bluuebunny/crossref_metadata_2025 huggingface dataset:
Lebanese Waterpipe Dependence Scale (LWDS-11) validation in a sample of Lebanese adolescents
Authors: Hallit Souheil , Obeid Sahar , Sacre Hala , Salameh Pascale
Published: September 2021

Background

Salameh et al. developed the Lebanese Waterpipe Dependence Scale (LWDS-11) that assesses nicotine dependence among adult waterpipe smokers. In view of the high waterpipe use among Lebanese youth and other neighboring countries, it was deemed necessary to check the psychometric properties of the LWDS-11, originally adapted to the Lebanese population, to measure nicotine dependence among adolescents.

Methods

Two cross-sectional investigations were conducted; Study 1 (January and May 2019) enrolled a total of 449 students who were exclusive waterpipe smokers; this sample was used to conduct the exploratory factor analysis. Study 2 enrolled another sample composed of 243 waterpipe smoking adolescents. This sample was independent from the first one and was used to conduct the confirmatory analysis.

Results

The results also showed that 312 (69.5%) [95% CI 0.652–0.738] had high waterpipe dependence (scores of ≥10). Results of the factor analysis in sample 1 showed that all LWDS-11 items were extracted following the factor analysis. Items converged over a solution of one factor; total variance explained = 70.45%, αCronbach = 0.96). The results of the confirmatory factor analysis were as follows: the Maximum Likelihood Chi-Square = 129.58 and Degrees of Freedom = 45, which gave a χ2/df = 2.88. For non-centrality fit indices, the Steiger-Lind Root Mean Square Error of Approximation (RMSEA) was 0.08 [0.071–0.106]. Moreover, the Comparative Fit Index (CFI) value was 0.77.

Conclusion

The preliminary results suggest that the LWDS-11 has good psychometric properties to measure waterpipe dependence among adolescents. We hope this tool would serve the benefit of research and epidemiology.
IMplementation and evaluation of the school-based family support PRogram a Healthy School Start to promote child health and prevent OVErweight and obesity (IMPROVE) – study protocol for a cluster-randomized trial
Authors: Elinder Liselotte Schäfer , Wiklund Camilla A. , Norman Åsa , Stattin Nouha Saleh , Andermo Susanne , Patterson Emma , Hemmingsson Erik , Cook Clayton , Raposo Sara , Kwak Lydia
Published: September 2021

Background

IMPROVE aims to conduct a hybrid type 3 evaluation design to test the effectiveness of bundled implementation strategies on intervention fidelity of the Healthy School Start (HSS) program, while simultaneously monitoring effects on health outcomes of children and parents. The HSS is a 4-component family support program for children starting school (5–7 years of age) promoting healthy dietary habits and physical activity in the home environment to prevent childhood obesity and parents’ risk of developing type 2 diabetes.

Methods

IMPROVE is a cluster-randomized controlled trial with two arms to evaluate and compare the effects of two different bundles of implementation strategies on intervention fidelity expressed as adherence and responsiveness at 12 and 24 months (primary outcomes). Thirty schools in two municipalities will participate in the study reaching about 1400 families per school year. In stakeholder workshops, key implementation determinants were identified according to the domains of the Consolidated Framework for Implementation Research. Through a consensus process with stakeholders, two bundles of implementation strategies were tailored to address context-specific determinants. Schools randomly assigned to group 1 will receive bundle 1 (Basic) and group 2 will receive bundle 1 + 2 (Enhanced). Bundle 2 consists of external facilitation, fidelity monitoring and feedback strategies. Secondary outcomes will include change in acceptability, appropriateness, feasibility, and organisational readiness as perceived by school staff. In addition, child weight status and diet, and parents’ feeding practices and risk of type 2 diabetes will be monitored. Linear and ordinal regression analysis will be used to test the effect on the primary and secondary outcomes, taking clustering and covariates into consideration where needed. Process evaluation will be conducted through key stakeholder interviews to investigate experiences of the program and perceptions on sustainability.

Discussion

This systematic approach to investigating the effectiveness of two different bundles of implementation strategies tailored to context-specific determinants on the fidelity of the HSS intervention will provide new insight into feasible implementation strategies and external support needed for the HSS to be effective and sustainable. Results will help inform how to bridge the gap between the research on school-based health programs and routine practice in schools.

Trial registration

Registered prospectively at ClinicalTrials.gov ID: NCT04984421, registered July 30, 2021
The relationship between readiness to change pain-related exercise participation and perceived work ability: a cross-sectional study of factory workers
Authors: Shawcross Paul , Lyons Melinda , Filingeri Victoria
Published: September 2021

Background

Healthy lifestyle behaviours are associated with protection against health disorders and pain. Exercise participation is one such behaviour, associated with improved outcomes in those experiencing pain. Musculoskeletal pain is highly prevalent in the workplace, particularly in factory workers and associated loss of work function is recognised as having a great impact on individuals, society and the economy. A worker’s ‘readiness to change pain behaviour’ is an important factor to consider in achieving a healthy lifestyle behaviour and potentially improved function. This study aimed to examine the relationship between a cohort of factory workers ‘readiness to change pain behaviour’ such as exercise and their ‘perceived work ability’.

