bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional Analysis of Hypothetical Proteins of Vibrio parahaemolyticus Reveals the Presence of Virulence Factors and Growth-Related Enzymes With Therapeutic Potential
Authors: Shahrear Sazzad , Afroj Zinnia Maliha , Sany Md. Rabi Us , Islam Abul Bashar Mir Md. Khademul
Published: November 2022

Vibrio parahaemolyticus, an aquatic pathogen, is a major concern in the shrimp aquaculture industry. Several strains of this pathogen are responsible for causing acute hepatopancreatic necrosis disease as well as other serious illness, both of which result in severe economic losses. The genome sequence of two pathogenic strains of V. parahaemolyticus, MSR16 and MSR17, isolated from Bangladesh, have been reported to gain a better understanding of their diversity and virulence. However, the prevalence of hypothetical proteins (HPs) makes it challenging to obtain a comprehensive understanding of the pathogenesis of V. parahaemolyticus. The aim of the present study is to provide a functional annotation of the HPs to elucidate their role in pathogenesis employing several in silico tools. The exploration of protein domains and families, similarity searches against proteins with known function, gene ontology enrichment, along with protein-protein interaction analysis of the HPs led to the functional assignment with a high level of confidence for 656 proteins out of a pool of 2631 proteins. The in silico approach used in this study was important for accurately assigning function to HPs and inferring interactions with proteins with previously described functions. The HPs with function predicted were categorized into various groups such as enzymes involved in small-compound biosynthesis pathway, iron binding proteins, antibiotics resistance proteins, and other proteins. Several proteins with potential druggability were identified among them. In addition, the HPs were investigated in search of virulent factors, which led to the identification of proteins that have the potential to be exploited as vaccine candidate. The findings of the study will be effective in gaining a better understanding of the molecular mechanisms of bacterial pathogenesis. They may also provide an insight into the process of evaluating promising targets for the development of drugs and vaccines against V. parahaemolyticus.
Surveying Over the Counter and Prescription Only Medication Misuse in Treatment Services During COVID-19
Authors: Gittins Rosalind , Vaziri Roya , Maidment Ian
Published: November 2022

Background:

A greater understanding of Over the Counter (OTC) and Prescription Only Medication (POM) misuse amongst adults accessing substance misuse services (SMS) during COVID-19 is required to identify how SMS can better meet the needs of the people who require treatment.

Aim:

To use a questionnaire to explore OTC/POM misuse during COVID-19 in adults accessing community SMS in England.

Methods:

In 2020 to 2021 anonymous self-administered online/paper questionnaires which collated quantitative and qualitative data were completed. They were piloted for suitability and ethical approval was obtained. Thematic analysis was conducted for qualitative data and chi-square tests used to assess the relationship between quantitative variables.

Results:

Participants were Caucasian (94.6% British), majority male (58.9%), aged 18 to 61 years. Most were prescribed medication for problematic substance use, with a 92.5% self-reported adherence rate. The misuse of benzodiazepines (22.2%) codeine products (30.8%) and pregabalin (14.5%) predominated and 37.5% misused 2 or more medicines. Administration was usually oral and concomitant use of other substances was common: alcohol 44.6% (52% daily), tobacco/vaping 73.2% and illicit substances 58.9%. There were statistically significant associations identified, including between changes during COVID-19 to OTC/POM misuse and illicit use. Only 56 questionnaires were included in the analysis: we believe this low number was because of infection control measures, limited footfall in services, pressures on staff limiting their capacity to distribute the paper questionnaires and reliance upon telephone consultations limiting online distribution. Increasing OTC/POM misuse and obtaining illicit supplies were reported when access to usual supplies were restricted; however, changes to doses/dispensing arrangement liberalisation in response to COVID-19 were positively viewed.

Conclusion:

OTC/POM misuse, including polypharmacy and concomitant use of other substances occurred during COVID-19: SMS need to be vigilant for these issues and mitigate the associated risks for example with harm reduction interventions. Further qualitative research is required to explore the issues identified.
Developing the pediatric surgery patient satisfaction scale and assessment of its validity and reliability
Authors: Unal Aysun , Bektaş Murat , Turan Mantar Neriman , Ateş Oğuz , Hakgüder Faika Gülce
Published: November 2022

Aim of this study was to develop a patient satisfaction scale for needs and expectations of pediatric surgery patients and to propose a new measurement tool in this field. Population of study consisted of all patients between May 2018 and February 2020 at a pediatric surgery service of a university hospital in Turkey. A pool of 70 items was prepared for scale. Two items were removed in line with expert opinions and suggestions. As a result of content validity and test application, 36 items were removed, and scale was revised. Data were transferred to SPSS Statistics 23 and AMOS 22 program. After evaluating scope validity of scale, Content Validity, Structural Validity, Exploratory Factor Analysis, and finally Reliability Analysis were examined. As a result of the analyses, 32 items with eight sub-dimensions were obtained from scale. Eight-factor scale explained 60.42% of total variance. Cronbach Alpha internal consistency of scale was found to be 0.88. Item factor loads of scale were created and the reliability of scale were obtained at desired level. The scale is suitable for patients aged 6 to 18 years old.
Properties of complex damping Helmholtz–Duffing oscillator arising in fluid mechanics
Authors: El-Dib Yusry O
Published: November 2022

