this work is: the effective, efficient, and inclusive policies considering globalization, renewable and non-renewable energy consumption, information and communication technology, financial development, education rate, and economic growth should be formulated and executed for guaranteeing health status.
Examining pathways between family or peer factors and smoking cessation in a nationally representative US sample of adults with mental health conditions who smoke: a structural equation analysis
Authors: Nagawa Catherine S. , Wang Bo , Davis Maryann , Pbert Lori , Cutrona Sarah L. , Lemon Stephenie C. , Sadasivam Rajani S.
Published: August 2022

Background

Supportive family or peer behaviors positively impact smoking cessation in people with mental health problems who smoke. However, the limited understanding of the pathways through which family or peer factors impact quitting limits the development of effective support interventions. This study examined pathways through which family or peer views on tobacco use, family or peer smoking status, and rules against smoking in the home influenced quitting in adults with mental health problems who smoke.

Methods

We used data from the Population Assessment of Tobacco and Health Study, a national longitudinal survey. Baseline data were collected in 2015, and follow-up data in 2016. We included adults’ current smokers who had experienced two or more mental health symptoms in the past year (unweightedn = 4201). Structural equation modeling was used to test the relationships between family and peer factors, mediating factors, and smoking cessation.

Results

We found that having family or peers with negative views on tobacco use had a positive indirect effect on smoking cessation, mediated through the individual’s intention to quit (regression coefficient: 0.19) and the use of evidence-based approaches during their past year quit attempt (regression coefficient: 0.32). Having rules against smoking in the home (regression coefficient: 0.33) and having non-smoking family members or peers (regression coefficient: 0.11) had a positive indirect effect on smoking cessation, mediated through smoking behaviors (regression coefficient: 0.36). All paths were statistically significant (p <  0.01). The model explained 20% of the variability in smoking outcomes.

Conclusion

Family or peer-based cessation interventions that systematically increase intentions to quit and monitor smoking behavior may be able to assess the efficacy of family and peer support on quitting in people with mental health problems who smoke.
Neutrophil-to-lymphocyte ratio is a predictive marker for anti-MDA5 positive dermatomyositis
Authors: Liu Tao , Li Wen , Zhang Zehao , Jiang Ting , Fei Yu , Huang Jing , Xie Qibing
Published: August 2022

Background

NLR is a systemic inflammatory marker that have been associated with overall survival in patients with some rapidly progressive disease. There are few data about the diagnostic and predictive value of NLR in autoimmune diseases, and it has not been described in anti-MDA5 positive DM. We try to correlate neutrophil-to-lymphocyte ratio (NLR) with fatality from dermatomyositis in anti-MDA5 positive patients.

Method

A retrospective study in which 195 patients were enrolled was conducted. Clinical and laboratory information was collated and ratios of neutrophil to lymphocyte counts (NLR) calculated. The primary end point was all-cause death.

Result

Of the 195 patients studied, all had interstitial lung disease, including 140 survivors and 55 non-survivors. An optimal NLR cut-off value of 4.86 for mortality prediction was identified. The NLR of non-survivors was significantly higher than that of survivors (p < 0.001). Plasma levels of lactate dehydrogenase (LDH) and C-reactive protein were significantly increased when NLR was greater than 4.86. Results of multivariate analysis established that NLR > 4.86 was an independent predictor of mortality (HR: 2.52; 95%CI: 1.33–4.78; p = 0.005). Abstinence from smoking (HR: 2.66; 95%CI: 1.33–4.78; p = 0.003), emergence of rapidly progressive interstitial lung disease (RPILD; HR: 4.38; 95%CI: 2.37–8.08; p < 0.001), low plasma LDH (HR: 3.82; 95%CI: 2.06–7.11; p < 0.001) and presentation with dyspnea (HR: 2.17; 95%CI: 1.22–3.86; p = 0.009) were all protective factors predictive of survival.

