bluuebunny/crossref_metadata_2025 huggingface dataset:
Essential newborn care practice and associated factors among obstetric care providers of public hospitals in Sidama regional state, Ethiopia
Authors: Gonfa Dejene Negesse , Dadhi Aberash Eifa , Kassa Andargachew , Bekele Gemechu Gelan , Yami Amare Tesfaye , Moti Berhane Ejara , Bededa Worku Ketema
Published: March 2022

Introduction:

The global neonatal death rate was predicted to be 18 per 1000 live births during the first 28 days of life. Ethiopia continues to have one of the highest neonatal mortality rates in the world. Essentially, over 70% of these deaths may have been averted or prevented if proper essential newborn care had been provided. The purpose of this study was to assess the practice of essential newborn care and associated factors among obstetric care providers in public hospitals in Sidama regional state, Ethiopia.

Methods:

This study was conducted from 1 to 30 July 2020, using an institutionally based cross-sectional study design. The study comprised 182 obstetric care professionals from six hospitals chosen at random. EpiData (version 3.1) was used to enter data, which was then exported to SPSS (version 20). Descriptive, bivariable, and multivariable logistic regression were used. Statistical significance of the explanatory variables was declared at p values <0.05.

Results:

The overall prevalence of good practice on essential newborn care was 56.6% (95% confidence interval = 49.4–63.7). Working in the delivery room (adjusted odds ratio = 3.53, 95% confidence interval = 2.04–10.06), having training in essential newborn care (adjusted odds ratio = 3.65, 95% confidence interval = 1.63–8.17), and access to established essential newborn care protocols (adjusted odds ratio = 6.88, 95% confidence interval = 3.10–15.26) were found to be statistically significant factors of essential newborn care practice.

Conclusion:

The study found that having necessary newborn care standards, being interested in working in the delivery room, and having essential newborn care training are all important factors in implementing essential newborn care practices. Important knowledge gaps were noted in key areas of essential newborn care.
Phenotypic differentiation and diversifying selection in populations of Eruca sativa along an aridity gradient
Authors: Bajpai Prabodh Kumar , Weiss Harel , Dvir Gony , Hanin Nir , Wasserstrom Haggai , Barazani Oz
Published: March 2022

Background

The aridity gradient in the eastern Mediterranean offers an opportunity to investigate intra-specific genetic differentiation and local adaptation in plant populations. Here we used genetic (FST) and quantitative trait (PST) differentiation to assess local adaptation among three natural populations of Eruca sativa (Brassicaceae) distributed along a climatic range representing desert, semi-arid and Mediterranean habitats.

Results

Amplified fragment length polymorphism (AFLP) analysis revealed high genetic diversity in each population, but low genetic differentiation between populations and relatively high gene flow. Further phenotypic evaluation in a common garden experiment (conduced in a Mediterranean habitat) showed clear differences in phenological traits among populations (day of flowering and duration of the reproductive stage), shoot and root biomass, as well as fitness-related traits (total number of fruits and total seed weight). FST–PST comparison showed that PST values of the phenological traits, as well as below- and above-ground biomass and fitness-related traits, were higher than the FST values.

Conclusions

Overall, our results support the identification of genotypic and phenotypic differentiation among populations of E. sativa. Furthermore, the FST–PST comparison supports the hypothesis that these were subjected to past diversifying selection. Thus, the results clearly demonstrate adaptive divergence among populations along an aridity gradient, emphasize the ecological value of early flowering time in arid habitats, and contribute to our understanding of the possible impact of climate change on evolutionary processes in plant populations.
Effect of phenyllactic acid on silage fermentation and bacterial community of reed canary grass on the Qinghai Tibetan Plateau
Authors: Lu Yongxiang , Li Ping , Bai Shiqie , Chen Shiyong , Zhao Man , Gou Wenlong , You Minghong , Cheng Qiming
Published: March 2022

Background

This study aimed to investigate the effect of phenyllactic acid as an additive on silage fermentation and bacterial community of reed canary grass (RCG, Phalaris arundinacea L.) on the Qinghai Tibetan Plateau. At the heading stage, RCG was harvested, chopped and ensiled in small bag silos. The silage was treated without (control, 1.0 g/mL sterile water, on a fresh matter basis (FM)) or with phenyllactic acid (PLA, 3 mg/mL, FM), antimicrobial additive (PSB, a mixture of potassium sorbate and sodium benzoate, 2%, FM), lactic acid bacteria inoculant (LABi, L. plantarum + L. curvatus, 1 × 106 cfu/g, FM) and PLA + LABi, and then stored in a dark room at the ambient temperature (5 ~ 15 °C) for 60 days.

Results

Compared with control, PLA decreased lactic acid, acetic acid and ammonia-N contents, and subsequently increased CP content of RCG silage. PLA enhanced the growth of lactic acid bacteria and reduced the count of yeasts (P < 0.05) in RCG silage, with reduced bacterial richness index (Chao1), observed operational taxonomic units and diversity index (Simpson). In relative to control, moreover, PLA and PLA + LABi increased the relative abundance of Lactococcus in RCG silage by 27.73 and 16.93%, respectively.

