bluuebunny/crossref_metadata_2025 huggingface dataset:
Higher Education Quality and Student Satisfaction: Meta-Analysis, Subgroup Analysis and Meta-Regression
Authors: Dhawan Shivangi
Published: March 2022

This article reports the findings of a systematic literature review and meta-analysis carried out to identify various quality dimensions in higher education that contributes to student satisfaction. The results of heterogeneity generated from the meta-analysis were further explored via subgroup analysis and meta-regression. To fulfil these objectives, we summarized 122 qualitative studies and 40 quantitative studies that were relevant and important. Most of the included studies for meta-analysis ( N = 40) assessed the relationship between different quality dimensions in higher education institutions and student satisfaction. All six dimensions were found to be positively associated with the dependent variable (student satisfaction). Administrative service quality was found to have the highest correlation with student satisfaction, followed by student support quality, lecturer quality, teaching quality, curriculum quality, and physical evidence quality. The three categorical variables (student, university, and country) were included to test for moderation individually and collectively—these categorical variables, when taken together, moderates all the relationships except lecturer quality–student satisfaction. To our understanding, the current research will be the first one to examine the relationship between six higher education quality dimensions and student satisfaction based on a meta-analysis and meta-regression. The current analysis offers more novel details on the detection of significant moderating variables (type of student, type of university, and country of the study). These consolidated findings help us in identifying the existing state of literature, that is, what we consider and what we do not.
Heterogeneity Effect of Central Bank Independence on Inflation in Developing Countries
Authors: Anwar Cep Jandi
Published: March 2022

This research investigates the relationship between central bank independence and inflation for 37 developing countries during the period from 1972 to 2019. Given that most developing countries experienced high inflation, many opted for central bank independence to enhance their focus on inflation. Central bank independence reforms were anticipated to create a higher level of independence, which would result in a low inflation rate. We employed pooled least square with the assumption of homogeneity of co-efficients; the result showed no significant relationship between central bank independence and inflation. We checked the homogeneity assumption of the panel by applying Chow and Roy–Zellner tests; results showed that the model was not homogeneous. Furthermore, we performed the panel heterogeneity model with the pooled mean group estimator which indicated that a reverse relationship exists between central bank independence and inflation. This finding is robust as we split the sample into two groups: moderate and high inflation countries; the negative relationship between those variables still exists.
A longitudinal study of foreign language enjoyment and boredom: A latent growth curve modeling
Authors: Kruk Mariusz , Pawlak Mirosław , Elahi Shirvan Majid , Taherian Tahereh , Yazdanmehr Elham
Published: March 2022

The present research aimed to explore the dynamic growth of two emotional constructs: foreign language enjoyment (FLE) and foreign language learning boredom (FLLB) among L2 learners. To do so, we used a method that would capture the inherent dynamicity of L2 learners’ enjoyment and boredom during an EFL course. To this aim, a bivariate latent growth curve model (LGCM) was employed to examine the covariance between 412 EFL learners’ initial and growth levels of FLE and FLLB on four measurement occasions at two-week intervals. To collect the data, the original FLE scale and the newly developed FLLB scale were used. The model including the covariance between intercepts and slopes of FLE and FLLB was tested in Mplus 7. The analysis of the data revealed that the covariance between the intercept and slope of the FLE and FLLB was statistically significant and negative. This attests to the existence of a parallel process (co-variance) of FLE and FLLB, which indicates that an increase in the level of FLE among the participating L2 learners was strongly associated with a decrease in the level of FLLB during the whole course. The findings and implications are discussed in light of the existing literature.
Reliability assessment of phased mission systems with ternary components
Authors: Bidarmaghz Hamid Reza , Zarezadeh Somayeh
Published: March 2022

Phased mission systems (PMSs) appear in many areas of science and technology. A PMS accomplishes its mission in multiple non-overlapping consecutive phases. The system may perform different tasks in the phases under different success criteria, configurations, and environmental situations. In this article, we consider a PMS with components having three states: complete performance, partial performance, and complete failure. The reliability of the system is explored under two different scenarios. The first case is about the PMS with similar components in the phases and the latter one is on the PMS which may have multiple types of components in the phases. To this, in each case, a new version of survival signature is defined for the system which depends only on the system structure and is free of the random mechanism of components failure. Then, under these circumstances, some compact expressions are given for the PMS reliability in which the structure of PMS is separated from the reliability functions of the components. The results are generalized to the PMSs with multi-state components. Some examples and a real practical system are given to illustrate the proposed models.
Surgical resection of venous malformations of the forearm
Authors: Laurian Claude , Bisdorff Annouk , Masonni Claudine , Cerceau Pierre , Paraskevas Nikos
Published: March 2022

We retrospectively reviewed 35 patients with venous malformations located in the forearm and treated by surgery in a single institution during the period 2010–19. The common complaints were pain and swelling (34 patients) and impaired function with contractures of fingers (15 patients). Twenty-four had complete resection and 11 had an incomplete resection. Associated procedures were reconstruction or lengthening of tendons in 17 patients. At the last follow-up (mean 61 months), 32 of the 35 had no residual pain and 27 had no functional sequelae. On MRI follow-up exams, 27 had no residual venous malformations. Venous malformations in the anterior compartment of the forearm can impair the function of the hand. They are developed almost exclusively in the connective tissue around tendons and muscles, deforming the musculotendinous structures and involving nerves. Surgery seems an appropriate option for the condition in this area.

