bluuebunny/crossref_metadata_2025 huggingface dataset:
Split staphylectomy to address soft palate thickness in brachycephalic dogs: 75 cases (2016‐2018)
Authors: Holloway G. L. , Higgins J. , Beranek J. P.
Published: February 2022

Objectives

Describe the split staphylectomy procedure to address soft palate thickness and assess the complications and long‐term outcome of this procedure as a part of multi‐level surgery for brachycephalic obstructive airway syndrome. To consider whether same‐day discharge following this surgery can be recommended.

Materials and Methods

Medical records of dogs treated for brachycephalic obstructive airway syndrome using the split staphylectomy were reviewed. Owners were contacted to complete a questionnaire assessing initial postoperative concerns, the long‐term outcome and the effect of surgery on their dog's quality of life.

Results

Seventy‐five dogs underwent split staphylectomy during the study period. The overall complication rate was 8.3%, of which 2.7% were considered major. No life‐threatening complications occurred, and no complications were related to the staphylectomy. The questionnaire was completed by 66.7% of owners (median follow‐up 459 days), of which 88% felt that surgery had improved the quality of life for their dog. The majority (88%) of dogs were discharged from hospital on the day of surgery. Of the surveyed owners, 14% sought veterinary attention between their dog leaving the hospital and the scheduled postoperative reassessment 2 weeks after surgery. Four dogs were presented for veterinary intervention during this time period, but no intervention was related to the staphylectomy or for a life‐threatening condition.

Clinical Significance

The split staphylectomy offers a safe, straightforward method of addressing both excess thickness and length of soft palate in dogs with brachycephalic obstructive airway syndrome. Dogs can be discharged on the same day as brachycephalic obstructive airway syndrome surgery including split staphylectomy without an increased risk of complications.
The complicated impact of media use before bed on sleep: Results from a combination of objective EEG sleep measurement and media diaries
Authors: Ellithorpe Morgan E. , Ulusoy Ezgi , Eden Allison , Hahn Lindsay , Yang Chia‐Lun , Tucker Robin M.
Published: February 2022

Media use has been linked to sleep disturbance, but the results are inconsistent. This study explores moderating conditions. A media diary study with 58 free‐living adults measured the time spent with media before bed, the location of use, and multitasking. Electroencephalography (EEG) captured bedtime, total sleep time, and the percent of time spent in deep (Stage N3), and rapid eye movement (REM) sleep. Media use in the hour before sleep onset was associated with an earlier bedtime. If the before bed use did not involve multitasking and was conducted in bed, that use was also associated with more total sleep time. Media use duration was positively associated with (later) bedtime and negatively associated with total sleep time. Sleep quality, operationalised as the percent of total sleep time spent in N3 and REM sleep, was unaffected by media use before bed. Bedtime media use might not be as detrimental for sleep as some previous research has shown. Important contextual variables moderate the relationship, such as location, multitasking, and session length.
Longitudinal association between sleep disturbance and inflammation, and the role of positive affect
Authors: Zagaria Andrea , Lombardo Caterina , Ballesio Andrea
Published: February 2022

Previous longitudinal evidence suggested that sleep disturbance (i.e., difficulties in sleep onset and sleep maintenance) may be longitudinally associated with systemic inflammation, which is involved in the pathophysiology of mental and somatic illness. The mechanisms underlying this association, however, remain largely unexplored. In the context of health psychology, a substantial body of literature showed that positive affect may have a favourable impact on immune and inflammatory response and buffer the proinflammatory effects of stress. Therefore, the aim of this study was to assess whether subjective sleep disturbance is longitudinally associated with serum high sensitivity C‐reactive protein (hs‐CRP), a marker of systemic inflammation, and whether this association is mediated by a decrease in positive affect. The data of 1894 participants aged 64.11 ± 8.02 years from the English Longitudinal Study of Ageing (ELSA) across three waves of data collection were analysed. Self‐reported sleep disturbance was assessed in 2008–2009, (wave 4), positive affect was assessed in 2010–2011 (wave 5), and hs‐CRP was assessed in 2012–2013 (wave 6). Path analysis adjusted for health‐related variables including depressive symptoms, cardiovascular disease, BMI, smoking, alcohol consume, and drug intake showed a significant direct effect of sleep disturbance to positive affect; positive affect directly predicted hs‐CRP. Lastly, an indirect effect between sleep disturbance to hs‐CRP through the mediating role of positive affect emerged. The findings suggest that sleep onset and sleep maintenance difficulties may be associated with inflammation through the mediation of low positive affect. The clinical significance of the findings should be further explored.
Measurement of benefits in economic evaluations of nutrition interventions in low‐ and middle‐income countries: A systematic review
Authors: Wun Jolene , Kemp Christopher , Puett Chloe , Bushnell Devon , Crocker Jonny , Levin Carol
Published: February 2022

