bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of a planned lactation education program on the mother’s breastfeeding practice and weight gain in low birth weight infants: a randomized clinical trial study
Authors: Omidi Afsar , Rahmani Sahar , Amini Roya , Karami Manoochehr
Published: June 2022

Background

Low birth weight (LBW) infants are more prone to possible growth disorders, and their mothers need more specific education sessions regarding breastfeeding practice. This study aimed to investigate the effect of a planned lactation education program on the mother’s breastfeeding practice and weight gain in LBW infants.

Methods

A randomized clinical trial study was conducted on 80 mother-LBW infant dyads admitted to a gynecology and obstetrics hospital. The participants were selected randomly and divided into an experimental group and a control group, each with 40 mothers. Information on LBW infants’ weight and the mothers’ breastfeeding practice was collected using a questionnaire at birth. Then, a planned lactation education program was implemented in the experimental group in two sessions in the hospital and three 20-minute sessions in comprehensive health centers. Finally, the weight of 14–15 day-old and two-month-old LBW infants and the mothers’ breastfeeding practice for 14–15 day-old LBW infants in the two groups were recollected and analyzed using SPSS software version 16.

Results

Comparing the LBW infants’ weights and mothers’ breastfeeding practice revealed no statistically significant difference between the two groups pre-intervention. However, significant differences were observed between the two groups post-intervention in terms of weight gain in the LBW infants over 14–15 days and two months of age (F = 4720.6,p < 0.001) and the mothers’ breastfeeding practice for 14-15-day-old infants (p < 0.001).

Conclusions

Given the positive impact of lactation education on the mother’s breastfeeding practice and LBW infants’ weight, planned lactation education courses should be applied for LBW infants’ mothers.

Trial registration

This study was retrospectively registered in the Clinical Trial Registration Center of Iran, with the code:IRCT20120215009014N421on 14/04/2022.
The LEGACy study: a European and Latin American consortium to identify risk factors and molecular phenotypes in gastric cancer to improve prevention strategies and personalized clinical decision making globally
Authors: van Schooten Tessa Suzanne , Derks Sarah , Jiménez-Martí Elena , Carneiro Fatima , Figueiredo Ceu , Ruiz Erika , Alsina Maria , Molero Cristina , Garrido Marcelo , Riquelme Arnoldo , Caballero Carmelo , Lezcano Eva , O’Connor Juan Manuel , Esteso Federico , Farrés Judith , Mas José Manuel , Lordick Florian , Vogt Jeannette , Cardone Antonella , Girvalaki Charis , Cervantes Andrés , Fleitas Tania ,   on behalf of the members of LEGACy consortium
Published: June 2022

Background

Gastric Cancer (GC) is the fourth most deadly cancer worldwide. Enhanced understanding of its key epidemiological and molecular drivers is urgently needed to lower the incidence and improve outcomes. Furthermore, tumor biology in European (EU) and Latin American (LATAM) countries is understudied. The LEGACy study is a Horizon 2020 funded multi-institutional research approach to 1) detail the epidemiological features including risk factors of GC in current time and 2) develop cost-effective methods to identify and integrate biological biomarkers needed to guide diagnostic and therapeutic approaches with the aim of filling the knowledge gap on GC in these areas.

Methods

This observational study has three parts that are conducted in parallel during 2019–2023 across recruiting centers from four EU and four LATAM countries: Part 1) A case-control study (800 cases and 800 controls) using questionnaires on candidate risk factors for GC, which will be correlated with clinical, demographic and epidemiological parameters. Part 2) A case-control tissue sampling study (400 cases and 400 controls) using proteome, genome, microbiome and immune analyses to characterize advanced (stage III and IV) GC. Patients in this part of the study will be followed over time to observe clinical outcomes. The first half of samples will be used as training cohort to identify the most relevant risk factors and biomarkers, which will be selected to propose cost-effective diagnostic and predictive methods that will be validated with the second half of samples. Part 3) An educational study, as part of our prevention strategy (subjects recruited from the general public) to test and disseminate knowledge on GC risk factors and symptoms by a questionnaire and informative video. Patients could be recruited for more than one of the three LEGACy studies.

Discussion

The LEGACy study aims to generate novel, in-depth knowledge on the tumor biological characteristics through integrating epidemiological, multi-omics and clinical data from GC patients at an EU-LATAM partnership. During the study, cost-effective panels with potential use in clinical decision making will be developed and validated.

Trial registration

ClinicalTrials.gov Identifiers:

Part 1: NCT03957031.

Part 2: NCT04015466.

Part 3: NCT04019808.
Eat, sleep, play: health behaviors and their association with psychological health among cancer survivors in a nationally representative sample
Authors: Glasgow Trevin E. , McGuire Kandace P. , Fuemmeler Bernard F.
Published: June 2022

Background

Cancer survivors are able to live much longer today than in the past due to advances in treatment. The promotion of health behaviors is important to address among cancer survivors. Not only can health behaviors reduce the risk of comorbidities, but they may also be key to improving psychological health among cancer survivors, such as psychological distress, perceptions of one’s general health, and distress of cancer mortality (i.e., cancer fatalism). Our overall goal is to 1) determine which individual health behaviors (e.g., fruit consumption, physical activity, and sleep) are associated with psychological health among cancer survivors and 2) determine if the number of health behaviors engaged in is associated with better psychological health among cancer survivors.

