bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of advanced imaging in COVID-19 cardiovascular complications
Authors: Catapano Federica , Marchitelli Livia , Cundari Giulia , Cilia Francesco , Mancuso Giuseppe , Pambianchi Giacomo , Galea Nicola , Ricci Paolo , Catalano Carlo , Francone Marco
Published: February 2021

Clinical manifestations of COVID-19 patients are dominated by respiratory symptoms, but cardiac complications are commonly observed and associated with increased morbidity and mortality. Underlying pathological mechanisms of cardiac injury are still not entirely elucidated, likely depending on a combination of direct viral damage with an uncontrolled immune activation. Cardiac involvement in these patients ranges from a subtle myocardial injury to cardiogenic shock. Advanced cardiac imaging plays a key role in discriminating the broad spectrum of differential diagnoses. Present article aims to review the value of advanced multimodality imaging in patients with suspected SARS-CoV-2-related cardiovascular involvement and its essential role in risk stratification and tailored treatment strategies. Based on our experience, we also sought to suggest possible diagnostic algorithms for the rationale utilization of advanced imaging tools, such as cardiac CT and CMR, avoiding unnecessary examinations and diagnostic delays.
Mesenchymal stem cell-derived conditioned medium protects vascular grafts of brain-dead rats against in vitro ischemia/reperfusion injury
Authors: Korkmaz-Icöz Sevil , Zhou Pengyu , Guo Yuxing , Loganathan Sivakkanan , Brlecic Paige , Radovits Tamás , Sayour Alex Ali , Ruppert Mihály , Veres Gábor , Karck Matthias , Szabó Gábor
Published: February 2021

Background

Brain death (BD) has been suggested to induce coronary endothelial dysfunction. Ischemia/reperfusion (IR) injury during heart transplantation may lead to further damage of the endothelium. Previous studies have shown protective effects of conditioned medium (CM) from bone marrow-derived mesenchymal stem cells (MSCs) against IR injury. We hypothesized that physiological saline-supplemented CM protects BD rats’ vascular grafts from IR injury.

Methods

The CM from rat MSCs, used for conservation purposes, indicates the presence of 23 factors involved in apoptosis, inflammation, and oxidative stress. BD was induced by an intracranial-balloon. Controls were subjected to a sham operation. After 5.5 h, arterial pressures were measured in vivo. Aortic rings from BD rats were harvested and immediately mounted in organ bath chambers (BD group, n = 7) or preserved for 24 h in 4 °C saline-supplemented either with a vehicle (BD-IR group, n = 8) or CM (BD-IR+CM group, n = 8), prior to mounting. Vascular function was measured in vitro. Furthermore, immunohistochemistry and quantitative real-time polymerase chain reaction (qRT-PCR) have been performed.

Results

BD in donors was associated with significantly impaired hemodynamic parameters and higher immunoreactivity of aortic myeloperoxidase (MPO), nitrotyrosine, caspase-3, caspase-8, caspase-9, and caspase-12 compared to sham-operated rats. In organ bath experiments, impaired endothelium-dependent vasorelaxation to acetylcholine in the BD-IR group compared to BD rats was significantly improved by CM (maximum relaxation to acetylcholine: BD 81 ± 2% vs. BD-IR 50 ± 3% vs. BD-IR + CM 72 ± 2%, p < 0.05). Additionally, the preservation of BD-IR aortic rings with CM significantly lowered MPO, caspase-3, caspase-8, and caspase-9 immunoreactivity compared with the BD-IR group. Furthermore, increased mRNA expression of vascular cell adhesion molecule (VCAM)-1 and intercellular adhesion molecule (ICAM)-1 in the aortas from the BD-IR rats compared to BD group were significantly decreased by CM.

Conclusions

The preservation of BD rats’ vascular grafts with CM alleviates endothelial dysfunction following IR injury, in part, by reducing levels of inflammatory response and caspase-mediated apoptosis.
Myogenic progenitor cell transplantation for muscle regeneration following hindlimb ischemia and reperfusion
Authors: Messner Franka , Thurner Marco , Müller Jule , Blumer Michael , Hofmann Julia , Marksteiner Rainer , Couillard-Despres Sebastien , Troppmair Jakob , Öfner Dietmar , Schneeberger Stefan , Hautz Theresa
Published: February 2021

Background

Muscle is severely affected by ischemia/reperfusion injury (IRI). Quiescent satellite cells differentiating into myogenic progenitor cells (MPC) possess a remarkable regenerative potential. We herein established a model of local application of MPC in murine hindlimb ischemia/reperfusion to study cell engraftment and differentiation required for muscle regeneration.

Methods

A clamping model of murine (C57b/6 J) hindlimb ischemia was established to induce IRI in skeletal muscle. After 2 h (h) warm ischemic time (WIT) and reperfusion, reporter protein expressing MPC (TdTomato or Luci-GFP, 1 × 106 cells) obtained from isolated satellite cells were injected intramuscularly. Surface marker expression and differentiation potential of MPC were analyzed in vitro by flow cytometry and differentiation assay. In vivo bioluminescence imaging and histopathologic evaluation of biopsies were performed to quantify cell fate, engraftment and regeneration.

