bluuebunny/crossref_metadata_2025 huggingface dataset:
Building resilience and performance in turbulent times: The influence of shared leadership and passion at work across levels
Authors: Salas-Vallina Andrés , Rofcanin Yasin , Las Heras Mireia
Published: July 2021

The COVID-19 pandemic has tested health care professionals to the extreme. This study investigated the re-enchanting effect of shared leadership and passion at work in the context of public health care. This study advances on the Self-Determination Theory to suggest that shared leadership has a positive effect on resilience and performance through passion at work at different levels of analysis. A sample of 518 physicians working in Spanish public hospitals was used. The results showed that shared leadership was associated with team and individual outcomes via passion at work at team level, while no significant mediating effect was found for passion at work at the individual level. The theoretical and practical implications of the findings are discussed, limitations are considered, and future research directions are suggested.

JEL CLASSIFICATION: M12, M54
Predictors of Unmet Dental Health Needs in US Adults in 2018: A Cross-Sectional Analysis
Authors: Gaskin D.J. , Zare H. , McCleary R. , Kanwar O. , Davis A.L.
Published: July 2021

Objective:

To identify predictors of unmet dental needs for adults 18 y of age or older in the United States.

Method:

Using the Aday and Andersen framework and data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we ran logistic regression to estimate predictors for adults of not having a dental visit within 5 y and having lost any teeth using a national sample of 155,060 survey respondents.

Results:

Results showed that predisposing factors (age, race/ethnicity, gender, and educational attainment) and enabling factors (income and health insurance status) are important predictors for losing teeth due to decay or gum disease. Men, the elderly, and less educated and low-income residents were less likely to have seen a dentist within the past 5 y and more likely to have lost their permanent teeth. Compared to non-Hispanic White adults, Hispanics adults were more likely to have had a dental visit within the past 5 y. Unmet dental needs varied across states. People living in states with extensive Medicaid dental care benefit coverage were less likely to lose their teeth and more likely to have had a dental visit within the past 5 y.

Conclusion:

Efforts to improve oral health should address unmet dental needs of men and adults with low socioeconomic status. Studying the variation between state oral health care programs could further our understanding of how public policy can improve population oral health.

Knowledge Transfer Statement:

Men, non-Hispanic Blacks, mixed and other race minorities, and low socioeconomic status adults are most at risk of unmet dental needs. States can address these needs by expanding Medicaid coverage for adults.
An erythroid-to-myeloid cell fate conversion is elicited by LSD1 inactivation
Authors: Yu Lei , Myers Greggory , Ku Chia-Jui , Schneider Emily , Wang Yu , Singh Sharon A. , Jearawiriyapaisarn Natee , White Andrew , Moriguchi Takashi , Khoriaty Rami , Yamamoto Masayuki , Rosenfeld Michael G. , Pedron Julien , Bushweller John H. , Lim Kim-Chew , Engel James Douglas
Published: July 2021

Histone H3 lysine 4 methylation (H3K4Me) is most often associated with chromatin activation, and removing H3K4 methyl groups has been shown to be coincident with gene repression. H3K4Me demethylase KDM1a/LSD1 is a therapeutic target for multiple diseases, including for the potential treatment of β-globinopathies (sickle cell disease and β-thalassemia), because it is a component of γ-globin repressor complexes, and LSD1 inactivation leads to robust induction of the fetal globin genes. The effects of LSD1 inhibition in definitive erythropoiesis are not well characterized, so we examined the consequences of conditional inactivation of Lsd1 in adult red blood cells using a new Gata1creERT2 bacterial artificial chromosome transgene. Erythroid-specific loss of Lsd1 activity in mice led to a block in erythroid progenitor differentiation and to the expansion of granulocyte-monocyte progenitor–like cells, converting hematopoietic differentiation potential from an erythroid fate to a myeloid fate. The analogous phenotype was also observed in human hematopoietic stem and progenitor cells, coincident with the induction of myeloid transcription factors (eg, PU.1 and CEBPα). Finally, blocking the activity of the transcription factor PU.1 or RUNX1 at the same time as LSD1 inhibition rescued myeloid lineage conversion to an erythroid phenotype. These data show that LSD1 promotes erythropoiesis by repressing myeloid cell fate in adult erythroid progenitors and that inhibition of the myeloid-differentiation pathway reverses the lineage switch induced by LSD1 inactivation.
Single-nucleotide Fcγ receptor polymorphisms do not impact obinutuzumab/rituximab outcome in patients with lymphoma
Authors: Strefford Jonathan C. , Nowicka Malgorzata , Hargreaves Chantal E. , Burton Cathy , Davies Andrew , Ganderton Rosalind , Hiddemann Wolfgang , Iriyama Chisako , Klapper Wolfram , Latham Kate V. , Martelli Maurizio , Mir Farheen , Parker Helen , Potter Kathleen N. , Rose-Zerilli Matthew J. J. , Sehn Laurie H. , Trněný Marek , Vitolo Umberto , Bolen Christopher R. , Klein Christian , Knapp Andrea , Oestergaard Mikkel Z. , Cragg Mark S.
Published: July 2021

