bluuebunny/crossref_metadata_2025 huggingface dataset:
‘It was kinda like D.I.Y closure’. Using Photovoice to capture the experiences of final year social work students graduating amidst the pandemic
Authors: McGookin Naomi Katie
Published: June 2022

This article examines a recent research project that explored the lived experiences of 5 final year social work students in Scotland who graduated during the coronavirus pandemic. The project used Photovoice as the primary data collection method, followed by a 3 hour long online focus group where the participants and the researcher worked collaboratively to identify themes for further analysis. The findings demonstrated that while the data collected by participants through the photographs and captions were highly personal to each participant, there were recurring themes that connected all of them which were identified broadly as; (dis)connection, closure and identity – all of which were discussed in great detail in a virtual focus group after the data was collected. This article focusses predominantly on the Photovoice method adopted for the study and how this was an effective method for participatory research. This article also focusses on how the pandemic affected the transitionary period between the participants’ identity shift from students to professionals. This study followed the principles of Participatory Action Research which meant that participants and the researcher worked together to cultivate and analyse the data collected and the findings that are discussed here reflect this collaborative process. As this report is being written, numerous new studies, reports and predictions as to the pandemics impact on our collective mental health emerge daily and so it is hoped that this project will serve as a small time stamp as to how the pandemic impacted this small group of students in Scotland and will honour their stories, creating a lasting space for them to be heard among the ever-increasing bombardment of news.
Mechanism Study on Radiosensitization Effect of Curcumin in Bladder Cancer Cells Regulated by Filamin A
Authors: Wang Zhenfan , He Shuqing , Jiang Minjun , Li Xue , Chen Na
Published: June 2022

Objective

To study the radiosensitization effect of curcumin, a natural product with anti-inflammatory and anti-cancer properties, in bladder cancer cells and identify the specific role of FLNA gene in that process.

Methods

CCK-8 method was initially adopted to identify the proper interventional concentration of curcumin. T24 bladder cancer cells were subjected to CCK-8, flow cytometry, and colony formation assay to study the cell biological behaviors under different interventions. γ-H2AX test was performed to test the level of damage in T24 cells. RT-qPCR and Western blot were conducted to measure FLNA mRNA and protein levels.

Results

Low-dose curcumin (10, 20 μM) following X-ray exposure resulted in increased DNA damage, augmented apoptosis, and reduced proliferation of T24 cells. Certain radiosensitization was demonstrated when curcumin was applied at 10 μM. Additionally, elevation of FLNA gene and protein levels was also indicated upon combination treatment.

Conclusion

Low-dose curcumin has certain radiosensitization effect in bladder cancer, where FLNA plays a certain regulatory role.
An Innovative Approach to Health Promotion and Wellness for University Students with Intellectual and Physical Disabilities: A Case Series
Authors: Tucker Jennifer , Korte Steve , Kilduff Brittany , Pabian Patrick
Published: June 2022

A university setting offers a unique opportunity to address physical activity for individuals with disabilities. The purpose of this case series was to highlight the development of a formal student-assisted exercise program and examine its impact on the perceived quality of life, exercise confidence, and functional mobility of college-aged individuals with intellectual and physical disabilities. Data from twelve participants was analyzed. Seven participants demonstrated an improvement in scores on the Self-Efficacy to Exercise scale and eight improved in functional measures associated with strength. Thus, a collaborative assisted exercise program in a university setting may positively impact health and physical activity, and exercise participation in young adults with physical and/or intellectual disabilities.
Transcarotid revascularization in obese patients
Authors: Dakour-Aridi Hanaa , Tanaka Akiko , Mirza Aleem K , Motaganahalli Raghu L , Leckie Katherin E , Keyhani Arash , Keyhani Kourosh , Wang S Keisin
Published: June 2022

Objective

Transcarotid revascularization (TCAR) is a minimally invasive hybrid surgical carotid stenting technique which utilizes cerebral flow reversal as embolic protection during carotid lesion manipulation. This investigation was performed to define the perioperative risks associated with this operation in the obese patient.

Methods

A retrospective review of tandem carotid revascularization databases maintained at two high-volume health systems was performed to capture all TCARs performed between 2015 and 2022. A threshold of body mass index of 35 kg/m2 defined the “obese” patient. Demographics, intraoperative, perioperative, and follow-up characteristics were compared using univariate analysis.