Results

2h WIT induced severe IRI on muscle, and muscle fiber regeneration as per histopathology within 14 days after injury. Bioluminescence in vivo imaging demonstrated reporter protein signals of MPC in 2h WIT animals and controls over the study period (75 days). Bioluminescence signals were detected at the injection site and increased over time. TdTomato expressing MPC and myofibers were visible in host tissue on postoperative days 2 and 14, respectively, suggesting that injected MPC differentiated into muscle fibers. Higher reporter protein signals were found after 2h WIT compared to controls without ischemia, indicative for enhanced growth and/or engraftment of MPC injected into IRI-affected muscle antagonizing muscle damage caused by IRI.

Conclusion

WIT-induced IRI in muscle requests increased numbers of injected MPC to engraft and persist, suggesting a possible rational for cell therapy to antagonize IRI. Further investigations are needed to evaluate the regenerative capacity and therapeutic advantage of MPC in the setting of ischemic limb injury.
Diagnosis of tuberculosis in wildlife: a systematic review
Authors: Thomas Jobin , Balseiro Ana , Gortázar Christian , Risalde María A.
Published: February 2021

Animal tuberculosis (TB) is a multi-host disease caused by members of theMycobacterium tuberculosiscomplex (MTC). Due to its impact on economy, sanitary standards of milk and meat industry, public health and conservation, TB control is an actively ongoing research subject. Several wildlife species are involved in the maintenance and transmission of TB, so that new approaches to wildlife TB diagnosis have gained relevance in recent years. Diagnosis is a paramount step for screening, epidemiological investigation, as well as for ensuring the success of control strategies such as vaccination trials. This is the first review that systematically addresses data available for the diagnosis of TB in wildlife following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The article also gives an overview of the factors related to host, environment, sampling, and diagnostic techniques which can affect test performance. After three screenings, 124 articles were considered for systematic review. Literature indicates that post-mortem examination and culture are useful methods for disease surveillance, but immunological diagnostic tests based on cellular and humoral immune response detection are gaining importance in wildlife TB diagnosis. Among them, serological tests are especially useful in wildlife because they are relatively inexpensive and easy to perform, facilitate large-scale surveillance and can be used bothante-and post-mortem. Currently available studies assessed test performance mostly in cervids, European badgers, wild suids and wild bovids. Research to improve diagnostic tests for wildlife TB diagnosis is still needed in order to reach accurate, rapid and cost-effective diagnostic techniques adequate to a broad range of target species and consistent over space and time to allow proper disease monitoring.
Efficacy, acceptability, and safety of antidepressants for low back pain: a systematic review and meta-analysis
Authors: Ferraro Michael C. , Bagg Matthew K. , Wewege Michael A. , Cashin Aidan G. , Leake Hayley B. , Rizzo Rodrigo R. N. , Jones Matthew D. , Gustin Sylvia M. , Day Richard , Loo Colleen K. , McAuley James H.
Published: February 2021

Background

Antidepressant medicines are used to manage symptoms of low back pain. The efficacy, acceptability, and safety of antidepressant medicines for low back pain (LBP) are not clear. We aimed to evaluate the efficacy, acceptability, and safety of antidepressant medicines for LBP.

Methods

We searched CENTRAL, MEDLINE, Embase, CINAHL, ClinicalTrials.gov, the EU Clinical Trials Register, and the WHO International Clinical Trial Registry Platform from inception to May 2020. We included published and trial registry reports of RCTs that allocated adult participants with LBP to receive an antidepressant medicine or a placebo medicine. Pairs of authors independently extracted data in duplicate. We extracted participant characteristics, study sample size, outcome values, and measures of variance for each outcome. We data using random-effects meta-analysis models and calculated estimates of effects and heterogeneity for each outcome. We formed judgments of confidence in the evidence in accordance with GRADE. We report our findings in accordance with the PRISMA statement. We prespecified all outcomes in a prospectively registered protocol. The primary outcomes were pain intensity and acceptability. We measured pain intensity at end-of-treatment on a 0–100 point scale and considered 10 points the minimal clinically important difference. We defined acceptability as the odds of stopping treatment for any reason.

Results

We included 23 RCTs in this review. Data were available for pain in 17 trials and acceptability in 14 trials. Treatment with antidepressants decreased pain intensity by 4.33  points (95% CI − 6.15 to − 2.50) on a 0–100 scale, compared to placebo. Treatment with antidepressants increased the odds of stopping treatment for any reason (OR 1.27 [95% CI 1.03 to 1.56]), compared to placebo.

Conclusions

Treatment of LBP with antidepressants is associated with small reductions in pain intensity and increased odds of stopping treatment for any reason, compared to placebo. The effect on pain is not clinically important. The effect on acceptability warrants consideration. These findings provide Level I evidence to guide clinicians in their use of antidepressants to treat LBP.

Trial registration

We prospectively registered the protocol for this systematic review on PROSPERO (CRD42020149275).
Post-rape medicolegal service provision and policy in East Africa: a scoping review protocol
Authors: Rockowitz Sarah , Flowe Heather , Bradbury-Jones Caroline
Published: February 2021

Background

Sexual and gender-based violence (SGBV) is an epidemic that continues to affect both men and women in East Africa. Despite the high prevalence of SGBV in this region, sexual offense policies are often unclear, poorly enforced, or completely lacking. When policies do exist practitioners who assist survivors in the aftermath of the violation often are unaware of them, or may not implement them for a host of reasons (e.g., culture, personal beliefs, and resource limitations). This scoping review seeks to evaluate the literature on existing sexual offense policies in East Africa and understand the consequences of its implementation, or lack thereof, on a survivor’s justice and medical and psychological wellbeing.

