bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of maternal education and encouragement on newborn care utilization: a health system intervention
Authors: Kolahi Ali-Asghar , Abbasi-Kangevari Mohsen , Abadi Alireza
Published: July 2021

Background

The objective of this health system interventional study was to determine the effect of delivering newborn-care-oriented education and encouragement on newborn care utilization.

Methods

This study was performed in the urban health centers of the catchment area of Tehran Defined Population, which covered 10 of the 22 municipality districts of Tehran. The two catchment areas included 10,000 families in the intervention and 20,000 families in the control areas. As many as 4837 newborns (intervention = 1544, control = 3293) were enrolled and followed until the end of the second month of life. The utilization of the three newborn care visits, as recommended by national guidelines, was compared among the intervention and control groups.

Results

As many as 877 (56.8%) newborns in the intervention group and 1214 (36.9%) in the control group received all their three newborn care visits. The mean number of newborn care visits was higher in the intervention group compared to the control group: 2.26 (0.99) versus 1.84 (1.07), p < 0.001. The number of newborns who did not attend any of their three newborn care visits was 143 (9.3%) in the intervention group and 468 (14.2%) in the control group.

Conclusions

The intervention improved newborn care utilization during the first 2 months after birth. It could be suggested that active follow-up be added to newborn care guidelines. Parents need to be informed of the necessity and benefits of newborn care and be encouraged to perform all three newborn care visits.
A randomised feasibility trial of an employer-based intervention for enhancing successful return to work of cancer survivors (MiLES intervention)
Authors: Greidanus M. A. , de Rijk A. E. , de Boer A. G. E. M. , Bos M. E. M. M. , Plaisier P. W. , Smeenk R. M. , Frings-Dresen M. H. W. , Tamminga S. J.
Published: July 2021

Background

Employers express a need for support during sickness absence and return to work (RTW) of cancer survivors. Therefore, a web-based intervention (MiLES) targeted at employers with the objective of enhancing cancer survivors’ successful RTW has been developed. This study aimed to assess feasibility of a future definitive randomised controlled trial (RCT) on the effectiveness of the MiLES intervention. Also preliminary results on the effectiveness of the MiLES intervention were obtained.

Methods

A randomised feasibility trial of 6 months was undertaken with cancer survivors aged 18–63 years, diagnosed with cancer < 2 years earlier, currently in paid employment, and sick-listed < 1 year. Participants were randomised to an intervention group, with their employer receiving the MiLES intervention, or to a waiting-list control group (2:1). Feasibility of a future definitive RCT was determined on the basis of predefined criteria related to method and protocol-related uncertainties (e.g. reach, retention, appropriateness). The primary effect measure (i.e. successful RTW) and secondary effect measures (e.g. quality of working life) were assessed at baseline and 3 and 6 months thereafter.

Results

Thirty-five cancer survivors were included via medical specialists (4% of the initially invited group) and open invitations, and thereafter randomised to the intervention (n = 24) or control group (n = 11). Most participants were female (97%) with breast cancer (80%) and a permanent employment contract (94%). All predefined criteria for feasibility of a future definitive RCT were achieved, except that concerning the study’s reach (90 participants). After 6 months, 92% of the intervention group and 100% of the control group returned to work (RR: 0.92, 95% CI: 0.81–1.03); no difference were found with regard to secondary effect measures.

Conclusions

With the current design a future definitive RCT on the effectiveness of the MiLES intervention on successful RTW of cancer survivors is not feasible, since recruitment of survivors fell short of the predefined minimum for feasibility. There was selection bias towards survivors at low risk of adverse work outcomes, which reduced generalisability of the outcomes. An alternative study design is needed to study effectiveness of the MiLES intervention.

Trial registration

The study has been registered in the Dutch Trial Register (NL6758/NTR7627).
Differential in infant, childhood and under-five death clustering among the empowered and non-empowered action group regions in India
Authors: Paul Ronak , Rashmi Rashmi , Srivastava Shobhit
Published: July 2021

Background

With 8,82,000 deaths in the under-five period, India observed varied intra-state and inter-regional differences across infant and child mortality in 2018. However, scarce literature is present to capture this unusual concentration of mortality in certain families by examining the association of the mortality risks among the siblings of those families along with various unobserved characteristics of the mother. Looking towards the regional and age differential in mortality, this paper attempts to provide evidence for the differential in mortality clustering among infants (aged 0–11 months), children (12–59 months) and under-five (0–59 months) period among mothers from the Empowered Action Group (EAG) and non-EAG regions of India.

Methods

The study used data from the National Family Health Survey (2015–16) which includes all the birth histories of 475,457 women aged 15–49 years. Bivariate and multivariate analyses were used to fulfil the objectives of the study. A two-level random intercept Weibull regression model was used to account for the unexplained mother (family) level heterogeneity.

Results

About 3.3% and 5.9% of infant deaths and 0.8% and 1.6% of childhood deaths were observed in non-EAG and EAG regions respectively. Among them, a higher percentage of infant and child death was observed due to the death of a previous sibling. There were 1.67 times [95% CI: 1.55–1.80] and 1.46 times [CI: 1.37–1.56] higher odds of infant and under-five mortality of index child respectively when the previous sibling at the time of conception of the index child was dead in the non-EAG regions. In contrast, the odds of death scarring (death of previous sibling scars the survival of index child) were 1.38 times [CI: 1.32–1.44] and 1.24 times [CI: 1.20–1.29] higher for infant and under-five mortality respectively in the EAG regions.

