bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of midwives and obstetrical nurses in the promotion of healthy lifestyle during pregnancy
Authors: Bahri Khomami Mahnaz , Walker Ruth , Kilpatrick Michelle , de Jersey Susan , Skouteris Helen , Moran Lisa J.
Published: August 2021

Women with maternal obesity, an unhealthy lifestyle before and during pregnancy and excess gestational weight gain have an increased risk of adverse pregnancy and birth outcomes that can also increase the risk of long-term poor health for them and their children. Pregnant women have frequent medical appointments and are highly receptive to health advice. Healthcare professionals who interact with women during pregnancy are in a privileged position to support women to make lasting healthy lifestyle changes that can improve gestational weight gain and pregnancy outcomes and halt the intergenerational nature of obesity. Midwives and obstetrical nurses are key healthcare professionals responsible for providing antenatal care in most countries. Therefore, it is crucial for them to build and enhance their ability to promote healthy lifestyles in pregnant women. Undergraduate midwifery curricula usually lack sufficient lifestyle content to provide emerging midwives and obstetrical nurses with the knowledge, skills, and confidence to effectively assess and support healthy lifestyle behaviours in pregnant women. Consequently, registered midwives and obstetrical nurses may not recognise their role in healthy lifestyle promotion specific to healthy eating and physical activity in practice. In addition, practising midwives and obstetrical nurses do not consistently have access to healthy lifestyle promotion training in the workplace. Therefore, many midwives and obstetrical nurses may not have the confidence and/or skills to support pregnant women to improve their lifestyles. This narrative review summarises the role of midwives and obstetrical nurses in the promotion of healthy lifestyles relating to healthy eating and physical activity and optimising weight in pregnancy, the barriers that they face to deliver optimal care and an overview of what we know works when supporting midwives and obstetrical nurses in their role to support women in achieving a healthy lifestyle.
Ground-motion models for Vrancea intermediate-depth earthquakes
Authors: Manea Elena Florinela , Cioflan Carmen Ortanza , Danciu Laurentiu
Published: August 2021

A newly compiled high-quality ground-shaking dataset of 207 intermediate-depth earthquakes recorded in the Vrancea region of the south-eastern Carpathian mountains in Romania was used to develop region-specific empirical predictive equations for various intensity measures: peak ground acceleration, peak ground velocity, and 5%-damped pseudo-spectral acceleration up to 10 s. Besides common predictor variables (e.g. moment magnitude, depth, hypocentral distance, and site conditions), additional distance scaling parameters were added to describe the specific attenuation pattern observed at the stations located not only on the back and fore but also along the Carpathian arc. In this model, we introduce a proxy measure for the site as the fundamental frequency of resonance to characterize the site response at each recording seismic station beside the soil classes. To additionally reduce the site-to-site variability, a non-ergodic methodology was considered, resulting in a lower standard deviation of about 25%. Statistical evaluation of the newly proposed ground-motion models indicates robust performance compared to regional observations. The model shows significant improvements in describing the spatial variability (at different spectral ordinates), particularly for the fore-arc area of the Carpathians where a deep sedimentary basin is located. Furthermore, the model presented herein improves estimates of ground shaking at longer spectral ordinates (>1 s) in agreement with the observations. The proposed ground-motion models are valid for hypocentral distances less than 500 km, depths over 70 km and within the moment magnitude range of 4.0–7.4.
Statistical analysis and modeling to examine the exterior and interior building damage pertaining to the 2016 Kumamoto earthquake
Authors: Xiu Haoyi , Shinohara Takayuki , Matsuoka Masashi , Inoguchi Munenari , Kawabe Ken , Horie Kei
Published: August 2021

After an earthquake occurs, field surveys are conducted by relevant authorities to assess the damage suffered by buildings. The field survey is essential as it ensures the safety of residents and provides the necessary information to local authorities for post-disaster recovery. In Japan, a primary (mandatory) exterior survey is conducted first, and a secondary (voluntary) interior survey is performed subsequently if the residents request a reinvestigation. However, a major challenge associated with field surveys is the substantial time cost of determining the damage grades. Moreover, an interior survey is performed only after receiving the reinvestigation request from occupants, which further delays the decision-making process. In addition, the risk of incorrect damage estimation during the exterior survey must be considered because underestimating the damage can endanger the residents. Therefore, in this study, a three-part analysis (Parts I–III), where each part corresponds to a distinct stage of the standard damage assessment procedure, was performed to characterize the relationship between the building parameters and damage grades at different stages. To further explore the possibility of accelerating decision-making, predictive modeling was performed in each part. The Part I results indicate that estimating the final damage grade for all buildings immediately after the exterior survey is similar to treating the exterior survey results as the final ones. The Part II results show that buildings that potentially require an interior survey can be predicted with reasonable accuracy after the exterior survey. In buildings for which reinvestigations have been requested, Part III demonstrates that the risk of underestimation in the exterior survey can be predicted reliably.
FcεRIγ-negative NK cells persist in vivo and enhance efficacy of therapeutic monoclonal antibodies in multiple myeloma
Authors: Bigley Austin B. , Spade Shanae , Agha Nadia H. , Biswas Sujit , Tang Suni , Malik Muhammad H. , Dai Lu , Masoumi Shalaleh , Patiño-Escobar Bonell , Hale Martina , DiPierro Guy , Martell Ronald , Hann Byron , Shah Nina , Wiita Arun P. , Liu Xinli
Published: August 2021

