bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of high dose vitamin D supplementation as a nutritional intervention strategy on biochemical and inflammatory factors in adults with COVID-19: Study protocol for a randomized controlled trial
Authors: Khorasanchi Zahra , Jafazadeh Esfehani Ali , Sharifan Payam , Hasanzadeh Elahe , Shadmand Foumani Moghadam Mohammad Reza , Ahmadi Omid , Ebrahimi Reyhaneh , Lotfi Seyede Zahra , Milani Nasrin , Mozdourian Mahnaz , Rezvani Reza , Vatanparast Hasan , Assaran Darban Reza , Ferns Gordon , Ghayour Mobarhan Majid
Published: March 2022

Introduction: Low serum vitamin D has been shown to be a risk factor for Coronavirus 2019 (COVID-19). The aim of this study was to assess the effects of high dose vitamin D supplementation on hs-CRP, ESR and clinical outcomes, including duration of hospitalization, quality of life and New York Heart Association (NYHA) Functional Classification, in adults with COVID-19. Methods: This double-blind, randomized control trial will be conducted on patients with RT-PCR and/or chest CT scan diagnosis of COVID-19 admitted in Imam Reza Hospital, Mashhad, Iran. Participants will be randomized into control and intervention groups based on randomization sampling. The intervention group will receive soft gel containing 50,000 IU vitamin D on the first day followed by 10,000 IU/day through a supplement drop daily for 29 days. The control group will receive 1000 IU vitamin D daily through supplement drop and a placebo soft gel. All participants will undergo laboratory assessment including inflammatory markers, serum 25)OH)D, complete blood count (CBC), liver and renal profile, lipid profile and erythrocyte sedimentation rate (ESR) at baseline and at day 30. The mortality rate will be recorded in both groups. Results: Data will be presented using descriptive statistics. Comparison of changes in study parameters over the study period will be performed using analysis of covariance adjusting for possible confounders. Conclusions: The findings of this will provide evidence on the effects of high dose vitamin D supplementation on inflammatory markers in hospitalized COVID-19 patients.
Effect of obesity on venous hemodynamics of the lower limbs during laparoscopic cholecystectomy
Authors: Lu Mingshu , Bi Jingpeng , Li Yunhui , Hao Zhiqiang
Published: March 2022

Objective

The present study aims to compare the changes of venous flow parameters of the lower limbs under the assessment based on the duplex ultrasound scanning in obese and non-obese individuals by complying with body mass index during laparoscopic cholecystectomy.

Methods

A prospective cohort study was conducted in non-obese (body mass index <25 kg/m2) and obese individuals (body mass index >30 kg/m2) during laparoscopic cholecystectomy to analyze venous hemodynamics of the lower limbs. The assessment was conducted on Femoral vein diameter, Femoral vein cross-sectional area, Femoral vein peak velocity, and Femoral vein volume flow. The change values (%) of venous flow parameters of the lower limbs were calculated as a percentage by: (intra-operative parameter-pre-operative parameter)/ pre-operative parametersX100%.

Results

45 right lower limbs were examined in 45 non-obese individuals and 33 right lower limbs in 33 obese individuals during laparoscopic cholecystectomy. The statistically significant difference was identified in the pre-operative and intra-operative values of Femoral vein diameter, Femoral vein cross-sectional area, Femoral vein peak velocity, as well as Femoral vein volume flow in both groups when these were analyzed independently ( p = .00). When the change values of venous flow parameters of the lower limbs of the two groups were compared, more changes were identified significantly in the obese group, Femoral vein diameter ( p = .042), Femoral vein cross-sectional area ( p = .013), Femoral vein peak velocity ( p = .002), and Femoral vein volume flow ( p = .032).

Conclusion

The changes of lower limb venous flow parameters showed more significant difference in obese than in non-obese individuals during laparoscopic cholecystectomy. The mentioned findings may in part explain why obese patients undergoing laparoscopic cholecystectomy have a higher rate of post op deep venous thrombosis.
Repetitive transcranial magnetic stimulation improves consciousness in some patients with disorders of consciousness
Authors: Fan Jianzhong , Zhong Yuhua , Wang Huijuan , Aierken Nilubaier , He Renhong
Published: March 2022

Objective

To investigate the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) in patients with disorders of consciousness.

Design and Setting

We performed a randomized, double-blinded, sham-controlled trial.

Participants

Patients (N = 40) with disorders of consciousness.

Interventions

Forty patients with disorders of consciousness (time since onset of the disorder 49.0 ± 24.6 days) were enrolled and randomized to groups receiving either active-rTMS or sham-rTMS. The active-TMS protocol had a frequency of 20 Hz, was delivered over the left dorsolateral prefrontal cortex and had a 100% rest motor threshold. The sham-rTMS protocol was the same as the active protocol without magnetic stimulation over the cortex.

Main Outcome Measures

Consciousness was evaluated by the Coma Recovery Scale-Revised (CRS-R) before and after the four-week intervention. The ratio of patients that awakened from disorders of consciousness was followed up at discharge.

Results

Before rTMS sessions, there were no significant differences in consciousness scores between groups. Compared to sham-rTMS (6.25 ± 1.29), patients with disorders of consciousness treated by active rTMS showed strikingly improved consciousness (8.45 ± 3.55). In-depth analysis revealed that only some patients showed obvious increases in consciousness scores induced by active rTMS. Furthermore, rTMS did not significantly enhance the awakening ratio.