Conclusion

The extent of infant and child mortality clustering and unobserved heterogeneity was higher among mothers in the non-EAG regions in comparison to their EAG region counterparts. With the growing situation of under-five mortality clustering in non-EAG states, region-wise interventions are recommended. Additionally, proper care is needed to ameliorate the inter-family variation in mortality risk among the children of both EAG and non-EAG regions throughout their childhood.
Handgrip strength during admission for COPD exacerbation: impact on further exacerbation risk
Authors: Lee Chi-Tai , Wang Ping-Huai
Published: July 2021

Background

Low handgrip strength (HGS) is independently associated with a higher exacerbation risk in stable chronic obstructive pulmonary disease (COPD); however, the relationship between HGS while being admitted for COPD exacerbation and further exacerbation risk after discharge remains unclear.

Methods

We enrolled patients admitted for COPD exacerbation between January 2018 and June 2019. HGS tests were done within 3 days after admission. The primary endpoint was exacerbations within 12 months after the index admission, which needed emergency room visits or hospital admission. We analyzed the relationships among demographics, HGS, pulmonary function parameters, and acute exacerbation events.

Results

Among 43 enrolled patients, 31 (72.1%) participants (HGSw) had HGS weakness (22.1 ± 4.1 kg). The other 12 (27.9%) participants (non-HGSw) had the strength of handgrips 33.7 ± 3.1 kg. HGSw group showed a significantly higher rate of emergency room visits within 6, 9, and 12 months after the index admission than non-HGSw group (0.81 ± 1.30 vs. 0.08 ± 0.29, p = 0.045; 1.26 ± 1.59 vs. 0.17 ± 0.38, P = 0.019; 1.48 ± 1.86 vs. 0.25 ± 0.62, P = 0.027, respectively). There was a trend to have higher admission rate within 9 and 12 months in HGSw group, which did not achieve statistical significance (0.77 ± 1.38 vs. 0.08 ± 0.29, P = 0.064; 0.94 ± 1.56 vs. 0.08 ± 0.29, P = 0.062, respectively).

Conclusions

HGS weakness measured upon admission for COPD exacerbation was associated with a higher risk of exacerbation in the next year.

Trial registration ClinicalTrials.gov Identifier: NCT04885933.
How does narrative medicine impact medical trainees’ learning of professionalism? A qualitative study
Authors: Huang Chien-Da , Jenq Chang-Chyi , Liao Kuo-Chen , Lii Shu-Chung , Huang Chi-Hsien , Wang Tsai-Yu
Published: July 2021

Background

Narrative medicine (NM) is an approach involving narrative skills and is regarded as a model for medical humanism and effective medical practice. This study aims to explore how NM impacts medical trainees’ learning of professionalism during a clerkship in a Taiwanese clinical setting.

Methods

A qualitative interview study adopting a purposive sampling method was undertaken. Thirty medical trainees participated in this study, including five fifth-year medical students (MSs), ten sixth-year MSs, nine seventh-year MSs, and six postgraduate year (PGY) trainees. Thematic framework analysis was applied, and a modified realist evaluation approach was further used to analyse the interview data.

Results

We identified self-exploration, reflection, and awareness of professional identity as mechanisms explaining how NM impacted professionalism learning in our participants. Furthermore, empathy, communication, doctor-patient relationship and understanding patients were identified as the outcomes of the NM intervention for trainees’ learning of professionalism.

Conclusions

NM facilitates medical trainees’ self-exploration, reflection, and awareness of professional identity, thereby affecting their learning of professionalism in clinical settings. Adopting NM as an educational intervention in undergraduate medical education could play an important role in professionalism learning, as trainees can thereby be supported to gradually develop self-exploration and reflection capabilities and heightened awareness of professional identity reflectively through a narrative process.
An ensemble-based feature selection framework to select risk factors of childhood obesity for policy decision making
Authors: Shi Xi , Nikolic Gorana , Epelde Gorka , Arrúe Mónica , Bidaurrazaga Van-Dierdonck Joseba , Bilbao Roberto , De Moor Bart
Published: July 2021

Background

The increasing prevalence of childhood obesity makes it essential to study the risk factors with a sample representative of the population covering more health topics for better preventive policies and interventions. It is aimed to develop an ensemble feature selection framework for large-scale data to identify risk factors of childhood obesity with good interpretability and clinical relevance.

Methods

We analyzed the data collected from 426,813 children under 18 during 2000–2019. A BMI above the 90th percentile for the children of the same age and gender was defined as overweight. An ensemble feature selection framework, Bagging-based Feature Selection framework integrating MapReduce (BFSMR), was proposed to identify risk factors. The framework comprises 5 models (filter with mutual information/SVM-RFE/Lasso/Ridge/Random Forest) from filter, wrapper, and embedded feature selection methods. Each feature selection model identified 10 variables based on variable importance. Considering accuracy, F-score, and model characteristics, the models were classified into 3 levels with different weights: Lasso/Ridge, Filter/SVM-RFE, and Random Forest. The voting strategy was applied to aggregate the selected features, with both feature weights and model weights taken into consideration. We compared our voting strategy with another two for selecting top-ranked features in terms of 6 dimensions of interpretability.