Economic evaluation of nutrition interventions that compares the costs to benefits is essential to priority‐setting. However, there are unique challenges to synthesizing the findings of multi‐sectoral nutrition interventions due to the diversity of potential benefits and the methodological differences among sectors in measuring them. This systematic review summarises literature on the interventions, sectors, benefit terminology and benefit types included in cost‐effectiveness, cost‐utility and benefit‐cost analyses (CEA, CUA and BCA, respectively) of nutrition interventions in low‐ and middle‐income countries. A systematic search of five databases published from January 2010 to September 2019 with expert consultation yielded 2794 studies, of which 93 met all inclusion criteria. Eighty‐seven per cent of the included studies included interventions delivered from only one sector, with almost half from the health sector (43%), followed by food/agriculture (27%), water, sanitation and hygiene (WASH) (10%), and social protection (8%). Only 9% of studies assessed programmes involving more than one sector (health, food/agriculture, social protection and/or WASH). Eighty‐one per cent of studies used more than one term to refer to intervention benefits. The included studies calculated 128 economic evaluation ratios (57 CEAs, 39 CUAs and 32 BCAs), and the benefits they included varied by sector. Nearly 60% measured a single benefit category, most frequently nutritional status improvements; other health benefits, cognitive/education gains, dietary diversity, food security, knowledge/attitudes/practices and income were included in less than 10% of all ratios. Additional economic evaluation of non‐health and multi‐sector interventions, and incorporation of benefits beyond nutritional improvements (including cost savings) in future economic evaluations is recommended.
What are the determinants of low exclusive breastfeeding prevalence in China? A cross‐sectional study
Authors: Duan Yifan , Yang Zhenyu , Bi Ye , Wang Jie , Pang Xuehong , Jiang Shan , Zhang Huanmei , Xu Lili , Lai Jianqiang
Published: February 2022

Exclusive breastfeeding (EBF) status is far from the national target in China. To identify the modifiable factors associated with EBF of infants aged under 6 months in China. A cross‐sectional study was conducted in 12 provinces/municipalities across China in 2017–2018. We used multistage stratified cluster sampling and collected data through face‐to‐face interviews with mothers using an electronic questionnaire. Totally, 5287 pairs of mother–infant aged <6 months were investigated. The EBF prevalence was 29.2% (1544/5287). Mothers with correct knowledge of colostrum (adjusted odds ratio [AOR]:1.32, 95% confidence interval [CI]: 1.07, 1.62), EBF (AOR: 1.39, 95% CI: 1.06, 1.81) and the highest scores of perceptions for breastfeeding benefits (AOR: 1.36, 95% CI: 1.14, 1.61) were more likely to exclusively breastfeed. However, mothers with more frequent unwillingness of breastfeeding during the first month postpartum were less likely to practice EBF (AOR: 0.68, 95% CI: 0.52, 0.90). Infants having their first breast milk within 24 h of birth increased the odds of EBF (AOR: 2.41, 95% CI: 1.86, 3.13). Infants were less likely to be exclusively breastfed in the families in which the main caregiver was the grandmothers. Mothers without receiving infant formula feeding suggestions via the health facilities, media, or the Internet (AOR: 1.57, 95% CI: 1.33, 1.85) or without the experience of infant formula feeding in public (AOR: 1.45, 95% CI: 1.23, 1.72) might more likely to practice EBF. To acquire comprehensively correct knowledge and keep a positive attitude of breastfeeding for the mothers are crucial for improving the EBF prevalence. Family supports are potential interventions worth focusing on. Infant formula promotion remains a great barrier for EBF in China.
Aspergillus‐PCR in bronchoalveolar lavage ‐ diagnostic accuracy for invasive pulmonary aspergillosis in critically ill patients
Authors: Mikulska Malgorzata , Furfaro Elisa , Dettori Silvia , Giacobbe Daniele Roberto , Magnasco Laura , Dentone Chiara , Ball Lorenzo , Russo Chiara , Taramasso Lucia , Vena Antonio , Angelucci Emanuele , Pelosi Paolo , Bassetti Matteo
Published: February 2022

Background

The diagnosis of invasive pulmonary aspergillosis (IPA) in intensive care unit (ICU) patients is challenging, and the role of Aspergillus‐PCR in bronchoalveolar lavage (BAL) is unknown.

Objectives

This study evaluated diagnostic accuracy of Aspergillus‐PCR in BAL in IPA in three different cohorts: ICU‐admitted patients with COVID‐19, ICU‐admitted patients without COVID‐19 and immunocompromised patients.

Methods

All stored available BAL samples collected from three patient groups were tested with Aspergillus‐PCR (AsperGenius®). IPA was diagnosed according to appropriate criteria for each patient group.

Results

We included 111 BAL samples from 101 patients: 52 (51%) patients admitted to ICU for COVID‐19, 24 (24%) admitted to ICU for other reasons and 25 (25%) immunocompromised. There were 31 cases of IPA (28%). Aspergillus‐PCR sensitivity was 64% (95% CI 47–79) and specificity 99% (95% CI 93–100). Aspergillus‐PCR sensitivity was 40% (95%CI 19–64) in ICU COVID‐19, 67% (95% CI 21‐93) in non‐COVID‐19 ICU patients and 92% (95%CI 67–98) in the immunocompromised. The concordance between positive BAL‐GM and BAL‐PCR in patients with and without IPA was significantly lower in ICU patients (32%; 43% in COVID‐19, 18% in non‐COVID‐19) than in the immunocompromised (92%), p < .001.