Level of evidence: IV
Future challenges in rheumatology – is telemedicine the solution?
Authors: Thurah Annette de , Marques Andrea , Souza Savia de , Crowson Cynthia S. , Myasoedova Elena
Published: March 2022

The COVID-19 pandemic has become an unprecedented facilitator of rapid telehealth expansion within rheumatology. Due to demographic shifts and workforce shortages in the future, new models of rheumatology care will be expected to emerge, with a growing footprint of telehealth interventions. Telehealth is already being used to monitor patients with rheumatic diseases and initial studies show good results in terms of safety and disease progression. It is being used as a tool for appointment prioritization and triage, and there is good evidence for using telehealth in rehabilitation, patient education and self-management interventions. Electronic patient-reported outcomes (ePROs) offer a number of long-term benefits and opportunities, and a routine collection of ePROs also facilitates epidemiological research that can inform future healthcare delivery. Telehealth solutions should be developed in close collaboration with all stakeholders, and the option of a telehealth visit must not deprive patients of the possibility to make use of a conventional ‘face-to-face’ visit. Future studies should especially focus on optimal models for rheumatology healthcare delivery to patients living in remote areas who are unable to use or access computer technology, and other patient groups at risk for disparity due to technical inequity and lack of knowledge.
Protecting and Scaffolding: How Parents Facilitate Children's Activities in Public Space in Urban China
Authors: Luo (落鑫) Xin
Published: March 2022

Purpose

During the past decades, China has seen a rapid urbanization that has (re)shaped not only its city landscape but also (re)created public space where children live, play, and learn. However, little research has focused on how urban public space influences young children's learning and development and how parents navigate children's development in the public space. Therefore, this research aims to study how public space influences parents’ engagement with their young children.

Design/Approach/Methods

This study is informed of Bronfenbrenner's Processes, Person, Context, and Time (PPCT) model that sees children's learning as complex and multilateral interactions among various stakeholders including schools, families, and environment. It employed ethnographic approach to study the interactions between children and their parents in a public playground in a Western Chinese city.

Findings

It found that parents realized public space had been reshaped by urbanization. While they accompanied their children to play, they actively monitored children's safety and cultivated children's physical and social development. In this process, male parents tended to contribute more than they would do in other settings.

Originality/Value

This study fills the gap by providing a nuanced study exploring how parents fulfill their responsibilities in an integral space of children's development, which has rarely been explored.
Contextualising Colonial Education from a Historiographical Perspective in the Nineteenth Century: Institutions and Policies
Authors: Kumari Sangeeta
Published: March 2022

India was colonised by the British and was under the British rule for almost 200 years. During the British rule the shape of India changed and almost all aspects of life was affected. In this historical context that the paper is trying to locate the educational changes brought about not only by the British government but also by the philanthropists, missionaries in Delhi. The policies were changed to suit the needs of the colonial state and how the different sections of the society responded to those changes and apart from government run educational institutions many other institutions were set up. The controversy around the issue of medium of education that is whether it should be in indigenous language or in English language that knowledge should be disseminated to native population came up and the Macaulay Minutes, 1835 decided in favour of English as the medium of instruction. The whole process of the colonial policy change led to decimation of the existing extensive indigenous knowledge system of India.
Impact of Organizational Culture on the Effectiveness of Organizations: A Case Study of Some Service Sector Organizations in Manipur
Authors: Nungchim Bridget Nungchensha , Leihaothabam Jibon Kumar Sharma
Published: March 2022

Background:

It may be understood to assume that the performance and effectiveness of an organization solely depend on the setup of organizational culture as it (organizational culture) embodies the vision and mission of the organization including the attitudes and behaviors of the employees and the organization’s manner of functioning in the organization. Nonetheless, the association between the organizational culture and its effectiveness in service sector organizations appears to vary from one organization to the other with varying degrees and directions within the state.

Aims and objectives:

To assess the impact of organizational culture on the overall effectiveness and to evaluate the association between each component of organizational culture and its effectiveness of service sector organizations.

Materials and methods:

The present study is based on a primary sample of 140 employees selected from Manipur in Northeast India. The sample size is estimated on the findings of the pilot survey, and stratified random sampling is adopted as the type of sampling. The paired t-test is used as the statistical formula for testing of significance between the mean percentage scores; and Karl Pearson correlation co-efficient r is applied to establish the correlation between overall effectiveness of service sector organization and overall and each facet of organizational culture separately.

