bluuebunny/crossref_metadata_2025 huggingface dataset:
Two decades of family planning in Ethiopia and the way forward to sustain hard-fought gains!
Authors: Kibret Mengistu Asnake , Gebremedhin Lia Tadesse
Published: June 2022

Family planning (FP) is a human right, and ensuring women’s access to FP is central to protecting the health and wellbeing of mothers and children. Over the past two decades, Ethiopia has made FP service more widely available, increasing the contraceptive prevalence rate from 8% in 2000 to 41% in 2019. This remarkable fivefold increase can be attributed to the country’s overall development, including investment in education (particularly for girls) and reduction in child marriage, as well as the adoption and implementation of several enabling FP policies and strategies. In Ethiopia, achieving universal access to sexual and reproductive health care services, information, and education, including FP, by 2030 means enhancing these effective government policies and programs. Achieving universal access requires increasing financial resources, including domestic financing through greater government commitment for commodity security and program implementation; strengthening public–private partnerships; and improving service delivery for populations that are hard to reach and/or in humanitarian crisis. The persistence of equity gaps due to regional and/or sociodemographic disparities and the low quality of FP service delivery challenge our progress in Ethiopia. The papers included in this supplement provide additional detail on the overall progress described in this commentary and highlight focal areas for improvement in responding to unmet needs. Current policies and services must adapt, maintain, and build upon these gains and focus on targeted actions in areas identified for improvement. We must sustain the hard-fought gains of the past decades and help shape the prosperous future we advocate for in our society by 2030 and beyond—Leaving No One Behind.
Ivermectin under scrutiny: a systematic review and meta-analysis of efficacy and possible sources of controversies in COVID-19 patients
Authors: Shafiee Arman , Teymouri Athar Mohammad Mobin , Kohandel Gargari Omid , Jafarabady Kyana , Siahvoshi Sepehr , Mozhgani Sayed-Hamidreza
Published: June 2022

Background

We conducted a systematic review and meta-analysis to evaluate the efficacy of ivermectin for COVID-19 patients based on current peer-reviewed RCTs and to address disputes over the existing evidence.

Methods

MEDLINE (Pubmed), Scopus, Web of Science, Cochrane library, Google scholar and Clinicaltrials.gov were searched for RCTs assessing the efficacy of Ivermectin up to 20 February 2022. A systematic review and meta-analysis of studies was performed based on the PRISMA 2020 statement criteria.

Results

19 and 17 studies were included in this systematic review and meta-analysis, respectively. There was no significant difference in progression to severe disease (log OR − 0.27 [95% CI − 0.61 to 0.08], I2 = 42.29%), negative RT-PCR (log OR 0.25 [95% CI − 0.18–0.68], I2 = 58.73%), recovery (log OR 0.11 [95% CI − 0.22–0.45], I2 = 13.84%), duration of hospitalization (SMD − 0.40 [95% CI − 0.85–0.06], I2 = 88.90%), time to negative RT-PCR (SMD − 0.36 [95% CI − 0.89–0.17], I2 = 46.2%), and viral load (SMD -0.17 [95% CI -0.45 to 0.12], I^2 = 0%). It is worth noting that, based on low-certainty evidence, ivermectin may possibly reduce mortality (log OR − 0.67 [95% CI − 1.20 to − 0.13], I2 = 28.96%). However, studies with a higher risk of bias were more likely to indicate positive effects on the efficacy of this drug, according to our subgroup analyses based on study quality.

Conclusion

Ivermectin did not have any significant effect on outcomes of COVID-19 patients and as WHO recommends, use of ivermectin should be limited to clinical trials.
Dietary inflammatory index and metabolic syndrome in US children and adolescents: evidence from NHANES 2001–2018
Authors: Jia Guhua , Wu Chieh-Chen , Su Chun-Hsien
Published: June 2022

Background

An increasing number of children and adolescents are affected by metabolic syndrome (MetS). Dietary inflammatory index (DII) was associated with MetS in adult population. This study aimed to determine the associations between DII scores, MetS, and MetS components among children and adolescents.

Methods

Data of children and adolescents in the National Health and Nutrition Examination Survey (NHANES) database 2001–2008 were obtained. DII was calculated for each participant based on the 24-h dietary recall interview. Univariate and multivariate logistic regression were conducted to determine the associations between DII, the other study variables and abnormal MetS components.

Results

A total of 5,656 US children and adolescents (mean age = 15.49) in the 2001–2018 NHANES database were included. After adjusting for all confounders in the multivariate analysis, the top DII quartile was significantly and independently associated with increased odds of high blood pressure (BP) (aOR = 2.27, 95% CI: 1.02–5.07) as compared with the lowest DII quartile. DII in quartile 2, 3 or 4 were not significantly associated with increased odds of MetS, high waist circumference (WC), low high density lipoprotein-cholesterol (HDL-c), triglyceride (TG) or fasting plasma glucose (FPG) as compared with the lowest quartile. In stratified analysis by recommended physical activity level for children and adolescents, no significant association was observed between higher DII and MetS.

