bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitamin D in the time of the coronavirus (COVID-19) pandemic – a clinical review from a public health and public mental health perspective
Authors: Werneke Ursula , Gaughran Fiona , Taylor David M.
Published: July 2021

Individuals with serious mental disorders (SMD) may have a higher risk of vitamin D (VIT-D) deficiency. They also experience higher mortality because of coronavirus disease 2019 (COVID-19) infection. Therefore, we have conducted a comprehensive review to examine the significance of VIT-D for public health and public mental health during the ongoing COVID-19 pandemic. This review had three specific aims, from a global perspective to (a) create a profile of VIT-D and review the epidemiology of VIT-D deficiency, (b) explore VIT-D deficiency as risk factor for SMD and COVID-19 infections and (c) examine the effectiveness of VIT-D supplementation for both conditions. We found that, in terms of SMD, the evidence from laboratory and observational studies points towards some association between VIT-D deficiency and depression or schizophrenia. Mendelian randomisation studies, however, suggest no, or reverse, causality. The evidence from intervention studies is conflicting. Concerning COVID-19 infection, on proof of principle, VIT-D could provide a plausible defence against the infection itself and against an adverse clinical course. But data from observational studies and the first preliminary intervention studies remain conflicting, with stronger evidence that VIT-D may mitigate the clinical course of COVID-19 infection rather than the risk of infection in the first place. From a public health and public mental health point of view, based on the currently limited knowledge, for individuals with SMD, the benefits of VIT-D optimisation through supplementation seem to outweigh the risks. VIT-D supplementation, however, should not substitute for vaccination or medical care for COVID-19 infection.
Magnitude and factors associated with anemia among diabetic patients in Ethiopia: A systematic review and meta-analysis
Authors: Atlaw Daniel , Tariku Zerihun
Published: July 2021

Background:

In Ethiopia, diabetes is estimated to affect about half a million people. About 35% of individuals with diabetes are complicated by microvascular diseases like retinopathy, nephropathy, cardiovascular, and anemia. Even though there are some studies conducted on prevalence and associated factors of anemia in diabetic patients, their findings were variable. Therefore, this meta-analysis is aimed to determine the pooled prevalence and factors associated with anemia among diabetic patients.

Methods:

PubMed, CINAHL, POPLINE, ScienceDirect, African Journals Online, and Google Scholar were systematically searched to identify related studies. The heterogeneity of studies was assessed using Cochran’s Q test and I2 tests. A random-effects model was used to estimate the pooled prevalence of anemia among diabetic patients in Ethiopia. Publication bias was evaluated by employing Egger’s tests.

Results:

After reviewing 503 articles, 6 articles fulfilled inclusion criteria and remained for the final meta-analysis. The pooled prevalence of anemia among diabetic patients was 24.81% (95% confidence interval: 19.38–30.25). Age greater than 60 years old (pooled odds ratio, 95% confidence interval: 3.73 (2.23–6.77)), glomerular filtration rate less than 60 mL/min/1.73 m2 (pooled odds ratio, 95% confidence interval: 12.65 (8.71–18.37)), and being diabetic for more than 10 years (pooled odds ratio, 95% confidence interval: 10.21 (7.00–15.04)) were found to be determinants of anemia among diabetic patients in Ethiopia.

Conclusion:

Overall, one in four diabetic patients develops anemia in Ethiopia. Age, glomerular filtration rate, and duration of being diabetic are factors significantly associated with the occurrence of anemia in diabetic patients.
Using a multidisciplinary approach to reveal decision-making capacity within acute care for an individual with aphasia
Authors: Maxwell Ruth , O’Brien Michelle , O’Donnell Deirdre , Christophers Lauren , Kroll Thilo
Published: July 2021

Formal assessments of cognition that rely on language may conceal the non-linguistic cognitive function of people with aphasia. This may have detrimental consequences for how people with aphasia are supported to reveal communicative and decision-making competence. This case report demonstrates a multidisciplinary team approach to supporting the health and social care decision-making of people with aphasia. The case is a 67-year-old woman with Wernicke’s type aphasia. As the issue of long-term care arose, the speech and language therapist used a supported communication approach with the patient who expressed her wish to go home. A multidisciplinary team functional assessment of capacity was undertaken which involved functional assessments and observations of everyday tasks by allied health, nursing, catering and medical staff. In this way, the patient’s decision-making capacity was revealed and she was discharged home. A collaborative multidisciplinary team approach using supported communication and functional capacity assessments may be essential for scaffolding the decision-making capacity of people with aphasia.
The Effectiveness of Telenursing for Self-Management Education on Cardiometabolic Conditions: A Pilot Project on a Remote Island of Ōsakikamijima, Japan
Authors: Moriyama Michiko , Kazawa Kana , Jahan Yasmin , Ikeda Mika , Mizukawa Mariko , Fukuoka Yasuko , Harada Koji , Rahman Md Moshiur
Published: July 2021

Introduction:

Providing self-management education for residents with cardiometabolic conditions in remote islands is a challenge due to the shortage of primary care practitioners (PCPs), specialist physicians, and nurses. Therefore, we applied telenursing with lifestyle-related chronic diseases in remote island residents in Japan. This project aimed to improve the self-management behavior, cardiometabolic indicators, self-efficacy, and quality of life (QoL) of residents with cardiometabolic risks.