Single-nucleotide polymorphisms (SNPs) have been shown to influence Fcγ receptor (FcγR) affinity and activity, but their effect on treatment response is unclear. We assessed their importance in the efficacy of obinutuzumab or rituximab combined with chemotherapy in untreated advanced follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL) in the GALLIUM (www.clinicaltrials.gov #NCT01332968) and GOYA (#NCT01287741) trials, respectively. Genomic DNA was extracted from patients enrolled in GALLIUM (n = 1202) and GOYA (n = 1418). Key germline SNPs, FCGR2A R131H (rs1801274), FCGR3A F158V (rs396991), and FCGR2B I232T (rs1050501), were genotyped and assessed for their impact on investigator-assessed progression-free survival (PFS). In both cohorts there was no prognostic effect of FCGR2A or FCGR3A. In FL, FCGR2B was associated with favorable PFS in univariate and multivariate analyses comparing I232T with I232I, with a more modest association for rituximab-treated (univariate: hazard ratio [HR], 0.78; 95% confidence interval [CI], 0.54-1.14; P = .21) vs obinutuzumab-treated patients (HR, 0.56; 95% CI, 0.34-0.91; P = .02). Comparing T232T with I232I, an association was found for obinutuzumab (univariate: HR, 2.76; 95% CI, 1.02-7.5; P = .0459). Neither observation retained significance after multiple-test adjustment. FCGR2B was associated with poorer PFS in multivariate analyses comparing T232T with I232I in rituximab- but not obinutuzumab-treated patients with DLBCL (HR, 4.40; 95% CI, 1.71-11.32; P = .002; multiple-test–adjusted P = .03); however, this genotype was rare (n = 13). This study shows that FcγR genotype is not associated with response to rituximab/obinutuzumab plus chemotherapy in treatment-naive patients with advanced FL or DLBCL.
Prognostic significance of FCGR2B expression for the response of DLBCL patients to rituximab or obinutuzumab treatment
Authors: Nowicka Malgorzata , Hilton Laura K. , Ashton-Key Margaret , Hargreaves Chantal E. , Lee Chern , Foxall Russell , Carter Matthew J. , Beers Stephen A. , Potter Kathleen N. , Bolen Christopher R. , Klein Christian , Knapp Andrea , Mir Farheen , Rose-Zerilli Matthew , Burton Cathy , Klapper Wolfram , Scott David W. , Sehn Laurie H. , Vitolo Umberto , Martelli Maurizio , Trneny Marek , Rushton Christopher K. , Slack Graham W. , Farinha Pedro , Strefford Jonathan C. , Oestergaard Mikkel Z. , Morin Ryan D. , Cragg Mark S.
Published: July 2021

Fc γ receptor IIB (FcγRIIB) is an inhibitory molecule capable of reducing antibody immunotherapy efficacy. We hypothesized its expression could confer resistance in patients with diffuse large B-cell lymphoma (DLBCL) treated with anti-CD20 monoclonal antibody (mAb) chemoimmunotherapy, with outcomes varying depending on mAb (rituximab [R]/obinutuzumab [G]) because of different mechanisms of action. We evaluated correlates between FCGR2B messenger RNA and/or FcγRIIB protein expression and outcomes in 3 de novo DLBCL discovery cohorts treated with R plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) reported by Arthur, Schmitz, and Reddy, and R-CHOP/G-CHOP-treated patients in the GOYA trial (NCT01287741). In the discovery cohorts, higher FCGR2B expression was associated with significantly shorter progression-free survival (PFS; Arthur: hazard ratio [HR], 1.09; 95% confidence interval [CI], 1.01-1.19; P = .0360; Schmitz: HR, 1.13; 95% CI, 1.02-1.26; P = .0243). Similar results were observed in GOYA with R-CHOP (HR, 1.26; 95% CI, 1.00-1.58; P = .0455), but not G-CHOP (HR, 0.91; 95% CI, 0.69-1.20; P = .50). A nonsignificant trend that high FCGR2B expression favored G-CHOP over R-CHOP was observed (HR, 0.67; 95% CI, 0.44-1.02; P = .0622); however, low FCGR2B expression favored R-CHOP (HR, 1.58; 95% CI, 1.00-2.50; P = .0503). In Arthur and GOYA, FCGR2B expression was associated with tumor FcγRIIB expression; correlating with shorter PFS for R-CHOP (HR, 2.17; 95% CI, 1.04-4.50; P = .0378), but not G-CHOP (HR, 1.37; 95% CI, 0.66-2.87; P = .3997). This effect was independent of established prognostic biomarkers. High FcγRIIB/FCGR2B expression has prognostic value in R-treated patients with DLBCL and may confer differential responsiveness to R-CHOP/G-CHOP.
Multiple large shareholders and corporate fraud: evidence from China
Authors: Zhao Xibo , Yang Dan , Li Zhengguang , Song Lynda
Published: July 2021

This study tests the effect of multiple large shareholders on the level of corporate fraud using the data of Chinese listed companies from 2010 to 2018. We find lower probabilities and lower corporate fraud frequencies when there are multiple large shareholders in Chinese listed companies, indicating that their presence plays a supervisory role in internal governance. These results persist after we control for endogeneity. Moreover, the effect of multiple large shareholders on corporate fraud is strengthened with the separation of control right and cash flow right. Further analyses reveal that companies with multiple large shareholders experience considerably reduced information disclosure fraud but no reduction in operating or leader frauds. Additionally, information asymmetry and the capital occupation of controlling shareholders both play a mediating role in the relationship between multiple large shareholders and the level of corporate fraud. This study enriches the literature on the determinants of corporate fraud and the effects of multiple large shareholders. Our findings also provide implications for companies and regulators regarding ways to reduce fraud.
Impact of domestic violence against pregnant women in Minia governorate, Egypt: a cross sectional study
Authors: Elkhateeb Reham , Abdelmeged Ayman , Ahmad Samar , Mahran Ahmad , Abdelzaher Walaa Yehia , Welson Nermeen N. , Al-Zahrani Yahea , Alhuwaydi Ahmed Mohammed , Bahaa Haitham Ahmed
Published: July 2021

Background

Domestic violence is a common problem that is related to many serious short-term and long-term health hazards around the world.