Monoclonal antibodies (mAbs) are a central component of therapy for hematologic malignancies. Widely used mAb agents in multiple myeloma (MM) include daratumumab and elotuzumab. However, not all patients respond to these agents, and resistance is a significant clinical issue. A recently discovered subset of human natural killer (NK) cells lacking expression of FcεRIγ (g-NK cells) was found to have a multifold increase in antibody-dependent effector functions after CD16 crosslinking. In this study, we tested the capacity of g-NK cells to enhance the efficacy of therapeutic mAbs against MM. In vitro, we found that g-NK cells have strikingly superior anti-myeloma cytotoxicity compared with conventional NK (cNK) cells when combined with daratumumab or elotuzumab (∼sixfold; P < .001). In addition, g-NK cells naturally expressed minimal surface CD38 and SLAMF7, which reduced the incidence of therapeutic fratricide. In tumor-naïve murine models, the persistence of g-NK cells in blood and spleen was >10 times higher than that of cNK cells over 31 days (P < .001). In vivo efficacy studies showed that the combination of daratumumab and g-NK cells led to a >99.9% tumor reduction (by flow cytometry analysis) compared with the combination of daratumumab and cNK cells (P < .001). Moreover, treatment with daratumumab and g-NK cells led to complete elimination of myeloma burden in 5 of 7 mice. Collectively, these results underscore the unique ability of g-NK cells to potentiate the activity of therapeutic mAbs and overcome limitations of current off-the-shelf NK cell therapies without the need for cellular irradiation or genetic engineering.
BREC: an R package/Shiny app for automatically identifying heterochromatin boundaries and estimating local recombination rates along chromosomes
Authors: Mansour Yasmine , Chateau Annie , Fiston-Lavier Anna-Sophie
Published: August 2021

Background

Meiotic recombination is a vital biological process playing an essential role in genome's structural and functional dynamics. Genomes exhibit highly various recombination profiles along chromosomes associated with several chromatin states. However, eu-heterochromatin boundaries are not available nor easily provided for non-model organisms, especially for newly sequenced ones. Hence, we miss accurate local recombination rates necessary to address evolutionary questions.

Results

Here, we propose an automated computational tool, based on the Marey maps method, allowing to identify heterochromatin boundaries along chromosomes and estimating local recombination rates. Our method, called BREC (heterochromatin Boundaries and RECombination rate estimates) is non-genome-specific, running even on non-model genomes as long as genetic and physical maps are available. BREC is based on pure statistics and is data-driven, implying that good input data quality remains a strong requirement. Therefore, a data pre-processing module (data quality control and cleaning) is provided. Experiments show that BREC handles different markers' density and distribution issues.

Conclusions

BREC's heterochromatin boundaries have been validated with cytological equivalents experimentally generated on the fruit fly Drosophila melanogaster genome, for which BREC returns congruent corresponding values. Also, BREC's recombination rates have been compared with previously reported estimates. Based on the promising results, we believe our tool has the potential to help bring data science into the service of genome biology and evolution. We introduce BREC within an R-package and a Shiny web-based user-friendly application yielding a fast, easy-to-use, and broadly accessible resource. The BREC R-package is available at the GitHub repository https://github.com/GenomeStructureOrganization.
JA signal-mediated immunity of Dendrobium catenatum to necrotrophic Southern Blight pathogen
Authors: Li Cong , Shen Qiuyi , Cai Xiang , Lai Danni , Wu Lingshang , Han Zhigang , Zhao Tianlun , Chen Donghong , Si Jinping
Published: August 2021

Background

Dendrobium catenatum belongs to the Orchidaceae, and is a precious Chinese herbal medicine. In the past 20 years, D. catenatum industry has developed from an endangered medicinal plant to multi-billion dollar grade industry. The necrotrophic pathogen Sclerotium delphinii has a devastating effection on over 500 plant species, especially resulting in widespread infection and severe yield loss in the process of large-scale cultivation of D. catenatum. It has been widely reported that Jasmonate (JA) is involved in plant immunity to pathogens, but the mechanisms of JA-induced plant resistance to S. delphinii are unclear.

Results

In the present study, the role of JA in enhancing D. catenatum resistance to S. delphinii was investigated. We identified 2 COI1, 13 JAZ, and 12 MYC proteins in D. catenatum genome. Subsequently, systematic analyses containing phylogenetic relationship, gene structure, protein domain, and motif architecture of core JA pathway proteins were conducted in D. catenatum and the newly characterized homologs from its closely related orchid species Phalaenopsis equestris and Apostasia shenzhenica, along with the well-investigated homologs from Arabidopsis thaliana and Oryza sativa. Public RNA-seq data were investigated to analyze the expression patterns of D. catenatum core JA pathway genes in various tissues and organs. Transcriptome analysis of MeJA and S. delphinii treatment showed exogenous MeJA changed most of the expression of the above genes, and several key members, including DcJAZ1/2/5 and DcMYC2b, are involved in enhancing defense ability to S. delphinii in D. catenatum.