Methods

Using data from the HINTS 5 Cycle III survey (N = 856 cancer survivors), we compared whether participants who met guidelines for seven health behaviors (e.g., fruit and vegetable consumption, moderate physical activity, sleep duration) had improved psychological health. Multiple ordinal regression models controlling for sociodemographic variables were used to determine if meeting more recommendations was related to psychological health and then specifically which behaviors were of greatest importance to psychological health.

Results

Meeting guidelines for sleep quality and moderate physical activity was associated with higher general health and meeting guidelines for vegetable intake and better sleep quality was associated with less psychological distress. Although the associations were not significant, cancer survivors who met more of the health behavior guidelines reported higher general health, lower psychological distress, and less distress about what could be done to lower one’s chances to get cancer.

Conclusions

Meeting the guidelines for individual and multiple health behaviors is associated with favorable psychological health among cancer survivors. The findings can contribute to the development of health behavior interventions that focus on multiple health behaviors to improve psychological health and quality of life among cancer survivors.
The effect of individual counseling based on the GATHER principles on perceived stress and empowerment of the mothers with high-risk pregnancies: an experimental study
Authors: Aliabadi Sahar , Shayan Arezoo , Refaei Mansoureh , Tapak Leili , Moradveisi Latif
Published: June 2022

Background

High-risk pregnancy causes different responses, including negative emotions, feelings of vulnerability and psychological stress in the mother. The aim of this study was to investigate the effect of individual counseling on the empowerment and the perceived stress of high-risk pregnant mothers.

Methods

This study was a two-group experimental study. The study was performed on 82 high-risk pregnant women hospitalized in Fatemieh Hospital in Hamadan, Iran. Inclusion criteria were high-risk pregnancy, being literate, gestational age 24 to 36 weeks. The samples were divided into experimental and control groups using randomized block design. Data were collected using Cohen’s perceived stress scale and Kameda empowerment questionnaires. For the experimental group, four sessions of individual counseling according to GATHER principles (Greet, Ask, Tell, Help, Explain, and Return) were performed for 45–60 minutes for two consecutive weeks. SPSS 25 software was used for data analysis.

Results

The mean score of the perceived stress after the intervention in the control and experimental groups were 27.07(5.80) and 25.30(4.95), respectively (P = 0.097). There was a substantial difference in the mean score of empowerment 84.76)9.14) and 88.75 (6.17) (P < 0.001) and different dimensions of empowerment (self-efficacy, Future image, self-esteem, Support and assurance from others) between the control and intervention groups after the intervention.

Conclusions

The findings of this study indicate individual counseling is effective in empowering the mothers with high-risk pregnancy but has no significant effect on their perceived stress.
Problem drinkers and high risk-taking behaviors under the stay-at-home policy of the COVID-19 emergency declaration
Authors: Wakabayashi Mami , Takada Midori , Kinjo Aya , Sugiyama Yoshifumi , Iso Hiroyasu , Tabuchi Takahiro
Published: June 2022

Background

To the best of the authors’ knowledge, this is the first study to examine whether problem drinkers have had high risk-taking behaviors during the stay-at-home policy (e.g., dining out at a bar) under the COVID-19 emergency declaration.

Methods

We investigated data from Japan COVID-19 and Society Internet Survey(JACSIS)study—a web-based nationwide survey, conducted from August to September 2020. From a total of 12,076 current drinkers, problem drinkers were detected by Cut, Annoyed, Guilty, and Eye-opener (CAGE) questions. A CAGE score of 4 showed potential alcohol use disorder and scores of 2 to3 showed potential alcohol abuse; individuals with these scores were regarded as problem drinkers compared to light-or-no-risk drinkers, with a CAGE score of 0 to 1. The outcome assessed the presence of 18 behaviors against the stay-at-home policy, such as dining out at a bar, meeting people, or going to crowded places. All these behaviors were limited in Japan during the first declaration of emergency between April and May 2020.

Results

Based on the multivariable logistic regression, the participants with potential alcohol use disorder demonstrated 16 out of the 18 risk-taking behaviors, such as dining out at a bar (adjusted odds ratio (aOR): 2.08; 95% confidence interval (CI): 1.56–2.79), dining out at a restaurant (aOR: 1.79; 95% CI:1.37–2.35), visiting friends (aOR: 1.81; 95% CI: 1.34–2.44), going to karaoke (1.97; 95% CI: 1.26–3.10), and riding on a crowded train (aOR: 1.46; 95% CI: 1.07–1.99), compared to light-or-no risk drinkers with a CAGE score of 0 to 1. Additionally, participants with potential alcohol abuse (CAGE score of 2 to 3) had 10 out of 18 behaviors against the stay-at-home policy: the corresponding aORs for the aforementioned behaviors were 1.45 (95% CI: 1.25–1.67), 1.27 (95% CI: 1.12–1.44), 1.17 (95% CI: 1.01–1.36), 1.49 (95% CI: 1.17–1.90), and 1.19 (95% CI: 1.03–1.38), respectively. Problem drinkers had a significant association with being men, a higher income and job position, smoking, sleep deprivation, depression, and other mental diseases.

