bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 and LGBTQ Emerging Adults: Risk in the Face of Social Distancing
Authors: Scroggs Barrett , Love Heather A. , Torgerson Chelsey
Published: October 2020

The coronavirus pandemic that began in December 2019 (COVID-19) quickly spread globally with an increased transmission in the United States beginning in March 2020. Social distancing guidelines were instituted across the country, limiting contact individuals could have with others. This compared the mental health of lesbian, gay, bisexual, transgender, and queer (LGBTQ) emerging adults who completed the survey before ( n = 1,190) many social distancing guidelines went into effect with those who completed the survey after ( n = 705). Participants who participated in the survey after social distancing guidelines were initiated reported lower levels of hope for the future, higher levels of alcohol use, a lower sense of connection to and pride regarding the LGBTQ community, and a lower sense of minority stress. Results indicate a detrimental response to social distancing in the days immediately following the onset of such guidelines as confusion reigned and expectations changed day to day.
Injury Incidence, Patterns, and Risk Factors in Functional Training Athletes in an Asian Population
Authors: Cheng Timothy Tsin Jien , Mansor Azura , Lim Yi Zhen , Hossain Parash M. Tanveer
Published: October 2020

Background:

Functional training, also known as CrossFit, is a unique sport that combines weightlifting, gymnastics, and metabolic conditioning into a single program. There are an estimated 50 functional training centers in Malaysia.

Purpose:

To analyze the injury rates, patterns, and risk factors of functional training/CrossFit.

Study Design:

Descriptive epidemiology study.

Methods:

Electronic questionnaires were distributed to 244 participants from 15 centers in the country. Descriptive data regarding the athletes, injury occurrence within the past 6 months, injury details, and risk factors were collected.

Results:

Of the 244 athletes, 112 (46%) developed at least 1 new injury over the previous 6 months. Injury rates were significantly higher in athletes from nonaffiliate training gyms compared with CrossFit-affiliated gyms, in athletes with previous injuries, and in those who perceived themselves as having more than average fitness.

Conclusion:

Coaches and athletes need to be more aware of risk factors for injury to enable safer and better training strategies.
Visual Observation of Apparent Infraspinatus Muscle Atrophy in Male Professional Tennis Players
Authors: Ellenbecker Todd S. , Dines David M. , Renstrom Per A. , Windler Gary S.
Published: October 2020

Background:

Previous studies have reported visually observed apparent muscle atrophy in the infraspinous fossa of the dominant arm of overhead athletes. Several mechanisms have been proposed as etiological factors, including eccentric overload, compressive spinoglenoid notch paralabral cysts, and cumulative tensile suprascapular neurapraxia.

Purpose:

To report the prevalence of apparent infraspinatus atrophy in male professional tennis players and to determine whether the suspected atrophy correlates with objectively measured weakness of external rotation.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 153 male professional tennis players underwent a musculoskeletal screening examination that included visual inspection of the infraspinous fossa. Infraspinatus atrophy was defined as hollowing or loss of soft tissue bulk inferior to the scapular spine in the infraspinous fossa of one extremity that was visibly different from the contralateral extremity. This finding was observed and independently agreed upon by both an orthopaedic surgeon and a physical therapist during the examination. Also assessed were rotator cuff instrument-assisted manual muscle testing, visual observation of scapular kinesis (or motion), and glenohumeral joint range of motion for internal and external rotation and horizontal adduction.

Results:

In the 153 players, dominant-arm infraspinatus atrophy was observed in 92 players (60.1%), and only 1 player (0.7%) was identified with nondominant infraspinatus atrophy. A Pearson correlation showed a significant relationship between the presence of dominant-arm infraspinatus atrophy and dominant-arm external rotation strength measured in neutral abduction/adduction (at the side) ( P = .001) as well as between the presence of dominant-arm infraspinatus atrophy and bilateral external rotation strength measured at 90° of glenohumeral joint abduction ( P = .009 for dominant arm and .002 for nondominant arm). No significant correlation was found with scapular dyskinesis, glenohumeral range of motion, or instrument-assisted manual muscle testing of the supraspinatus (empty-can test).

Conclusion:

Visually observed infraspinatus muscle atrophy is a common finding in the dominant shoulder of asymptomatic male professional tennis players and is significantly correlated with external rotation weakness. This condition is present in uninjured players without known shoulder pathology and is not related to glenohumeral joint internal rotation, total rotation range of motion, or scapular dysfunction. Players with visually observed infraspinatus atrophy should be evaluated for external rotation strength and may require preventive strengthening.
Preoperative Fatty Infiltration of the Teres Minor Negatively Affects Postoperative Outcomes in Patients With Rotator Cuff Pathology
Authors: Sarkissian Erik J. , Xiao Michelle , Abrams Geoffrey D.
Published: October 2020

Background:

The teres minor is a critical component of the rotator cuff and serves as one of the few external rotators of the humerus. Information is lacking regarding the effect of teres minor atrophy in isolation and in the setting of concomitant full-thickness rotator cuff tears on outcomes in patients undergoing rotator cuff surgery.