Methods

A cross-sectional study design was used to establish the relationship between ‘readiness to change pain behaviours’ and ‘perceived work ability’. The Multidimensional Pain Related Change Questionnaire 2 (MPRCQ2) was used to measure readiness to change various pain behaviours including exercise. The Work Ability Index (WAI) was used to assess ‘perceived work ability’. Seventy-five factory workers, aged over 18 (66 male, 9 female) were recruited using convenience sampling between September–November 2019. Correlation and multiple regression were used for statistical analysis.

Results

Mean WAI, MPRCQ2 and MPRCQ2 exercise component were 41.89 (SD 5.28), 4.26 (SD 1.01) and 4.40 (SD 1.69). MPRCQ2 and MPRCQ2 exercise component were not significant predictors of WAI in factory workers (F (2, 72) = 2.17, p > 0.001). There was no significant relationship between MPRCQ2 and WAI (rs = .09, p > .05). However, there was a significant positive relationship between MPRCQ2 exercise component and WAI (rs = .23, p < .05).

Conclusions

This study suggests that readiness to change pain-related exercise participation has a positive association with ‘perceived work ability’. Further research should explore the causal relationship and consider strength training as a specific type of exercise.
Organ donation after euthanasia starting at home in a patient with multiple system atrophy
Authors: Tajaâte Najat , van Dijk Nathalie , Pragt Elien , Shaw David , Kempener-Deguelle A. , de Jongh Wim , Bollen Jan , van Mook Walther
Published: September 2021

Background

A patient who fulfils the due diligence requirements for euthanasia, and is medically suitable, is able to donate his organs after euthanasia in Belgium, the Netherlands and Canada. Since 2012, more than 70 patients have undergone this combined procedure in the Netherlands. Even though all patients who undergo euthanasia are suffering hopelessly and unbearably, some of these patients are nevertheless willing to help others in need of an organ.

Organ donation after euthanasia is a so-called donation after circulatory death (DCD), Maastricht category III procedure, which takes place following cardiac arrest, comparable to donation after withdrawal of life sustaining therapy in critically ill patients. To minimize the period of organ ischemia, the patient is transported to the operating room immediately after the legally mandated no-touch period of 5 min following circulatory arrest. This means that the organ donation procedure following euthanasia must take place in the hospital, which appears to be insurmountable to many patients who are willing to donate, since they already spent a lot of time in the hospital.

Case presentation

This article describes the procedure of organ donation after euthanasia starting at home (ODAEH) following anesthesia in a former health care professional suffering from multiple system atrophy. This case is unique for at least two reasons. He spent his last conscious hours surrounded by his family at home, after which he underwent general anaesthesia and was intubated, before being transported to the hospital for euthanasia and organ donation. In addition, the patient explicitly requested the euthanasia to be performed in the preparation room, next to the operating room, in order to limit the period of organ ischemia due to transport time from the intensive care unit to the operating room. The medical, legal and ethical considerations related to this illustrative case are subsequently discussed.

Conclusions

Organ donation after euthanasia is a pure act of altruism. This combined procedure can also be performed after the patient has been anesthetized at home and during transportation to the hospital.
Response to language barriers with patients from refugee background in general practice in Australia: findings from the OPTIMISE study
Authors: Saito Shoko , Harris Mark F , Long Katrina M , Lewis Virginia , Casey Sue , Hogg William , Cheng I-Hao , Advocat Jenny , Marsh Geraldine , Gunatillaka Nilakshi , Russell Grant
Published: September 2021

Background

Language is a barrier to many patients from refugee backgrounds accessing and receiving quality primary health care. This paper examines the way general practices address these barriers and how this changed following a practice facilitation intervention.

Methods

The OPTIMISE study was a stepped wedge cluster randomised trial set within 31 general practices in three urban regions in Australia with high refugee settlement. It involved a practice facilitation intervention addressing interpreter engagement as one of four core intervention areas. This paper analysed quantitative and qualitative data from the practices and 55 general practitioners from these, collected at baseline and after 6 months during which only those assigned to the early group received the intervention.

Results

Many practices (71 %) had at least one GP who spoke a language spoken by recent humanitarian entrants. At baseline, 48 % of practices reported using the government funded Translating and Interpreting Service (TIS). The role of reception staff in assessing and recording the language and interpreter needs of patients was well defined. However, they lacked effective systems to share the information with clinicians. After the intervention, the number of practices using the TIS increased. However, family members and friends continued to be used to interpret with GPs reporting patients preferred this approach. The extra time required to arrange and use interpreting services remained a major barrier.