Conclusions

Among US children and adolescents, high DII is associated with prevalent high BP but not MetS. The finding may contribute to future policymaking in promoting children’s health.
Time course of pulmonary inflammation and trace element biodistribution during and after sub-acute inhalation exposure to copper oxide nanoparticles in a murine model
Authors: Areecheewakul Sudartip , Adamcakova-Dodd Andrea , Haque Ezazul , Jing Xuefang , Meyerholz David K. , O’Shaughnessy Patrick T. , Thorne Peter S. , Salem Aliasger K.
Published: June 2022

Background

It has been shown that copper oxide nanoparticles (CuO NPs) induce pulmonary toxicity after acute or sub-acute inhalation exposures. However, little is known about the biodistribution and elimination kinetics of inhaled CuO NPs from the respiratory tract. The purposes of this study were to observe the kinetics of pulmonary inflammation during and after CuO NP sub-acute inhalation exposure and to investigate copper (Cu) biodistribution and clearance rate from the exposure site and homeostasis of selected trace elements in secondary organs of BALB/c mice.

Results

Sub-acute inhalation exposure to CuO NPs led to pulmonary inflammation represented by increases in lactate dehydrogenase, total cell counts, neutrophils, macrophages, inflammatory cytokines, iron levels in bronchoalveolar lavage (BAL) fluid, and lung weight changes. Dosimetry analysis in lung tissues and BAL fluid showed Cu concentration increased steadily during exposure and gradually declined after exposure. Cu elimination from the lung showed first-order kinetics with a half-life of 6.5 days. Total Cu levels were significantly increased in whole blood and heart indicating that inhaled Cu could be translocated into the bloodstream and heart tissue, and potentially have adverse effects on the kidneys and spleen as there were significant changes in the weights of these organs; increase in the kidneys and decrease in the spleen. Furthermore, concentrations of selenium in kidneys and iron in spleen were decreased, pointing to disruption of trace element homeostasis.

Conclusions

Sub-acute inhalation exposure of CuO NPs induced pulmonary inflammation, which was correlated to Cu concentrations in the lungs and started to resolve once exposure ended. Dosimetry analysis showed that Cu in the lungs was translocated into the bloodstream and heart tissue. Secondary organs affected by CuO NPs exposure were kidneys and spleen as they showed the disruption of trace element homeostasis and organ weight changes.
Crowberry inhibits cell proliferation and migration through a molecular mechanism that includes inhibition of DEK and Akt signaling in cholangiocarcinoma
Authors: Wang Xue , Zhou Xuebing , Zhang Ludan , Zhang Xin , Yang Chunyu , Piao Yingshi , Zhao Jinhua , Jin Lili , Jin Guihua , An Renbo , Ren Xiangshan
Published: June 2022

Background

Cholangiocarcinoma (CCA) is a rare biliary adenocarcinoma related to poor clinical prognosis. Crowberry is an herbal medicine used to control inflammatory diseases and reestablish antioxidant enzyme activity. Although crowberry shows significant therapeutic efficacy in various tumors and diseases, its anticancer effects and specific molecular mechanisms in CCA are poorly understood.

Aim of the study

This study was conducted to characterize crowberry effects on CCA cells behavior.

Materials and methods

The chemical profiles of crowberry extract was qualitatively analyzed by high-performance liquid chromatography (HPLC) and HPLC–tandem mass spectrometry. MTT, colony formation and EdU assays were performed to measure cell proliferation. The effect of crowberry treatment on CCA cell migration was assessed by wound healing and migration assays. Moreover, Hoechst staining assay and flow cytometry were performed to assess the cell apoptosis rate. Western blotting was used to assess the protein expression levels of key factors associated with apoptosis, the Akt signaling pathway, and the epithelial-mesenchymal transition. A xenograft model was established and immunohistochemical and H&E staining was performed to assess crowberry antitumor effects in vivo.

Results

Crowberry clearly inhibited CCA cells proliferation and migration in a dose-dependent manner and induced apoptosis in vitro. Crowberry inactivated the PI3K/Akt signaling pathway by regulating DEK in vitro and significantly inhibited tumor growth by downregulating the DEK expression in xenograft models.

Conclusion

Crowberry inhibits CCA cells proliferation and migration through a molecular mechanism that includes inhibition of DEK and Akt signaling pathway inhibition in vitro and in vivo.

Graphical Abstract
Lifetime extension and the recent cause of death in Werner syndrome: a retrospective study from 2011 to 2020
Authors: Kato Hisaya , Koshizaka Masaya , Kaneko Hiyori , Maezawa Yoshiro , Yokote Koutaro
Published: June 2022

Background

Werner syndrome (WS) is an autosomal recessive premature ageing disease that causes accelerated ageing-like symptoms after puberty. Previous studies conducted in the late 2000s reported that malignant neoplasms and atherosclerotic diseases were the two leading causes of death, with life expectancies in the mid-50 s. However, the recent lifespan and cause of death in patients with WS remain unclear.

Objective

To clarify the latest lifespan and causes of death in patients with WS.

Method

We conducted a questionnaire-based survey in 2020 among the primary doctors of WS patients who were identified in previous nationwide surveys in Japan and clarified the following: the age of WS patients (age of death, if the patient had already died), sex, and cause of death. Patients who died in 2010 or earlier were excluded from the analysis.