Purpose:

To investigate the effect of preoperative teres minor fatty infiltration on postoperative clinical outcomes in patients with and without full-thickness rotator cuff pathology.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective review of patients undergoing primary arthroscopic shoulder surgery between 2014 and 2016 was performed. Preoperative magnetic resonance imaging was used to determine fatty infiltration for each rotator cuff muscle using the modified Goutallier classification. American Shoulder and Elbow Surgeons (ASES) as well as the shortened version of Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores were obtained preoperatively and during follow-up. Exclusion criteria included prior surgery on the ipsilateral shoulder or a diagnosis of inflammatory arthropathy. For analysis, patients were dichotomized to grade 0 or grade 1-4 atrophy of the teres minor as well as to full-thickness or partial-thickness rotator cuff pathology.

Results:

A total of 36 of 47 (76.6%) patients (mean age, 63 years; range, 45-76 years) were available for postoperative follow-up at a mean of 40 months (range, 30-48 months). Postoperative ASES score was significantly higher and QuickDASH score was significantly lower among all patients in the grade 0 group compared with the grade 1-4 group. Postoperative ASES and QuickDASH scores were not significantly different in patients with partial-thickness rotator cuff tears at any time point. However, the postoperative ASES score was significantly higher and QuickDASH score was significantly lower in the grade 0 versus grade 1-4 group for patients with full-thickness rotator cuff pathology.

Conclusion:

Preoperative teres minor atrophy in patients undergoing surgery for rotator cuff pathology may impair postoperative clinical outcomes, especially in patients with full-thickness tears.
Methods and Tools for Teaching Health Profession Students How to Perform Community Health Needs Assessments
Authors: Caron Rosemary M. , Hewitt Anne M. , Hooker Edmond A. , Carmalt Julie H.
Published: October 2020

Public health and health administration programs play a critical role in training future health profession leaders to be strategic and efficacious in this current dynamic environment. As the health care system rapidly transitions from a fee-for-service environment to a value-based delivery system, the role of population health management is a critical concept. A key tool for managing the health of populations requires a health system to discern the community’s problems and resources with the intent of developing, implementing, and evaluating strategies to improve the health of those who live there. The purpose of this work was to (1) engage health educators in a dialogue about the best ways to teach students how to perform a community health needs assessment (CHNA) for the improvement of a population’s health; (2) identify key CHNA data sets; and (3) identify current models and tools, course content, and resources appropriate for undergraduate and graduate health courses when teaching the CHNA process. Authors facilitated group work with participants attending an Educational Session at the annual meeting of the Association of University Programs in Health Administration. This research provides educators with resources to allow them to teach students about CHNAs and how to utilize them when they work for health care organizations.
An Evolved Approach to Advisory Boards in Rare Disease Drug Development: 5-Step Model to Finding and Engaging Patient Advisors
Authors: Dillon Carlotta , Knapp Joyce , Stinson Mark
Published: October 2020

Nearly all new product development teams at pharmaceutical companies will routinely conduct patient advisory boards. These board meetings will help collect and document the experience of patients and caregivers for medical product development and regulatory decision-making. Recently, in June 2020, The US Food and Drug Administration (FDA) published a final guidance on methodological patient-focused drug development (PFDD) to address, in a stepwise manner, how stakeholders (patients, researchers, medical product developers, and others) can successfully use these patient forums. In the process of developing this guidance, the FDA acknowledged that leading its own PFDD meetings, especially when limited to organized disease advocacy groups, cannot address the gaps in information on the patient perspective. So, it has expressed support for advancing the science and utilization of patient input other means. Because traditional methods of conducting patient advisory boards often do not achieve the full potential of patient centricity, the authors of this article share an approach to consider when selecting patient advisors, in order to gain the most actionable input to a product development team.
A Novel Curriculum for Medical Student Training in LGBTQ Healthcare: A Regional Pathway Experience
Authors: Gibson Alec W , Gobillot Theodore A , Wang Kevin , Conley Elizabeth , Coard Wendy , Matsumoto Kim , Letourneau Holly , Patel Shilpen , Merel Susan E , Sairenji Tomoko , Whipple Mark E , Ryan Michael R , Morales Leo S , Heinen Corinne
Published: October 2020

Background:

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals face considerable health disparities, often due to a lack of LGBTQ-competent care. Such disparities and lack of access to informed care are even more staggering in rural settings. As the state medical school for the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region, the University of Washington School of Medicine (UWSOM) is in a unique position to train future physicians to provide healthcare that meets the needs of LGBTQ patients both regionally and nationally.

Objective:

To describe our methodology of developing a student-driven longitudinal, region-wide curriculum to train medical students to provide high-quality care to LGBTQ patients.

Methods:

A 4-year LGBTQ Health Pathway was developed and implemented as a student-led initiative at the UWSOM. First- and second-year medical students at sites across the WWAMI region are eligible to apply. Accepted Pathway students complete a diverse set of pre-clinical and clinical components: online modules, didactic courses, longitudinal community service/advocacy work, a scholarly project, and a novel clinical clerkship in LGBTQ health developed specifically for this Pathway experience. Students who complete all requirements receive a certification of Pathway completion. This is incorporated into the Medical Student Performance Evaluation as part of residency applications.