Results

Our method performed the best to select the features with good interpretability and clinical relevance. The top 10 features selected by BFSMR are age, sex, birth year, breastfeeding type, smoking habit and diet-related knowledge of both children and mothers, exercise, and Mother’s systolic blood pressure.

Conclusion

Our framework provides a solution for identifying a diverse and interpretable feature set without model bias from large-scale data, which can help identify risk factors of childhood obesity and potentially some other diseases for future interventions or policies.
Can health service equity alleviate the health expenditure poverty of Chinese patients? Evidence from the CFPS and China health statistics yearbook
Authors: Tang Shaoliang , Yao Ling , Ye Chaoyu , Li Zhengjun , Yuan Jing , Tang Kean , Qian David
Published: July 2021

Objectives

To comprehend the relationship between various indicators of health service equity and patients’ health expenditure poverty in different regions of China, identify areas where equity in health service is lacking and provide ideas for improving patients’ health expenditure poverty.

Method

Data from China Family Panel Studies (CFPS) in 2018 and the HFGT index formula were used to calculate the health expenditure poverty index of each province. Moreover, Global Moran’s I and Local Moran’s I test are applied to measure whether there is spatial aggregation of health expenditure poverty. Finally, an elastic net regression model is established to analyze the impact of health service equity on health expenditure poverty, with the breadth of health expenditure poverty as the dependent variable and health service equity as the independent variable.

Results

In the developed eastern provinces of China, the breadth of health expenditure poverty is relatively low. There is a significant positive spatial agglomeration. “Primary medical and health institutions per 1,000 population”, “rural doctors and health workers per 1,000 population”, “beds in primary medical institutions per 1,000 population”, “proportion of government health expenditure” and “number of times to participate in medical insurance (be aided) per 1,000 population” have a positive impact on health expenditure poverty. “Number of health examinations per capita” and “total health expenditure per capita” have a negative impact on health expenditure poverty. Both effects passed the significance test.

Conclusion

To enhance the fairness of health resource allocation in China and to alleviate health expenditure poverty, China should rationally plan the allocation of health resources at the grassroots level, strengthen the implementation of hierarchical diagnosis and treatment and encourage the investment in business medical insurance industry. Meanwhile, it is necessary to increase the intensity of medical assistance and enrich financing methods. All medical expenses of the poorest should be covered by the government.
Short term physician visits and medication prescriptions for allergic disease associated with seasonal tree, grass, and weed pollen exposure across the United States
Authors: Saha Shubhayu , Vaidyanathan Ambarish , Lo Fiona , Brown Claudia , Hess Jeremy J.
Published: July 2021

Background

While year-round exposure to pollen is linked to a large burden of allergic diseases, location-specific risk information on pollen types and allergy outcomes are limited. We characterize the relationship between acute exposure to tree, grass and weed pollen taxa and two allergy outcomes (allergic rhinitis physician visit and prescription allergy medication fill) across 28 metropolitan statistical areas (MSA) in the United States.

Methods

We obtained daily pollen data from National Allergy Bureau (NAB) monitors at these 28 MSAs for 2008–2015. We revised the NAB guidelines to classify taxa-specific pollen severity each day. Daily information on allergic rhinitis and prescribed allergy medications for individuals with employer-based health insurance from the IBM MarketScan Research database for these MSAs. We combined the daily pollen and health data for each MSA into a longitudinal dataset. We conducted a MSA-specific conditional quasi-Poisson regression analysis to assess how different levels of pollen concentration impact the health outcomes, controlling for local air pollution, meteorology and Influenza-like illness (ILI). We used a random effects meta-analysis to produce an overall risk estimate for each pollen type and health outcome.

Results

The seasonal distribution of pollen taxa and associated health impacts varied across the MSAs. Relative risk of allergic rhinitis visits increased as concentrations increased for all pollen types; relative risk of medication fills increased for tree and weed pollen only. We observed an increase in health risk even on days with moderate levels of pollen concentration. 7-day average concentration of pollen had stronger association with the health outcomes compared to the same-day measure. Controlling for air pollution and ILI had little impact on effect estimates.

Conclusion

This analysis expands the catalogue of associations between different pollen taxa and allergy-related outcomes across multiple MSAs. The effect estimates we present can be used to project the burden of allergic disease in specific locations in the future as well inform patients with allergies on impending pollen exposure.
An integrated primary care workforce planning toolkit at the regional level (part 1): qualitative tools compiled for decision-makers in Toronto, Canada
Authors: Chamberland-Rowe Caroline , Simkin Sarah , Bourgeault Ivy Lynn
Published: July 2021

Background

A regional health authority in Toronto, Canada, identified health workforce planning as an essential input to the implementation of their comprehensive Primary Care Strategy. The goal of this project was to develop an evidence-informed toolkit for integrated, multi-professional, needs-based primary care workforce planning for the region. This article presents the qualitative workforce planning processes included in the toolkit.