Conclusions

rTMS showed therapeutic efficacy for improving consciousness in some, but not all, patients with disorders of consciousness. It is essential to discern the potential patients whose consciousness can be improved by rTMS.
Isolated bilateral, large, basal ganglia haemorrhage following a traumatic brain injury: A case report
Authors: Anh Tuan Nguyen , Thi Huyen Ngo , Duc Thuan Nguyen
Published: March 2022

Traumatic basal ganglia haemorrhage is rarely seen in clinical practice. Bilateral basal ganglia hematoma without any other cerebral lesions due to trauma is extremely uncommon and has been reported only in a few cases. Although the mechanisms of this condition are unclear, haemorrhagic contusions are thought to arise as a consequence of a shearing strain on cranial blood vessels due to high-velocity forces at the time of the injury. Here we describe a 63-year-old female patient with an isolated bilateral, large, basal ganglia haemorrhage secondary to a road traffic accident. The patient was promptly diagnosed and conservatively treated and had fully recovered after two months.
Shared E-Scooter Trajectory Analysis During the COVID-19 Pandemic in Austin, Texas
Authors: Dean Matthew D. , Zuniga-Garcia Natalia
Published: March 2022

By March of 2020, most cities worldwide had enacted stay-at-home public health orders to slow the spread of COVID-19. Restrictions on nonessential travel had extensive impacts across the transportation sector in the short term. This study explores the effects of COVID-19 on shared e-scooters by analyzing route trajectory data in the pre- and during-pandemic periods in Austin, TX, from a single provider. Although total shared e-scooter trips decreased during the pandemic, partially owing to vendors pulling out of the market, this study found average trip length increased, and temporal patterns of this mode did not meaningfully change. A count model of average daily trips by road segment found more trips on segments with sidewalks and bus stops during the pandemic than beforehand. More trips were observed on roads with lower vehicle miles traveled and fewer lanes, which might suggest more cautious travel behavior since there were fewer trips in residential neighborhoods. Stay-at-home orders and vendor e-scooter rebalancing operations inherently influence and can limit trip demand, but the unique trajectory data set and analysis provide cities with information on the road design preferences of vulnerable road users.
Enjoyment of Sexuality and Longevity in Late Midlife and Older Adults: The Longitudinal Ageing Study Amsterdam
Authors: Beerepoot Shanice , Luesken Suzanne W. M. , Huisman Martijn , Deeg Dorly J. H.
Published: March 2022

Sexual well-being refers to the evaluation of one’s sexuality. We examined the association of enjoyment of sexuality with longevity and the moderating role of perceived importance of sexuality in this association. In the population-based Longitudinal Ageing Study Amsterdam, the survival of initially 55–84-year-olds was followed during 27 years. Complete data were available for 1042 participants (45.3%). Analyses were adjusted for health-related and psychosocial covariates. 60% of the participants experienced their sexuality as enjoyable and 44% as important. Enjoyment of sexuality was weakly, positively associated with longevity (B[CI] = 0.29[-0.004;0.58]). Perceived importance modified this association: only in those who perceived sexuality as important, the association between enjoyment and longevity was statistically significant (B[CI] = 0.78[0.29;1.27]). Positive affect, functional limitations, emotional loneliness, self-rated health, sense of mastery and alcohol consumption accounted for 35% of the latter association. Interventions may target older adults who perceive sexuality as important but not enjoyable.
Clinicoradiologic Correlation in 22 Egyptian Children With Megalencephalic Leukoencephalopathy With Subcortical Cysts
Authors: Sadek Abdelrahim A. , Aladawy Mohammed A. , Mansour Tarek M. M. , Ibrahim Mohamed F. , Mohamed Montaser M. , Gad Eman F. , Othman Amr A. , Ahmed Hosny A. , Kasim Abdin K. , Wagdy Wael M. , Hasan Mohamed H. T. , Abdelkreem Elsayed
Published: March 2022

Megalencephalic leukoencephalopathy with subcortical cysts (MLC) is a rare genetic form of cerebral white matter disease whose clinicoradiologic correlation has not been completely understood. In this study, we investigated the association between clinical and brain magnetic resonance imaging (MRI) features in 22 Egyptian children (median age 7 years) with MLC. Gross motor function was assessed using the Gross Motor Function Classification System, and evaluation of brain MRI followed a consistent scoring system. Each parameter of extensive cerebral white matter T2 hyperintensity, moderate-to-severe wide ventricle/enlarged subarachnoid space, and greater than 2 temporal subcortical cysts was significantly associated ( P < .05) with worse Gross Motor Function Classification System score, language abnormality, and ataxia. Having >2 parietal subcortical cysts was significantly related to a worse Gross Motor Function Classification System score ( P = .04). The current study indicates that patients with MLC manifest signification association between certain brain MRI abnormalities and neurologic features, but this should be confirmed in larger studies.
Predictors of Discordance and Concordance in Reporting of Intimate Partner Violence: Evidence From a Large Sample of Rural Ethiopian Couples
Authors: Leight Jessica , Deyessa Negussie , Sharma Vandana
Published: March 2022