Methods:

We chose Ōsakikamijima Island, Hiroshima Prefecture, Japan, which is designated under the Remote Islands Development Act. The project was conducted from 2013 to 2014. The residents aged over 40 and under 75 years old, selected from the annual specific health check-up examination and from PCPs for screening cardiometabolic risks (urinary protein, glycohemoglobin A1c, systolic and diastolic blood pressure (BP), Low-density lipoprotein cholesterol, High-density lipoprotein cholesterol, and triglyceride) were included. The effectiveness of telenursing for self-management education was 6-month-long with a 6-month follow-up and evaluated by a single-group pre-and post-test design. Face-to-face health education was applied at the initial interview followed by telenursing (biweekly telephone calls till third-month, and a monthly telephone call during the fourth and fifth-month) by the trained nurses outside the island. To enhance participants’ self-monitoring health behavior changes, the nurses used motivational interviewing and behavior change techniques based on the transtheoretical model.

Results:

A total of 130 residents, 42 agreed to participate, 41 finished the 6-month program, and 33 completed the 12-month follow-up. Most of their behavior changes like self-management behaviors, cardiometabolic indicators, and self-efficacy at 6-month were improved significantly except QoL. Among the 12-month study periods, self-management behaviors, body mass index, systolic BP, diastolic BP, and self-efficacy (sense of control), (all P < .05) showed significant improvement.

Conclusion:

This study results indicated that telenursing might be effective to improve the lifestyles-related behaviors in chronic diseases on the remote island of Ōsakikamijima, Japan.
Outcomes for older people with long-term conditions attending day care services delivered by paid staff or volunteers: a comparative study
Authors: Lunt Catherine , Shiels Chris , Dowrick Christopher , Lloyd-Williams Mari
Published: July 2021

Background:

Day care services support older people living with long-term conditions (LTC’s).

Aims:

The aims of the study were to determine outcomes in terms of loneliness and health-related quality of life for older people with LTCs attending day care services in the United Kingdom.

Methods:

Newly referred older people with LTCs to day care services in North West of England and Wales were invited to participate. The EQ-5D-3L and De Jong Loneliness questionnaires were completed at recruitment, 6 and 12 weeks.

Results:

Ninty-four older people (64% female), age range 65–99 years; mean number of LTCs 4.3 (range: 2–9) were recruited. About 52% lived alone and 36% lived in one of the 20% most deprived local authorities in England and Wales. Outcomes over 12 weeks were comparable for paid, blended, and for volunteer-led services.

Conclusion:

Following the Covid-19 pandemic, it is increasingly urgent to support older people with LTCs who may have lost physical and cognitive function during lockdown and to support their recovery. Our study suggests that volunteers can provide services and complement the care provided by paid staff, freeing up resources and enabling increasing numbers of older people to be supported.
The effects of shoulder arthroscopy on ultrasound image quality of the interscalene brachial plexus: a pre-procedure vs post-procedure comparative study
Authors: Panchamia Jason K. , Jagannathan Ram , Pulos Bridget P. , Amundson Adam W. , Sanchez-Sotelo Joaquin , Martin David P. , Smith Hugh M.
Published: July 2021

Background

Fluid extravasation from the shoulder compartment and subsequent absorption into adjacent soft tissue is a well-documented phenomenon in arthroscopic shoulder surgery. We aimed to determine if a qualitative difference in ultrasound imaging of the interscalene brachial plexus exists in relation to the timing of performing an interscalene nerve block (preoperative or postoperative).

Methods

This single-center, prospective observational study compared pre- and postoperative interscalene brachial plexus ultrasound images of 29 patients undergoing shoulder arthroscopy using a pretest-posttest methodology where individual patients served as their own controls. Three fellowship-trained regional anesthesiologists evaluated image quality and confidence in performing a block for each ultrasound scan using a five-point Likert scale. The association of image quality with age, gender, BMI, duration of surgery, obstructive sleep apnea, and volume of arthroscopic irrigation fluid were analyzed as secondary outcomes.

Results

Aggregate preoperative mean scores in quality of ultrasound visualization were higher than postoperative scores (preoperative 4.5 vs postoperative 3.8; p < .001), as was confidence in performing blockade based upon the imaging (preoperative 4.8 vs postoperative 4.2; p < .001). Larger BMI negatively affected visualization of the brachial plexus in the preoperative period (p < 0.05 for both weight categories). Patients with intermediate-high risk or confirmed obstructive sleep apnea had lower aggregate postoperative mean scores compared to the low-risk group for both ultrasound visualization (3.4 vs 4.0; p < .05) and confidence in block performance (3.8 vs 4.4; p < .05).

Conclusion

Due to the potential reduction of ultrasound visualization of the interscalene brachial plexus after shoulder arthroscopy, we advocate for a preoperative interscalene nerve block when feasible.

Trial registration

ClinicalTrials.gov (NCT03657173; September 4, 2018).
Simultaneous heart-kidney transplantation results in respectable long-term outcome but a high rate of early kidney graft loss in high-risk recipients – a European single center analysis
Authors: Beetz Oliver , Thies Juliane , Weigle Clara A. , Ius Fabio , Winkler Michael , Bara Christoph , Richter Nicolas , Klempnauer Jürgen , Warnecke Gregor , Haverich Axel , Avsar Murat , Grannas Gerrit
Published: July 2021

Background

In spite of renal graft shortage and increasing waiting times for transplant candidates, simultaneous heart and kidney transplantation (HKTx) is an increasingly performed procedure established for patients with combined end-stage cardiac and renal failure. Although data on renal graft outcome in this setting is limited, reports on reduced graft survival in comparison to solitary kidney transplantation (KTx) have led to an ongoing discussion of adequate organ utilization.