Results:

The LGBTQ Health Pathway is currently in its fourth year. A total of 43 total students have enrolled, of whom 37.3% are based in the WWAMI region outside of Seattle. Pathway students have completed a variety of scholarly projects on LGBTQ topics, and over 1000 hours of community service/advocacy. The first cohort of 8 students graduated with a certificate of Pathway completion in spring 2020.

Conclusions:

The LGBTQ Health Pathway at UWSOM is a novel education program for motivated medical students across the 5-state WWAMI region. The diverse milestones, longitudinal nature of the program, focus on rural communities, and opportunities for student leadership are all strengths and unique aspects of this program. The Pathway curriculum and methodology described here serve as a model for student involvement and leadership in medical education. This program enables medical students to enhance their training in the care of LGBTQ patients and provides a unique educational opportunity for future physicians who strive to better serve LGBTQ populations.
Personnel and Human Resource Management in Britain
Authors: Hendry Chris
Published: October 2020

Personnel management in Britain continues to evolve with the adoption of ideas from human resource management (HRM). This has been controversial, however, due to the antagonism which many academics have for an American import which signifies (for them) an attack on the structures of collective bargaining. For personnel professionals, it has been seen as a slight on their pretensions to take a strategic approach to employment, and to threaten their exclusive claims to professional expertise. The paper attempts to separate reality from myth by reviewing the progress of HRM in terms of four criteria - commitment, flexibility, quality, and strategic integration - which are commonly associated with HRM. It concludes that strategic integration is the most important differentiating factor, but that there is more than one emerging model of HRM. Finally, it proposes employment systems and skill as two essential concepts for a strategic perspective.
Personalwirtschaft in Schweden - Zur Nicht-Institutionalisierung eines Faches
Authors: Damm Margarete , Wolff Rolf
Published: October 2020

Der Artikel gibt einen Überblick über die Entwicklung der Personalwirtschaft in Schweden und der sie im wesentlichen bestimmenden gesellschaftlichen und ökonomischen Kräfte. Es stellt sich heraus, daß sich in Schweden (und tendenziell wohl in allen skandinavischen Ländern) der Personalbereich in der Praxis gegenüber der Arbeitsorganisation und Linienverantwortung wesentlich weniger verselbständigt und spezialisiert hat als man dies etwa für die deutsche Praxis kennt. Kann dies - gleichsam als frühe Antizipation des “Human Resource Management” - durchaus als Vorzug gelten, so hat diese mangelnde Herausdifferenzierung auch zu einer wenig entwickelten speziellen Personalwirtschaftslehre (als akademisches Feld, als Professionalisierungsbasis) geführt.
Personalmanagement als Wissenschaftsdisziplin in Polen
Authors: Szelocn Zbigniew
Published: October 2020

Der Beitrag vermittelt zuächst einen Rückblick aufdie personalwirtschaftliche Lehre im Hochschulbereich Polens vor der Revolution. Er informiert sodann über die Hauptinhalte eines den Hochschulen vorgegebenen zentralen Lehrplans für das personalwirtschaftliche Kemstudium. Weiterhin werden drei Beispiele für hochschulspezifischepersonalwirtschaftliche Spezialfiicher verschiedener Hochschulen mitgeteilt. Schliej3lich charakterisiert der Beitrag aktuelle Entwicklungen der personalwirtschaftlichen Lehre und Forschung in Polen.
Ökologieorientiertes Personalmanagement: Kritische Thesen zum Status quo in Wissenschaft und Praxis
Authors: Kuhn Thomas , Wittmann Stephan
Published: October 2020

Wurde das ökologieorientierte Personalmanagement noch vor kurzer Zeit als vernachlässigtes “Stiefkind der Unternehmen” (vgl. Nitschke 1990) apostrophiert, so ist diese Vernachlässigung zwischenzeitlich einer durchaus größeren Beachtung gewichen. Gleichwohl scheinen grundlegende Aspekte einer ökologiebezogenen Personalarbeit in der bisherigen Diskussion noch zu wenig reflektiert bzw. expliziert zu sein. Dieses Defizit gab den Anlaß zum vorliegenden Beitrag, der sich zunächst mit dem State of the Art des ökologieorientierten Personalmanagements auseinandersetzt (Abschnitt 1), um anschließend ausgewählte Aspekte der aktuellen Sichtweise kritisch zu diskutieren. Ausgangspunkt ist dabei die häufig vernachlässigte betriebswirtschaftliche Begründung eines ökologieorientierten Personalmanagements. Diese kann in strategischen Kontexten zwar geleistet werden (Abschnitt 2), ist aber mit der Notwendigkeit verbunden, die Effizienz ökologieorientierten Personalmanagements durch pragmatische Schwerpunktsetzungen zu optimieren (Abschnitt 3). Eine kurze Zusammenfassung der Thesen schließt den vorliegenden Beitrag ab (Abschnitt 4).
Visual Acuity Outcomes in Patients Receiving Frequent Treatment of Neovascular Age-Related Macular Degeneration in Clinical Practice
Authors: Moshfeghi Andrew A. , Pitcher John D. , Lucas Genevieve , Boucher Nick , Saroj Namrata
Published: October 2020

Purpose:

This work evaluates dosing frequency with intravitreal antivascular endothelial growth factor (anti-VEGF) agents over 2 years and visual acuity (VA) outcomes in neovascular age-related macular degeneration (nAMD).