Conclusions

In this study a whole of practice facilitation intervention resulted in improvements in procedures for and engagement of interpreters. However, there were barriers such as the extra time required, and family members continued to be used. Based on these findings, further effort is needed to reduce the administrative burden and GP’s opportunity cost needed to engage interpreters, to provide training for all staff on when and how to work with interpreters and discuss and respond to patient concerns about interpreting services.
Experiences of frontline healthcare workers and their views about support during COVID-19 and previous pandemics: a systematic review and qualitative meta-synthesis
Authors: Billings Jo , Ching Brian Chi Fung , Gkofa Vasiliki , Greene Talya , Bloomfield Michael
Published: September 2021

Background

Healthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support.

Methods

We searched key healthcare databases (Medline, PsychINFO and PubMed) from inception to September 28, 2020. We also reviewed relevant grey literature, screened pre-print servers and hand searched reference lists of key texts for all published accounts of healthcare workers’ experiences of working on the frontline and views about support during COVID-19 and previous pandemics/epidemics. We conducted a meta-synthesis of all qualitative results to synthesise findings and develop an overarching set of themes and sub-themes which captured the experiences and views of frontline healthcare workers across the studies.

Results

This review identified 46 qualitative studies which explored healthcare workers’ experiences and views from pandemics or epidemics including and prior to COVID-19. Meta-synthesis derived eight key themes which largely transcended temporal and geographical boundaries. Participants across all the studies were deeply concerned about their own and/or others’ physical safety. This was greatest in the early phases of pandemics and exacerbated by inadequate Personal Protective Equipment (PPE), insufficient resources, and inconsistent information. Workers struggled with high workloads and long shifts and desired adequate rest and recovery. Many experienced stigma. Healthcare workers’ relationships with families, colleagues, organisations, media and the wider public were complicated and could be experienced concomitantly as sources of support but also sources of stress.

Conclusions

The experiences of healthcare workers during the COVID-19 pandemic are not unprecedented; the themes that arose from previous pandemics and epidemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of previous crises, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.
Facilitators and barriers for the implementation of telemedicine from a local government point of view - a cross-sectional survey in Germany
Authors: Weißenfeld Maja Maria , Goetz Katja , Steinhäuser Jost
Published: September 2021

Background

Telemedicine offers additional ways of delivering medical care, e.g., in primary care in rural areas. During the last decades, projects including telemedicine are being implemented worldwide. However, implementation of telemedicine is in some countries, e.g., Germany somewhat slower compared to northern European countries. One important part of successful implementation is to include the citizen perspective. The aims of this study were to explore the perception of representatives of the local government regarding telemedicine in the context of a perceived GP shortage and to tailor future telemedicine offers according to these perceived needs.

Methods

Considering the multidisciplinary assessment suggested by the Model for Assessment of Telemedicine a questionnaire with 19 questions was developed by identifying determinants of telemedicine out the literature. After pre-testing, the questionnaire was sent to all 2199 mayors from the federal states of Schleswig-Holstein (North Germany) and Baden-Württemberg (South Germany) as representatives of the citizens (cross- sectional study; full population survey). The final questionnaire contained sections for socio-demographic data, telemedicine and perceived GP shortage. All responses from November 2018 until 2019 were included and analyzed descriptively.

Results

The response rate was 32% (N = 699), of which 605 were included in the analysis. A majority of the participants stated they live in a rural area and 46% were in the office for up to 8 years. The mayors had predominantly a positive perception about telemedicine (60%) and 76% of them stated, their community would benefit from telemedicine. A GP shortage was reported by 39% of the participants. The highest risk of telemedicine was seen in misdiagnosing. In case of an emergency situation 291 (45%) of the participants considered data privacy as not as relevant. Mayors from a community with a perceived GP shortage had a more negative perception regarding telemedicine.

Conclusion

The acceptance of telemedicine is rapidly rising compared to former studies. Communities with a perceived GP shortage had a more negative perception. Barriers like data security concerns were seen as less important in case of an emergency. The highest risk of telemedicine was seen in misdiagnosing. These findings need to be considered in designing future telemedicine offers.
Critical comparative analysis of data sources toward understanding referral during pregnancy and childbirth: three perspectives from Nigeria
Authors: Radovich Emma , Banke-Thomas Aduragbemi , Campbell Oona M. R. , Ezeanochie Michael , Gwacham-Anisiobi Uchenna , Ande Adedapo B. A. , Benova Lenka
Published: September 2021

Background

The highest risk of maternal and perinatal deaths occurs during and shortly after childbirth and is preventable if functional referral systems enable women to reach appropriate health services when obstetric complications occur. Rising numbers of deliveries in health facilities, including in high mortality settings like Nigeria, require formalised coordination across the health system to ensure that women and newborns get to the right level of care, at the right time. This study describes and critically assesses the extent to which referral and its components can be captured using three different data sources from Nigeria, examining issues of data quality, validity, and usefulness for improving and monitoring obstetric care systems.

