bluuebunny/crossref_metadata_2025 huggingface dataset:
Analyses of key gene networks controlling carotenoid metabolism in Xiangfen 1 banana
Authors: Dong Chen , Wang Jiuxiang , Hu Yulin , Xiao Weijun , Hu Huigang , Xie Jianghui
Published: January 2022

Background

Banana fruits are rich in various high-value metabolites and play a key role in the human diet. Of these components, carotenoids have attracted considerable attention due to their physiological role and human health care functions. However, the accumulation patterns of carotenoids and genome-wide analysis of gene expression during banana fruit development have not been comprehensively evaluated.

Results

In the present study, an integrative analysis of metabolites and transcriptome profiles in banana fruit with three different development stages was performed. A total of 11 carotenoid compounds were identified, and most of these compounds showed markedly higher abundances in mature green and/or mature fruit than in young fruit. Results were linked to the high expression of carotenoid synthesis and regulatory genes in the middle and late stages of fruit development. Co-expression network analysis revealed that 79 differentially expressed transcription factor genes may be responsible for the regulation of LCYB (lycopene β-cyclase), a key enzyme catalyzing the biosynthesis of α- and β-carotene.

Conclusions

Collectively, the study provided new insights into the understanding of dynamic changes in carotenoid content and gene expression level during banana fruit development.
More opportunities more species: Pleistocene differentiation and northward expansion of an evergreen broad-leaved tree species Machilus thunbergii (Lauraceae) in Southeast China
Authors: Fan Dengmei , Lei Shuqing , Liang Hua , Yao Qi , Kou Yixuan , Cheng Shanmei , Yang Yi , Qiu Yingxiong , Zhang Zhiyong
Published: January 2022

Background

The broad continuum between tropical and temperate floras in Eastern Asia (EAS) are thought to be one of the main factors responsible for a prominent species diversity anomaly of temperate plants between EAS and eastern North America (ENS). However, how the broad continuum and niche evolution between tropical and temperate floras in EAS contributes to lineage divergence and species diversity remains largely unknown.

Results

Population genetic structure, demography, and determinants of genetic structure [i.e., isolation-by-distance (IBD), isolation-by-resistance (IBR), and isolation-by-environment (IBE)] of Machilus thunbergii Sieb. et Zucc. (Lauraceae) were evaluated by examining sequence variation of ten low-copy nuclear genes across 43 populations in southeast China. Climatic niche difference and potential distributions across four periods (Current, mid-Holocene, the last glacial maximum, the last interglacial) of two genetic clusters were determined by niche modelling. North and south clusters of populations in M. thunbergii were revealed and their demarcation line corresponds well with the northern boundary of tropical zone in China of Zhu & Wan. The divergence time between the clusters and demographic expansion of M. thunbergii occurred after the mid-Pleistocene climate transition (MPT, 0.8–1.2 Ma). Migration rates between clusters were asymmetrical, being much greater from north to south than the reverse. Significant effects of IBE, but non-significant effects of IBD and IBR on population genetic divergence were detected. The two clusters have different ecological niches and require different temperature regimes.

Conclusions

The north-south genetic differentiation may be common across the temperate-tropical boundary in southeast China. Divergent selection under different temperature regimes (possibly above and below freezing temperature in winter) could account for this divergence pattern. The broad continuum between tropical and temperate floras in EAS may have provided ample opportunities for tropical plant lineages to acquire freezing tolerance and to colonize the temperate regions during the late-Cenozoic global cooling. Our findings shed deeper insights into the high temperate plant species diversity in EAS.
Intestinal Claudin-7 deficiency impacts the intestinal microbiota in mice with colitis
Authors: Ding Yuhan , Wang Kun , Xu Chang , Hao Mengdi , Li Huimin , Ding Lei
Published: January 2022

Background

Intestinal epithelial cells form a physical barrier that protects the intestine against the intestinal microbiota through tight junctions (TJs) and adhesive junctions, while barrier disruption may lead to inflammatory bowel disease (IBD). Claudin-7 (Cldn7) has been implicated in this protection as an important member of TJs. Here, we experimentally study the effect of Cldn7 deletion on intestinal microbiota in colitis.

Methods

Colitis model was established based on inducible intestinal conditional Cldn7 gene knockout mice (Cldn7fl/fl; villin-CreERT2), by feeding with dextran sodium sulfate (DSS). AB-PAS staining and immunohistochemical staining of Muc2 mucin were used to detect the effect of Cldn7 deficiency on the mucus layer of mice with colitis, and fluorescence in situ hybridization was used to detect how Cldn7 promotes spatial separation of the gut microbiota from the host. The microbiota population was characterized by high-throughput 16S rRNA gene sequencing of DNA extracted from fecal samples.

Results

Compared with the controls, Cldn7 knockout increased susceptibility to colitis, including greater degree of weight loss, colon shortening, and a significantly higher disease activity index score. DSS-treated Cldn7 knockout mice promoted the migration of bacteria to the intestinal epithelium to some extent by damaging the intestinal mucus layer. Sequencing of 16S rRNA showed that DSS-treated Cldn7 knockout mice reduced the gut microbiota diversity and had greater relative abundance of Escherichia coli. LEfSe analysis indicated that Escherichia coli may be the key bacteria in Cldn7 knockout mice during DSS-induced colitis. Furthermore, the Tax4Fun analysis predicted that DSS-treated Cldn7 knockout mice enriched for microbiota impacting infectious diseases, immune system and metabolic functions.