Methods:

This retrospective analysis assesses electronic medical record data (Vestrum Health treatment and outcomes database) of newly diagnosed nAMD in patients who were initiated on intravitreal anti-VEGF treatment at US clinical sites. Eyes were divided into 2 injection frequency subcohorts (≤ 6 or > 6 injections/y); treatment frequency and change in mean VA (Early Treatment Diabetic Retinopathy Study letters) were evaluated.

Results:

Overall, 8127 of 213 824 eyes met inclusion criteria in year 1 and 4968 in year 2. During year 1, 77% of the eyes received more than 6 injections (n = 6287), the majority of which received injections at the same frequency during year 2. Mean VA gain from baseline at year 1 was lower in the ≤ 6 than > 6 injections/y subcohort (2.2 vs 6.5, P < .001). Decrease in mean VA from the end of year 1 to year 2 was significantly greater for eyes administered 6 or fewer injections in year 2 than those that received more frequent injections, irrespective of the frequency of injections in the first year.

Conclusions:

In routine clinical practice, most eyes with nAMD that completed at least 1 year of follow-up were treated with more than 6 injections of anti-VEGF agents during the first year of treatment, resulting in better VA gains than eyes treated less frequently during the same period.
Guidance vs. guidelines: the role of evidence-based medicine in the COVID-19 pandemic
Authors: Kodadek Lisa M , Berger Jonathan C , Haut Elliott R
Published: October 2020

The COVID-19 pandemic has challenged the practice of high-quality evidence-based medicine because no uniformly accepted treatment protocols or rigorous guidelines are widely available. This article examines the role of practice management guidelines versus clinical guidance for safe and evidence-based clinical care of patients with COVID-19.
Meta-analysis on short-term exposure to ambient ultrafine particles and respiratory morbidity
Authors: Samoli Evangelia , Rodopoulou Sophia , Schneider Alexandra , Morawska Lidia , Stafoggia Massimo , Renzi Matteo , Breitner Susanne , Lanki Timo , Pickford Regina , Schikowski Tamara , Okokon Enembe , Zhang Siqi , Zhao Qi , Peters Annette
Published: October 2020

Aim

There is growing interest in the health effects following exposure to ambient particles with a diameter <100 nm defined as ultrafine particles (UFPs), although studies so far have reported inconsistent results. We have undertaken a systematic review and meta-analysis for respiratory hospital admissions and emergency room visits following short-term exposure to UFPs.

Methods

We searched PubMed and the Web of Science for studies published up to March 2019 to update previous reviews. We applied fixed- and random-effects models, assessed heterogeneity between cities and explored possible effect modifiers.

Results

We identified nine publications, reporting effects from 15 cities, 11 of which were European. There was great variability in exposure assessment, outcome measures and the exposure lags considered. Our meta-analyses did not support UFP effects on respiratory morbidity across all ages. We found consistent statistically significant associations following lag 2 exposure during the warm period and in cities with mean daily UFP concentrations <6000 particles·cm‒3, which was approximately the median of the city-specific mean levels. Among children aged 0–14 years, a 10 000 particle·cm‒3increase in UFPs 2 or 3 days before was associated with a relative risk of 1.01 (95% CI 1.00–1.02) in respiratory hospital admissions.

Conclusions

Our study indicates UFP effects on respiratory health among children, and during the warm season across all ages at longer lags. The limited evidence and the large heterogeneity of previous reports call for future exposure assessment harmonisation and expanded research.
Structural evolution along the Susa Shear Zone: the role of a first-order shear zone in the exhumation of meta-ophiolite units (Western Alps)
Authors: Ghignone Stefano , Balestro Gianni , Gattiglio Marco , Borghi Alessandro
Published: October 2020

In the Western Alps, different shear zones acting at different depths have been investigated for explaining multistage exhumation of (U)HP units, and several exhumation models have been proposed for explaining present-day stacking of different tectonometamorphic units. This study aims to reconstruct the tectonic evolution of the Susa Shear Zone (SSZ), a polyphasic first-order shear zone, outcropping in the Susa Valley. The SSZ consists of a thick mylonitic zone, along which units characterized by different Alpine metamorphic P–T peaks are coupled. In the study area, the footwall of the SSZ mostly consists of oceanic units (i.e., Internal Piedmont Zone), which record eclogitic conditions, whereas the hanging wall consists of oceanic units (i.e., External Piedmont Zone), which record blueschist-facies conditions. These tectonic units were deformed during subduction- and exhumation-related Alpine history, throughout four main regional deformation phases (from D1 to D4), and were coupled along the SSZ, wherein two shearing events have been distinguished (T1 and T2). T1 occurred during early exhumation and was characterized by “apparent reverse” Top-to-E kinematics, whereas T2 occurred during late exhumation and was characterized by Top-to-W kinematics. Detailed fieldwork and structural analysis allowed us to describe the main features of the different deformation stages and define the deformation relative timing. As final result, we propose a four-step geodynamic model, focused on the different stages developed along the SSZ, from pre-T1 to syn-T2, showing the geometrical relationships between the tectonic units involved in the exhumation. The model aims at explaining the role of the SSZ in the axial sector of the Western Alps.
Mapping green infrastructure and socioeconomic indicators as a public management tool: the case of the municipalities of Andalusia (Spain)
Authors: Caparrós Martínez José Luis , Milán García Juan , Rueda López Nuria , de Pablo Valenciano Jaime
Published: October 2020