Methods

This scoping review will be guided by the amended Arksey and O’Malley framework recommendations (Levac et al., Implementation Science. 2010) and the 2015 Joanna Briggs Institute guidelines (Peters et al., Joanna Briggs Institute Reviewer’s Manual, 2020). The results will be presented using the adapted Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Reviews chart (PRISMA-ScR). The search strategy for this scoping review will include entering search terms into electronic databases, including PubMed, SCOPUS, CINAHL Plus, The British Library, and Web of Science. A “cited by” search will be conducted, which will also include entering references from the reference lists from other articles. Grey literature will be included in the review, which will be identified through searching individual country’s government websites, and other websites, such as the World Health Organization and the United Nations Human Rights Council. All references will be exported to Endnote library. Two independent reviewers will screen titles, abstracts, and full articles. Thematic analysis will be used to evaluate the included articles.

Discussion

Understanding the legal and regulatory context of SGBV in East Africa and its associations with service provision will generate knowledge on implications for wellbeing. This information can be used to evaluate potential human rights violations and inform future policy.

Systematic review registration

Open Science Framework https://osf.io/vh3gm
Soil quality evaluation under different land use types in Kersa sub-watershed, eastern Ethiopia
Authors: Mulat Yared , Kibret Kibebew , Bedadi Bobe , Mohammed Muktar
Published: February 2021

Background

Soil quality, which can be inferred using indicators that interact synergistically, is affected by land use types and agricultural management practices. This study assessed the status of soil quality under three adjacent land uses (cultivated, grazing, and fallow) in Kersa subwatershed (622 ha). Soil samples were collected from the surface soil (0–20 cm depth) of the identified land uses with three replications and the soil quality parameters were analyzed. A minimum data set of soil quality indicators were selected from physical, chemical, and biological parameters using the literature review and expert opinion method. Linear scoring functions were used to give the unitless scores for the selected data sets, which were then integrated into a soil quality index (SQI).

Results

The results revealed that bulk density, aggregate stability, pH, cation exchange capacity (CEC), available P, and soil organic carbon (SOC) had a significant difference in SQI among the different land uses. The soil quality indices were 0.69 for grazing land, 0.62 for cultivated land, and 0.59 for the fallow land. The SQI of all the land uses falls in the intermediate soil quality (0.55 < SQI < 0.70) class.

Conclusion

In almost all the quality indicators assessed, the grazing land was superior to the cultivated and fallow lands. Therefore, implementing management practices that enhance soil quality like organic matter-controlled systems is imperative for sustainable agricultural production in the study area.
Molecular causes of congenital anomalies of the kidney and urinary tract (CAKUT)
Authors: Kohl Stefan , Habbig Sandra , Weber Lutz T. , Liebau Max C.
Published: February 2021

Congenital anomalies of the kidney and urinary tract (CAKUT) occur in 0.5–1/100 newborns and as a group they represent the most frequent cause for chronic kidney failure in children. CAKUT comprise clinically heterogeneous conditions, ranging from mild vesicoureteral reflux to kidney aplasia. Most forms of CAKUT share the pathophysiology of an impaired developmental interaction of the ureteric bud (UB) and the metanephric mesenchyme (MM). In most cases, CAKUT present as an isolated condition. They also may occur as a component in rare multi-organ syndromes. Many CAKUT probably have a multifactorial etiology. However, up to 20% of human patients and > 200 transgenic mouse models have a monogenic form of CAKUT, which has fueled our efforts to unravel molecular kidney (mal-)development. To date, genetic variants in more than 50 genes have been associated with (isolated) CAKUT in humans. In this short review, we will summarize typical imaging findings in patients with CAKUT and highlight recent mechanistic insight in the molecular pathogenesis of monogenic forms of CAKUT.
A cationic quantum dot-based ratiometric fluorescent probe to visually detect berberine hydrochloride in human blood serums
Authors: Liu Mingyang , Du Xuejun , Xu Ke , Yan Binwei , Fan Zaibi , Gao Zideng , Ren Xueqin
Published: February 2021

Berberine hydrochloride (BH) is an isoquinoline alkaloid normally used as drug to treat diseases. Compared with the traditional detection methods, the carbon quantum dots (CQDs) have better selectivity, high sensitivity, easy operation, and is inexpensive which could be widely utilized as fluorescent nanoprobes to detect various compounds quantificationally. And ratiometric fluorescent sensors conspicuously increase sensitivity and precision detection and improve quantification. In this work, we use water-soluble and fluorescent cationic carbon dots cetylpyridinium chloride monohydrate (CPC)-CQDs to connect with pinacyanol chloride (PC) and sodium tetraphenylborate (ST) as the ratiometric fluorescent probe to detect BH. The ratiometric fluorescent probe has high sensitivity towards alkaloids and metal ions, photochemical stability (60 min), and pH stability (from 6.0 to 8.0), with the detection range from 0 to 200 μM, and limit was as low as 57.35 nM. The accuracy of the method was verified by spiked recovery experiment in different human blood serums which were drawn from healthy adult volunteers to explore the practicability. The recoveries were in the range 94.34 to 105.48% with relative standard deviations (RSD) of 0.80 to 2.92%. In addition, we could observe that the fluorescence was gradually darkened, and the color turned yellow to realize the visual detection. It is expected that this work would open up a new strategy for detecting BH in the environment and human blood serums.
Dimerization of cell-penetrating buforin II enhances antimicrobial properties
Authors: Lee Hyunhee , Yang Sungtae
Published: February 2021