The current paper presents the first treatment to obtain the solution of a complex Helmholtz–Duffing oscillator. This model has described the elevation of the surface waves in fluid mechanics. The non-perturbative approach is used to convert the nonlinear oscillator to a linear oscillator to derive the solution of the complex nonlinear oscillator. This paper has opened the path for a new way to study more complex nonlinear elevation of surface waves.
On the moral grounds of professional argumentative talk: English-mediated talk in Iranian PhD dissertation defences
Authors: Izadi Ahmad
Published: November 2022

This paper reports on two anomalous cases of intervention in two English-medium dissertation defence sessions in Iran. The first is an intervention by a co-supervisor to take side against his co-supervisor as well as to adversely retort to an examiner, pulling rank over him. The second case echoes frequent interventions by an examiner to defend the candidate against his co-examiner. The paper argues that behind this manifestation of such stark disagreements lies a moral judgement that overrides other considerations. While such interventions pose great challenges to the participants’ interpersonal relationships and lead to a great deal of face-loss and humiliation for the object of intervention, their practice is warranted by interveners to tackle a moral issue. The paper argues that invoking moral order in claims to specialised knowledge is an integral part of professional practice and are influential in the many ways that professional identities are co-constructed in situ.
Conceptualizations of active learning in departments engaged in instructional change efforts
Authors: Williams Molly , Uhing Karina , Bennett Amy , Voigt Matthew , Funk Rachel , Smith Wendy M , Donsig Allan
Published: November 2022

Several academic departments have increased their use of active learning to address low student success rates. However, it is unclear whether those implementing active learning have a consistent conceptualization of it. Like other educational terms, the phrase “active learning” is in danger of becoming overused and misunderstood, which puts the utility of active learning into question. This study examines 115 conceptualizations of active learning across six institutions of higher education that are infusing more active learning into their mathematics courses. We use the four pillars of inquiry-based mathematics education as a basis for analyzing these conceptualizations and compare them in two ways: by stakeholder role and by institution. Our findings show that many participants conceptualize active learning as student engagement and activities other than lecture, yet there was limited focus on the role of the teacher and content. Only eight participants mentioned issues of equity. Comparison within individual institutions shows that faculty within departments may hold common understandings of active learning. Implications of these findings include a need to develop an understanding of active learning that attends to all four pillars and is shared across departments, institutions, and disciplines.
Nurturing an aesthetic tribe: Consuming and (re)producing ‘Quarantine Art’
Authors: Hietala Iida
Published: November 2022

This article explores ‘quarantine art’ – an Instagram challenge of recreating well-known artworks in self-isolation for the consumption of others – to investigate how people come together on social media to form an aesthetic tribe of consumer-producers. Drawing on a mixed-method qualitative approach, it presents netnographic observations and participant interviews subjected to representational and non-representational analyses. The findings illuminate the broad assemblage of visual arts, crafty practices and social media affordances that allow for a new communal expression, an aesthetic form of being together, and an emancipatory embrace of the ancient ‘maternal’ trope. That is, a new type of female subjectivity is brought to the fore – one that, separated from its ancient predecessors burdened by ‘caring for others’, celebrates aesthetic expression, nurturing and caretaking as a means to break down isolation. Overall, this study offers a feminist post-postmodern reading and elaboration of research into consumer tribes and virtual communities gathered around art, culture and aesthetics.
Numerical study on the noise propagation characteristics of rotor in non-uniform downwash flowfield Based on Linearized Euler Equations
Authors: Yang Tao , Chen Xi , Zhao Qijun , Zhao Guoqing
Published: November 2022

To study the influence of non-uniform flowfield on the propagation characteristics of helicopter rotor noise, a Hybrid Computational Aeroacoustics (HCAA) method is developed. The acoustic source region is simulated by Computational Fluid Dynamics (CFD) technique with the Unsteady Reynolds Averaged Navier-Stokes equations (URANS) as the governing equations. Acoustic near-field is simulated by Computational Aeroacoustics (CAA) technique with the Linearized Euler Equations (LEE) as the governing equations, and the numerical discretization of the LEE is accomplished by Runge-Kutta Discontinuous Galerkin (RKDG) method. A novel acoustic source extraction method based on pressure and pressure gradient is proposed to accomplish the one-way CFD-CAA weak coupling. The HCAA method is validated through comparisons with noise experimental data of the UH-1H model rotor and the BO-105 model rotor. Based on the proposed HCAA method, the convection and refraction effects of rotor noise under different collective pitch angles are analyzed. The results show that the distortion effect of the rotor noise is most affected by the non-uniformly distributed downwash velocity field, resulting in an increment of acoustic energy below the rotor plane. The effect of non-uniformly distributed downwash velocity on noise propagation increases with the increase of the collective pitch angle. For the UH-1H model rotor, the maximum change of the sound pressure level is 0.8 dB (about 10% change of the effective sound pressure).
Principals’ perspectives on the shift to short-cycle school improvement planning
Authors: Aaron Tiffany S , Meyers Coby V , Hitt Dallas Hambrick , VanGronigen Bryan A
Published: November 2022