Conclusions

Our data suggests an association between intestinal Cldn7 knockout and microbiota dysbiosis during inflammatory events.
The characteristics of overseas imported COVID-19 cases and the effectiveness of screening strategies in Beijing, China
Authors: Li Li , Ma Cheng-Jie , Chang Yu-Fei , Yang Si-Yuan , Tang Yun-Xia , Wang Ling-Hang
Published: January 2022

Background

In March 2020, the WHO declared the novel coronavirus outbreak a global pandemic. While great success in coronavirus disease 2019 (COVID-19) control has been achieved in China, imported cases have become a major challenge. This study aimed to describe the epidemiological and clinical characteristics of imported COVID-19 cases and to assess the effectiveness of screening strategies in Beijing, China.

Methods

This retrospective study included all imported cases transferred to Beijing Ditan Hospital from 29 February to 20 March 2020 who were screened by both chest computed tomography (CT) and reverse-transcriptase-polymerase chain reaction (RT-PCR) at the initial presentation. Demographic, clinical and laboratory data, in addition to chest CT imaging, were collected and analysed.

Results

In total, 2545 cases were included, among which 71 (2.8%) were finally diagnosed with laboratory-confirmed COVID-19. The majority 63 (88.7%) were from Europe. The most common initial symptoms were cough and fever, which accounted for 49.3% and 42.3%, respectively. Only four cases (5.6%) had lymphocytopenia, and thirteen cases (18.3%) demonstrated elevated levels of C-reactive protein (CRP). All cases had normal serum levels of procalcitonin (PCT). At initial presentation, among the 71 confirmed cases, 59 (83.1%) had a positive RT-PCR assay, and 35 (49.3%) had a positive chest CT. Twelve (16.9%) had a negative RT-PCR assay but a positive chest CT.

Conclusions

A combination of RT-PCR and chest CT is an effective strategy for the screening of imported COVID-19 cases. Our findings provide important information and clinical evidence about the infection control of imported COVID-19 cases.
Prevalence of risk factors for human immunodeficiency virus among women of reproductive age in Sierra Leone: a 2019 nationwide survey
Authors: Kawuki Joseph , Kamara Kassim , Sserwanja Quraish
Published: January 2022

Background and aim

For over 40 years of the HIV/AIDS global epidemic, no effective cure nor vaccine is yet available, making the current control strategies focused on curbing new infections through risk reduction. The study aimed to determine the prevalence of HIV risk factors and their associated socio-demographics among women of reproductive age in Sierra Leone.

Methods

We used weighted data from the Sierra Leone Demographic and Health Survey (SLDHS) of 2019 for 12,005 women aged 15–49 years. Multistage sampling was used to select study participants. Exposure to HIV risk factors was considered if a woman reported at least one of the following; having multiple sexual partners, transactional sex, non-condom use for the unmarried, and having other sexually transmitted infections (STIs). We, then, conducted multivariable logistic regression to explore the associated socio-demographics. All the analyses were done using SPSS (version 25).

Results

Of the 12,005 women, 38.1% (4577/12005) (95% confidence interval (CI) 37.3–39.0) had at least one of the four risk factors. Women of 15 to 19 years (adjusted odds ratio (AOR) = 1.34, 95% CI 1.00–1.80) and 20 to 34 years (AOR = 1.25, 95% CI 1.05–1.49) had more odds of having HIV risk factors compared to those of 35 to 49 years. Urban residents (AOR = 1.49, 95% CI 1.17–1.89) and those from the Northwestern region (AOR = 1.81, 95% CI 1.26–2.60) were also more likely to encounter HIV risk factors compared to their respective counterparts. Moreover, unmarried women (AOR = 111.17, 95% CI 87.55–141.18) and those working (AOR = 1.38, 95% CI 1.14–1.67) also had higher odds of having HIV risk factors, compared to their respective counterparts. Sex of household head and parity were also significant associates.

Conclusions

More than a third of women in Sierra Leone had encountered at least one HIV risk factor, and this was associated with age, place of residence, region, marital status, working status, household head and parity. There is a need for strengthening HIV/AIDS education programs, laws and policies targeting the young, working, unmarried and urban-resident women.
Can telerehabilitation services combined with caregiver-mediated exercises improve early supported discharge services poststroke? A study protocol for a multicentre, observer-blinded, randomized controlled trial
Authors: Mulder Marijn , Nikamp Corien , Nijland Rinske , van Wegen Erwin , Prinsen Erik , Vloothuis Judith , Buurke Jaap , Kwakkel Gert
Published: January 2022

Background

Recovery of walking ability is an important goal for patients poststroke, and a basic level of mobility is critical for an early discharge home. Caregiver-mediated exercises could be a resource-efficient strategy to augment exercise therapy and improve mobility in the first months poststroke. A combination of telerehabilitation and face-to-face support, blended care, may empower patient-caregiver dyads and smoothen the transition from professional support to self-management. The Armed4Stroke study aims to investigate the effects of a caregiver-mediated exercise program using a blended care approach in addition to usual care, on recovery of mobility in the first 6 months poststroke.

Methods

A multicentre, observer-blinded randomized clinical trial in which 74 patient-caregiver dyads will be enrolled in the first 3 months poststroke. Dyads are randomly allocated to a caregiver-mediated exercises intervention or to a control group. The primary endpoint is the self-reported mobility domain of the Stroke Impact Scale. Secondary endpoints include care transition preparedness and psychological functioning of dyads, length of inpatient stay, gait-related measures and extended ADL of patients, and caregiver burden. Outcomes are assessed at enrolment, end of treatment and 6 months follow-up.