Results:

The findings of the study conclude that the better the organizational culture the better the effectiveness of the organization.
Dissecting platelet proteomics to understand the pathophysiology of immune thrombocytopenia: studies in mouse models
Authors: Martínez-Botía Patricia , Meinders Marjolein , De Cuyper Iris M. , Eble Johannes A. , Semple John W. , Gutiérrez Laura
Published: March 2022

Immune thrombocytopenia (ITP) is an autoimmune disease characterized by enhanced platelet clearance and defective platelet production. Diagnosis by exclusion and trial-and-error treatment strategies is common practice, and despite the advancement in treatment options, many patients remain refractory. Although the existence of different pathophysiological entities is acknowledged, we are still far from stratifying and understanding ITP. To investigate, we sought to dissect the platelet proteome dynamics in so-called passive and active preclinical ITP mouse models, with which we propose to phenocopy respectively acute/newly diagnosed and persistent/chronic stages of ITP in humans. We obtained the platelet proteome at the thrombocytopenic stage and after platelet count recovery (reached naturally or by IVIg-treatment, depending on the model). Although most of the proteomic alterations were common to both ITP models, there were model-specific protein dynamics that accompanied and explained alterations in platelet aggregation responses, as measured in the passive ITP model. The expression dynamics observed in Syk may explain, extrapolated to humans and pending validation, the increased bleeding tendency of patients with ITP when treated with fostamatinib as third or later– as opposed to second line of treatment. We propose that the platelet proteome may give diagnostic and prognostic insights into ITP and that such studies should be pursued in humans.
ERS International Congress 2021: highlights from the Thoracic Surgery and Lung Transplantation Assembly
Authors: Bos Saskia , Ricciardi Sara , Caruana Edward J. , Acet Öztürk Nilüfer Aylin , Magouliotis Dimitrios , Pompili Cecilia , Migliore Marcello , Vos Robin , Meloni Federica , Elia Stefano , Hellemons Merel
Published: March 2022

The thoracic surgery and lung transplantation assembly of the European Respiratory Society (ERS) is delighted to present the highlights from the 2021 ERS International Congress. We have selected four sessions that discussed recent advances across a wide range of topics including: digital health surveillance in thoracic surgery, emerging concepts in pulmonary metastasectomy, advances in mesothelioma care, and novel developments in lung graft allocation and monitoring. The sessions are summarised by early career members in close collaboration with the assembly faculty. We aim to give the reader an update on the highlights of the conference in the fields of thoracic surgery and lung transplantation.
Prediction of maximal oxygen uptake from 6-min walk test in pulmonary hypertension
Authors: Appenzeller Paula , Gautschi Fiorenza , Müller Julian , Lichtblau Mona , Saxer Stéphanie , Schneider Simon R. , Schwarz Esther I. , Ulrich Silvia
Published: March 2022

Maximal oxygen uptake (V′O2max), assessed by cardiopulmonary exercise testing (CPET), is an important parameter for risk assessment in patients with pulmonary hypertension (PH). However, CPET may not be available for all PH patients. Thus, we aimed to test previously published predictive models ofV′O2maxfrom the 6-min walk distance (6MWD) for their accuracy and to create a new model.

We tested four models (two by Rosset al. (2010), one by Miyamotoet al. (2000) and one by Zapicoet al. (2019)). To derive a new model, data were split into a training and testing dataset (70:30) and step-wise linear regression was performed. To compare the different models, the standard error of the estimate (SEE) was calculated and the models graphically compared by Bland–Altman plots. Sensitivity and specificity for correct prediction into low-risk classification (V′O2max>15 mL/min/kg) was calculated for all models.

A total of 276 observations were included in the analysis (194/82 training/testing dataset); 6MWD andV′O2maxwere significantly correlated (r=0.65, p<0.001). Linear regression showed significant correlation of 6MWD, weight and heart rate response (HRR) withV′O2maxand the best fitting prediction equation was:V′O2max= 1.83 + 0.031 × 6MWD (m) – 0.023 × weight (kg) – 0.015 × HRR (bpm). SEEs for the different models were 3.03, 3.22, 4.36 and 3.08 mL/min/kg for the Rosset al., Miyamotoet al., Zapicoet al. models and the new model, respectively. Predicted meanV′O2maxwas 16.5 mL/min/kg (versusobserved 16.1 mL/min/kg).

6MWD andV′O2maxreveal good correlation in all models. However, the accuracy of all models is inadequate for clinical use. Thus, CPET and 6MWD both remain valuable risk assessment tools in the management of PH.
Extensive evaluation of ATAC-seq protocols for native or formaldehyde-fixed nuclei
Authors: Zhang Hao , Rice Michael E. , Alvin Joseph W. , Farrera-Gaffney Dominique , Galligan James J. , Johnson Michael D. L. , Cusanovich Darren A.
Published: March 2022

Background

The “Assay for Transposase Accessible Chromatin sequencing” (ATAC-seq) is an efficient and easy to implement protocol to measure chromatin accessibility that has been widely used in multiple applications studying gene regulation. While several modifications or variants of the protocol have been published since it was first described, there has not yet been an extensive evaluation of the effects of specific protocol choices head-to-head in a consistent experimental setting. In this study, we tested multiple protocol options for major ATAC-seq components (including three reaction buffers, two reaction temperatures, two enzyme sources, and the use of either native or fixed nuclei) in a well-characterized cell line. With all possible combinations of components, we created 24 experimental conditions with four replicates for each (a total of 96 samples). In addition, we tested the 12 native conditions in a primary sample type (mouse lung tissue) with two different input amounts. Through these extensive comparisons, we were able to observe the effect of different ATAC-seq conditions on data quality and to examine the utility and potential redundancy of various quality metrics.