Principals are responsible for planning school improvement efforts at the school level to leverage increases in student achievement. Recent research underscores how principals engage in satisficing behaviors that result in low-quality school improvement plans (SIPs). To disrupt compliance-based planning practices and produce high-quality SIPs, some districts have shifted from yearlong planning to short-cycle planning. Districts need to establish a coherent understanding of improvement planning to motivate and sustain new principal planning practices. Through the coherence framework, this qualitative study explored one large urban district's shift from yearlong planning processes to short-cycle planning processes to understand principals’ perspectives on improvement planning and the potential shift to short-cycle planning. Researchers examined eight principals’ short-cycle plans. Principals who participated in a two-year partnership with a University System Leadership Program (USLP) for school-level support for school improvement were interviewed. Principal interviews, USLP site lead feedback, and principal supervisors’ interview data to triangulate the short-cycle plans. Data analysis revealed the existence of a perverse coherence that impeded principals’ shift to short-cycle planning. Findings suggest that districts examine their internal practices and processes influencing principals’ improvement planning practices and attend to principals’ understanding and practice of improvement planning by providing continuous professional learning and feedback.
States as platforms following the new EU regulations on online platforms
Authors: Papakonstantinou Vagelis
Published: November 2022

The recent adoption by the European Parliament of the Digital Services Act means that, when it comes into effect, it will formally introduce into EU law the term ‘online platforms’. In effect, between the Digital Services Act and the Digital Markets Act, a comprehensive framework for the regulation of online platforms is being introduced into EU law, the first of its kind both in Europe and internationally. However, European regulatory innovation invites a different viewpoint: Could states be considered platforms? What if this new regulatory framework was applied to states themselves? This article first outlines the regulations on online platforms in EU law. Then it discusses the role of states as information brokers in order to support its main argument, that states can be viewed as (online) platforms. A discussion of the consequences of such a conclusion is included in the final part of this analysis.
Assetization and the ‘new asset geographies’
Authors: Birch Kean , Ward Callum
Published: November 2022

An asset is both a resource and property, in that it generates income streams with its sale price based on the capitalization of those revenues. Although an asset's income streams can be financially sliced up, aggregated, and speculated upon across highly diverse geographies, there still has to be something underpinning these financial operations. Something has to generate the income that a political economic actor can lay claim to through a property or other right, entailing a process of enclosure, rent extraction, property formation, and capitalization. Geographers and other social scientists are producing a growing literature illustrating the range of new (and old) asset classes created by capitalists in their search for revenue streams, for which we argue assetization is a necessary concept to focus on the moment of enclosure and rent extraction. It is a pressing task for human geographers to unpack the diverse and contingent ‘asset geographies’ entailed in this assetization process. As a middle range concept and empirical problematic, we argue that assetization is an important focal point for wider debates in human geography by focusing attention on the moment of enclosure, rent extraction, and material remaking of society which the making of a financial asset implies.
Novel approaches in the treatment of Hansen’s disease (Leprosy): a case series of multidrug therapy of monthly rifampin, moxifloxacin, and minocycline (RMM) in the United States
Authors: Franco-Paredes Carlos , Garcia-Creighton Elizabeth , Henao-Martínez Andrés , Kallgren Diane L. , Banjade Rashmi , Dyer Jon A. , Nelson Taylor , Zaesim Araya , Peluso Michael J. , Jain Vivek , Lee Dong Heun , Minces Lucio R. , Wirshup Mary , Sierra Hoffman Miguel , Katsolis Jenn , Brust Karen , Giron Jose , Smiarowski Lauren , Hoosepian-Mer Pauline A. , Stryjewska Barbara
Published: November 2022

The World Health Organization (WHO) recommends multidrug therapy (MDT) for the treatment of paucibacillary and multibacillary forms of leprosy, also known as Hansen’s disease (HD). MDT combinations of dapsone, rifampin, and clofazimine have reduced the prevalence of the disease but are not without adverse effects impacting regimen adherence. Hence, an urgent need exists to consider alternative MDT regimens with an improved safety profile that promotes treatment adherence. Herein, we described a case series of 10 patients with HD (nine patients with multibacillary leprosy and one with pure neural leprosy) treated with monthly rifampin, moxifloxacin, and minocycline (RMM). The United States National Hansen’s Disease Program (NHDP) diagnosed and treated patients across US institutions. All patients received a regimen of 12–24 months of RMM. We reviewed the clinical outcomes, adherence, rate of completion, and adverse events of patients treated with monthly RMM from January 2019 to August 2022. Nine patients had multibacillary leprosy, with some having type-2 reactions. One patient had pure neural leprosy with a reversal reaction. In this case series, we identified that all patients completed the RMM regimen without treatment interruptions. None of the patients experienced any skin hyperpigmentation or any significant side effects. All patients tolerated the monthly RMM regimen with rapid improvement of skin lesions and without logistic hurdles. Based on previous clinical evidence and the results of this case series, the NHDP and other programs should consider the RMM regimen as first-line therapy.
Smartphone digital phenotyping, surveys, and cognitive assessments for global mental health: Initial data and clinical correlations from an international first episode psychosis study
Authors: Lakhtakia Tanvi , Bondre Ameya , Chand Prabhat Kumar , Chaturvedi Nirmal , Choudhary Soumya , Currey Danielle , Dutt Siddharth , Khan Azaz , Kumar Mohit , Gupta Snehil , Nagendra Srilakshmi , Reddy Preethi V , Rozatkar Abhijit , Scheuer Luke , Sen Yogendra , Shrivastava Ritu , Singh Rahul , Thirthalli Jagadisha , Tugnawat Deepak Kumar , Bhan Anant , Naslund John A , Patel Vikram , Keshavan Matcheri , Mehta Urvakhsh Meherwan , Torous John
Published: November 2022

Objective

To examine feasibility and acceptability of smartphone mental health app use for symptom, cognitive, and digital phenotyping monitoring among people with schizophrenia in India and the United States.