Methods

To inform the workforce planning process, we undertook a targeted review of the health workforce planning literature and an assessment of existing planning models. We assessed models based on their alignment with the core needs and key challenges of the health authority: multi-professional, population needs-based, accommodating short-term planning horizons and multiple planning scales, and addressing key challenges including population mobility and changing provider practice patterns. We also assessed the strength of evidence surrounding the models’ performance and acceptability.

Results

We developed a fit-for-purpose health workforce planning toolkit, integrating elements from existing models and embedding key features that address the region’s specific planning needs and objectives. The toolkit outlines qualitative workforce planning processes, including scenario generation tools that provide opportunities for patient and provider engagement. Tools include STEEPLED Analysis, SWOT Analysis, an adaptation of Porter’s Five Forces Framework, and Causal Loop Diagrams. These planning processes enable the selection of policy interventions that are robust to uncertainty and that are appropriate and acceptable at the regional level.

Conclusions

The qualitative inputs that inform health workforce planning processes are often overlooked, but they represent an essential part of an evidence-informed toolkit to support integrated, multi-professional, needs-based primary care workforce planning.
Rethinking approaches of science, technology, and innovation in healthcare during the COVID-19 pandemic: the challenge of translating knowledge infrastructures to public needs
Authors: da Silva Renan Gonçalves Leonel , Chammas Roger , Novaes Hillegonda Maria Dutilh
Published: July 2021

The coronavirus disease 2019 (COVID-19) outbreak made it clear that despite the potential of science, technology, and innovation (ST&I) to positively impact healthcare systems worldwide, as shown by the rapid development of SARS-CoV-2 test diagnostics and new mRNA vaccines, healthcare stakeholders have faced significant challenges in responding to the crisis through well-integrated ST&I-oriented health initiatives and policies. Therefore, the pandemic has mobilized experts, industry, and governments to evaluate alternative trajectories to promote a more efficient dialogue between ST&I and public health. This article presents a critical thinking about the contemporary asymmetries in the technical and political infrastructures available for particular approaches in ST&I in health, such as precision medicine, and for public health systems worldwide, uncovering a persistent gap in the translation of knowledge and technologies to adequately coordinated responses to the pandemic. We stimulate the understanding of this process as a matter of translation between platforms of knowledge and policy rationales shaped by different institutionalized frames of organizational practices and agendas. We draw attention to the need to strengthen governance tools for the promotion of ST&I as a strategic component of the post-pandemic agenda in public health, to prepare societies to respond efficiently to future emergencies.
The informed road map to prevention of Alzheimer Disease: A call to arms
Authors: McDade Eric , Llibre-Guerra Jorge J. , Holtzman David M. , Morris John C. , Bateman Randall J.
Published: July 2021

Alzheimer disease (AD) prevention trials hold the promise to delay or prevent cognitive decline and dementia onset by intervening before significant neuronal damage occurs. In recent years, the first AD prevention trials have launched and are yielding important findings on the biology of targeting asymptomatic AD pathology. However, there are limitations that impact the design of these prevention trials, including the translation of animal models that recapitulate key stages and multiple pathological aspects of the human disease, missing target validation in asymptomatic disease, uncertain causality of the association of pathophysiologic changes with cognitive and clinical symptoms, and limited biomarker validation for novel targets. The field is accelerating advancements in key areas including the development of highly specific and quantitative biomarker measures for AD pathology, increasing our understanding of the course and relationship of amyloid and tau pathology in asymptomatic through symptomatic stages, and the development of powerful interventions that can slow or reverse AD amyloid pathology. We review the current status of prevention trials and propose key areas of needed research as a call to basic and translational scientists to accelerate AD prevention. Specifically, we review (1) sporadic and dominantly inherited primary and secondary AD prevention trials, (2) proposed targets, mechanisms, and drugs including the amyloid, tau, and inflammatory pathways and combination treatments, (3) the need for more appropriate prevention animal models and experiments, and (4) biomarkers and outcome measures needed to design human asymptomatic prevention trials. We conclude with actions needed to effectively move prevention targets and trials forward.
Ethics in extracorporeal life support: a narrative review
Authors: Schou Alexandra , Mølgaard Jesper , Andersen Lars Willy , Holm Søren , Sørensen Marc
Published: July 2021

During 50 years of extracorporeal life support (ECLS), this highly invasive technology has left a considerable imprint on modern medicine, and it still confronts researchers, clinicians and policymakers with multifarious ethical challenges. After half a century of academic discussion about the ethics of ECLS, it seems appropriate to review the state of the argument and the trends in it. Through a comprehensive literature search on PubMed, we identified three ethical discourses: (1) trials and evidence accompanying the use of ECLS, (2) ECLS allocation, decision-making and limiting care, and (3) death on ECLS and ECLS in organ donation. All included articles were carefully reviewed, arguments extracted and grouped into the three discourses. This article provides a narrative synthesis of these arguments, evaluates the opportunities for mediation and substantiates the necessity of a shared decision-making approach at the limits of medical care.
Recruiting ‘hard to reach’ parents for health promotion research: experiences from a qualitative study
Authors: Tully Louise , Spyreli Eleni , Allen-Walker Virginia , Matvienko-Sikar Karen , McHugh Sheena , Woodside Jayne , McKinley Michelle C. , Kearney Patricia M. , Dean Moira , Hayes Catherine , Heary Caroline , Kelly Colette
Published: July 2021

Objective

Marginalised populations are less likely to take part in health research, and are sometimes considered ‘easy to ignore’. We aimed to describe our approach and results of recruiting parents who experience disadvantage, for focus groups exploring infant feeding on the island of Ireland. Upon receiving ethical approval, we implemented recruitment strategies that included building rapport with community organisations through existing networks, targeting specific organisations with information about our aims, and utilising social media groups for parents.