Conclusions

Overall, problem drinkers were more likely to have higher risk-taking behaviors against the stay-at-home policy, compared to light-or-no-risk drinkers.
Prediction of high-flow nasal cannula outcomes at the early phase using the modified respiratory rate oxygenation index
Authors: Li Zhe , Chen Chen , Tan Zhangjun , Yao Yulong , Xing Shunpeng , Li Yan , Gao Yuan , Zhao Zhanqi , Deng Yuxiao , Zhu Mingli
Published: June 2022

Background

This study was designed to explore the early predictive value of the respiratory rate oxygenation (ROX) index modified by PaO2 (mROX) in high-flow nasal cannula (HFNC) therapy in patients with acute hypoxemia respiratory failure (AHRF).

Method

Seventy-five patients with AHRF treated with HFNC were retrospectively reviewed. Respiratory parameters at baseline and 2 h after HFNC initiation were analyzed. The predictive value of the ROX (ratio of pulse oximetry/FIO2 to respiratory rate) and mROX (ratio of arterial oxygen /FIO2 to respiratory rate) indices with two variations by adding heart rate to each index (ROX-HR and mROX-HR) was evaluated.

Results

HFNC therapy failed in 24 patients, who had significantly higher intensive care unit (ICU) mortality and longer ICU stay. Both the ROX and mROX indices at 2 h after HFNC initiation can predict the risk of intubation after HFNC. Two hours after HFNC initiation, the mROX index had a higher area under the receiver operating characteristic curve (AUROC) for predicting HFNC success than the ROX index. Besides, baseline mROX index of greater than 7.1 showed a specificity of 100% for HFNC success.

Conclusion

The mROX index may be a suitable predictor of HFNC therapy outcomes at the early phase in patients with AHRF.
Guillain-Barré syndrome with transition from hashimoto's to graves' disease: a case report
Authors: Asano Mari , Kenzaka Tsuneaki
Published: June 2022

Background

On rare occasions, there can be a transition from Hashimoto's to Graves' disease. However, there are no reported cases of transition from Hashimoto's to Graves' disease triggered by the onset of Guillain-Barré syndrome.

Case presentation.

Sixteen years prior, a 55-year-old woman was diagnosed with Hashimoto's disease and followed up without medication. One week after the appearance of signs of intestinal inflammation, weakness in the extremities was observed, and a cerebrospinal fluid test was positive for anti-GM1 IgG antibody, leading to the diagnosis of Guillain-Barré syndrome. In addition, hyperthyroidism was observed at the time of admission, and Graves' disease was diagnosed based on autoantibodies and thyroid echoes. Numbness in the extremities was relieved by high-dose intravenous gamma globulin.

Conclusion

With the onset of Guillain-Barré syndrome, helper T cells became predominantly type 1, effector B cells increased in number, and thyroid-stimulating antibodies were produced, leading to the conclusion that Hashimoto's disease progressed to Graves' disease. Therefore, it is necessary to pay attention to the transition of thyroid function during Guillain-Barré syndrome.
Effect of osseodensification on the increase in ridge thickness and the prevention of buccal peri-implant defects: an in vitro randomized split mouth pilot study
Authors: Frizzera Fausto , Spin-Neto Rubens , Padilha Victor , Nicchio Nicolas , Ghiraldini Bruna , Bezerra Fábio , Marcantonio Elcio
Published: June 2022

Background

Implant installation with conventional drilling can create buccal bone defects in areas of limited ridge thickness. Implant installation with osseodensification may aid in preventing buccal bone defects in these situations. This in vitro pilot study evaluated the impact of osseodensification on the increase in alveolar ridge thickness and the prevention of buccal peri-implant defects.

Methods

Ten fresh pig mandibles with limited bone thickness were selected for use in an experimental randomized split mouth pilot study. Two site-preparation protocols were used: conventional drilling with cutting burs (CTL, n = 10) and osseodensification with Densah® burs (OD, n = 10). After implant bed preparation, 20 implants (4.5 × 10 mm) were placed in the prepared sites and the insertion torque was recorded. Clinical and photographic analysis evaluated ridge thickness and the extent (height, width, and area) of bone defects in the buccal and lingual bone walls following implant placement. Three-dimensional measurements were performed using STL files to analyze the increase in buccal ridge thickness following site preparation and implant placement. The height of the buccal bone defect was considered as the primary outcome of this study. Defect width, area, implant insertion torque, and linear buccal ridge increase after implant site preparation and installation were also assessed. Non-parametric evaluations were carried out with the Mann–Whitney test to verify intergroup differences.

Results

There was no statistically significant difference between groups in the baseline ridge thickness. OD presented a significantly higher insertion torque, associated with reduced buccal and lingual bone defect width, in comparison to CTL.

Conclusions

The increase in buccal ridge thickness after site preparation and implant placement was significantly higher in OD compared to CTL. Osseodensification increased the ridge thickness through expansion and reduced buccal bone defects after implant installation.
Evaluation of residual monomer release after polymerization of different restorative materials used in pediatric dentistry
Authors: Duruk Gülsüm , Akküç Sibel , Uğur Yılmaz
Published: June 2022

Background

The choice of the restorative resin material to be used in pediatric dentistry is of a great importance due to the cytotoxic effects caused by residual monomers. In this study, it was aimed to investigate the amount of residual monomer released over time from different resin-based restorative materials, which are widely used in pediatric dentistry, by using high performance liquid chromatography with photodiode array detector (HPLC–PDA).