Results

During 8 weeks, caregivers are trained to become an exercise coach using a blended care approach. Dyads will receive a tailor-made, progressive training program containing task-specific exercises focusing on gait, balance, physical activity and outdoor activities. Dyads are asked to perform the training program a minimum of 5 times a week for 30 min per session, supported by a web-based telerehabilitation system with instruction videos and a messaging environment to communicate with their physiotherapist.

Conclusions

We hypothesize that the Armed4Stroke program will increase self-reported mobility and independence in ADL, facilitating an early discharge poststroke. In addition, we hypothesize that active involvement of caregivers and providing support using blended care, will improve the care transition when professional support tapers off. Therefore, the Armed4Stroke program may complement early supported discharge services.

Trial registration

Netherlands Trial Register,NL7422. Registered 11 December 2018.
Quality of acute ischemic stroke care at a tertiary Hospital in Ghana
Authors: Kumi Frank , Bugri Amos A. , Adjei Stephen , Duorinaa Elvis , Aidoo Matthew
Published: January 2022

Background

Information on the quality of acute ischemic stroke care provided in lower-to-middle income countries is limited.

Objective

This study was undertaken to examine the quality of acute ischemic stroke care provided at Tamale Teaching Hospital in Ghana.

Methods

The medical records of patients admitted into the medical ward of the hospital between January to October 2021 were reviewed retrospectively. Extent of compliance to 15 stroke performance indicators were determined.

Results

Under the study period, 105 patients were admitted at the hospital with acute ischemic stroke. The mean (±SD) age was 65 ± 12 years; 38.1% were males; 65.7% had National Health Insurance Scheme coverage. Glasgow Coma Scale was the only functional stroke rating scale used by physicians to rate stroke severity. About a quarter of the patients had CT scan performed within 24 h of admission. Less than a quarter of the patients had a last known well time documented. Rate of thrombolytic administration was 0%. Less than a quarter of the patients were prescribed venous thromboembolism prophylaxis on the day of admission or day after. Only 13.8% of patients had documented reasons for not being prescribed venous thromboembolism prophylaxis. Antiplatelet therapy was prescribed to 33.3% of the patients by the end of day 2 of admission. Anticoagulation was prescribed to all patients who had comorbid condition of atrial fibrillation as part of the discharge medications. More than half of the patients were discharged to go home with statin medications. Documented stroke education was provided to 31.4% caretakers or patients. Slightly less than half of the patients were assessed for or received rehabilitation. Less than a quarter had documented dysphagia screening within 24 h of admission. None of the patient had their stroke severity rated with National Institutes of Health Stroke Scale on arrival. No patient obtained carotid imaging assessment by end of day 2.

Conclusion

There were several gaps in the quality of acute ischemic stroke care provided to patients at the Tamale Teaching Hospital. With the exception of discharging patients on statin medications, there was poor adherence to all other stroke performance indicators.
The fear of social stigma experienced by men: a barrier to male involvement in antenatal care in Misungwi District, rural Tanzania
Authors: Boniphace Maendeleo , Matovelo Dismas , Laisser Rose , Yohani Victoria , Swai Hadija , Subi Leonard , Masatu Zabroni , Tinka Sylvia , Mercader Hannah Faye G. , Brenner Jennifer L. , Mitchell Jennifer L.
Published: January 2022

Background

Evidence has shown that male involvement is associated with improved maternal health outcomes. In rural Tanzania, men are the main decision makers and may determine women’s access to health services and ultimately their health outcomes. Despite efforts geared towards enhancing male participation in maternal health care, their involvement in antenatal care (ANC) remains low. One barrier that impacts men’s participation is the fear and experience of social stigma. This study, builds on previous findings about men’s perspectives in attending antenatal care appointments in Misungwi district in Tanzania, examining more closely the fear of social stigma amongst men attending ANC together with their partners.

Methods

Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers and expectant fathers. In-depth interviews were conducted with health providers, volunteer community health workers and village leaders. Interviews were audiotaped, and transcripts were transcribed and translated to English. Transcripts were organized in NVivo V.12 then analyzed using thematic approach.

Results

Three main themes were found to create fear of social stigma for men: 1. Fear of HIV testing; 2. Traditional Gender Norms and 3. Insecurity about family social and economic status.

Conclusion

Respondent’s experiences reveal that fear of social stigma is a major barrier to attend ANC services with their partners. Attention must be given to the complex sociocultural norms and social context that underly this issue at the community level. Strategies to address fear of social stigma require an understanding of the real reasons some men do not attend ANC and require community engagement of community health workers (CHWs), government officials and other stakeholders who understand the local context.
Microsatellite instability is biased in Amsterdam II-defined Lynch-related cancer cases with family history but is rare in other cancers: a summary of 1000 analyses
Authors: Matsubayashi Hiroyuki , Higashigawa Satomi , Kiyozumi Yoshimi , Oishi Takuma , Sasaki Keiko , Ishiwatari Hirotoshi , Imai Kenichiro , Hotta Kinichi , Yabuuchi Yohei , Ishikawa Kazuma , Satoh Tatsunori , Ono Hiroyuki , Todaka Akiko , Kawakami Takeshi , Shirasu Hiromichi , Yasui Hirofumi , Sugiura Teichi , Uesaka Katsuhiko , Kagawa Hiroyasu , Shiomi Akio , Kado Nobuhiro , Hirashima Yasuyuki , Kiyohara Yoshio , Bando Etsuro , Niwakawa Masashi , Nishimura Seiichiro , Aramaki Takeshi , Mamesaya Nobuaki , Kenmotsu Hirotsugu , Horiuchi Yasue , Serizawa Masakuni
Published: January 2022

Background

Microsatellite instability (MSI) is a key marker for predicting the response of immune checkpoint inhibitors (ICIs) and for screening Lynch syndrome (LS).