Methods

Participants in Boston, USA and Bhopal and Bangalore, India used a smartphone app to monitor symptoms, play cognitive games, access relaxation and psychoeducation resources and for one month, with an initial clinical and cognitive assessment and a one-month follow-up clinical assessment. Engagement with the app was compared between study sites, by clinical symptom severity and by cognitive functioning. Digital phenotyping data collection was also compared between three sites.

Results

By Kruskal-Wallis rank-sum test, we found no difference between app activities completed or digital phenotyping data collected across the three study sites. App use also did not correlate to clinical or cognitive assessment scores. When using the app for symptom monitoring, preliminary findings suggest app-based assessment correlate with standard cognitive and clinical assessments.

Conclusions

Smartphone app for symptom monitoring and digital phenotyping for individuals with schizophrenia appears feasible and acceptable in a global context. Clinical utility of this app for real-time assessments is promising, but further research is necessary to determine the long-term efficacy and generalizability for serious mental illness.
Feasibility of Patient Navigation for Care Planning in Primary Care
Authors: Hinesley Jennifer L. Gilbert , Brooks Edward Marshall , O’Loughlin Kristen , Webel Benjamin , Britz Jacqueline , Kashiri Paulette Lail , Scheer Jonathan , Richards Alicia , Lavallee Martin , Sabo Roy T. , Huebschmann Amy G. , Krist Alex H.
Published: November 2022

Objectives:

To help better control chronic conditions we need to address root causes of poor health like unhealthy behaviors, mental health, and social needs. However, addressing these needs in primary care is difficult. One solution may be connecting patients with a navigator for support creating a personal care goal.

Methods:

As part of an RCT to evaluate a feasible approach to care planning, 24 clinicians from 12 practices in the Virginia Ambulatory Care Outcomes Research Network (ACORN) and 87 intervention patients with uncontrolled chronic conditions participated in a care planning intervention. We had a structured process to guide patients, train navigators, and adapt the navigation process to meet the needs of each practice.

Results:

Only 1 practice had bandwidth for staff to serve as a patient navigator, even for extra pay. For the other 11 practices, a research team member needed to provide navigation services. On average, patients wanted 25 weeks of support to complete care plans. The average time patients needed to speak with navigators on the phone was 7 min and 3 s. In exit interviews, patients consistently shared how motivational it was to have a caring person check in on them, offer help, and hold them accountable.

Conclusion:

Patient navigation to address care plans should be feasible. The time commitment is minimal. It does not require intensive training, and primary care is already doing much of this work. Yet, given the burden and competing demands in primary care, this help cannot be offered without additional resources.
Influence of Surgeon Specialty on 30-day Outcomes Following Single-Level Cervical Disc Arthroplasty: A Propensity-Matched Analysis
Authors: Gupta Puneet , Hassan Fthimnir M , Thomas George M , Lombardi Joseph M , Sardar Zeeshan M
Published: November 2022

Study Design

Retrospective, propensity-matched analysis

Objectives

Cervical disc arthroplasty (CDA) is being increasingly utilized for cervical disc generation. Surgeon specialty has been shown to influence the risk for postoperative complications in spine surgery, but this has not yet been explored for CDA. Thus, the purpose of this study is to determine whether there is any difference in 30-day complications between patients undergoing single-level CDA by neurosurgeons vs by orthopaedic surgeons.

Methods

A retrospective, 1:1 propensity score matched analysis was performed using the NSQIP database from 2015 to 2020. Patient demographics, operative characteristics, and postoperative complications were recorded. Independent multivariate logistic regression models were constructed using the propensity-matched dataset to assess surgical specialty influence on any complication, any site complication, any operative infection, and any medical complications.

Results

3179 single-level CDAs (28.8% orthopaedic surgery patients, 71.2% neurosurgery patients) were identified that met the inclusion criteria. Well-matched cohorts of 916 patients each were generated. After controlling for all possible confounders, orthopedic surgery specialty was not associated with a higher odds for any complication (OR: .87, 95% CI: .35 – 2.20, P = .7696), any site complication (OR: .32, 95% CI: .08 – 1.32, P = .1359), any operative infection (OR: .31, 95% CI: .07 – 1.34), P = .1172), nor any medical complication (OR: 2.11, 95% CI: .62 – 7.20, P = .2311) vs neurosurgery.

Conclusion

This is the first propensity-matched analysis to show that spine surgeon specialty does not influence the risk for any complication, any site complication, any operative infection, nor any medical complication following single-level CDA within the first 30 days after surgery.
Influence of Central Sensitization on Surgical Outcomes of Patients With Degenerative Cervical Myelopathy After Posterior Decompression Surgery: A Multicenter Prospective Study
Authors: Akeda Koji , Takegami Norihiko , Yamada Junichi , Fujiwara Tatsuhiko , Murata Koichiro , Kono Toshifumi , Sudo Takao , Imanishi Takao , Kurata Tatsuya , Kawakita Eiji , Sakakibara Toshihiko , Kondo Tetsushi , Takegami Kenji , Sato Masayoshi , Sudo Akihiro
Published: November 2022

Study Design

Multicenter prospective study.

