bluuebunny/crossref_metadata_2025 huggingface dataset:
The Workings and Effects of Precarious Employment on Black Women Educators in Development Studies: An Autoethnographic Account of an International Fieldtrip
Authors: Schofield Lilian N.
Published: April 2022

This observation is an autoethnographic contribution to understand the epistemological complexities of being employed on a precarious contract and challenging racialized abuse in a higher education institution. I ask the following question: What does it mean for precariously employed Black staff to face and challenge racialized acts and have their expertise questioned by students? This observation draws on my experience of teaching and accompanying students on their compulsory overseas field study. A key finding is the implication that precarious employment practices perpetuate inequality in the discipline of development studies by limiting the ability of Black educators to confront or challenge abuse.
Exploring the Effects of Yoga Therapy on Heart Rate Variability and Patient-Reported Outcomes After Cancer Treatment: A Study Protocol
Authors: Brunet Jennifer , Wurz Amanda , Hussien Julia , Pitman Anne , Conte Ellen , Ennis Julie K. , Herry Christophe L. , Seely Andrew J. E. , Seely Dugald
Published: April 2022

Background:

Following cancer treatment, adults commonly report worsened patient-reported outcomes (PROs) such as anxiety, stress, depression, persistent and upsetting cognitive complaints, unrelenting fatigue, and reduced quality of life. Poorer PROs are associated with disrupted autonomic nervous system functioning as measured by heart rate variability (HRV), both of which have been associated with greater morbidity and mortality. Interventions to improve HRV and PROs among adults following cancer treatment are needed. Yoga therapy holds promise as an intervention to improve HRV and PROs. Therefore, we conducted a single-subject exploratory experimental study to investigate the effects of yoga therapy on HRV and specific PROs (ie, cancer-related fatigue, anxiety, cognitive function, depression, stress, quality of life) in adults treated for cancer. To reduce publication bias, improve reproducibility, and serve as a reference for forthcoming reporting of study results, we present the study protocol for this study herein.

Methods:

Participants were adults who completed cancer treatment that were recruited from the Ottawa Integrative Cancer Centre. Consenting and eligible participants received one 1:1 yoga therapy session (ie, 1 participant, 1 Yoga Therapist) and 6 weekly group-based yoga therapy sessions (ie, 2-3 participants, 1 Yoga Therapist). Participants completed assessments 7 times: 3 times prior to the program (ie, −6 weeks, −3 weeks, immediately prior to the 1:1 yoga therapy session), immediately following the 1:1 yoga therapy session, prior to the first group-based yoga therapy session, after the last group-based yoga therapy session, and at a 6-week follow-up. Hierarchical linear modeling will be used to test the average effects of the yoga therapy program across participants.

Discussion:

This study will explore several novel hypotheses, including whether yoga therapy can improve HRV and/or specific PROs among adults treated for cancer acutely (ie, during a 1:1 yoga therapy session) and/or through repeated exposure (ie, after completing 6 weeks of group-based yoga therapy). Although the findings will require confirmation or refutation in future trials, they may provide initial evidence that YT may benefit adults treated for cancer.

Trial registration:

ISRCTN registry, ISRCTN64763228. Registered on December 12, 2021. This trial was registered retrospectively. URL of trial registry record: https://www.isrctn.com/ISRCTN64763228
Electro-thermal buckling of FG graphene platelets-strengthened piezoelectric beams under humid conditions
Authors: Sobhy Mohammed , Abazid Mohammad Alakel , Al Mukahal Fatemah HH
Published: April 2022

In this article, thermal buckling analysis of multilayer functionally graded graphene platelets (FGGPL) strengthened piezoelectric beam subjected to external electric voltage as well as humid conditions is illustrated. The effective Young’s modulus of the nanocomposite beam is estimated within the framework of Halpin-Tsai model. While, Poisson’s ratio, mass density, and piezoelectric properties are calculated by the rule of the mixture. Four FGGPL distribution types are considered in this study. A refined two-unknown beam theory considering shear deformation as well as thickness stretching effect is employed to describe the displacement components. The principle of virtual work including thermal, moisture, and electric loads is used to derive the stability differential equations. To check the accuracy of the obtained buckling temperature, some comparison examples are performed. The impacts of the GPLs volume fraction, distribution type, length-to-depth ratio, humid conditions, external electric voltage, and piezoelectric properties on the critical buckling temperature are studied.
Shadowing as a method of principal development: A qualitative cross-case study in China
Authors: Shan Xue , Yulian Zheng , Ng Mooi Ashley , Jiwen Liang
Published: April 2022

The purpose of this paper is to explore how shadowing has been applied as a method for principal development in China, in terms of its aims, the procedure and the transfer of learning. Four shadowing programmes countrywide were selected. The information on the experience of the participants, providers and mentors from high-performing site schools was obtained using semi-structured interviews. A total of 16 programme participants, 4 providers and 4 mentors from high-performing site schools were involved. This study presents a comprehensive picture of the use of shadowing as a method for principal development in China by exploring individuals who were directly involved in the shadowing programmes, and by bridging leadership learning to leadership practice stressing on transfer of learning upon completion of the programmes. The research found that learning by shadowing transferred into some positive changes in participants, at both cognitive and practical levels, when they shadow in high-performing schools. However, orientations for learning and relationships during learning were weakly established in most of the programmes, which could hardly support participants to internalise and contextualise their learning into practice for strategic or systematic changes.
Japanese people's attitudes toward acculturation and intercultural relations
Authors: Park Joonha , Berry John W. , Joshanloo Mohsen
Published: April 2022