Methods

The study included three data sources on referral for childbirth care in Nigeria: a nationally representative household survey, patient records from multiple facilities in a state, and patient records from the apex referral facility in a city. We conducted descriptive analyses of the extent to which referral status and components were captured across the three sources. We also iteratively developed a visual conceptual framework to guide our critical comparative analysis.

Results

We found large differences in the proportion of women referred, and this reflected the different denominators and timings of the referral in each data source. Between 16 and 34% of referrals in the three sources originated in government hospitals, and lateral referrals (origin and destination facility of the same level) were observed in all three data sources. We found large gaps in the coverage of key components of referral as well as data gaps where this information was not routinely captured in facility-based sources.

Conclusions

Our analyses illustrated different perspectives from the national- to facility-level in the capture of the extent and components of obstetric referral. By triangulating across multiple data sources, we revealed the strengths and gaps within each approach in building a more complete picture of obstetric referral. We see our visual framework as assisting further research efforts to ensure all referral pathways are captured in order to better monitor and improve referral systems for women and newborns.
Pharmacokinetics and diuretic effect of furosemide after single intravenous, oral tablet, and newly developed oral disintegrating film administration in healthy beagle dogs
Authors: Koh Suk-Kyu , Jeong Jong-Woo , Choi Seo-In , Kim Rae Man , Koo Tae-Sung , Cho Kwan Hyung , Seo Kyoung-Won
Published: September 2021

Background

Furosemide, a diuretic that acts on the loop of Henle, is commonly used to treat congestive heart failure in veterinary medicine. Some owners have difficulty in administering oral tablet medication to animal patients, which leads to noncompliance, especially during long-term administration. Oral disintegrating film (ODF) has the advantages of easy administration via a non-invasive route, rapid dissolution, and low suffocating risk. The objective of this study was to research the pharmacokinetic (PK) profiles and diuretic effect of furosemide after intravenous (IV), orally uncoated tablet (OUT), and newly developed ODF administration in healthy beagle dogs. In this study, a furosemide-loaded ODF (FS-ODF) formulation was developed and five beagle dogs were administered a single dose (2 mg/kg) of furosemide via each route using a cross-over design.

Results

The most suitable film-forming agent was sodium alginate; thus, this was used to develop an ODF for easy drug administration. No significant differences were detected in the PK profiles between OUT and FS-ODF. In the blood profiles, the concentration of total protein was significantly increased compared to the baseline (0 h), whereas no significant difference was detected in the concentration of creatinine and hematocrit compared to the baseline. FS-ODF resulted in a similar hourly urinary output to OUT during the initial 2 h after administration. The urine specific gravity was significantly decreased compared to the baseline in each group. The peak times of urine electrolyte (sodium and chloride) excretion per hour were 1 h (IV), 2 h (OUT), and 2 h (FS-ODF).

Conclusions

These results suggest that the PK/PD of furosemide after administration of newly developed FS-ODF are similar to those of OUT in healthy dogs. Therefore, the ODF formulation has the benefits of ease and convenience, which would be helpful to owners of companion animals, such as small dogs (< 10 kg), for the management of congestive heart failure.
Challenging suicide, burnout, and depression among veterinary practitioners and students: text mining and topics modelling analysis of the scientific literature
Authors: Brscic Marta , Contiero Barbara , Schianchi Alessandro , Marogna Cristina
Published: September 2021

Background

Worldwide, veterinary practitioners and students are reported to be at higher risk of suicide, burnout, and depression compared to other occupational groups. The aim of the current study was to apply text mining and topic modelling analysis on scientific literature regarding suicide, burnout, and depression among veterinary practitioners and students to extract meaningful and synthetic information. These statistical approaches can be used to comprehend more in deep the phenomena involving veterinarians and veterinary students and to suggest the potential changes needed in admission to veterinary school, veterinary curricula, and post-graduation initiatives as preventive actions.

Results

A systematic search protocol was set up to identify scientific literature that published on the topic from 1985 to 2019. Two-hundred-eleven records were selected with abstracts/texts submitted to text mining and topic modelling analysis. Student, stress, work, anim*, and euthanasia resulted the most frequent terms. Topics modelling allowed to differentiate groups of words and papers in 3 areas of interest: 1) students’ difficulties encountered during their studies that increase stress and anxiety impairing their psychological health; 2) exposure to death and euthanasia as risk factor for mental health; and 3) need of support among those providing medical and health care, and of supportive group work to cope with such profession.