Conclusions

Therefore, phenyllactic acid at ensiling improved nutritional quality of RCG silage by advancing the disappearance of yeasts and the dominance of Lactococcus.
Effects of ‘Candidatus Liberibacter solanacearum’ haplotypes A and B on tomato gene expression and geotropism
Authors: Harrison Kyle , Levy Julien G. , Tamborindeguy Cecilia
Published: March 2022

Background

The tomato psyllid, Bactericera cockerelli Šulc (Hemiptera: Triozidae), is a pest of solanaceous crops such as tomato (Solanum lycopersicum L.) in the U.S. and vectors the disease-causing pathogen ‘Candidatus Liberibacter solanacearum’ (or Lso). Disease symptom severity is dependent on Lso haplotype: tomato plants infected with Lso haplotype B experience more severe symptoms and higher mortality compared to plants infected with Lso haplotype A. By characterizing the molecular differences in the tomato plant’s responses to Lso haplotypes, the key components of LsoB virulence can be identified and, thus, targeted for disease mitigation strategies.

Results

To characterize the tomato plant genes putatively involved in the differential immune responses to Lso haplotypes A and B, RNA was extracted from tomato ‘Moneymaker’ leaves 3 weeks after psyllid infestation. Gene expression levels were compared between uninfected tomato plants (i.e., controls and plants infested with Lso-free psyllids) and infected plants (i.e., plants infested with psyllids infected with either Lso haplotype A or Lso haplotype B). Furthermore, expression levels were compared between plants infected with Lso haplotype A and plants infected with Lso haplotype B. A whole transcriptome analysis identified 578 differentially expressed genes (DEGs) between uninfected and infected plants as well as 451 DEGs between LsoA- and LsoB-infected plants. These DEGs were primarily associated with plant defense against abiotic and biotic stressors, growth/development, plant primary metabolism, transport and signaling, and transcription/translation. These gene expression changes suggested that tomato plants traded off plant growth and homeostasis for improved defense against pathogens, especially when infected with LsoB. Consistent with these results, tomato plant growth experiments determined that LsoB-infected plants were significantly stunted and had impaired negative geotropism. However, it appeared that the defense responses mounted by tomatoes were insufficient for overcoming the disease symptoms and mortality caused by LsoB infection, while these defenses could compensate for LsoA infection.

Conclusion

The transcriptomic analysis and growth experiments demonstrated that Lso-infected tomato plants underwent gene expression changes related to abiotic and biotic stressors, impaired growth/development, impaired plant primary metabolism, impaired transport and signaling transduction, and impaired transcription/translation. Furthermore, the transcriptomic analysis also showed that LsoB-infected plants, relative to LsoA-infected, experienced more severe stunting, had improved responses to some stressors and impaired responses to others, had poorer transport and signaling transduction, and had impaired carbohydrate synthesis and photosynthesis.
Relationship of leisure-time and household physical activity level and type with cardiovascular disease: secondary analysis of the Takashima Study data
Authors: Iwase Hiroaki , Tanaka-Mizuno Sachiko , Takashima Naoyuki , Kadota Aya , Matsui Kenji , Nakamaura Yasuyuki , Miura Katsuyuki , Ueshima Hirotsugu , Kita Yoshikuni
Published: March 2022

Background

High levels of participation in leisure-time and household physical activity lower the risk of cardiovascular disease (CVD), although it is unclear whether the number of activity types is related to new-onset CVD. We aimed to evaluate the effect of the amount of leisure-time physical activity and the number of types of leisure-time physical activities on the risk of CVD incidence.

Methods

From 2002 to 2003, 3,741 participants without any history of CVD participated in the Takashima Study. Data on the amount of leisure-time and household physical activity and the types of leisure-time and household physical activity were obtained from a self-administered questionnaire. Hazard ratios for CVD (acute myocardial infarction and stroke) incidence (follow-up data from 2002 to 2013), according to the participation level and number of activity types, were calculated using Cox proportional hazards models.

Results

The mean age of the subjects was 58.7 ± 13.1 years. During the mean follow-up period of 8.0 ± 1.1 years, 92 participants developed CVD. An inverse dose–response relationship was noted between the amount of leisure-time and household physical activity and CVD events. After adjusting for baseline characteristics, lifestyle-related diseases, and the amount of physical activity other than leisure-time and household, the risk of CVD onset was compared by dividing the participants into two groups by the level of participation; the highest activity group had an adjusted hazard ratio (95% confidence interval) of 0.40 (0.20–0.82) compared to the lowest activity group. Compared to participants who engaged in 0–1 type of activity, participants who engaged in two or more types of activities had a multivariable-adjusted hazard ratio (95% confidence interval) of 0.31 (0.12–0.79).

Conclusion

Increasing the amount of leisure-time and household physical activity and promoting engagement in two or more types of such activities may reduce the rate of CVD incidence in the Japanese general population.
Violence against caregivers of older adults with chronic diseases is associated with caregiver burden and depression: a cross-sectional study
Authors: Pinyopornpanish Kanokporn , Wajatieng Winita , Niruttisai Niphaporn , Buawangpong Nida , Nantsupawat Nopakoon , Angkurawaranon Chaisiri , Jiraporncharoen Wichuda
Published: March 2022

Background

Caregivers play a vital role in caring for the aging population, however the occurrence of violence against the caregiver is an increasing area of concern. This study aimed to investigate the prevalence of violence against the primary caregivers of community dwelling older adults with chronic diseases, and to determine the factors associated with violence and its association with caregiver outcomes.

Methods

A cross-sectional study was conducted. HITS questionnaire, the 22-item Zarit Burden Interview and Patient Health Questionnaire-9 were used to assess violence against caregiver, caregiver burden and depression, respectively.