Intimate partner violence (IPV) is a major worldwide health challenge, and addressing this challenge requires high-quality data. This analysis uses a large-scale survey of 5033 households in rural Ethiopia in which both men and women were surveyed about past-year IPV in order to quantify the degree of discordance, including both husband only reporting and wife only reporting, for multiple forms of IPV (emotional, physical, and sexual). In addition, logistic regression is employed to analyze the effects of demographic characteristics and individual norms and behaviors on the probability of discordant reporting. The results suggest that almost half of households (44%) are characterized by discordant reporting in at least one dimension of IPV. Given the high level of discordance, 61.4% of households report any physical and/or sexual IPV using the household-level measure, compared to a rate of 41.9% from the women’s data only. In addition, men who report more gender-equitable attitudes and behaviors (failing to concur with justifications for IPV, reporting higher support for gender equitable norms, and reporting a higher level of female engagement in decision-making and intrahousehold task-sharing) are more likely to be members of wife only reporting households: that is, they are less likely to report perpetration of IPV. Women who report more gender-equitable attitudes and behaviors, by contrast, are more likely to be members of husband only reporting households.
Does Alcohol Consumption Influence People’s Perceptions of Their Own and a Drinking Partner’s Ability to Consent to Sexual Behavior in a Non-sexualized Drinking Context?
Authors: Jozkowski Kristen N. , Marcantonio Tiffany , Malachi Willis  , Drouin Michelle
Published: March 2022

The purpose of this study was to examine the extent that alcohol consumption affected participants’ perceptions of their own and their friend’s ability to consent to sex in a non-bar drinking environment. We interviewed 176 people at tailgates in dyads about their own and their friends’ alcohol consumption, intoxication symptoms, and ability to consent. Participants reported consuming a mean of 4.6 drinks and had a breath alcohol concentration (BrAC) of .075 on average, but few thought they or their friend had diminished cognitive function. Accordingly, 92.6% indicated they could consent to sex and 81.8% indicated their friend could consent to sex. Number of drinks people reported consuming, self-reported intoxication levels and symptoms, and BrACs were not significantly related to participants’ perceptions of their own or their friends’ ability to consent to sex. However, gender pairing of the dyad was significant; those in man–man pairs were more likely than those in woman–woman pairs to indicate their friend could consent and they would allow their friend to have sex if approached by an interested party. Participants also indicated that they did not perceive themselves or their friends to be “too intoxicated” as common reasons why they believed they and their friend could consent. Because alcohol-facilitated sexual assault is common among college students, we recommend sexual assault prevention educators focus on raising awareness regarding alcohol’s negative cognitive effects, particularly related to consent communication.
Assessment of a Fruit and Vegetable Prescription Program in the Northern Manhattan Community
Authors: Abel Dori , Drucker Gabriela , Leander Rose , Huber Cheryl , Nieto Andres , Hulse Emma , Kannan Nandini , Rausch John C.
Published: March 2022

Purpose

This study aimed to assess whether produce prescription redemption was associated with food insecurity (FI), sociodemographics, and nutrition-related health measures, and to identify factors affecting participation.

Design

Retrospective, cross-sectional study. Patients, equally divided between groups who redeemed and did not redeem prescriptions, completed a follow-up survey.

Setting

Northern Manhattan, NY.

Subjects

242 patients referred to Nutrition at an academic medical center between June and November 2019.

Intervention

All patients referred to Nutrition received prescriptions for produce at local Greenmarkets (patients with FI received $20; other patients received $10).

Measures

We assessed patient satisfaction and factors impacting participation. Sociodemographics and nutrition-related health measures were extracted from medical records.

Analysis

The χ 2 test for categorical data and Student’s t-test for continuous variables.

Results

Prescription redeemers were significantly more likely to be very satisfied with the program ( P < .001), have FI ( P < .01), and have elevated hemoglobin A1C than non-redeemers (6.3 vs 5.5%, P < .001). Distance, time constraints, and forgetting or losing the prescription were common barriers, while convenience and valuing healthy eating facilitated redemption.

Conclusion

Higher FI and worse hemoglobin A1c in patients who redeemed prescriptions suggests that our program reaches the target audience: patients needing food assistance and a healthier diet. Awareness of barriers offers areas for improvement. This provides a feasible model for hospital investment to increase access to produce to improve health and health equity.
The Influence of Loneliness on the Smoking and Physical Activity of Community-Dwelling Older Adults: Results from the Health and Retirement Study
Authors: Yang Jie , Yockey R Andrew , Chu Yoosun , Lee Joseph G. L.
Published: March 2022

Purpose

To use the loneliness model in examining the influence of loneliness on the number cigarettes smoked per day and the different intensity levels of physical activity among community-dwelling older Americans in the United States.

Design, setting, sample

This study analyzed a nationally representative sample of older adults aged 65+ in two waves (2010 and 2012) of data from the Health and Retirement Study. Response rates for the two waves were 81% and 89.1%. The sample size for smoking model was 199, and for physical activity models was 3018.

Measures

Outcomes included number of cigarettes smoked per day and physical activity at three intensity levels: light, moderate, and vigorous. Independent variable was the UCLA loneliness scale.

Analysis

A lagged dependent approach for modeling longitudinal data was adopted. Models controlled for outcomes at the first timepoint (Wave 1), health/physical functioning, and demographic variables.