Methods

During obtaining the medical history from the participants, the questions used to assess the abuse were derived from the widely used Abuse Assessment Screen (AAS). Potential risk factors including a variety of socio-demographic and reproductive health-relation indicators were assessed. The influence of violence on the pregnancy outcome was determined by the continuous follow-up till giving birth.

Results

513 pregnant women were included. The prevalence of violence among them was 50.8%. The prevalence of physical, sexual, verbal, and emotional abuse was 30.2, 20, 41.7, and 45.4% respectively. Exposure to violence during pregnancy had significant effects on the women and their pregnancy outcome in the form of development of vaginal infection (P-value =0.036), vaginal bleeding (P-value = 0.008), preterm labour (P-value = 0.003), premature rupture of membrane (P-value = 0.001).

Conclusion

Violence against pregnant women in Minia Governorate, Egypt is common especially emotional violence and it has many adverse effects on the women and their pregnancy outcome. One of the most important risk factors is the fear of the husband which makes violence a continuous vicious circle.
Hypertension in women: the role of adolescent childbearing
Authors: Datta Biplab K. , Husain Muhammad J. , Kostova Deliana
Published: July 2021

Background

Adolescent childbearing is associated with various health risks to the mother and child, and potentially with adverse socioeconomic outcomes. However, little is known about the role of adolescent childbearing in maternal health outcomes in adulthood. This study investigates the link between childbirth in adolescence and later-life risk of hypertension among women in India.

Methods

We obtained nationally representative data on demographic and health outcomes for 442,845 women aged 25 to 49 from the India National Family Health Survey (NFHS) 2015-16. We assessed the difference in hypertension prevalence between women who gave birth in adolescence (age 10 to 19) and those who did not, for the full sample and various sub-samples, using linear probability models with controls for individual characteristics, hypertension risk factors, and geographic fixed effects.

Results

Nearly 40% of the women in the sample gave birth in adolescence. The adjusted probability of being hypertensive in adulthood was 2.3 percentage points higher for this group compared to women who did not give childbirth in adolescence. This added probability was larger for women who gave birth earlier in adolescence (4.8 percentage points) and for women who gave birth more than once in adolescence (3.4 percentage points).

Conclusions

Adolescent childbearing was strongly associated with a higher probability of adult female hypertension in India. This finding illustrates the intertemporal relationship between health risk factors during the life cycle, informing the importance of addressing adverse early life events (e.g. child marriage and adolescent childbirth) for hypertension outcomes among women in India.
Development and psychometric testing of the ‘barriers to physical activity during pregnancy scale’ (BPAPS)
Authors: Amiri-Farahani Leila , Ahmadi Katayon , Hasanpoor-Azghady Syedeh Batool , Pezaro Sally
Published: July 2021

Background

Pregnancy can affect the amount of physical activity that women engage in, so ensuring adequate physical activity in pregnant women can be a challenge. Therefore, there is a need to explore and identify barriers to physical activity in this population. Consequently, this study was conducted in order to develop and validate a scale to assess barriers to physical activity in pregnant populations.

Methods

The study was conducted in two phases. During phase 1, a comprehensive review of the most relevant literature from electronic databases on barriers to physical activity was carried out and appropriate scale items were extracted using a deductive approach. During phase 2, the psychometric properties of the extracted scale items were determined using face, content and construct validity, internal consistency and stability. Qualitative and quantitative face validity was assessed via face-to-face interviews with 30 and 10 pregnant women, respectively. To confirm the qualitative and quantitative content validity, 10 experts in the field of research and instrument design were invited to complete the resulting scale. To assess construct validity, the scale items were further tested among 320 pregnant women attending perinatal clinics at health centers in Ilam, Iran, where data were collected via continuous sampling. The internal consistency and stability of the study were measured by Cronbach’s alpha and intra-class correlation coefficient (ICC), respectively.

Results

Following a review of the relevant literature, 48 items for the BPAPS were extracted. Subsequent to the assessment of face and content validity, the number of items was reduced to 38. Through a subsequent exploratory factor analysis, the number of items dropped further to 29. These items were then structured under four major factors. Finally, the internal consistency and stability of the scale was confirmed by a Cronbach alpha coefficient of 0.824 and a test-retest reliability score of 0.87.

Conclusion

Findings show that the 29-item scale to assess barriers to physical activity in pregnant populations is a valid and appropriate instrument.
Translation and validation of the Chinese version of the MD Anderson symptom inventory for measuring perioperative symptom burden in patients with gynecologic cancer
Authors: Zhang Ting , Zheng Ying-ying , Yang Zhi-rong , Shi Qiuling , Wang Xin Shelley , Zhao Jun , Yang Min , Wu Chun-lin , Wang Guo-rong
Published: July 2021

Background

Gynecologic cancers are among the most prevalent malignancies in China. Cervical and uterine cancer respectively account for the sixth and eighth highest incidence of cancer among Chinese women. Abdominal surgery is one of the important treatment methods for gynecological tumors. However, the tumor- and surgery-related symptom burden are not well studied owing to a lack of a standardized and validated assessment tool in the Chinese population. The study aimed to translate and validate the MD Anderson Symptom Inventory for measuring perioperative symptom burden in gynecologic cancer patients (MDASI-PeriOp-GYN) and examine the utility of the Chinese version of MDASI-PeriOp-GYN.