Conclusions

Aspergillus‐PCR in BAL improves the diagnostic accuracy of BAL‐GM in ICU patients.
Effects of housing demolition on labor supply: Evidence from China
Authors: Zhao Xuecun , Liu Yanrong
Published: February 2022

This paper investigates how housing demolition affects labor supply using the China Family Panel Studies, a nationally representative household survey from China. We argue that housing demolition is likely to be random across households within the same community. We find that housing demolition reduces overall labor force participation by ~3.3 percentage points and farm work participation by ~4.4 percentage points. We also find that the negative impact on labor force participation is mainly driven by older people, women, less‐educated people, and people living in rural regions. The negative impact of housing demolition on labor force participation persists over time.
Closer than they Appear: A Bayesian Perspective on Individual-Level Heterogeneity in Risk Assessment
Authors: Lum Kristian , Dunson David B. , Johndrow James
Published: February 2022

Risk assessment instruments are used across the criminal justice system to estimate the probability of some future event, such as failure to appear for a court appointment or re-arrest. The estimated probabilities are then used in making decisions at the individual level. In the past, there has been controversy about whether the probabilities derived from group-level calculations can meaningfully be applied to individuals. Using Bayesian hierarchical models applied to a large longitudinal dataset from the court system in the state of Kentucky, we analyse variation in individual-level probabilities of failing to appear for court and the extent to which it is captured by covariates. We find that individuals within the same risk group vary widely in their probability of the outcome. In practice, this means that allocating individuals to risk groups based on standard approaches to risk assessment, in large part, results in creating distinctions among individuals who are not meaningfully different in terms of their likelihood of the outcome. This is because uncertainty about the probability that any particular individual will fail to appear is large relative to the difference in average probabilities among any reasonable set of risk groups.
Moral distress experienced by care leaders’ in older adult care: A qualitative study
Authors: Ahokas Fanny , Hemberg Jessica
Published: February 2022

Background

Many healthcare professionals have left their professions recently because of increased moral distress, and the COVID‐19 pandemic has had a further major impact on the ever‐changing healthcare environment.

Aim

The purpose of the study was to examine care leaders’ experiences of moral distress in their daily work in older adult care.

Methodology

A qualitative design was used. The data consisted of texts from interviews with care leaders (N = 8) in an older adult care context. Content analysis was used to analyse the data.

Findings

Five themes emerged: (1) moral distress arises from a lack of time, (2) moral distress contributes to a sense of inadequacy but also a sense of responsibility, (3) moral distress arises from an imbalance in values, (4) increased knowledge and open discussion help reduce moral distress and (5) reflection, increased support and increased resources can reduce moral distress.

Conclusion

Moral distress is something that care leaders, according to this study, experience daily in an older adult care context and it is considered to have increased. Care leaders can experience moral distress from a lack of time; patient‐related, relative‐related or other ethically difficult situations or an imbalance between own values and an organisation's, other caregivers’, patients’ and/or patients’ relatives values. Increased staffing resources, more knowledge (training and lectures) and time for reflection individually, in groups or with an outside expert could increase care leaders’ insights into and ability to reduce moral distress. Although situations that are characterised by moral distress are burdensome, care leaders have the opportunity to learn from such situations through reflection and discussion and can develop strategies for future ethical challenges. Future research could focus on exploring caregivers’ experiences of moral distress.
Influence of muscle‐belly and tendon gearing on the energy cost of human walking
Authors: Monte Andrea , Tecchio Paolo , Nardello Francesca , Bachero‐Mena Beatriz , Ardigò Luca Paolo , Zamparo Paola
Published: February 2022

This study combines metabolic and kinematic measurements at the whole‐body level, with EMG and ultrasound measurements to investigate the influence of muscle‐tendon mechanical behavior on the energy cost (Cnet) of walking (from 2 to 8 km·h−1). Belly gearing (Gb = Δmuscle‐belly length/Δfascicles length) and tendon gearing (Gt = ∆muscle‐tendon unit length/∆muscle‐belly length) of vastus lateralis (VL) and gastrocnemius medialis (GM) were calculated based on ultrasound data. Pendular energy recovery (%R) was calculated based on kinematic data, whereas the cumulative activity per distance travelled (CMAPD) was calculated for the VL, GM, tibialis anterior, and biceps femoris as the ratio between their EMG activity and walking speed. Finally, total CAMPD (CMAPDTOT) was calculated as the sum of the CMAPD of all the investigate muscles. Cnet and CMAPDTOT showed a U‐shaped behavior with a minimum at 4.2 and 4.1 km·h−1, respectively; while %R, VL, and GM belly gearing showed an opposite trend, reaching a maximum (60% ± 5%, 1.1 ± 0.1 and 1.5 ± 0.1, respectively), between 4.7 and 5 km·h−1. Gt was unaffected by speed in GM (3.5 ± 0.1) and decreased as a function of it in VL. A multiple stepwise linear regression indicated that %R has the greatest influence on Cnet, followed by CMAPDTOT and GM belly gearing. The role of Gb on Cnet could be attributed to its role in determining muscle work: when Gb increases, fascicles shortening decreases compared with that of the muscle‐belly, thereby reducing the energy cost of contraction.
Correctional rehabilitation and positive psychology: Opportunities and challenges
Authors: Morse Stephanie J. , Wright Kevin A. , Klapow Max
Published: February 2022

At this point it is clear that the pursuit of the rehabilitative ideal is stitched into the DNA of American corrections. However, in our collective quest to establish and defend ‘what works,’ correctional rehabilitation has lingered in a state of preoccupation with risks, deficits, and individual pathology. The framework of Positive Psychology provides an alluring blueprint for an approach to correctional rehabilitation where people are not considered different humans who are reduced to their deficits and their worst decisions. In the current paper we explore the possibilities of incorporating the principles of Positive Psychology into correctional rehabilitation to help promote a notion of correctional success that is more dynamic, humanizing, and inclusive. We begin by discussing the development, progression, and current state of correctional rehabilitation. We then turn to discussing the development, progression, and current state of Positive Psychology, suggesting that there is a missed opportunity in applying its principles to people who are impacted by the criminal justice system. We conclude with a section discussing the opportunities and challenges of bringing correctional rehabilitation and Positive Psychology together.
Superhydrophobic Cobalt–Graphene Composite for the Corrosion Protection of Copper Bipolar Plates in Proton Exchange Membrane Fuel Cells
Authors: Mohamed Mohamed E. , Abd-El-Nabey Beshier A.
Published: February 2022