Background

Green Infrastructure (GI) is defined as a strategically planned network of natural and semi-natural spaces that provide society, in both rural and urban areas, with a large number of goods and services of great value and economic importance such as clean air and water, carbon storage, pollination or protection against the effects of climate change. Traditionally, municipalities, like other territorial units, are characterized by a series of social and economic indicators that determine their degree of local development. The objective of this article is to identify and assess, through a system of indicators, what role urban and rural municipalities in Andalusia (Spain) play in the provision and reception of ecosystem services. To this end, Geographical Information System (GIS) techniques are used and a cluster analysis is carried out to contrast the results.

Results

Rural municipalities show the largest portion of GI area in the whole region. However, they show a low socioeconomic level, with high unemployment rates.

Conclusions

It can be said that the municipalities in rural areas are "ecologically" financing the entire Andalusian population. Faced with this situation, the decisions, and actions of policymakers in this region should aim at promoting measures that can restore and conserve GIs, addressing the demographic and/or socioeconomic imbalances of the region.
Evaluation of the effects of acetylcholinesterase inhibitors in the zebrafish touch-evoked response: quantitative vs. qualitative assessment
Authors: Guzman Laura , Besa Gisela , Linares Daniela , González Lara , Pont Caterina , Bartolini Manuela , Haigis Ann-Cathrin , Legradi Jessica , Muñoz-Torrero Diego , Gómez-Catalán Jesús , Barenys Marta
Published: October 2020

Background

The difficulty of finding new treatments for neurological diseases with great impact in our society like Alzheimer’s disease can be ascribed in part to the complexity of the nervous system and the lack of quick and cost-effective screening tools. Such tools could not only help to identify potential novel treatments, but could also be used to test environmental contaminants for their potential to cause neurotoxicity. It has been estimated that 5–10% of the anthropogenic chemicals are developmental neurotoxic (DNT) and exposure to DNT compounds has been linked to several neurological diseases. Within this study we were testing the applicability of a quick and cost-effective behavioural test using zebrafish embryos: the touch-evoked response assay, in this case, an assay evaluating the swimming response to a tap in the tail. Two acetylcholinesterase (AChE) inhibitors positive controls (paraoxon and huprine Y), as well as 10 huprine-derivative compounds were tested and the results were evaluated using 2 different methods, a quantitative and a qualitative one.

Results

We could show that the methodology presented is able to detect behavioural effects of AChE inhibitors. A good correlation between the results obtained with the quantitative and the qualitative method was obtained (R2 = 0.84).

Conclusions

Our proposed method enables combination of screening for new drugs with toxicity screening in a whole embryo model alternative to animal experimentation, thereby merging 2 drug development steps into one.
New administrative data on welfare dynamics in Germany: the Sample of Integrated Welfare Benefit Biographies (SIG)
Authors: Bruckmeier Kerstin , Dummert Sandra , Grunau Philipp , Hohmeyer Katrin , Lietzmann Torsten
Published: October 2020

The Sample of Integrated Welfare Benefit Biographies (SIG) is a new administrative longitudinal microdata set representative of recipients of Germany’s main welfare programme, the Unemployment Benefit II (UB II, Arbeitslosengeld II). The data set contains detailed longitudinal information on welfare receipt and labour market activities, and hence enables researchers to analyse the dynamics of benefit receipt, income and employment. A distinct feature of the SIG is that it provides information not only for individual benefit recipients but also for family members, including children and partners. This is possible because eligibility for UB II benefits depends on the household structure, and it is means-tested on household income. In addition to socio-demographic and regional information, the SIG contains extensive information on the employment biographies of benefit recipients and their household members from the Integrated Employment Biographies (IEB) of the Institute for Employment Research (IAB). This allows researchers to examine the interaction between labour market participation and benefit receipt. The SIG is available to researchers at the Research Data Centre (FDZ) of the Federal Employment Agency (BA) at the IAB.
Comparison of the impact of propofol versus sevoflurane on early postoperative recovery in living donors after laparoscopic donor nephrectomy: a prospective randomized controlled study
Authors: Han Sangbin , Park Jaesik , Hong Sang Hyun , Lim Soojin , Park Yong Hyun , Chae Min Suk
Published: October 2020

Background

Enhancing postoperative recovery of the donor is important to encourage living kidney donation. We investigated the effects of anesthetic agents (intravenous [IV] propofol versus inhaled [IH] sevoflurane) on the quality of early recovery of healthy living kidney donors after hand-assisted laparoscopic nephrectomy (HALN) under analgesic intrathecal morphine injection.

Methods

This single-center, prospective randomized controlled study enrolled 80 living donors undergoing HALN from October 2019 to June 2020 at Seoul St. Mary’s Hospital. Donors were randomly assigned to the IV propofol group or IH sevoflurane group. To measure the quality of recovery, we used the Korean version of the Quality of Recovery-40 questionnaire (QoR-40 K) on postoperative day (POD) 1, and ambulation (success rate, number of footsteps) 6–12 h after surgery and on POD 1. The pain score for the wound site, IV opioid requirement, postoperative complications including incidences of nausea/vomiting, and length of in-hospital stay were also assessed.