Methods

This retrospective study was conducted to evaluate prognostic factors and outcomes of 27 patients undergoing HKTx in comparison to a matched cohort of 27 patients undergoing solitary KTx between September 1987 and October 2019 in one of Europe’s largest transplant centers.

Results

Median follow-up was 100.33 (0.46–362.09) months. Despite lower five-year kidney graft survival (62.6% versus 92.1%; 111.73 versus 183.08 months; p = 0.189), graft function and patient survival (138.90 versus 192.71 months; p = 0.128) were not significantly inferior after HKTx in general. However, in case of prior cardiac surgery requiring sternotomy we observed significantly reduced early graft and patient survival (57.00 and 94.09 months, respectively) when compared to patients undergoing solitary KTx (183.08 and 192.71 months; p < 0.001, respectively) or HKTx without prior cardiac surgery (203.22 and 203.22 months; p = 0.016 and p = 0.019, respectively), most probably explained by the significantly increased rate of primary nonfunction (33.3%) and in-hospital mortality (25.0%).

Conclusions

Our data demonstrates the increased rate of early kidney graft loss and thus significantly inferior graft survival in high-risk patients undergoing HKTx. Thus, we advocate for a “kidney-after-heart” program in such patients to ensure responsible and reasonable utilization of scarce resources in times of ongoing organ shortage crisis.
Coexistence of neuronal intranuclear inclusion disease and amyotrophic lateral sclerosis: an autopsy case
Authors: Sugiyama Atsuhiko , Takeda Takahiro , Koide Mizuho , Yokota Hajime , Mukai Hiroki , Kitayama Yoshihisa , Shibuya Kazumoto , Araki Nobuyuki , Ishikawa Ai , Isose Sagiri , Ito Kimiko , Honda Kazuhiro , Yamanaka Yoshitaka , Sano Terunori , Saito Yuko , Arai Kimihito , Kuwabara Satoshi
Published: July 2021

Background

Neuronal intranuclear inclusion disease (NIID) is a rare neurodegenerative disease. Pathologically, it is characterized by eosinophilic hyaline intranuclear inclusions in the cells of the visceral organs as well as central, peripheral, and autonomic nervous system cells. Recently, a GGC repeat expansion in the NOTCH2NLC gene has been identified as the etiopathological agent of NIID. Interestingly, this GGC repeat expansion was also reported in some patients with a clinical diagnosis of amyotrophic lateral sclerosis (ALS). However, there are no autopsy-confirmed cases of concurrent NIID and ALS.

Case presentation

A 60-year-old Taiwanese woman reported a four-month history of progressive weakness beginning in the right foot that spread to all four extremities. She was diagnosed with ALS because she met the revised El Escorial diagnostic criteria for definite ALS with upper and lower motor neuron involvement in the cervical, thoracic, and lumbosacral regions. She died of respiratory failure at 22 months from ALS onset, at the age of 62 years. Brain magnetic resonance imaging (MRI) revealed lesions in the medial part of the cerebellar hemisphere, right beside the vermis (paravermal lesions). The subclinical neuropathy, indicated by a nerve conduction study (NCS), prompted a potential diagnosis of NIID. Antemortem skin biopsy and autopsy confirmed the coexistence of pathology consistent with both ALS and NIID. We observed neither eccentric distribution of p62-positive intranuclear inclusions in the areas with abundant large motor neurons nor cytopathological coexistence of ALS and NIID pathology in motor neurons. This finding suggested that ALS and NIID developed independently in this patient.

Conclusions

We describe a case of concurrent NIID and ALS discovered during an autopsy. Abnormal brain MRI findings, including paravermal lesions, could indicate the coexistence of NIID even in patients with ALS showing characteristic clinical phenotypes.
Speech in a consecutive series of children born with cleft lip and palate with and without syndromes and/or additional malformations
Authors: Klintö Kristina , Sporre Maria , Becker Magnus
Published: July 2021

Background

When evaluating speech in children with cleft palate with or without cleft lip (CP/L), children with known syndromes and/or additional malformations (CP/L+) are usually excluded. The aim of this study was to present speech outcome of a consecutive series of 5-year-olds born with CP/L, and to compare speech results of children with CP/L + and children with CP/L without known syndromes and/or additional malformations (CP/L-).

Methods

One hundred 5-year-olds (20 with CP/L+; 80 with CP/L-) participated. All children were treated with primary palatal surgery in one stage with the same procedure for muscle reconstruction. Three independent judges performed phonetic transcriptions and rated perceived velopharyngeal competence from audio recordings. Based on phonetic transcriptions, percent consonants correct (PCC) and percent non-oral errors were investigated. Group comparisons were performed.

Results

In the total group, mean PCC was 88.2 and mean percent non-oral errors 1.5. The group with bilateral cleft lip and palate (BCLP) had poorer results on both measures compared to groups with other cleft types. The average results of PCC and percent non-oral errors in the CP/L + group indicated somewhat poorer speech, but no significant differences were observed. In the CP/L + group, 25 % were judged as having incompetent velopharyngeal competence, compared to 15 % in the CP/L- group.