Superhydrophobic cobalt and cobalt–graphene films were fabricated on copper bipolar plates (BPPs) using potentiostatic electrodeposition to improve their corrosion resistance and surface conductivity. A scanning electron microscope (SEM) was used to study the surface morphology of the prepared superhydrophobic films. The results show that the cobalt film modified by stearic acid (Co-SA) and cobalt–graphene composite modified by stearic acid (Co–G-SA) exhibit micro–nano structures. The results of the Fourier transforming infrared (FTIR) spectrophotometer confirm that the copper substrate was coated by Co-SA and Co–G-SA films. The wettability results of the prepared superhydrophobic films demonstrate that the films display superhydrophobicity, where the fabricated Co-SA and Co–G-SA films have contact angles (CAs) of 159 deg and 165 deg, respectively. Chemical stability, mechanical abrasion resistance, surface conductivity, and corrosion resistance in a simulated proton exchange membrane fuel cells (PEMFCs) environment are significantly higher for copper coated by Co–G-SA film. Because the copper coated with Co–G-SA has a low interfacial contact resistance (ICR) value and a high corrosion resistance, it is thought to be a good choice for PEMFC bipolar plates.
Electronics-free soft robot has a nice ring to it
Authors: Dorsey Kristen L.
Published: February 2022

A fluidic ring oscillator provides timing to soft robots, thus enabling complex locomotion and load carrying.
Prevalence and Correlates of Phenazine Resistance in Culturable Bacteria from a Dryland Wheat Field
Authors: Perry Elena K. , Newman Dianne K.
Published: February 2022

Microbial communities contribute to crop health in important ways. For example, phenazine metabolites are a class of redox-active molecules made by diverse soil bacteria that underpin the biocontrol of wheat and other crops.
Gastric Non-Helicobacter pylori Urease-Positive Staphylococcus epidermidis and Streptococcus salivarius Isolated from Humans Have Contrasting Effects on H. pylori-Associated Gastric Pathology and Host Immune Responses in a Murine Model of Gastric Cancer
Authors: Shen Zeli , Dzink-Fox JoAnn , Feng Yan , Muthupalani Sureshkumar , Mannion Anthony J. , Sheh Alexander , Whary Mark T. , Holcombe Hilda R. , Piazuelo Blanca M. , Bravo Luis E. , Josenhans Christine , Suerbaum Sebastian , Wilson Keith T. , Peek Richard M. , Wang Timothy C. , Fox James G.
Published: February 2022

Chronic infection with
H. pylori
is the main cause of gastric cancer, which is a global health problem. In two Colombian populations with high levels of
H. pylori
prevalence, the regional gastric cancer rates are considerably different.
Biofilm Bacterial Dynamics and Changes in Inorganic Nitrogen Density Due to the Presence of Freshwater Pearl Mussels
Authors: Takeuchi Kayano , Takeuchi Motoi , Kakino Wataru , Uyeno Yutaka
Published: February 2022

The abundance of freshwater unioid mussels exhibited more diverse patterns of inorganic nitrogen flow and bacterial communities than the areas without mussels. This study demonstrates the effect of mussels on different freshwater ecosystem processes with variable organismal densities and biogeochemical factors.
Characterization of Genetic Elements Carrying
mcr-1
Gene in Escherichia coli from the Community and Hospital Settings in Vietnam
Authors: Vu Thi Ngoc Bich , Le Viet Thanh , Nguyen Thi Tuyet Mai , Nguyen Thi Hong Thuong , Nguyen Thi Ngoc Diep , Le Van Duyet , Chu Thi Loan , Tran Huy Hoang , Penders John , Wertheim Heiman , van Doorn H. Rogier
Published: February 2022

The article presented advances our understanding of genetic elements carrying
mcr-1
in
Escherichia coli
in both community and hospital settings. We provide evidence to suggest that diverse plasmid types, including multireplicon plasmids, have facilitated the successful transmission of
mcr-1
in different reservoirs.
Mycoplasma pneumoniae among Chinese Outpatient Children with Mild Respiratory Tract Infections during the Coronavirus Disease 2019 Pandemic
Authors: Chen Jiande , Zhang Jing , Lu Zhiwei , Chen Yu , Huang Songsong , Li Hengtao , Lin Shuzhu , Yu Jun , Zeng Xueqi , Ji Cuihong , Zheng Yuejie , Dai Fangfang , Dong Wei , Xu Huiting , Chen Weichao , Jin Xiaoqun , Cui Zhen , Qiao Jing , Qin Wei , Chen Hui , Jiang Wei , Zhang Xiaoying , Song Jingrong , Shao Jie , Su Wen , Wang Chao , Liu Fang , Zhao Yuhua , Zou Yingxue , Guo Run , Zhang Lei , Wu Jinhong , Yuan Shuhua , Tang Mingyu , Wu Yufen , Lin Jie , Dong Wenfang , Chen Xing , Sun Xinrong , Yin Yong
Published: February 2022