Antimicrobial peptides (AMPs) that selectively permeabilize bacterial membranes are promising alternatives to conventional antibiotics. Dimerization of AMP is considered an attractive strategy to enhance antimicrobial and membrane-lytic activity, but it also increases undesired hemolytic and cytotoxic activity. Here, we prepared Lys-linked homodimers of membrane-permeabilizing magainin II and cell-penetrating buforin II. Dimerization did not significantly alter conformational behavior, but it had a substantial impact on antimicrobial properties. We found that while the magainin II dimer showed increased antimicrobial and cytotoxic effects, the buforin II dimer conferred much greater antibacterial potency without exhibiting cytotoxic activity. Interestingly, the buforin II dimer was highly effective against several antibiotic-resistant bacterial isolates. Membrane permeabilization experiments indicated that the magainin II dimer rapidly disrupted both anionic and zwitterionic membranes, whereas the buforin II dimer selectively disrupted anionic membranes. Like the monomeric form, the buforin II dimer was efficiently translocated across lipid bilayers. Therefore, our results suggest that the dimerization of cell-penetrating buforin II not only disrupts the bacterial membrane, but also translocates it across the membrane to target intracellular components, resulting in effective antimicrobial activity. We propose that dimerization of intracellular targeting AMPs may present a superior strategy for therapeutic control of pathogenic bacteria.
Intrathecal chloroprocaine or hyperbaric prilocaine for ambulatory knee surgery? A prospective randomized study
Authors: Guntz E , Vasseur C , Ifrim D , Louvard A , Fils J F , Kapessidou Y
Published: February 2021

Purpose

The aim of this study was to compare intrathecal 1% chloroprocaine with 2% hyperbaric prilocaine in the setting of ambulatory knee arthroscopy. We hypothesized that complete resolution of the sensory block was faster with chloroprocaine.

Methods

Eighty patients scheduled for knee arthroscopy were included in this prospective randomized double-blind study. Spinal anesthesia was performed with either chloroprocaine (50 mg) or hyperbaric prilocaine (50 mg). Characteristics of sensory and motor blocks and side effects were recorded.

Results

Mean time to full sensory block recovery was shorter with chloroprocaine (169 (56.1) min vs 248 (59.4)). The characteristics of the sensory blocks were similar at the T12 dermatome level between the two groups. Differences appeared at T10: the percentage of patients with a sensory block was higher, onset quicker and duration longer with hyperbaric prilocaine. The number of patients with a sensory block at T4 dermatome level in both groups was minimal. Times to full motor recovery were identical in both groups (85 (70–99) vs 86 (76–111) min). Time to spontaneous voiding was shorter with chloroprocaine (203 (57.6) min vs 287.3 (47.2) min). Incidence of side effects was low in both groups.

Conclusions

When considering the characteristics of the sensory block, the use of chloroprocaine may allow an earlier discharge of patients. Cephalic extension was to a higher dermatomal level and the sensory block at T10 level was of prolonged duration with hyperbaric prilocaine, suggesting that the choice between the two drugs should also be performed based on the level of the sensory block requested by the surgery.

This study is registered in the US National Clinical Trials Registry, registration number: NCT030389, the first of February 2017, Retrospectively registered.
Health monitoring of finishing pigs by secondary data use – a longitudinal analysis
Authors: Grosse-Kleimann Julia , Plate Heiko , Meyer Henning , Gerhardy Hubert , Heucke Corinna Elisabeth , Kreienbrock Lothar
Published: February 2021

Background

In Germany, animal welfare has become an increasingly important issue. Since 2006, German legislation demands self-monitoring of animal welfare by farmers, but there is a lack of prescribed indicators for governmental monitoring. Since recording of the health status through examinations on individual farms requires many resources, secondary data use is obvious. Therefore, this study deals with the overall evaluation and utilization of existing production data from the German pork production. Performance data and information on antibiotic usage and meat inspection were used for a benchmarking system of animal health in finishing pigs.

Results

Seven health scores and one total score were evaluated for 184 finishing pig herds on semi-annual basis between July 2017 and June 2019, based on the health indicators mortality, average daily gain, feed conversion ratio, treatment frequency, respiratory lesions, exterior lesions and animal management. In preparation, the selected health indicators were brought to the same scale and skewed data were transformed to build scores (MOR, ADG, FCR, TF, RESP, EXT and MANG). A differentiated analysis was carried out for three classes of initial body weight regarding to farmers’ fattening management strategies.