Results

The global QoR-40 K score and all subscale scores (physical comfort, emotional state, physical independence, psychological support, and pain) were significantly higher in the IV propofol group than in the IH sevoflurane group. The numbers of footsteps at all time points were also higher in the IV propofol group. Donors in the IV propofol group had a lower incidence of nausea/vomiting, and a shorter hospitalization period.

Conclusions

Total IV anesthesia with propofol led to better early postoperative recovery than that associated with IH sevoflurane.

Trial registration

Clinical Research Information Service, Republic of Korea (approval number: KCT0004351) on October 18, 2019.
Prevalence and associated factors of birth asphyxia among live births at Debre Tabor General Hospital, North Central Ethiopia
Authors: Bayih Wubet Alebachew , Yitbarek Getachew Yideg , Aynalem Yared Asmare , Abate Biruk Beletew , Tesfaw Aragaw , Ayalew Metadel Yibeltal , Belay Demeke Mesfin , Hailemeskel Habtamu Shimelis , Alemu Abebaw Yeshambel
Published: October 2020

Background

More than one third of the neonatal deaths at Neonatal Intensive Care Unit (NICU) in Debre Tabor General Hospital (DTGH) are attributable to birth asphyxia. Most of these neonates are referred from the maternity ward in the hospital. Concerns have also been raised regarding delayed intrapartum decisions for emergency obstetrics action in the hospital. However, there has been no recent scientific evidence about the exact burden of birth asphyxia and its specific determinants among live births at maternity ward of DTGH. Moreover, the public health importance of delivery time and professional mix of labor attendants haven’t been addressed in the prior studies.

Methods

Hospital based cross sectional study was conducted on a sample of 582 mother newborn dyads at maternity ward. Every other mother newborn dyad was included from December 2019 to March 2020. Pre-tested structured questionnaire and checklist were used for data collection. The collected data were processed and entered into Epidata version 4.2 and exported to Stata version 14. Binary logistic regressions were fitted and statistical significance was declared at p less than 0.05 with 95% CI.

Results

The prevalence of birth asphyxia was 28.35% [95% CI: 26.51, 35.24%]. From the final model, fetal mal-presentation (AOR = 6.96: 3.16, 15.30), premature rupture of fetal membranes (AOR = 6.30, 95% CI: 2.45, 16.22), meconium stained amniotic fluid (AOR = 7.15: 3.07, 16.66), vacuum delivery (AOR =6.21: 2.62, 14.73), night time delivery (AOR = 6.01: 2.82, 12.79) and labor attendance by medical interns alone (AOR = 3.32:1.13, 9.78) were positively associated with birth asphyxia at 95% CI.

Conclusions

The prevalence of birth asphyxia has remained a problem of public health importance in the study setting. Therefore, the existing efforts of emergency obstetric and newborn care should be strengthened to prevent birth asphyxia from the complications of fetal mal-presentation, premature rupture of fetal membranes, meconium stained amniotic fluid and vacuum delivery. Moreover, night time deliveries and professional mixes of labor and/delivery care providers should be given more due emphasis.
The reliability of the health related quality of life questionnaire PedsQL 3.0 cancer module in a sample of Swedish children
Authors: Sand Peter , Kleiberg Anna Nilsson , Kljajić Marizela , Lannering Birgitta
Published: October 2020

Background

The Pediatric Quality of Life Inventory (PedsQL) is a modular instrument, designed to integrate generic and disease specific measures, and includes both self- and proxy-reports. The aim of the study was to assess the reliability and limited validity of the Swedish version of the disease specific Pediatric Quality of Life Inventory 3.0 Cancer Module Scales (PedsQL 3.0), in a sample of Swedish children diagnosed with cancer.

Method

A total of 94 families at The Queen Silvia Children’s Hospital, Sahlgrenska University participated in the study. The Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL 4.0) and the PedsQL 3.0 were administered to 63 children (aged 5–18 years) with cancer and to 94 parents of children with cancer aged 2–18 years.

Results

The internal consistency of the PedsQL 3.0, reached or exceeded Cronbach’s alpha values of 0.70 for both -self- and proxy-reports. The PedsQL 4.0 and PedsQL 3.0 were highly correlated (r = 0.94 for proxy-reports and r = 0.91 for self-reports), indicating convergent validity.

Conclusion

PedsQL 3.0 Cancer Module Scales can be used as a valuable tool for measuring cancer-specific HRQOL in child populations, both in research and in clinical practice.
Trends and determinants of condomless sex in gonorrhoea patients diagnosed in France through the sentinel surveillance network ResIST, 2005–2014
Authors:   Referents for the Regional Offices of the French National Public Health Agency (Santé Publique France), Itodo Oche Adam , Viriot Delphine , Velter Annie , Leon Lucie , Dupin Nicolas , Bercot Beatrice , Goubard Agathe , Lassau François , Fouere Sébastien , Martinet Pervenche , Tosini William , Florence Sophie , Lot Florence , Ndeikoundam Ngangro Ndeindo
Published: October 2020

Background

Gonorrhoea is increasing in France since its resurgence in the late 1990’s. Understanding trends of condomless sex is a requirement to tailor prevention toward most exposed individuals. This study aims to analyse trends and determinants of condomless penetrative sex (PS) in MSM and heterosexuals diagnosed with gonorrhoea in France.