Results

Out of 123 caregivers of older adults, the overall prevalence of violence was 28.46%. Independent variables which could be the protective factors for violence against caregiver included higher ADL, older age of caregiver, and being a relative. The patient characteristic that is a potential risk factor for violence against caregiver was having cancer as a principal diagnosis. Statistically significant associations were found between violence and caregiver burden (aOR 4.94, p 0.004) and depression (aOR 7.03, p 0.006).

Conclusion

Violence against caregivers of older adults is not uncommon. Experiencing violence was found to be associated with caregiver outcomes including depression and caregiver burden. Therefore, this important issue must not be ignored.
Barriers to prescribing oral anticoagulants to inpatients aged 80 years and older with nonvalvular atrial fibrillation: a cross-sectional study
Authors: Xia Xin , Wang Lishuang , Lin Taiping , Yue Jirong , Yang Zhonghua , Mi Chongqing , Liao Zaibo , Chen Yanyu , Ge Ning , Wu Chenkai
Published: March 2022

Background

To investigate the temporal trend of the prevalence of underprescription of anticoagulation treatment and explore the factors associated with underprescription of oral anticoagulants (OACs) among inpatients aged ≥ 80 years with nonvalvular atrial fibrillation (NVAF).

Methods

We retrospectively reviewed the medical records of inpatients with a discharge diagnosis of NVAF from a medical database. We used the Pearson chi-square or Fisher’s exact test to compare categorical variables between patients with and without OAC prescriptions during hospitalization. Logistic regression analysis was used to assess the association between risk factors and underprescription of OACs.

Results

A total of 4375 patients aged ≥ 80 years with AF were assessed in the largest academic hospital in China from August 1, 2016, to July 31, 2020, and 3165 NVAF patients were included. The prevalence of underprescription of OACs was 79.1% in 2017, 71.3% in 2018, 64.4% in 2019, and 56.1% in 2020. Of all participants, 2138 (67.6%) were not prescribed OACs; 66.3% and 68.2% of patients with and without prior stroke did not receive OACs, respectively. Age (85–89 vs 80–84, OR = 1.48, 95% CI (1.25–1.74); 90 + vs 80–84, OR = 2.66, 95% CI: 2.09–3.42), clinical department where patients were discharged (Reference = Cardiology, Geriatrics: OR = 2.97, 95% CI: 2.45- 3.61; neurology: OR = 1.25, 95% CI: 0.96, 1.63; others: OR = 4.23, 95% CI: 3.43- 5.24), use of antiplatelets (OR = 1.69, 95% CI: 1.45- 1.97), and history of stroke (OR = 0.83, 95% CI: 0.71- 0.98 adjusted age), and dementia (OR = 2.16, 95% CI: 1.60- 2.96) were significantly associated with not prescribing OACs.

Conclusions

The prevalence of underprescription of OACs has decreased over the past several years. The rate of underprescription of OACs was higher among NVAF patients who were older, prescribed antiplatelets, discharged from nondepartmental cardiology, and suffered from comorbidities. This study found iatrogenic factors affecting the underprescription of OACs in inpatients aged ≥ 80 years, providing clues and a basis for the standardized use of OACs in inpatients.
Bevacizumab versus PARP-inhibitors in women with newly diagnosed ovarian cancer: a network meta-analysis
Authors: Suh Young Ju , Lee Banghyun , Kim Kidong , Jeong Yujin , Choi Hwa Yeon , Hwang Sung Ook , Kim Yong Beom
Published: March 2022

Background

In women with newly diagnosed ovarian cancer, bevacizumab and poly (ADP-ribose) polymerase inhibitors (PARPi) exhibit improved progression-free survival (PFS) when administered concurrent with chemotherapy and/or maintenance therapy, but no study has directly compared their effects. Therefore, this study aimed to compare the efficacy and safety of bevacizumab and PARPi in women with newly diagnosed ovarian cancer using a network meta-analysis.

Methods

PubMed, Medline, and Embase databases were searched, and five randomized trials assessing PFS in women with newly diagnosed ovarian cancer treated with either bevacizumab, PARPi, or placebo or no additional agent (controls) were identified. PFS was compared in the overall population with ovarian cancer, women with a BRCA1/2 mutation (BRCAm) and women with homologous-recombination deficiency (HRD). Adverse events (grade ≥ 3) were compared in all populations of the included studies.

Results

PARPi improved PFS significantly more than bevacizumab in women with a BRCAm (HR 0.47; 95% CI 0.36–0.60) and with HRD (HR 0.66; 95% CI 0.50–0.87). However, in the overall population with ovarian cancer, no significant difference in PFS was observed between women treated with PARPi and those treated with bevacizumab. PARPi exhibited the highest surface under the cumulative ranking probabilities value as the most effective treatment for PFS (PARPi vs. bevacizumab: 98% vs. 52% in the overall population with ovarian cancer; 100% vs. 50% in women with BRCAm; 100% vs. 50% in women with HRD). For adverse events, the risk of all treatments was similar. However, PARPi had a higher adverse risk than the control group (relative risk 2.14; 95% CI 1.40–3.26).