Conclusions

The present study shows that existing production data of German finishing pigs are usable for welfare monitoring. However, preparatory editing steps are crucial. The total score can only be an estimate of health status because partly bad or good performance could be disguised. It has also been demonstrated, that relative benchmarking is suitable for depicting temporary fluctuations in the investigated collective.
COVID-19 and instability of stock market performance: evidence from the U.S.
Authors: Hong Hui , Bian Zhicun , Lee Chien-Chiang
Published: February 2021

The effect of COVID-19 on stock market performance has important implications for both financial theory and practice. This paper examines the relationship between COVID-19 and the instability of both stock return predictability and price volatility in the U.S over the period January 1st, 2019 to June 30th, 2020 by using the methodologies of Bai and Perron (Econometrica 66:47–78, 1998.10.2307/2998540; J Appl Econo 18:1–22, 2003.10.1002/jae.659), Elliot and Muller (Optimal testing general breaking processes in linear time series models. University of California at San Diego Economic Working Paper, 2004), and Xu (J Econ 173:126–142, 2013.10.1016/j.jeconom.2012.11.001). The results highlight a single break in return predictability and price volatility of both S&P 500 and DJIA. The timing of the break is consistent with the COVID-19 outbreak, or more specifically the stock selling-offs by the U.S. senate committee members before COVID-19 crashed the market. Furthermore, return predictability and price volatility significantly increased following the derived break. The findings suggest that the pandemic crisis was associated with market inefficiency, creating profitable opportunities for traders and speculators. Furthermore, it also induced income and wealth inequality between market participants with plenty of liquidity at hand and those short of funds.
Retrobulbar hematoma following the repair of an orbital wall fracture: a case series
Authors: Kim Jeong-Mo
Published: February 2021

Background

Retrobulbar hematoma is a rare complication after the repair of an orbital wall fracture, but the caution is required because the condition can cause blindness.

Case presentation

In this article, 3 cases of retrobulbar hematoma after the surgical repair of an orbital wall fracture are reported. In the first patient, the permanent loss of vision was involved, while in the second patient, the author was able to prevent loss of vision by performing immediate decompression after definite diagnosis and consulting with an ophthalmologist. In the third patient, there was no surgical treatment involved; he recovered on his own without major sequelae.

Conclusions

Retrobulbar hematoma is a very serious condition that can result in blindness. Thus, when it is recognized, every effort should be made to preserve the patient’s vision and prevent blindness.
Exploring rhizosphere and potato microbiome as potential antagonist to control blackleg and potato soft rot diseases in Morocco
Authors: Sbai Idrissi Nisrine , Ouarzane Aicha , Elouazni Latifa , Hmyene Aziz , Elantri Said , Amine Abdessamad
Published: February 2021

Background

Blackleg and tuber soft rot are among the most important potato diseases caused by the bacteria belonging to the genera Pectobacterium. This pathogen causes significant economic losses each year. The antagonistic activity of different bacterial cultures against this pathogen was studied.

Results

Six hundred eight bacterial cultures isolated from potato tubers and rhizosphere soils procured from different locations across Morocco were tested for their antagonistic activity against Pectobacterium carotovorum. Forty isolates, all originating from tubers, showed positive antagonistic activity during preliminary screening. Among the 40 isolates, 10 were found to have a symptom suppression superior to 90%. Of the 10 isolates, 9 showed clear zone in the agar medium (in vitro test), with differences between antagonist’s inhibition diameter. For the in vivo test, 8 isolates induced total suppression of soft rot on potato slices (in vivo test). The other 2 biocontrol strains (Amo-23 and Atd-2) were capable to minimize soft rot symptoms of up to 94.4 and 96.2%, respectively. Among the selected strains for in planta experiment, 6 strains (namely Ame-4, Atd-2, Atd-4, Ag-216, Al-51, and Ama-501) showed total reduction of disease symptoms. Biochemical and molecular tests identified 8 strains of Bacillus sp. and 2 strains of Pseudomonas sp.

Conclusions

The results of the in vivo and the greenhouse experiments indicated that the selected isolates had a greatly significant effectiveness for suppressing blackleg and soft rot symptoms. The selected isolates could, therefore, be used as a biocontrol agent against blackleg and soft rot of potato.
Implementation evaluation of staff support and wellbeing programmes at an academic health science centre during COVID-19: study protocol
Authors: Krausova Barbora , Gnanapragasam Sam Nishanth , Demetriou Len , Beck Alison , Pires-Yfantouda Renata , Docherty Mary Jane , Sevdalis Nick
Published: February 2021

Background

Evidence from previous pandemics as well as early evidence from COVID-19 suggests risk of adverse mental health and wellbeing outcomes for healthcare workers. In response to these concerns, healthcare systems and organisations rapidly established staff support and wellbeing programmes. While there is emerging literature related to the effectiveness of such interventions, what is less well understood and evaluated is the evidence base regarding how such programmes are implemented; what supports and hinders their implementation; and how or if they are maintained following the initial acute phase of the pandemic. This study addresses this gap by studying the implementation process of COVID-19-related staff wellbeing programmes in the three UK NHS Trusts that make up one of Europe’s largest academic health sciences centres, King’s Health Partners.