Aim

This study aimed to see the characteristics of cancers with high level of MSI (MSI-H) in genetic medicine and precision medicine.

Methods

This study analyzed the incidence of MSI-H in 1000 cancers and compared according to several clinical and demographic factors.

Results

The incidence of MSI-H was highest in endometrial cancers (26.7%, 20/75), followed by small intestine (20%, 3/15) and colorectal cancers (CRCs)(13.7%, 64/466); the sum of these three cancers (15.6%) was significantly higher than that of other types (2.5%)(P < 0.0001). MSI-H was associated with LS-related cancers (P < 0.0001), younger age (P = 0.009), and family history, but not with smoking, drinking, or serum hepatitis virus markers. In CRC cases, MSI-H was significantly associated with a family history of LS-related cancer (P < 0.0001), Amsterdam II criteria [odds ratio (OR): 5.96], right side CRCs (OR: 4.89), and multiplicity (OR: 3.31). However, MSI-H was very rare in pancreatic (0.6%, 1/162) and biliary cancers (1.6%, 1/64) and was null in 25 familial pancreatic cancers. MSI-H was more recognized in cancers analyzed for genetic counseling (33.3%) than in those for ICI companion diagnostics (3.1%)(P < 0.0001). Even in CRCs, MSI-H was limited to 3.3% when analyzed for drug use.

Conclusions

MSI-H was predominantly recognized in LS-related cancer cases with specific family histories and younger age. MSI-H was limited to a small proportion in precision medicine especially for non-LS-related cancer cases.
RETRACTED ARTICLE: Factors associated with insomnia among frontline nurses during COVID-19: a cross-sectional survey study
Authors: Nazari Nabi , Sadeghi Masoud , Samusenkov Vadim , Aligholipour Akram
Published: January 2022

Background

Research predominantly suggests that nurses are at high risk of developing psychopathology. The empirical data show that the occurrence rate of problem-related sleep quality among clinical nurses is high. Therefore, this study was conducted to address the lack of information on the relationship between the coronavirus disease 2019 (COVID-19) pandemic and insomnia.

Methods

A convenience sample of nurses (n = 680) completed an online survey that included the Insomnia severity index, the COVID-19-related psychological distress scale, the general health questionnaire, neuroticism, dysfunctional beliefs, attitudes about sleep scale, and difficulties in emotion regulation scale.

Results

The results showed that 35.8% (n = 253) of nurses were classified as individuals with moderate to severe clinical insomnia. The results showed that the psychological distress generated by COVID-19 predicted insomnia (β = .47, SE = 0.02, P < .001, t = 13.27, 95% CI 0.31–0.46). Additionally, the association is mediated by psychopathology vulnerabilities, emotion dysregulation, dysfunctional beliefs about sleep, and neuroticism. Moreover, female nurses exhibited higher levels of insomnia (Cohen’s d = .37), neuroticism (Cohen’s d = 30), psychopathology vulnerability (Cohen’s d = .26), and COVID-19-related psychological distress (Cohen’s d = .23).

Conclusion

The present study’s findings help to explain how pandemic consequences can be associated with insomnia. Additionally, the findings make a significant contribution to better understanding the role of neuroticism, emotion dysregulation, beliefs, and psychopathology vulnerability in the development of insomnia among nurses. The findings suggest the potential influence of cognitive behavioral therapy for insomnia (CBT-I) and transdiagnostic integrated therapies that could be incorporated into therapeutic programs designed to develop as a way of inhibiting or preventing insomnia among clinical nurses.
Protocol of the Inner Mongolian Healthy Aging Study (IMAGINS): a longitudinal cohort study
Authors: Xi Yunfeng , Tian Qiuyue , Na Buqi , Han Ke , Duan Mingrui , Zhang Xingguang , Wang Wenrui , Wang Youxin
Published: January 2022

Background

Cardiovascular diseases (CVDs) remain the leading cause of premature mortality and burden of diseases in the world. The Inner Mongolia Autonomous Region is located in northern China, constitute 17.66% individuals with Mongolian, which have unique diet and lifestyles. Therefore, the Inner Mongolian Healthy Aging Study (IMAGINS) was designed to explore risk factors for chronic diseases and evaluate the effectiveness of health management on CVDs in population at high-risk.

Methods

The IMAGINS is an ongoing and prospective cohort study of men and women aged ≥35 years from Inner Mongolian Autonomous Region, northern China. This study performed in investigating risk factors for CVDs, screening and providing health management strategy for high-risk population of CVDs. The IMAGINS began in September 2015 and scheduled to recruiting and follow-up outcome until 2030. For general population, a long-term follow-up will be conducted every 5 years to collect the information above and data on clinical outcomes. For high-risk population, comprehensive health managements were performed and scheduled to follow-up annually. All IMAGINS participants are followed for incident CVDs and death.