Conclusions

The findings indicate exogenous MeJA treatment affects the expression level of DcJAZ1/2/5 and DcMYC2b, thereby enhancing D. catenatum resistance to S. delphinii. This research would be helpful for future functional identification of core JA pathway genes involved in breeding for disease resistance in D. catenatum.
The correlation between patent foramen ovale and brain ischemia in plateau residents
Authors: Liu Gang , Feng Zhao , Feng Fan , Xue Changju , Liu Fei , Xie Xiaoting
Published: August 2021

Background

It has been suggested that patent foramen ovale (PFO) contributes to the majority of cryptogenic stroke cases in young people, however, the direct link is still undetermined. Here we analyzed the correlation between PFO and brain ischemia lesions in a cohort of cases that were long-term residents in the plateau to provide solid evidence to support the causal relation between PFO and brain ischemia lesion or cryptogenic stroke.

Methods

Long-term residents with young age from Qinghai Plateau were recruited and separated by PFO positivity. Brain MRI was used to image 100 PFO positive cases and 100 healthy controls. The diameter of PFO was measured by echocardiography. The location, number and anterior/posterior circulation of ischemia lesions were also evaluated. The correlation between PFO (including positivity and diameter) and brain ischemia lesion (including positivity and other characteristics) was analyzed by chi-square test. Further, the chi-square test for the trend test was used to analyze the linear correlation between these groups.

Results

We found a strong correlation between the positivity of PFO and brain ischemia lesion, with 71% of PFO cases showing the presence of brain ischemia lesions, and only 19% for healthy controls (p < 0.001). The diameter of PFO is strongly and linearly correlated with the incidence rate of brain ischemia lesion (RR = 3.737 (95%CI 2.496 to 5.767).

Conclusion

We found a convincing correlation between the positivity of PFO and brain ischemia lesion in residents of the plateau. Our findings provide another solid evidence of the direct causal relation between PFO and brain ischemia lesion.
Identifying trauma patients with benefit from direct transportation to Level-1 trauma centers
Authors: Sewalt Charlie A. , Gravesteijn Benjamin Y. , Nieboer Daan , Steyerberg Ewout W. , Den Hartog Dennis , Van Klaveren David
Published: August 2021

Background

Prehospital triage protocols typically try to select patients with Injury Severity Score (ISS) above 15 for direct transportation to a Level-1 trauma center. However, ISS does not necessarily discriminate between patients who benefit from immediate care at Level-1 trauma centers. The aim of this study was to assess which patients benefit from direct transportation to Level-1 trauma centers.

Methods

We used the American National Trauma Data Bank (NTDB), a retrospective observational cohort. All adult patients (ISS > 3) between 2015 and 2016 were included. Patients who were self-presenting or had isolated limb injury were excluded. We used logistic regression to assess the association of direct transportation to Level-1 trauma centers with in-hospital mortality adjusted for clinically relevant confounders. We used this model to define benefit as predicted probability of mortality associated with transportation to a non-Level-1 trauma center minus predicted probability associated with transportation to a Level-1 trauma center. We used a threshold of 1% as absolute benefit. Potential interaction terms with transportation to Level-1 trauma centers were included in a penalized logistic regression model to study which patients benefit.

Results

We included 388,845 trauma patients from 232 Level-1 centers and 429 Level-2/3 centers. A small beneficial effect was found for direct transportation to Level-1 trauma centers (adjusted Odds Ratio: 0.96, 95% Confidence Interval: 0.92–0.99) which disappeared when comparing Level-1 and 2 versus Level-3 trauma centers. In the risk approach, predicted benefit ranged between 0 and 1%. When allowing for interactions, 7% of the patients (n = 27,753) had more than 1% absolute benefit from direct transportation to Level-1 trauma centers. These patients had higher AIS Head and Thorax scores, lower GCS and lower SBP. A quarter of the patients with ISS > 15 were predicted to benefit from transportation to Level-1 centers (n = 26,522, 22%).

Conclusions

Benefit of transportation to a Level-1 trauma centers is quite heterogeneous across patients and the difference between Level-1 and Level-2 trauma centers is small. In particular, patients with head injury and signs of shock may benefit from care in a Level-1 trauma center. Future prehospital triage models should incorporate more complete risk profiles.
Attitude towards ageing and perceived health status of community-dwelling older persons in a low resource setting: a rural-urban comparison
Authors: Cadmus E. O. , Adebusoye L. A. , Owoaje E. T.
Published: August 2021

Background

Older person’s attitude to ageing is critical for their adjustment, acceptance of health-related behaviour, survival and choices. Their attitude influences how they cope with the challenges experienced while ageing, which affects their quality of life and health-related outcomes. Despite the increasing number of older persons in sub-Saharan Africa, there is limited information about their experience. This study examines the experience and attitude of older persons in Nigeria regarding the ageing process.

Methods

A descriptive cross-sectional study among older persons aged 60 years and above was carried out in a selected rural and an urban community in Oyo State, south-western Nigeria. The study participants were selected using a multi-stage sampling technique. Trained research assistants collected data with the aid of an interviewer-administered, semi-structured questionnaire. The Attitude to Ageing Questionnaire (AAQ) was used to measure participants’ perception of ageing in three domains (psychosocial loss, physical changes and psychological growth). Data were analysed using Stata version 14 at a level of significance p < 0.05.