Results

We performed 793 TCAR procedures that qualified for study inclusion within the prespecified time. After applying our obesity definition, 129 patients qualified as obese and were compared to the remainder. There were no significant differences in baseline demographics as comparable Charlson Comorbidity Indices were noted between groups; however, obese patients had a significantly higher prevalence of hypertension, hyperlipidemia, and diabetes. Intraoperative, case complexity in the obese patients did not seem to be increased, as measured by operative time (68.4 ± 23.0 vs 64.2 ± 25.8 min, p = 0.09), fluoroscopic time (4.9 ± 3.2 vs 4.6 ± 3.6 min, p = 0.38), and estimated blood loss (40.6 ± 49.0 vs 46.6 ± 49.4 min, p = 0.22). Similarly, no disparities were observed with respect to ipsilateral stroke (3.1 vs. 1.7%, p = 0.29), contralateral stroke (0 vs. 0.2%, p > 0.99), death (0 vs. 1.1%, p = 0.61), and stroke/death (3.1 vs. 3.0%, p > 0.99) in the 30-day perioperative period. Both cohorts were followed for approximately 1 year (12.0 ± 13.4 vs 11.6 ± 13.4 months, p = 0.76). During this period, rates of ipsilateral stroke (3.1% vs. 2.7%, p > 0.99), contralateral stroke (1.1 vs. 0.8%, p > 0.99), and death (4.7 vs. 6.2%, p = 0.68) were similar.

Conclusions

TCAR performed in the obese population was not more challenging by intraoperative characteristics and did not result in a statistically higher incidence of adverse events in the perioperative phase.
Update of leadership-as-practice “practice theory”: Featuring Joe Raelin Interviewed by Jenny Robinson
Authors: Raelin Joseph A , Robinson Jennifer L
Published: June 2022

This article constitutes an interview between a new researcher of the field of Leadership-as-Practice (L-A-P), Jenny Robinson, with one of the co-creators of the field, Joe Raelin. It is dedicated to providing an update and refinement of leadership-as-practice “practice theory,” which has gone through a fair degree of transformation since this journal’s first article on the subject in 2008. The call for such an update is precipitated by the need for emerging L-A-P researchers to appreciate the subject’s conceptual boundaries for more consistent and integrated exploration. In particular, L-A-P claims to differentiate not only from other plural traditions in leadership but from other “as-practice” approaches in the wider management field. Some of the other distinctions covered in this article comprise the role of theory in L-A-P, its contribution to leadership research and leadership development, its connection to other related fields, and its phenomenological, ethical, democratic, and post-humanistic foundations.
Concealment, coexistence, and citizenship: (Post-)conflict strategies of survival and inclusion in Sacsamarca, Peru
Authors: Willems Eva
Published: June 2022

What happens when the memory duty—the idea that remembrance leads to prevention, redemption, and recognition—intersects with a contentious past of violence between “intimate enemies”? This article turns to the microhistory of a small highland town that became a scenery of both collaboration and resistance during the insurgency of the Maoist rebels of Shining Path in Peru (1980–2000) to answer this question. An analysis of the (post-)conflict strategies deployed by the villagers reveals processes of both appropriation and contestation of the memory duty. On the one hand, the heroic narrative of resistance against Shining Path that dominates public remembrance in Sacsamarca serves to demand recognition by the Peruvian state for the community’s role in opposing the Maoist revolutionaries. On the other, putting emphasis on resistance enables the villagers to downplay their initial support for Shining Path, a necessary precondition for claiming reparations and citizenship as well as for maintaining a tense coexistence between community members.
Caring as the Default of Empathic Direct Perception
Authors: Lampert Khen
Published: June 2022

The phenomenological understanding of empathy as the direct experiencing of the mental states (feelings, intentions, moods) of others eschews the identification of empathy with caring. At the same time, it leaves open the possibility of sadistic pleasure, indifference, or malice as consequences of empathic experience. In this paper, I intend to defend the place of caring as an inseparable part of the empathic experience, specifically when understood as direct perception. My defense relies on (a) conceiving of attentive concern as a perceptual predisposition, and (b) understanding the caring responsiveness of the empathizer as embedded in her direct perception of the empathee's mental states. My claim proceeds by three steps. Firstly, I will present the need to include caring within empathy through the problem that arises from excluding it. Secondly, I will argue for the presence of active responsiveness, inherent in the phenomenological concept of perception and expressed more explicitly in its Gibsonian understanding. Thirdly, I will propose my understanding of attentive concern as a predisposition, which together with the intentionality attributed to the other (itself also a disposition) forms the pre-perceptual basis for identifying empathy with caring.
Risk perception, anxiety, and depression among hospital pharmacists during the COVID-19 pandemic: The mediating effect of positive and negative affect
Authors: Zhang Ning , Hong Dongsheng , Yang Hongyu , Mengxi Guo , Huang Xin , Wang Anran , Wang Linrun
Published: June 2022