This is the first and largest prospective, multicenter, active, population-based surveillance study of the epidemiology of
Mycoplasma pneumoniae
among outpatient children with mild respiratory tract infections (RTIs) during the COVID-19 pandemic. Nationwide measures like strict face mask wearing and restrictions on population movement implemented to prevent the spread of COVID-19 might also effectively prevent the spread of
M. pneumoniae
.
Bismuth Drugs Reverse Tet(X)-Conferred Tigecycline Resistance in Gram-Negative Bacteria
Authors: Deng Tian , Jia Yuqian , Tong Ziwen , Shi Jingru , Wang Zhiqiang , Liu Yuan
Published: February 2022

Recently, high-level tigecycline resistance mediated by
tet
(X4) and its variants represents a serious challenge for global public health. Antibiotic adjuvant strategy that enhances the activity of the existing antibiotics by using nonantibiotic drugs offers a distinct approach to combat the antibiotic resistance crisis. In this study, we found that bismuth drugs involve bismuth nitrate, a compound previously approved for treatment of stomach-associated diseases, remarkably potentiates tigecycline activity against
tet
(X)-positive bacteria.
Escherichia fergusonii, an Underrated Repository for Antimicrobial Resistance in Food Animals
Authors: Tang Biao , Chang Jiang , Chen Yifei , Lin Jiahui , Xiao Xingning , Xia Xiaodong , Lin Jun , Yang Hua , Zhao Guoping
Published: February 2022

E. fergusonii
, a member of the genus
Escherichia
, has been reported to transmit via the food chain and cause diseases in humans. However, the prevalence of multidrug-resistant
E. fergusonii
, especially
mcr-1
-positive
E. fergusonii
isolates, has rarely been reported.
Heat Shock Protein Member 8 (HSPA8) Is Involved in Porcine Reproductive and Respiratory Syndrome Virus Attachment and Internalization
Authors: Wang Lei , Li Rui , Geng Rui , Zhang Longxiang , Chen Xin-xin , Qiao Songlin , Zhang Gaiping
Published: February 2022

PRRSV has caused huge economic losses to the pork industry around the world. Currently, safe and effective strategies are still urgently required to prevent and control PRRSV infection.
Broadly Reactive Real-Time RT-PCR Assay for the Detection of Hepatitis E Virus and Simultaneous Genotyping by Single Nucleotide Polymorphism Analysis
Authors: Ishida Setsuko , Yoshizumi Shima , Sakata Hidekatsu , Matsubayashi Keiji
Published: February 2022

The distribution of HEV-3 and HEV-4 has been changing. HEV-4, which had been predominantly found in Asia, is now being detected in other parts of the world, and there are now reports of chronic infections.
Massive purulent pericardial effusion with ultrasound features of tamponade secondary to non-typhoid Salmonella infection
Authors: Jacobs Kelly , Beringer Craig , Abdulla Saif Mohammed , Mahomed Zeyn
Published: February 2022

Purulent pericardial effusions are rare and represent the most severe form of bacterial pericarditis. The authors present a case of a male in his 40s with a massive purulent pericardial effusion due to non-typhoid Salmonella, who presented with ultrasound features of a cardiac tamponade. Invasive non-typhoid Salmonella cardiac infection is a rare but important consideration in immunocompromised individuals. This of particular concern in sub-Saharan Africa, where there is a high prevalence of HIV-infected individuals.
Perivascular epithelioid cell tumour (PEComa): an unusual cause of painful defaecation
Authors: Chua Deborah , Loh Alwin Hwai-Liang , Tan Emile , Seow-En Isaac
Published: February 2022

Perivascular epithelioid cell tumours (PEComa) are rare tumours of mesenchymal origin. We report a 39-year-old patient who presented with painful defecation secondary to an anorectal mass. The diagnosis of anorectal PEComa was confirmed following excision and histopathological examination. We review the literature and discuss the management of this uncommon entity.
Advances in the management of cardioembolic stroke associated with patent foramen ovale
Authors: Mac Grory Brian , Ohman E Magnus , Feng Wuwei , Xian Ying , Yaghi Shadi , Kamel Hooman , Reznik Michael E
Published: February 2022

Patent foramen ovale (PFO) describes a valve in the interatrial septum that permits shunting of blood or thrombotic material between the atria. PFOs are present in approximately 25% of the healthy population and are not associated with any pathology in the vast majority of cases. However, comparisons between patients with stroke and healthy controls suggest that PFOs may be causative of stroke in certain patients whose stroke is otherwise cryptogenic. Options for the diagnosis of PFO include transthoracic echocardiography, transesophageal echocardiography, and transcranial Doppler ultrasonography. PFOs associated with an interatrial septal aneurysm seem to be more strongly linked to risk of recurrent stroke. Therapeutic options for secondary stroke prevention in the setting of a PFO include antiplatelet therapy, anticoagulation, and percutaneous device closure. Recent randomized clinical trials suggest that percutaneous closure reduces the subsequent risk of stroke in appropriately selected patients, with a large relative benefit but small absolute benefit. Referral for percutaneous PFO closure should therefore be considered in certain patients after a multidisciplinary, patient centered discussion. Areas for future study include structural biomarkers to aid in determining the role of PFO closure in older people with possible PFO associated stroke, the role of direct oral anticoagulants, and very long term outcomes after device closure.
Physical therapy and orthopaedic equipment-induced reduction in the biomechanical risk factors related to knee osteoarthritis: a systematic review and Bayesian network meta-analysis of randomised controlled trials
Authors: Huang Xi-Meng , Yuan Fu-Zhen , Chen You-Rong , Huang Ying , Yang Ze-Xi , Lin Lin , Yu Jia-Kuo
Published: February 2022

Objective

Are physical therapy or orthopaedic equipment efficacious in reducing the biomechanical risk factors in people with tibiofemoral osteoarthritis (OA)? Is there a better therapeutic intervention than others to improve these outcomes?