Results

In general, native samples yielded more peaks (particularly at loci not overlapping transcription start sites) than fixed samples, and the temperature at which the enzymatic reaction was carried out had a major impact on data quality metrics for both fixed and native nuclei. However, the effect of various conditions tested was not always consistent between the native and fixed samples. For example, the Nextera and Omni buffers were largely interchangeable across all other conditions, while the THS buffer resulted in markedly different profiles in native samples. In-house and commercial enzymes performed similarly.

Conclusions

We found that the relationship between commonly used measures of library quality differed across temperature and fixation, and so evaluating multiple metrics in assessing the quality of a sample is recommended. Notably, we also found that these choices can bias the functional class of elements profiled and so we recommend evaluating several formulations in any new experiments. Finally, we hope the ATAC-seq workflow formulated in this study on crosslinked samples will help to profile archival clinical specimens.
Expression characterization and cross-species complementation uncover the functional conservation of YABBY genes for leaf abaxial polarity and carpel polarity establishment in Saccharum spontaneum
Authors: She Zeyuan , Huang Xiaoyi , Aslam Mohammad , Wang Lulu , Yan Maokai , Qin Rongjuan , Chen Yingzhi , Qin Yuan , Niu Xiaoping
Published: March 2022

Background

Cell polarity establishment and maintenance is indispensable for plant growth and development. In plants, the YABBY transcription factor family has a distinct role in leaf asymmetric polarity establishment and lateral organ initiation. However, for the important sugar crop Saccharum, little information on YABBY genes is available.

Results

In this study, a total of 20 sequences for 7 SsYABBY genes were identified in the sugarcane genome, designated as SsYABBY1-7 based on their chromosome locations, and characterized by phylogenetic analysis. We provided a high-resolution map of SsYABBYs’ global expression dynamics during vegetative and reproductive organ morphogenesis and revealed that SsYABBY3/4/5 are predominately expressed at the seedling stage of stem and leaf basal zone; SsYABBY2/5/7 are highly expressed in ovules. Besides, cross-species overexpression and/or complementation verified the conserved function of SsYABBY2 in establishing leaf adaxial-abaxial polarity and ovules development. We found that the SsYABBY2 could successfully rescue the leaves curling, carpel dehiscence, and ovule abortion defects in Arabidopsis crc mutant.

Conclusions

Collectively, our study demonstrates that SsYABBY genes retained a conserved function in establishing and preserving leaf adaxial-abaxial polarity and lateral organ development during evolution.
Effect of CYP2C19 genetic polymorphism on the pharmacodynamics and clinical outcomes for patients treated with ticagrelor: a systematic review with qualitative and quantitative meta-analysis
Authors: Xie Qiufen , Xiang Qian , Liu Zhiyan , Mu Guangyan , Zhou Shuang , Zhang Zhuo , Ma Lingyue , Gong Yanjun , Jiang Jie , Cui Yimin
Published: March 2022

Background

Studies show inconsistent results regarding the impact ofCYP2C19genotype on the pharmacodynamics (PD) and clinical outcomes of ticagrelor. With the implementation of genotype-guided individualized antiplatelet therapy, the association betweenCYP2C19polymorphism and the efficacy and safety of ticagrelor for patients is still worthy of exploring and studying.

Methods

This systematic review protocol has been registered in the PROSPERO network (No. CRD 42020158920). Electronic databases of PubMed, EmBase, and the Cochrane Library were systematically searched from inception to January 6th, 2022 to select studies investigating the impact ofCYP2C19genotype on PD and clinical outcomes of ticagrelor. The results were presented as odds ratio (OR) or weight mean difference with its 95% confidence interval (CI) by using the random-effects model. Trial sequential analysis (TSA) was used to control risk of random errors and detect the robustness of outcomes.

Results

Eight studies recruited a total of 6405 patients treated with ticagrelor. Mostly trials reported no significant effect of any or noCYP2C19loss-of-function (LOF) allele (*2 or *3) on all the endpoints. Compared with no LOF allele carriers, subgroup analysis suggested any LOF allele in Asian patients was associated with a significant decreased risk of bleeding events (OR: 0.41; 95% CI: 0.22–0.75;P = 0.004). Furthermore, any LOF allele carriers didn’t yield any impact on the risk of MACEs (OR: 1.11; 95% CI: 0.76–1.64;P = 0.586), stroke (OR: 1.71; 95% CI: 0.99–2.96;P = 0.054), definite stent thrombosis (OR: 0.88; 95% CI: 0.17–4.60;P = 0.882), bleeding (OR: 0.63; 95% CI: 0.27–1.46;P = 0.281), myocardial infarction (OR: 0.81; 95% CI: 0.30–2.20;P = 0.682), and revascularization (OR: 0.81; 95% CI: 0.33–2.00;P = 0.649) in all patients. The results of TSA were indicated that more further trials would be required.