Conclusion

NLR is a cost-effective and widely accessible biomarker with utility for risk stratification in patients with anti-MDA5 + dermatomyositis.
A prospective cohort study: platelet-rich plasma combined with carpal tunnel release treating carpal tunnel syndrome
Authors: Gao Yan-chun , Wang Qi-yang , Wang Chen-chen , Zhao Shichang , Chen Hua
Published: August 2022

Background

PRP injection was proved to promote the health condition of individuals with mild to moderate Carpal Tunnel Syndrome (CTS). However, carpal tunnel release (CTR) was still a necessary treatment for individuals with moderate and severe CTS.

Methods

To explore whether adjuvant PRP treatment would improve the prognosis while using CTR, we included 82 patients in this study. Preoperative and postoperative visual analog scale (VAS), Boston carpal tunnel syndrome questionnaire-symptom severity scale (BCTQ-SSS), Boston carpal tunnel syndrome questionnaire-functional status scale (BCTQ-FSS), and grip strength were used to examine the patient's symptoms and function.

Results

CTR combined with PRP treatment improved the VAS (1.9 ± 0.5 versus 1.4 ± 0.4, P < .05), BCTQ-SSS (1.8 ± 0.4versus 1.5 ± 0.3, P < .05) and BCTQ-FSS (1.8 ± 0.5 versus 1.4 ± 0.6, P < .05) in patients with moderate symptoms within one month after surgery. At the same time, it does not show any advantages in treating individuals with severe carpal tunnel syndrome.

Conclusions

PRP does not affect long-term prognosis while increasing the surgery cost. To conclude, PRP as an adjuvant treatment of CTR has limited effect. Considering the additional financial burden on patients, CTR combined with PRP should be cautious in CTS treatment.
Knowledge, attitude and factors associated with induced abortion among female students ‘of Private Colleges in Ambo town, Oromia regional state, Ethiopia: a cross-sectional study
Authors: Gutema Rebuma Muleta , Dina Gurmesa Daba
Published: August 2022

Background

Around 73 million induced abortions take place worldwide each year. Six out of 10 (61%) of all unintended pregnancies, and 3 out of 10 (29%) of all pregnancies, end in induced abortion. In Africa, nearly half of all abortions occur under the least safe circumstances. In Ethiopia 35% of women obtaining induced abortions service. Therefore, thisstudy aims to assess knowledge, attitude, and associated factors towards induced abortion serviceamong female students of private Colleges in Ambo town, Ethiopia, 2022.

Methods

An Institution-based cross-sectional study was conducted from January 15, 2022, to February 15, 2022, among college students in Ambo, Ethiopia. Data were collected from 631 female students using semi-structured self-administered questionnaires by a systematic sampling method. We collected data on demographics, Institutional factors: facility policy and regulation, sexual experience, knowledge, and attitude. Bivariable and multivariable logistic regression analyses were done to identify the association of dependent and independent variables using SPSS, version 26, at 95% of confidence interval by adjusting for confounding factors. Finally, variables with p-value ≤ 0.05 were taken as factors associated.

Results

All the participants gave their responses.Among the participants 279 (44.2) have good knowledge while the majority 352 (55.8%) of the students had poor knowledge about induced abortion. Age [AOR = 4.64, 95% CI (2.95,7.30)], Marital status [AOR = 5.24, 95% CI (3.16, 8.69)], religion [AOR = 0.48, 95% CI (0.26,0.81)], Year of study [AOR = 4.51, 95% CI (2.88,7.08)], Monthly earn/income [AOR = 2.07, 95% (CI 1.40,3.07)], Ever had sex [AOR = 1.92, 95% CI (1.26,2.92)] and urban residence [AOR = 1.87, 95% CI (1.26, 4.35)] were factors associated with knowledge of students towards induced abortion. Regarding attitude, 377 (59.7%) of students had good attitude towards induced abortion. Marital status [AOR = 2.30, 95% CI (1.30, 4.0)], and Religion [AOR = 0.47, 95% CI (0.10, 2.23)] were factors significantly associated with attitude towards induced abortion.