Methods

The MDASI-PeriOp-GYN was translated in a stepwise manner. First, two native speakers independently translated the 9 PeriOp-GYN symptom items. Then the nine items were translated back into English by two different bilingual translators. After discussion and revision, the four translators reached an agreement. Finally, the finalized Chinese version was administered to women with three common gynecologic cancer types (cervical, ovarian, and endometrial cancers) recruited from the gynecological oncology department of Sichuan Cancer Hospital & Institute between July and October 2019. The reliability and validity of the translated version were assessed.

Results

Overall, 324 women with gynecologic cancers were enrolled. Cronbach’s α values were 0.826 and 0.735 for the symptom severity and interference scales, respectively. Test–retest reliability values were 0.885, 0.873, and 0.914 for symptom severity, PeriOp-GYN, and interference scales. Significant correlations were found between the MDASI-PeriOp-GYN-C and EORTC QLQ-C30 along with the QLQ-OV28 module (− 0.608–0.871, P < 0.001). Known-group validity was supported by significant differences in the scores of the four scales grouped by time intervals, surgery type, and functional status (all P < 0.01).

Conclusions

The MDASI-PeriOp-GYN-C is a valid and reliable tool for measuring symptoms in Chinese patients undergoing surgery for gynecologic cancers. The tool could be used in clinical practice and clinical trials to instantly gather patients’ health and quality of life data.
Timing of physical therapy for individuals with patellofemoral pain and the influence on healthcare use, costs and recurrence rates: an observational study
Authors: Young Jodi L. , Snodgrass Suzanne J. , Cleland Joshua A. , Rhon Daniel I.
Published: July 2021

Background

Early physical therapy has been shown to decrease downstream healthcare use, costs and recurrence rates in some musculoskeletal conditions, but it has not been investigated in individuals with patellofemoral pain. The purpose was to evaluate how the use and timing of physical therapy influenced downstream healthcare use, costs, and recurrence rates.

Methods

Seventy-four thousand four hundred eight individuals aged 18 to 50 diagnosed with patellofemoral pain between 2010 and 2011 in the Military Health System were categorized based on use and timing of physical therapy (first, early, or delayed). Healthcare use, costs, and recurrence rates were compared between the groups using descriptive statistics and a binary logit regression.

Results

The odds for receiving downstream healthcare use (i.e. imaging, prescription medications, and injections) were lowest in those who saw a physical therapist as the initial contact provider (physical therapy first), and highest in those who had delayed physical therapy (31–90 days after patellofemoral pain diagnosis). Knee-related costs for those receiving physical therapy were lowest in the physical therapy first group ($1,136, 95% CI $1,056, $1,217) and highest in the delayed physical therapy group ($2,283, 95% CI $2,192, $2,374). Recurrence rates were lowest in the physical therapy first group (AOR = 0.55, 95% CI 0.37, 0.79) and highest in the delayed physical therapy group (AOR = 1.78, 95% CI 1.36, 2.33).

Conclusions

For individuals with patellofemoral pain using physical therapy, timing is likely to influence outcomes. Healthcare use and costs and the odds of having a recurrence of knee pain were lower for patients who had physical therapy first or early compared to having delayed physical therapy.
So many ways to naturally kill a cancer cell
Authors: Mitchison Timothy J.
Published: July 2021

Natural killer (NK) cells participate in cancer immunosurveillance and cancer immunotherapy. Live cell imaging of cancer cells targeted by NK cells, published today in BMC Biology by Zhu et al., reveals a remarkable diversity of programmed cell death pathways induced in individual cells. Pathway choice depends on the state of the target cell actin cytoskeleton and a novel death pathway, granzyme-induced necroptosis, could be of broad importance in cancer immunotherapy.
Temporal trends in cause-specific mortality among individuals with newly diagnosed atrial fibrillation in the Framingham Heart Study
Authors: Kornej Jelena , Huang Qiuxi , Preis Sarah R. , Lubitz Steven A. , Ko Darae , Murabito Joanne M. , Benjamin Emelia J. , Trinquart Ludovic
Published: July 2021

Background

All-cause mortality following atrial fibrillation (AF) has decreased over time. Data regarding temporal trends in causes of death among individuals with AF are scarce. The aim of our study was to analyze temporal trends in cause-specific mortality and predictors for cardiovascular (CVD) and non-CVD deaths among participants with incident AF in the Framingham Heart Study.

Methods

We categorized all newly diagnosed AF cases according to age at AF diagnosis (< 70, 70 to < 80, and ≥ 80 years) and epoch of AF diagnosis (< 1990, 1990–2002, and ≥ 2003). We followed participants until death or the last follow-up. We categorized death causes into CVD, non-CVD, and unknown causes. For each age group, we tested for trends in the cumulative incidence of cause-specific death across epochs. We fit multivariable Fine-Gray models to assess subdistribution hazard ratios (HR) between clinical risk factors at AF diagnosis and cause-specific mortality.

Results

We included 2125 newly diagnosed AF cases (mean age 75.5 years, 47.8% women). During a median follow-up of 4.8 years, 1657 individuals with AF died. There was evidence of decreasing CVD mortality among AF cases diagnosed < 70 years and 70 to < 80 years (ptrend < 0.001) but not ≥ 80 years (p = 0.76). Among the cases diagnosed < 70 years, the cumulative incidence of CVD death at 75 years was 67.7% in epoch 1 and 13.9% in epoch 3; among those 70 to < 80 years, the incidence at 85 years was 58.9% in epoch 1 and 18.9% in epoch 3. Advancing age (HR per 1 SD increase 6.33, 95% CI 5.44 to 7.37), prior heart failure (HR 1.49, 95% CI 1.14–1.94), and prior myocardial infarction (HR 1.44, 95% CI 1.15–1.80) were associated with increased rate of CVD death.