Results

We approached 74 organisations of which 17 helped with recruitment. We recruited 86 parents/carers (one male) for 19 focus groups (15 urban/4 rural). Seventy two percent met at the eligibility criteria. Most participants were recruited through organisations (91%), and the remainder on social media (9%). Recruitment barriers included multiple steps, research fatigue, or uncertainty around expectations. Factors such as building rapport, simplifying the recruitment process and being flexible with procedures were facilitators. Despite comprehensive, multi-pronged approaches, the most marginalised parents may not have been reached. Further alternative recruitment strategies are required for recruiting fathers, rural populations, or those without the capacity or opportunity to engage with local services.
Large-scale lipidomic profiling identifies novel potential biomarkers for prion diseases and highlights lipid raft-related pathways
Authors: Kim Yong-Chan , Lee Junbeom , Lee Dae-Weon , Jeong Byung-Hoon
Published: July 2021

Prion diseases are transmissible spongiform encephalopathies induced by the abnormally-folded prion protein (PrPSc), which is derived from the normal prion protein (PrPC). Previous studies have reported that lipid rafts play a pivotal role in the conversion of PrPC into PrPSc, and several therapeutic strategies targeting lipids have led to prolonged survival times in prion diseases. In addition, phosphatidylethanolamine, a glycerophospholipid member, accelerated prion disease progression. Although several studies have shown that prion diseases are significantly associated with lipids, lipidomic analyses of prion diseases have not been reported thus far. We intraperitoneally injected phosphate-buffered saline (PBS) or ME7 mouse prions into mice and sacrificed them at different time points (3 and 7 months) post-injection. To detect PrPSc in the mouse brain, we carried out western blotting analysis of the left hemisphere of the brain. To identify potential novel lipid biomarkers, we performed lipid extraction on the right hemisphere of the brain and liquid chromatography mass spectrometry (LC/MS) to analyze the lipidomic profiling between non-infected mice and prion-infected mice. Finally, we analyzed the altered lipid-related pathways by a lipid pathway enrichment analysis (LIPEA). We identified a total of 43 and 75 novel potential biomarkers at 3 and 7 months in prion-infected mice compared to non-infected mice, respectively. Among these novel potential biomarkers, approximately 75% of total lipids are glycerophospholipids. In addition, altered lipids between the non-infected and prion-infected mice were related to sphingolipid, glycerophospholipid and glycosylphosphatidylinositol (GPI)-anchor-related pathways. In the present study, we found novel potential biomarkers and therapeutic targets of prion disease. To the best of our knowledge, this study reports the first large-scale lipidomic profiling in prion diseases.
rpoS-mutation variants are selected in Pseudomonas aeruginosa biofilms under imipenem pressure
Authors: Duan Xiangke , Pan Yanrong , Cai Zhao , Liu Yumei , Zhang Yingdan , Liu Moxiao , Liu Yang , Wang Ke , Zhang Lianhui , Yang Liang
Published: July 2021

Background

Pseudomonas aeruginosa is a notorious opportunistic pathogen causing various types of biofilm-related infections. Biofilm formation is a unique microbial strategy that allows P. aeruginosa to survive adverse conditions such as antibiotic treatment and human immune clearance.

Results

In this study, we experimentally evolved P. aeruginosa PAO1 biofilms for cyclic treatment in the presence of high dose of imipenem, and enriched hyperbiofilm mutants within six cycles in two independent lineages. The competition assay showed that the evolved hyperbiofilm mutants can outcompete the ancestral strain within biofilms but not in planktonic cultures. Whole-genome sequencing analysis revealed the hyperbiofilm phenotype is caused by point mutations in rpoS gene in all independently evolved mutants and the same mutation was found in P. aeruginosa clinical isolates. We further showed that mutation in rpoS gene increased the intracellular c-di-GMP level by turning on the expression of the diguanylate cyclases. Mutation in rpoS increased pyocyanin production and virulence in hyperbiofilm variants.

Conclusion

Here, our study revealed that antibiotic treatment of biofilm-related P. aeruginosa infections might induce a hyperbiofilm phenotype via rpoS mutation, which might partially explain antimicrobial treatment failure of many P. aeruginosa biofilm-related infections.
Malaria: elimination tale from Yunnan Province of China and new challenges for reintroduction
Authors: Yang Heng-Lin , Baloch Zulqarnain , Xu Jian-Wei , Sun Xiao-Dong , Lin Zu-Rui , Zhou Yao-Wu , Zhao Xiao-Tao , Lv Quan , Xu Shi-Yuan , Ding Chun-Li , Chen Qi-Yan , Tian Peng , Dung Kai-Xia , Xia Xue-Shan , Zhou Hong-Ning
Published: July 2021

Background

Eradication of infectious disease is the sanctified public health and sustainable development goal around the world.