Conclusions

In women with newly diagnosed ovarian cancer, PARPi might be more effective in terms of PFS compared to bevacizumab. The risk of serious adverse events was similar for PARPi and bevacizumab.
Inadequate housing and pulmonary tuberculosis: a systematic review
Authors: Lee Ju-Yeun , Kwon Namhee , Goo Ga-yeon , Cho Sung-il
Published: March 2022

Background

Tuberculosis (TB) is a global health issue that has long threatened and continues to threaten human health. While previous studies are important in the search for a cure for TB, to eradicate the disease it is also crucial to analyze environmental influences. Therefore, this study determined the potential effect of inadequate housing on TB and the magnitude of the effect.

Methods

This is a systematic review of the effects of inadequate housing on TB. Between Jan 1, 2011 and Oct 25, 2020, we searched four electronic databases using the search terms “housing AND tuberculosis” or “housing AND TB”. The target population comprised residents of inadequate housing and the homeless.

Results

We found 26 eligible studies. The distribution of the studies across continents was uneven, and the housing issues of interest seemed to vary depending on the economic level of the country. The eight steps identified in TB development and the consequences thereof were more strongly associated with housing affordability than with housing quality.

Conclusions

This is the first systematic review to identify the effects of inadequate housing on TB and to categorize inadequate-housing-related exposure to TB in terms of affordability and quality. The steps identified in TB development and the consequences thereof had a greater association with housing affordability than with housing quality. Therefore, public health interventions regarding housing affordability could be more diverse, and interventions that support affordable housing for residents of inadequate housing and the homeless should proceed simultaneously to improve housing quality.
Facilitators and barriers of intersectoral co-operation to promote healthier and more environmentally friendly behaviour: a qualitative evaluation through focus groups for the INHERIT project
Authors: van der Vliet Nina , den Broeder Lea , Romeo-Velilla Maria , Staatsen Brigit , Kruize Hanneke , Friedrich Bettina , Schuit A. Jantine
Published: March 2022

Background

Tackling challenges related to health, environmental sustainability and equity requires many sectors to work together. This “intersectoral co-operation” can pose a challenge on its own. Research commonly focuses on one field or is conducted within one region or country. The aim of this study was to investigate facilitators and barriers regarding intersectoral co-operative behaviour as experienced in twelve distinct case studies in ten European countries. The COM-B behavioural system was applied to investigate which capabilities, opportunities and motivational elements appear necessary for co-operative behaviour.

Method

Twelve focus groups were conducted between October 2018 and March 2019, with a total of 76 participants (policymakers, case study coordinators, governmental institutes and/or non-governmental organisations representing citizens or citizens). Focus groups were organised locally and held in the native language using a common protocol and handbook. One central organisation coordinated the focus groups and analysed the results. Translated data were analysed using deductive thematic analysis, applying previous intersectoral co-operation frameworks and the COM-B behavioural system.

Results

Amongst the main facilitators experienced were having highly motivated partners who find common goals and see mutual benefits, with good personal relationships and trust (Motivation). In addition, having supportive environments that provide opportunities to co-operate in terms of support and resources facilitated co-operation (Opportunity), along with motivated co-operation partners who have long-term visions, create good external visibility and who have clear agreements and clarity on roles from early on (Capability). Barriers included not having necessary and/or structural resources or enough time, and negative attitudes from specific stakeholders.

Conclusions

This study on facilitators and barriers to intersectoral co-operation in ten European countries confirms findings of earlier studies. This study also demonstrates that the COM-B model can serve as a relatively simple tool to understand co-operative behaviour in terms of the capability, opportunity and motivation required amongst co-operation partners from different sectors. Results can support co-operators’ and policymakers’ understanding of necessary elements of intersectoral co-operation. It can help them in developing more successful intersectoral co-operation when dealing with challenges of health, environmental sustainability and equity.
Morphological characteristics of subaxial cervical pedicles and surrounding critical structures in patients with vertebral artery dominance - an anatomical study based on computed tomographic imaging
Authors: Yang Jin , Li Tao , Wang Qing , Wang Gaoju , Wang Song , Xu Shuang , Zhang Shuai , Li Qiuhan
Published: March 2022

Background

No study has assessed the feasibility and safety of cervical pedicle screw implantation in patients with vertebral artery dominance (VAD), a common vertebral artery (VA) variation which can increase VA injury (VAI) risk. This study was to assess morphological characteristics of the subaxial cervical pedicles and surrounding critical structures, and identify their correlations in patients with VAD.

Methods

Computed tomography arteriography scans of 152 patients were used for retrospectively measuring parameters including pedicle outer width (POW), the distance from the lateral pedicle border to the closest part of VA (DPVA), diameter of VA (DVA), area of VA (AVA), area of transverse foramen (ATF) and occupational ratio of transverse foramen (TF). Moreover, correlations among some critical parameters were assessed.

Results

One hundred eight males and 44 females, with a mean age of 55.9 years were included. POW was smaller on the dominant side than on the non-dominant side, whereas DPVA, DVA, AVA, ATF, and TF were larger on the dominant side than those on the non-dominant side. On both sides, POW < 4 mm and POW + DPVA < 5 mm were observed most frequently at C3 and C4. On both sides, POW was correlated to ATF, and ATF was correlated to DVA and AVA. DPVA was correlated to ATF on the dominant side.

Conclusion

Patients with VAD exhibited smaller POW on the dominant side, most frequently at C3 and C4. Dominant VA may indirectly affect POW. TF may be a key determinant of DPVA and POW.
Open-mindedness trait affects the development of intercultural communication competence in short-term overseas study programs: a mixed-method exploration
Authors: Wang Chen , Wu Shuang-Ying , Nie Yi-Zi , Cui Guan-Yu , Hou Xiang-Yu
Published: March 2022

Background

Overseas study trips can enhance healthcare students’ intercultural communication competence. An opportunity to immerse in the new culture enables them to develop their ability to offer services to people from different countries. However, the role that open-mindedness (i.e., a personality trait) can play in this process has not been explored.