Objective

The influence of central sensitization (CS) on neurological symptoms and surgical outcomes in patients with degenerative cervical myelopathy (DCM) remains unknown. This study aimed to investigate the effects of preoperative CS on surgical outcomes of patients with DCM following posterior decompression surgery.

Methods

77 consecutive patients with DCM (mean age 67.1) who received posterior decompression surgery were included in this study. The participants completed CS inventory (CSI) scores and the following patient-reported outcome measures (PROMs) preoperatively and 12 months postoperatively: the Japanese Orthopaedic Association (JOA) score for cervical myelopathy and JOA cervical myelopathy evaluation questionnaire (JOACMEQ) for cervical spinal diseases. The association of preoperative CSI scores with preoperative and postoperative PROMs was analyzed, and their changes were statistically evaluated.

Results

The preoperative CSI score was significantly decreased at 12 months postoperatively, and it was significantly associated with the JOA score and JOACMEQ preoperatively and at 12 months postoperatively. However, no significant association was observed between preoperative CSI and the postoperative change of any PROMs at 12 months. The posterior decompression surgery significantly improved the JOA scores and ‘lower extremity function’ and ‘quality of life (QOL)’ domains of the JOACMEQ, independent of the severity of preoperative CSI score. Multiple regression analysis demonstrated that preoperative CSI was significantly associated with the ‘QOL’ domain of JOACMEQ and original JOA score at 12 months postoperatively.

Conclusion

The CSI score can be an auxiliary indicator of surgical outcomes of patients with DCM following posterior decompression surgery.
Acute kidney injury (AKI) post-mRNA SARS-CoV-2 vaccine in patients with cancer, treated with immune check point inhibitor (ICPi): An immune double whammy!
Authors: Baker Richard , Gosalia Kinjal , Jhaveri Kenar D , Gudsoorkar Prakash
Published: November 2022

Background:

Immune check point inhibitors (ICPi) have become the first line treatment for most of the cancers and have shown promising results. However, they can provoke reactions, the most feared being immune related adverse events (irAE).

Case presentation:

We present a series of three cases, of patients recieving ICPi. All three patients developed AKI after administration of SARS-CoV-2 mRNA vaccine. Two patients had kidney-biopsy-proven acute interstitial nephritis (AIN) which responded to ICPi discontinuation and treatment with steroids. One had presumed AIN based on the high levels of CRP and urine retinol binding protein to creatinine ratio and responded to cessation of ICPi alone.

Conclusion:

These three cases demonstrate that a strong immune response from the SARS-CoV-2 mRNA vaccine combined with an uninhibited immune system under influence of ICPi led to an amplification of autoimmunity leading to AKI presenting as AIN.
Effectiveness of Hallux Valgus Surgery on Post-Operative Outcomes in Skeletally Mature Patients
Authors: Aran Fernando S. , Lukosius Eric , Easley Mark E. , Naseer Zahid , Wong Raymond
Published: November 2022

Category:

Bunion

Introduction/Purpose:

To evaluate the outcomes of 1st MTP motion preserving hallux valgus surgery using Patient Reported Outcomes (PROMs) in the literature since 2001. This paper also tries to eliminate some of the heterogeneity in reporting by using the effect size of the treatment using Minimally Important Clinical Differences (MCIDs).

Methods:

For this systematic review, we searched for peer-reviewed English-language articles published in 2001 or later, using the electronic databases Medline, Embase, SCOPUS, PEDro, CINAHL, Global Index Medicus, Web of Science, and World Wide Science. There were a total of 5,544 articles published on bunions. We reviewed all the abstracts and 1,200 papers were selected for full text evaluation. Finally, we analyzed 310 of the articles for this review. In total, there were 21,109 patients in 401 cohorts that underwent surgery on a total of 24,231 feet.

Results:

Our primary endpoint was patient reported outcomes measures (PROMs) and was stratified based on location of the osteotomy on the metatarsal shaft as well as follow up time. AOFAS was the most common PROM used and was included in 83.5% of the articles. We found that double osteotomies had the greatest overall change score in PROMs with an overall mean improvement of 1.69 MCIDs (CI +/- 0.7), compared to 1.23 (CI +/-0.46) for distal osteotomies; shaft and proximal osteotomies were similar to the distal subgroup. Although it had the highest positive change, double osteotomies were associated with the highest complication rates of recurrence (11.2%), malunion (4.8%), and avascular necrosis (3.2%). Minimally invasive vs open techniques had similar changes in HVA, IMA, and PROMs. There was a slightly higher satisfaction rate in the Open group at 91.6% vs 89.6% in the MIS group.