Results

A total of 123 living patients were identified at the time of the survey in 2020. Fourteen WS patients died between 2011 and 2020, with a mean age of 59.0 ± 8.9 years (mean ± SD). The most common cause of death was non-epithelial tumours, accounting for eight deaths, while no patient died of atherosclerotic diseases.

Conclusions

Compared to previous studies, this study suggests that the lifespan of patients with WS has been extended. Although there were no deaths due to atherosclerotic diseases, non-epithelial tumours were still the leading cause of death. Further development of screening and treatment methods for these tumours is required.
Care burden and associated factors in caregivers of children with cancer
Authors: Chaghazardi Mahnaz , Janatolmakan Maryam , Rezaeian Shahab , Khatony Alireza
Published: June 2022

Background

Evidence suggests that many parents who care for their children with cancer are affected by the care burden due to the chronic nature of the disease. The aim of this study was to determine the burden of care level and its related factors in the caregivers of children with cancer.

Method

A total of 270 caregivers of children with cancer were included in this cross-sectional study by convenience sampling method. Data collection tools were a personal information form and the Novak & Guest’s Caregiver Burden Inventory. Data were analyzed by descriptive and inferential statistics (chi-square and univariate linear regression model).

Results

The mean ages of caregivers and patients were 35.7 ± 7.0 and 3.1 ± 1.6 years, respectively. The mean care burden was 68.4 ± 1.5 out of 120. About 50 and 36% of caregivers had moderate and severe care burden, respectively.

Conclusion

Caregivers had moderate to high care burden. A number of factors associated with care burden were identified. Health authorities need to take family-centered measures to reduce the burden of caregivers.
Association between periodontitis and ossification of the posterior longitudinal ligament: a case report
Authors: Tsuru Michiyo , Oosio Takayoshi , Higashi Teruyo , Nagata Kensei , Wada Kanichiro , Ishibashi Yasuyuki
Published: June 2022

Introduction

Ossification of the posterior longitudinal ligament in the spinal ligament compresses the spinal cord, causing various spinal nerve diseases. The ligament tissue is an important connective tissue in the joints, teeth, and spine, which, when torn and damaged, reduces the range of movement.

Case presentation

We report the treatment of periapical periodontitis and tooth preservation in a 41-year-old Japanese woman previously diagnosed with ossification of the posterior longitudinal ligament. She presented with widespread pain from the paranasal sinuses to the head caused by the onset of periapical periodontitis of the upper front tooth.

Discussion

The patient received an oral zinc supplement, which resolved periapical periodontitis over a 2-year follow-up period.

Conclusion

The findings from this case imply that, when patients with ossification of the posterior longitudinal ligament develop periapical periodontitis, they should be tested for zinc deficiency.
Patterns of multidrug resistant organism acquisition in an adult specialist burns service: a retrospective review
Authors: Cleland Heather , Tracy Lincoln M. , Padiglione Alex , Stewardson Andrew J.
Published: June 2022

Background

Multidrug resistant organisms (MDROs) occur more commonly in burns patients than in other hospital patients and are an increasingly frequent cause of burn-related mortality. We examined the incidence, trends and risk factors for MDRO acquisition in a specialist burns service housed in an open general surgical ward, and general intensive care unit.

Methods

We performed a retrospective study of adult patients admitted with an acute burn injury to our specialist statewide tertiary burns service between July 2014 and October 2020. We linked patient demographics, injury, treatment, and outcome details from our prospective burns service registry to microbiology and antimicrobial prescribing data. The outcome of interest was first MDRO detection, stratified into the following groups of interest: methicillin-resistantStaphylococcus aureus(MRSA), vancomycin-resistant Enterococcus (VRE), two groups ofPseudomonas(carbapenem resistant, and piperacillin-tazobactam or cefepime resistant), carbapenem-resistantAcinetobacterspecies,Stenotrophomonas maltophilia, carbapenem-resistant Enterobacteriaceae (CRE), and extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE). We used a Cox proportional hazards model to evaluate the association between antibiotic exposure and MDRO acquisition.

Results

There were 2,036 acute admissions, of which 230 (11.3%) had at least one MDRO isolated from clinical specimens, most frequently wound swabs. While acquisition rates of individual MDRO groups varied over the study period, acquisition rate of any MDRO was reasonably stable over time. Carbapenem-resistantPseudomonaswas acquired at the highest rate over the study period (3.5/1000 patient days). The 12.8% (29/226) of MDROs isolated within 48 h were predominantly MRSA andStenotrophomonas.Median (IQR) time from admission to MDRO detection was 10.9 (5.6–20.5) days, ranging from 9.8 (2.7–24.2) for MRSA to 23.6 (15.7–36.0) for carbapenem-resistantP. aeruginosa. Patients with MDROs were older, had more extensive burns, longer length of stay, and were more likely to have operative burn management. We were unable to detect a relationship between antibiotic exposure and emergence of MDROs.