Conclusions

This qualitative and quantitative study suggested Asian patients carrying anyCYP2C19LOF allele might have a lower risk of bleeding events comparing with no LOF allele carriers when treated with ticagrelor. However, we did not prove an important role ofCYP2C19genotype on the risk of PD and clinical endpoints in the whole cohort. In future, more large-scale prospective studies and more different ethnic populations should be included.
Cardiovascular risks before myocardial infarction differences between men and women
Authors: Nyström Alice , Strömberg Susanne , Jansson Karin , Faresjö Åshild Olsen , Faresjö Tomas
Published: March 2022

Background

Prodromal cardiac symptoms are warning signals preceding cardiac disease. Previous studies have shown some gender differences in prodromal symptoms as well as established risk factors for MI. This study aims to map possible gender differences in social factors and established risk factors preceding myocardial infarction (MI).

Methods

The study includes data of N = 213 middle-aged men and women, all diagnosed with myocardial infarction (ICD-10 I21.9) from the region of south-east Sweden. They answered a questionnaire at discharge from the cardiologic clinic and additional clinical data from medical records were merged from the National Swedeheart Register.

Results

The dominant prodromal symptom for both sexes were experience of chest pain at the onset of MI. The major gender differences were that significantly more females (p = 0.015) had a hyperlipidemia diagnose. Females also reported to have experienced higher stress load the year preceding myocardial infarction with serious life events (p = 0.019), strained economy (p = 0.003), and reports of sadness/depression (p < 0.001). Females reported higher perceived stress load than men (p = 0.006). Men had higher systolic blood pressure than women at hospital admission and a higher systolic- and diastolic blood pressure at discharge.

Conclusions

Influences of the social environment, such as serious life events, strained economy, depression, stress, and sleep deprivation were stronger as potential risk factors for myocardial infarction in women than among men. Of the traditional risk factors only, hyperlipidemia was more frequent among women. These findings could contribute to a deeper understanding of diagnostic differences between gender, as well as a more gender-oriented cardiovascular preventive work.
Imaging features of biliary adenofibroma of the liver with malignant transformation: a case report with literature review
Authors: Hu Wenjun , Zhao Ying , Liu Yunsong , Hua Zhengyu , Liu Ailian
Published: March 2022

Background

Biliary adenofibroma (BAF) is a rare primary hepatic tumor with the potential risk of malignant transformation. Given the extreme rarity of the disease, the imaging features of BAF are unclear. We presented a case of malignant BAF and conducted a systematic literature review. We highlighted the key imaging features in the diagnosis and aggressiveness assessment of BAF, as well as the role of various imaging modalities in evaluating BAF.

Case presentation

We reported a 64-year-old woman with a 5-months history of pain in the right upper quadrant abdomen. US of the liver showed a hypoechoic subcapsular nodule. CT scan revealed a subcapsular solid-cystic mass in segment V of the liver. The mass showed a marked enhancement in the arterial phase followed by wash-out in the venous phase. The patient underwent partial resection of liver’s right lobe. The mass was diagnosed as BAF with malignant transformation by postoperative pathology.

Conclusions

CT and MRI are helpful in recognizing and characterizing BAF. The imaging features of BAF include a solitary, large solid-cystic mass with a well-defined margin, lobulated shape, and internal septa; subcapsular location; no intrahepatic bile duct communication; the presence of von Meyenberg complexes in background liver. The enhancement patterns may have the potential to assess the aggressiveness of BAF, and that marked enhancement in the arterial phase followed by wash-out in the venous phase is suggestive of malignant BAF.
Refractory thrombocytopenia could be a rare initial presentation of Noonan syndrome in newborn infants: a case report and literature review
Authors: Tang Xiujun , Chen Zheng , Shen Xiaoxia , Xie Tian , Wang Xiaohong , Liu Taixiang , Ma Xiaolu
Published: March 2022

Background

Noonan syndrome (NS) is a relatively rare inherited disease. Typical clinical presentation is important for the diagnosis of NS. But the initial presentation of NS could be significant variant individually which results in the difficult of working diagnosis. Here we report a rare neonatal case of NS who presented with refractory thrombocytopenia as the initial manifestation.

Case presentation

This was a preterm infant with refractory thrombocytopenia of unknown origin transferred from obstetric hospital at 6 weeks of age. During hospitalization, typical phenotypes of NS in addition to thrombocytopenia were observed, such as typical facial characteristics, short stature, atrial septal defect, cryptochidism, coagulation defect and chylothorax. Genetic testing showed a pathogenic variant at exon 2 of the PTPN11 gene with c.124A > G (p.T42A). Respiratory distress was deteriorated with progressive chylothorax. Chest tube was inserted for continuous draining. Chemical pleurodesis with erythromycin was tried twice, but barely effective. Finally, parents decided to withdraw medical care and the patient died.

Conclusions

Thrombocytopenia could be the first symptom of Noonan syndrome. After ruling out other common causes of thrombocytopenia, NS should be considered as the working diagnosis.
Risk factors and incidence of invasive bacterial infection in severe bronchiolitis: the RICOIB prospective study
Authors: Guitart Carmina , Alejandre Carme , Bobillo-Perez Sara , Girona-Alarcon Monica , Sole-Ribalta Anna , Cambra Francisco Jose , Balaguer Monica , Jordan Iolanda
Published: March 2022

Background

Bacterial infection (BI), both community-acquired (CA-BI) and hospital-acquired (HAI), might present as a severe complication in patients with bronchiolitis. This study aimed to describe BI in children with severe bronchiolitis, and to define risk factors for BI.