Conclusion:

Bony correction of bunions demonstrated a clinically significant improvement in patient reported outcomes with an aggregate MCID between 1.26-1.69. They performed significantly better than soft tissue procedures +/- proximal phalanx osteotomy. Although double osteotomy did perform better than the other bony osteotomies it did have a higher complication rate and the group was a much smaller cohort which makes it more susceptible to bias. MIS vs Open bunion correction demonstrated similar correction and AOFAS scores, the satisfaction rate was about 2% higher in open which was statistically significant but may not have clinical significance
Social Work and Community Engagement: A Case Study of a University/Community Collaborative Project in Trinidad and Tobago
Authors: Boodram Cheryl-Ann Sarita , Thomas Samantha Onieka
Published: November 2022

Over the past decade, there has been a call for social work education to promote student engagement more meaningfully in communities. Despite this, there is limited literature which provides insights into the experiences of establishing university–community partnerships and the possibilities of social work education to engage in such partnerships. This article reports on a case study in Trinidad and Tobago and outlines the processes involved in establishing the University of the West Indies (UWI)/Farm Road Collaborative Project, a university partnership with a community in the immediate vicinity of the university. This article contributes to the emerging literature on the roles of universities and schools of social work in addressing community development needs and has special implications for university–community engagements in the Global South.
International Cash Conduits and Real Estate Empires: A Case Study in Canadian Philanthropic Crime
Authors: Howe Miles , Sylvestre Paul
Published: November 2022

We analyze an instance of philanthropic law-breaking by a group of Canadian charities, who funnelled millions in tax-exempt funds to foreign recipients. Analyzing 20 years of tax data, we identify a pattern of regulatory violation we are calling the burner charity phenomenon. We track a chronological sequence of organizational behaviour characterized by hibernation, growth, and abandonment, across three linked burner charities. Backstopping burner charities, we show, is a network of public and private foundations. We argue that the purpose of burner charities is to enable foundations to transfer funds to foreign agents while remaining shielded from Canadian law. Combining insights from white collar crime and a Zemiology, we conclude by considering the multi-faceted dimensions of harm associated with burner charities.
Custom Endoprosthesis: A Versatile Surgical Technique for Optimizing Pediatric Mandibular Reconstruction and Dental Restoration
Authors: Kondra Katelyn , Stanton Eloise , Jimenez Christian , Garg Ravi , Liu Alice , Munabi Naikhoba C. O. , Chen Kevin , Wolfswinkel Erik M. , Steinberg Jordan P. , Urata Mark M. , Hammoudeh Jeffrey A.
Published: November 2022

Goals of pediatric mandibular reconstruction are restoring form, function, and esthetics while providing platforms for dental restoration. Though many techniques recreate the inferior mandibular border, most fail to address form and function in a manner that optimizes dental rehabilitation. We describe a surgical technique using a novel custom endoprosthesis that recapitulates the native mandibular contour while supporting the bone construct in a cephalad direction with a medial ledge facilitating implant placement and oral rehabilitation. This multi-institutional retrospective review at high-volume pediatric craniofacial surgery departments features patients with large mandibular resections warranting custom constructs. Thirteen patients underwent mandibular resection and endoprosthesis reconstruction with either free fibula osteocutaneous flaps (n = 9), soft tissue free flaps without bone graft (n = 2), rib graft (n = 1), or iliac crest bone graft (n = 1). Five patients required revisions for distal flap necrosis, intraoral granuloma, and orocutaneous fistulas; one endoprosthesis required removal. Excellent esthetic and reconstructive outcomes were achieved; however, only 2 patients completed dental restoration given financial constraints. A custom endoprosthesis represents an untapped avenue toward comprehensive pediatric mandibular reconstruction. It shows compatibility with microvascular flaps while optimizing facial contour and bone height for implant placement. Given these advantages, substantial financial barriers to dental restoration should be addressed.
Creating an automated contemporaneous cohort in sickle cell anemia to predict survival after disease-modifying therapy
Authors: Cronin Robert M. , Wuichet Kristin , Ghafuri Djamila L , Hodges Brock , Chopra Maya , He Jing , Niu Xinnan , Kassim Adetola A. , Wilkerson Karina , Rodeghier Mark , DeBaun Michael R.
Published: November 2022

The Food and Drug Administration requires contemporaneous controls to compare clinical outcomes for participants receiving experimental gene therapy or gene editing clinical trials. However, developing a contemporaneous cohort of rare diseases requires multiple person-hours. In a single referral center for sickle cell disease, we tested the hypothesis that we could create an automated contemporaneous cohort of children and adults with sickle cell anemia (SCA) to predict mortality. Data were obtained between 1 January 2004 and 30 April 2021. We identified 419 individuals with SCA with consistent medical care defined as followed continuously for >0.5 years with no visit gaps >3.0 years. The median age was 10.2 years (IQR, 1-24 years), with a median follow-up of 7.4 years (IQR, 3.6-13.5 years) and 47 deaths. A total of 98% (274 of 277) of the children remained alive at 18 years of age, and 34.3% (94 of 274) of those children were followed into adulthood. For adults, the median age of survival was 49.3 years. Treatment groups were mutually exclusive and in a hierarchical order: hematopoietic stem cell transplant (n = 22)>regular blood transfusion for at least 2 years (n = 56)>hydroxyurea for at least 1 year (n = 243)>no disease-modifying therapy (n = 98). Compared to those receiving no disease-modifying treatment, those treated with hydroxyurea therapy had a significantly lower hazard of mortality (hazard ratio = 0.38; P = 0.016), but no statistical difference for those receiving regular blood transfusions compared to no disease-modifying therapy (hazard ratio = 0.71; P = 0.440). An automated contemporaneous SCA cohort can be generated to estimate mortality in children and adults with SCA.
Spatial distribution of rotavirus immunization coverage in Ethiopia: a geospatial analysis using the Bayesian approach
Authors: Atalell Kendalem Asmare , Liyew Alemneh Mekuriaw , Alene Kefyalew Addis
Published: November 2022

Introduction

Rotavirus causes substantial morbidity and mortality every year, particularly among under-five children. Despite Rotavirus immunization preventing severe diarrheal disease in children, the vaccination coverage remains inadequate in many African countries including Ethiopia. Measuring rotavirus immunization coverage in a lower geographic area can provide information for designing and implementing a targeted immunization campaign. This study aimed to investigate the spatial distributions of rotavirus immunization coverage in Ethiopia.