Conclusion

More than half of the participants have poor knowledge while majority of the students have a good attitude toward induced abortion. Since majority of the students (55.8%) have poor knowledge about induced abortion: health education, short course training, panel discussions and communication programs for youth on induction of abortion services is crucial.
The development of a web-based app employing machine learning for delirium prevention in long-term care facilities in South Korea
Authors: Moon Kyoung Ja , Son Chang-Sik , Lee Jong-Ha , Park Mina
Published: August 2022

Background

Long-term care facilities (LCFs) in South Korea have limited knowledge of and capability to care for patients with delirium. They also often lack an electronic medical record system. These barriers hinder systematic approaches to delirium monitoring and intervention. Therefore, this study aims to develop a web-based app for delirium prevention in LCFs and analyse its feasibility and usability.

Methods

The app was developed based on the validity of the AI prediction model algorithm. A total of 173 participants were selected from LCFs to participate in a study to determine the predictive risk factors for delerium.

The app was developed in five phases: (1) the identification of risk factors and preventive intervention strategies from a review of evidence-based literature, (2) the iterative design of the app and components of delirium prevention, (3) the development of a delirium prediction algorithm and cloud platform, (4) a pilot test and validation conducted with 33 patients living in a LCF, and (5) an evaluation of the usability and feasibility of the app, completed by nurses (Main users).

Results

A web-based app was developed to predict high risk of delirium and apply preventive interventions accordingly. Moreover, its validity, usability, and feasibility were confirmed after app development. By employing machine learning, the app can predict the degree of delirium risk and issue a warning alarm. Therefore, it can be used to support clinical decision-making, help initiate the assessment of delirium, and assist in applying preventive interventions.

Conclusions

This web-based app is evidence-based and can be easily mobilised to support care for patients with delirium in LCFs. This app can improve the recognition of delirium and predict the degree of delirium risk, thereby helping develop initiatives for delirium prevention and providing interventions. Moreover, this app can be extended to predict various risk factors of LCF and apply preventive interventions. Its use can ultimately improve patient safety and quality of care.
Effectiveness of a whole health model of care emphasizing complementary and integrative health on reducing opioid use among patients with chronic pain
Authors: Zeliadt Steven B. , Douglas Jamie H. , Gelman Hannah , Coggeshall Scott , Taylor Stephanie L. , Kligler Benjamin , Bokhour Barbara G.
Published: August 2022

Background

The opioid crisis has necessitated new approaches to managing chronic pain. The Veterans Health Administration (VHA) Whole Health model of care, with its focus on patient empowerment and emphasis on nonpharmacological approaches to pain management, is a promising strategy for reducing patients’ use of opioids. We aim to assess whether the VHA’s Whole Health pilot program impacted longitudinal patterns of opioid utilization among patients with chronic musculoskeletal pain.

Methods

A cohort of 4,869 Veterans with chronic pain engaging in Whole Health services was compared with a cohort of 118,888 Veterans receiving conventional care. All patients were continuously enrolled in VHA care from 10/2017 through 3/2019 at the 18 VHA medical centers participating in the pilot program. Inverse probability of treatment weighting and multivariate analyses were used to adjust for observable differences in patient characteristics between exposures and conventional care. Patients exposed to Whole Health services were offered nine complementary and integrative health therapies alone or in combination with novel Whole Health services including goal-setting clinical encounters, Whole Health coaching, and personal health planning.

Main measures

The main measure was change over an 18-month period in prescribed opioid doses starting from the six-month period prior to qualifying exposure.

Results

Prescribed opioid doses decreased by -12.0% in one year among Veterans who began complementary and integrative health therapies compared to similar Veterans who used conventional care; -4.4% among Veterans who used only Whole Health services such as goal setting and coaching compared to conventional care, and -8.5% among Veterans who used both complementary and integrative health therapies combined with Whole Health services compared to conventional care.

Conclusions

VHA’s Whole Health national pilot program was associated with greater reductions in prescribed opioid doses compared to secular trends associated with conventional care, especially when Veterans were connected with complementary and integrative health therapies.