Dealing with cultural diversity is one of the key challenges in contemporary societies, with Japan being no exception. However, relatively little is known about how minority group members are viewed by members of the dominant group. The current paper presents a study that evaluated three hypotheses that are related to these issues with a survey of 210 Japanese adult participants. The study also examines moderating roles of national identities in acculturation expectations and psychological functioning in the dominant group. Perceived security about the society in terms of national culture, and personal conditions in a multicultural society predict the most tolerant form of acculturation expectation. This association is mediated by one's multicultural ideology. Although acculturation expectations are not predictive of psychological functioning, particular national identity (i.e., internationalism) alleviates the negative effect of the closest form of expectation (exclusion) on psychological problems. The study implies the need for analysis on culture-specific constructs of multicultural society in perceptions and attitudes in the dominant group in Japanese society.
Bicelle Composed of 1,2-Dipalmitoyl-sn-Glycero-3-Phosphatidylcholine and Sodium Cholate
Authors: Uchida Noriyuki , Yanagi Masayoshi , Hamada Hiroki
Published: April 2022

A mixture of 1,2-dipalmitoyl- sn-glycero-3-phosphatidylcholine (DPPC) phospholipid and sodium chelate (SC) formed bicelles (DPPC–SC bicelle) at around 50 °C. In 2H nuclear magnetic resonance (NMR) measurement of the dispersion of DPPC–SC bicelle, quadrupole splitting of D2O, an index of the ability to orient molecules, was observed.
The Role of School Nurses During the 1918 Pandemic: Lessons That Apply to COVID-19
Authors: Maughan Erin D. , Ellen Luehr Ruth
Published: April 2022

The current COVID-19 pandemic has been compared with the Spanish Flu of 1918 that devastated the United States. With so many parallels being drawn, what could be learned from 1918 regarding the role of school nurses? Many of the activities from 1918 are still being done today. School nurses have worked tirelessly to assure the health and safety of students and school. The purpose of this article is to compare the role of school nurses in two pandemics, as well as provide suggestions on how school nurses’ important contributions to history are not lost. The recommendations have an added benefit of providing school nurses with healing and building their resilience.
Inclusive School Leadership in Developing Context: What Are the Levers of Change?
Authors: Opoku Maxwell Peprah
Published: April 2022

In developing sub-Saharan Africa, a region, that is, in the early stages of implementing inclusive education, there is limited discussion on inclusive leadership modules for training leaders. The qualitative study presented in this paper attempted to fill this knowledge gap by considering school leaders’ contributions to implementing inclusive education for students with disabilities. The paper identifies the challenges faced by schools and the initiatives they have implemented to promote inclusive education. The paper concludes by presenting a proposed heuristic leadership model that could be used to train leaders in low-income contexts to enable them to create inclusive learning environments.
Clomid after failed Onco-microsurgical testicular sperm extraction: A case for delaying contralateral surgical sperm retrieval
Authors: Khan Nawal , Yap Tet , Kopeika Julia , Shabbir Majed
Published: April 2022

Background & Objectives:

Onco-microsurgical testicular sperm extraction (Onco-microTESE) allows the microsurgical extraction of testicular sperm from the unaffected regions of the tumour-bearing testis at the time of radical orchidectomy. We report the case of a 36-year-old hypogonadotropic male with a testicular tumour and non-obstructive azoospermia.

Method:

A left radical orchidectomy was performed with simultaneous onco-microTESE. Although some sperm were found during the procedure, these were unsuitable for cryopreservation due to abnormal morphology. Given his low testosterone level (4.1 nmol/L), contralateral surgical sperm retrieval at the same sitting was not performed. Histology of the affected testicle demonstrated a classical seminoma and ‘Sertoli cell only’ appearance. He was subsequently started on clomiphene citrate.

Results:

After 9 months of clomiphene citrate, repeat semen analysis showed a total of 2.8 million sperm (1 million/mL), with 80% motility. Four vials of semen were cryopreserved, and this ejaculated sperm was used for in vitro-fertilisation (IVF) with intracytoplasmic sperm injection (ICSI). All six harvested eggs were fertilised. By day 5, there were two top grade blastocysts available, one of which was transferred and another frozen. After 9 months, the couple welcomed the birth of a healthy male infant.

Conclusion:

To our knowledge, this case is the first to demonstrate the benefit of clomiphene citrate in a patient with testis cancer resulting in a reversal of azoospermia and a subsequent live birth with assisted conception.