Methods

The compomers in all colors (Twinky Star and Glasiositte A2), two composites with different hybrid properties (Arabesk-GrandioSO), and RMGIC (Ionolux) samples with 2 × 5 mm diameters were prepared. The samples were polymerized with an LED light unit (CELALUX 2, VOCO, Cuxhaven, Germany) and then finishing-polishing procedures were applied. A total of 156 samples were obtained, 13 samples in each of the 12 groups. The amount of residual monomer (BIS-GMA; HEMA, TEGDMA, UDMA) (µg/mL) released into the 75% ethanol solution was determined at different times, (1st hour, 1st, 7th, 14th, and 21st day) by using HPLC–PDA.

Results

The residual monomer release continued on day 21 and BIS-GMA was the most released monomer in all groups. HEMA release showed a maximum increase in all the materials at day 7. The highest amount of residual monomer was detected in the gold-colored compomer. HEMA and BIS-GMA release from RMGIC was less than others in all time frames.

Conclusions

The color and composition of resin-based restorative materials affect the amount of residual monomer. Pediatric dentists should prefer gold-colored compomers less than others as a restorative material, especially in deep cavities. More studies are needed about the subject.
Do health sector measures of violence against women at different levels of severity correlate? Evidence from Brazil
Authors: Reynolds Sarah Anne
Published: June 2022

Objective

To evaluate if characteristics of reports of violence against women at different levels of severity are similar and to test if their prevalence is correlated at the municipal level.

Methods

I use data from women ages 15–49 who were killed by homicide in Brazil’s national death registry (N = 14,373), were hospitalized for aggression (N = 14,701), or were included in the medical mandatory reports of incidents of violence against women (N = 42,134) between 2011 and 2016 in select municipalities. I provide national level descriptive statistics from 2016 contrasting distributions of victims (age, education, and race) and distributions of the characteristics of the incidents (location and time of day). Then, for 63 municipalities with a high number of violent incidents, I calculate the correlation coefficients between measures of violence against women using quarterly data from 2011 to 2016. I use multiple regression of municipal characteristics at baseline to examine which factors (poverty, spending, health, and civic engagement) predict the correlation.

Results

Victim characteristics and incident characteristics are similar across the measures of violence at the national level. Despite these aggregate similarities, correlations at the municipal level are quite varied, ranging from − 0.69 to 0.83. I find no municipal characteristics that consistently predict these correlation coefficients.

Conclusions

Despite some similarities at an aggregate level, these measures of violence against women do not have consistent patterns of correlation at the municipality level. Measures of severe levels of violence against women are not good proxies for incidence of violence at less severe physical levels. Lack of correlations could be due to differences in reporting, but may also be due to differences in underlying processes that share similar victims and event characteristics.
Menthol carbonates as potent antiparasitic agents: synthesis and in vitro studies along with computer-aided approaches
Authors: Clemente Camila M. , Robledo Sara M. , Ravetti Soledad
Published: June 2022

Introduction

Despite the number of deaths and the significant economic and social costs associated with Chagas, Leishmaniasis and Malaria diseases worldwide, available drugs are limited and have serious side effects and high toxicity for the patient. Therefore, there is an urgent need for safe, low-cost, and effective treatments. Natural products are an important source of bioactive compounds and there is current interest in finding natural bioactive molecules that can be used for treating these parasitic diseases. In the present study we proposed to evaluate the in vitro antiparasitic activity of new menthol derivatives against Trypanosoma cruzi, Leishmania braziliensis and Plasmodium falciparum; moreover, we propose to explore their mode of action through in silico approaches.

Material and methods

A series of carbonate prodrugs (1–9) were synthesized from menthol with different aliphatic alcohols. Spectroscopic techniques were used to confirm the structures of the synthesized compounds. The cytotoxicity of the compounds was assessed using U-937 cells. In vitro trypanocidal, leishmanicidal and antiplasmodial activity were evaluated using a T. cruzi, L. braziliensis and P. falciparum organism, respectively. In addition, in silico studies were also performed through molecular dynamics simulations and MM-PBSA analysis.

Results

The assay revealed that most of the compounds were highly active against intracellular amastigotes of T. cruzi and L. braziliensis, and had moderate activity against the total forms of P. falciparum. Compound 2 was one of the drugs that showed a high selectivity index (SI) for the three organisms evaluated. The prediction of the ADME properties suggests that all the compounds have drug-like molecular properties and the probability to be lead candidates. Finally, molecular dynamics simulations, and MM-PBSA studies indicate that menthol at the substrate binding site of TcDHODH, LbDHODH and PfDHODH is structurally stable in the same order as the natural substrate; also, interactions of menthol with residues involved in the inhibition of TcDHODH and PfDHODH proteins were predicted.

Conclusions

The present study demonstrates that menthol prodrugs are promising antiparasitic agents; however, the mechanisms of action proposed in this study need to be experimentally verified by future enzymatic assays.
Studying nursing activities in inpatient units: a road to sustainability for hospitals
Authors: Hossny Eman Kamel
Published: June 2022

Background

Since the United Nations has adopted the Sustainable Development Goals in 2015, sustainability has been increasingly considered. Working time is an important resource (time is money), as well as the nurses inside hospitals. So, nursing activities must be studied and analyzed well. Consequently, the resulting information gives hospital managers a clear picture of the current status—the basics of developing plans for sustainability and keeping pace with developed countries.