Methods

The present study adopted a mixed-method design to identify how open-mindedness trait affected this overseas learning process. Thirty-two undergraduate healthcare students in Australia took part in the study. Questionnaires, which measured socio-demographic information, intercultural communication competence and open-mindedness trait were administered to the participants before and after their overseas trip. Half of the participants (n = 16) were interviewed after the overseas trip.

Results

The correlational analysis showed that the open-mindedness trait was correlated with cultural skills, a component of intercultural communication competence, but not significant with the other three components. Three themes emerging from the qualitative data indicated that the open-mindedness trait affected students’ cultural exposure. This trait enabled participants to be actively involved in the immersion in the local culture. They were willing to learn from peer fellows, and keen to embrace novel challenges.

Conclusion

It is concluded that open-mindedness trait is vital for increasing cultural immersion, and hence promote intercultural communication skills.
The effect of Patient’s Own Medication use on patient’s self-reported medication knowledge during hospitalisation: a pre-post intervention study
Authors: van Herpen-Meeuwissen Loes J. M. , van den Bemt Bart J. F. , Derijks Hieronymus J. , van den Bemt Patricia M. L. A. , Maat Barbara , van Onzenoort Hein A. W.
Published: March 2022

Background

Improving patient’s medication knowledge and consequently medication use is essential for optimal treatment outcomes. As patient knowledge about medication is currently suboptimal, interventions to optimise medication knowledge are necessary. Implementation of Patient’s Own Medication (POM) in which patients bring their outpatient medication to the hospital, and nurses administer these during admission, may increase medication knowledge. The aim of this study is to explore the impact of POM use on self-reported medication knowledge of hospitalised patients compared to standard care. Patient’s sense of medication safety, attitude to the provision of information, and to inpatient medication use were studied in both standard care and during POM use too.

Method

In this nationwide intervention study perceived medication knowledge was assessed with a questionnaire pre and post implementing POM use. The questionnaire assessed perceived medication knowledge at admission and discharge, medication safety during hospitalisation, the provision of information during hospitalisation and at discharge, and inpatient medication use during hospitalisation. Patients’ answers were categorised into positive and negative/neutral. The proportion of patients with adequate medication knowledge, in the standard care and POM use group at hospital admission and discharge, were calculated and compared with adjustment for potential confounders.

Results

Among the 731 patients (393 received standard care and 338 POM) who completed the questionnaire (80.2%), POM use seemed to be positively associated with self-reported knowledge onhowto use medication at discharge (adjusted OR: 3.22 [95% CI 2.01–5.16]). However, for the other two knowledge related statements POM use was not associated. Medication knowledge at admission was the most important variable associated with perceived medication knowledge at discharge. The majority perceived POM use to be safer (52.9% of standard care patients versus 74.0% POM users;P <  0.01), POM users knew better which medicines they still used during hospitalisation (85.8% versus 92.3% resp.;P = 0.01), and most patients preferred POM use regardless of having experienced it (68.2% versus 82.2% resp.;P <  0.01).

Conclusion

POM use positively affects patient’s medication knowledge abouthowto use medication and patients’ perception of medication safety. With POM use more patients have a positive attitude towards the provision of information. The majority of patients prefer POM use. In conclusion, POM use seems a valuable intervention and requires further investigation.
Multi-professional and multi-agency model PLUSS to facilitate early detection and support of pre-school children with neurodevelopmental difficulties – a model description
Authors: Gustafsson Berit M. , Steinwall Samina , Korhonen Laura
Published: March 2022

Background

Neurodevelopmental difficulties, such as problems in social inter-relatedness, communication, motor coordination, and attention, are frequent in preschoolers and constitute a risk for later negative consequences. This article describes the development of a multi-professional and multi-agency model, PLUSS, to facilitate care and interventions for preschoolers with neurodevelopmental difficulties.

Methods

The PLUSS model was developed for children aged 1.5–5 years with a need for a further assessment of neurodevelopmental symptoms. The model is evaluated using a quasi-experimental study design along with qualitative interviews that study preschool teacher, and parent experiences of PLUSS. Outcomes of interest are a) implementation, b) effectiveness related to processes and multi-agency collaboration, c) capacity building among professionals, d) child-related outcomes with a longitudinal follow-up as well as d) parental wellbeing and satisfaction.

Results

The model was launched in 2019 and so far, approximately 130 children have been assessed. Results from a pilot study with 62 children (27–72 months; boys: girls 2.65:1) show that the total mean SDQ score in parental rating was 15 ± 6 and in preschool teacher ratings 14 ± 7, exceeding the Swedish cut-off of 12. 54 parents have participated in parental training and rate high levels of satisfaction (mean score 4.5, max 5.0). In addition, 74 pre-school professionals have been trained in early signs of neurodevelopmental difficulties to facilitate early detection. Feedback from participants indicates high satisfaction with educational activities (mean score 4.2, max 5.0 = very satisfied).

Conclusions

The pilot study shows that the screening procedure can detect children with clinically significant problems. In addition, participant satisfaction is high in parent- and preschool teacher training. The longitudinal study approach enables both child follow-up and evaluation of interventions provided by the working model.