Design

Systematic review with network meta-analysis (NMA) of randomised trials.

Data sources

PubMed, Web of Science, Cochrane Library, Embase and MEDLINE were searched through January 2021.

Eligibility criteria for selecting studies

We included randomised controlled trials exploring the benefits of using physical therapy or orthopaedic equipment in reducing the biomechanical risk factors which included knee adduction moment (KAM) and knee adduction angular impulse (KAAI) in individuals with tibiofemoral OA.

Data extraction and synthesis

Two authors extracted data independently and assessed risk of bias. We conducted an NMA to compare multiple interventions, including both direct and indirect evidences. Heterogeneity was assessed (sensitivity analysis) and quantified (I2statistic). Grading of Recommendations Assessment, Development and Evaluation assessed the certainty of the evidence.

Results

Eighteen randomised controlled trials, including 944 participants, met the inclusion criteria, of which 14 trials could be included in the NMA. Based on the collective probability of being the overall best therapy for reducing the first peak KAM, lateral wedge insoles (LWI) plus knee brace was closely followed by gait retraining, and knee brace only. Although no significant difference was observed among the eight interventions, variable-stiffness shoes and neuromuscular exercise exhibited an increase in the first peak KAM compared with the control condition group. And based on the collective probability of being the overall best therapy for reducing KAAI, gait retraining was followed by LWI only, and lower limb exercise.

Conclusion

The results of our study support the use of LWI plus knee brace for reducing the first peak KAM. Gait retraining did not rank highest but it influenced both KAM and KAAI and therefore it was the most recommended therapy for reducing the biomechanical risk factors.
Citation impact and social media visibility of Great Barrington and John Snow signatories for COVID-19 strategy
Authors: Ioannidis John P
Published: February 2022

Objective

The Great Barrington Declaration (GBD) and the John Snow Memorandum (JSM), each signed by numerous scientists, have proposed hotly debated strategies for handling the COVID-19 pandemic. The current analysis aimed to examine whether the prevailing narrative that GBD is a minority view among experts is true.

Methods

The citation impact and social media presence of the key GBD and JSM signatories was assessed. Citation data were obtained from Scopus using a previously validated composite citation indicator that incorporated also coauthorship and author order and ranking was against all authors in the same Science-Metrix scientific field with at least five full papers. Random samples of scientists from the longer lists of signatories were also assessed. The number of Twitter followers for all key signatories was also tracked.

Results

Among the 47 key GBD signatories, 20, 19 and 21, respectively, were top-cited authors for career impact, recent single-year (2019) impact or either. For comparison, among the 34 key JSM signatories, 11, 14 and 15, respectively, were top cited. Key signatories represented 30 different scientific fields (9 represented in both documents, 17 only in GBD and 4 only in JSM). In a random sample of n=30 scientists among the longer lists of signatories, five in GBD and three in JSM were top cited. By April 2021, only 19/47 key GBD signatories had personal Twitter accounts versus 34/34 of key JSM signatories; 3 key GBD signatories versus 10 key JSM signatories had >50 000 Twitter followers and extraordinary Kardashian K-indices (363–2569). By November 2021, four key GBD signatories versus 13 key JSM signatories had >50 000 Twitter followers.

Conclusions

Both GBD and JSM include many stellar scientists, but JSM has far more powerful social media presence and this may have shaped the impression that it is the dominant narrative.
Monitoring of SARS-CoV-2 seroprevalence among primary healthcare patients in the Barcelona Metropolitan Area: the SeroCAP sentinel network protocol
Authors: Sentís Alexis , Torán Pere , Esperalba Juliana , Agustí Cristina , Ángel Munoz Miguel , Fernández Gema , Dopico Eva , Salvador-González Betlem , González Maria Victoria , Bordas Anna , Antón Andrés , Violan Concepció , Montoro-Fernández Marcos , Aceiton Jordi , Egea-Cortés Laia , Alonso Lucía , Dacosta-Aguayo Rosalia , Calatayud Laura , Lejardi Yolanda , Mendioroz Jacobo , Basora Josep , Reyes-Urueña Juliana , Casabona Jordi
Published: February 2022

Introduction

SARS-CoV-2 seroprevalence studies are currently being recommended and implemented in many countries. Forming part of the COVID-19 monitoring and evaluation plan of the Catalan Government Health Department, our network aims to initiate a primary healthcare sentinel monitoring system as a surrogate of SARS-CoV-2 exposure in the Barcelona Metropolitan Area.

Methods and analysis

The seroCAP is a serial cross-sectional study, which will be performed in the Barcelona Metropolitan Area to estimate antibodies against SARS-CoV-2. From February 2021 to March 2022, the detection of serum IgG antibodies against SARS-CoV-2 trimeric spike protein will be performed on a monthly basis in blood samples collected for diverse clinical purposes in three reference hospitals from the three Barcelona healthcare areas (BCN areas). The samples (n=2588/month) will be from patients attended by 30 primary healthcare teams at 30 basic healthcare areas (BHA). A lab software algorithm will systematically select the samples by age and sex. Seroprevalence will be estimated and monitored by age, sex, BCN area and BHA. Descriptive and cluster analysis of the characteristics and distribution of SARS-CoV-2 infections will be performed. Sociodemographic, socioeconomic and morbidity-associated factors will be determined using logistic regression. We will explore the association between seroprevalence, SARS-CoV-2 confirmed cases and the implemented measures using interrupted time series analysis.