Results

A total of 1,180 participants (588 rural vs. 592 urban) were recruited for the study. The mean age was 73.2 ± 9.3 years. The majority (69.7 %) were females and still working (50.5 %). Overall, urban-dwelling participants had a better attitude to the ageing process in all the domains compared with rural-dwelling participants (psychological growth 32.5 ± 3.4 vs. 32.4 ± 3.3, p = 0.30; physical change 27.5 ± 5.1 vs. 26.9 ± 5.0, p = 0.03; and psychosocial loss 25.3 ± 5.7 vs. 25.0 ± 5.3, p = 0.60). Among the rural and urban-dwelling participants, good self-rated health was significantly associated with a positive attitude to ageing across the domains.

Conclusions

Older persons residing in urban communities had higher positivity to ageing than their rural older counterparts. The common factor significantly associated with a positive attitude to ageing in both groups was good self-rated health. This information can be used for the planning of targeted interventions and informing policy formation for improved provisions for community-dwelling older persons in Nigeria and other sub-Saharan African countries.
Increase in consumption of alcohol-based hand rub in German acute care hospitals over a 12 year period
Authors: Kramer Tobias Siegfried , Walter Janine , Schröder Christin , Behnke Michael , Clausmeyer Jörg , Reichardt Christiane , Gastmeier Petra , Bunte Karin
Published: August 2021

Background

Hand hygiene plays a crucial role in the transmission of pathogens and the prevention of healthcare-associated infections. In 2007, a voluntary national electronic surveillance tool for the documentation of consumption of alcohol-based hand rub (AHC) was introduced as a surrogate for hand hygiene compliance (HAND-KISS) and for the provision of benchmark data as feedback.

The aim of the study was to determine the trend in alcohol-based hand rub consumption between 2007 and 2018.

Materials and methods

In this cohort study, AHC and patient days (PD) were documented on every ward in participating hospitals by trained local staff. Data was collected and validated in HAND-KISS. Intensive care units (ICU), intermediate care units (IMC), and regular wards (RW) that provided data during the study period between 2007 until 2018 were included into the study.

Results

In 2018, 75.2% of acute care hospitals in Germany (n = 1.460) participated. On ICUs (n = 1998) mean AHC increased 1.74 fold (95%CI 1.71, 1.76; p < .0001) from 79.2 ml/PD to 137.4 ml/PD. On IMCs (n = 475) AHC increased 1.69 fold (95%CI 1.60, 1.79; p < .0001) from 41.4 ml/PD to 70.6 ml /PD..On RWs (n = 14,857) AHC was 19.0 ml/PD in 2007 and increased 1.71 fold (95%CI 1.70, 1.73; p < .0001) to 32.6 ml/PD in 2018.

Conclusions

AHC in German hospitals increased on all types of wards during the past 12 years. Surveillance of AHC is widely established in German hospitals. Large differences among medical specialties exist and warrant further investigation.
Increasing the HIV testing among MSM through HIV test result exchange mechanism: study protocol for a cluster randomized controlled trial
Authors: Shi Yuning , Qiu Jialing , Yang Qingling , Chen Tailin , Lu Yongheng , Chen Sha , Fan Xiaoru , Lin Zhiye , Han Zhigang , Lu Jie , Qian Haobing , Gu Jing , Xu Dong Roman , Gu Yuzhou , Hao Chun
Published: August 2021

Background

HIV testing is an essential gateway to HIV prevention and treatment thus controlling the HIV epidemic. More innovative interventions are needed to increase HIV testing among men who have sex with men (MSM) since their testing rate is still low. We proposed an online HIV test results exchange mechanism whereby the one without a certified online HIV report will be asked to test HIV for exchanging HIV report with others. The exchange mechanism is developed as an extension to the existing online HIV testing service system. Through the extended system, MSM can obtain certified online HIV reports and exchange their reports with friends via WeChat. This study aims to assess effectiveness of the exchange mechanism to increase the HIV testing rate among MSM.

Methods

This study will use a cluster randomized controlled trial (RCT) design. Participants are recruited based on the unit of individual social network, the sender and the receivers of the HIV report. An individual social network is composed of one sender (ego) and one or more receivers (alters). In this study, MSM in an HIV testing clinic are recruited as potential egos and forwarded online reports to their WeChat friends voluntarily. Friends are invited to participate by report links and become alters. Ego and alters serve as a cluster and are randomized to the group using the certified online HIV report with exchange mechanism (intervention group) or without exchange mechanism (control group). Alters are the intervention targeting participants. The primary outcome is HIV testing rate. Other outcomes are sexual transmitted infections, sexual behaviors, HIV testing norms, stigma, risk perception and HIV report delivery. The outcomes will be assessed at baseline and follow-up questionnaires. Analysis will be according to intention to treat approach and using mixed-effect models with networks and individuals as random effects.

Discussion

This is the first study to evaluate the effectiveness of an HIV test result exchange mechanism to increase the HIV testing among MSM. This assessment of the intervention will also provide scientific evidence on other potential effects. Findings from this study will yield insights for sustainability driven by communities' intrinsic motivation.