Conclusions

MDROs are a common and consistent presence in our burns unit. The pattern of acquisition suggests various causes, including introduction from the community and nosocomial spread. More regular surveillance of incidence and targeted interventions may decrease their prevalence, and limit the development of invasive infection.
Reviewing the effects of deploying building information modelling (BIM) on the adoption of sustainable design in Gulf countries: a case study in Saudi Arabia
Authors: Alghamdi Mushref S. , Beach Thomas H. , Rezgui Yacine
Published: June 2022

Sustainable construction is a challenging prospect in Gulf countries such as Saudi Arabia and the use of Building Information Modelling (BIM) is often suggested as a solution. However, achieving improvement is associated with considerable challenges, particularly regarding energy efficiency improvements. Furthermore, the extreme environmental conditions in Saudi Arabia increase the demand for energy. As energy consumption in buildings is one of the main problems related to the built environment in both dry and hot climates, although in hot climates especially the issue is exacerbated by the particularly great need for cooling systems in buildings. On the other hand, one of the most important factors that affect Saudi Arabia’s building design is gender and function, demonstrating how the culture of Saudi Arabia, significantly influenced by the Islamic religion, affects design. This paper aims to present a literature review of the area of sustainable building design and the impact of cultural issues, focusing on the case of Saudi Arabia. This paper has analysed related literature in the area of sustainable building design and the influence of cultural issues, focusing on the case of Saudi Arabia. This review has identified the lack of using technology to support designs in Saudi Arabia, lack of achieving sustainability in Saudi Arabia, culture issues effect on designing in Saudi Arabia, and lack of using Building Information Modelling (BIM) in Saudi Arabia for both public and private project. These issues have led to a series of recommendations that have the potential to improve the adoption of sustainable design in Saudi Arabia by using (BIM). Some of these recommendations are developing and understanding the influence of cultural issues on achieving sustainable design. Secondly, analysing the different viewpoints on sustainability between the experts and members of the public. Furthermore, developing a framework of measures of sustainable design for buildings with consideration of specific factors. Additionally, showing the current level of using BIM technologies. Finally, developing a methodology, supported by BIM, for both government and private projects.
From pomiculture waste to biotechnological raw material: efficient transformation using ligninosomes and cellulosomes from Pleurotus spp.
Authors: Ćilerdžić Jasmina , Galić Milica , Stajić Mirjana
Published: June 2022

The goal of this study was to determine the capacity of Pleurotus spp. lignocellulosome to transform frequent pomiculture residues (grapevine-, plum-, and raspberry sawdust) into raw materials for biotechnological processes. All three lignocellulosics induced the synthesis of ligninolytic and cellulolytic enzymes in the tested species. Laccase was dominant in the ligninolytic cocktail, with a maximum activity of 40,494.88 U L−1 observed after the cultivation of P. pulmonarius on grapevine sawdust. Grapevine sawdust also proved to be the optimal substrate for the synthesis of versatile peroxidases especially in P. eryngii (1010.10 U L−1), while raspberry sawdust favored the production of Mn-dependent peroxidase in P. pulmonarius (479.17 U L−1). P. pulmonarius was the dominant cellulolytic agent and raspberry sawdust was optimal for the synthesis of xylanases, and endo- and exo-cellulases (15,746.35 U L−1, 9741.56 U L−1, and 836.62 U L−1), while grapevine sawdust mostly induced β-glucosidase activity (166.11 U L−1). The degree of residues delignification was more substrate- than species-dependent, ranging between 6.44 and 23.72% after the fermentation of grapevine and raspberry sawdust with P. pulmonarius. On the other hand, the lowest level of cellulose consumption was also observed on raspberry sawdust after the cultivation of P. eryngii, which together with high delignification also induced the highest selectivity index (1.27). The obtained results show the exceptional lignocellulolytic potential of Pleurotus spp. enzyme cocktails which opens up many possibilities for their application in numerous biotechnological processes.

Graphical Abstract
NEMA characterization of the SAFIR prototype PET insert
Authors: Khateri Parisa , Lustermann Werner , Ritzer Christian , Tsoumpas Charalampos , Dissertori Günther
Published: June 2022

Background

The SAFIR prototype insert is a preclinical Positron Emission Tomography (PET) scanner built to acquire dynamic images simultaneously with a 7 T Bruker Magnetic Resonance Imaging (MRI) scanner. The insert is designed to perform with an excellent coincidence resolving time of 194 ps Full Width Half Maximum (FWHM) and an energy resolution of 13.8% FWHM. These properties enable it to acquire precise quantitative images at activities as high as 500 MBq suitable for studying fast biological processes within short time frames (< 5 s). In this study, the performance of the SAFIR prototype insert is evaluated according to the NEMA NU 4-2008 standard while the insert is inside the MRI without acquiring MRI data.

Results

Applying an energy window of 391–601 keV and a coincidence time window of 500 ps the following results are achieved. The average spatial resolution at 5 mm radial offset is 2.6 mm FWHM when using the Filtered Backprojection 3D Reprojection (FBP3DRP) reconstruction method, improving to 1.2 mm when using the Maximum Likelihood Expectation Maximization (MLEM) method. The peak sensitivity at the center of the scanner is 1.06%. The Noise Equivalent count Rate (NECR) is 799 kcps at the highest measured activity of 537 MBq for the mouse phantom and 121 kcps at the highest measured activity of 624 MBq for the rat phantom. The NECR peak is not yet reached for any of the measurements. The scatter fractions are 10.9% and 17.8% for the mouse and rat phantoms, respectively. The uniform region of the image quality phantom has a 3.0% STD, with a 4.6% deviation from the expected number of counts per voxel. The spill-over ratios for the water and air chambers are 0.18 and 0.17, respectively.