This study investigated the impacts of risk perception of COVID-19 on anxiety and depression symptoms among hospital pharmacists in China. We conducted a cross-sectional study with hospital pharmacists during the COVID-19 pandemic in China. Some 4,219 hospital pharmacists completed an online survey including demographic questions, risk perception of COVID-19, General Anxiety Disorder-7, Patient Health Questionnaire-9, and Positive and Negative Affect Schedule. Multivariate regression and mediation analyses were conducted. The results indicated that 41.9% and 29.4% of hospital pharmacists experienced mild to severe levels of anxiety and depression symptoms, respectively. In older age, a higher level of risk perception of COVID-19, and negative affect experience were risk factors, whereas positive affect experience was a protective factor for anxiety and depression symptoms among pharmacists. Experience of positive and negative affect mediated the relationship between risk perception of COVID-19 and anxiety and depression among hospital pharmacists in China. Timely mental health services need to be provided for hospital pharmacists during the COVID-19 pandemic.
Impacts of the psychological stress response on aggression in adolescents during the COVID-19 epidemic in China
Authors: Wei Zhen , Hu Yan , Xiao Jiayi , Wang Ruotong , Huang Qianchu , Peng Ziwen , Hou Gangqiang , Chen Qi
Published: June 2022

The sudden outbreak of COVID-19 has exerted a tremendous impact on the psyche of people around the world, especially adolescents. In order to provide a valuable theoretical basis for effective measures to prevent psychological problems in adolescents during public health emergencies in the future, this study examined the mediating effect of coping style (CS, including positive coping style (PCS) and negative coping style (NCS)) and the moderating effect of emotional management ability (EMA) on the relationship between the psychological stress response (PSR) and aggression (AGG) in adolescents during the COVID-19 epidemic in China. The Buss–Warren Aggression Questionnaire, Simplified Coping Style Questionnaire, and Emotion Management Questionnaire were employed to investigate the mental health of Chinese adolescents from April 10–20 (Time point 1, T1) and May 20–30 (Time point 2, T2), 2020. A total of 1,931 adolescents (aged 10–25 years, M = 19.18 years, 51.4% male) were examined at T1 and 334 adolescents (aged 11–25 years, M = 19.97 years, 48.7% male) were reinvestigated at T2. Overall, 17.6% of the participants at T1 and 16.8% at T2 reported obvious PSR activation. NCS partly mediated the relationship between the PSR and AGG, and the indirect effect was moderated by EMA reported at T2. There were regional differences in the moderated mediation model in low-risk areas at T1. The moderated effects of EMA at T1 and T2 were opposite. Specifically, high EMA resulted in a stronger relationship between NCS and AGG at T1, whereas high EMA resulted in a weaker relationship between NCS and AGG at T2. Psychological reactions resulting from sudden public health events may trigger AGG in younger individuals. However, EMA may have a buffering effect on the onset of AGG. This research expands our understanding of the development of AGG in adolescents during the pandemic.
Interventional therapies for management of hip fracture pain peri-operatively: A review article
Authors: Lim Zhen Wei , Liu Christopher W , Chan Diana XH
Published: June 2022

Background

Hip fracture is a common reason for elderly admission to hospital and majority of patients will require a hip fixation surgery. Pain originating from a hip fracture is usually severe and the need to improve comfort is paramount, especially before the hip fixation surgery because severe pain results in unnecessary stress response such as catecholamines release, tachycardia and hypertension. This worsens outcomes, increases risk of complications such as myocardial ischaemia, strokes, pulmonary embolus or deep vein thrombosis. Multimodal systemic analgesia has been shown to be effective in reducing pain in hip fractures but the associated side effects and contraindications have accelerated the adoption of nerve blocks in the peri-operative management of hip fracture patients. 1 As a result, this has been increasingly recognised as a important component of the hip fracture pathway (as part of a multimodal approach for analgesia) and many hospitals have protocols to perform various interventional therapies (various nerve blocks) for newly admitted patients with hip fracture to alleviate pain immediately and potentially provide intra and post-operative analgesia.