Level of evidence:

Not applicable
Promoting Successful Transitions in High School Students With Emotional Disturbance in Saudi Arabia: Educators’ Voices
Authors: Alsalamah Areej A.
Published: April 2022

Providing transition planning and services to students with emotional disturbance (ED) can enhance their success in postsecondary education, employment, and independent living. This qualitative study explores how special educators in Riyadh, the capital city of the Kingdom of Saudi Arabia (KSA), perceive the necessity of promoting transition services for high school students with ED and developing important aspects to implement these services. Study participants were ten special educators majoring in ED who were purposefully sampled from a special education graduate program. The results indicate that all study participants believe there is a need to promote transition services in Saudi schools to support students with ED. The results also highlight four fundamental foundations that educators want to develop to promote the implementation of transition services in Saudi schools: the regulation of special education, transition assessment tools, transition teamwork, and teacher professional development programs in transition. Recommendations for future research are discussed as well.
Pre-Operative Planning in Complex Deformities and Use of Patient-Specific UNiD™ Instrumentation
Authors: Ou-Yang David , Burger Evalina L. , Kleck Christopher J.
Published: April 2022

Study Design

Review of current literature and authors experience.

Objective

Pre-operative planning is an integral part of complex spine surgery. With the advent of computer-assisted planning, multiple surgical plans can be evaluated utilizing alignment parameters, and the best plan for individual patients selected. However, the ability to evaluate and measure surgical correction goals intraoperatively are still limited. The use of patient-specific UNiD rods, created based on pre-operative plans, provided an initial tool for implementation of pre-operative plans in the operative setting.

Methods

A literature review for the use of patient-specific UNiD rods in thoracolumbar spine complex surgery was performed. The articles were selected and reviewed for the initial experience/outcomes of these techniques. Further, the initial experience of the authors at The University of Colorado is described.

Results

The use of UNiD patient-specific rods, in combination with pre-operative planning has been shown to provide a higher rate of patients with spinopelvic alignment parameters within currently accepted ranges. This includes improvement of sagittal vertical axis (SVA) < 50 mm and pelvic incidence (PI)–lumbar lordosis (LL) = ± 10°. Multiple authors have shown improvement in pelvic tilt to age adjusted values but note continued difficulties in obtaining correction goals.

Conclusions

The use of pre-operative planning software and UNiD patient-specific rods has been shown to improve surgeon’s ability to achieve spinopelvic alignment parameters, specifically SVA and PI-LL, along with other possible benefits. Further research is needed regarding long-term value of the technology.
MIS TLIF, EndoTLIF, and the Ability of Navigation/Robotics to Enable Spinal Surgery in an Ambulatory Care Setting
Authors: Kim Choll W.
Published: April 2022

Study Design

Technical Report.

Objective

Performing surgeries in the ambulatory surgery center affords improved efficiencies in terms of cost and speed. However, ambulatory surgery is only successful if complications, re-admissions, and re-operations are avoided. This report describes the San Diego Outpatient Lumbar Fusion Program, a culmination of cumulative incremental improvements in patient selection and patient education, meticulous peri-operative management, minimally invasive techniques together with navigation/robotics.

Methods

Retrospective review of prospectively collected data on 1–2 level minimally invasive transforaminal lumbar interbody fusions (MIS TLIF).

Results

Healthy patients (age 72 years old or less, BMI less than 50, ASA 1 or 2) with good social support and reasonable pre-operative function (ODI 50 or less) treated with the MIS TLIF technique can be discharged home in less than 1 midnight with good clinical results.

Conclusions

Relatively young, healthy patients can safely and effectively undergo 1–2 level lumbar fusion surgery in the ASC setting when using contemporary minimally invasive techniques and computer-assisted navigation/robotics.
Artificial intelligence reshapes current understanding and management of osteoarthritis: A narrative review
Authors: Yick Hin Ting Victor , Chan Ping Keung , Wen Chunyi , Fung Wing Chiu , Yan Chun Hoi , Chiu Kwong Yuen
Published: April 2022

Current practice of osteoarthritis has its insufficiencies which researchers are tackling with artificial intelligence (AI). This article discusses three kinds of AI models, namely diagnostic models, prediction models and morphological models. Diagnostic models enhance efficiency in diagnosis by providing an automated algorithm in knee images processing. Prediction models utilize behavioral and radiological data to assess the risk of osteoarthritis before symptom onset and needs to perform surgery. Morphological models detect biomechanical changes to facilitate understanding of pathophysiology and provide personalized intervention. Through reviewing present evidence, we demonstrate that AI could assist doctors in diagnosis, predict osteoarthritis and guide future research.
Does Foreign Direct Investment Facilitate Entrepreneurial Activities? Evidence from BRICS Countries
Authors: Rani Ritu , Kumar Naresh
Published: April 2022