Conclusions

In this community-based cohort, CVD mortality among AF cases decreased over time. Most deaths in individuals with AF are no longer CVD-related, regardless of age at AF diagnosis.
Infiltration of thyroid papillary cancer tissue with myeloid leukemic cells: a case report
Authors: Sözen Mehmet , Vural Çiğdem , Selek Alev , Kiraz Umay , Cantürk Zeynep , Çetinarslan Berrin , Gezer Emre , Köksalan Damla
Published: July 2021

Background

Extramedullary leukemia, also known as myeloid sarcoma, is a rare form of acute myeloid leukemia and often accompanies bone marrow involvement. Myeloid infiltration of the thyroid gland is extremely rare. Here, a unique case in which thyroid cancer tissue was infiltrated with myeloid cells is presented.

Case presentation

We present a case of thyroid papillary cancer infiltrated by blastic cells and bilateral breast and axillary myeloid sarcoma in a 30-year-old Caucasian female patient with a history of osteosarcoma and MDS-RAEB2. The patient firstly received 6 cycles of chemotherapy for osteosarcoma, and allogeneic hematopoietic stem cell transplantation was performed after anthracycline-based chemotherapy due to MDS-RAEB2. The patient remained in remission on follow-up in terms of both osteosarcoma and MDS-RAEB2. Malignant features (Bethesda VI) were observed in the fine needle aspiration biopsy performed from a newly developed firm, fixed thyroid nodule approximately 4–5 cm in length in the left thyroid lobe. Because of the Bethesda VI thyroid nodule, the patient underwent total thyroidectomy. In the pathological evaluation, CD34-, CD117-, MPO-, and HLA-DR-positive blastic cells which infiltrated into follicular variant papillary thyroid carcinoma were detected. In the evaluation performed due to blastic cell infiltration, multiple lesions showing increased 18-fluorodeoxyglucose activity in bilateral breast and axillae were detected. Myeloid sarcoma was found as a result of tru-cut biopsy from these lesions. A fungal cystic lesion was detected in the frontal region of the patient who developed altered consciousness after the second cycle of treatment of myeloid sarcoma. During her follow-up in the intensive care unit, she died of cranial septic embolism and acute infarction.

Conclusions

Here, we present a very interesting case that is the first. A staged approach to diagnosis with methods including immunohistochemical staining, radiological imaging methods, and cytogenetic and molecular analyses can help make the definitive diagnosis.
Burnout and work-life balance among physicians: the role of migration background
Authors: Hussenoeder Felix S. , Bodendieck Erik , Conrad Ines , Jung Franziska , Riedel-Heller Steffi G.
Published: July 2021

Background

We want to analyze the effect of migration background (MB) on physician burnout and work-life balance.

Methods

In September 2019, physicians from various specialties answered a questionnaire on work and health. We analyzed a subsample of 526 physicians that were working full time in a hospital, 14% with an MB and 47.9% were female.

Results

Multivariate analysis showed that physicians with an MB exhibit significantly less favorable scores on all three burnout dimensions, and this effect persisted in the regression analysis after adding age, gender, and marital status as control variables. There were no differences with regard to work-life balance.

Conclusions

To our knowledge, our study is the first one to suggest that MB plays a significant role in physician mental health. Future research will benefit from identifying the factors behind that connection, e.g., problems related to acculturation, communication and social integration, which can then be addressed by policymakers in order to maintain and improve the medical infrastructure.
Arterial abnormalities in the hands of workers with vibration white fingers – a magnetic resonance angiography case series
Authors: Vihlborg Per , Makdoumi Karim , Gavlovská Hana , Wikström Sverre , Graff Pål
Published: July 2021

Vibration white finger (VWF) is a complication from exposure to hand-arm vibrations. Poor knowledge of the pathophysiology of VWF means that making an accurate prognosis is difficult. Thus, a better understanding of VWF’s pathophysiology is of importance.

The purpose of this study was to investigate whether there were arterial abnormalities in the hands in patients with VWF and a positive Allen’s test, using ultrasound and MRA imaging.

This was a case series where arterial abnormalities in the hands were investigated in ten participants with VWF and using prolonged Allen’s test (> 5 s). The participants had an average vibration exposure of 22 years and underwent Doppler ultrasound and Magnetic Resonance Angiography (MRA) to check for arterial abnormalities.

The participants had VWF classified as 1–3 on the Stockholm workshop scale. Ultrasound and MRA identified vascular abnormalities in all participants, the predominant finding was missing or incomplete superficial arch. Also, stenosis was identified in four participants.

This study reveals a high proportion of arterial stenosis and abnormalities in patients with VWF and a prolonged Allen’s test.
COVEPIC (Cognitive and spOrt Virtual EPIC training) investigating the effects of home-based physical exercise and cognitive training on cognitive and physical functions in community-dwelling older adults: study protocol of a randomized single-blinded clinical trial
Authors: Dupuy Emma Gabrielle , Besnier Florent , Gagnon Christine , Vincent Thomas , Grégoire Catherine-Alexandra , Blanchette Caroll-Ann , Saillant Kathia , Bouabdallaoui Nadia , Iglesies-Grau Josep , Payer Marie , Marin Marie-France , Belleville Sylvie , Juneau Martin , Vitali Paolo , Gayda Mathieu , Nigam Anil , Bherer Louis
Published: July 2021

Background

In the context of the COVID-19 pandemic, lockdown and social distancing measures are applied to prevent the spread of the virus. It is well known that confinement and social isolation can have a negative impact on physical and mental health, including cognition. Physical activity and cognitive training can help enhance older adults’ cognitive and physical health and prevent the negative collateral impacts of social isolation and physical inactivity. The COVEPIC study aims to document the effects of 6 months of home-based physical exercise alone versus home-based physical exercise combined with cognitive training on cognitive and physical functions in adults 50 years and older.