Aim

This study was designed to study nursing activities performed in inpatient units and to determine which types of nursing activities are the most frequent and time-consuming, how much time each category of nursing personnel spends in different activities, and how units divide their time between patient care and other activities.

Method

A work sampling method was used on 36 nurses in six units for three successive years, using two tools: a demographic data sheet and guidelines for the level of activities and area of activities.

Results

There were 5,184 observations per year. According to area of activities, personal, and patient activities were the most time-consuming and frequent. According to the level of activities, unclassified and nursing activities were the most time-consuming among the intensive care, medical, and surgical units under study (44.1%, 41.6%, and 55.2%, respectively, and 28.2%, 34.8%, and 28.3%, respectively). The work of technical and diploma nurses was similar.

Conclusion

Personal, unclassified, and patient activities consumed a large portion of nursing hours during the morning shift. Meanwhile, unit and personnel activities have consumed a minimal portion of hours. No significant differences in work were observed between technical and diploma nurses.

Recommendations

Nursing managers and leaders should take a step to improve sustainability in their hospitals through study the nursing activities to gather data to develop plans for the future and rearrange the entire nursing staff in hospital units according to the needs of each shift.
Death anxiety, moral courage, and resilience in nursing students who care for COVID-19 patients: a cross-sectional study
Authors: Mohammadi Fateme , Masoumi Zahra , Oshvandi Khodayar , Khazaei Salman , Bijani Mostafa
Published: June 2022

Background

Being on the frontline of the battle against COVID-19, nurses and nursing students have been under considerable psychological stress and pressure. The present study is done to explore death anxiety, moral courage, and resilience in nursing students caring for COVID-19 patients in the south of Iran.

Methods

The present study is cross-sectional research conducted between September and December 2021. A total of 420 senior nursing students (nursing interns) who were undergoing their clinical training courses were invited to participate in the study by convenience sampling method from three hospitals affiliated with the University of Medical Sciences of Southern Iran. Data were collected using a demographics survey, Nurses’ Moral Courage Questionnaire, Connor-Davidson Resilience Scale, and Templer’s Death Anxiety Scale. 

Results

The nursing students participating in this study had a death anxiety mean score of 12.78 ± 1.17. The results showed that there was a significant and indirect correlation between death anxiety on the one hand and moral courage (r = -0.91, p < 0.001) and resilience (r = -0.89, p < 0.001) on the other in nursing students caring for patients with COVID-19. Also, it was found that there was a significant and direct correlation between the students’ resilience and moral courage scores (r = 0.91, p < 0.001).

Conclusion

The nursing students caring for COVID-19 patients had experienced high levels of death anxiety in the past few months. Considering the persistence of the COVID-19 crisis in Iran and other countries, there is an urgent need for measures to preserve and improve the physical, mental, and spiritual health of nursing students, enhance their moral courage and resilience and reduce their death anxiety.
Intercalary allograft reconstruction following femoral tumour resection: mid- and long-term results and benefits of adding a vascularised fibula autograft
Authors: Crenn Vincent , Quinette Yonis , Bouthors Charlie , Missenard Gilles , Viard Brice , Anract Philippe , Boisgard Stéphane , Mascard Eric , Gouin François ,   The Société d’Orthopédie de l’Ouest
Published: June 2022

Purpose

Bone healing in femoral reconstructions using intercalary allografts can be compromised in a tumour context. There is also a high revision rate for non-union, infection, and fractures in this context. The advantages and disadvantages of an associated vascularised fibula graft (VFG) are still a matter of debate.

Methods

In a multicentre study, we retrospectively analysed 46 allograft reconstructions, operated on between 1984 and 2017, of which 18 were associated with a VFG (VFG+) and 28 without (VFG−), with a minimum follow-up of 2 years. We determined the cumulative probability of bone union as well as the mid- and long-term revision risks for both categories by Kaplan-Meier survival analysis and a multivariate Cox model. We also compared the MSTS scores.

Results

Significant differences in favour of VFG+ reconstruction were observed in the survival analyses for the probability of bone union (log-rank, p = 0.017) and in mid- and long-term revisions (log-rank, p = 0.032). No significant difference was observed for the MSTS, with a mean MSTS of 27.6 in our overall cohort (p = 0.060). The multivariate Cox model confirmed that VFG+ was the main positive factor for bone union, and it identified irradiated allografts as a major risk factor for the occurrence of mid- and long-term revisions.

Conclusion

Bone union was achieved earlier in both survival and Cox model analyses for the VFG+ group. It also reduced the mid- and long-term revision risk, except when an irradiated allograft was used. In case of a tumour, we thus recommend using VFG+ from a fresh-frozen allograft, as it appears to be a more reliable long-term option.
Teamwork quality and health workers burnout nexus: a new insight from canonical correlation analysis
Authors: Wang Wenxin , Atingabili Samuel , Mensah Isaac Adjei , Jiang Hong , Zhang Hao , Omari-Sasu Akoto Yaw , Tackie Evelyn Agba
Published: June 2022

Background

Burnout is evidenced to have  adverse effect on the well-being of health workers. Although several risk factors of burnout have been found, only a hand full of studies have examined the role of teamwork quality. This study therefore sought to explore the relationship between the sub-dimensions of burnout and teamwork quality.