This article investigates the impact of foreign direct investment (FDI) on the entrepreneurial activities in Brazil, Russia, India, China and South Africa (BRICS nations) by assessing the influence of both inward and outward FDI during the period of 2002–2019. We resort to a fixed as well as random effect model on the panel data of five nations, that is BRICS. The article also explored the reverse impact of total entrepreneurial activities (TEA) on inward and outward FDI. The results highlight that inward FDI has a positive impact on entrepreneurial activities while outward FDI has a negative influence on entrepreneurial activities in BRICS nations. Nevertheless, the TEA have a positive and significant impact on inward FDI, while relationships between outward FDI and TEA are found to be insignificant in BRICS economies. In addition, economic growth is also found to be important factor to encourage FDI. The results suggest that more inward FDI should be encouraged to provide innovation and markets to entrepreneurs, as they are the bridge between invention and commercialization.
Moral Distress Experienced by US Nurses on the Frontlines During the COVID-19 Pandemic: Implications for Nursing Policy and Practice
Authors: Simonovich Shannon D. , Webber-Ritchey Kashica J. , Spurlark Roxanne S. , Florczak Kristine , Mueller Wiesemann Lucy , Ponder Tiffany N. , Reid Madeline , Shino Denita , Stevens Bonnie R. , Aquino Elizabeth , Badowski Donna , Lattner Christina , Soco Cheryl , Krawczyk Susan , Amer Kim
Published: April 2022

Introduction

The ongoing COVID-19 pandemic represents the largest contemporary challenge to the nursing workforce in the 21st century given the high stress and prolonged strain it has created for both human and healthcare supply resources. Nurses on the frontlines providing patient care during COVID-19 have faced unrivaled psychological and physical demands. However, no known large-scale qualitative study has described the emotions experienced by nurses providing patient care during the first wave of the COVID-19 pandemic in the US. Objective: Therefore, the purpose of this study was to qualitatively describe the emotions experienced by US nurses during the initial COVID-19 pandemic response.

Methods

One hundred individual interviews were conducted with nurses across the United States from May to September of 2020 asking participants to describe how they felt taking care of COVID-19 patients. All interviews followed a semi-structured interview guide, were audio recorded, transcribed, verified, and coded by the research team.

Results

Participants narratives of the emotions they experienced providing patient care during COVID-19 unequivocally described (1) moral distress, and moral distress related (1.1) fear, (1.2) frustration, (1.3) powerlessness, and (1.4) guilt. In sum, the major emotional response of nurses across the US providing patient care during the pandemic was that of moral distress.

Conclusion

Investments in healthcare infrastructures that address moral distress in nurses may improve retention and reduce burnout in the US nursing workforce.
Fragmented mitochondrial genomes of seal lice (family Echinophthiriidae) and gorilla louse (family Pthiridae): frequent minichromosomal splits and a host switch of lice between seals
Authors: Dong Yalun , Zhao Min , Shao Renfu
Published: April 2022

Background

The mitochondrial (mt) genomes of 15 species of sucking lice from seven families have been studied to date. These louse species have highly dynamic, fragmented mt genomes that differ in the number of minichromosomes, the gene content, and gene order in a minichromosome between families and even between species of the same genus.

Results

In the present study, we analyzed the publicly available data to understand mt genome fragmentation in seal lice (family Echinophthiriidae) and gorilla louse, Pthirus gorillae (family Pthiridae), in particular the role of minichromosome split and minichromosome merger in the evolution of fragmented mt genomes. We show that 1) at least three ancestral mt minichromosomes of sucking lice have split in the lineage leading to seal lice, 2) one minichromosome ancestral to primate lice has split in the lineage to the gorilla louse, and 3) two ancestral minichromosomes of seal lice have merged in the lineage to the northern fur seal louse. Minichromosome split occurred 15-16 times in total in the lineages leading to species in six families of sucking lice investigated. In contrast, minichromosome merger occurred only four times in the lineages leading to species in three families of sucking lice. Further, three ancestral mt minichromosomes of sucking lice have split multiple times independently in different lineages of sucking lice. Our analyses of mt karyotypes and gene sequences also indicate the possibility of a host switch of crabeater seal louse to Weddell seals.

Conclusions

We conclude that: 1) minichromosome split contributes more than minichromosome merger in mt genome fragmentation of sucking lice, and 2) mt karyotype comparison helps understand the phylogenetic relationships between sucking louse species.
Immunohistochemical detection of chlamydia trachomatis in sexually transmitted infectious proctitis
Authors: Arévalo Fernando , Rayme Soledad , Zurita Fiorella , Ramírez Rocio , Franco David , Montes Pedro , Fustamante Jaime , Monge Eduardo
Published: April 2022

Introduction

Since 2003, a progressive increase in sexually transmitted infections (STI), presented as proctitis, has been described in homosexual men. In 2013 Arnold et al. described microscopic features that enable pathologists to formulate a histological diagnosis of STI related proctitis. The aim of this study is to identify the presence of Chlamydia trachomatis by immunohistochemistry in a group of patients with male to male sexual activity and pathology compatible with STI proctitis.

Methods

Cross-sectional study. The study included 54 patients with risky sexual activity and histopathology compatible with STI-proctitis according to Arnold´s recommendations. The Chlamydia trachomatis identification was carried out retrospectively on paraffin blocks using mouse monoclonal antibodies from Santa Cruz biotechnology.

Results

all patients were young men with male to male sexual activity, 69% were positive for HIV. The most common endoscopic presentation was rectal ulcer (61%). Basal lymphoplasmacytic inflammation and mild crypt distortion were the most common histological findings. The immunohistochemical study identified positivity for Chlamydia trachomatis in 40% (18 of 45 tested) of STI proctitis cases.