Main body

Three antimalarial barriers were developed to control imported malarial cases, and an effective surveillance strategy known as the “1–3–7 approach” was developed to eliminate malaria from the Chinese population. From 2011 to 2019, 5254 confirmed malaria cases were reported and treated in Yunnan Province, China. Among them, 4566 cases were imported from other countries, and 688 cases were indigenous from 2011 to 2016. Since 2017, no new local malarial case has been reported in China. Thus, malaria has been completely eliminated in Yunnan Province. However, malaria is detected in overseas travellers on a regular basis, such as visitors from neighbouring Myanmar.

Conclusion

Hence, the strategies should be further strengthened to maintain a robust public health infrastructure for disease surveillance and vector control programs in border areas. Such programs should be supported technically and financially by the government to avert the possibility of a malarial resurgence in Yunnan Province.

Graphic Abstract
Chew and spit (CHSP) in bariatric patients: a case series
Authors: Aouad Phillip , Stedal Kristin , Walø-Syversen Gro , Hay Phillipa , Lindvall Dahlgren Camilla
Published: July 2021

Background

Studies into the disordered eating behaviour of chew and spit have alluded to several cohorts more likely to engage in the behaviour, one such group being bariatric surgery candidates and patients. Weight-loss surgery candidates have received little to no attention regarding engaging in chew and spit behaviour. Changes in pre- and post- surgery eating pathology related to chew and spit behaviour has yet to be explored and described in academic literature.

Case presentation

The current study reports on three cases of individual women, aged 30, 35, and 62 respectively, who indicated engagement in chew and spit. All three cases underwent bariatric surgery (two underwent gastric bypass, one underwent vertical sleeve gastrectomy). Eating pathology—including chew and spit behaviour, anxiety and depression, and adherence to the Norwegian nutritional guidelines were examined pre-operatively and post-operatively (one and two-year follow-up). At baseline (pre-surgery), two participants reported that they engaged in chew and spit, compared to one patient post-surgery. All three cases reported that they, to at least some extent, adhered to dietary guidelines post-surgery. Subjective bingeing frequency appeared to be relatively low for all three cases, further declining in frequency at one-year follow-up. At baseline, one participant reported clinically significant depression and anxiety, with no clinically significant depression or anxiety reported at follow-ups in participants that chew and spit.

Conclusions

The current study provides a starting point for the exploration of chew and spit as a pathological symptom of disordered eating in bariatric patients. It highlights the need to further explore chew and spit before and after weight-loss surgery.
Downstream effects of polypathology on neurodegeneration of medial temporal lobe subregions
Authors: Wisse L. E. M. , Ravikumar S. , Ittyerah R. , Lim S. , Lane J. , Bedard M. L. , Xie L. , Das S. R. , Schuck T. , Grossman M. , Lee E. B. , Tisdall M. D. , Prabhakaran K. , Detre J. A. , Mizsei G. , Trojanowski J. Q. , Artacho-Pérula E. , de Iñiguez de Onzono Martin M. M. , M. Arroyo-Jiménez M. , Muñoz Lopez M. , Molina Romero F. J. , P. Marcos Rabal M. , Cebada Sánchez S. , Delgado González J. C. , de la Rosa Prieto C. , Córcoles Parada M. , Wolk D. A. , Irwin D. J. , Insausti R. , Yushkevich P. A.
Published: July 2021

The medial temporal lobe (MTL) is a nidus for neurodegenerative pathologies and therefore an important region in which to study polypathology. We investigated associations between neurodegenerative pathologies and the thickness of different MTL subregions measured using high-resolution post-mortem MRI. Tau, TAR DNA-binding protein 43 (TDP-43), amyloid-β and α-synuclein pathology were rated on a scale of 0 (absent)—3 (severe) in the hippocampus and entorhinal cortex (ERC) of 58 individuals with and without neurodegenerative diseases (median age 75.0 years, 60.3% male). Thickness measurements in ERC, Brodmann Area (BA) 35 and 36, parahippocampal cortex, subiculum, cornu ammonis (CA)1 and the stratum radiatum lacunosum moleculare (SRLM) were derived from 0.2 × 0.2 × 0.2 mm3 post-mortem MRI scans of excised MTL specimens from the contralateral hemisphere using a semi-automated approach. Spearman’s rank correlations were performed between neurodegenerative pathologies and thickness, correcting for age, sex and hemisphere, including all four proteinopathies in the model. We found significant associations of (1) TDP-43 with thickness in all subregions (r =  − 0.27 to r =  − 0.46), and (2) tau with BA35 (r =  − 0.31) and SRLM thickness (r =  − 0.33). In amyloid-β and TDP-43 negative cases, we found strong significant associations of tau with ERC (r =  − 0.40), BA35 (r =  − 0.55), subiculum (r =  − 0.42) and CA1 thickness (r =  − 0.47). This unique dataset shows widespread MTL atrophy in relation to TDP-43 pathology and atrophy in regions affected early in Braak stageing and tau pathology. Moreover, the strong association of tau with thickness in early Braak regions in the absence of amyloid-β suggests a role of Primary Age-Related Tauopathy in neurodegeneration.
Ancient mural classification methods based on a multichannel separable network
Authors: Cao Jianfang , Jia Yiming , Chen Huiming , Yan Minmin , Chen Zeyu
Published: July 2021