Conclusions

The results indicated relatively good speech compared to speech of children with CP/L in previous studies. Speech was poorer in many children with more extensive clefts. No significant differences in speech outcomes were observed between CP/L + and CP/L- groups.
Public health messages on arboviruses transmitted by Aedes aegypti in Brazil
Authors: Clancy India L. , Jones Robert T. , Power Grace M. , Logan James G. , Iriart Jorge Alberto Bernstein , Massad Eduardo , Kinsman John
Published: July 2021

Background

The outbreak of Zika virus in Brazil in 2015 followed the arrival of chikungunya in 2014 and a long history of dengue circulation. Vital to the response to these outbreaks of mosquito-borne pathogens has been the dissemination of public health messages, including those promoted through risk communication posters. This study explores the content of a sample of posters circulated in Brazil towards the end of the Zika epidemic in 2017 and analyses their potential effectiveness in inducing behaviour change.

Methods

A content analysis was performed on 37 posters produced in Brazil to address outbreaks of mosquito-borne pathogens. The six variables of the Health Belief Model were used to assess the potential effectiveness of the posters to induce behaviour change.

Results

Three overarching key messages emerged from the posters. These included (i) the arboviruses and their outcomes, (ii) a battle against the mosquito, and (iii) a responsibility to protect and prevent. Among the six variables utilised through the Health Belief Model, cues to action were most commonly featured, whilst the perceived benefits of engaging in behaviours to prevent arbovirus transmission were the least commonly featured.

Conclusions

The posters largely focused on mosquito-borne transmission and the need to eliminate breeding sites, and neglected the risk of the sexual and congenital transmission of Zika and the importance of alternative preventive actions. This, we argue, may have limited the potential effectiveness of these posters to induce behaviour change.
Economic support, education and sexual decision making among female adolescents in Zambia: a qualitative study
Authors: Milimo J. , Zulu J. M. , Svanemyr J. , Munsaka E. , Mweemba O. , Sandøy I. F.
Published: July 2021

Background

The importance of educating female adolescents has been recognized as critical to the development of any country. However, in low income countries like Zambia they often drop out of school due to poverty, early pregnancy and early marriages. Some studies indicate that economic support such as Social Cash Transfers (SCTs) can mitigate the effects of poverty on female adolescents by improving their school participation and helping postpone pregnancy and marriage. This study aimed to explore the role of economic support in influencing education and sexual decision making among female adolescents in a randomised controlled trial in Zambia.

Methods

The study adopted a qualitative approach. It utilized purposive and convenient sampling. Data were collected from 6 schools using 18 in-depth interviews (IDIs) and 4 focus group discussions (FGDs) comprising 48 school-going female adolescents in grade 8 aged 14 to 17. All participants received economic support in form of SCTs and payment of school fees as part of the Research Initiative to Support the Empowerment of Girls (RISE), a Cluster Randomised Controlled Trial. Data were analyzed using thematic analysis.

Results

Findings suggested several benefits of the economic support for the female adolescents such as economic independence and empowerment; increased assertiveness and autonomy; reduced desire for sexual relationships with boys in exchange for cash and gifts; increased motivation for school; enhanced parental and community support for female adolescents’ education and; reduced school dropouts. However, they also experienced jealousy from those who did not benefit from the economic support.

Conclusion

Economic support played a significant role in influencing both educational and sexual decision making among female adolescents.

Trial registration

ISRCTN Registry: ISRCTN12727868, (4 March 2016).
Is working in later life good for your health? A systematic review of health outcomes resulting from extended working lives
Authors: Baxter Susan , Blank Lindsay , Cantrell Anna , Goyder Elizabeth
Published: July 2021

Background

Work, rather than unemployment, is recognised as being good for health, but there may be an age when the benefits are outweighed by adverse impacts. As countries around the world increase their typical retirement age, the potential effect on population health and health inequalities requires scrutiny.

Methods

We carried out a systematic review of literature published since 2011 from developed countries on the health effects of employment in those over 64 years of age. We completed a narrative synthesis and used harvest plots to map the direction and volume of evidence for the outcomes reported. We followed the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist in our methods and reporting.

Results

We identified seventeen relevant studies, which were of cohort or cross-sectional design. The results indicate evidence of beneficial or neutral effects from extended working on overall health status and physical health for many employees, and mixed effects on mental health. The benefits reported however, are most likely to be for males, those working part-time or reducing to part-time, and employees in jobs which are not low quality or low reward.

Conclusions

Extending working life (particularly part time) may have benefits or a neutral effect for some, but adverse effects for others in high demand or low reward jobs. There is the potential for widening health inequalities between those who can choose to reduce their working hours, and those who need to continue working full time for financial reasons. There is a lack of evidence for effects on quality of life, and a dearth of interventions enabling older workers to extend their healthy working life.
A hybrid technique combining intramedullary pinning with extramedullary plate fixation in unstable and comminuted radial head fractures following on-table reconstruction
Authors: Gao Xu , Dai Shi-you , Yin Hai-lei , Li Fei , Sui Yong-qiang , Huang Rui , Fan Hai-yu
Published: July 2021

Background

Management of comminuted radial fractures remains controversial. Currently, the emergence of on-table reconstruction technique has made fixation in comminuted radial head fractures more viable. However, the present study reported an intro-operative unstable displacement from the reconstructed radial head to the neck during plate fixation, characterized by a poor radiocapitellar contact and incongruity between the radial head and neck. A hybrid technique combining with intramedullary pining was performed in our study to restore the normal alignment and maintain the stability of fixation. Therefore, the purpose of this article aimed to prove the feasibility of unstable comminuted radial head fractures treated with the extramedullary plate and intramedullary pinning fixation using titanium elastic nails.