Method

This is an empirical study involving health workers who have practising certificate from the National Health Commission of the People’s Republic of China. Relying on the study’s target population, a sample of 939 healthworkers complied to partake in the survey. Data were obtained from the administration of a well-structured electronic questionnaire containing the Maslach Burnout Inventory together with Healthy and Resilient Organization (HERO) scales correspondingly. The scales were then analysed using the canonical correlation approach (CCA).

Results

The results unveiled a statistically significant correlation between teamwork quality and health worker burnout indicating that teamwork quality and burnout are canonically correlated. Further, examination on the relationship existing between the dimensions of teamwork quality and burnout unveiled that with the exception of personal accomplishment and teamwork dedication, teamwork quality sub-scales (teamwork vigour and teamwork absorption) were negatively related to emotional exhaustion and depersonalization as sub-scales of burnout, respectively.

Conclusion

The study concluded that, surge in teamwork quality leads to reduced emotional exhaustion and reduced depersonalization while simultaneously increasing professional accomplishment. Therefore, this study presents a solid foundation for decreasing burnout syndrome in healthcare that can be implemented by successfully increasing levels of teamwork quality.
Assessing the contribution of immigrants to Canada’s nursing and health care support occupations: a multi-scalar analysis
Authors: Harun Rafael , Walton-Roberts Margaret
Published: June 2022

Background

The World Health Organization adopted the Global Strategy on Human Resources for Health Workforce 2030 in May 2016. It sets specific milestones for improving health workforce planning in member countries, such as developing a health workforce registry by 2020 and ensuring workforce self-sufficiency by halving dependency on foreign-trained health professionals. Canada falls short in achieving these milestones due to the absence of such a registry and a poor understanding of immigrants in the health workforce, particularly nursing and healthcare support occupations. This paper provides a multiscale (Canada, Ontario, and Ontario’s Local Health Integration Networks) overview of immigrant participation in nursing and health care support occupations, discusses associated enumeration challenges, and the implications for health workforce planning focusing on immigrants.

Methods

Descriptive data analysis was performed on Canadian Institute for Health Information dataset for 2010 to 2020, and 2016 Canadian Census and other relevant data sources.

Results

The distribution of nurses in Canada, Ontario, and Ontario’s Local Health Integration Networks reveal a growth in Nurse Practitioners and Registered/Licensed Practical Nurses, and contraction in the share of Registered Nurses. Immigrant entry into the profession was primarily through the practical nurse cadre. Mid-sized communities registered the highest growth in the share of internationally educated nurses. Data also pointed towards the underutilization of immigrants in regulated nursing and health occupations.

Conclusion

Immigrants comprise an important share of Canada’s nursing and health care support workforce. Immigrant pathways for entering nursing occupations are complex and difficult to accurately enumerate. This paper recommends the creation of an integrated health workforce dataset, including information about immigrant health workers, for both effective national workforce planning and for assessing Canada’s role in global health workforce distribution and utilization.
Changes in the prevalence of child marriage in Ethiopia, 2005–2016
Authors: Erulkar Annabel
Published: June 2022

Background

Child marriage has powerful implications for a young woman’s reproductive health, education, and personal development as well as the development of communities and nations. Child marriage frequently marks the beginning of a young woman’s sexual activity and early childbearing. As a country where child marriage is common, Ethiopia has placed additional emphasis on addressing child marriage over the past years.

Methods

Using data from Ethiopia Demographic and Health Surveys for 2005, 2011 and 2016, this paper explores trends in child marriage over the last decade in various locations and regions of Ethiopia.

Results

Between 2005 and 2016, the percentage of young Ethiopian women married before age 18 declined from 49 to 40%, a reduction of 18% from 2005 levels. The percentage of women married before age 15 experienced even greater reductions, declining by 26% in the same period. The greatest reductions in child marriage took place in the Addis Ababa, Amhara, and Tigray regions. Over the period, estimates for Oromia and Somali suggest that child marriage has increased in these regions. Notwithstanding recent declines, Afar, Beneshangul-Gumuz, Somali, and Oromia are regions where nearly half or more of all girls are married before age 18.

Conclusions

Nationally, Ethiopia has experienced impressive declines in child marriage over the last decade. However, progress has also been uneven. Trends in the last decade have resulted in a geographical shift in where child marriage is most prevalent. In particular, locations that are challenging in terms of access, including the most remote and hard to reach, pose persistent challenges to those attempting to eradicate the practice. Intensifying efforts in rural areas and underserved regions can facilitate further declines in child marriage in Ethiopia.
Vacuum sealing drainage combined with naso-intestinal and gastric decompression tubes for the treatment of esophagogastrostomy neck fistula
Authors: Tian Chuan , Xu Kaihao , Zhao Yanan , Li Yahua , Wu Kunpeng , Jiao Dechao , Han Xinwei
Published: June 2022

Objective

To evaluate the clinical results of the vacuum sealing drainage (VSD) combined with a naso-intestinal nutritional tube (NIT) and a gastric decompression tube (GDT) for the treatment of esophagogastrostomy neck fistula (ENF).

Methods

From January 2018 to October 2020, twenty patients (13 men and 7 women, ages 46–72) with ENF secondary to esophagogastrostomy were treated with VSD combined with NIT and GDT. Technical and clinical success rates, the incidence of early/late complications, the time of fistula closure (TFC) and therapy-related indicators were analyzed. The Karnofsky score and Eastern Cooperative Oncology Group (ECOG) score were compared before and after triple treatment.