Trial registration

Clinical Trials 2021, PLUSS identifier, NCT04815889. First registration 25/03/2021.
Evaluation of genetic variants using chromosomal microarray analysis for fetuses with polyhydramnios
Authors: Wu Xiaoqing , Li Ying , Lin Na , Su Linjuan , Xie Xiaorui , Liang Bing , Shen Qingmei , Cai Meiying , Guo Danhua , Huang Hailong , Xu Liangpu
Published: March 2022

Background

Polyhydramnios, the excessive accumulation of amniotic fluid, is associated with an elevated risk of abnormal karyotype, particularly aneuploidy. Studies focusing on chromosomal microarray analysis (CMA) in pregnancies with polyhydramnios are limited. The aim of this study is to evaluate the implications of pregnancy with polyhydramnios by CMA testing and routine karyotyping.

Methods

Data from 131 singleton and 17 twin pregnancies that underwent prenatal CMA testing due to polyhydramnios between May 2017 and May 2021 were reviewed. Enrolled cases were grouped into isolated polyhydramnios (N = 39) and non-isolated polyhydramnios (N = 111). Non-isolated group was further categorized as subgroup of soft markers (n = 59) and non-soft markers (n = 52).

Results

CMA revealed an additional 10 (6.7%) chromosomal aberrations with clinical significance in 9 fetuses from singleton pregnancies and 1 from a twin pregnancy. Six microdeletion/microduplication syndromes were observed, of which 4 were located on chromosome 17. The incremental yields of clinically significant CMA findings in non-isolated polyhydramnios was 8.1%, and the values in fetuses along with soft markers and non-soft markers were 5.1% and 11.5% (p > 0.05), respectively. Only one incidental finding related to neuropathy with liability to pressure palsies was detected from 39 fetuses with isolated polyhydramnios.

Conclusions

Non-isolated polyhydramnios is associated with several microdeletion/microduplication syndromes, regardless of singleton or twin pregnancies. Our results suggest insufficient evidence to recommend CMA in pregnancies with isolated polyhydramnios.
Machine learning classification of multiple sclerosis patients based on raw data from an instrumented walkway
Authors: Hu Wenting , Combden Owen , Jiang Xianta , Buragadda Syamala , Newell Caitlin J. , Williams Maria C. , Critch Amber L. , Ploughman Michelle
Published: March 2022

Background

Using embedded sensors, instrumented walkways provide clinicians with important information regarding gait disturbances. However, because raw data are summarized into standard gait variables, there may be some salient features and patterns that are ignored. Multiple sclerosis (MS) is an inflammatory neurodegenerative disease which predominantly impacts young to middle-aged adults. People with MS may experience varying degrees of gait impairments, making it a reasonable model to test contemporary machine leaning algorithms. In this study, we employ machine learning techniques applied to raw walkway data to discern MS patients from healthy controls. We achieve this goal by constructing a range of new features which supplement standard parameters to improve machine learning model performance.

Results

Eleven variables from the standard gait feature set achieved the highest accuracy of 81%, precision of 95%, recall of 81%, and F1-score of 87%, using support vector machine (SVM). The inclusion of the novel features (toe direction, hull area, base of support area, foot length, foot width and foot area) increased classification accuracy by 7%, recall by 9%, and F1-score by 6%.

Conclusions

The use of an instrumented walkway can generate rich data that is generally unseen by clinicians and researchers. Machine learning applied to standard gait variables can discern MS patients from healthy controls with excellent accuracy. Noteworthy, classifications are made stronger by including novel gait features (toe direction, hull area, base of support area, foot length and foot area).
NETosis and SARS-COV-2 infection related thrombosis: a narrative review
Authors: Behzadifard Mahin , Soleimani Masoud
Published: March 2022

Background

Coronavirus disease 2019 (COVID-19) infection is related to immune hyperactivity, the release of inflammatory cytokines, and immunothrombosis. Among the underlying mechanisms in COVID-19 thrombosis, neutrophil extracellular traps (NETs) formation, NETosis, may have a significant role. COVID-19 thrombi obtained from extracorporeal membrane oxygenation contained an accumulation of neutrophils and in a higher amount of NETs when compared with non-COVID-19 thrombi specimens.

Main body

During sepsis and inflammatory status, NETs released from neutrophils and histones and nucleosomes extruded into the extracellular space and take part in the host innate immunity defense, inflammation, and thrombosis. Excessive NETosis is related to clinical progression and respiratory failure in infections and sepsis. NETosis act as a scaffold for thrombus formation, and new associative data support the relation between deregulated immune responses with thrombus formation and organ failure. NETosis is reported in COVID-19 patients. In COVID-19 infection, overproduction of tissue factor (TF) by neutrophils has a role in immunothrombosis. Additionally, NETs can trap TF pathway inhibitor (TFPI) as the only endogenous protein that effectively inhibits the activity of the significant proteases– complexes, TF–FVIIa and prothrombinase.