Ethics and dissemination

Ethical approval was obtained from the University Institute Foundation for Primary Health Care Research Jordi Gol i Gurina ethics committee. An informed consent is not required regarding the approval of the secondary use of biological samples within the framework of the COVID-19 pandemic. A report will be generated quarterly. The final analysis, conclusions and recommendations will be shared with the stakeholders and communicated to the general public. Manuscripts resulting from the network will be submitted for publication in peer-reviewed journals.
Protocol for the development of a core outcome set for stillbirth care research (iCHOOSE Study)
Authors: Bakhbakhi Danya , Fraser Abigail , Siasakos Dimitris , Hinton Lisa , Davies Anna , Merriel Abi , Duffy James M N , Redshaw Maggie , Lynch Mary , Timlin Laura , Flenady Vicki , Heazell Alexander Edward , Downe Soo , Slade Pauline , Brookes Sara , Wojcieszek Aleena , Murphy Margaret , de Oliveira Salgado Heloisa , Pollock Danielle , Aggarwal Neelam , Attachie Irene , Leisher Susannah , Kihusa Wanijiru , Mulley Kate , Wimmer Lindsey ,   UK iCHOOSE parent involvement group, Burden Christy
Published: February 2022

Introduction

Stillbirth is associated with significant physical, psychosocial and economic consequences for parents, families, wider society and the healthcare system. There is emerging momentum to design and evaluate interventions for care after stillbirth and in subsequent pregnancies. However, there is insufficient evidence to inform clinical practice compounded by inconsistent outcome reporting in research studies. To address this paucity of evidence, we plan to develop a core outcome set for stillbirth care research, through an international consensus process with key stakeholders including parents, healthcare professionals and researchers.

Methods and analysis

The development of this core outcome set will be divided into five distinct phases: (1) Identifying potential outcomes from a mixed-methods systematic review and analysis of interviews with parents who have experienced stillbirth; (2) Creating a comprehensive outcome long-list and piloting of a Delphi questionnaire using think-aloud interviews; (3) Choosing the most important outcomes by conducting an international two-round Delphi survey including high-income, middle-income and low-income countries; (4) Deciding the core outcome set by consensus meetings with key stakeholders and (5) Dissemination and promotion of the core outcome set. A parent and public involvement panel and international steering committee has been convened to coproduce every stage of the development of this core outcome set.

Ethics and dissemination

Ethical approval for the qualitative interviews has been approved by Berkshire Ethics Committee REC Reference 12/SC/0495. Ethical approval for the think-aloud interviews, Delphi survey and consensus meetings has been awarded from the University of Bristol Faculty of Health Sciences Research Ethics Committee (Reference number: 116535). The dissemination strategy is being developed with the parent and public involvement panel and steering committee. Results will be published in peer-reviewed specialty journals, shared at national and international conferences and promoted through parent organisations and charities.

PROSPERO registration number

CRD42018087748.
Digital auscultation as a novel childhood pneumonia diagnostic tool for community clinics in Sylhet, Bangladesh: protocol for a cross-sectional study
Authors: Ahmed Salahuddin , Mitra Dipak Kumar , Nair Harish , Cunningham Steven , Khan Ahad Mahmud , Islam ASMD Ashraful , McLane Ian Mitra , Chowdhury Nabidul Haque , Begum Nazma , Shahidullah Mohammod , Islam Muhammad Shariful , Norrie John , Campbell Harry , Sheikh Aziz , Baqui Abdullah H , McCollum Eric D
Published: February 2022

Introduction

The WHO’s Integrated Management of Childhood Illnesses (IMCI) algorithm for diagnosis of child pneumonia relies on counting respiratory rate and observing respiratory distress to diagnose childhood pneumonia. IMCI case defination for pneumonia performs with high sensitivity but low specificity, leading to overdiagnosis of child pneumonia and unnecessary antibiotic use. Including lung auscultation in IMCI could improve specificity of pneumonia diagnosis. Our objectives are: (1) assess lung sound recording quality by primary healthcare workers (HCWs) from under-5 children with the Feelix Smart Stethoscope and (2) determine the reliability and performance of recorded lung sound interpretations by an automated algorithm compared with reference paediatrician interpretations.

Methods and analysis

In a cross-sectional design, community HCWs will record lung sounds of ~1000 under-5-year-old children with suspected pneumonia at first-level facilities in Zakiganj subdistrict, Sylhet, Bangladesh. Enrolled children will be evaluated for pneumonia, including oxygen saturation, and have their lung sounds recorded by the Feelix Smart stethoscope at four sequential chest locations: two back and two front positions. A novel sound-filtering algorithm will be applied to recordings to address ambient noise and optimise recording quality. Recorded sounds will be assessed against a predefined quality threshold. A trained paediatric listening panel will classify recordings into one of the following categories: normal, crackles, wheeze, crackles and wheeze or uninterpretable. All sound files will be classified into the same categories by the automated algorithm and compared with panel classifications. Sensitivity, specificity and predictive values, of the automated algorithm will be assessed considering the panel’s final interpretation as gold standard.

Ethics and dissemination

The study protocol was approved by the National Research Ethics Committee of Bangladesh Medical Research Council, Bangladesh (registration number: 09630012018) and Academic and Clinical Central Office for Research and Development Medical Research Ethics Committee, Edinburgh, UK (REC Reference: 18-HV-051). Dissemination will be through conference presentations, peer-reviewed journals and stakeholder engagement meetings in Bangladesh.