Results

Technical and clinical success rates were 100% and 85%, respectively. Early complications occurred in 5/20 (25%) patients, and late complications occurred in 8/20 (40%) patients. The median TFC was 18 days (range 10–23). All therapy-related indicators were normalized posttreatment. The Karnofsky score and ECOG score after treatment were significantly different compared with pretreatment scores (p < 0.001).

Conclusion

VSD combined with NIT and GDT is a safe and effective strategy for ENF, while severe strictures warrant further research.
Chest radiotherapy after left upper lobectomy may be a risk factor for thrombosis in the pulmonary vein stump
Authors: Song Cheng-Yang , Kimura Daisuke , Fukuda Ikuo , Tsushima Fumiyasu , Sakai Takehiro , Tsushima Takao
Published: June 2022

Background

Thrombosis in the pulmonary vein stump (PVS) is not a well-known complication after pulmonary lobectomy, but it has the potential to cause embolism to vital organs. The aim of this study was to evaluate the risk factors for thrombosis in the PVS after pulmonary lobectomy.

Methods

A total of 439 patients who underwent pulmonary lobectomy from 2008 to 2017 were retrospectively reviewed, and 412 patients were further analyzed. The state of the PVS was evaluated by chest contrast-enhanced computed tomography (CECT). Univariate analysis was performed to evaluate the potential risk factors for thrombosis in the PVS.

Results

Thrombosis in the PVS was detected in 6 of 412 (1.5%) patients, and 5 of them underwent left upper lobectomy (LUL) (5/100, 5.0%) (P = 0.004). In the analyses of the LUL group, postoperative chest radiotherapy was identified as a risk factor for thrombosis in the PVS (P = 0.024), and postoperative atrial fibrillation showed a tendency to be a risk factor for thrombosis (P = 0.058).

Conclusions

Chest radiotherapy after LUL is a possible risk factor for thrombosis in the PVS. Periodic chest CECT is recommended after postoperative chest radiotherapy for patients after LUL.
Identification of ER/SR resident proteins as biomarkers for ER/SR calcium depletion in skeletal muscle cells
Authors: Greer Lacey K. , Meilleur Katherine G. , Harvey Brandon K. , Wires Emily S.
Published: June 2022

Background

Aberrations to endoplasmic/sarcoplasmic reticulum (ER/SR) calcium concentration can result in the departure of endogenous proteins in a phenomenon termed exodosis. Redistribution of the ER/SR proteome can have deleterious effects to cell function and cell viability, often contributing to disease pathogenesis. Many proteins prone to exodosis reside in the ER/SR via an ER retention/retrieval sequence (ERS) and are involved in protein folding, protein modification, and protein trafficking. While the consequences of their extracellular presence have yet to be fully delineated, the proteins that have undergone exodosis may be useful for biomarker development. Skeletal muscle cells rely upon tightly coordinated ER/SR calcium release for muscle contractions, and perturbations to calcium homeostasis can result in myopathies. Ryanodine receptor type-1 (RYR1) is a calcium release channel located in the SR. Mutations to the RYR1 gene can compromise calcium homeostasis leading to a vast range of clinical phenotypes encompassing hypotonia, myalgia, respiratory insufficiency, ophthalmoplegia, fatigue and malignant hyperthermia (MH). There are currently no FDA approved treatments for RYR1-related myopathies (RYR1-RM).

Results

Here we examine the exodosis profile of skeletal muscle cells following ER/SR calcium depletion. Proteomic analysis identified 4,465 extracellular proteins following ER/SR calcium depletion with 1,280 proteins significantly different than vehicle. A total of 54 ERS proteins were identified and 33 ERS proteins significantly increased following ER/SR calcium depletion. Specifically, ERS protein, mesencephalic astrocyte-derived neurotrophic factor (MANF), was elevated following calcium depletion, making it a potential biomarker candidate for human samples. Despite no significant elevation of MANF in plasma levels among healthy volunteers and RYR1-RM individuals, MANF plasma levels positively correlated with age in RYR1-RM individuals, presenting a potential biomarker of disease progression. Selenoprotein N (SEPN1) was also detected only in extracellular samples following ER/SR calcium depletion. This protein is integral to calcium handling and SEPN1 variants have a causal role in SEPN1-related myopathies (SEPN1-RM). Extracellular presence of ER/SR membrane proteins may provide new insight into proteomic alterations extending beyond ERS proteins. Pre-treatment of skeletal muscle cells with bromocriptine, an FDA approved drug recently found to have anti-exodosis effects, curbed exodosis of ER/SR resident proteins.