Results

Loneliness was associated with an increased number of cigarettes smoked per day (β = 2.93, P < .05) and decreased engagement in moderate and vigorous physical activity for older adults (β = .12, P < .05; β = .12, P <. 05), after controlling for these behaviors at baseline and other covariates.

Conclusion

The findings call for smoking reduction and physical activity enhancement interventions targeting older adults who have high levels of loneliness. Efforts to enhance social support will be crucial to eradicating the harmful health impact of loneliness. Critical limitations include self-reported measures and unobserved confounders.
Segregation, Diversity, and Pathology: School Quality and Student Demographics in Gentrifying New York
Authors: Freidus Alexandra
Published: March 2022

Discussions of school integration often contrast the perceived deficits of segregated schools with the perceived strengths of schools with diverse student bodies. In this study, I examine the relationships that school community members infer between student demographics and school quality in diversifying areas of New York City. I use portraits of three New Yorkers to examine the ways that school community members reluctantly re-inscribe the stigma associated with segregated schools, assuming that the best way to improve a school is to increase its diversity. These braided discourses of pathology and diversity call into question the extent to which advocacy for integration advances the goals of educational justice.
The Space Beyond Equity: A Blueprint of Radical Possibilities in School Design
Authors: Syeed Esa
Published: March 2022

School facilities are increasingly seen as essential to achieving educational equity. By foregrounding often taken-for-granted school spaces, this conceptual article seeks to situate school design within broader antiracist efforts in education. To that end, I make a few critical contributions: (a) I shift attention to the social construction and contestation of school spaces; and (b) I develop a framework for dealing with racialized imaginaries of school spaces that goes beyond conventional equity applications. Applying this framework to school design literature and planning documents, I derive a blueprint to examine minoritized school spaces that encompasses aspects of culture, wellbeing, and power.
Parenteral Nutrition Total Energy Dosing and Risk for Central Line–Associated Bloodstream Infection: A Case-Control Study
Authors: Rosen Abbie N. , Ross Robert C. , Tran Kenneth K. , Franck Andrew J.
Published: March 2022

Background: Central line–associated bloodstream infection (CLABSI) is a complication of central venous access devices used for parenteral nutrition (PN). PN overfeeding is associated with increased adverse effects; however, whether risk for CLABSI is influenced by PN dosing is uncertain. Objective: The purpose of the study was to assess differences in CLABSI risk associated with recommended total energy dosing in hospitalized adult patients receiving PN. Methods: A case-control study was conducted in a single United States Veterans Health Administration health system to assess the potential CLABSI risk factor of weight-based PN kilocalorie dosing. Hospitalized adult patients who developed CLABSI while receiving PN were identified and compared to a control group of patients who did not develop CLABSI. The exposures evaluated were overfeeding, defined as greater than 30 kcal/kg/day, and underfeeding, defined as less than 20 kcal/kg/day. Results: Twenty-nine cases of CLABSI were identified and compared with 274 controls. Odds of CLABSI were significantly higher in patients receiving greater than 30 kcal/kg/day (OR, 3.63; 95% CI, 1.55-8.48; P < .01). No significant difference in odds was found for patients receiving less than 20 kcal/kg/day (OR, .74; 95% CI, 0.21-2.57; P = .63). Conclusion: Increased risk for CLABSI in hospitalized adult patients receiving PN was found to be associated with overfeeding, but not underfeeding. These results may aid clinicians in the management of patients requiring PN and in the generation of hypothesis for future investigations.
North Carolina Pharmacists’ Support for Hormonal Contraception Prescription Status Change
Authors: Parry Rachel A. , Seamon Gwen , Scott Mollie Ashe , Tak Casey R.
Published: March 2022

Background

Pharmacist-prescribed hormonal contraception (HC) may offer additional avenues of access for patients; however, it is unknown whether pharmacists would support over-the-counter access to contraception over pharmacist-prescribed models. Objective: The objective of this study was to understand how North Carolina (NC) pharmacists believed HC should be classified and how pharmacist and pharmacy characteristics were associated with those beliefs. Methods: This study was a secondary analysis of a cross-sectional, anonymous, online survey completed by 587 licensed NC pharmacists. The primary outcome of interest was how pharmacists believed HC should be classified: prescription-only, pharmacist-prescribed, behind-the-counter, or over-the-counter. Multinomial bivariate and multivariable regression analyses were conducted to describe the association between pharmacist and pharmacy characteristics with the outcomes of interest through odds ratios and adjusted odds ratios, respectively. Chi-square tests were used to examine the association of geographic location with distribution of attitudes toward HC classification. Results: Fifty-one percent of NC pharmacists supported classification of HC as pharmacist-prescribed, while 23% supported non-prescription (behind- or over-the-counter) classification. Controlling for pharmacist demographics and pharmacy characteristics, completing residency training was significantly associated with supporting pharmacist-prescribed vs prescription-only classification (adjusted odds ratio (aOR) = 2.55, P = .02). Pharmacists had higher odds of supporting pharmacist-prescribed vs prescription-only HC if they agreed that they were well trained to do so (aOR = 3.14, P < .01). Distribution of attitudes about classification of HC did not significantly differ by geographic location (P = .14). Conclusions: Most NC pharmacists support deviating from the current prescription-only classification of HC, with more support for pharmacist-prescribed classification. Continuing education programs should focus on training pharmacists to feel more confident prescribing HC.
Research on the dual-channel electro-impulse de-icing system of aircrafts
Authors: Wang Yusong , Guo Tao , Li Kai , Zhu Chunling , Du Qian
Published: March 2022