Ancient murals are of high artistic value and boast rich content. The accurate classification of murals is a challenging task for researchers and can be arduous even for experienced researchers. The image classification algorithms currently available are not effective in the classification of mural images with strong background noise. A new multichannel separable network model (MCSN) is proposed in this study to solve this issue. Using the GoogLeNet network model as the basic framework, we adopt a small convolution kernel for the extraction of the shallow-layer background features of murals and then decompose larger, two-dimensional convolution kernels into smaller convolution kernels, for example, 7 × 7 and 3 × 3 kernels into 7 × 1 and 1 × 7 kernels and 3 × 1 and 1 × 3 kernels, respectively, to extract important deep-layer feature information. A soft thresholding activation scaling strategy is adopted to enhance the stability of the network during training, and finally, the murals are classified through the softmax layer. A minibatch SGD algorithm is employed to update the parameters. The accuracy, recall and F1-score reached 88.16%, 90.01%, and 90.38%, respectively. Compared with mainstream classification algorithms, the model demonstrates improvement in terms of classification accuracy, generalizability, and stability to a certain extent, supporting its suitability in efficiently classifying murals.
Seasonal variation of inter-hemispheric field-aligned currents deduced from time-series analysis of the equatorial geomagnetic field data during solar cycle 23–24
Authors: Ranasinghe Manjula , Fujimoto Akiko , Yoshikawa Akimasa , Jayaratne Chandana
Published: July 2021

The east–west component of magnetic field variation (∆D-component) at Davao station (Philippines, geomagnetic latitude: – 2.22˚N) are used to investigate the characteristics of the long-term Inter-Hemispheric Field-Aligned Currents (IHFACs) based on the time-series analysis from August 1998 to July 2020. Recent in situ satellite and ground-based observations have reported that dusk-side current polarity of IHFAC is often opposite to that of the noon IHFAC, being inconsistent with Fukushima's IHFACs model. We investigated the consistency of the dusk-side IHFAC polarity derived from the observations with the polarity expected from Fukushima’s IHFACs model and examined the solar cycle dependence of IHFACs. It was confirmed that the dusk-side IHFACs during June and December solstices flow in the same direction of the noontime IHFACs, which was consistent with the IHFAC polarities suggested by the Fukushima model. The dusk-side IHFACs around March and September–November months disagreed with the Fukushima model. The ∆D variations clearly showed seasonal asymmetry in the dawn and noon sectors, whereas the ∆D variations in the dusk sector demonstrated seasonal symmetry. Solar cycle dependence of IHFACs was exhibited in the dusk sector. For the dawn and noon sectors, the yearly peak-to-peak ∆D amplitude in the later solar cycle SC24 decreased by about 35% in comparison with the earlier solar cycle SC23. In contrast, the dusk-side yearly peak-to-peak ∆D amplitude increased by about 200%. The dusk-side IHFAC yearly amplitude tended to be in inverse proportion to solar activity.
The use of augmented reality for limb and component alignment in total knee arthroplasty: systematic review of the literature and clinical pilot study
Authors: Iacono V. , Farinelli L. , Natali S. , Piovan G. , Screpis D. , Gigante A. , Zorzi C.
Published: July 2021

Purpose

A systematic review of the literature has been carried out to assess the actual evidence of the use of augmented reality in total knee arthroplasty (TKA). We then conducted a pilot clinical study to examine the accuracy of the Knee + augmented reality navigation in performing TKA. The present augmented reality (AR) system allows the surgeon to view the tibial and femur axis superimposed on the surgical field through the smart glasses. It provides real-time information during surgery and intraoperative feedback.

Methods

A systematic review of the PubMed, MEDLINE, and Embase databases up to May 2021 using the keywords “augmented reality”, “knee arthroplasty”, “computer assisted surgery”, “navigation knee arthroplasty” was performed by two independent reviewers. We performed five TKAs using the Knee + system. Patients were 4 females, with mean age of 76.4 years old (range 73–79) and mean Body Max Index (BMI) of 31.9 kg/m2 (range 27–35). The axial alignment of the limb and the orientation of the components were evaluated on standardized pre and postoperative full leg length weight-bearing radiographs, anteroposterior radiographs, and lateral radiographs of the knee. The time of tourniquet was recorded. The perception of motion sickness was assessed by Virtual Reality Sickness Questionnaire (VRSQ) subjected to surgeon immediately after surgery.

Results

After duplicate removal, a total of 31 abstracts were found. However, only two studies concerned knee arthroplasty. Unfortunately, both were preclinical studies. Knee + system is able to perform a cutting error of less than 1° of difference about coronal alignment of femur and tibia and less than 2° about flexion/extension of femur and posterior tibial slope. The absolute differences between the values obtained during surgery and the measurement of varus femur, varus tibia, posterior slope, and femur flexion angle on post-operative radiographs were 0.6° ± 1.34°, 0.8° ± 0.84°, 0.8° ± 1.79°, and 0.4 mm ± 0.55 mm, respectively.

Conclusions

On light of our preliminary results, the Knee + system is accurate and effective to perform TKA. The translation from pilot study to high-level prospective studies is warranted to assess accuracy and cost-effective analysis compared to conventional techniques.