Methods

Rotavirus immunization coverage data were obtained from the recent Ethiopian Demographic and Health Survey (EDHS 2019). Covariate data were assembled from different publicly available sources. A Bayesian geostatistics model was used to estimate the national rotavirus immunization coverage at a pixel level and to identify factors associated with the spatial clustering of immunization coverages.

Result

The national rotavirus immunization coverage in Ethiopia was 52.3% (95% CI: 50.3, 54.3). The immunization coverage varied substantially at the sub-national level with spatial clustering of low immunization coverage observed in the Eastern, Southeastern, and Northeastern parts of Ethiopia. The spatial clustering of the rotavirus immunization coverage was positively associated with altitude of the area [mean regression coefficient (β): 0.38; 95% credible interval (95% CrI): 0.18, 0.58] and negatively associated with travel time to the nearest cities in minutes [mean regression coefficient (β): − 0.45; 95% credible interval (95% CrI): (− 0.73, − 0.18)] and distance to the nearest health facilities [mean regression coefficient (β): − 0.71908; 95% credible interval (95% CrI): (− 1.07, − 0.37)].

Conclusions

This study found that the rotavirus immunization coverage varied substantially at sub-national and local levels in Ethiopia. The spatial clustering of rotavirus immunization coverage was associated with geographic and healthcare access factors such as altitude, distance to health facilities, and travel time to the nearest cities. The immunization program should be strengthened in Ethiopia, especially in the Eastern, Southeastern, and Northeastern parts of the Country. Outreach immunization services should be also implemented in areas with low coverage.
Prevalence of hepatotoxicity among HIV-infected patients in Ethiopia: a systematic review and meta-analysis
Authors: Mohammed Ousman , Alemayehu Ermiyas , Bisetegn Habtye , Tilahun Mihret , Gedefie Alemu , Ebrahim Endris , Fiseha Mesfin , Necho Mogesie , Fiseha Temesgen
Published: November 2022

Background

Globally, the human immunodeficiency virus has been recognized as a major public health concern. The direct toxicity of antiretroviral medicines or their active metabolites causes liver cell destruction by different mechanisms, inducing immune-mediated inflammation, oxidative stress, and other mechanisms. On the other hand, the virus itself also produces hepatotoxicity. Therefore, this systematic review and meta-analysis aimed to assess the pooled prevalence of hepatotoxicity among HIV-infected patients in Ethiopia.

Methods

PubMed, Science Direct, Cochrane Library, Web of Science, and ResearchGate databases were used to find relevant articles. As well, various professional associations were searched to retrieve grey literature. The Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of recruited studies. The data were extracted using Microsoft Excel, and the meta-analysis was carried out using STATA 14 software. I2and Cochran’s Q test were employed to assess the presence of heterogeneity between studies. A random effect model was used. The funnel plot and Egger’s statistics were used to assess publication bias. Moreover, subgroup analysis and sensitivity analysis were also done.

Results

The pooled prevalence of hepatotoxicity among HIV patients in Ethiopia was 25.45% (95% CI = 20.06–30.84%). There was high heterogeneity, with an I2value of 93.7%. Subgroup analysis by HAART status showed a higher pooled prevalence of hepatotoxicity among HIV patients taking HAART (23.63%) than among HAART naive patients (7.29%). In subgroup analysis, the pooled prevalence of hepatotoxicity among HIV/Tb co-infected and HIV mono-infected patients was 26.3% and 17.94%, respectively.

Conclusion

The current systematic review and meta-analysis showed a high prevalence of hepatotoxicity among HIV-infected patients. Therefore, regular monitoring of hepatotoxicity among HIV-infected patients is required in order to avoid liver damage and other complications.

Systematic review registrationPROSPERO (2022:CRD42022334704)
Central hypersomnia and chronic insomnia: expanding the spectrum of sleep disorders in long COVID syndrome - a prospective cohort study
Authors: Moura Alissa Elen Formiga , Oliveira Danilo Nunes , Torres Danielle Mesquista , Tavares-Júnior José Wagner Leonel , Nóbrega Paulo Ribeiro , Braga-Neto Pedro , Sobreira-Neto Manoel Alves
Published: November 2022

Introduction

Long-onset COVID syndrome has been described in patients with COVID-19 infection with persistence of symptoms or development of sequelae beyond 4 weeks after the onset of acute symptoms, a medium- and long-term consequence of COVID-19. This syndrome can affect up to 32% of affected individuals, with symptoms of fatigue, dyspnea, chest pain, cognitive disorders, insomnia, and psychiatric disorders. The present study aimed to characterize and evaluate the prevalence of sleep symptoms in patients with long COVID syndrome.

Methodology

A total of 207 patients with post-COVID symptoms were evaluated through clinical evaluation with a neurologist and specific exams in the subgroup complaining of excessive sleepiness.