Conclusions

The results satisfy all the requirements initially considered for the insert, proving that the SAFIR prototype insert can obtain dynamic images of small rodents at high activities ($$\sim$$∼500 MBq) with a high sensitivity and an excellent count-rate performance.
A d-axis based current differential protection scheme for an active distribution network
Authors: Zang Lindong , Zou Guibin , Zhou Chenghan , Zheng Maoran , Du Tao
Published: June 2022

The emergence of distributed generators has changed the operational mode and fault characteristics of the distribution network, in a way which can severely influence protection. This paper proposes a d-axis-based current differential protection scheme. The d-axis current characteristics of inverter-interfaced distributed generators and synchronous generators are analyzed. The differential protection criterion using sampling values of the d-axis current component is then constructed. Compared to conventional phase-based current differential protection, the proposed protection reduces the number of required communication channels, and is suitable for distribution networks with inverter-interfaced distributed generators with complex fault characteristics. Finally, a 10 kV active distribution network model is built in the PSCAD platform and protection prototypes are developed in RTDS. Superior sensitivity and fast speed are verified by simulation and RTDS-based tests.
Inclusion of information technology-based assessments of health-related quality of life in routine oncology practice in Uruguay
Authors: Castillo Cecilia , Alfonso Ana Laura , Dapueto Juan J. , Camejo Natalia , Silva Martín
Published: June 2022

Background

Previous research has shown that the inclusion of patient-reported outcomes measures in the patient’s visit to the oncologists might improve the quality of global health care. The aim of the study was to assess the feasibility, acceptance, and utility perceived by patients and oncologists of health-related quality of life (HRQL) assessments obtained prior to clinical visits, and to evaluate if this has an impact on patient’s well-being in a sample of Spanish-speaking patients from Uruguay.

Methods

Patients assisted regularly in the Oncology Clinic were randomized into two groups: an intervention group that completed a set of questionnaires (European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire-C30 (EORTC QLQ-C30) and Hospital Anxiety and Depression Scale using a touch screen device and a control group that did not respond to these questionnaires. At 2 months, the responses of all the participants to the Functional Assessment of Cancer Therapy-General (FACT-G) were collected over a telephone to determine whether there were differences in the HRQL between the intervention and control groups. The graphed scores of the intervention group were included in the clinical history of the patient during consultation. Patients and physicians completed the questionnaires on the usefulness of these measurements.

Results

In total, 58 patients participated in this study: 36 in the intervention group and 22 in the control group; 65% of the participants were female, and median age was 59 years (18–79). Regarding patients, 97% found the questionnaires easy to complete and thought that they included important questions. As for oncologists, 68.8% used the information and 87.5% found it useful for the consultation. There were no significant differences in the FACT-G scores between the intervention and control groups.

Conclusions

The routine HRQL assessments using an electronic device prior to the consultations were positively valued by almost all patients and physicians. This could significantly contribute to a better understanding of the patient's overall problems during consultation. These results confirm the benefits of integrating the patient’s self-reported quality of life outcomes into consultations.
Mental health impact on healthcare workers due to the COVID-19 pandemic: a U.S. cross-sectional survey study
Authors: Biber Joshua , Ranes Bethany , Lawrence Shanieek , Malpani Vishal , Trinh Trong Tony , Cyders Andrew , English Steven , Staub Charles L. , McCausland Kristen L. , Kosinski Mark , Baranwal Nishtha , Berg Daniel , Pop Rodica
Published: June 2022

Background

The COVID-19 pandemic has impacted the mental health and well-being of health care workers (HCWs). This study examined mental health outcomes and COVID-related stress impacts among a diverse sample of ambulatory HCWs, including clinicians and support staff, as well as the associations between mental health outcomes and work impairments in this population. Detailing these results can help in designing interventions to alleviate this burden.

Methods

“The Health Care Worker Stress Survey” was administered to ambulatory care providers and support staff at three multispecialty care delivery organizations as part of an online, cross-sectional study conducted between June 8, 2020, and July 13, 2020.

Results

The greatest stress impact reported by HCWs was the uncertainty regarding when the COVID-19 outbreak would be under control, while the least reported concern was about self-dying from COVID-19. Differences in COVID-19 stress impacts were observed by age, gender, and occupational risk factors. Approximately 50% of participants reported more than a minimal level of anxiety, including 22.5% who indicated moderate to severe levels of anxiety. Higher levels of anxiety were observed with younger ages and female gender, while occupational roles with increased exposure risk did not report higher levels of anxiety. Roughly two-thirds of the sample reported less than good sleep quality and one-third to one-half of the sample reported other sleep related problems that differed by age and gender. Role limitations due to emotional health correlated with COVID-19 related stress, anxiety and sleep problems.