Conclusion

Because of NETosis can induce intrinsic and extrinsic coagulation cascade activation through the production of TF, activation of FXII, and inhibition of TFPI and fibrinolysis and induce immunothrombosis, targeting NETosis may diminish thrombus formation related to NETs in COVID-19 patients.
Ebselen prevents cigarette smoke-induced cognitive dysfunction in mice by preserving hippocampal synaptophysin expression
Authors: De Luca Simone N. , Brassington Kurt , Chan Stanley M. H. , Dobric Aleksandar , Mou Kevin , Seow Huei Jiunn , Vlahos Ross
Published: March 2022

Background

Cigarette smoking (CS) is the leading cause of chronic obstructive pulmonary disease (COPD). The “spill-over” of pulmonary inflammation into the systemic circulation may damage the brain, leading to cognitive dysfunction. Cessation of CS can improve pulmonary and neurocognitive outcomes, however, its benefit on the neuroinflammatory profile remains uncertain. Here, we investigate how CS exposure impairs neurocognition and whether this can be reversed with CS cessation or an antioxidant treatment.

Methods

Male BALB/c mice were exposed to CS (9 cigarettes/day for 8 weeks) followed by 4 weeks of CS cessation. Another cohort of CS-exposed mice were co-administrated with a glutathione peroxidase mimetic, ebselen (10 mg/kg) or vehicle (5% CM-cellulose). We assessed pulmonary inflammation, spatial and working memory, and the hippocampal microglial, oxidative and synaptic profiles.

Results

CS exposure increased lung inflammation which was reduced following CS cessation. CS caused spatial and working memory impairments which were attributed to hippocampal microglial activation and suppression of synaptophysin. CS cessation did not improve memory deficits or alter microglial activation. Ebselen completely prevented the CS-induced working and spatial memory impairments, which was associated with restored synaptophysin expression without altering microglial activation.

Conclusion

We were able to model the CS-induced memory impairment and microglial activation seen in human COPD. The preventative effects of ebselen on memory impairment is likely to be dependent on a preserved synaptogenic profile. Cessation alone also appears to be insufficient in correcting the memory impairment, suggesting the importance of incorporating antioxidant therapy to help maximising the benefit of cessation.
Muscle oxygenation and time to task failure of submaximal holding and pulling isometric muscle actions and influence of intermittent voluntary muscle twitches
Authors: Dech Silas , Bittmann Frank N. , Schaefer Laura V.
Published: March 2022

Background

Isometric muscle actions can be performed either by initiating the action, e.g., pulling on an immovable resistance (PIMA), or by reacting to an external load, e.g., holding a weight (HIMA). In the present study, it was mainly examined if these modalities could be differentiated by oxygenation variables as well as by time to task failure (TTF). Furthermore, it was analyzed if variables are changed by intermittent voluntary muscle twitches during weight holding (Twitch). It was assumed that twitches during a weight holding task change the character of the isometric muscle action from reacting (≙ HIMA) to acting (≙ PIMA).

Methods

Twelve subjects (two drop outs) randomly performed two tasks (HIMA vs. PIMA or HIMA vs. Twitch, n = 5 each) with the elbow flexors at 60% of maximal torque maintained until muscle failure with each arm. Local capillary venous oxygen saturation (SvO2) and relative hemoglobin amount (rHb) were measured by light spectrometry.

Results

Within subjects, no significant differences were found between tasks regarding the behavior of SvO2 and rHb, the slope and extent of deoxygenation (max. SvO2 decrease), SvO2 level at global rHb minimum, and time to SvO2 steady states. The TTF was significantly longer during Twitch and PIMA (incl. Twitch) compared to HIMA (p = 0.043 and 0.047, respectively). There was no substantial correlation between TTF and maximal deoxygenation independently of the task (r = − 0.13).

Conclusions

HIMA and PIMA seem to have a similar microvascular oxygen and blood supply. The supply might be sufficient, which is expressed by homeostatic steady states of SvO2 in all trials and increases in rHb in most of the trials. Intermittent voluntary muscle twitches might not serve as a further support but extend the TTF. A changed neuromuscular control is discussed as possible explanation.
Geotemporospatial and causal inferential epidemiological overview and survey of USA cannabis, cannabidiol and cannabinoid genotoxicity expressed in cancer incidence 2003–2017: part 2 – categorical bivariate analysis and attributable fractions
Authors: Reece Albert Stuart , Hulse Gary Kenneth
Published: March 2022

Background

As the cannabis-cancer relationship remains an important open question epidemiological investigation is warranted to calculate key metrics including Rate Ratios (RR), Attributable Fractions in the Exposed (AFE) and Population Attributable Risks (PAR) to directly compare the implicated case burden between emerging cannabinoids and the established carcinogen tobacco.

Methods

SEER*Stat software from Centres for Disease Control was used to access age-standardized state census incidence of 28 cancer types (including “All (non-skin) Cancer”) from National Cancer Institute in US states 2001–2017. Drug exposures taken from the National Survey of Drug Use and Health 2003–2017, response rate 74.1%. Federal seizure data provided cannabinoid exposure. US Census Bureau furnished income and ethnicity. Exposure dichotomized as highest v. lowest exposure quintiles. Data processed in R.