Objective

The aim of this review is to elucidate the various interventional therapies currently available (including pericapsular nerve group (PENG) block which was first described in 2018), their evidence and the pros and cons.

Methods

We reviewed the latest evidence for femoral nerve block (FNB), 3-in-1 block, lumbar plexus block (LPB), fascia iliaca block (FIB), erector spinae plane block (ESPB) and pericapsular nerve group (PENG) block.

Results and conclusion

Each block has its pros and cons, as discussed in this review article. The procedurist should deliberate these considerations before deciding which block is most appropriate.
Efficacy of COVID-19 treatments among geriatric patients: a systematic review
Authors: Senderovich Helen , Vinoraj Danusha , Stever Madeline , Waicus Sarah
Published: June 2022

Introduction:

A majority of the fatalities due to COVID-19 have been observed in those over the age of 60. There is no approved and universally accepted treatment for geriatric patients. The aim of this review is to assess the current literature on efficacy of COVID-19 treatments in geriatric populations.

Methods:

A systematic review search was conducted in PubMed, MedRxiv, and JAMA databases with the keywords COVID-19, geriatric, hydroxychloroquine, dexamethasone, budesonide, remdesivir, favipiravir, ritonavir, molnupiravir, tocilizumab, bamlanivimab, baricitinib, sotrovimab, fluvoxamine, convalescent plasma, prone position, or anticoagulation. Articles published from January 2019 to January 2022 with a population greater than or equal to 60 years of age were included. Interventions examined included hydroxychloroquine, remdesivir, favipiravir, dexamethasone, budesonide, tocilizumab, bamlanivimab, baricitinib, sotrovimab, convalescent plasma, prone position, and anticoagulation therapy. Outcome measures included viral load, viral markers, ventilator-free days, or clinical improvement.

Results:

The search revealed 302 articles, 52 met inclusion criteria. Hydroxychloroquine, dexamethasone, and remdesivir revealed greater side effects or inefficiency in geriatric patients with COVID-19. Favipiravir, bamlanivimab, baricitinib, and supportive therapy showed a decrease in viral load and improvement of clinical symptoms. There is conflicting evidence with tocilizumab, convalescent plasma, and anticoagulant therapy in reducing mortality, ventilator-free days, and clinical improvements. In addition, there was limited evidence and lack of data due to ongoing trials for treatments with sotrovimab and budesonide.

Conclusion:

No agent is known to be effective for preventing COVID-19 after exposure to the virus. Further research is needed to ensure safety and efficacy of each of the reviewed interventions for older adults.
Continuous monitoring with wearables in multiple sclerosis reveals an association of cardiac autonomic dysfunction with disease severity
Authors: Hilty Marc , Oldrati Pietro , Barrios Liliana , Müller Tamara , Blumer Claudia , Foege Magdalena , consortium PHRT , Holz Christian , Lutterotti Andreas
Published: June 2022

Background

Dysfunction of the autonomic nervous system is common in multiple sclerosis patients, and probably present years before diagnosis, but its role in the disease is poorly understood.

Objectives

To study the autonomic nervous system in patients with multiple sclerosis using cardiac autonomic regulation measured with a wearable.

Methods

In a two-week study, we present a method to standardize the measurement of heart rate variability using a wearable sensor that allows the investigation of circadian trends. Using this method, we investigate the relationship of cardiac autonomic dysfunction with clinical hallmarks and subjective burden of fatigue and autonomic symptoms.

Results

In 55 patients with multiple sclerosis and 24 healthy age- and gender-matched controls, we assessed the cumulative circadian heart-rate variability trend of two weeks. The trend analysis revealed an effect of inflammation ( P = 0.0490, SMD = -0.5466) and progressive neurodegeneration ( P = 0.0016, SMD = 1.1491) on cardiac autonomic function. No association with subjective symptoms could be found.

Conclusions

Trend-based heart rate variability measured with a wearable provides the opportunity for unobtrusive long-term assessment of autonomic functions in patients with multiple sclerosis. It revealed a general dysregulation in patients with multiple sclerosis.
The Christian education health check: A survey for understanding church school climate
Authors: McLure Felicity , Aldridge Jill
Published: June 2022

Understanding students’ perceptions of Christian education is essential for schools seeking to make changes that enhance opportunities for students to understand and engage with Christian faith. This study introduces and describes the validation of an accessible survey that probes students’ perceptions of the Christian culture of their school and the degree to which the school culture has influenced their willingness to engage with and adopt a faith stance. Schools can use the survey to identify areas for change related to the school climate, teaching and social-emotional learning, in conversation with teachers and students.
Representation and Legitimacy in the Supreme Court: Adjudicating Law and Religion in India
Authors: Vakil Raeesa
Published: June 2022