Discussion

The epidemiological and endoscopic characteristics of the patients studied are similar to those previously reported. In accordance with Arnold et al., the most common histological findings were (a) mild distortion of the crypts; (b) dense and basal lymphoplasmacytic infiltrate and (c) scarcity of eosinophils. The positivity of chlamydia trachomatis in immunohistochemistry was lower than others studies that used PCR for this purpose. We did not find similar published studies to compare our results.

Conclusions

In summary, 54 cases of patients with STI related proctitis are presented, all of them with distinctive histological characteristics and third of the cases tested positive by IHC for Chlamydia trachomatis.
Intrinsic capacity of older people in the community using WHO Integrated Care for Older People (ICOPE) framework: a cross-sectional study
Authors: Leung Angela Y. M. , Su Jing Jing , Lee Elsa S. H. , Fung Jeff T. S. , Molassiotis Alex
Published: April 2022

Background

The World Health Organization (WHO) published the Integrated Care for Older People (ICOPE) framework to guide assessing and promoting intrinsic capacity of older adults. This study, adopting the WHO ICOPE framework, assessed the intrinsic capacity impairment and investigated the relationship among intrinsic capacity, social engagement, and self-care capacity on performing activities of daily living. It also assessed the sensitivity of the initial brief screening and the detailed full assessment.

Methods

This is a cross-sectional study conducted in 11 community centers in Hong Kong. Intrinsic capacity was assessed in two steps identical to WHO ICOPE handbook: using WHO ICOPE brief screening tool (step 1) and detailed full assessment (step 2) to assess the intrinsic capacity domains of locomotion, cognition, vitality, psychological well-being, and sensory capacity (hearing and vision). Structural equational modeling analysis was used to examine the relationship among intrinsic capacity, social engagement, and self-care capacity, and the mediating role of intrinsic capacity in the relationships.

Results

A total of 304 older adults with a mean age 76.73 (SD = 7.25) years participated in WHO ICOPE Step 1 brief screening, and 221 participants (72.7%) showed intrinsic capacity impairment. After completing Step 2 full assessment, 202 participants (66.4%) had one or more impaired intrinsic capacity domains. The overall sensitivity and specificity of the screening tool were 95% and 57.6% respectively, whereas the sensitivity of each domain ranged from 74.7% to 100%. The percentage of impairment in locomotion (117, 39.8%), cognition (75, 25.5%), psychological well-being (34, 11.6%), vision (75, 24.7%), hearing capacity (82, 27.9%), and vitality (8, 2.7%). People in younger old age (β = -0.29, p < 0.001), with more education (β = 0.26, p < 0.001), and absence of hypertension (β = -0.11, p < 0.05) were more likely to have better intrinsic capacity. Intrinsic capacity was positively associated with self-care capacity in performing activities of daily living (β = 0.21, p < 0.001) and social engagement (β = 0.31, p < 0.001).

Conclusions

The ICOPE screening tool is a sensitive instrument to detect intrinsic capacity impairment among community-dwelling older adults and it does not demand substantial workforce; its use is worthy to be supported. The intrinsic capacity impairment in community-dwelling older adults are prevalent, in particular, in locomotor and cognitive capacity. Actions should be taken to slow or prevent the impairment, support self-care and social engagement in old age.
Development and validation of polygenic risk scores for prediction of breast cancer and breast cancer subtypes in Chinese women
Authors: Hou Can , Xu Bin , Hao Yu , Yang Daowen , Song Huan , Li Jiayuan
Published: April 2022

Background

Studies investigating breast cancer polygenic risk score (PRS) in Chinese women are scarce. The objectives of this study were to develop and validate PRSs that could be used to stratify risk for overall and subtype-specific breast cancer in Chinese women, and to evaluate the performance of a newly proposed Artificial Neural Network (ANN) based approach for PRS construction.

Methods

The PRSs were constructed using the dataset from a genome-wide association study (GWAS) and validated in an independent case-control study. Three approaches, including repeated logistic regression (RLR), logistic ridge regression (LRR) and ANN based approach, were used to build the PRSs for overall and subtype-specific breast cancer based on 24 selected single nucleotide polymorphisms (SNPs). Predictive performance and calibration of the PRSs were evaluated unadjusted and adjusted for Gail-2 model 5-year risk or classical breast cancer risk factors.

Results

The primary PRSANN and PRSLRR both showed modest predictive ability for overall breast cancer (odds ratio per interquartile range increase of the PRS in controls [IQ-OR] 1.76 vs 1.58; area under the receiver operator characteristic curve [AUC] 0.601 vs 0.598) and remained to be predictive after adjustment. Although estrogen receptor negative (ER−) breast cancer was poorly predicted by the primary PRSs, the ER− PRSs trained solely on ER− breast cancer cases saw a substantial improvement in predictions of ER− breast cancer.