Methods

One hundred twenty-two healthy older adults (> 50 years old) will be recruited from the community and randomized to one of the two arms for 6 months: (1) home-based physical exercises monitoring alone and (2) combined physical exercises monitoring with home-based cognitive training. The primary outcome is cognition, including general functioning (Montreal Cognitive Assessment (MoCA) score), as well as executive functions, processing speed, and episodic memory (composite Z-scores based on validated neuropsychological tests and computerized tasks). The secondary outcome is physical functions, including balance (one-leg stance test), gait and mobility performance (Timed Up and Go, 4-meter walk test), leg muscle strength (5-time sit-to-stand), and estimated cardiorespiratory fitness (Matthews’ questionnaire). Exploratory outcomes include mood, anxiety, and health-related quality of life as assessed by self-reported questionnaires (i.e., Geriatric depression scale-30 items, Perceived stress scale, State-trait anxiety inventory-36 items, Perseverative thinking questionnaire, Connor-Davidson Resilience Scale 10, and 12-item Short Form Survey).

Discussion

This trial will document the remote monitoring of home-based physical exercise alone and home-based physical combined with cognitive training to enhance cognitive and physical health of older adults during the COVID-19 pandemic period. Remote interventions represent a promising strategy to help maintain or enhance health and cognition in seniors, and potentially an opportunity to reach older adults in remote areas, where access to such interventions is limited.

Trial registration

Clinical trial Identifier NCT04635462. COVEPIC was retrospectively registered on November 19, 2020.
Efficacy of afoxolaner (NexGard®) in preventing the transmission of Leishmania infantum and Dirofilaria immitis to sheltered dogs in a highly endemic area
Authors: Panarese Rossella , Iatta Roberta , Mendoza-Roldan Jairo Alfonso , Zatelli Andrea , Beugnet Frederic , Otranto Domenico
Published: July 2021

Background

Leishmania infantum and Dirofilaria immitis are among the most important canine vector-borne pathogens (CVBPs) of zoonotic concern in Europe. In endemic areas for both of these CVBPs, the use of systemic ectoparasiticides, such as afoxolaner (NexGard®; Boehringer Ingelheim Animal Health), may have the potential for controlling these infections. The aim of this study was to assess, for the first time, the insecticidal efficacy of NexGard® in decreasing the transmission of D. immitis and L. infantum to sheltered dogs living in a hyperendemic area, compared to the year before treatment, as well as its impact on the abundance of mosquito and sand fly populations.

Methods

All dogs (n = 179) enrolled in the study were divided into two groups based on their infection status at enrollment: a non-infected group (G1) and an infected group (G2; infected with D. immitis, L. infantum or both). The study was conducted from March 2020 to March 2021. In order to exclude all animals infected with L. infantum and D. immitis before March 2020 (sampling time: T0), dogs in G1 were sampled in June (T1; i.e. T0 + 90 days) and in October 2020 (T2; i.e. T0 + 210 days). From March to September 2020, all animals (G1 and G2) were weighed and treated monthly with NexGard®. Animals in G1 were tested for the last time in March 2021 (T3; i.e. T0 + 330 days) for assessing post-treatment incidence rate of infection and prevention efficacy.

Results

The post-treatment incidence of D. immitis was 3.7% (1/27; 95% confidence interval [CI]: 0.2–18.1) and that of L. infantum was 3.6% (3/83; 95% CI: 1.0–10.1). Considering the annual incidence in 2019 and 2020, the protective efficacy against D. immitis and L. infantum infections was 94.2 and 64%, respectively. Of the female mosquitoes collected (n = 146), only one pool out of 50 tested positive for D. immitis DNA, whereas out of 1252 female Sergentomya minuta specimens collected, only four tested positive for L. infantum (0.3%).

Conclusions

Afoxolaner is efficacious in decreasing the rate of transmission of both D. immitis and L. infantum; however, comparison of the pre- and post-treatment period demonstrated that there was a significant difference only in the seasonal incidences of D. immitis infection. Preventive measures are recommended throughout the year in endemic areas to reduce the risk of pathogen transmission to animals and humans.

Graphical abstract
Melanosis coli in a peritoneal dialysis patient: a case report
Authors: Zakaria Nor Fadhlina , Ahmad Nurul Izah , Mokhtar Elmina , Zukiman Wan Zul Haikal Hafiz Wan , Shah Anim Md
Published: July 2021

Background

Patients who undergo peritoneal dialysis (PD) are at risk of gut bacteria translocation leading to peritonitis when there is chronic diarrhea. Chronic diarrhea is defined as any course of diarrhea that lasts at least 4 weeks, which can be continuous or intermittent. Chronic diarrhea of any duration may cause dehydration, electrolyte imbalance, and life-threatening hypovolemic shock. In PD patients, excessive ultrafiltration from the exchanges, combined with severe gastrointestinal loss, may cause hypovolemic shock, electrolyte imbalance, and metabolic acidosis. There are multiple causes of chronic diarrhea in PD patients including infective causes, mitotic lesions, and rarely the regular and excessive use of laxatives, which is a diagnosis of exclusion.