The electro-impulse de-icing system (EIDI) is a mechanical de-icing system that guarantees the safe flight of the aircraft under icing weather conditions. It owns many merits such as high reliability and low energy consumption. To solve the problem of the small de-icing area under single-channel, a dual-channel EIDI system model is proposed. The electro-magnetic field and de-icing results of the dual-channel EIDI system are investigated. Comparisons of de-icing results between simulations and experiments on the flat aluminum plate are also made. Furthermore, the de-icing research is carried out with a real wing structure by varying the excitation time and magnitude of impulse load. Simulation results of the electro-magnetic field show that the maximum of the density of electro-magnetic force always appears at the midpoint of the inner and outer radius of coils. The excitation of the two coils is independent and can be decoupled. The de-icing results illustrate that the de-icing rate increases with the striking intervals and impulse load. The load multiple (LM) should be selected between 1.5 and 3 for the dual-channel EIDI system for energy optimization. In addition, it is advisable to distribute the impulse loads with the largest possible difference on both sides when the LM is 1–3.
Pearls for the diagnosis and possible pathophysiological mechanisms of valproic acid-induced lupus erythematosus: A literature review
Authors: Papadopoulou Efthymia , Saroglou Maria , Ismailos Georgios , Fletsios Demosthenes , Tsavlis Drosos , Tryfon Stavros
Published: March 2022

Background: Drug-induced lupus erythematosus (DILE) accounts for 10-15% of systemic lupus erythematosus (SLE) cases, with more than 100 pharmaceutical agents implicated in its development. Depending on the offending drug, clinical and serological manifestations present great variability and, thus, DILE may be overlooked in clinical practice. Valproic acid (VPA) – induced lupus erythematosus has not been analytically reported in the literature, rendering the recognition of such cases even more difficult.

Objective: The aim of this study was to analyze VPA – induced lupus features and to discuss possible pathophysiological mechanisms.

Materials and Methods: This literature review was conducted in PubMed and Embase databases in June 2021, in search of DILE cases induced by VPA. We found 164 manuscripts, out of which 140 articles regarding other adverse effects or drugs were discarded. Finally, 15 cases fulfilled the eligibility criteria to be included in this review.

Results: Although SLE is more common in females, VPA-induced lupus presented a male predilection. Patients developed DILE within the first three months of treatment with VPA at a percentage of 50%, whereas four patients from one to five years after VPA initiation. DILE frequently presented with mild symptoms. In most patients, serositis manifested with polyarthritis, pleural effusion or pericarditis. Notably, one patient presented with Rowell's syndrome, a rare subtype of lupus erythematosus with erythema multiforme and speckled pattern of antinuclear antibodies (ANAs). Central nervous system, renal and skin involvement was scarcely observed. Cytopenia was noted in 7 patients. Immunological findings included positive ANAs in the vast majority of the patients (86.7%), positive anti-histone antibodies in five, positive anti-dsDNA antibodies in three and hypocomplementemia in two patients. Despite the prompt resolution of clinical symptoms after VPA discontinuation, serological abnormalities persisted up to 18 months. Apart from the discontinuation of VPA administration for the resolution of DILE, treatment included corticosteroids in 8 cases.

Conclusion: Valproic acid has been implicated in several cases of DILE. Clinicians should be aware of this entity and recognize it promptly to ensure a favorable outcome. Possible pathophysiologic associations may be extrapolated, but a clearer understanding of this syndrome is to be gained by further studies.
Efficacy and safety of belimumab therapy in systemic lupus erythematosus: A systematic review and meta-analysis
Authors: Chiang Hsin-Yu , Guo Zi-An , Wu Ta-Wei , Peng Tzu-Rong
Published: March 2022

Background

Belimumab is the first biological agent approved for the treatment of systemic lupus erythematosus (SLE). The efficacy and safety of belimumab for SLE patients are not clear. Therefore, this meta-analysis is integrating the efficacy and safety of belimumab for patients with SLE.

Methods

PubMed, EMBASE, and Cochrane Library were searched for randomized clinical trials (RCTs) that studied the efficacy and safety of belimumab plus standard therapy before November 1, 2021. Data were pooled using the random-effects model and are expressed as risk ratios (RRs) or mean difference (MD) and corresponding 95% confidence intervals (CIs). Heterogeneity was assessed and quantified using I2.

Results

Seven RCTs with 3,009 participants were included in this meta-analysis. Belimumab showed significantly decreased at least a 4-point improvement in Safety of Estrogen in Lupus National Assessment (SELENA)-Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score than placebo (RR, 1.32; 95% CI, 1.21–1.44; p < 0.001). However, belimumab significantly reduced the prednisone dose by 50% or more than placebo (RR, 1.59; 95% CI, 1.17–2.15; p = 0.003) and belimumab significantly increased the 36 Physical Component Summary (PCS) score (MD, 1.60; 95% CI, 0.30–2.90; p = 0.02). Regarding adverse events, there was no significant difference between the belimumab group and the control group.