Trail registration: ClinicalTrials.gov NCT03984136. Registered 12 June 2019.
Cerebral epidural empyema due to Bartonella henselae: a case report
Authors: Matta Stéphanie , Rousseau Audrey , Chenouard Rachel , Lemarié Carole , Eveillard Matthieu , Kempf Marie , Mahieu Rafaël , Pailhoriès Hélène
Published: August 2021

Background

Cat scratch disease frequently involves a benign, self-limited disease. Neurological forms associated with Bartonella henselae are uncommon, consisting mostly in neuroretinitis, encephalitis and meningitis. Cerebral epidural empyema has never described.

Case presentation

An adult patient was hospitalized for isolated headaches. Magnetic Resonance Imaging (MRI) identified typical features of cerebral epidural empyema. The diagnosis of B. henselae was performed incidentally by 16S rDNA gene sequencing on the abscess fluid, and confirmed by specific qPCR. We report here the first case, to our knowledge, of cerebral epidural empyema associated with B. henselae. Further follow-up visits allowed identifying frequent cat scratches on the scalp as the presumptive source of infection.

Conclusions

This case report alerts about such atypical clinical presentation, which requires an extensive clinical investigation. It also emphasizes on the usefulness of additional molecular diagnosis techniques in such CNS infection cases.
Assessment of nicotine dependence among tobacco users visiting outreach programs in Dharan, Nepal: a cross-sectional study
Authors: Subedi Krishna , Shrestha Ashish , Bhagat Tarakant
Published: August 2021

Background

Nicotine is a highly addictive substance present in tobacco. This study was conducted to assess the level of nicotine dependence among smokers and smokeless tobacco users visiting dental outreach programs of B.P. Koirala Institute of Health Sciences -Dharan, Nepal.

Methods

A cross sectional study was conducted from June 2018 to April 2019. A total of 726 people were selected from participants of dental outreach programs of 6 districts using convenience sampling technique. The data collection was done using semi-structured questionnaire through face-to-face interview by a single researcher. History of tobacco use and level of nicotine dependency was measured using Nepali translated and validated form of Fagerström Test for Nicotine Dependence for smoking and smokeless tobacco. The mean age of the tobacco users was 39.55 ± 15.57. Descriptive statistics including the mean, median, percentage, standard deviations and interquartile range were computed. Chi-square test, Fisher’s exact test, univariate and bivariate logistic regression were used where needed.

Results

Nicotine dependence (moderate and severe) was found in 80% of smokeless tobacco users and 48% of smokers. Among the smokeless tobacco users, nicotine dependency was found to be more with increase in duration of tobacco use (AOR = 50.25, 95%CI = 3.51–718.62, p = 0.004), low socioeconomic status (AOR = 6.27, 95%CI = 1.30–30.31, p = 0.02), less number of tobacco packets used per day and tried to quit tobacco use in last 1 year. Among smokers nicotine dependency was found to be significantly higher with smoking more than 10 cigarettes per day (AOR = 7.14, 95% CI = 2.00–25.40, p = 0.002).

Conclusions

The study concluded that level of nicotine dependence for both smoking and smokeless tobacco was high among the people visiting dental outreach programs. It is high time to develop a policy to control tobacco use along with creating tobacco cessation centers. Currently, tobacco control program is mostly focusing on smoking. However, it is also important to incorporate smokeless tobacco control at policy level.
Seasonal variation in lifestyle behavior in Poland: Google searches and market sales analysis
Authors: Kamiński Mikołaj , Kręgielska-Narożna Matylda , Bogdański Paweł
Published: August 2021

Background

Detection of the seasonal patterns of healthy and unhealthy behavior could be helpful for designing individual and population health interventions programs. This study investigates the seasonal variation in sales of common types of products in Poland and Polish Google queries related to healthy behavior.

Methods

Data of index sales from a large Polish retail store franchise, from January 2014 to August 2019, has been analyzed. The commercial data included twelve types of products. The interest of Google users was investigated using Google Trends statistics for the same period for six lifestyle-related topics. The seasonality was checked using time series analysis.

Results

Six of the consumer goods (dairy, ready-made meals, salty snacks, meats, beer, and cigarettes) were most commonly purchased in summer months, four (processed fish, food fats, wine, and alcohol 30%+) in December, and two (bread and sweets) in October. The lowest sales indexes were observed mostly in February. The interest in four topics that have been analyzed (“Diet,” “Dietitian,” “Weight loss,” and “Gym”), was highest in January, while interest in “Dietary supplements” was high in February, and “Running” in May. The search volume of the Google topics were the lowest in December.

Conclusion

The purchase of food, drinks, and cigarettes, and the interest in information regarding different components of a healthy lifestyle has seasonal variation. New Year and Lent might be good periods to encourage healthy behavior. The motivation may decrease in summer and during Christmas.
Urban-rural differences in healthcare utilization among beneficiaries in China’s new cooperative medical scheme
Authors: Luo Dian , Deng Jing , Becker Edmund R.
Published: August 2021

Background

The New Cooperative Medical Scheme (NCMS) is a voluntary social health insurance program launched in 2002 for rural Chinese residents where 80% of people were without health insurance of any kind. Over time, several concerns about this program have been raised related to healthcare utilization disparities for NCMS participants in urban versus rural regions. Our study uses 2015 national survey data to evaluate the extent of these urban and rural disparities among NCMS beneficiaries.