Conclusion

Based on the most frequent words included in the clouds and on the contents of the papers clusterised in them, some suggestions are interfered. It is emphasized that the veterinary curricula should include courses that prepare them early to deal with animal death and post-death grief of pet owners, to handle ethical dilemmas and moral stressors, to communicate with clients and staff members, to work in team, to balance work-family life and to promote individual and team resources. Specific courses for veterinary practitioners could keep them updated on their new roles and ways to handle them among functioning as potential feedbacks to monitor their psychological wellbeing.
Carcinogenic effect of adenylosuccinate lyase (ADSL) in prostate cancer development and progression through the cell cycle pathway
Authors: Liao Jinling , Song Qiong , Li Jie , Du Kechen , Chen Yang , Zou Chunlin , Mo Zengnan
Published: September 2021

Background

Prostate cancer (PCa) is still a serious male malignant disease across the world. However, no exact pathogenesis had been explained. Although adenylosuccinate lyase (ADSL) gene was identified to be important in PCa early in 1987, its comprehensive functions for PCa have not been presented.

Methods

The cBioPortal for Cancer Genomics, Oncomine and GEO database were retrieved to investigate the associations between of the ADSL gene and PCa. Then, the PC-3, DU145 and C4-2B cell lines were applied in vitro experiments. RNA sequencing and further western blot (WB) were applied to explore the potential mechanisms of ADSL gene in PCa.

Results

Based on PCa clinical datasets, we firstly found ADSL gene highly expressed in PCa tissues. Moreover, its transcript level increased in the metastatic PCa further. Elevated ADSL gene expression indicated a poor prognosis of PCa. While inhibiting the expression of ADSL with siRNA, the ability of cell proliferation and migration all declined markedly, with increased cell apoptosis inversely. Most of cells were blocked in the G0/G1 phase. Additionally, RNA sequencing also discovered the inactivity of cell cycle pathway after ADSL knockdown, which had also confirmed on the proteins levels.

Conclusions

Our study identified the ADSL as an oncogene of PCa through regulating the cell cycle pathway firstly, with explicit cell and clinical phenotypes. Further mechanisms were needed to confirm its carcinogenic effect.
Circular RNAs and their role in renal cell carcinoma: a current perspective
Authors: Liu Zhongyuan , Li Ming
Published: September 2021

Circular RNAs (circRNAs) are a new class of long non-coding RNAs, that results from a special type of alternative splicing referred to as back-splicing. They are widely distributed in eukaryotic cells and demonstrate tissue-specific expression patterns in humans. CircRNAs actively participate in various important biological activities like gene transcription, pre-mRNA splicing, translation, sponging miRNA and proteins, etc. With such diverse biological functions, circRNAs not only play a crucial role in normal human physiology, as well as in multiple diseases, including cancer. In this review, we summarized our current understanding of circRNAs and their role in renal cell carcinoma (RCC), the most common cancer of kidneys. Studies have shown that the expression level of several circRNAs are considerably varied in RCC samples and RCC cell lines suggesting the potential role of these circRNAs in RCC progression. Several circRNAs promote RCC development and progression mostly via the miRNA/target gene axis making them ideal candidates for novel anti-cancer therapy. Apart from these, there are a few circRNAs that are significantly downregulated in RCC and overexpression of these circRNAs leads to suppression of RCC growth. Differential expression patterns and novel functions of circRNAs in RCC suggest that circRNAs can be utilized as potential biomarkers and therapeutic targets for RCC therapy. However, our current understanding of the role of circRNA in RCC is still in its infancy and much comprehensive research is needed to achieve clinical translation of circRNAs as biomarkers and therapeutic targets in developing effective treatment options for RCC.
Robotic devices for paediatric rehabilitation: a review of design features
Authors: Gonzalez Alberto , Garcia Lorenzo , Kilby Jeff , McNair Peter
Published: September 2021

Children with physical disabilities often have limited performance in daily activities, hindering their physical development, social development and mental health. Therefore, rehabilitation is essential to mitigate the adverse effects of the different causes of physical disabilities and improve independence and quality of life. In the last decade, robotic rehabilitation has shown the potential to augment traditional physical rehabilitation. However, to date, most robotic rehabilitation devices are designed for adult patients who differ in their needs compared to paediatric patients, limiting the devices’ potential because the paediatric patients’ needs are not adequately considered. With this in mind, the current work reviews the existing literature on robotic rehabilitation for children with physical disabilities, intending to summarise how the rehabilitation robots could fulfil children’s needs and inspire researchers to develop new devices. A literature search was conducted utilising the Web of Science, PubMed and Scopus databases. Based on the inclusion–exclusion criteria, 206 publications were included, and 58 robotic devices used by children with a physical disability were identified. Different design factors and the treated conditions using robotic technology were compared. Through the analyses, it was identified that weight, safety, operability and motivation were crucial factors to the successful design of devices for children. The majority of the current devices were used for lower limb rehabilitation. Neurological disorders, in particular cerebral palsy, were the most common conditions for which devices were designed. By far, the most common actuator was the electric motor. Usually, the devices present more than one training strategy being the assistive strategy the most used. The admittance/impedance method is the most popular to interface the robot with the children. Currently, there is a trend on developing exoskeletons, as they can assist children with daily life activities outside of the rehabilitation setting, propitiating a wider adoption of the technology. With this shift in focus, it appears likely that new technologies to actuate the system (e.g. serial elastic actuators) and to detect the intention (e.g. physiological signals) of children as they go about their daily activities will be required.
Association between gender-based discrimination and medical visits and HIV testing in a large sample of transgender women in northeast Brazil
Authors: Leite Beo Oliveira , de Medeiros Danielle Souto , Magno Laio , Bastos Francisco Inácio , Coutinho Carolina , de Brito Ana Maria , Cavalcante Maria Socorro , Dourado Inês
Published: September 2021