Conclusion

The results suggest that belimumab plus standard therapy is more effective than placebo plus standard therapy in SLE patients.
Induction of Human Umbilical Mesenchymal Stem Cell Differentiation Into Retinal Pigment Epithelial Cells Using a Transwell-Based Co-culture System
Authors: Chang Yu-Hsun , Kumar V. Bharath , Wen Yao-Tseng , Huang Chih-Yang , Tsai Rong-Kung , Ding Dah-Ching
Published: March 2022

There is an increasing interest in generating retinal pigment epithelial (RPE) cells from stem cells for treating degenerative eye diseases. However, whether human umbilical cord mesenchymal stem cells (HUCMSCs) can differentiate into RPE-like cells in a co-culture system has not been fully understood. In this study, induction of HUCMSC differentiation into RPE-like cells was performed by co-culturing HUCMSCs and a human RPE-like cell line (ARPE19) in a transwell system and then analyzed for biomarkers using quantitative reverse transcription polymerase chain reaction (RT-PCR) and immunofluorescence staining technique. Moreover, the functional characterization of induced cells was carried out by examining their phagocytic and neurotrophic factor–secreting activities. Our results showed that mRNA expressions of RPE-specific markers—MITF, OTX2, RPE65, PEDF, PME17, and CRALBP—and protein markers—RPE65, CRALBP, and ZO-1—were significantly increased in HUCMSC-derived RPE-like cells. Functional characteristic studies showed that these induced cells were capable of engulfing photoreceptor outer segments and secreting brain-derived neurotrophic factor (BDNF) and glial-derived neurotrophic factor (GDNF), which are typical functions of RPE-like cells. Overall, the study findings indicate that the morphology and proliferation of HUCMSCs can be maintained in a serum-free medium, and differentiation into RPE-like cells can be induced by simply co-culturing HUCMSCs with ARPE19 cells. Thus, the study provides fundamental information regarding the clinical-scale generation of RPE-like cells from HUCMSCs.
Building Growth Areas in Asia for Development and Peace
Authors: Haas Michael
Published: March 2022

A new type of international cooperation has arisen in Asia—economic cooperation between provinces of adjacent countries. While the principal motivation is joint economic development, the peace dividend involves cooperation among the people across borders to establish and strength ties of friendship. Although much funding comes from private investment, the Asian Development Bank (ADB) has been instrumental in identifying many of the most feasible projects. This article identifies one proposed growth triangle, a few that are dormant, and some currently are in operation, providing their historical origins, organizational components, funding, and success in conducting operational projects or promoting peaceful relations among members. To determine which projects have been more successful, variables are identified from the viable projects, testing whether criteria from the rational choice paradigm give a better explanation of success than the community-building paradigm. Results indicate that the two paradigms explain quite different aspects of success. Consistent with the rational choice paradigm, success is more likely when ‘growth area’ organizations have more funding and support from the ADB. As predicted by the community building paradigm, successful ‘growth area’ organizations have support from the leaders of their respective countries and are composed of countries with rough equality in national income. One variable—whether countries involved are democracies—has little impact on either economic development or peace dividend success.
The Role of Olfactory System in the Etiogenesis of Parkinson’s Diseases: An Overview
Authors: Avanipully Jiju Narayanan , Thekkekkara Dithu , M Sahyadri , Parihar Vipan K. , Manjula Santhepete Nanjundaiah
Published: March 2022

Parkinson’s disease (PD) mainly affects the dopaminergic neuronal networks of the substantia nigra, which leads to both motor and nonmotor symptoms of the disease. Based on the reports from the previous studies, 95% of the cases are presented along with olfactory dysfunction. The relevant publications from 2002 to 2021 were searched and shortlisted using PubMed and Google Scholar. In this review, we have discussed the correlation between olfactory dysfunction and PD. Olfactory damage presents earlier than the motor symptoms. Because there are no current methodologies for the early detection of PD, olfactory dysfunction can be used as a potential marker for the early detection of PD and hence paving the way for better therapeutic approaches.
Exposure to Azathioprine Metabolites and Clinical Outcome in Indian Patients with Crohn’s Disease
Authors: Prabha Ratna , Mathew Sumith K. , Joseph A. J. , Mathew Binu Susan
Published: March 2022

Aim:

To determine the concentration of 6-thioguanine nucleotide (6-TGN) and 6-methylmercaptopurine (6-MMP), the interpatient variability, and the relationship with disease activity in patients with Chron’s disease on long-term stable doses of azathioprine (AZA).

Methods:

This is a prospective, tertiary care single-center hospital study in adult Chron’s disease patients treated with AZA. The quantification of phenotypic thiopurine methyltransferase enzyme activity in red blood cells and the estimation of the concentration of 6-TGN and 6-MMP in whole blood was performed using the HPLC-UV detector method. A clinical response was categorized as remission (Harvey-Bradshaw Index [HBI] < 5) or improvement (drop from baseline of at least three points of HBI) based on HBI. Exposure to metabolite concentrations and the clinical response to AZA treatment was observed.

Results:

Study analysis included 30 patients who were initiated on AZA, and they were followed up with an estimation of metabolite concentrations to determine their clinical outcome. At six months, 93% of ( n = 28) patients continued to be on AZA and had clinical improvement. All the patients achieved remission of Chron’s disease. Only two patients developed adverse effects such as joint pain and thrombocytopenia.