Discussion

The IMAGINS is designed to increase understanding how cardiovascular-related risk factors contribute to the development of CVDs and the positive effect of health management strategy for high-risk CVD participants. Key features of this study include (i) a carefully characterized cohort between high risk of CVDs and non-high risk population; (ii) detailed measurement of CVDs risk factors and health management strategies for high risk population; (iii) long-term follow-up of CVDs and death. The IMAGINS represents a good research opportunity to investigate clinical and genetic factors in high-risk population, might providing basis for the prevention and control of non-communicable diseases.
Ceramic-on-ceramic versus ceramic-on-polyethylene in total hip arthroplasty: a comparative study at a minimum of 13 years follow-up
Authors: Giuseppe Malerba , Mattia Basilico , Nadia Bonfiglio , Raffaele Vitiello , Pasquale Ruberto , Stefano D’ Adamio , Mattia Sirgiovanni , Vincenzo De Santis , Giulio Maccauro
Published: January 2022

Background

Nowadays hip replacement is one of the most successful surgery in terms of clinical outcome and patient’s satisfaction. Therefore, the choice of biomaterials in hip replacement is increasingly important with the aim of obtaining a long-term satisfaction of patient and a greater survivorship of the implants. Ceramic-on-polyethylene (COP) and ceramic-on-ceramic (CoC) bearings are two common coupling used in total hip arthroplasty. The aim of this retrospective study was to compare clinical and radiological outcomes between patients treated using CoC and CoP THA at a mean follow-up of 15 years.

Methods

86 patients, average age 65.6, were included in the study: 43 in group A bearing CoC and 43 in group B bearing CoP. Minimum follow-up was 13 years.

Primary outcome was a clinical evaluation assessed by HOOS and SF-12 questionnaires.

Secondary outcome was a radiological evaluation on a A-P pelvis x-ray calculating acetabular cup inclination and anteversion and detecting osteolysis.

Result

After a multivariate analysis was performed, our results show clinical outcomes in group B significantly better than in group A: statistically significant value (p < 0,05) was found in the mean HOOS-symptoms subscale (83.0 ± 15.4 in Group A vs 90.3 ± 12.2 in group B) in the SF-12 physical component score (39.7 ± 11.0 in Group A vs 48.1 ± 10.1 in group B) and in HOOS (79.0 ± 16 in Group A vs 87.0 ± 16 in group B). 3 squeaking was found in group A. The calculated mean acetabular cup inclination value was 44,87 in group A and 44,5 in group B and the mean socket version was 17,54 in group A and 15,10 in group B. No significant statistically relationship between radiographic parameters analyzed and clinical outcomes was noted.

Conclusion

The current results provide us important information about the THA long-term outcome. CoP offered significantly better results compared with CoC at long-term follow up, and thus it should be considered in the choose of bearing in THA.
Radiographic outcomes of cortical screw fixation as an alternative to Kirschner wire fixation for temporary lateral column stabilization in displaced Lisfranc joint fracture-dislocations: a retrospective cohort analysis
Authors: Sethuraman Saranya A. , Silverstein Rachel S. , Dedhia Nicket , Shaner Adam C. , Asprinio David E.
Published: January 2022

Background

Injuries of the tarsometatarsal joint complex ranging from purely ligamentous to multidirectionally unstable midfoot fracture-dislocations are anatomically fixed to minimize long-term sequelae including post-traumatic arthritis, pes planus deformity, and chronic pain. Lateral column disruption is commonly treated with temporary Kirschner wire (K-wire) fixation, maintaining alignment during healing and allowing resumption of physiologic motion after hardware removal. More unstable fracture patterns may require temporary cortical screw fixation to maintain adequate reduction. We evaluated the efficacy of temporary lateral column screw fixation compared to K-wire fixation for Lisfranc fracture-dislocation treatment.

Methods

This retrospective cohort study reviewed 45 patients over fourteen years who underwent Lisfranc fracture-dislocation fixation at a level-one trauma center. All patients underwent medial and middle column fixation; 31 underwent lateral column fixation. Twenty six patients remained after excluding those without electronic records or follow-up. The primary outcome was radiographic lateral column healing before and after hardware removal; secondary outcomes included pain, ambulation, and return to normal shoe wear.

Results

Twenty patients were male, with mean age 41 years. Thirteen patients underwent cortical screw fixation and twelve K-wire fixation. One had both implants. Twenty four patients underwent lateral column hardware removal; all had radiographic evidence of bony healing before hardware removal. Mean follow-up was 88.2 ± 114 weeks for all patients. The cortical screw cohort had significantly longer mean time to hardware removal (p = 0.002). The K-wire cohort had significantly more disuse osteopenia (p = 0.045) and postoperative pain (p = 0.019).

Conclusions

Radiographic and clinical outcomes of unstable Lisfranc fracture-dislocation treatment support temporary lateral column screw fixation as an alternate technique.

Level of clinical evidence

3 (retrospective cohort study)
Does obesity affect patient-reported outcomes following total knee arthroplasty?
Authors: Baghbani-Naghadehi Fatemeh , Armijo-Olivo Susan , Prado Carla M. , Gramlich Leah , Woodhouse Linda J.
Published: January 2022

Background

There is an existing perception that obesity has a negative impact on complications following total knee arthroplasty (TKA). However, data on the impact of obesity levels on patient-reported outcomes (PROMs) is sparse. We investigated the association between different obesity classes with PROMs among patients who underwent TKA.