Conclusions

Using established, validated measures, we quantified mental health outcomes within a diverse sample of ambulatory care HCWs during the pandemic. Younger and female HCWs reported greater anxiety burden; HCWs with higher occupational risk of COVID exposure did not report higher levels of anxiety. Notable proportions of HCWs reported sleep and work impairments. Due to the cross-sectional nature of the study, it is difficult to attribute these patterns to the pandemic. These results underscore the depth and extent of mental health outcomes in HCWs in ambulatory settings and raise important questions on new interventions to relieve that burden. Further research is needed to study specific interventions to support the mental health and wellbeing of HCWs.
Comparative performance of the EuroQol EQ-5D-5L and the CDC healthy days measures in assessing population health
Authors: Derkach Maryna , Al Sayah Fatima , Ohinmaa Arto , Svenson Lawrence W. , Johnson Jeffrey A.
Published: June 2022

Objectives

To examine the comparative performance of EuroQol EQ-5D-5L and Center for Disease Control Healthy Days measures in assessing population health.

Methods

Using data from 2014 Alberta Community Health Survey, a cross-sectional population-based survey (N = 7559), conducted in Alberta, Canada, we examined construct validity of the measures as indicators of population health. Differences in EQ-5D-5L index score, visual analogue scale (EQ-VAS), and CDC unhealthy days index across socio-demographic subgroups were tested by Mann–Whitney and Kruskal–Wallis tests using known-groups approach.

Results

EQ-5D-5L and CDC Healthy Days provided comparable assessments of population health in this sample. Both measures discriminated between subgroups defined by self-perceived health status, level of education, and material deprivation. The discriminative ability of CDC Healthy Days was limited in capturing variability in health among age groups compared to the EQ-5D-5L. Among participants who reported 0 unhealthy days, the proportion of those with level 3 problems in pain/discomfort varied from 1.1% for participants aged 18–24 to 19.2% for those over 75 years.

Conclusions

EQ-5D-5L demonstrated better construct validity than CDC Healthy Days in assessing health in a population-based sample of adults.
Healthcare provider and medical cannabis patient communication regarding referral and medication substitution: the Canadian context
Authors: Holman Alexis , Kruger Daniel J. , Lucas Philippe , Ong Kaye , Bergmans Rachel S. , Boehnke Kevin F.
Published: June 2022

Background

Patients use medical cannabis for a wide array of illnesses and symptoms, and many substitute cannabis for pharmaceuticals. This substitution often occurs without physician oversight, raising patient safety concerns. We aimed to characterize substitution and doctor-patient communication patterns in Canada, where there is a mature market and national regulatory system for medical cannabis.

Methods

We conducted an anonymous, cross-sectional online survey in May 2021 for seven days with adult Canadian federally-authorized medical cannabis patients (N = 2697) registered with two global cannabis companies to evaluate patient perceptions of Primary Care Provider (PCP) knowledge of medical cannabis and communication regarding medical cannabis with PCPs, including PCP authorization of licensure and substitution of cannabis for other medications.

Results

Most participants (62.7%, n = 1390) obtained medical cannabis authorization from their PCP. Of those who spoke with their PCP about medical cannabis (82.2%, n = 2217), 38.6% (n = 857) reported that their PCP had “very good” or “excellent” knowledge of medical cannabis and, on average, were moderately confident in their PCP’s ability to integrate medical cannabis into treatment. Participants generally reported higher ratings for secondary care providers, with 82.8% (n = 808) of participants rating their secondary care provider’s knowledge about medical cannabis as “very good” or “excellent.” Overall, 47.1% (n = 1269) of participants reported substituting cannabis for pharmaceuticals or other substances (e.g., alcohol, tobacco/nicotine). Of these, 31.3% (n = 397) reported a delay in informing their PCP of up to 6 months or more, and 34.8% (n = 441) reported that their PCP was still not aware of their substitution. Older, female participants had higher odds of disclosing cannabis substitution to their PCPs.

Conclusion

Most of the surveyed Canadian medical cannabis patients considered their PCPs knowledgeable about cannabis and were confident in their PCPs’ ability to integrate cannabis into treatment plans. However, many surveyed patients substituted cannabis for other medications without consulting their PCPs. These results suggest a lack of integration between mainstream healthcare and medical cannabis that may be improved through physician education and clinical experience.
Antiplatelets or anticoagulants? Secondary prevention in cervical artery dissection: an updated meta-analysis
Authors: The Ei Zune , Lin Ne Naing , Chan Ching Jocelyn , Loon Jason Cher Wei , Tan Benjamin Yong-Qiang , Seet Chee Seong Raymond , Teoh Hock Luen , Vijayan Joy , Yeo Leong Litt Leonard
Published: June 2022

Background

Extracranial artery dissection involving either internal carotid artery or vertebral artery is a major cause of stroke in adults under 50 years of age. There is no conclusive evidence whether antiplatelets or anticoagulants are better suited in the treatment of extracranial artery dissection.

Objectives

To determine whether antiplatelets or anticoagulants have advantage over the other in the treatment of extracranial artery dissection for secondary prevention of recurrent ischemic events or death.

Methods

Present meta-analysis followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement. Database search was done in Medline, Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov from inception to May 2021 using pre-defined search strategy. Additional studies were identified from reference lists from included studies, reviews and previous meta-analyses. Outcome measures were ischaemic stroke, ischaemic stroke or transient ischaemic attack (TIA), and death.

Results

Two RCTs and 64 observational studies were included in the meta-analysis. While the outcome measures of stroke, stroke or TIA and death were numerically higher with antiplatelet use, there were no statistically significant differences between antiplatelets and anticoagulants.