Case presentation

We report a case of Melanau lady with chronic diarrhea secondary to laxative usage in a patient being treated with automated peritoneal dialysis (APD). The patient went into hypovolemic shock, but luckily did not contract peritonitis. A colonoscopy revealed brown to black discoloration of the colon, a feature suggestive of melanosis coli. A biopsy of the intestine further confirmed the diagnosis by histopathological examination. Withdrawal of laxatives and the introduction of probiotics improved the symptoms tremendously.

Conclusions

The chronic use of laxatives in PD patients can potentially lead to a devastating problem; thus, the management team must monitor treatment commencement appropriately.
IOT security privacy protection mechanism and mechanical structure design simulation optimization
Authors: Guo Caiping , Li Daqing
Published: July 2021

Once the Internet of Things was proposed, it has received great attention from all walks of life and has become one of the top ten technologies that change the world. Therefore, more and more people are engaged in the research of the Internet of Things, after the unremitting efforts of all seniors. Now the Internet of Things has been applied to every aspect of our lives. However, in the application process of the Internet of Things, the protection of personal privacy will undoubtedly be involved. If this problem is not effectively resolved, it will become a major obstacle to the development of the Internet of Things. At present, the research of fully homomorphic technology has attracted great attention from the cryptography community. You can directly calculate the encrypted text encryption to obtain the output and decrypt the output. The result is the same as the output of the unencrypted plain text. This article first comprehensively describes the solution to the privacy protection problem in the existing Internet of Things, and then proposes to apply the fully homomorphic technology to the Internet of Things to make the services provided by the network more secure. Through the analysis of the basic composition and architecture of the existing Internet of Things system, a privacy protection interaction model for the Internet of Things is established, which uses a completely homomorphic technology. On this basis, the algorithm for implementing simple homomorphic encryption is improved, and general homomorphic encryption theory is proposed for some security issues. After using this method to encrypt privacy, the success rate of cracking dropped by 24%.
Burden of non-communicable diseases in Cyprus, 1990–2017: findings from the Global Burden of Disease 2017 study
Authors: Charalampous Periklis , Pallari Elena , Tyrovolas Stefanos , Middleton Nicos , Economou Mary , Devleesschauwer Brecht , Haagsma Juanita A.
Published: July 2021

Background

Non-communicable diseases (NCDs) accounted for over 90% of all deaths in the Cypriot population, in 2018. However, a detailed and comprehensive overview of the impact of NCDs on population health of Cyprus over the period of 1990 to 2017, expressed in disability-adjusted life years (DALYs), is currently not available. Knowledge about the drivers of changes in NCD DALYs over time is paramount to identify priorities for the prevention of NCDs in Cyprus and guide evidence-based decision making. The objectives of this paper were to: 1) assess the burden of NCDs in terms of years of life lost (YLLs), years lived with disability (YLDs), and DALYs in Cyprus in 2017, and 2) identify changes in the burden of NCDs in Cyprus over the 28-year period and assess the main drivers of these changes.

Methods

We performed a secondary database descriptive study using the Global Burden of Disease (GBD) 2017 results on NCDs for Cyprus from 1990 to 2017. We calculated the percentage change of age-standardized DALY rates between 1990 and 2017 and decomposed these time trends to assess the causes of death and disability that were the main drivers of change.

Results

In Cyprus in 2017, 83% (15,129 DALYs per 100,000; 12,809 to 17,707 95%UI) of total DALYs were due to NCDs. The major contributors to NCD DALYs were cardiovascular diseases (16.5%), neoplasms (16.3%), and musculoskeletal disorders (15.6%). Between 1990 and 2017, age-standardized NCD DALY rates decreased by 23%. For both males and females, the largest decreases in DALY rates were observed in ischemic heart disease and stroke. For Cypriot males, the largest increases in DALY rates were observed for pancreatic cancer, drug use disorders, and acne vulgaris, whereas for Cypriot females these were for acne vulgaris, psoriasis and eating disorders.

Conclusion

Despite a decrease in the burden of NCDs over the period from 1990 to 2017, NCDs are still a major public health challenge. Implementation of interventions and early detection screening programmes of modifiable NCD risk factors are needed to reduce occurrence and exacerbation of leading causes of NCDs in the Cypriot population.
Accuracy of digital impressions versus conventional impressions for 2 implants: an in vitro study evaluating the effect of implant angulation
Authors: Abduo Jaafar , Palamara Joseph E. A.
Published: July 2021

Background

Accurate implant impression is an essential requirement for the fabrication of implant prosthesis. This in vitro study evaluated the accuracy of digital impressions by intraoral scanner (IOS) systems in comparison to conventional impressions for recording the position of 2 parallel implants and 2 divergent implants.

Materials and methods

In vitro 3-unit prosthesis master models with 2 tissue level implants were fabricated; one model had parallel implants, and the other model had one 15° tilted implant. The conventional open-tray impressions were obtained with non-splinted (NSP) and splinted (SP) impression copings. Trios 4 (TS), Medit i500 (MT), and True Definition (TD) were used to make digital impressions with scan bodies. A total of 10 impressions were obtained with every technique. The virtual test images of the conventional and digital impressions were converted to 2 virtual implant images. For each group, trueness, precision, inter-implant distance deviation, and angle deviation were measured.