Methods

A standardized self-administered questionnaire filled by 3453 patients was used to monitor condomless sex through the sentinel surveillance network ResIST between 2005 and 2014. Trends were used to describe consistent condom use for penetrative sex (PS). A logistic regression model analysed patients’ characteristics associated with condomless PS.

Results

Between 2005 and 2014, condomless PS increased regardless of sexual orientation. Condomless PS was particularly common among HIV positive men who have sex with men (MSM (65%)). People living in metropolitan regions outside Paris area (adjusted odds-ratio (AOR) [95% CI] =1.33[1.12–1.58]) were more likely to engage in condomless PS. Conversely, MSM (AOR [95% CI] =0.21 [0.16–0.29]), HIV seronegative patients (AOR [95% CI] =0.68 [0.51–0.89]), patients diagnosed in hospital (AOR [95% CI] = 0.66 [0.45–0.97]) and multi-partners (≥ 10 partners, AOR [95% CI] = 0.54 [0.40–0.74]) were more likely to use condoms.

Conclusions

These findings highlight a decreasing use of condom in MSM and heterosexuals diagnosed with gonorrhoea. Prevention strategies should take in account drivers of condomless sex in a context of uncontrolled STI epidemics.
Global health education in medical schools (GHEMS): a national, collaborative study of medical curricula
Authors:   InciSioN UK Collaborative
Published: October 2020

Background

Global health is the study, research, and practice of medicine focused on improving health and achieving health equity for all persons worldwide. International and national bodies stipulate that global health be integrated into medical school curricula. However, there is a global paucity of data evaluating the state of global health teaching in medical schools. This study aimed to evaluate the extent of global health teaching activities at United Kingdom (UK) medical schools.

Methods

A national, cross-sectional study assessing all timetabled teachings sessions within UK medical courses for global health content during the academic year 2018/19. Global health content was evaluated against a comprehensive list of global health learning outcomes for medical students.

Results

Data from 39 medical courses representing 86% (30/36) of eligible medical schools was collected. Typically, medical courses reported timetabled teaching covering over three-quarters of all global health learning outcomes. However, a wide degree of variation existed among granular global health learning objectives covered within the different medical courses. On average, each learning outcome had a 79% [95% CI: 73, 83%] probability of being included in course curricula. There were a number of learning outcomes that had a lower probability, such as ‘access to surgeons with the necessary skills and equipment in different countries’ (36%) [95% CI: 21, 53%], ‘future impact of climate change on health and healthcare systems’ (67%) [95% CI: 50, 81%], and ‘role of the WHO’ (54%) [95% CI: 28, 60%].

Conclusions

This study served as the first national assessment of global health education and curricula within UK medical schools. Through a formalised assessment of teaching events produced by medical schools around the country, we were able to capture a national picture of global health education, including the strengths of global health prioritisation in the UK, as well as areas for improvement. Overall, it appears broad-level global health themes are widely discussed; however, the granularities of key, emerging areas of concern are omitted by curricula. In particular, gaps persist relating to international healthcare systems, multilateral global health agencies such as the WHO, global surgery, climate change and more.
Permeability of the windows of the brain: feasibility of dynamic contrast-enhanced MRI of the circumventricular organs
Authors: Verheggen Inge C. M. , de Jong Joost J. A. , van Boxtel Martin P. J. , Postma Alida A. , Verhey Frans R. J. , Jansen Jacobus F. A. , Backes Walter H.
Published: October 2020

Background

Circumventricular organs (CVOs) are small structures without a blood–brain barrier surrounding the brain ventricles that serve homeostasic functions and facilitate communication between the blood, cerebrospinal fluid and brain. Secretory CVOs release peptides and sensory CVOs regulate signal transmission. However, pathogens may enter the brain through the CVOs and trigger neuroinflammation and neurodegeneration. We investigated the feasibility of dynamic contrast-enhanced (DCE) MRI to assess the CVO permeability characteristics in vivo, and expected significant contrast uptake in these regions, due to blood–brain barrier absence.

Methods

Twenty healthy, middle-aged to older males underwent brain DCE MRI. Pharmacokinetic modeling was applied to contrast concentration time-courses of CVOs, and in reference to white and gray matter. We investigated whether a significant and positive transfer from blood to brain could be measured in the CVOs, and whether this differed between secretory and sensory CVOs or from normal-appearing brain matter.

Results

In both the secretory and sensory CVOs, the transfer constants were significantly positive, and all secretory CVOs had significantly higher transfer than each sensory CVO. The transfer constants in both the secretory and sensory CVOs were higher than in the white and gray matter.

Conclusions

Current measurements confirm the often-held assumption of highly permeable CVOs, of which the secretory types have the strongest blood-to-brain transfer. The current study suggests that DCE MRI could be a promising technique to further assess the function of the CVOs and how pathogens can potentially enter the brain via these structures.