This article presents the argument that the Supreme Court of India’s jurisprudence on procedural bars to litigation is insufficient to address challenges that arise in cases involving religious rights. Examining the Court’s views on standing (the right to litigate) in three key public interest decisions (the Sabarimala Temple case, the Ram Janmabhoomi case, and the triple talaq case), I argue that the Court has privileged a discretionary, ends-based reasoning over an approach based on principle and law, resulting in erratic and inconsistent outcomes. The result is an uncertain level of protection to minority rights in judicial processes.
Effect of COVID-19 on Injury Rates and Timing in the National Football League
Authors: Omari Ali M. , Paul Ryan W. , Fliegel Brian , Osman Alim , Bishop Meghan E. , Erickson Brandon J. , Alberta Frank G.
Published: June 2022

Background:

The coronavirus 2019 (COVID-19) pandemic resulted in the cancellation of the 2020 National Football League (NFL) preseason and a decreased preseason roster size. The effect of this disruption on athlete injury rates is unknown.

Purpose/Hypothesis:

The purpose was to quantify the rates of anterior cruciate ligament (ACL), Achilles tendon, and hamstring tendon injuries in NFL players before and after the COVID-19 pandemic. We hypothesized that injury rates in the 2020 season would be higher than those seen prepandemic.

Study Design:

Descriptive epidemiology study. Level of evidence, 4.

Methods:

An online search using publicly available data was carried out to identify all NFL players who sustained an ACL, Achilles tendon, or hamstring tendon injury between April 1, 2017, and March 31, 2021. Data collected included player characteristics as well as career and season of injury workloads.

Results:

The number of Achilles tendon (27 vs 20; P = .024) and hamstring tendon (186 vs 149; P < .001) injuries, respectively, in the 2020 NFL season were significantly higher than the average of the 2017 to 2019 seasons. However, the number of ACL injuries sustained remained constant (43 vs 46; P = .175). More than half (52.9%) of ACL injuries in the 2017 to 2019 seasons occurred in the preseason, while most of the injuries (34.9%) in the 2020 season occurred in weeks 1 to 4. There was no player characteristic or career workload variable collected that was significantly different for players who sustained an ACL, Achilles tendon, or hamstring tendon injury in the 2020 NFL season compared with the 2017 to 2019 seasons.

Conclusion:

In the 2020 NFL season, the number of Achilles tendon and hamstring tendon injuries rose while the number of ACL injuries remained constant compared with the 2017 to 2019 seasons. Injuries that occurred during the first 4 games of the 2020 NFL season were consistent, with higher rates of injuries seen in the preseason in previous years.
“Acquiring the Skills Needed to Communicate What Is in Our Teams’ Heart: Love, Compassion and Partnership”: Qualitative Analysis of Intact Multidisciplinary Teams’ Experience of Relationship-Centered Communication Training
Authors: Middour-Oxler Brandi , Hirschmann Krista , Chace Carol , Collins Lauren , Gordon Chandra , Mann Michelle , Swope Chandler , George Cynthia
Published: June 2022

The Partnership Enhancement Program (PEP) is a 6-hour relationship-centered communication training for intact cystic fibrosis (CF) teams. The aim of this study was to analyze qualitative responses from survey participants regarding their takeaways from the training. A total of 210 professionals participated in 20 pilot workshops at 19 care centers in the United States from November 2018 to December 2019. After the workshop, qualitative feedback was captured by PEP facilitators during a feedback gathering session or submitted immediately in writing by participants. The manuscript team used grounded theory and qualitative methods of coding to identify recurring themes across participant responses. Thematic analysis revealed 5 primary themes and a web of interconnected subthemes. Primary themes include the acquisition of skills to improve communication, strengthened patient/provider connection, improved quality of communication, improved team building, and the ability to change and enhance practice. Participants who completed PEP training endorse acquiring communication skills that increase coproduction of care with patients and caregivers as well as improve relationships across the healthcare system.
Technology Leadership Practices of End Users and the Adoption of E-Learning in Midwifery Institutions in Uganda
Authors: Bigirwa June Patrick , Ndawula Stephen , Naluwemba Esther Frances
Published: June 2022