Background

Gender-based discrimination remains a substantial barrier to health care access and HIV prevention among transgender women in Brazil. The aim of this study was to investigate the association between gender-based discrimination and medical visits, as well as with HIV testing among transgender women in the last 12 months in northeast Brazil.

Methods

This is a cross-sectional study of 864 transgender women recruited using Respondent-Driven Sampling in three cities in northeastern Brazil in 2016. A socio-behavioral questionnaire was applied. Multivariate analyses were performed using logistic regression, with odds ratio and respective 95% confidence intervals estimation, to estimate the effect of gender-based discrimination on two outcomes: i) medical visits and ii) HIV testing in the last 12 months.

Results

547 transgender women (67·0%) had medical visits, and 385 (45·8%) underwent HIV testing in the last 12 months. In the multivariate analysis, gender-based discrimination was associated with a reduced likelihood of medical visits (OR: 0·29; 95%CI: 0·14–0·63) and HIV testing (OR: 0·41; 95%CI: 0·22–0·78) in the last 12 months.

Conclusion

Gender-based discrimination played an essential role in reducing the access of TGW to medical visits and HIV testing services. Furthermore, by confirming the association between gender-based discrimination and medical visits and HIV testing in the multivariate analysis, we have demonstrated how this predictive variable can affect by reducing access to health services. The findings point to the need for non-discriminatory policies based on the defense and promotion of human rights that may foster the access of transgender women to Brazilian health services.
Processionary caterpillar reactions in Southern Italy forestry workers: description of three cases
Authors: Ricciardi Luisa , Giorgianni Concetto , Briguglio Giusi , Gangemi Sebastiano , Spatari Giovanna
Published: September 2021

Background

Processionary caterpillar (PC), also namedThaumatopea pityocampa, has been reported to cause hypersensitivity reactions after contact with a toxin contained in hair-like bristles which cover this insect. Occupational exposure to PC is underestimated in outdoor workers and especially in forestry workers (FW) and is globally diffusing because of rising temperatures.

Cases presentation

We present the first three cases of FW from Sicily, a Southern Italy (SI) region, which reported hypersensitivity reactions due to exposure to PC infested trees. These cases were identified by the occupational health physician during the annual screening of FW working in the Mountains of north-eastern Sicily. Interviewing a population of 630 FW, 1 male and 2 females reported direct contact skin reactions together with airborne contact reactions to PC hairs causing mild respiratory symptoms in two cases and ocular symptoms in one case, which needed treatment with systemic corticosteroids and antihistamines.

Conclusions

This is the first report of hypersensitivity reactions in SI FW due to occupational exposure to PC. Further screenings not only in FW but also in other populations of outdoor workers are needed in order to assess the real incidence of contact and airborne reactions due to occupational exposure to PC. Though so far no correlation has been found with atopy, it seems apparent that the reactions occur in susceptible subjects; further research is needed for a correct diagnosis and to identify possible desensitization procedures.
Injectable exosome-functionalized extracellular matrix hydrogel for metabolism balance and pyroptosis regulation in intervertebral disc degeneration
Authors: Xing Hongyuan , Zhang Zengjie , Mao Qijiang , Wang Chenggui , Zhou Youlong , Zhou Xiaopeng , Ying Liwei , Xu Haibin , Hu Shaojun , Zhang Ning
Published: September 2021