Trial registration: Netherlands Trial Register number: NL6358, date of registration: 2017-03-24
The reliability, validity and factorial structure of the Swahili version of the 7-item generalized anxiety disorder scale (GAD-7) among adults living with HIV from Kilifi, Kenya
Authors: Nyongesa Moses K. , Mwangi Paul , Koot Hans M. , Cuijpers Pim , Newton Charles R. J. C. , Abubakar Amina
Published: October 2020

Background

Generalized Anxiety Disorder (GAD) is under-investigated in people living with HIV/AIDS from sub-Saharan Africa. In part, this is due to paucity of culturally appropriate measures for GAD which are psychometrically robust. This study aimed to evaluate the reliability, factorial structure, and validity of Swahili version of the 7-item GAD questionnaire (GAD-7) among adults living with HIV.

Study design

Descriptive cross-sectional study.

Methods

450 adults receiving comprehensive care from an HIV specialized clinic in Kilifi County, coastal Kenya, were consecutively recruited. Swahili versions of GAD-7, Patient Health Questionnaire (PHQ-9) and a 12-item HIV stigma scale were administered alongside measures of psychosocial and health-related characteristics. Internal consistency, test–retest reliability, factorial structure, convergent validity, and discriminant validity of Swahili GAD-7 were examined using Cronbach’s alpha (α), intra-class correlation coefficient (ICC), Confirmatory Factor Analysis (CFA), Pearson’s correlation, and analysis of covariance (ANCOVA), respectively.

Results

Internal consistency of Swahili GAD-7 was good,α = 0.82 (95%CI0.78, 0.85). Its test–retest reliability (2 weeks apart) was acceptable, ICC = 0.70 (95%CI0.55, 0.81). A confirmatory analysis of a one-factor solution indicated an excellent fit to the hypothesized structure (RMSEA = 0.00 [95% confidence interval 0.00, 0.05], CFI = 1.00, TLI = 1.00). Multi-group CFA substantiated factorial invariance for sex and age for the one-factor structure of Swahili GAD-7. Scores of GAD-7, Swahili version, significantly correlated with those of PHQ-9 (r = 0.73; p < 0.001)and the HIV stigma scale (r = 0.36; p < 0.001)suggesting good convergent validity. Statistically significant differences were observed between participants on first-line antiretroviral therapy compared to those on second-line treatment(F [1, 441] = 5.55, p = 0.02)indicative of good discriminant validity of Swahili GAD-7.

Conclusion

GAD-7 Swahili version retained its original unidimensional latent structure with good psychometric properties among adults living with HIV from Kilifi, Kenya. It can be used to identify symptoms of GAD in similar research settings. However, to confidently identify those in need of mental health treatment or referral services in HIV primary care clinics, more research on the validity of Swahili GAD-7 is needed especially its discriminant validity and diagnostic accuracy at different cut-off scores.
Host phylogeny matters: Examining sources of variation in infection risk by blood parasites across a tropical montane bird community in India
Authors: Gupta Pooja , Vishnudas C. K. , Robin V. V. , Dharmarajan Guha
Published: October 2020

Background

Identifying patterns and drivers of infection risk among host communities is crucial to elucidate disease dynamics and predict infectious disease risk in wildlife populations. Blood parasites of the generaPlasmodiumandHaemoproteusare a diverse group of vector-borne protozoan parasites that affect bird populations globally. Despite their widespread distribution and exceptional diversity, factors underlying haemosporidian infection risk in wild bird communities remain poorly understood. While some studies have examined variation in avian haemosporidian risk, researchers have primarily focused on host ecological traits without considering host phylogenetic relationships. In this study, we employ a phylogenetically informed approach to examine the association between host ecological traits and haemosporidian infection risk in endemic bird communities in the Western Ghats Sky Islands.

Methods

We used parasite sequence data based on partial mitochondrial cytochromebgene, that was amplified from genomic DNA extracted from 1177 birds (28 species) across the Western Ghats to assess infection of birds with haemosporidian parasites. We employed a Bayesian phylogenetic mixed effect modelling approach to test whether haemosporidian infection risk was affected by seven species-specific and four individual-level ecological predictors. We also examined the effect of host phylogenetic relationships on the observed patterns of variation in haemosporidian infection risk by estimating phylogenetic signal.

Results

Our study shows that host ecological traits and host phylogeny differentially influence infection risk byPlasmodium(generalist parasite) andHaemoproteus(specialist parasite). ForPlasmodium, we found that sociality, sexual dimorphism and foraging strata were important ecological predictors. ForHaemoproteus, patterns of infection risk among host species were associated with sociality, species elevation and individual body condition. Interestingly, variance in infection risk explained by host phylogeny was higher forHaemoproteusparasites compared toPlasmodium.

Conclusions

Our study highlights that while host ecological traits promoting parasite exposure and host susceptibility are important determinants of infection risk, host phylogeny also contributes substantially to predicting patterns of haemosporidian infection risk in multi-host communities. Importantly, infection risk is driven by joint contributions of host ecology and host phylogeny and studying these effects together could increase our ability to better understand the drivers of infection risk and predict future disease threats.

Graphical abstract