Methods

Data for our study are based on the Chinese Health and Retirement Longitudinal Study (CHARLS) for 2015. Our 12,190-patient sample are urban and rural patients insured by NCMS. We use logistic regression analyses to compare the extent of disparities for urban and rural residence of NCMS beneficiaries in (1) whether individuals received any inpatient or outpatient care during 2015 and (2) for those individuals that did receive care, the extent of the variation in the number of inpatient and outpatient visits among each group.

Results

Our regression results reveal that for urban and rural NCMS patients in 2015, there were no significant differences in inpatient or outpatient utilization for either of the dependent variables – 1) whether or not the patient had a visit during the last year, or 2) for those that had a visit, the number of visits they had. Patient characteristics: age, sex, employment, health status, chronic conditions, and per capita annual expenditures – all had significant impacts on whether or not there was an inpatient or outpatient visit but less influence on the number of inpatient or outpatient visits.

Conclusions

For both access to inpatient and outpatient facilities and the level of utilization of these facilities, our results reveal that both urban and rural NCMS patients have similar levels of resource utilization. These results from 2015 indicate that utilization angst about urban and rural disparities in NCMS patients do not appear to be a significant concern.
Carbon ion radiotherapy for prostate cancer with bladder invasion
Authors: Miyasaka Yuhei , Kawamura Hidemasa , Sato Hiro , Kubo Nobuteru , Mizukami Tatsuji , Matsui Hiroshi , Miyazawa Yoshiyuki , Ito Kazuto , Nakano Takashi , Suzuki Kazuhiro , Ohno Tatsuya
Published: August 2021

Background

The optimal management of clinical T4 (cT4) prostate cancer (PC) is still uncertain.
At our institution, carbon ion radiotherapy (CIRT) for nonmetastatic PC, including tumors invading the bladder, has been performed since 2010. Since carbon ion beams provide a sharp dose distribution with minimal penumbra and have biological advantages over photon radiotherapy, CIRT may provide a therapeutic benefit for PC with bladder invasion. Hence, we evaluated CIRT for PC with bladder invasion in terms of the safety and efficacy.

Methods

Between March 2010 and December 2016, a total of 1337 patients with nonmetastatic PC received CIRT at a total dose of 57.6 Gy (RBE) in 16 fractions over 4 weeks. Among them, seven patients who had locally advanced PC with bladder invasion were identified. Long-term androgen-deprivation therapy (ADT) was also administered to these patients. Adverse events were graded according to the Common Terminology Criteria for Adverse Event version 5.0.

Results

At the completion of our study, all the patients with cT4 PC were alive with a median follow-up period of 78 months. Grade 2 acute urinary disorders were observed in only one patient. Regarding late toxicities, only one patient developed grade 2 hematuria and urinary urgency. There was no grade 3 or worse toxicity, and gastrointestinal toxicity was not observed. Six (85.7%) patients had no recurrence or metastasis. One patient had biochemical and local failures 42 and 45 months after CIRT, respectively. However, the recurrent disease has been well controlled by salvage ADT.

Conclusions

Seven patients with locally advanced PC invading the bladder treated with CIRT were evaluated. Our findings seem to suggest positive safety and efficacy profiles for CIRT.
RNA-sequencing profiling analysis of pericyte-derived extracellular vesicle–mimetic nanovesicles-regulated genes in primary cultured fibroblasts from normal and Peyronie’s disease penile tunica albuginea
Authors: Yin Guo Nan , Piao Shuguang , Liu Zhiyong , Wang Lei , Ock Jiyeon , Kwon Mi-Hye , Kim Do-Kyun , Gho Yong Song , Suh Jun-Kyu , Ryu Ji-Kan
Published: August 2021

Background

Peyronie’s disease (PD) is a severe fibrotic disease of the tunica albuginea that causes penis curvature and leads to penile pain, deformity, and erectile dysfunction. The role of pericytes in the pathogenesis of fibrosis has recently been determined. Extracellular vesicle (EV)–mimetic nanovesicles (NVs) have attracted attention regarding intercellular communication between cells in the field of fibrosis. However, the global gene expression of pericyte-derived EV–mimetic NVs (PC–NVs) in regulating fibrosis remains unknown. Here, we used RNA-sequencing technology to investigate the potential target genes regulated by PC–NVs in primary fibroblasts derived from human PD plaque.

Methods

Human primary fibroblasts derived from normal and PD patients was cultured and treated with cavernosum pericytes isolated extracellular vesicle (EV)–mimetic nanovesicles (NVs). A global gene expression RNA-sequencing assay was performed on normal fibroblasts, PD fibroblasts, and PD fibroblasts treated with PC–NVs. Reverse transcription polymerase chain reaction (RT-PCR) was used for sequencing data validation.

Results

A total of 4135 genes showed significantly differential expression in the normal fibroblasts, PD fibroblasts, and PD fibroblasts treated with PC–NVs. However, only 91 contra-regulated genes were detected among the three libraries. Furthermore, 20 contra-regulated genes were selected and 11 showed consistent changes in the RNA-sequencing assay, which were validated by RT-PCR.