Methods

The clinical, functional and radiographic outcomes of the groups were compared during follow-up. The radiographic examination was conducted to evaluate the status of bone union, heterotopic ossification and post-traumatic arthritis. The functional assessment was performed to evaluate clinical effects, which included measurements of range of motion (ROM) in the elbow, Visual Analog Scale (VAS) score, Elbow Self-Assessment score (ESAS), Mayo Elbow Performance score (MEPS), and Disabilities of the Arm, Shoulder, and Hand (DASH)Outcome Measure score.

Results

Thirteen patients with unstable fractures were participated with an average follow-up of (38.6 ± 4.5) months for the experimental group and (32.0 ± 6.3) months for the control group, respectively. The functional outcomes in the experimental group, including MEPS and DASH, were significantly superior to the control group. However, no significant difference was observed in the elbow ROM and VAS score between two groups. In the last follow-up, one patient with post-traumatic arthritis rated as grades 1 and two with heterotopic ossifications were observed in the experimental group. In the control group, degenerative changes were observed in three cases (grade 1 in two cases and grade 2 in one case) and heterotopic ossifications rated as grade I were found in two patients.

Conclusion

Collectively, intramedullary pinning with extramedullary plate fixation is feasible in unstable comminuted radial head fractures, which can be considered as a remedial surgery for on-table reconstruction technique.
Simulation in physiotherapy students for clinical decisions during interaction with people with low back pain: randomised controlled trial
Authors: Sandoval-Cuellar Carolina , Alfonso-Mora Margareth Lorena , Castellanos-Garrido Adriana Lucia , del Pilar Villarraga-Nieto Angélica , Goyeneche-Ortegón Ruth Liliana , Acosta-Otalora Martha Lucia , del Pilar Castellanos-Vega Rocío , Cobo-Mejía Elisa Andrea
Published: July 2021

Background

Low back pain (LBP) is a condition with a high global prevalence, which is getting health professionals’ attention, including physiotherapists as they must have the skills to provide treatment that increases the patient’s quality of life. Clinical simulations could be a pedagogic strategy that facilitates adequate training for students to acquire skills to improve their professional reasoning in this clinical situation.

Objective

This study sought to determine the effects of clinical simulations with simulated patients (SP) on the physiotherapy students’ clinical decision-making within a role-playing (RP) scenario while caring of LBP patients.

Methods

This experimental study included 42 participants from two Colombian universities, randomized into two groups (SP, n = 21; RP, n = 21). The clinical skill of performing the Objective Structured Clinical Examination (OSCE-LBP) was evaluated while students cared for patients with LBP; after that, a pedagogical method was conducted that included clinical simulation and, finally, the OSCE-LBP was applied again to compare both groups.

Results

Changes occurred in the OSCE-LBP among both groups of students: the scores increased (0.66 and 0.59 in RP and SP, respectively), and neither of the two was superior (p value 0.01; 95%CI − 0.21 to 0.23).

Conclusion

Both types of simulation favor decision-making in professional reasoning in physiotherapy students during interactions with individuals with LBP.

Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04428892 Identifying number: NCT04428892. It was retrospectively registered.
Participant perspectives of a telehealth trial investigating the use of telephone and text message support in obesity management: a qualitative evaluation
Authors: Lewis Emily , Hassmén Peter , Pumpa Kate L.
Published: July 2021

Background: Quantitative evidence suggests that interventions involving telephone calls and text message are feasible and effective for improving lifestyle intervention adherence and clinical outcomes among adults with obesity. The aim of this article is to provide qualitative insight into the perspectives and experiences of participants who completed a telehealth trial exploring the use of telephone and text support as adjunctive tools to support a community-based obesity management program. Methods: Focus groups were conducted in order to evaluate program acceptability and overall participant perceptions of the clinical trial. Thematic content analysis was used to analyse the data, aided by the development of a thematic network. Results: The telehealth trial was well received. Participants found the telephone and text message support highly beneficial, providing encouragement, motivation and accountability via a simple and convenient mode of communication. Conclusions: These findings suggest a high degree of promise for the incorporation of telephone and text support in obesity management.
Effectiveness of self-administered mirror therapy on upper extremity impairments and function of acute stroke patients: study protocol
Authors: Rajendran Venkadesan , Jeevanantham Deepa , Larivière Céline , Singh Ravinder-Jeet , Zeman Lisa , Papuri Padma
Published: July 2021

Background

Many therapeutic interventions are performed by physiotherapists to improve upper extremity function and/or activities of daily living (ADL) in stroke patients. Mirror therapy (MT) is a simple technique that can be self-administered by the patients with intact cognition following patient education by a skilled physiotherapist. However, the effectiveness of self-administered MT in post-stroke patients in upper extremity function remains unclear. Therefore, the objective of this study is to examine the effectiveness of MT in improving upper extremity function and recovery in acute stroke patients.

Methods

This study is a single-center, prospective, randomized, open-label, controlled trial with blinded outcome evaluation (PROBE design), in which a total of 36 eligible acute stroke patients will be randomly assigned to control (n=18) and experimental group (n=18). Participants in the control group will receive regular rehabilitation interventions whereas participants in the experimental group will receive MT education in addition to their regular interventions for 4 weeks.

Study outcome

The primary outcome measure will be upper extremity function that will be measured using the Fugl-Meyer Assessment scale and the Wolf Motor Function Test. The secondary outcome measure will be behaviors related to ADL as estimated using the Modified Barthel Index. Outcome measures will be assessed at baseline and at 4 weeks post-rehabilitation intervention/MT.