Conclusion:

AZA is a safe and effective therapy in managing Chron’s disease when administered after determining thiopurine methyltransferase phenotype and with dose optimization performed using therapeutic drug monitoring of 6-TGN and 6-MMP.
Model Policies to Protect U.S. Fire-Based EMS Responders From Workplace Stress and Violence
Authors: Taylor Jennifer A. , Murray Regan M. , Davis Andrea L. , Brandt-Rauf Sherry , Allen Joseph A. , Borse Robert , Pellechia Diane , Picone David
Published: March 2022

The stress and violence to fire-based emergency medical service responders (SAVER) Systems-Level Checklist is an organizational-level intervention to address stress and violence in emergency medical service (EMS), focused on the development of policy and training. Fire and EMS leadership, first responders, dispatchers, and labor union representatives participated in the SAVER Model Policy Collaborative to develop model policies that resulted from the most feasible checklist items. ThinkLets technology was employed to achieve consensus on the model policies, and an Action SWOT analysis was then conducted to assess facilitators and barriers to policy implementation. The resultant model policies are a systems-level workplace violence intervention for the U.S. fire and rescue service that is ready for implementation. Expected improvements to organizational outcomes such as burnout, job engagement, and job satisfaction are anticipated, as are decreasing assaults and injuries. The SAVER Model Policies have the potential to inform national standards and regulations on workplace violence in EMS.
“The Drug Use Unfortunately isn’t all Bad”: Chronic Disease Self-Management Complexity and Strategy Among Marginalized People Who Use Drugs
Authors: Boucher Lisa M. , Shoemaker Esther S. , Liddy Clare E. , Leonard Lynne , MacPherson Paul A. , Presseau Justin , Martin Alana , Pineau Dave , Lalonde Christine , Diliso Nic , Lafleche Terry , Fitzgerald Michael , Kendall Claire E.
Published: March 2022

Self-management programs improve health outcomes and self-management is recommended for chronic conditions. Yet chronic disease self-management supports have rarely been applied to people who use drugs (PWUD). Thus, our objective was to explore self-management experiences among marginalized PWUD. We used community-based participatory methods and conducted qualitative interviews. Participants self-identified as having long-term and past year experience using non-prescribed drugs, one other chronic condition, and socioeconomic marginalization. We analyzed the data using reflexive thematic analysis. Although many participants considered drug use a chronic health issue, self-medicating with non-prescribed drugs was also a key self-management strategy to address other health issues. Participants also described numerous other strategies, including cognitive and behavioral tactics. These findings highlight the need for a safe supply of pharmaceutical-grade drugs to support self-management among marginalized PWUD. Self-management supports should also be tailored to address relevant topics (e.g., harm reduction, withdrawal), include creative activities, and not hinder PWUD’s agency.
Progression of COVID-19 Among Black Pregnant Women: Population-Based Study
Authors: dos Santos Gustavo Gonçalves , de Andrade Luis Henrique , de Sordi Mônica Aparecida de Paula , Nunes Hélio Rubens de Carvalho , Parada Cristina Maria Garcia de Lima
Published: March 2022

The aim of this study was to evaluate the evolution of COVID-19 related to race/skin color among Brazilian pregnant women registered on the Sistema de Informação de Vigilância da Gripe (SIVEP Gripe). This is a population-based study, based on the data from SIVEP Gripe, with data collected at two time points, August 2020 and February 2021. From the complete database (575,935 cases on August 8, 2020 and 1,048,576 cases on January 2, 2021), the weeks 13 to 32 (563,851 cases) and 33 to 53 (469,241 cases) were selected. We selected cases of pregnant women with white, brown and black skin color and final evolution (1,884 and 1,286 cases). The final sample (939 and 858 cases) was defined by including participants who had all the targeted information recorded. The outcome variables were hospitalization, Intensive Care Unit (ICU) admission and COVID-19 deaths. The present study identified that there was a drop of approximately two-thirds in the proportion of pregnant women who required ICU care or died, when comparing the first and second periods. In the second period, black pregnant women had approximately five times higher risk of death compared to white and brown women.
Parental Factors That Confer Risk and Resilience for Remote Learning Outcomes During the COVID-19 Pandemic Among Children With and Without Attention-Deficit/Hyperactivity Disorder
Authors: Silverman Melanie R. , Stadterman Jill , Lorenzi Danny , Feuerstahler Leah , Hirsch Emily , Roy Amy K.
Published: March 2022

Objective:

To test whether parental factors including internalizing symptoms, parenting style, and confidence in assisting with remote learning conferred risk/resilience for children with/without ADHD’s learning and emotional outcomes during the COVID-19 pandemic.

Method:

291 parents of children (ages 6–13; n = 180 males) with ( n = 148) and without ADHD completed questionnaires online (April–July 2020).

Results:

Structural equation modeling identified parental risk/resilience factors. Across groups, risk predicted greater difficulties with learning, internalizing and externalizing symptoms, while parent confidence in educating their child predicted better outcomes. A positive association was observed between parental involvement and child difficulties, which was stronger in families of children with ADHD. Children with/without ADHD did not differ in remote learning difficulties.

Conclusion:

Parent factors impacted child emotional and learning outcomes during the pandemic. With increases in remote learning practices, there is a need for improved understanding of how parent factors impact outcomes of children with/without ADHD.
Live surgery outcomes in cataract surgery
Authors: Puzo Pasquale , D’Oria Francesco , Imburgia Aurelio , Incandela Cosimo , Sborgia Alessandra , Marchegiani Eleonora B , Rania Laura , Mularoni Alessandro , Alessio Giovanni
Published: March 2022

Purpose

To evaluate and compare the outcomes of live surgery (LS) and no-live surgery (NLS) on cataract surgery with implantation of different types of intraocular lenses (IOLs).