Trial registration number

NCT03959956.
Health system readiness for non-communicable diseases at the primary care level: a systematic review
Authors: Kabir Ashraful , Karim Md Nazmul , Islam Rakibul M , Romero Lorena , Billah Baki
Published: February 2022

Objective

To synthesise evidence on the primary healthcare system’s readiness for preventing and managing non-communicable diseases (NCDs).

Design

Systematic review.

Data sources

Ovid MEDLINE, EMBASE, CINAHL, PsycINFO and Scopus were searched from 1 January 1984 to 30 July 2021, with hand-searching references and expert advice.

Eligibility criteria

Any English-language health research with evidence of readiness/preparedness of the health system at the primary healthcare level in the context of four major NCDs: diabetes mellitus, cancer, chronic respiratory diseases (CRDs) and cardiovascular diseases (CVDs).

Data extraction and synthesis

Two authors independently extracted data and assessed the bias. The full-text selected articles were then assessed using the Mixed Methods Appraisal Tool. Health system readiness was descriptively and thematically synthesised in line with the health system dynamics framework.

Results

Out of 7843 records, 23 papers were included in this review (15 quantitative, 3 qualitative and 5 mixed-method studies). The findings showed that existing literature predominantly examined health system readiness from the supply-side perspective as embedded in the WHO’s health system framework. However, at the primary healthcare level, these components are insufficiently prepared for NCDs. Among NCDs, higher levels of readiness were reported for diabetes mellitus and hypertension in comparison to CRDs (asthma, chronic obstructive pulmonary disease), CVDs and cancer. There has been a dearth of research on the demand-side perspective, which is an essential component of a health system and must be addressed in the future research.

Conclusion

The supply-side components at the primary healthcare level are inadequately ready to address the growing NCD burden. Improving supply-side factors, with a particular focus on CRDs, CVDs and cancer, and improving understanding of the demand-side components of the health system’s readiness, may help to prevent and manage NCDs at the primary healthcare level.
Modern genomic techniques in the identification of genetic causes of cardiomyopathy
Authors: Spracklen Timothy F , Keavney Bernard , Laing Nakita , Ntusi Ntobeko , Shaboodien Gasnat
Published: February 2022

Over the past three decades numerous disease-causing genes have been linked to the pathogenesis of heritable cardiomyopathies, but many causal genes are yet to be identified. Next-generation sequencing (NGS) platforms have revolutionised clinical testing capacity in familial cardiomyopathy. In this review, we summarise how NGS technologies have advanced our understanding of genetic non-syndromic cardiomyopathy over the last decade. First, 26 putative new disease-causing genes have been identified to date, mostly from whole-exome sequencing, and some of which (FLNC,MTO1,HCN4) have had a considerable clinical impact and are now included in routine diagnostic gene panels. Second, we consider challenges in variant interpretation and the importance of large-scale NGS population control cohorts for this purpose. Third, an emerging role of common variation in some forms of genetic cardiomyopathy is being elucidated through recent studies which have illustrated an additive effect of numerous polymorphic loci on cardiac parameters; this may explain phenotypic variability and low rates of genetic diagnosis from sequencing studies. Finally, we discuss the clinical utility of genetic testing in cardiomyopathy in Western settings, where NGS panel testing of core disease genes is currently recommended with possible implications for patient management. Given the findings of recent studies, whole-exome or whole-genome sequencing should be considered in patients of non-European ancestry with clearly familial disease, or severe paediatric disease, when no result is obtained on panel sequencing. The clinical utility of polygenic risk assessment needs to be investigated further in patients with unexplained dilated cardiomyopathy and hypertrophic cardiomyopathy in whom a pathogenic variant is not identified.
Interleukin-10 attenuates renal injury after myocardial infarction in diabetes
Authors: Fan Xiaoming , Zhang Xiaolu , Liu Lijun C , Kim Annes Y , Curley Sean P , Chen Xiaohuan , Dworkin Lance D , Cooper Christopher J , Gupta Rajesh
Published: February 2022

Acute kidney injury (AKI) is a common complication after myocardial infarction (MI) and associated with significant morbidity and mortality. AKI after MI occurs more frequently in patients with diabetes, however, the underlying mechanisms are poorly understood, and specific treatments are lacking. Using the murine MI model, we show that diabetic mice had higher expression of the kidney injury marker, neutrophil gelatinase-associated lipocalin (NGAL), 3 days after MI compared with control mice. This higher expression of NGAL was still significant after controlling for differences in myocardial infarct size between diabetic and control mice. Prior data demonstrate increased cell-free hemoglobin after MI in diabetic mice. Therefore, we investigated heme clearance components, including heme oxygenase 1 (HO-1) and CD163, in the kidneys and found that both HO-1 and CD163 were dysregulated in diabetic mice pre-MI and post-MI. Significantly higher levels of urine iron were also observed in diabetic mice compared with control mice after MI. Next, the renal protective effect of interleukin 10 (IL-10) after MI was tested in diabetic MI. IL-10 treatment demonstrated multiple protective effects after diabetic MI including reduction in acute renal inflammation, upregulation of renal heme clearance pathways, attenuation of chronic renal fibrosis, and reduction in albuminuria after diabetic MI. In vitro, IL-10 potentiated hemoglobin-induced HO-1 expression in mouse bone marrow-derived macrophages and renal proximal tubule (HK-2) cells. Furthermore, IL-10 reduced hemoglobin-induced reactive oxygen species in HK-2 cells and collagen synthesis in mouse embryonic fibroblast cells. We conclude that impaired renal heme clearance pathways in diabetes contribute to AKI after MI, and IL-10 attenuates renal injury after diabetic MI.