Exosome therapy is a promising therapeutic approach for intervertebral disc degeneration (IVDD) and achieves its therapeutic effects by regulating metabolic disorders, the microenvironment and cell homeostasis with the sustained release of microRNAs, proteins, and transcription factors. However, the rapid clearance and disruption of exosomes are the two major challenges for the application of exosome therapy in IVDD. Herein, a thermosensitive acellular extracellular matrix (ECM) hydrogel coupled with adipose-derived mesenchymal stem cell (ADSC) exosomes (dECM@exo) that inherits the superior properties of nucleus pulposus tissue and ADSCs was fabricated to ameliorate IVDD. This thermosensitive dECM@exo hydrogel system can provide not only in situ gelation to replenish ECM leakage in nucleus pulposus cells (NPCs) but also an environment for the growth of NPCs. In addition, sustained release of ADSC-derived exosomes from this system regulates matrix synthesis and degradation by regulating matrix metalloproteinases (MMPs) and inhibits pyroptosis by mitigating the inflammatory response in vitro. Animal results demonstrated that the dECM@exo hydrogel system maintained early IVD microenvironment homeostasis and ameliorated IVDD. This functional system can serve as a powerful platform for IVD drug delivery and biotherapy and an alternative therapy for IVDD.
NIR-II-driven and glutathione depletion-enhanced hypoxia-irrelevant free radical nanogenerator for combined cancer therapy
Authors: Zhang Li , Fan Yadi , Yang Zhe , Yang Mo , Wong Chun-Yuen
Published: September 2021

Background

Though the combination of photodynamic therapy (PDT) and chemodynamic therapy (CDT) appears to be very attractive in cancer treatment, hypoxia and overproduced glutathione (GSH) in the tumor microenvironment (TME) limit their efficacy for further application.

Results

In this work, a smart hypoxia-irrelevant free radical nanogenerator (AIPH/PDA@CuS/ZIF-8, denoted as APCZ) was synthesized in situ via coating copper sulphide (CuS)-embedded zeolitic imidazolate framework-8 (ZIF-8) on the free radical initiator 2,2′-azobis[2-(2-imidazolin-2-yl)propane]-dihydrochloride (AIPH)-loaded polydopamine (PDA). APCZ showed promising GSH-depleting ability and near-infrared (NIR)-II photothermal performance for combined cancer therapy. Once internalized by 4T1 cells, the outer ZIF-8 was rapidly degraded to trigger the release of CuS nanoparticles (NPs), which could react with local GSH and sequentially hydrogen peroxide (H2O2) to form hydroxyl radical (·OH) for CDT. More importantly, the hyperthermia generated by APCZ upon 1064 nm laser excitation not only permitted NIR-II photothermal therapy (PTT) and promoted CDT, but also triggered the decomposition of AIPH to give toxic alkyl radical (·R) for oxygen-independent PDT. Besides, the PDA together with CuS greatly decreased the GSH level and resulted in significantly enhanced PDT/CDT in both normoxic and hypoxic conditions. The tumors could be completely eradicated after 14 days of treatment due to the prominent therapeutic effects of PTT/PDT/CDT. Additionally, the feasibility of APCZ as a photoacoustic (PA) imaging contrast agent was also demonstrated.

Conclusions

The novel APCZ could realize the cooperative amplification effect of free radicals-based therapies by NIR-II light excitation and GSH consumption, and act as a contrast agent to improve PA imaging, holding tremendous potential for efficient diagnosis and treatment of deep-seated and hypoxic tumors.

Graphic abstract
The Health Impact Fund: making the case for engagement with pharmaceutical laboratories in Brazil, Russia, India, and China
Authors: Lee Vivian Chia-Jou , Yao Jacqueline , Zhang William
Published: September 2021

Despite progress in global health, the general disease burden still disproportionately falls on low- and middle-income countries. The health needs of these countries’ populations are unmet because there is a shortage in drug research and development, as well as a lack of access to essential drugs. This health disparity is especially problematic for diseases associated with poverty, namely neglected tropical diseases and microbial infections. Currently, the pharmaceutical landscape focuses on innovations determined by profit margins and intellectual property protection. To expand drug accessibility and catalyze research and development for neglected diseases, a team of researchers proposed the Health Impact Fund as a potential solution. However, the fund is predominantly considering partnerships with pharmaceutical giants in high-income countries. This commentary explores the limitations and benefits in partnering with pharmaceutical companies based in Brazil, Russia, India, and China (BRIC), with the goal of expanding the Health Impact Fund’s vision to incorporate long-term, local partnerships. Identified limitations to a BRIC country partnership include lower levels of drug development expertise compared to their high-income pharmaceutical counterparts, and whether the Health Impact Fund and the participating stakeholders have the financial capability to assist in bringing a new drug to market. However, potential benefits include the creation of new incentives to fuel competitive local innovation, more equitable routes to drug discovery and development, and a product pipeline that could involve stakeholders in lower- and middle-income countries. Our commentary explores how partnership with pharmaceutical firms in BRIC countries might be advantageous for all: The Health Impact Fund, pharmaceutical companies in BRIC economies, and stakeholders in low- and middle- income countries.
Profiling diverse sequence tandem repeats in colorectal cancer reveals co-occurrence of microsatellite and chromosomal instability involving Chromosome 8
Authors: Shin GiWon , Greer Stephanie U. , Hopmans Erik , Grimes Susan M. , Lee HoJoon , Zhao Lan , Miotke Laura , Suarez Carlos , Almeda Alison F. , Haraldsdottir Sigurdis , Ji Hanlee P.
Published: September 2021