Methods

This was a prospective, descriptive study that included infants admitted to the pediatric intensive care unit (PICU) due to bronchiolitis between 2011 and 2017. The BROSJOD score was calculated to rate the severity of bronchiolitis.

Results

Inclusion of 675 patients, with a median age of 47 days (IQR 25–99). 175 (25.9%) patients developed BI, considered HAI in 36 (20.6%). Patients with BI had higher BROSJOD score, PRISM III, and required invasive mechanical ventilation and inotropic support more frequently (p < 0.001). BI was independently associated with BROSJOD higher than 12 (OR 2.092, 95%CI 1.168–3.748) CA-BI was associated to BROSJOD > 12 (OR 2.435, 95%CI 1.379–4.297) and bacterial co-infection (OR 2.294 95%CI 1.051–5.008). Concerning HAI, an independent association was shown with mechanical ventilation longer than 7 days (OR 5.139 95%CI 1.802–14.652). Infants with BI had longer PICU and hospital stay (p < 0.001), Mortality was higher in patients with HAI.

Conclusions

A quarter of infants with severe bronchiolitis developed BI. A BROSJOD > 12 may alert the presence of CA-BI, especially pneumonia. Patients with BI have higher morbidity and mortality.
Seeing pre-screened, regular clients associated with lower odds of workplace sexual violence and condom refusal amidst sex work criminalization: findings of a community-based cohort of sex workers in Metro Vancouver, Canada (2010-2019)
Authors: McBride Bronwyn , Shannon Kate , Pearson Jennie , Krüsi Andrea , Braschel Melissa , Goldenberg Shira M.
Published: March 2022

Background

Research that accurately represents how characteristics of sex work clients relate to sex workers’ labour conditions is crucial for informing evidence-based legislation which upholds sex workers’ human rights. As little quantitative research has examined how seeing regulars (repeat clients) impacts sex workers’ occupational safety, particularly under ‘end-demand’ criminalization in Canada, our study aimed to explore how seeing mostly regulars shapes workplace sexual violence and client condom refusal.

Methods

We drew on longitudinal data from a community-based open cohort of 900+ sex workers in Vancouver, recruited via time-location sampling during day and late-night outreach to indoor, outdoor, and online solicitation spaces. We used logistic regression analyses and multivariable GEE confounder models to 1) describe correlates of seeing mostly pre-screened, regular clients, 2) identify associations between seeing mostly regulars and odds of experiencing occupational outcomes of workplace sexual violence and client condom refusal, and 3) examine the interaction between seeing mostly regulars and work environment on workplace sexual violence and client condom refusal.

Results

Participants’ median age was 35, and 55.6% had completed high school. Over the 9-year study (n=925), 20.9% (193) experienced 282 events of workplace sexual violence and 40.2% (372) faced 702 events of client condom refusal. In multivariable GEE confounder models, seeing mostly regulars was associated with reduced odds of sexual violence (AOR 0.73, 95%CI 0.53-1.02, p=0.067) and client condom refusal (AOR 0.70, 95%CI 0.57-0.86). In multivariable GEE confounder models examining the additive interaction between seeing mostly regulars and work environment, participants who saw mostly regulars and primarily worked in outdoor or informal indoor venues faced significantly lower odds of experiencing workplace sexual violence (AOR 0.69, 95%CI 0.49-0.95) and client condom refusal (AOR 0.64, 95%CI 0.52 -0.80) relative to those who worked in the same venues and did not see mostly regulars.

Conclusion

Our findings highlight protective effects of seeing pre-screened regulars within a criminalized setting. Removal of ‘end-demand’ client criminalization is needed to enable sex workers to effectively screen clients, support HIV/STI prevention, and advance sex workers’ human rights.
Physiotherapist or physician as primary assessor for patients with suspected knee osteoarthritis in primary care – a cost-effectiveness analysis of a pragmatic trial
Authors: Ho-Henriksson Chan-Mei , Svensson Mikael , Thorstensson Carina A , Nordeman Lena
Published: March 2022

Background

Over the next decade, the number of osteoarthritis consultations in health care is expected to increase. Physiotherapists may be considered equally qualified as primary assessors as physicians for patients with knee osteoarthritis. However, economic evaluations of this model of care have not yet been described. To determine whether physiotherapists as primary assessors for patients with suspected knee osteoarthritis in primary care are a cost-effective alternative compared with traditional physician-led care, we conducted a cost-effectiveness analysis alongside a randomized controlled pragmatic trial.

Methods

Patients were randomized to be assessed and treated by either a physiotherapist or physician first in primary care. A cost-effectiveness analysis compared costs and effects in quality adjusted life years (QALY) for the different care models. Analyses were applied with intention to treat, using complete case dataset, and missing data approaches included last observation carried forward and multiple imputation. Non-parametric bootstrapping was conducted to assess sampling uncertainty, presented with a cost-effectiveness plane and cost-effectiveness acceptability curve.