Methods

We performed retrospective secondary analyses on data extracted from the total joint replacement data repository (Alberta, Canada) managed by the Alberta Bone and Joint Health Institute (ABJHI). Patients had WOMAC and EQ5D scores measured at baseline in addition to 3 and/or 12 months following TKA. Patients were stratified according to the World Health Organization (WHO) classification, into five body mass index (BMI) groups of normal, overweight, BMI class I, BMI class II, and BMI class III. The association between BMI and mean changes in WOMAC subscales (pain, function, and stiffness) and EQ-5D-5L index over the time intervals of baseline to 3 months and 3 to 12 months following TKA was assessed. Linear mixed-effects models were used, and the models were adjusted for age, sex, length of surgery, comorbidities, year of surgery, and geographical zone where the surgery was performed.

Results

Mean age was 65.5 years (SD = 8.7). Postoperatively, there was a significant improvement (p < 0.001) in WOMAC subscales of patient-reported pain, function, and stiffness, as well as EQ-5D-5L regardless of BMI group. Although, patients in BMI class II and class III reported significantly improved pain 3 months after TKA compared to those with normal BMI, all BMI groups attained similar level of pain reduction at 12 months after TKA. The greatest improvement in all WOMAC subscales, as well as EQ5D index, occurred between baseline and 3 months (adjusted p < 0.0001).

Conclusion

The findings indicate that patients reported improved pain, function, and stiffness across all BMI groups following TKA. Patients with BMI classified as obese reported similar benefits to those with BMI classified as normal weight. These results may help health care providers to discuss expectations regarding the TKA recovery in terms of pain, function, and quality of life improvements with their TKA candidates.
Determining the influence of different linking patterns on the stability of students’ score adjustments produced using Video-based Examiner Score Comparison and Adjustment (VESCA)
Authors: Yeates Peter , McCray Gareth , Moult Alice , Cope Natalie , Fuller Richard , McKinley Robert
Published: January 2022

Background

Ensuring equivalence of examiners’ judgements across different groups of examiners is a priority for large scale performance assessments in clinical education, both to enhance fairness and reassure the public. This study extends insight into an innovation called Video-based Examiner Score Comparison and Adjustment (VESCA) which uses video scoring to link otherwise unlinked groups of examiners. This linkage enables comparison of the influence of different examiner-groups within a common frame of reference and provision of adjusted “fair” scores to students. Whilst this innovation promises substantial benefit to quality assurance of distributed Objective Structured Clinical Exams (OSCEs), questions remain about how the resulting score adjustments might be influenced by the specific parameters used to operationalise VESCA. Research questions, How similar are estimates of students’ score adjustments when the model is run with either: fewer comparison videos per participating examiner?; reduced numbers of participating examiners?

Methods

Using secondary analysis of recent research which used VESCA to compare scoring tendencies of different examiner groups, we made numerous copies of the original data then selectively deleted video scores to reduce the number of 1/ linking videos per examiner (4 versus several permutations of 3,2,or 1 videos) or 2/examiner participation rates (all participating examiners (76%) versus several permutations of 70%, 60% or 50% participation). After analysing all resulting datasets with Many Facet Rasch Modelling (MFRM) we calculated students’ score adjustments for each dataset and compared these with score adjustments in the original data using Spearman’s correlations.

Results

Students’ score adjustments derived form 3 videos per examiner correlated highly with score adjustments derived from 4 linking videos (median Rho = 0.93,IQR0.90–0.95,p < 0.001), with 2 (median Rho 0.85,IQR0.81–0.87,p < 0.001) and 1 linking videos (median Rho = 0.52(IQR0.46–0.64,p < 0.001) producing progressively smaller correlations. Score adjustments were similar for 76% participating examiners and 70% (median Rho = 0.97,IQR0.95–0.98,p < 0.001), and 60% (median Rho = 0.95,IQR0.94–0.98,p < 0.001) participation, but were lower and more variable for 50% examiner participation (median Rho = 0.78,IQR0.65–0.83, some ns).

Conclusions

Whilst VESCA showed some sensitivity to the examined parameters, modest reductions in examiner participation rates or video numbers produced highly similar results. Employing VESCA in distributed or national exams could enhance quality assurance or exam fairness.
Nurses’ attitudes towards the nursing profession and associated factors in selected public hospitals, Addis Ababa, Ethiopia, 2021: a cross-sectional study
Authors: Rekisso Abdurkie Defa , Mengistu Zuriash , Wurjine Teshome Habte
Published: January 2022

Background

Unfavorable attitude toward nursing profession remaining the global issue across in the various level of health institutions attitude is the most important concept in nursing. Because of high ambiguity and role conflict in the profession.

Objective

This study aimed to explore nurses’ attitudes toward their profession and associated factors in selected public hospitals, Addis Ababa, Ethiopia, 2021.

Methodology

Institutional based quantitative cross- sectional study design was conducted in five randomly selected public hospitals of Addis Ababa, Ethiopia, from May to April 2021. Systematic random sampling method was used to select sample of 357 nurses working in selected hospitals. Data were collected using standard self-administer questionnaire and the collected data were entered and analyzed by using SPSS 25version. Descriptive, Bi-variate and multiple logistic regression analysis were computed to describe the association between attitude of nurses and independent variables that show P-values ≤0.05 with 95% Confidence Interval consider statistically significant factors for attitude toward professionalism.