Methods

We will conduct a prospective, cross-sectional descriptive study using qualitative research methods and non-probability purposive sampling to identify a study participant group representative of the population and implementation activity of interest. We will conduct semi-structured interviews of between 30 min and 1 h. We will identify theory-driven elements in the dataset using the Consolidated Framework for Implementation Research (barriers and drivers), Exploration, Preparation, Implementation, Sustainment Framework (timeline/chronology/evolution of the implementation and different issues at different times) and Expert Recommendations for Implementing Change (implementation strategies). We will then identify indicators of these constructs within the dataset and report them, as well as their inter-relationships.

Discussion

Through this study, we hope to better understand what factors hindered and enabled the implementation of three inter-linked staff support and wellbeing programmes and how/to what extent have these programmes been sustained. We will also explore whether implementation science frameworks are applicable and beneficial in conceptualising and understanding crisis driven and rapidly implemented interventions and in what ways, if any, they need to be adjusted when used in unprecedented circumstances such as the COVID-19 pandemic.
Patterns and motivations for method choices in suicidal thoughts and behaviour: qualitative content analysis of a large online survey
Authors: Marzano Lisa , Katsampa Dafni , Mackenzie Jay-Marie , Kruger Ian , El-Gharbawi Nazli , Ffolkes-St-Helene Denika , Mohiddin Hafswa , Fields Bob
Published: February 2021

Background

Choice of suicide method can strongly influence the outcome of suicidal behaviour, and is an important aspect of the process and planning involved in a suicide attempt. Yet, the reasons why individuals consider, choose or discard particular methods are not well understood.

Aims

This is the first study to explore method choices among people with a history of suicidal behaviour and individuals who have experienced, but not enacted, suicidal thoughts.

Method

Via an online survey, we gathered open-ended data about choice of methods in relation to suicidal thoughts and behaviours, including reasons for and against specific means of harm.

Results

A total of 712 respondents had attempted suicide, and a further 686 experienced suicidal thoughts (but not acted on them). Self-poisoning was the most commonly contemplated and used method of suicide, but most respondents had considered multiple methods. Method choices when contemplating suicide included a broader range of means than those used in actual attempts, and more unusual methods, particularly if perceived to be lethal, ‘easy’, quick, accessible and/or painless. Methods used in suicide attempts were, above all, described as having been accessible at the time, and were more commonly said to have been chosen impulsively. Key deterrents against the use of specific methods were the presence of and impact on other people, especially loved ones, and fears of injury and survival.

Conclusions

Exploration of method choices can offer novel insights into the transition from suicidal ideation to behaviour. Results underscore the need for preventative measures to restrict access to means and delay impulsive behaviour.
Factors Associated With Colorectal Cancer Screening Via Immunochemical Fecal Occult Blood Test in an Average-Risk Population From a Multiethnic, Middle-Income Setting
Authors: Bujang Nur-Nadiatul-Asyikin , Lee Yu-Jie , Mohd-Zain Siti-Anis-Suraya , Aris Junita-Harizon , Md-Yusoff Fitri-Amalina , Suli Zailiza , Abu-Hassan Muhammad-Radzi , Bhoo-Pathy Nirmala
Published: February 2021

PURPOSE

The Malaysian Ministry of Health had launched free opportunistic screening for colorectal cancer using immunochemical fecal occult blood test (iFOBT) targeting the average-risk individuals since 2014. This study aims to determine factors associated with colorectal cancer screening using iFOBT among the average-risk Malaysian population.

METHODS

A cross-sectional study was conducted at five government-run health clinics in the state of Selangor. Adults with an average risk of colorectal cancer (age > 50 years, asymptomatic, and no family history of colorectal cancer) were recruited using systematic random sampling. An interviewer-administered questionnaire adapted from the Cancer Awareness Measure and Health Belief Model was used.

RESULTS

The median age of participants was 61 years (interquartile range, 56 to 66). Almost 60% of participants indicated their willingness to be screened. However, only 7.5% had undergone iFOBT. Good knowledge of risk factors of colorectal cancer, perceived susceptibility to the disease, and the doctor's recommendation were associated with increased willingness to be screened: adjusted odds ratio (aOR), 1.66 (95% CI, 1.12 to 2.46); aOR, 1.70 (95% CI, 1.08 to 2.70); and aOR, 5.76 (95% CI, 2.13 to 15.57), respectively. Nevertheless, being elderly (aOR, 0.67; 95% CI, 0.45 to 0.99) and high negative perception toward the testing method (iFOBT) (aOR, 0.12; 95% CI, 0.05 to 0.30) were independently associated with lower willingness to be screened. Multivariable analysis within the average-risk individuals who were willing to be screened for colorectal cancer showed that the doctor’s recommendations remained as an important cue for positive action, whereas negative perception toward the test was a significant barrier to the actual uptake of iFOBT.

CONCLUSION

The present findings must be factored in when tailoring colorectal cancer screening promotion activities in multiethnic, middle-income settings.
GPS Assay Association With Long-Term Cancer Outcomes: Twenty-Year Risk of Distant Metastasis and Prostate Cancer–Specific Mortality
Authors: Brooks Michael A. , Thomas Lewis , Magi-Galluzzi Cristina , Li Jianbo , Crager Michael R. , Lu Ruixiao , Abran John , Aboushwareb Tamer , Klein Eric A.
Published: February 2021

PURPOSE

To assess the association between the Oncotype DX Genomic Prostate Score (GPS) result and long-term oncological outcomes following radical prostatectomy (RP).