Results

69 patients were randomized to a physiotherapist (n = 35) or physician first (n = 34). There were significantly higher costs for physician visits and radiography in the physician group (p < 0.001 and p = 0.01). Both groups improved their health-related quality of life 1 year after assessment compared with baseline. There were no statistically significant differences in QALYs or total costs between groups. The incremental cost-effectiveness ratio for physiotherapist versus physician was savings of 24,266 €/lost QALY (societal perspective) and 15,533 €/lost QALY (health care perspective). There is a 72–80% probability that physiotherapist first for patients with suspected knee osteoarthritis is less costly and differs less than ±0.1 in QALY compared to traditional physician-led care.

Conclusion

These findings suggest that physiotherapist-led care model might reduce health care costs and lead to marginally less QALYs, but confidence intervals were wide and overlapped no difference at all. Health consequences depending on the profession of the first assessor for knee osteoarthritis seem to be comparable for physiotherapists and physicians. Direct access to physiotherapist in primary care seems to lead to fewer physician consultations and radiography. However, larger clinical trials and qualitative studies to evaluate patients’ perception of this model of care are needed.

Clinical trial registration

The study was retrospectively registered in clinicaltrial.gov, ID: NCT03822533.
Application of a lateral intertubercular sulcus plate in the treatment of proximal humeral fractures: a finite element analysis
Authors: Li Dong , Lv WenXue , Chen WenMing , Meng Jing , Liu Song , Duan ZongKang , Yu Bo
Published: March 2022

Background

Inversion deformities caused by insufficient medial support are especially common when the PHILOS locking plate is used to treat proximal humeral fractures. Using finite element analysis, we aimed to compare the biomechanical properties of a PHILOS locking plate (PLP) and a PLP combined with a lateral intertubercular sulcus plate (PLP-LSP) in the fixation of proximal humeral fractures with loss of the medial column.

Methods

After creating a three-dimensional finite element model of a proximal humeral fracture with loss of the medial column, three implant models were established. A full-screw PLP was used in Group A, a PHILOS plate lacking medial screw support and an additional steel plate (MPLP-LSP) were used in Group B, and a full-screw PLP-LSP was used in Group C. The three fixation models were applied to the proximal humeral fracture model, following which horizontal, compressive, and rotational loads were applied to the humerus model. We evaluated structural stiffness and stress distribution in the implant and compared displacement and angle changes among the three models.

Results

Displacement and angle changes were smallest in Group C (PLP-LSP). The implant model used in Group C also exhibited greater structural rigidity, endured less von Mises stress, and was more stable than the models used in Group A and Group B.

Conclusion

An LSP placed at the intertubercular sulcus provides effective lateral and medial support, thereby reducing stress on the PLP and providing better stability with proximal humeral fractures.
Examining educational attainment and allostatic load in non-Hispanic Black women
Authors: Williams Brittany Marie , Laurent Christian , Chawla Rishab , Moore Justin Xavier
Published: March 2022

Background

Research suggests that non-Hispanic Black (henceforth, Black) women and people with lower educational attainment have higher levels of allostatic load (AL). This study sought to determine the association between educational attainment and AL among a large sample of Black women.

Methods

We analyzed data among 4177 Black women from the National Health and Nutrition Examination Survey years 1999–2018. AL score was defined as the total for abnormal measures of eight biomarkers. We further categorized participants with AL score greater than or equal to 4 as having high AL. We calculated mean estimates of total allostatic load scores using generalized linear models. We performed modified Poisson Regression models with robust variance estimation to estimate prevalence ratios (PRs) of high allostatic load and their associated 95% confidence intervals (CIs) by educational attainment.

Results

Black women with a college degree or higher had the lowest prevalence of high allostatic load (31.8% vs. 42.7%, 36.3%, 36.6%), and age adjusted mean allostatic load scores (mean = 1.90 vs. mean = 2.34, mean = 1.99, mean = 2.05) when compared to Black women with less than a high school diploma, high school diploma or GED, and some college or associates degree respectively. Even after accounting for age, poverty-to-income ratio, smoking, congestive heart failure, and heart attack, Black college graduates had an 14.3% lower prevalence of high allostatic load (PR = 0.857, 95% CI 0.839–0.876) when compared to Black women with lower educational attainment.

Conclusions

Black women with a baccalaureate degree or higher educational attainment had lower allostatic load compared to Black women with less than a high school education. This finding further confirms higher education is a social determinant of health. Future research should explore differences in AL by more granular degree types.
Protective effect of Sophora pachycarpa seed extract on carbon tetrachloride-induced toxicity in rats
Authors: Aramjoo Hamed , Mohammadparast-Tabas Pouria , Farkhondeh Tahereh , Zardast Mahmoud , Makhdoumi Marzieh , Samarghandian Saeed , Kiani Zahra
Published: March 2022