Results

A total of 348 nurses were participated in the study, with 97.5% response rate. From this 60.6% (n = 211) of study participants were female nurses. Only 46% of nurses in Addis Ababa city public hospitals had favorable attitude towards their profession. Experienced nurses [(AOR: 1.19; 95% CI: 0.625, 13.37)], had good managerial support [(AOR: 2.40; 95% CI: 0.197, 26.702)], had ethical related training [(AOR: 1.50; 95% CI: 0.35, 6.407)], had positive image toward nursing profession [(AOR: 2.32; 95% CI: 0.166, 34.950)], who believe in our community had positive image toward nursing profession [(AOR: 4.73; 95% CI: 2.136, 88.109)] were positively associated with the overall nurses’ attitude toward their profession.

Conclusion

This study offers an interesting insight about nurses’ image toward their profession and associated factors in Addis Ababa city. The overall attitude of nurses in Addis Ababa city public hospitals toward their profession was falls below the average level. Given the importance of the attitude in nursing and various factors, efforts are directed to achieve the desired level and reducing the barriers.
Nudging customers towards healthier food and beverage purchases in a real-life online supermarket: a multi-arm randomized controlled trial
Authors: Stuber Josine M. , Lakerveld Jeroen , Kievitsbosch Loes W. , Mackenbach Joreintje D. , Beulens Joline W. J.
Published: January 2022

Background

Nudging is increasingly used to promote healthy food choices in supermarkets. Ordering groceries online is gaining in popularity and nudging seems efficacious there as well, but is never comprehensively tested in real-life. We evaluated the real-life effectiveness of nudging in an online supermarket on healthy food purchases.

Methods

We conducted a multi-arm, parallel-group, individually randomized controlled trial in an online supermarket. During 1 month, all customers were randomized to (1) control condition, (2) information nudges, (3) position nudges, and (4) information and position nudges combined. Allocation was concealed and customers were not blinded, but unaware of the intervention. Mean differences between the control condition and the intervention arms in the total percentage of healthy purchases were assessed with a linear mixed model. We tested for effect modification by area-level deprivation.

Results

Based on sales data from 11,775 shoppers, no overall significant effects were detected. Yet, effects were modified by area-level deprivation (pArm 2 < 0.001). Among shoppers from deprived areas, those allocated to information nudges purchased a 2.4% (95%CI 0.8, 4.0) higher percentage of healthy products compared to controls. No significant differences were observed for position (− 1.3%; 95%CI − 2.8, 0.3) and combined nudges (− 0.1%; 95%CI − 1.7, 1.5). Shoppers from non-deprived areas exposed to information nudges (− 1.6%; 95%CI − 3.2, − 0.1) and the combined nudges (− 2.1%; 95%CI − 3.6, − 0.6), but not position nudges (− 0.9%; 95%CI − 2.4, 0.7), purchased a lower percentage of healthy products.

Conclusion

Information nudges in an online supermarket can increase healthy product purchases, but only for those living in deprived areas. The adverse effects found on purchasing behaviors for those from non-deprived areas call for further research. Further research should also focus on real-life effects of online healthy food nudging as part of a broader nutrition intervention strategy, and on the equitability of the online nudging intervention within populations.

Trial registration

Retrospectively registered in the ISRCTN registry at May 21, 2021 (ISRCTN10491616).
SLCO4A1-AS1 promotes colorectal tumourigenesis by regulating Cdk2/c-Myc signalling
Authors: Zhang Jia , Cui Kaisa , Huang Liuying , Yang Fan , Sun Shengbai , Bian Zehua , Wang Xue , Li Chaoqun , Yin Yuan , Huang Shengling , Zhou Leyuan , Fei Bojian , Huang Zhaohui
Published: January 2022

Background

SLCO4A1-AS1 was found to be upregulated in several cancer types, including colorectal cancer (CRC). However, the detailed roles of SLCO4A1-AS1 in CRC remain to be elucidated. Therefore, we investigated the functions, mechanism, and clinical significance of SLCO4A1-AS1 in colorectal tumourigenesis.

Methods

We measured the expression of SLCO4A1-AS1 in CRC tissues using qRT-PCR and determined its correlation with patient prognosis. Promoter methylation analyses were used to assess the methylation status of SLCO4A1-AS1. Gain- and loss-of-function assays were used to evaluate the effects of SLCO4A1-AS1 on CRC growth in vitro and in vivo. RNA pull-down, RNA immunoprecipitation, RNA-seq, luciferase reporter and immunohistochemistry assays were performed to identify the molecular mechanism of SLCO4A1-AS1 in CRC.

Results

SLCO4A1-AS1 was frequently upregulated in CRC tissues based on multiple CRC cohorts and was associated with poor prognoses. Aberrant overexpression of SLCO4A1-AS1 in CRC is partly attributed to the DNA hypomethylation of its promoter. Ectopic SLCO4A1-AS1 expression promoted CRC cell growth, whereas SLCO4A1-AS1 knockdown repressed CRC proliferation both in vitro and in vivo. Mechanistic investigations revealed that SLCO4A1-AS1 functions as a molecular scaffold to strengthen the interaction between Hsp90 and Cdk2, promoting the protein stability of Cdk2. The SLCO4A1-AS1-induced increase in Cdk2 levels activates the c-Myc signalling pathway by promoting the phosphorylation of c-Myc at Ser62, resulting in increased tumour growth.