METHODS

We evaluated the association of the GPS result assayed from the index lesion from RP tissue with the risk of distant metastases (DM) and prostate cancer–specific mortality (PCSM) over the 20 years following RP in a stratified cohort sample of 428 patients from 2,641 treated between 1987 and 2004. Cox regression of cause-specific hazards was used to estimate the absolute risk of both end points, with death from other causes treated as a competing risk. A correction for regression to the mean (RM) was applied since the GPS test was developed using this cohort. Exploratory analysis using presurgical parameters and the GPS test as prognostic variables was performed to assess the additional value of the GPS test on 20-year risk of DM and PCSM. Model discrimination was measured using the area under the receiver operating characteristic curve.

RESULTS

The GPS test appears to be independently associated with both 20-year risk of DM and PCSM with a low false discovery rate. Per 20-unit increase in GPS, multivariable analysis with RM correction estimated hazard ratios of 2.24 (95% CI, 1.49 to 3.53) and 2.30 (95% CI, 1.45 to 4.36) for DM and PCSM, respectively. Accuracy of models including clinical risk factors alone appeared to improve when including the GPS test in assessing risk of both end points.

CONCLUSION

The results suggest that the GPS test provides information on the risk for the meaningful long-term outcomes of DM and PCSM.
First Report of Spinal Anesthesia for Cesarean Delivery in a Parturient With Jeune Syndrome: A Case Report
Authors: Kondo Hiroaki , Hyuga Shunsuke , Fujita Tomoe , Adachi Mariko , Mochizuki Junko , Okutomi Toshiyuki
Published: February 2021

Jeune syndrome, also known as asphyxiating thoracic dystrophy, is a rare form of autosomal recessive skeletal dysplasia. Respiratory distress due to thoracic and lung dysplasia is the primary complication associated with this disorder in neonates. Women with Jeune syndrome seldom conceive and give birth, as only a few survive until adulthood. Herein, we report the world’s first case of a cesarean delivery under spinal anesthesia in a pregnant woman with Jeune syndrome with a history of chest wall reconstruction and spinal fusion surgeries.
Perioperative Management of an Adult Patient With Myoclonic Epilepsy With Ragged Red Fibers Syndrome: A Case Report
Authors: Valent Arnaud , Pharaboz Alexandre , Letord Alexia , Boughezala Samia , Boccara David , Plaud Benoit
Published: February 2021

Myoclonic epilepsy with ragged red fibers (MERRF) syndrome is a rare mitochondrial disease potentially associated with increased sensitivity to anesthesia and metabolic decompensation. We present the perioperative management in a 59-year-old man with MERRF scheduled for lipomatosis cure under general anesthesia (GA). Following a reduced fasting period, the patient had an uneventful balanced GA with propofol, sevoflurane, and rocuronium. The patient did not present metabolic decompensation nor malignant hyperthermia but prolonged neuromuscular blockade. Propofol and sevoflurane may be used in asymptomatic MERRF adult patients. Such patients present high risk of residual neuromuscular blockade that should be monitored and reversed.
Intraoperative Use of Angiotensin II for Severe Vasodilatory Shock During Liver Transplantation: A Case Report
Authors: Running Kati , Weinberg Devin , Trudo William , Sullivan Cinnamon L. , Patel Gaurav P.
Published: February 2021

Refractory hypotension is a known entity in liver transplantation. Catecholamine and vasopressin infusions are first-line therapies. There has been recent interest in angiotensin II (Ang-2) as an alternative vasopressor; however, liver failure patients were excluded from the original trials. Ang-2 has potential in this patient population. This case discusses a patient who received an infusion of Ang-2 during a liver transplant for combined liver failure–induced distributive shock and septic shock. It is the first known successful use of intraoperative Ang-2 in this situation, and it shows that Ang-2 may be safe in liver transplantation when traditional therapies fail.
Management of Factor X Deficiency for Vaginal Delivery in a Parturient: A Case Report
Authors: Yen Colleen B. , Katz Daniel J.
Published: February 2021

Factor X (FX) deficiency is a rare coagulopathy that may cause bleeding complications in parturients. The literature on rotational thromboelastometry (ROTEM; Instrumentation Laboratory, Bedford, MA) to guide factor repletion and neuraxial placement during partuition is limited. We present a 17-year-old parturient with FX deficiency after vaginal delivery with neuraxial anesthesia without bleeding complications. After FX concentrate administration, thromboelastometry was utilized to risk-stratify and manage her coagulopathy peripartum. Thromboelastometry may be a valuable adjunct to conventional monitoring in patient management. A limitation of this report is that coagulation tests and thromboelastometry were not assessed at identical timepoints.
Diving in hot water: a meta-analytic review of how diving vertebrate ectotherms will fare in a warmer world
Authors: Rodgers Essie M. , Franklin Craig E. , Noble Daniel W. A.
Published: February 2021