Conclusion

The gene expression profiling results suggested that these validated genes may be good targets for understanding potential mechanisms and conducting molecular studies into PD.
The role of angioembolization in the management of blunt renal injuries: a systematic review
Authors: Liguori Giovanni , Rebez Giacomo , Larcher Alessandro , Rizzo Michele , Cai Tommaso , Trombetta Carlo , Salonia Andrea
Published: August 2021

Background

Recently, renal angioembolization (RAE) has gained an important role in the non-operative management (NOM) of moderate to high-grade blunt renal injuries (BRI), but its use remains heterogeneous. The aim of this review is to examine the current literature on indications and outcomes of angioembolization in BRI.

Methods

We conducted a search of MEDLINE, EMBASE, SCOPUS and Web of Science Databases up to February 2021 in accordance with PRISMA guidelines for studies on BRI treated with RAE. The methodological quality of eligible studies and their risk of bias was assessed using the Newcastle–Ottawa scale

Results

A total of 16 articles that investigated angioembolization of blunt renal injury were included in the study. Overall, 412 patients were included: 8 presented with grade II renal trauma (2%), 97 with grade III renal trauma (23%); 225 with grade IV (55%); and 82 with grade V (20%). RAE was successful in 92% of grade III–IV (294/322) and 76% of grade V (63/82). Regarding haemodynamic status, success rate was achieved in 90% (312/346) of stable patients, but only in 63% (42/66) of unstable patients. The most common indication for RAE was active contrast extravasation in hemodynamic stable patients with grade III or IV BRI.

Conclusions

This is the first review assessing outcomes and indication of angioembolization in blunt renal injuries. The results suggest that outcomes are excellent in hemodynamic stable, moderate to high-grade renal trauma.
The use of bipolar coagulation forceps prevented salivary fistula in patients with parotidectomy: a retrospective study
Authors: Wu Kun , Zhu Keke , Ye Yingxi , Li Sainan , Wu Hanjiang , Zhang Sheng
Published: August 2021

Background

Salivary fistula is a relatively common complication in patients who have undergone a parotidectomy. The purpose of this study was to investigate the effects of bipolar coagulation forceps use on salivary fistulas.

Methods

From March 2015 to June 2020, 177 patients who underwent a parotidectomy in the Department of Oral and Maxillofacial Surgery at the Second Xiangya Hospital of Central South University were recruited. The patients were divided into an experimental group and a control group based on whether bipolar coagulation forceps or sutures were used, respectively.

Results

The drainage output of the experimental group was significantly lower than that of the control group (p = 0.04). The duration of dressing pressure applied in the experimental group was significantly shorter than that in the control group (p = 0.0003). Moreover, the incidence of salivary fistula in the experimental group (9.8%, 8/82) was notably lower than that in the control group (34.7%, 33/95) (p < 0.0001). In the logistic regression model for salivary fistula development, both the use of bipolar coagulation forceps (p = 0.0021) and drainage output (p = 0.0237) were associated with the presence of salivary fistulas.

Conclusions

Our findings indicate that the use of bipolar coagulation forceps decreases the incidence of salivary fistula in patients who have undergone a parotidectomy. The use of bipolar coagulation forceps is a safe, effective, and convenient method to prevent salivary fistulas in patients who undergo a parotidectomy.

Trial registration: Current Controlled Trials ChiCTR2100044722, Date: 26/03/2021, Retrospectively registered.
Exploring the barriers to Pap smear test in Iranian women: a qualitative study
Authors: Marashi Tayebeh , Irandoost Seyed Fahim , Yoosefi Lebni Javad , Soofizad Goli
Published: August 2021

Background

Cervical cancer is one of the most frequent types of cancer in females. The Pap smear is one of the most essential ways of diagnosing and screening for this malignancy, and any failure can be caused by a number of causes. The current study sought to investigate barriers to Pap smear in Iranian women.

Method

This qualitative content analysis study was conducted in Iran in 2019. Data was gathered through focus groups and individual semi-structured interviews with 32 women and health professionals. The interviewees were chosen using a combination of purposive and theoretical sampling. The data was then analyzed using the content analysis approach developed by Graneheim and Lundman. Guba and Lincoln's criteria for establishing trustworthiness were explored.

Results

Data analysis resulted in the identification of four primary categories, seventeen subcategories, and 186 original concepts. The main categories include weakness of health system, difficult accessibility, low health literacy, and socio-cultural factors.

Conclusion

By informing women about the necessity and importance of Pap smear, providing the conditions, facilities, and equipment to facilitate the testing process, and paying more attention to cultural and social factors in cervical cancer and Pap smear planning, interventions, and policies, barriers to Pap testing can be eliminated.
Rapid Cycle Implementation and Retrospective Evaluation of a SARS-CoV-2 Checklist in Labor and Delivery
Authors: Zucco Liana , Levy Nadav , Li Yunping , Golen Toni , Shainker Scott A. , Hess Philip E. , Ramachandran Satya Krishna
Published: August 2021

Background

Preparedness efforts for a COVID-19 outbreak required redesign and implementation of a perioperative workflow for the management of obstetric patients. In this report we describe factors which influenced rapid cycle implementation of a novel comprehensive checklist for the perioperative care of the COVID-19 parturient.