Methods

Retrospective, contralateral eye, case series of patients that underwent cataract surgery in live or non-live view during two consecutive editions of national meetings. Both eyes of the same patients were implanted with the same IOL, one in LS and the other in NLS.

Results

108 eyes of 54 patients, aged between 50 and 82 (72 ± 8.2) and implanted with different types of IOLs, were reviewed. Both eyes in each patient were well matched at baseline in terms of intraocular biometric characteristics, corneal curvature and endothelial cell density (ECD) (p > 0.05). There are no statistically significant differences between the biometric and topographic parameters, aberrometric data and the loss of ECD in the post-operative outcomes (p > 0.05). However, comparing the different types of IOLs, there is a significant loss of ECD in eyes implanted with a toric IOL during LS (p = 0.0014 and p = 0.04, in 2017 and 2018 edition respectively).

Conclusions

In this series of live cataract surgery, eyes operated in LS or NLS have comparable outcomes, underlying the importance and the benefits of live view in terms of medical education and the low-risk of complications. Nevertheless, we have found a significant increase in ECD loss in patients implanted with toric IOLs during LS.
Nutrient Recovery From Organic-Rich Wastewater Through Struvite Precipitation using Air Cathode Electrocoagulation Technology
Authors: Effendi Agus Jatnika , Baashen Mellyana Said , Hidayat Syarif
Published: March 2022

This study developed an innovative method for phosphate recovery contained in wastewater using air cathode electrocoagulation (ACEC) technology. This technique has the advantage of low energy consumption since it can effectively produce the struvite precipitate without any electrical-grid energy consumption. The experiments were conducted under recirculating batch mode by varying the recirculation rate and initial pH of wastewater to investigate their effects on the ACEC reactor performance. SEM-EDS and XRD analyses were performed to examine the morphology and structure of the produced crystals. The result showed that the precipitates exhibited in the form of crystals with irregularly shaped accompanied by a sharp at the surface and composed of Mg (6.67%), P (6.78%), N (1.66%), and O (47.41%). XRD chromatogram showed that the precipitate matched the reference pattern for struvite. The recirculation rate of 2.0 mL min−1 was determined as an optimum condition with nitrogen and phosphate removal, nitrogen and phosphate removal rate, and struvite precipitation rate was 14.7% ± 1.2%, 57.1% ± 1.1%, 22.9 ± 0.9 mg L−1 h−1, 18.6 ± 0.9 mg L−1 h−1, and 498 mg h−1, respectively. The recirculation rate affects the reactor performance through the magnitude of the hydraulic retention time of nutrients on the reactor and the potential electrical energy generated in the reactor. On the other hand, the reactor with initial pH 8 achieved the best performance with the nitrogen and phosphate removal of 24.6% ± 1.6% to 88.4% ± 3.8%, nitrogen and phosphate removal rate of 24.2 ± 2.1 mg L−1 h−1 and 35.3 ± 2.1 mg L−1 h−1, respectively, and the struvite precipitation rate of 900 mg h−1. Furthermore, when the initial pH of wastewater increased from 7 to 8, the struvite precipitation rate increased from 499 to 900 mg−1. However, increasing the initial pH of wastewater from 8 to 9 caused a decrease in struvite precipitation rate from 900 to 656 mg h−1. These results demonstrated that the recirculation rate and initial pH of wastewater control the process of the struvite precipitation process in ACEC technology.
Factors Influencing Frequency of Pediatric Clinically Distinguishable Influenza: A 2 Season Case-Control Study
Authors: Salazar Ryan A. , Field Scott S.
Published: March 2022

Background:

Little is known about the individual differences in susceptibility to, or lifetime frequency of clinically distinguishable influenza in children.

Methods:

Rapid enzyme linked immunoassay-confirmed influenza pediatric cases (n = 96) in season 1 (2017-2018) were compared to age-matched (mean 7.7 years) controls (n = 171) with no evidence of influenza in season 1. The 2 cohorts were again studied in season 2 (2018-2019) for influenza outcomes and influences. Medical records, questionnaires, and interviews were used to determine past influenza disease and vaccine histories.

Results:

After season 2, known lifetime influenza illnesses per year of age averaged 22.6% in cases and 5.6% in controls, with 62% of controls still having never experienced known influenza. Having had prior influenza was marginally significant as a risk for season 1 influenza in cases versus controls ( P = .055), yet a significant risk factor in controls for season 2 ( P = .018). Influenza vaccine rates were significantly higher in controls than in cases for season 1, with a greater female vaccine benefit. Lack of previous influenza had greater calculated effectiveness (52%) than vaccination (17%-26%) in escaping season 2 influenza. Lifetime rates of vaccination did not correlate with lifetime rates of known influenza in either cohort.

Conclusions:

Lifetime clinically distinguishable influenza rates varied among children, with many escaping it for years even without being immunized against it. Findings of less than expected clinical influenza, no correlation between vaccination frequency and disease frequency, sex differences, and an association between past clinical influenza and current risk, point to innate differences in individual influenza experiences.