Diving ectothermic vertebrates are an important component of many aquatic ecosystems, but the threat of climate warming is particularly salient to this group. Dive durations typically decrease as water temperatures rise; yet, we lack an understanding of whether this trend is apparent in all diving ectotherms and how this group will fare under climate warming. We compiled data from 27 studies on 20 ectothermic vertebrate species to quantify the effect of temperature on dive durations. Using meta-analytic approaches, we show that, on average, dive durations decreased by 11% with every 1°C increase in water temperature. Larger increases in temperature (e.g. +3°C versus +8–9°C) exerted stronger effects on dive durations. Although species that respire bimodally are projected to be more resilient to the effects of temperature on dive durations than purely aerial breathers, we found no significant difference between these groups. Body mass had a weak impact on mean dive durations, with smaller divers being impacted by temperature more strongly. Few studies have examined thermal phenotypic plasticity (N=4) in diving ectotherms, and all report limited plasticity. Average water temperatures in marine and freshwater habitats are projected to increase between 1.5 and 4°C in the next century, and our data suggest that this magnitude of warming could translate to substantial decreases in dive durations, by approximately 16–44%. Together, these data shed light on an overlooked threat to diving ectothermic vertebrates and suggest that time available for underwater activities, such as predator avoidance and foraging, may be shortened under future warming.
Bioenergetics in environmental adaptation and stress tolerance of aquatic ectotherms: linking physiology and ecology in a multi-stressor landscape
Authors: Sokolova Inna
Published: February 2021

Energy metabolism (encompassing energy assimilation, conversion and utilization) plays a central role in all life processes and serves as a link between the organismal physiology, behavior and ecology. Metabolic rates define the physiological and life-history performance of an organism, have direct implications for Darwinian fitness, and affect ecologically relevant traits such as the trophic relationships, productivity and ecosystem engineering functions. Natural environmental variability and anthropogenic changes expose aquatic ectotherms to multiple stressors that can strongly affect their energy metabolism and thereby modify the energy fluxes within an organism and in the ecosystem. This Review focuses on the role of bioenergetic disturbances and metabolic adjustments in responses to multiple stressors (especially the general cellular stress response), provides examples of the effects of multiple stressors on energy intake, assimilation, conversion and expenditure, and discusses the conceptual and quantitative approaches to identify and mechanistically explain the energy trade-offs in multiple stressor scenarios, and link the cellular and organismal bioenergetics with fitness, productivity and/or ecological functions of aquatic ectotherms.
Factors that influence the implementation of health and social care Standards: a systematic review and meta-summary protocol
Authors: Kelly Yvonne , O’Rourke Niamh , Flynn Rachel , Hegarty Josephine , O’Connor Laura
Published: February 2021

Health and social care Standards are evidence-based statements that demonstrate a desired level of care. Setting Standards for health and social care is a mechanism by which quality improvements can be achieved. Limited evidence exists on appropriate implementation strategies to overcome challenges with implementing Standards. In order to inform the design of implementation strategies, there is a need to examine factors that influence their implementation. The aim of this protocol is to set out a comprehensive plan to undertake a systematic search, appraisal and mixed research synthesis of the international literature that examines implementation of health and social care Standards.

A research question, “What are the enablers and barriers to implementing health and social care Standards in health and social care services?” was designed using the ‘SPICE’ (Setting, Perspectives, Interest phenomenon of, Comparison, Evaluation) framework. Electronic databases, grey literature and reference lists from included studies will be searched. Primary qualitative, quantitative descriptive and mixed methods studies reporting on enablers and barriers to implementing nationally endorsed Standards, will be included. The review will focus on experiences and perspectives from multi-level stakeholders including patient and public involvement. The quality of studies will be appraised using appropriate tools and findings used to weight interpretation of findings. Search outputs, data extraction and quality appraisal will be undertaken by two reviewers independently. Sandelowski meta-summary will be used to synthesise the data. Frequency and intensity effect sizes of enablers and barriers will be calculated to evaluate their prevalence across the studies. The Confidence in Evidence from Reviews of Qualitative research (CERQual) approach will be applied to assess confidence in the findings of the review.

Findings from this examination will inform influencing factors to implementation. Subsequently, this will contribute to pairing Standards with appropriate implementation strategies that will optimise the enabling factors and overcome challenges to implementation.
Does last contraceptive method used impact the return of normal fertility?
Authors: Hofler Lisa , Dale Lindsay
Published: February 2021

Yes, according to a prospective observational study of more than 17,000 women that evaluated fecundability after stopping contraception. The authors found hormonal intrauterine device (IUD) users had slightly increased fecundability compared with users of barrier methods. There was no difference in fecundability for users of copper IUDs, implant, oral contraception, patches, rings, or natural methods compared with barrier methods. Users of injectable contraceptives experienced the longest delay in return of normal fertility, about 5 to 8 menstrual cycles.
Surgical Management of Lymphedema: An Overview of Preoperative Evaluation and Surgical Techniques
Authors: Suh Hyunsuk Peter , Pak Changsik John , Hong Joon Pio(Jp)
Published: February 2021

Lymphedema is a chronic and progressive disease that affects many of the patients who underwent cancer ablative surgery and decreases the quality of life of them. Surgical management including lymphovenous shunting and vascularized lymph node transfer become popular in the field of microsurgery. For the better outcome of microsurgical approach to lymphedema, understanding of multiple image modalities is essential. Also, understanding other conservative management tools is crucial for setting reasonable algorism for lymphedema management.
Uma releitura da recepção de Mestre Eckhart por Heidegger à luz dos "Cadernos negros"
Authors: García Ricardo Baeza
Published: February 2021

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