The aim of the present study was to investigate the protective effect of the Sophora pachycarpa (S. pachycarpa) seed extract against carbon tetrachloride-induced toxicity on body organs, blood, and biochemical factors. In this investigation, 40 male Wistar rats weighing 200–250 g were randomly divided into 5 groups: group I was used as control, group II received carbon tetrachloride (CCl4) (IP, 1 mL/kg) on day 21, group III and group IV received S. pachycarpa seed extract at doses of 150 mg/kg and 300 mg/kg, respectively for 21 days by oral gavage and CCl4 on day 21, group V received silymarin (300 mg/kg) for 21 days by oral gavage and CCl4 on day 21. CCl4 showed an increase of serum renal and hepatic markers creatinine, urea, blood urea nitrogen (BUN), and uric acid, alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Also, it significantly increased MDA level, and decreased CAT, FRAP, GSH, and SOD in the liver and kidney tissues. These changes and also hematological and histopathological alterations were significantly ameliorated by S. pachycarpa seed extract before CCl4 administration. In conclusion, the data obtained in our investigation confirm the protective effect of S. pachycarpa against acute exposure to CCl4-induced organ toxicity in rats.
Fruitflow inhibits platelet function by suppressing Akt/GSK3β, Syk/PLCγ2 and p38 MAPK phosphorylation in collagen-stimulated platelets
Authors: Chen Huilian , Zhang Shenghao , Wang Hui , Bao Li , Wu Wei , Qi Ruomei
Published: March 2022

Background

Platelets play an important role in the progression of atherosclerosis and cardiovascular events. The inhibition of platelet function is a main strategy to reduce risk of cardiovascular events. Some studies have shown that tomato extracts inhibit platelet function, but the molecular mechanisms remain unclear. Fruitflow is a water-solute tomato extract and the main ingredients including flavonoids, adenosine, chlorogenic acid, phytosterols, naringenin, and carotenoids. The present study investigated the effects of fruitflow on adenosine diphosphate (ADP)- and collagen- stimulated platelet aggregation, platelet adhesion, and levels of thromboxane B2 (TXB2), 6-keto-prostaglandin F1α (PGF1α), and platelet factor 4 (PF4) and explored the underlying molecular mechanisms.

Methods

Platelet-rich plasma (PRP) was used for measurement of platelet aggregation, TXB2, 6-keto- PGF1α, and PF4 levels. Platelet aggregation was analyzed using a Chrono-Log aggregometer. TXB2, 6-keto- PGF1α, and PF4 levels were determined using enzyme-linked immunosorbent assay kits. Immunoblotting was used to detect protein expression and phosphorylation on washed platelets. Platelet adhesion and spreading were determined by immunofluorescence.

Results

Fruitflow (1, 3, 10 and 100 μg/ml) dose-dependently inhibited platelet aggregation that was induced by ADP and collagen. Fruitflow (100 μg/ml) treatment completely suppressed ADP- and collagen-stimulated platelet aggregation. Fruitflow (100 μg/ml) significantly decreased TXB2 and 6-keto-PGF1α generation and PF4 release in ADP- and collagen-stimulated platelets. Treatment with fruitflow effectively blocked collagen-induced platelet spreading. To determine the potential molecule mechanism of action of fruitflow, we investigated the protein expression and phosphorylation of several signaling molecules in collagen-activated platelets. Fruitflow dose-dependently suppressed Akt, Glycogen synthase kinase-3β (GSK-3β), spleen tyrosine kinase (Syk) and phospholipase Cγ2 (PLCγ2) and p38 MAPK phosphorylation that was induced by collagen.

Conclusion

Fruitflow inhibited platelet aggregation and reduced TXB2, 6-keto-PGF1α, and PF4 levels in ADP- and collagen-stimulated platelets. The mechanism of action of fruitflow may be associated with the suppression of Akt/GSK3β, Syk/PLCγ2, and p38 MAPK phosphorylation in collagen-activated platelets. Fruitflow is a natural product derived from tomato and can be used as a health food for decreasing platelet activity.
Evidence-related requirements in Swedish public sector procurement of health and welfare technologies – a systematic review
Authors: Richardson Matt X. , Landerdahl Stridsberg Sara , Wamala Andersson Sarah
Published: March 2022

Background

Health and welfare technologies (HWT) are becoming increasingly employed in the Nordic countries, and in Sweden in particular. The amount of HWT public procurement is likely increasing at a similar rate, but requirements for evidence for effectiveness placed on bidders during this process may be lacking.

Method

This study investigated the use of evidence as a requirement in public sector tendering process of HWT, and how it affected bidder attributes and procurement outcomes. A novel type of systematic review and content analysis of requests for tenders for HWT announced prior to June 2021 was therefore conducted in Swedish public procurement databases.

Result

Ninety requests for tenders for 11 types of HWT met the inclusion criteria for review, accounting for potential contracts worth 246 to 296 million EUR. Criteria requiring evidence for effectiveness were used in 16 requests for tenders, accounting for 183 million EUR in potential contracts. Eight of the requests referred to an established independent standard to confirm such evidence, such as CE standard of conformity, MDR and/or MDD. This prevalence appears to cut across all types of procuring organisations and all types of HWT. The use of any evidence criteria, or lack thereof, does not appear to affect the outcomes of the tendering process.

Conclusion

Criteria requiring evidence for effectiveness are used in less than a fifth of all public procurements of health- and welfare technologies in Sweden, and less than 10% refer to some form of independent standard as confirmation of such evidence. The procurement process therefore risks creating a legacy of sub-optimal technologies in health- and social care services. More prevalent and specific requirements for evidence and its continual generation in the procurement process are highly recommended. Recommendations for decision makers, procurement managers, and developers are provided.