Results

A two-way repeated analysis of variance (ANOVA) with time and group effects will be used to analyze between-group differences. The level of significance will be set at P < 0.05.

Conclusion

The results of the study will provide critical information to include self-administered MT as an adjuvant to regular interventions and may facilitate recovery of the upper extremity function of stroke patients.

Trial registration

ClinicalTrials.gov NCT04542772. Registered on 9 September 2020. Protocol version: Final 1.0.
Genetic evidence substantiates transmission of Trichinella spiralis from one swine farm to another
Authors: Bilska-Zajac Ewa , Tonanzi Daniele , Pozio Edoardo , Rozycki Miroslaw , Cencek Tomasz , Thompson Peter C. , Rosenthal Benjamin M. , La Rosa Giuseppe
Published: July 2021

Background

Trichinella spiralisranks seventh in the risk posed by foodborne parasites. It causes most human cases of trichinellosis and is the most frequent cause ofTrichinellaoutbreaks on pig farms and in wild boar, worldwide. Veterinary inspectors seek the source of outbreaks in hopes of limiting the spread. Established molecular tools are inadequate for distinguishing among potentialT. spiralisinfection sources because genetic variability in these zoonotic pathogens is limited in Europe. Microsatellite markers proved successful in tracing an outbreak ofT. britovi, a related parasite harboring much more genetic variation. Here, we successfully employed microsatellite markers to determine the genetic structure ofT. spiralisisolates from two pig outbreaks, discovering notable uniformity among parasites within each farm and discovering an epidemiological link between these two outbreaks.

Methods

The individual larvae from five isolates ofT. spiralisfrom two pig farms and from ten wild boars were genotyped using nine microsatellite markers to examine their genetic structure.

Results

Notably uniform parasite populations constituted each farm outbreak, and the parasites from the first and second outbreaks resembled each other to a notable degree, indicating an epidemiological link between them. Wild boar harbored more genetically variable larval cohorts, distinguishing them from parasites isolated from domestic pigs.

Conclusions

Microsatellite markers succeeded in distinguishing isolates of the highly homogeneousT. spiralis, aiding efforts to track transmission. Each outbreak was composed of a homogenous group of parasites, suggesting a point source of contamination.

Graphical abstract
Pulmonary coinfection of Mycobacterium tuberculosis and Tropheryma whipplei: a case report
Authors: Zhu Binghua , Tang Jing , Fang Rong , Fei Xuejie , Wang Qing , Wang Wenqing , Wu Xueqin , Liu Chao , Wang Qian
Published: July 2021

Background

We diagnosed a clinical case of pulmonary infection involving Mycobacterium tuberculosis and Tropheryma whipplei in a patient with acute respiratory distress syndrome. The diagnosis was assisted by metagenomic next-generation sequencing of bronchoalveolar lavage fluid.

Case presentation

A 44-year-old Han Chinese inmate was transferred to the emergency department because of dry cough, chest tightness, and shortness of breath. The patient’s body temperature rose to 39.3 °C following empirical cephalosporin treatment for 1 week. The blood CD4+/CD8+ ratio was 0.7, suggesting immunodeficiency. Routine microbiological tests were performed, and tuberculosis interferon gamma release assays were positive. Mycobacterium tuberculosis polymerase chain reaction was also positive. Chest computed tomography scan revealed miliary nodules and ground-glass opacifications, which were in accordance with tuberculosis. To fully examine the etiology, we performed routine laboratory tests and metagenomic sequencing, the results of which indicated the presence of Mycobacterium tuberculosis and Tropheryma whipplei. We administered anti-tuberculosis regimen in combination with trimethoprim/sulfamethoxazole. The patient recovered, with chest computed tomography scan showing absorption of lesions.

Conclusions

Compared with traditional diagnostic methods such as culture and serology, metagenomic next-generation sequencing has the advantage of detecting a wide array of microorganisms in a single test and therefore can be used for clinical diagnosis of rare pathogens and microbial coinfections. It is particularly useful for immunocompromised patients as they are more prone to infection by opportunistic microorganisms.
Human immunodeficiency virus transmission from a 24-year-old woman to her 78-year-old grandmother: a case report
Authors: Pallangyo Pedro , Millinga Jalack , Swai Happy , Hemed Naairah R. , Mkojera Zabela , Mosha Silvia , Granima Marcelina , Bhalia Smita , Gandye Yona , Janabi Mohamed
Published: July 2021

Introduction

Since its debut recognition in 1981, human immunodeficiency virus/acquired immunodeficiency syndrome has affected over 77 million people and has resulted in premature cessation of 35.4 million lives worldwide. Commonly, human immunodeficiency virus is transmitted by sexual contact across mucosal surfaces, by sharing of injecting equipment, through contaminated blood transfusions, and by maternal–infant exposure. Nevertheless, accidental transmission incidences involving family members are rare but possible.