Conclusion

Changes to the extracellular content caused by intracellular calcium dysregulation presents an opportunity for biomarker development and drug discovery.
An update on choroidal abnormalities and retinal microvascular changes in neurofibromatosis type 1
Authors: Mallone Fabiana , Lucchino Luca , Giustini Sandra , Lambiase Alessandro , Moramarco Antonietta
Published: June 2022

Neurofibromatosis Type 1 (NF1) is a rare neurocutaneous disorder transmitted in an autosomal dominant fashion, mainly affecting the nervous system, the eye and skin. Ocular diagnostic hallmarks of NF1 include iris Lisch nodules, optic gliomas, orbital and eyelid neurofibromas, eyelid café-au-lait spots. In recent years, a new ocular sign represented by choroidal abnormalities (CAs) has been characterized in NF1. The CAs, identified with near-infrared reflectance, have been reported with a frequency of up to 100% in NF1, and have recently been added to the actual diagnostic criteria for NF1. The present Letter to the journal is intended to provide an update on features and clinical significance of CAs in NF1. Moreover, the relation with other ocular manifestations recently described in NF1 including hyperpigmented spots and retinal microvascular abnormalities is discussed.
Comparison of 6-month outcomes of sepsis versus non-sepsis critically ill patients receiving mechanical ventilation
Authors: Hodgson Carol L. , Higgins Alisa M. , Bailey Michael , Barrett Jonathon , Bellomo Rinaldo , Cooper D. James , Gabbe Belinda J. , Iwashyna Theodore , Linke Natalie , Myles Paul S. , Paton Michelle , Philpot Steve , Shulman Mark , Young Meredith , Serpa Neto Ary ,   The PREDICT Study Investigators
Published: June 2022

Background

Data on long-term outcomes after sepsis-associated critical illness have mostly come from small cohort studies, with no information about the incidence of new disability. We investigated whether sepsis-associated critical illness was independently associated with new disability at 6 months after ICU admission compared with other types of critical illness.

Methods

We conducted a secondary analysis of a multicenter, prospective cohort study in six metropolitan intensive care units in Australia. Adult patients were eligible if they had been admitted to the ICU and received more than 24 h of mechanical ventilation. There was no intervention.

Results

The primary outcome was new disability measured with the WHO Disability Assessment Schedule 2.0 (WHODAS) 12 level score compared between baseline and 6 months. Between enrollment and follow-up at 6 months, 222/888 (25%) patients died, 100 (35.5%) with sepsis and 122 (20.1%) without sepsis (P < 0.001). Among survivors, there was no difference for the incidence of new disability at 6 months with or without sepsis, 42/106 (39.6%) and 106/300 (35.3%) (RD, 0.00 (− 10.29 to 10.40), P = 0.995), respectively. In addition, there was no difference in the severity of disability, health-related quality of life, anxiety and depression, post-traumatic stress, return to work, financial distress or cognitive function.

Conclusions

Compared to mechanically ventilated patients of similar acuity and length of stay without sepsis, patients with sepsis admitted to ICU have an increased risk of death, but survivors have a similar risk of new disability at 6 months.

Trial registration NCT03226912, registered July 24, 2017.
The sit-to-stand test as a patient-centered functional outcome for critical care research: a pooled analysis of five international rehabilitation studies
Authors: O’Grady Heather K. , Edbrooke Lara , Farley Christopher , Berney Sue , Denehy Linda , Puthucheary Zudin , Kho Michelle E. ,   the International METRIC Critical Care Data Group, Ball Ian , Burns Karen , Clarke France , Cook Deborah , Costigan Aileen , Fox-Robichaud Alison , Gordon Ian , Haines Kimberley , Herridge Margaret , Karachi Tim , Lo Vincent , MacDonell Alexandra , Mathur Sunita , Molloy Alexander , Needham Dale , Pastva Amy , Reid Julie , Rochwerg Bram , Rose Joleen , Rudkowski Jill , Seely Andrew
Published: June 2022

Background

With ICU mortality rates decreasing, it is increasingly important to identify interventions to minimize functional impairments and improve outcomes for survivors. Simultaneously, we must identify robust patient-centered functional outcomes for our trials. Our objective was to investigate the clinimetric properties of a progression of three outcome measures, from strength to function.

Methods

Adults (≥ 18 years) enrolled in five international ICU rehabilitation studies. Participants required ICU admission were mechanically ventilated and previously independent. Outcomes included two components of the Physical Function in ICU Test-scored (PFIT-s): knee extensor strength and assistance required to move from sit to stand (STS); the 30-s STS (30 s STS) test was the third outcome. We analyzed survivors at ICU and hospital discharge. We report participant demographics, baseline characteristics, and outcome data using descriptive statistics. Floor effects represented ≥ 15% of participants with minimum score and ceiling effects ≥ 15% with maximum score. We calculated the overall group difference score (hospital discharge score minus ICU discharge) for participants with paired assessments.

Results

Of 451 participants, most were male (n = 278, 61.6%) with a median age between 60 and 66 years, a mean APACHE II score between 19 and 24, a median duration of mechanical ventilation between 4 and 8 days, ICU length of stay (LOS) between 7 and 11 days, and hospital LOS between 22 and 31 days. For knee extension, we observed a ceiling effect in 48.5% (160/330) of participants at ICU discharge and in 74.7% (115/154) at hospital discharge; the median [1st, 3rd quartile] PFIT-s difference score (n = 139) was 0 [0,1] (p < 0.05). For STS assistance, we observed a ceiling effect in 45.9% (150/327) at ICU discharge and in 77.5% (79/102) at hospital discharge; the median PFIT-s difference score (n = 87) was 1 [0, 2] (p < 0.05). For 30 s STS, we observed a floor effect in 15.0% (12/80) at ICU discharge but did not observe a floor or ceiling effect at hospital discharge. The median 30 s STS difference score (n = 54) was 3 [1, 6] (p < 0.05).

Conclusion

Among three progressive outcome measures evaluated in this study, the 30 s STS test appears to have the most favorable clinimetric properties to assess function at ICU and hospital discharge in moderate to severely ill participants.