Level of evidence

IV
Chemotherapy resumption in breast cancer patient after COVID-19
Authors: Horiguchi Julian , Nakashoji Ayako , Kawahara Naoki , Matsui Akira , Kinoshita Takayuki
Published: July 2021

Background

While many studies have verified the effect of recent anti-cancer treatment in patients with COVID-19, there are no data on the optimal time for cancer treatment resumption, as well as the safety of chemotherapy in COVID-19 patients. As many cancer patients are recovering from COVID-19, there is an urgent need for reliable clinical information. Herein, we report a case of invasive ductal carcinoma in which we were able to successfully resume chemotherapy after infection with SAR-CoV-2.

Case presentation

The patient was a 38-year-old non-smoking Japanese woman with no significant medical history. She had fever on days 5 and 6 of her second course of adjuvant FEC therapy, and on day 7, she tested positive for SARS-CoV-2 by RT-PCR. She was hospitalized for 11 days. We resumed the therapy on day 25 after discharge, as she had no remaining clinical symptoms. The patient completed four courses of the initial chemotherapy without any major adverse events nor the recurrence of COVID-19, and subsequently completed four courses of docetaxel as her second regimen therapy.

Conclusions

Evaluating the risk for each patient is essential when resuming anti-cancer therapy in cancer patient’s post-COVID-19.
Toxicological evaluation of the dried hydroethanolic extract of Amaranthus spinosus L. roots in Artemia salina larvae and Sprague Dawley rats
Authors: Atchou Kokou , Lawson-Evi Povi , Diallo Aboudoulatif , Eklu-Gadegbeku Kwashie
Published: July 2021

Background

Amaranthus spinosusis a medicinal plant used in traditional medicine to treat several diseases including diabetes and its complications. The aim of this study was to prove the safety of the plant in animal health.

Methods

The dry extract was obtained following the hydroethanolic extraction ofA. spinosusroots. The cytotoxicity was evaluatedin vitroby incubatingArtemia salinalarvae with the extract for 24 h.In vivotoxicity was assessed in Sprague Dawley rats. A single dose of 5000 mg/kg bw of extract was administered orally to female rats in acute toxicity and observed for 14 days for mortality and signs of toxicity. In subchronic toxicity, extract doses of 500 and 1000 mg/kg bw were administered orally to male and female rats for 28 consecutive days and observed for previous signs. Body weight was recorded daily and blood glucose levels every week. On day 29, blood was collected for biochemical and hematological studies. Organs were then exised for gross autopsy and histopathological examination.

Results

Thein vitrostudy showed that the extract had a LC50 = 1.178 mg/mL in larvae and was considered to be non-cytotoxic. Oral administration of extract at a single dose of 5000 mg/kg bw did not cause any mortality or sign of toxicity in gross necropsy. In subchronic oral toxicity, repeated doses of 500 and 1000 mg/kg bw of extract, did not also cause any mortality or significant change in body weight, relative weight of vital organs. Furthermore, hematological and biochemical parameters and histopathological examination did not show any significant change. The observed decrease in blood glucose levels did not correlate with organ damage and supports the safety of the plant. However, the reduction of LDL-cholesterol has shown that the extract can prevent cardiovascular disease.

Conclusions

This finding demonstrated thatA. spinosusroot is non-toxic with a LD50 > 5000 mg/kg bw. Thus, the extract can be used for cutaneous and subchronic oral administration at doses ≤ 1000 mg/kg bw. However, further studies such as embryo/fetotoxicity, genotoxicity and neurotoxicity will be needed to prove the safety of chronic administration of the extract in patients and fetuses.
Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox
Authors: Nalimu Florence , Oloro Joseph , Kahwa Ivan , Ogwang Patrick Engeu
Published: July 2021

Background

Aloe vera and Aloe ferox have over the years been among the most sought-after Aloe species in the treatment of ailments worldwide. This review provides categorized literature on the phytochemical and scientifically proven toxicological profiles of A. vera and A. ferox to facilitate their exploitation in therapy.

Main body of the abstract

Original full-text research articles were searched in PubMed, ScienceDirect, Research gate, Google Scholar, and Wiley Online Library using specific phrases. Phenolic acids, flavonoids, tannins, and anthraquinones were the main phytochemical classes present in all the two Aloe species. Most of the phytochemical investigations and toxicity studies have been done on the leaves. Aloe vera and Aloe ferox contain unique phytoconstituents including anthraquinones, flavonoids, tannins, sterols, alkaloids, and volatile oils. Aloe vera hydroalcoholic leaf extract showed a toxic effect on Kabir chicks at the highest doses. The methanolic, aqueous, and supercritical carbon dioxide extracts of A. vera leaf gel were associated with no toxic effects. The aqueous leaf extract of A. ferox is well tolerated for short-term management of ailments but long-term administration may be associated with organ toxicity. Long-term administration of the preparations from A. vera leaves and roots was associated with toxic effects.

Short conclusion

This review provides beneficial information about the phytochemistry and toxicity of A. vera and A. ferox and their potential in the treatment of COVID-19 which up to date has no definite cure. Clinical trials need to be carried out to clearly understand the toxic effects of these species.