Case presentation

A 78-year-old woman of African descent from Mtwara Region south of Tanzania was referred to us for further evaluation and treatment. She is 30 years postmenopausal and has a 35-year history of hypertension. Her last attendance to our institute was 11 months prior the index visit and she tested negative for human immunodeficiency virus. She came with complaints of weight loss, recurrent fevers, and cough. Her hematological tests revealed leukopenia with lymphocytosis, together with a normocytic normochromic anemia. Enzyme-linked immunosorbent assay for human immunodeficiency virus was positive, and she had a CD4 count of 177 cells/µL. We went back to history taking to identify the potential source of infection. We were informed that for the past 6 months, the 78-year-old lady has been living with her unwell 24-year-old granddaughter who has been divorced. The granddaughter had a history of recurrent fevers, significant weight loss, and a suppurative skin condition. As a way to show love and care, the old lady was puncturing the suppurative lesions with bare hands; then she would suck them to clear away the discharge. We requested to see the young lady, and she tested positive for human immunodeficiency virus. Both were started on tenofovir/lamivudine/dolutegravir combination plus cotrimoxazole 960 mg. The family was in total disarray following these findings. The patient was discharged through infectious diseases department and died of Pneumocystis jirovecii pneumonia 12 weeks later.

Conclusions

Certain sociocultural norms that are believed to express love, care, and togetherness in developing rural communities, particularly Sub-Saharan Africa, have a potential of spreading human immunodeficiency virus, thus warranting prompt transformation.
Effect of frequent assessment of suicidal thinking on its incidence and severity: high-resolution real-time monitoring study
Authors: Coppersmith Daniel D. L. , Fortgang Rebecca G. , Kleiman Evan M. , Millner Alexander J. , Yeager April L. , Mair Patrick , Nock Matthew K.
Published: July 2021

Researchers, clinicians and patients are increasingly using real-time monitoring methods to understand and predict suicidal thoughts and behaviours. These methods involve frequently assessing suicidal thoughts, but it is not known whether asking about suicide repeatedly is iatrogenic. We tested two questions about this approach: (a) does repeatedly assessing suicidal thinking over short periods of time increase suicidal thinking, and (b) is more frequent assessment of suicidal thinking associated with more severe suicidal thinking? In a real-time monitoring study (n = 101 participants, n = 12 793 surveys), we found no evidence to support the notion that repeated assessment of suicidal thoughts is iatrogenic.
Home-Based Management of Patients With Cancer Experiencing Treatment-Induced Toxicities With a Nurse-Led Telephone Triage (the NTT Study)
Authors: Calvetti Lorenzo , Tealdo Marta , Simionato Francesca , Pagiusco Gaetana , Cimenton Roberta , Gasparin Barbara , Corà Francesco , De Vivo Rocco , Merlini Laura , Aprile Giuseppe
Published: July 2021

PURPOSE:

Novel organization models ensure early management of treatment-related adverse events (TRAEs) of new anticancer drugs. The aim of this prospective observational study was to evaluate the impact of the introduction of a nurse-led telephone triage (NTT) in reducing hospitalization of patients with cancer (CPs).

PATIENTS AND METHODS:

CPs on active medical treatment were educated to call the NTT in case of symptoms or TRAEs. Assessment of TRAEs was performed by trained oncology nurses according to the Common Terminology Criteria for Adverse Events grading scales and subsequent actions were taken according to the severity of the events. The primary end point of the study was to compare the rate of hospitalization of CPs on anticancer treatment after the introduction of NTT with that of the 2017-2018 period.

RESULTS:

From September 2018 to September 2019, a total of 1,075 patients received systemic anticancer treatment ( v 936 patients in the same 2017-2018 period). Total consultations at NTT were 429 and 581 TRAEs were reported. Notably, 117 patients reported more than one TRAE. Common Terminology Criteria for Adverse Events were graded as G1 (237, 40.8%), G2 (231, 39.8%), or G3-4 (113, 19.4%). In the observation period, 109 CPs on treatment were hospitalized versus 138 in the 2017-2018 period with a normalized hospitalization rate of 10.1% versus 14.7% ( P = .002 chi-square) with a reduction in normalized number of hospitalization of 44 and an estimated cost savings of 345,246 euros.

CONCLUSION:

The implementation of the NTT system in the clinical practice may help reducing the rates of hospitalization through the emergency room of CPs receiving modern medical treatments.
Das Wohnhaus in der St. Alban-Vorstadt 62
Authors: Merki Matthias
Published: July 2021

Anlässlich einer Renovation mit teilweisem Umbau im Innern konnte die Denkmalpflege im Sommer 1993 das aufgehende Mauerwerk, soweit es freigelegt wurde, sowie den Dachstuhl des Gebäudes an der St. Alban-Vorstadt 62 untersuchen.
Zur Renovation der Dorfkirche St. Martin in Riehen
Authors: Helmig Guido , Schön Udo
Published: July 2021

In den wenigen Schnitten, die bereits bei der Renovation im Jahr 1942 ausgehoben worden sind , wurden Fundament-Mauerzüge angeschnitten, anhand derer sich ein hochmittelalterlicher Vorgängerbau mit interessantem kreuzförmigem Grundriss rekonstruieren liess.

Die Sanierungsarbeiten in den Jahren 1993-94 erbrachten neue Erkenntnisse für Denkmalpflege und Archäologie. So waren unter dem Dach des Kreuzgewölbes noch Partien der ältesten romanischen Langschiffmauer im originalen Zustand erhalten. Zudem werden die Bauphasen der Annexbauten und deren archäologische Interpretation zusammenfassend dargestellt.
Frühe Befunde vom äusseren Ende der Spalenvorstadt
Authors: Matt Christoph Ph. , Bing Christian
Published: July 2021

Die archäologische Untersuchung der Liegenschaft an der Spalenvorstadt 34 hat gezeigt, dass die Nutzung dieses Areals durch Gewerbebetriebe deutlich vor der ersten schriftlichen Erwähnung des Hauses einsetzte und in die Frühzeit der Vorstadt zurückreicht. 