Results

Nineteen thousand eight hundred seventy-seven age-standardized cancer rates were returned. Based on these rates and state populations this equated to 51,623,922 cancer cases over an aggregated population 2003–2017 of 124,896,418,350. Fifteen cancers displayed elevated E-Values in the highest compared to the lowest quintiles of cannabidiol exposure, namely (in order): prostate, melanoma, Kaposi sarcoma, ovarian, bladder, colorectal, stomach, Hodgkins, esophagus, Non-Hodgkins lymphoma, All cancer, brain, lung, CLL and breast. Eleven cancers were elevated in the highest THC exposure quintile: melanoma, thyroid, liver, AML, ALL, pancreas, myeloma, CML, breast, oropharynx and stomach. Twelve cancers were elevated in the highest tobacco quintile confirming extant knowledge and study methodology. For cannabidiol RR declined from 1.397 (95%C.I. 1.392, 1.402), AFE declined from 28.40% (28.14, 28.66%), PAR declined from 15.3% (15.1, 15.5%) and minimum E-Values declined from 2.13. For THC RR declined from 2.166 (95%C.I. 2.153, 2.180), AFE declined from 53.8% (53.5, 54.1%); PAR declined from 36.1% (35.9, 36.4%) and minimum E-Values declined from 3.72. For tobacco, THC and cannabidiol based on AFE this implies an excess of 93,860, 91,677 and 48,510 cases; based on PAR data imply an excess of 36,450, 55,780 and 14,819 cases.

Conclusion

Data implicate 23/28 cancers as being linked with THC or cannabidiol exposure with epidemiologically-causal relationships comparable to those for tobacco. AFE-attributable cases for cannabinoids (91,677 and 48,510) compare with PAR-attributable cases for tobacco (36,450). Cannabinoids constitute an important multivalent community carcinogen.
Actionable Tumor Alterations and Treatment Protocol Enrollment of Pediatric and Young Adult Patients With Refractory Cancers in the National Cancer Institute–Children's Oncology Group Pediatric MATCH Trial
Authors: Parsons D. Williams , Janeway Katherine A. , Patton David R. , Winter Cynthia L. , Coffey Brent , Williams P. Mickey , Roy-Chowdhuri Sinchita , Tsongalis Gregory J. , Routbort Mark , Ramirez Nilsa C. , Saguilig Lauren , Piao Jin , Alonzo Todd A. , Berg Stacey L. , Fox Elizabeth , Hawkins Douglas S. , Abrams Jeffrey S. , Mooney Margaret , Takebe Naoko , Tricoli James V. , Seibel Nita L. ,   the NCI-COG Pediatric MATCH Team
Published: March 2022

PURPOSE

The National Cancer Institute–Children's Oncology Group Pediatric MATCH trial aimed to facilitate evaluation of molecular-targeted therapies in biomarker-selected cohorts of childhood and young adult patients with cancer by screening tumors for actionable alterations.

PATIENTS AND METHODS

Tumors from patients age 1-21 years with refractory solid tumors, lymphomas, or histiocytic disorders were subjected to cancer gene panel sequencing and limited immunohistochemistry to identify actionable alterations for assignment to phase II treatment arms. The rates of treatment arm assignment and enrollment were compared between clinical and demographic groups.

RESULTS

Testing was completed for 94.7% of tumors submitted. Actionable alterations were detected in 31.5% of the first 1,000 tumors screened, with treatment arm assignment and enrollment occurring in 28.4% and 13.1% of patients, respectively. Assignment rates varied by tumor histology and were higher for patients with CNS tumors or enrolled at Pediatric Early Phase Clinical Trials Network sites. A reported history of prior clinical molecular testing was associated with higher assignment and enrollment rates. Actionable alterations in the mitogen-activated protein kinase signaling pathway were most frequent (11.2%). The most common reasons provided for not enrolling on treatment arms were patients receiving other treatment or poor clinical status.

CONCLUSION

The Pediatric MATCH trial has proven the feasibility of a nationwide screening Protocol for identification of actionable genetic alterations and assignment of pediatric and young adult patients with refractory cancers to trials of molecularly targeted therapies. These data support the early use of tumor molecular screening for childhood patients with cancer whose tumors have not responded to standard treatments.
African Americans and Land Loss in Texas: Government Duplicity and Discrimination Based on Race and Class
Authors: Reid Debra A.
Published: March 2022

"African American Farmers and Land Loss in Texas," surveys the ways that discrimination at the local, state, and national levels constrained minority farmers during the twentieth century. It considers the characteristics of small-scale farming that created liabilities for landowners regardless of race, including state and federal programs that favored commercial and agribusiness interests. In addition to economic challenges African American farmers had to negotiate racism in the Jim Crow South. The Texas Agricultural Extension Service, the state branch of the USDA’s Extension Service, segregated in 1915. The "Negro" division gave black farmers access to information about USDA programs, but it emphasized their subordinate position relative to white farmers. The Civil Rights Act of 1964 did not reverse decades of racial discrimination. Instead, USDA officials relied on federalism, a theory as old as the Constitution, to justify their tolerance of civil rights violations in Texas and elsewhere. Then, special needs legislation passed during the 1970s and 1980s did not realize its potential to serve ethnically diverse and economically disadvantaged rural Texans. Discrimination based on race combined with a bias toward commercial production. This crippled most black farmers and led to their near extinction.
Urban Demand and Agrarian Productivity in Pre-Plague England: Reassessing the Relevancy of von Thunen’s Model
Authors: Kitsikopoulos Harry
Published: March 2022

The article addresses the question as to whether manorial estates in pre-plague England were responsive to market stimuli, as the authors of a 1993 study have argued based on a model originally proposed by the nineteenth century agricultural economist Johann von Thunen. By testing three hypotheses referring to the degree of commercial orientation, levels of intensity regarding various inputs, and the spatial configuration of field systems, the paper concludes that the productive profiles of these estates did not conform very closely to the expectations of von Thunen’s model. The explanation lies in the fact that, by having access to the seigneurial prerogative of tapping into their peasants’ resources, manorial estates were not hard pressed to maximize profitability through a drive towards efficiency.