Results

There was a general tendency for digital impressions to provide a more accurate outcome for trueness, precision, and angle deviation. The 2 conventional impressions showed similar accuracy, except for the angle deviation, where the NSP was significantly inferior than SP (p < 0.01) for the divergent implants model. The TD was generally the least accurate among all the IOS systems, especially for the inter-implant distance deviation (p < 0.05).

Conclusions

Within the limitations of the laboratory set-up of the present study and the limited clinical resemblance, the digital impressions appeared to have sufficient accuracy for 2 implants and were least affected by the presence of angle between implants. The most inferior outcome was observed for the NSP technique.
Incorporating microgrids coupling with utilization of flexible switching to enhance self-healing ability of electric distribution systems
Authors: Mousavizadeh Saeed , Alahyari Arman , Ghodsinya Seyed Reza Movahhed , Haghifam Mahmoud-Reza
Published: July 2021

Electric distribution networks have to deal with issues caused by natural disasters. These problems possess unique characteristics, and their severity can make load restoration methods impotent. One solution that can help in alleviating the aftermath is the use of microgrids (MGs). Employing the cumulative capacity of the generation resources through MG coupling facilitates the self-healing capability and leads to better-coordinated energy management during the restoration period, while the switching capability of the system should also be considered. In this paper, to form and schedule dynamic MGs in distribution systems, a novel model based on mixed-integer linear programming (MILP) is proposed. This approach employs graph-related theories to formulate the optimal formation of the networked MGs and management of their proper participation in the load recovery process. In addition, the Benders decomposition technique is applied to alleviate computability issues of the optimization problem. The validity and applicability of the proposed model are evaluated by several simulation studies.
Knowledge, attitudes, and impact of COVID-19 pandemic among neurology patients in Jordan: a cross-sectional study
Authors: Athamneh Mohammad , Sa’di Qais , Aldabbour Belal , Khader Yousef , Batayha Waleed
Published: July 2021

Background

The impacts of the COVID-19 pandemic on health services offered to patients with non-communicable diseases, including chronic neurological illnesses, are diverse and universal. We used a self-reported questionnaire to investigate these impacts on neurology patients in Jordan and assess their knowledge and attitudes towards the pandemic.

Results

Most respondents had positive attitudes towards the COVID-19 pandemic, with 96% reporting they believed in the seriousness of the pandemic and adhered to prevention measures. Nearly 97% resorted to the internet and media outlets for medical information about the pandemic. About one in five clinic visitors had their appointments delayed due to interruption of health services. A similar portion of patients with MS, epilepsy, and migraine or tension headache reported medication interruptions during the pandemic. One in two patients reported new events or worsening illness since the start of the pandemic, and sleep disturbances were reported by nearly one in three patients who had epilepsy or headache.

Conclusion

The COVID-19 pandemic’s impacts on patients with neurological illnesses in Jordan were deep and diverse. Meanwhile, the majority of surveyed neurology patients demonstrated a positive attitude towards the pandemic.
Exploring the factors associated with coronaphobia among physicians during the COVID-19 outbreak in Egypt
Authors: Abdelghani Mohamed , Hassan Mervat S. , Elgohary Hayam M. , Fouad Eman
Published: July 2021

Background

Coronaphobia refers to intensified and persistent fears of contracting COVID-19 virus infection. This study aimed to evaluate the newly termed phenomenon, coronaphobia, and address its associated correlates among Egyptian physicians during the outbreak. A cross-sectional study, including a total of 426 Egyptian physicians working during COVID-19 outbreak, was conducted between March 1st and May 1st, 2020. The Fear of COVID-19 Scale (FCV-19S) and Hospital Anxiety and Depression Scale (HADS) were utilized for assessment of coronaphobia, and comorbid anxiety and depressive symptoms among physicians, respectively during the outbreak.

Results

Moderate-to-severe symptoms of anxiety and depression were reported by 28% and 30% of physicians, respectively. Physicians experiencing higher levels of coronaphobia were more likely to be females, nonsmokers, having death wishes and/or self-harming thoughts, receiving insufficient training, dissatisfied with their personal protective equipment (PPE), and had colleagues infected with COVID-19 virus infection. Coronaphobia was positively correlated with anxiety (r = 0.59, P < 0.001) and depressive symptoms (r = 0.47, P < 0.001).

Conclusions

Egyptian physicians experienced higher levels of coronaphobia, anxiety, and depressive symptoms during the COVID-19 outbreak. Yet, frontline physicians did not differ from their second-line counterparts regarding the aforementioned symptoms. Routine mental and physical assessment measures of medical staff should be implemented.
Pneumomediastinum, pneumopericardium, and subcutaneous emphysema—a rare complication in COVID-19 infection
Authors: Baburao Archana , Das Rinki , Shyamsunder Shylaja
Published: July 2021

Background

Coronavirus disease 2019 (COVID-19) has become a global pandemic and is posing a serious public health problem for almost all countries. Spontaneous pneumomediastinum, a rare condition, is usually seen in patients with underlying pulmonary pathology, infections, or mechanical ventilation. Spontaneous pneumomediastinum is a rare complication in COVID-19 pneumonia.

Case presentation

We report a case of spontaneous pneumomediastinum, pneumopericardium, and subcutaneous emphysema in a 62-year-old diabetic patient with COVID-19 infection who presented with cough, fever, and breathlessness, which turned to be a fatal complication.

Conclusion

Pneumomediastinum/subcutaneous emphysema, a not so common complication associated with COVID-19 infection, should be considered as a bad prognostic indicator of worsening disease and hence requires early recognition and careful monitoring of the patient for any possible unfavorable outcome.