Results

Among 189 patients included in the long COVID sample, 48 (25.3%) had sleep-related symptoms. Insomnia was reported by 42 patients (22.2%), and excessive sleepiness (ES) was reported by 6 patients (3.17%). Four patients with ES were evaluated with polysomnography and test, multiple sleep latencies test, and actigraphic data. Two patients had a diagnosis of central hypersomnia, and one had narcolepsy. A history of steroid use was related to sleep complaints (insomnia and excessive sleepiness), whereas depression was related to excessive sleepiness. We observed a high prevalence of cognitive complaints in these patients.

Conclusion

Complaints related to sleep, such as insomnia and excessive sleepiness, seem to be part of the clinical post-acute syndrome (long COVID syndrome), composing part of its clinical spectrum, relating to some clinical data.
Prevalence and risk prediction value of tricuspid regurgitation by echocardiography in precapillary pulmonary hypertension
Authors: Li Jiahui , Li Aili , Zhai Yanan , Li Lei , Zhang Yu , Chen Aihong , Tao Xincao , Gao Qian , Xie Wanmu , Zhai Zhenguo
Published: November 2022

Background

In precapillary pulmonary hypertension (PH), the incidence of different tricuspid regurgitation (TR) degree is poorly defined. The impact of TR severity on pulmonary artery pressure (PAP) assessment and clinical risk stratification in precapillary PH remains unclear.

Methods

A total of 207 patients diagnosed precapillary PH who underwent right heart catheterization (RHC) and echocardiography within 3 days were included. The severity of TR was graded as trace, mild, moderate and severe. Pearson correlation analysis was performed to evaluate the correlation between systolic PAP by echocardiography (sPAPECHO) and mean PAP by RHC (mPAPRHC) in different TR degree groups. The impact factors on risk stratification of precapillary PH were analyzed by logistic regression analysis.

Results

The proportion of None, Trace, Mild, Moderate and Severe TR group was 2.4%, 23.7%, 39.1%, 28.5% and 6.3% respectively. Right atrium (RA) area increased gradually with TR aggravation (p < 0.001). Moderate and Severe TR group had higher N-terminal pro-B-type natriuretic peptide (p < 0.001), right atrial pressure (RAP) (p = 0.018), right ventricular basal diameter (RVD)/left ventricular basal diameter (LVD) ratio (p < 0.001), larger right ventricle (RV) (p < 0.001) and lower tricuspid annular plane systolic excursion (p = 0.006) compared with Trace and Mild group. TR-sPAPECHO in Moderate TR group had the greatest correlation coefficient with mPAPRHC (0.742, p < 0.001) followed by Mild (0.635, p < 0.001) and severe group (0.592, p = 0.033), while there was no correlation in Trace TR group (0.308, p = 0.076). Multivariate logistic regression showed three significant independent echocardiography predictors of high-risk precapillary PH: RVD/LVD ratio (OR = 5.734; 95%CI1.502–21.889, p = 0.011), RA area (OR 1.054; 95% CI 1.004–1.107, p = 0.035) and systolic annular tissue velocity of the lateral tricuspid annulus (S’) (OR 0.735, 95% CI 0.569–0.949, p = 0.018).

Conclusions

Precapillary PH was not necessarily accompanied by significant TR. None or Trace TRaccounted for 26% in our population and TR-sPAPECHO was not applicable to estimate PAP in these patients. RVD/LVD ratio, RA area and S’ can independently predict the high-risk patients with precapillary PH. TR may play an indirect role in risk stratification by affecting these indicators.
Classical music restored fertility status in rat model of premature ovarian failure
Authors: Nazdikbin Yamchi Nahideh , Alizadeh Ashrafi Mohammad Mojtaba , Abbasi Hamed , Amjadi Farhad , Geranmayeh Mohammad Hossein , Shirazi Reza , Tamadon Amin , Rahbarghazi Reza , Mahdipour Mahdi
Published: November 2022

Background:

The restorative effect of classical music was assessed on the cyclophosphamide-induced animal model of premature ovarian failure (POF).

Methods:

Mozart’s piano classical music (K.448) was used for up to 4 and 8 weeks. Rats were exposed to music 6 h every day using a stereo system with a volume of 65–70 dB. Sera and ovarian tissue samples were collected for the evaluation of FSH, LH, and E2 and histopathological examination. At the same time points, samples were taken from the hypothalamus and hippocampus to monitor the expression of Ntrk2, Crh, and Pomc using real-time PCR. Mating trial was performed to evaluate the fertility status of POF rats.

Results:

Histopathological examination revealed a significant increase (p < 0.05) in the numbers of morphologically normal follicles at all the developmental stages in POF rats after music therapy compared to the POF group (p < 0.05). Music therapy decreased FSH and LH levels to near-to-normal levels conidied with elevation of E2 (p < 0.05). Ntrk2, Crh, and Pomc expressions were down-regulated in POF rats. Music therapy increasaed the expression of Ntrk2 in the hypothalamus of POF rats (p < 0.05). In contrast, Crh and Pomc failed to reach the detection limit before intervention and four weeks after the intervention however, these genes were expressed eight weeks after music therapy. Fertility status was increased (p < 0.05) in terms of litter size in POF rats after being exposed to music compared to the non-treated POF control group (p < 0.05).

Conclusion:

Results showed that music can exert therapeutic effects on POF rats via the alteration of sex-related hormones.