We developed a sensitive sequencing approach that simultaneously profiles microsatellite instability, chromosomal instability, and subclonal structure in cancer. We assessed diverse repeat motifs across 225 microsatellites on colorectal carcinomas. Our study identified elevated alterations at both selected tetranucleotide and conventional mononucleotide repeats. Many colorectal carcinomas had a mix of genomic instability states that are normally considered exclusive. AnMSH3mutation may have contributed to the mixed states. Increased copy number of chromosome arm 8q was most prevalent among tumors with microsatellite instability, including a case of translocation involving 8q. Subclonal analysis identified co-occurring driver mutations previously known to be exclusive.
Increasing incidence and antimicrobial resistance in Escherichia coli bloodstream infections: a multinational population-based cohort study
Authors: MacKinnon Melissa C. , McEwen Scott A. , Pearl David L. , Lyytikäinen Outi , Jacobsson Gunnar , Collignon Peter , Gregson Daniel B. , Valiquette Louis , Laupland Kevin B.
Published: September 2021

Background

Escherichia coli is an important pathogen in humans and is the most common cause of bacterial bloodstream infections (BSIs). The objectives of our study were to determine factors associated with E. coli BSI incidence rate and third-generation cephalosporin resistance in a multinational population-based cohort.

Methods

We included all incident E. coli BSIs (2014–2018) from national (Finland) and regional (Australia [Canberra], Sweden [Skaraborg], and Canada [Calgary, Sherbrooke, and western interior]) surveillance. Incidence rates were directly age and sex standardized to the European Union 28-country 2018 population. Multivariable negative binomial and logistic regression models estimated factors significantly associated with E. coli BSI incidence rate and third-generation cephalosporin resistance, respectively. The explanatory variables considered for inclusion in both models were year (2014–2018), region (six areas), age (< 70-years-old and ≥ 70-years-old), and sex (female and male).

Results

We identified 31,889 E. coli BSIs from 40.7 million person-years of surveillance. Overall and third-generation cephalosporin-resistant standardized rates were 87.1 and 6.6 cases/100,000 person-years, respectively, and increased 14.0% and 40.1% over the five-year study. Overall, 7.8% (2483/31889) of E. coli BSIs were third-generation cephalosporin-resistant. Calgary, Canberra, Sherbrooke, and western interior had significantly lower E. coli BSI rates compared to Finland. The significant association between age and E. coli BSI rate varied with sex. Calgary, Canberra, and western interior had significantly greater odds of third-generation cephalosporin-resistant E. coli BSIs compared to Finland. Compared to 2014, the odds of third-generation cephalosporin-resistant E. coli BSIs were significantly increased in 2016, 2017, and 2018. The significant association between age and the odds of having a third-generation cephalosporin-resistant E. coli BSI varied with sex.

Conclusions

Increases in overall and third-generation cephalosporin-resistant standardized E. coli BSI rates were clinically important. Overall, E. coli BSI incidence rates were 40–104% greater than previous investigations from the same study areas. Region, sex, and age are important variables when analyzing E. coli BSI rates and third-generation cephalosporin resistance in E. coli BSIs. Considering E. coli is the most common cause of BSIs, this increasing burden and evolving third-generation cephalosporin resistance will have an important impact on human health, especially in aging populations.
Evidence from Fogera district in Ethiopia on configuration of farmer's information literacy conditions that explain better productivity performance of the horticultural crops
Authors: Fikadu Asmiro Abeje , Gebre Girma Gezimu
Published: September 2021

Background

The combinational/configurational effects of the agricultural information literacy indicators are believed to have an influence on the productivity performance of the horticultural crops. Previous studies have emphasized the contributions of the net-effect of each information literacy condition of smallholder farmers on the productivity performance of the horticultural crops. Yet, these studies failed to make qualitative analysis on configurational effects of the agricultural information literacy conditions.

Methods

The study addresses the qualitative questions that are outside the scope of the conventional variable-oriented method. It aims to disentangle the causal complexity that links with productivity performance in Fogera district of the Amhara region, Ethiopia. A fuzzy-set qualitative comparative analysis (fsQCA) of 80 smallholder farmers was conducted through a simple ransom sampling technique from two kebeles of Fogera district to examine the combinational effects of agricultural information literacy condition on the productivity performance instead of individual net-effect.

Results

The results of the fsQCA model indicated that a combination of two or three conditions include the high levels of farm organizational, farm record-keeping, and farming skills to be consistently sufficient to attain high productivity performance of horticultural crops. These configurations help to seek relevant policy information and make policy strategies on the horticultural sector to improve its productivity performance.

Conclusion

Thus, improving the joint information literacy effects of the farmers regarding their organizational, farm recording, and farming skills should give due attention by governmental and non-governmental organizations that work to improve the productivity performance of the horticultural crops.