Conclusions

The 24 SNPs based PRSs can provide additional risk information to help breast cancer risk stratification in the general population of China. The newly proposed ANN approach for PRS construction has potential to replace the traditional approaches, but more studies are needed to validate and investigate its performance.
The co-management of tuberculosis-diabetes co-morbidities in Indonesia under the National Tuberculosis Control Program: results from a cross-sectional study from 2017 to 2019
Authors: Jiang Weixi , Trimawartinah  , Rahman Fauziah Mauly , Wibowo Adik , Sanjaya Adhi , Silitonga Permata Imani Ima , Tang Shenglan , Long Qian
Published: April 2022

Background

Indonesia suffers from a high burden of tuberculosis (TB) and diabetes (DM). The government initiated national TB-DM co-management activities under the National TB Control Program in 2017. This study investigates the detection and treatment outcomes of TB-DM in Jakarta after implementing these activities, and identifies the main factors associated with these outcomes.

Methods

A cross-sectional study was conducted using TB registry data in two districts of Jakarta, East Jakarta (low-income) and South Jakarta (high-income). A 5-step cascade analysis was used: diagnosed TB patients; TB patients tested for DM; diagnosed TB-DM patients; and patients received and completed TB treatment/cured. We conducted descriptive analyses to understand the characteristics of TB and TB-DM patients, and used a two-level mixed-effect logistic regression to explore factors associated with having a DM test and completing TB treatment/being cured.

Results

Over the study period (2017–2019) 50.8% of the new pulmonary TB patients aged over 15 were tested for DM. The percentage increased from 41.7% in 2017–2018 to 60.1% in 2019. Of the TB patients tested for DM, 20.8% were diagnosed with DM. Over 90% of the detected TB-DM patients received standard TB treatment, 86.3% of whom completed treatment/were cured. Patients in East Jakarta were more likely to be tested for DM and to complete standard TB treatment/be cured than patients in South Jakarta (P <  0.001). Bacteriologically positive TB patients were more likely to be tested for DM (OR = 1.37, 95% CIs 1.17,1.60). Patients diagnosed in sub-district level healthcare centers had a higher likelihood of being tested for DM than those in government and private hospitals (P <  0.05). Receiving DM treatment was associated with a higher likelihood of completing TB treatment/being cured (OR = 1.82, 95% CIs 1.20, 2.77).

Conclusions

TB-DM case detection significantly improved in 2019 after introducing TB-DM co-management activities in Jakarta, while gaps in TB-DM co-management existed between bacteriologically positive and clinically diagnosed TB patients, and across different types of health facilities. Collaboration between TB and DM departments should be strengthened, and more resources need to be mobilized to further improve the co-management of TB-DM in Indonesia.
Clinical characteristics and image features of pulmonary cryptococcosis: a retrospective analysis of 50 cases in a Chinese hospital
Authors: Lu Yuan , Ding Ming , Huang Jing , Fu Cuiping , Wan Yi , Jiang Jun , Huang Jie
Published: April 2022

Objective

To investigate the clinical manifestations and imaging characteristics of pulmonary cryptococcosis, and discuss its guidance in diagnosing.

Methods

The clinical data of patients diagnosed with cryptococcosis in our hospital from January 2014 to May 2020 were collected and retrospectively analyzed. Patients were divided into the immunocompromised group and the immunocompetent group. The symptomatic features, laboratory examination, imaging manifestations, and curative effect were analyzed.

Results

The most common symptoms of patients were cough and sputum production, followed by fever. The immunocompetent group has a significantly higher accident rate of cough and fever than the immunocompromised group, while the immunocompromised group has a significantly higher accident rate of headache and dizziness (P < 0.05). The positive rate of serum cryptococcal capsular antigen (CrAg) test of the two groups were 83.33% and 86.96%, respectively. While the positive rate of CrAg test in cerebrospinal fluid of the immunocompromised group was significantly higher than that of the immunocompetent group (P < 0.05). The lesions of pulmonary cryptococcosis were predominantly present in the lower part of the lung periphery and significantly distributed in the right lung (P < 0.05). The most common imaging finding of pulmonary cryptococcosis was halo sign (64.58%), followed by multiple nodules, and trachea sign was significantly more common in the immunocompetent group.

Conclusions

Cryptococcosis has an insidious onset, which can infect healthy people as well. Conducting a CrAg test is good for screening and diagnosing cryptococcosis. We should be alert for the high risk of cryptococcal meningoencephalitis in patients with compromised immune function.
Efficacy of non-surgical management and functional outcomes of partial ACL tears. A systematic review of randomised trials
Authors: Giummarra Michael , Vocale Loretta , King Matthew
Published: April 2022

Background

The incidence of anterior cruciate ligament (ACL) injuries represents a large burden of knee injuries in both the general and sporting populations, often requiring surgical intervention. Although there is much research on complete ACL tears including outcomes and indications for surgery, little is known about the short- and long-term outcomes of non-operative, physiotherapy led intervention in partial ACL tears. The primary aim of this study was to evaluate studies looking at the effectiveness of physiotherapy led interventions in improving pain and function in young and middle-aged adults with partial ACL tears. Additionally, the secondary aim was to evaluate the completeness of exercise prescription in randomised trials for physiotherapy led interventions in the management in partial ACL tears.