Conclusion

We found no significant difference between antiplatelet and anticoagulation treatment after extracranial artery dissection. The choice of treatment should be tailored to individual cases.
St. Jude Total Therapy studies from I to XVII for childhood acute lymphoblastic leukemia: a brief review
Authors: Omar Abdallah A. , Basiouny Lina , Elnoby Ahmed S. , Zaki Abeer , Abouzid Mohamed
Published: June 2022

The therapy design of childhood acute lymphoblastic leukemia (ALL) has evolved over the past 60 years. The St. Jude Children’s Research Hospital has developed 17 treatment protocols from 1962 to 2017, aiming to have the most effective and least toxic treatment form. This review summarizes each protocol’s objectives, inclusion criteria, treatment phases, pharmacological agents, irradiation therapy, response criteria, risk stratification, type of relapse, and overall survival. The enhancement and successful application of preventive therapy for ALL and following a risk-stratified approach have progressively improved the cure rate of childhood ALL, with relatively few adverse sequelae. Moreover, St. Jude’s scientific theme serves as a reminder of the principal factor of research directed to a catastrophic disease such as ALL.
Patients after lung resection heading to the high-dependency unit: a cost-effectiveness study for managing lung cancer patients
Authors: Elsayed Hany Hasan , Ahmed Mohamed Hussein , El Ghanam Mohamed , Hikal Tamer , Abdel-Gayed Mohammed , Moharram Assem Adel
Published: June 2022

Background

Recently, most thoracic surgery units allocate patients post lung resection to high-dependency units (HDU) rather than the old trend of intensive care units (ITU). The aim of the study is to assess the safety and efficacy of such a policy. We compared a single group of patients who underwent lobectomies who were admitted to ITU before March 2011 and patients whom their destination was to HDU after that date. Preoperative factors and postoperative outcomes were compared.

Results

A total of 408 patients were studied, 203 post-lobectomy patients were admitted routinely to ITU before March 2011, while 205 patients were admitted to HDU after that date. The mean postoperative length of stay in ITU was 1.2 days while in HDU was 1.1 days. In-hospital mortality for the ITU group was 2.5% (n = 5) while in the HDU group was 1.4% (n = 3) (p = 0.43). ITU readmission was observed in 6.5% (n = 13) in the ITU group and 4.3% (n = 9) in the HDU group (p = 0.31). Total complications were present in 39% in the ITU group and 33% in the HDU group (p = 0.16). The total estimated cost of one ITU day per patient is 850 GBP in comparison with 430 GBP for the HDU group (p = 0.007). The incremental cost-effectiveness ratio of the HDU stay per year was US $32.130/QALY.

Conclusion

The high-dependency unit is a safe destination for post-lobectomy patients. The same concept may apply to all thoracotomy patients. Hospitals could adopt such a policy which offers a better financial option without jeopardizing the level of patient care or outcome.
A case series of mucormycosis mimics on MRI—Tales of respite amidst the havoc
Authors: Sukhani Paresh , Goyal Alka , Bellamkondi Ashwini , Mendiratta Kuldeep , Rathi Bhavyansh
Published: June 2022

Background

Rhinocerebral mucormycosis is new bandit amidst present COVID-19 pandemic, it is an acute and lethal opportunistic fungal infection affecting immunocompromised and diabetic patients. Since the disease has got high morbidity and mortality despite aggressive treatment, radiologists play a very crucial role in early and accurate diagnosis. Erroneous diagnosis should be refrained by logistic approach and thorough clinico-radiological correlation.

Material and methods

Ours was a cross sectional study included six cases after taking written informed consent who recently presented with mucormycosis like symptoms and imaging findings during a period of 1 month, but by detailed clinical and radiological evaluation, we concluded that all these cases were either physiological mimics or extraneous artefacts, this helped greatly in relieving undue anxiety of patients and referral physicians and also avoided unnecessary further workup. This study was conducted after approval by the institutional ethical committee.

Results

Our study included 3 males and 3 females of age ranging from 32 to 62 years, all of which had history of COVID-positive having mild to moderate CT severity score who were treated with steroids and oxygen therapy (except one case). The most common presenting symptom was headache followed by nasal congestion. The mucor mimickers encountered were benign black turbinate sign, artifacts due to cosmetic dermal fillers and dental fillings, hemangioma, prolonged prone ventilation, and fungal ball.

Conclusions

Amidst the sudden spurt in the number of cases of mucormycosis in our country in the present COVID era, there has been an increase in the number of imaging requisitions. This series of cases aims to sensitize radiologists about the importance of detailed clinical history, thorough clinic-radiological correlation and at times also taking extra efforts to reconnect to patients regarding specific clinical history and avoid fallacious diagnosis.
The inhibition of protein translation promotes tumor angiogenic switch
Authors: Luo Hui , Shen Yuge , Liao Weiting , Li Qiqi , Wu Ni , Zhong Jian , Xiao Chaoxin , Gan Jia , Yang Yun , Dong E. , Zhang Guimin , Liu Binrui , Yue Xiaozhu , Xu Lin , Liu Yan , Zhao Chengjian , Zhong Qian , Yang Hanshuo
Published: June 2022