Die Anzeichen beginnen sich somit zu mehren, dass das gesamte Vorstadtgebiet zu Spalen bis zu den Toren der früheren Vorstadtbefestigungen schon recht früh überbaut worden ist.
Das 1994 abgebrochene Haus zum Bremgarten
Authors: Reicke Daniel
Published: July 2021

Der vorliegende Bericht behandelt das in städtebaulicher Hinsicht prominent gelegene Haus Steinenvorstadt 2/ Kohlenberg 1. In historischer Zeit war das Haus entsprechend der Lage des Hauseingangs zum Kohlenberg hin orientiert; die Adresse wurde erst in jüngster Zeit geändert.
Stiftsgasse 5
Authors: Tramèr Stephan
Published: July 2021

Die Ergebnisse der von der Basler Denkmalpflege 1994 durchgeführten Bauuntersuchung im Gebäude Stiftsgasse 5 fügen sich nahtlos an die Resultate der Untersuchungen im benachbarten Gebäudekomplex ,,Engelhof", Stiftsgasse 1, an.

Im Haus Nr 5 wurden Reste eines mittelalterlichen Steinhauses gefunden.
Tätigkeitsbericht des Kantonsarchäologen für das Jahr 1994
Authors: D'Aujourd'hui Rolf
Published: July 2021

Der erste Teil des Jahresberichts umfasst den Tätigkeitsbericht des Kantonsarchäologen, der die im Berichtsjahr erfolgten Aktivitäten des Amtes vorstellt und kommentiert, sowie eine Fundchronik mit einem Kurzbeschrieb sämtlicher im Laufe eines Jahres registrierter Fundstellen.
Bettingen, Auf dem Buechholz, 1995/11
Authors: Ebersbach Renate , Leuch-Bartels Katrin
Published: July 2021

Im Sommer 1995 wurde ein Hügel im Rahmen einer Lehrgrabung des Seminars für Ur- und Frühgeschichte gemeinsam mit der Archäologischen Bodenforschung untersucht, um seine mögliche prähistorische Zeitstellung zu prüfen.

Bei dem Hügel von Bettingen-Buechholz handelt es sich um eine natürliche Geländeerhebung aus plattig aufwitterndem Dolomit-Kalkstein. Anzeichen für anthropogene Eingriffe in den Hügel oder für dessen Aufschüttung in prähistorischer Zeit fehlen völlig.
Vorbericht über die Grabungen 1997 im Bereich der spätlatènezeitlichen Siedlung Basel-Gasfabrik
Authors: Spichtig Norbert
Published: July 2021

Berichte zu den archäologischen Untersuchungen in der Fundstelle «Basel-Gasfabrik» im Jahr 1997.
Stadtarchäologie und Öffentlichkeitsarbeit
Authors: D'Aujourd'hui Rolf
Published: July 2021

Der Dialog mit der Öffentlichkeit ist eine wichtige Voraussetzung für die Akzeptanz von Denkmalpflege und Archäologie. Vorbedingungen für eine zielgerichtete Öffentlichkeitsarbeit sind Organisationsformen und Methoden, die eine kontinuierliche Quellenschöpfung, Auswertung und Vermittlung gestatten.
Der Kontakt mit der Öffentlichkeit erfolgt über die Medien, Stadtführungen, Einladungen auf Grabungen und vor allem durch Informationsstellen im öffentlichen Raum. An verschiedenen Orten der Stadt wurden im Laufe der letzten Jahre archäologische und baugeschichtliche Befunde konserviert und didaktisch erläutert. Die Informationsstellen sind in vier Stadtrundgänge (Führungsblätter) eingebettet. Das Programm wird kontinuierlich ergänzt.
Tätigkeitsbericht des Kantonsarchäologen für das Jahr 1997
Authors: D'Aujourd'hui Rolf
Published: July 2021

Der erste Teil des Jahresberichts umfasst den Tätigkeitsbericht des Kantonsarchäologen, der die im Berichtsjahr erfolgten Aktivitäten des Amtes vorstellt und kommentiert, sowie eine Fundchronik mit einem Kurzbeschrieb sämtlicher im Laufe eines Jahres registrierter Fundstellen.
Intenções e ações em torno dos programas UPP e Morar Carioca
Authors: Tavares Ricarda Lucilia Domingues
Published: July 2021

No contexto histórico de intervenções em favelas na cidade do Rio de Janeiro, a década de 1990 é comumente destacada por ter iniciado um processo mais significativo, tanto em termos institucionais e técnicos quanto em termos de resultados práticos, não somente pelo número de favelas atendidas, mas pela visibilidade adquirida, em função dos agentes envolvidos. Este artigo apresenta as intenções e ações em torno de duas políticas públicas que, apontadas como continuidades do processo, incidiram recentemente sobre as favelas cariocas, o programa estadual de segurança pública “Unidades de Polícia Pacificadora – UPP” e o programa municipal de urbanização “Morar Carioca”. O objetivo é abordar genericamente os discursos, também fundamentados na “integração” entre favela e cidade, além de revelar como, na prática, as lógicas do planejamento estratégico, que se implantaram na administração da cidade do Rio de Janeiro a partir de 1993, mesmo tendo sofrido inflexões, se mantiveram no período em destaque (2007-2016). Neste sentido, torna-se relevante a análise de procedimentos e também de documentos e informações relacionados aos programas