Methods

Within our labour and delivery unit, implementation of a novel checklist for the COVID-19 parturient requiring perioperative care was accomplished through rapid cycling, debriefing and on-site walkthroughs. Post-implementation, consistent use of the checklist was reported for all obstetric COVID-19 perioperative cases (100% workflow checklist utilization). Retrospective analysis of the factors influencing implementation was performed using a group deliberation approach, mapped against the Consolidated Framework for Implementation Research (CFIR).

Results

Analysis of factors influencing implementation using CFIR revealed domains of process implementation and innovation characteristics as overwhelming facilitators for success. Constructs within the outer setting, inner setting, and characteristic of individuals (external pressures, baseline culture, and personal attributes) were perceived to act as early barriers. Constructs such as communication culture and learning climate, shifted in influence over time.

Conclusion

We describe the influential factors of implementing a novel comprehensive obstetric workflow for care of the COVID-19 perioperative parturient during the first surge of the pandemic using the CFIR framework. Early workflow adoption was facilitated primarily by two domains, namely thoughtful innovation design and careful implementation planning in the setting of a long-standing culture of improvement. Factors initially assessed as barriers such as communication, culture and learning climate, transitioned into facilitators once a perceived benefit was experienced by healthcare teams. These results provide important information for the implementation of rapid change during a time of crisis.
Effect of age, sex, and body size on the blood biochemistry and physiological constants of dogs from 4 wk. to > 52 wk. of age
Authors: Montoya Navarrete Ana Luisa , Quezada Tristán Teódulo , Lozano Santillán Samuel , Ortiz Martínez Raúl , Valdivia Flores Arturo Gerardo , Martínez Martínez Lizbeth , De Luna López María Carolina
Published: August 2021

Background

Blood biochemistry and reference intervals help to differentiate between healthy and ill dogs as well as to provide information for the prognosis, evaluation, and monitoring; however, these intervals are often obtained from adult animals. It is essential to understand that puppies and adults are physiologically different, which justifies the need to obtain age-specific biochemical reference intervals. The aim of this research was to assess the potential effect of age, sex, body size, and their interaction on routine biochemical analytes and physiological constants (body temperature, heart rate, and respiratory rate). To carry out the research, we selected 197 healthy dogs of both sexes and different body sizes (small, medium and large) classified by age: group I (4–8 wk), group II (9–24 wk), group III (25–52 wk), and group IV (> 52 wk). The biochemical analysis included the measurement of the enzymatic activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), and the concentrations of cholesterol, triglycerides, total proteins, albumin, globulins, glucose, urea, and creatinine. Statistical analyses used analysis of variance (ANOVA) and a general linear model (GLM), which allows the comparison of multiple factors at two or more levels (p < 0.05).

Results

The results of this study showed that ALT, total protein, albumin, globulin, urea, creatinine, and body temperature levels were lower in puppies than in adult dogs of group IV (p < 0.05), while the enzymatic activity of ALP, LDH, glucose concentration, and heart rate were higher. Whereas sex, body size and the interaction did not show a significant effect (p > 0.05).

Conclusions

Some biochemical components are influenced by age. For this reason, this manuscript contributes with additional data for the clinical interpretation of blood biochemical results in puppies.
A novel signature constructed by ferroptosis-associated genes (FAGs) for the prediction of prognosis in bladder urothelial carcinoma (BLCA) and associated with immune infiltration
Authors: Luan Jiao-chen , Zeng Teng-yue , Zhang Qi-jie , Xia De-run , Cong Rong , Yao Liang-yu , Song Le-bin , Zhou Xiang , Zhou Xuan , Chen Xiang , Xia Jia-dong , Song Ning-hong
Published: August 2021

Background

Ferroptosis, a novel form of regulated cell death, has been implicated in the pathogenesis of cancers. Nevertheless, the potential function and prognostic values of ferroptosis in bladder urothelial carcinoma (BLCA) are complex and remain to be clarified. Therefore, we proposed to systematically examine the roles of ferroptosis-associated genes (FAGs) in BLCA.

Methods

According to The Cancer Genome Atlas (TCGA) database, differently expressed FAGs (DEFAGs) and differently expressed transcription factors (DETFs) were identified in BLCA. Next, the network between DEFAGs and DETFs, GO annotations and KEGG pathway analyses were performed. Then, through univariate, LASSO and multivariate regression analyses, a novel signature based on FAGs was constructed. Moreover, survival analysis, PCA analysis, t-SNE analysis, ROC analysis, independent prognostic analysis, clinicopathological and immune correlation analysis, and experimental validation were utilized to evaluate the signature.

Results

Twenty-eight DEFAGs were identified, and four FAGs (CRYAB, TFRC, SQLE and G6PD) were finally utilized to establish the FAGs based signature in the TCGA cohort, which was subsequently validated in the GEO database. Moreover, we found that immune cell infiltration, immunotherapy-related biomarkers and immune-related pathways were significantly different between two risk groups. Besides, nine molecule drugs with the potential to treat bladder cancer were identified by the connectivity map database analysis. Finally, the expression levels of crucial FAGs were verified by the experiment, which were consistent with our bioinformatics analysis, and knockdown of TFRC could inhibit cell proliferation and colony formation in BLCA cell lines in vitro.

Conclusions

Our study identified prognostic ferroptosis-associated genes and established a novel FAGs signature, which could accurately predict prognosis in BLCA patients.