The ‘angiogenic switch’ is critical for tumor progression. However, the pathological details and molecular mechanisms remain incompletely characterized. In this study, we established mammal xenografts in zebrafish to visually investigate the first vessel growth (angiogenic switch) in real-time, by inoculating tumor cells into the perivitelline space of live optically transparent Transgenic (flk1:EGFP) zebrafish larvae. Using this model, we found that hypoxia and hypoxia-inducible factor (HIF) signaling were unnecessary for the angiogenic switch, whereas vascular endothelial growth factor A gene (Vegfa) played a crucial role. Mechanistically, transcriptome analysis showed that the angiogenic switch was characterized by inhibition of translation, but not hypoxia. Phosphorylation of eukaryotic translation initiation factor 2 alpha (Eif2α) and the expression of Vegfa were increased in the angiogenic switch microtumors, and 3D tumor spheroids, and puromycin-treated tumor cells. Vegfa overexpression promoted early onset of the angiogenic switch, whereas Vegfa knockout prevented the first tumor vessel from sprouting. Pretreatment of tumor cells with puromycin promoted the angiogenic switch in vivo similarly to Vegfa overexpression, whereas Vegfa knockdown suppressed the increase. This study provides direc and dynamic in vivo evidences that inhibition of translation, but not hypoxia or HIF signaling promotes the angiogenic switch in tumor by increasing Vegfa transcription.
Influence of the polyester non-wovens production type on their thermal and flammability properties
Authors: Petkova-Slipets Rositsa , Zlateva Penka , Staneva Desislava
Published: June 2022

In recent years, non-wovens have become the main segment of textile production because they can find applications in different areas. Thermal insulation properties, fire resistance, and flexibility make them cost-effective and efficient insulation panels for buildings. This paper aims to study the influence of the production method and surface treatment on the thermophysical characteristics and behavior under direct fire of two polyethylene terephthalate non-woven fabrics. The fibers have been bonded with polyacrylate adhesive or thermal and coated with silicone. Infrared spectroscopy, optical microscopy, and thermal analyses were applied to compare the non-wovens’ morphology, composition, and thermal properties. It founds that the non-woven polyester with acrylic additives and adhesive bonding has a higher thermal conductivity value and high flammability with complete combustion. In contrast, thermosetting siliconized polyester materials have limited flammability with limited droplet release. The silicone-based finish protects the polyester fibers leading to self-extinguishing and stopping the complete combustion of the sample.
A rare case of a patient with cystinosis and COVID-19 pneumonia with difficult weaning from mechanical ventilation: the “pocus force”
Authors: Vetrugno Luigi , Angelini Valentina , Smiraglia Simone Antonio , Saraceni Elisabetta , Di Giannatale Pierluigi , Maggiore Salvatore Maurizio
Published: June 2022

Here, we describe the case of a 39-year-old woman with cystinosis who already suffered from an extra parenchymal pattern of restrictive lung disease and, after SARS-CoV-2-related respiratory failure, had a difficult weaning from mechanical ventilation and required tracheostomy. In this rare disease, due to the mutation of the CTNS-gene located on chromosome 17p13, cystine accumulation in the distal muscle has been reported, even in the absence of manifest muscle fatigue. We were able to evaluate diaphragmatic weakness in this patient through the ultrasonographic evaluation of the diaphragm. We believe that diaphragm ultrasonography could be helpful to identify causes of difficult weaning thus supporting clinical decisions.
Nonlinear Rashba effect in a strongly correlated system
Authors: Yuan Xiao , Riseborough P. S.
Published: June 2022

There have been a number of reports of experimental observations of a field-dependent enhancement of the Rashba spin-orbit splitting in surface states. We show that strong Coulomb correlations lead to an enhancement of the spin-orbit coupling which is highly sensitive to band-bending and applied electric potentials. In a system with broken inversion symmetry, this leads to a nonlinear field-dependent Rashba interaction that could be responsible for the experimental observations.
Density functional study of thermodynamic properties, thermal expansion and lattice thermal conductivity of Fe2VAl in the high-temperature region
Authors: Sk Shamim , Pandey Sudhir K.
Published: June 2022

Here, we present the phonon calculations for thermodynamic properties, thermal expansion and lattice thermal conductivity of Fe2VAl in the temperature range of

and compare them with existing experiment. Phonon dispersion is computed using the finite displacement method and supercell approach. The positive frequencies of all the phonon modes indicate the mechanical stability of the compound. The specific heat at constant volume and Helmholtz free energy are calculated under harmonic approximation, while calculation of thermal expansion is done under quasi-harmonic approximation. Lattice thermal conductivity

is calculated using first-principle anharmonic lattice dynamics calculations. The zero-point energy and Debye temperature are computed as

and 638 K, respectively. The calculated thermal expansions are found to be

and

at 300 and 800 K, respectively. A significant deviation between calculated (

) and experimental (

) values of

are observed at 300 K. But, as the temperature increases, the calculated and experimental

come closer with the corresponding values of

and

at 800 K. The possible reasons for the deviation of

are addressed. The temperature dependence of phonon lifetime is computed in order to understand the feature of

. The present study suggests that DFT-based phononic calculations provide reasonably good explanations of available experimental phonon-related properties of Fe2VAl in the high-temperature range of

.