Conclusions

Our data demonstrate that SLCO4A1-AS1 acts as an oncogene in CRC by regulating the Hsp90/Cdk2/c-Myc axis, supporting SLCO4A1-AS1 as a potential therapeutic target and prognostic factor for CRC.
Exosomes in the hypoxic TME: from release, uptake and biofunctions to clinical applications
Authors: He Guangpeng , Peng Xueqiang , Wei Shibo , Yang Shuo , Li Xinyu , Huang Mingyao , Tang Shilei , Jin Hongyuan , Liu Jiaxing , Zhang Sheng , Zheng Hongyu , Fan Qing , Liu Jingang , Yang Liang , Li Hangyu
Published: January 2022

Hypoxia is a remarkable trait of the tumor microenvironment (TME). When facing selective pressure, tumor cells show various adaptive characteristics, such as changes in the expression of cancer hallmarks (increased proliferation, suppressed apoptosis, immune evasion, and so on) and more frequent cell communication. Because of the adaptation of cancer cells to hypoxia, exploring the association between cell communication mediators and hypoxia has become increasingly important. Exosomes are important information carriers in cell-to-cell communication. Abundant evidence has proven that hypoxia effects in the TME are mediated by exosomes, with the occasional formation of feedback loops. In this review, we equally focus on the biogenesis and heterogeneity of cancer-derived exosomes and their functions under hypoxia and describe the known and potential mechanism ascribed to exosomes and hypoxia. Notably, we call attention to the size change of hypoxic cancer cell-derived exosomes, a characteristic long neglected, and propose some possible effects of this size change. Finally, jointly considering recent developments in the understanding of exosomes and tumors, we describe noteworthy problems in this field that urgently need to be solved for better research and clinical application.
The risk of anaphylaxis behind authorized COVID-19 vaccines: a meta-analysis
Authors: Sobczak Marharyta , Pawliczak Rafał
Published: January 2022

Background

A serious allergic reaction that may occur in response to medical products is anaphylaxis, which potentially can lead to anaphylactic shock. In the light of recent COVID-19 pandemic, much public attention had been paid to the severe allergic reactions occurring after COVID-19 vaccination. Therefore, in our study we would like to investigate the risk of authorized COVID-19 vaccines to induce anaphylactic reaction, anaphylactoid reaction, anaphylactic shock and anaphylactoid shock.

Methods

We searched databases, such as PubMed, Web of Science and Embase and found eight articles about the incidence of anaphylactic and anaphylactoid reactions. Also, we used data from four databases from Canada, the U.S., the European Union and the United Kingdom. To calculate effect sizes, we used random effects model with inverse variance method. The risk ratio with 95% confidence interval were used for dichotomous outcomes. Statistical analysis was prepared in R. Results were considered statistically significant at p < 0.05.

Results

The most cases of anaphylactic reaction, anaphylactoid reaction, anaphylactic shock and anaphylactoid shock were reported in female aged 18–85 years after BNT162b2 vaccine according to data from the EU. Analyzed COVID-19 vaccines can cause the anaphylaxis/anaphylactic reaction with risk of 106.99 (95% CI [39.95; 286.57], p < 0.0001, I2 = 59%), whereas the anaphylactoid reaction, anaphylactic and anaphylactoid shocks with risk of 113.3 (95% CI [28.11; 456.53], p < 0.0001), 344.2 (95% CI [85.77; 1381.39], p < 0.0001), 14.9, 95% CI [1.96; 112.79], p = 0.009), respectively.

Conclusions

Our meta-analysis shows that the risk of anaphylactic reaction, anaphylactoid reaction, anaphylactic shock and anaphylactoid shock do not occur only after mRNA COVID-19 vaccines. Therefore, vaccination centers should be prepared to render assistance in the event of a reaction in all cases.
Assessing the cost-effectiveness of contraceptive methods from a health provider perspective: case study of Kiambu County Hospital, Kenya
Authors: Ngacha James Kiragu , Ayah Richard
Published: January 2022

Background

Kenya’s contraceptive prevalence rate at 53% is low, with wide disparity among the 47 counties that make up the country (2–76%). Significant financial investment is required to maintain this level of contraceptive use and increase it to levels seen in more developed countries. This is in the context of a growing population, declining donor funding, limited fiscal space and competing health challenges. Studies have shown that long-term contraceptive methods are more cost-effective than short-term methods. However, it is unclear if this applies in Sub-Saharan Africa; with limited financial resources, lower social economic status among users, and publicly managed commodity supply chains, in vertical programs largely dependent on donor funding. This study assessed the cost-effectiveness of contraceptive methods used in Kenya.

Methods

A cross-sectional study was undertaken in a county referral hospital in mid-2018. Purposive sampling of 5 family planning clinic providers and systematic sampling of 15 service delivery sessions per method was done. Questionnaire aided interviews were done to determine inputs required to provide services and direct observation to measure time taken to provide each method. Cost per method was determined using activity based costing, effectiveness via couple year protection conversion factors, and cost-effectiveness was expressed as cost per couple year protection.

Results

The intra-uterine copper device was most cost-effective at 4.87 US dollars per couple year protection followed by the 2-Rod Implant at 6.36, the 1-Rod Implant at 9.50, DMPA at 23.68, while the combined oral contraceptive pills were least cost-effective at 38.60 US dollars per couple year protection. Long-term methods attracted a higher initial cost of service delivery when compared to short-term methods.

Conclusion

Long-term contraceptive methods are more cost-effective. As such, investing in long-term contraceptives would save costs despite higher initial cost of service delivery. It is recommended, therefore, that Sub-Saharan Africa countries allocate more domestic financial resources towards availability of contraceptive services, preferably with multi-year planning and budget commitment. The resources should be invested in a wide range of interventions shown to increase uptake of long-term methods, including reduction of cost barriers for the younger population, thereby increasing contraceptive prevalence rates.