Methods

A comprehensive and systematic search was performed on six databases (Medline, CINAHL, EMBASE, PEDro, Scopus, SPORTDiscus and Cochrane). The search strategy consisted of two main concepts: (i) partial ACL tears, and (ii) non-operative management. 7,587 papers were identified by the search. After screening of eligible articles by two independent reviewers, 2 randomised studies were included for analysis. The same two reviewers assessed the completeness of reporting using the Toigio and Boutellier mechanobiological exercise descriptions and Template for Intervention Description and Replication (TIDieR) checklist. Group mean standard deviations (SD) for the main outcomes was extracted from both papers for analysis. Prospero Registration Number: CRD42020179892.

Results

The search strategy identified two studies; one looking at Tai Chi and the other Pilates. The analysis indicated that Tai Chi was significant in reducing pain scores and both Tai Chi and Pilates were found to increase Muscle Peak Torque Strength (MPTS) at 180 degrees. Furthermore, Tai Chi showed a significant increase in proprioception.

Conclusions

Physiotherapy led interventions such as Pilates, and Tai Chi may improve pain, proprioception and strength in young and middle-aged adults with partial ACL tears, however full scale, high-quality randomised studies are required with long term outcomes recorded.
Using radiomic features of lumbar spine CT images to differentiate osteoporosis from normal bone density
Authors: Xue Zhihao , Huo Jiayu , Sun Xiaojiang , Sun Xuzhou , Ai Song tao , LichiZhang  , Liu Chenglei
Published: April 2022

Objective

This study aimed to develop a predictive model to detect osteoporosis using radiomic features from lumbar spine computed tomography (CT) images.

Methods

A total of 133 patients were included in this retrospective study, 41 men and 92 women, with a mean age of 65.45 ± 9.82 years (range: 31–94 years); 53 had normal bone mineral density, 32 osteopenia, and 48 osteoporosis. For each patient, the L1–L4 vertebrae on the CT images were automatically segmented using SenseCare and defined as regions of interest (ROIs). In total, 1,197 radiomic features were extracted from these ROIs using PyRadiomics. The most significant features were selected using logistic regression and Pearson correlation coefficient matrices. Using these features, we constructed three linear classification models based on the random forest (RF), support vector machine (SVM), and K-nearest neighbor (KNN) algorithms, respectively. The training and test sets were repeatedly selected using fivefold cross-validation. The model performance was evaluated using the area under the receiver operator characteristic curve (AUC) and confusion matrix.

Results

The classification model based on RF had the highest performance, with an AUC of 0.994 (95% confidence interval [CI]: 0.979–1.00) for differentiating normal BMD and osteoporosis, 0.866 (95% CI: 0.779–0.954) for osteopenia versus osteoporosis, and 0.940 (95% CI: 0.891–0.989) for normal BMD versus osteopenia.

Conclusions

The excellent performance of this radiomic model indicates that lumbar spine CT images can effectively be used to identify osteoporosis and as a tool for opportunistic osteoporosis screening.
Lessons learned from a pandemic: implications for a combined exercise and educational programme for medical students
Authors: Worobetz Aubree , O’ Regan Andrew , Casey Monica , Hayes Peter , O’ Callaghan Mike , Walsh Jane C. , Bengoechea Enrique García , Woods Catherine , McGrath Deirdre , Glynn Liam G.
Published: April 2022

Background

The ‘MED-WELL’ programme is a combined exercise and educational intervention designed to promote well-being among medical students and educate students about prescribing exercise as medicine in clinical practice. Due to COVID-19 public health restrictions of social distancing the ‘MED-WELL’ programme was offered online instead of in-person in 2021. The aim of this study is to compare the experiences of participants in the ‘MED-WELL’ programme online to those that previously participated in the same programme in-person to understand the student experience and optimize programme delivery.

Methods

Purposive sampling was used to recruit 20 participants to a qualitative study using semi-structured interviews. Ten study participants took part in the ‘MED-WELL’ programme when it was offered in-person, and the other ten study participants took part in the programme when it was offered online. All interviews were audio-recorded and transcribed using Microsoft Teams. A combined inductive and deductive approach was used for analysis. An inductive thematic analysis was utilized to categorize data into higher order codes, themes, and overarching themes. The theory of online learning provided the theoretical framework for a deductive approach.

Results

Analysis of the data produced five overarching themes: ‘student-student’, ‘student-teacher’, ‘student-content’, ‘student-environment’, and ‘effects of a pandemic’. The first four themes detail distinct types of interaction that participants had with various entities of the ‘MED-WELL’ programme and the effects that these interactions had on participant experiences. ‘Effects of a pandemic’ refers to the context of delivering the ‘MED-WELL’ programme online during a pandemic and how this mode of delivery influenced participants and the programme.

Conclusions

Optimizing the ‘MED-WELL’ programme relies on an understanding of how participants interact with different entities of the programme and are motivated to attend and engage. Participants tended to favour an in-person mode of delivery, however certain advantages of delivering the programme online were also identified. The findings from this study can be used to inform similar experiential and educational exercise interventions, and may help plan for potential future restrictions on in-person educational and exercise-based programmes.
Patient-centred care and patient autonomy: doctors’ views in Chinese hospitals
Authors: Liang Zhanming , Xu Min , Liu Guowei , Zhou Yongli , Howard Peter
Published: April 2022

Background

Patient-centred care and patient autonomy is one of the key factors to better quality of service provision, hence patient outcomes. It enables the development of patients’ trusts which is an important element to a better doctor-patient relationship. Given the increasing number of patient disputes and conflicts between patients and doctors in Chinese public hospital, it is timely to ensure patient-centred care is fully and successfully implemented. However, limited studies have examined the views and practice in different aspects of patient-centred care among doctors in the Chinese public hospitals.

Methods

A quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China.

Results

In total, 614 doctors from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the inconsistent views among doctors in terms of their perception and practice in various aspects patient-centred care and patient autonomy regardless of the hospital where they work (category II or category III), their unit speciality (surgical or non-surgical), their gender or seniority. The high proportion of doctors (more than 20%) who did not perceive the importance of patient consultation prior to determining diagnostic and treatment procedure is alarming. This in in part due to the belief held by more than half of the doctors that patients were unable to make rational decisions and their involvement in treatment planning process did not necessarily lead to better treatment outcomes.

Conclusion

The study calls for the development of system level policy and organisation wide strategies in encouraging and enabling the practice of patient-centred care and patient autonomy with the purposes of improving the quality of the service provided to patients by Chinese hospitals.
Access to health care for people with stroke in South Africa: a qualitative study of community perspectives
Authors: Smythe T , Inglis-Jassiem G , Conradie T , Kamalakannan S , Fernandes S , van-Niekerk SM , English R , Webster J , Hameed S , Louw QA
Published: April 2022

Background

Incidence of stroke is increasing in sub-Saharan Africa. People who survive stroke experience disability and require long-term care. Health systems in South Africa (SA) are experiencing important challenges, and services in the public health system for people with stroke (PWS) are fragmented. We aimed to explore the perspectives and experiences of PWS related to stroke care services to inform health system strengthening measures.

Methods

In-depth interviews with 16 PWS in urban and rural areas in the Western and Eastern Cape Provinces of SA were conducted between August and October 2020. PWS were recruited through existing research networks, non-government organisations and organisations of persons with disabilities by snowball sampling. Interviews were transcribed, coded, and thematically analysed. We used the conceptual framework of access to health care as proposed by Levesque et al. to map and inform barriers to accessing health care from the user perspective.

Results

PWS recognised the need for health care when they experienced signs of acute stroke. Health literacy on determinants of stroke was low. Challenges to accessing stroke care include complex pathways to care, physical mobility related to stroke, long travel distances and limited transport options, waiting times and out of pocket expenses. The perceived quality of services was influenced by cultural beliefs, attitudinal barriers, and information challenges. Some PWS experienced excellent care and others particularly poor care. Positive staff attitude, perceived competence and trustworthiness went in hand with many technical and interpersonal deficits, such as long waiting times and poor staff attitude that resulted in poor satisfaction and reportedly poor outcomes for PWS.

Conclusions

Strategic leadership, governance and better resources at multiple levels are required to address the unmet demands and needs for health care of PWS. Stroke care could be strengthened by service providers routinely providing information about prevention and symptoms of stroke, treatment, and services to patients and their social support network. The role of family members in continuity of care could be strengthened by raising awareness of existing resources and referral pathways, and facilitating connections within services.
Report from the CVOT Summit 2021: new cardiovascular, renal, and glycemic outcomes
Authors: Schnell Oliver , Battelino Tadej , Bergenstal Richard , Blüher Matthias , Böhm Michael , Brosius Frank , Carr Richard D. , Ceriello Antonio , Forst Thomas , Giorgino Francesco , Guerci Bruno , Heerspink Hiddo J. L. , Itzhak Baruch , Ji Linong , Kosiborod Mikhail , Lalić Nebojša , Lehrke Michael , Marx Nikolaus , Nauck Michael , Rodbard Helena W. , Rosano Giuseppe M. C. , Rossing Peter , Rydén Lars , Santilli Francesca , Schumm-Draeger Petra-Maria , Vandvik Per Olav , Vilsbøll Tina , Wanner Christoph , Wysham Carol , Standl Eberhard
Published: April 2022

The 7th Cardiovascular Outcome Trial (CVOT) Summit on Cardiovascular, Renal, and Glycemic Outcomes, was held virtually on November 18–19, 2021. Pursuing the tradition of the previous summits, this reference congress served as a platform for in-depth discussion and exchange on recently completed CVOTs. This year’s focus was placed on the outcomes of EMPEROR-Preserved, FIGARO-DKD, AMPLITUDE-O, SURPASS 1–5, and STEP 1–5. Trial implications for diabetes and obesity management and the impact on new treatment algorithms were highlighted for endocrinologists, diabetologists, cardiologists, nephrologists, and general practitioners. Discussions evolved from outcome trials using SGLT2 inhibitors as therapy for heart failure, to CVOTs with nonsteroidal mineralocorticoid receptor antagonists and GLP-1 receptor agonists. Furthermore, trials for glycemic and overweight/obesity management, challenges in diabetes management in COVID-19, and novel guidelines and treatment strategies were discussed.

Trial registrationThe 8th Cardiovascular Outcome Trial Summit will be held virtually on November 10–11, 2022 (http://www.cvot.org)