E-learning has gained popularity in Uganda. Midwifery institutions have invested in it to manage the increasing demand for education. However, its adoption is low, which is likely to hinder the enhancement of numbers, competencies, and skill mix of midwives. The study intended to ascertain if technology leadership practices were significant to e-learning adoption and sketch core practices. Ten midwifery institutions and 167 end users participated in the study. Two phases of data collection and analysis were executed. Technology leadership practices had substantial effect on adoption of e-learning (n = 167, r = 0.691, & p = 0.000), and was responsible for 47.5% of the change. Core technology leadership practices were; commitment to provide e-learning facilities; encouragement of learners to use e-learning facilities; appreciating those who excel at using e-learning facilities; grooming of e-learning champions; supportive environment for technological use; and institutionalising technological use in school activities. Midwifery institutions can focus on technology leadership core practices to improve e-learning adoption.
Comparing neural models for nested and overlapping biomedical event detection
Authors: Espinosa Kurt , Georgiadis Panagiotis , Christopoulou Fenia , Ju Meizhi , Miwa Makoto , Ananiadou Sophia
Published: June 2022

Background

Nested and overlapping events are particularly frequent and informative structures in biomedical event extraction. However, state-of-the-art neural models either neglect those structures during learning or use syntactic features and external tools to detect them. To overcome these limitations, this paper presents and compares two neural models: a novel EXhaustive Neural Network (EXNN) and a Search-Based Neural Network (SBNN) for detection of nested and overlapping events.

Results

We evaluate the proposed models as an event detection component in isolation and within a pipeline setting. Evaluation in several annotated biomedical event extraction datasets shows that both EXNN and SBNN achieve higher performance in detecting nested and overlapping events, compared to the state-of-the-art model Turku Event Extraction System (TEES).

Conclusions

The experimental results reveal that both EXNN and SBNN are effective for biomedical event extraction. Furthermore, results on a pipeline setting indicate that our models improve detection of events compared to models that use either gold or predicted named entities.
Education differences in cardiometabolic risk in England, Scotland and the United States between 1992 and 2019
Authors: Montano Diego
Published: June 2022

Background

Education differences in cardiometabolic risk and disease still play a major role in the magnitude of the socioeconomic health disparities in high-income societies. However, the knowledge on how education differences may have changed over time regarding the distribution of multiple risk factors is rather limited. This study aims to provide a comprehensive assessment of the magnitude of those differences in three high-income countries.

Methods

Data from repeated cross-sectional population health and examination surveys conducted between 1992 and 2019 in England, Scotland and the United States are analysed (pooled sample size $$n = 362{,}275$$

n
=
362
,
275

). Six cardiometabolic risk factors, namely, systolic and diastolic blood pressure, body-mass-index, glycated haemoglobin HbA1c, serum total cholesterol and the cardiovascular risk score are analysed with linear mixed models.

Results

Education differences in cardiometabolic risk were found to have either increased or remained stable for the past 3 decades in the countries included in the analyses. Among individuals with no qualification the cardiometabolic risk has been higher than among the higher educated (mean difference: 0.136, 99% CI [0.119; 0.152]). Education differences were observed also for systolic blood pressure (2.788 mmHg, 99% CI [2.529; 3.047]), glycated haemoglobin HbA1c (0.160 %, 99% CI [0.136; 0.185]), total cholesterol (0.268 mmol/L, 99% CI [0.247; 0.289]) and body-mass-index (0.591 kg/m2, 99% CI [0.504; 0.679]).

Conclusion

The results suggest a more complex pattern of associations between education and health which may be due to education-dependent processes related to behavioural, cognitive and attitudinal modification and adaptation to changing socio-cultural conditions.
Risk-prone territories for spreading tuberculosis, temporal trends and their determinants in a high burden city from São Paulo State, Brazil
Authors: Berra Thaís Zamboni , Ramos Antônio Carlos Vieira , Arroyo Luiz Henrique , Delpino Felipe Mendes , de Almeida Crispim Juliane , Alves Yan Mathias , dos Santos Felipe Lima , da Costa Fernanda Bruzadelli Paulino , dos Santos Márcio Souza , Alves Luana Seles , Fiorati Regina Célia , Monroe Aline Aparecida , Gomes Dulce , Arcêncio Ricardo Alexandre
Published: June 2022

Objectives

To identify risk-prone areas for the spread of tuberculosis, analyze spatial variation and temporal trends of the disease in these areas and identify their determinants in a high burden city.

Methods

An ecological study was carried out in Ribeirão Preto, São Paulo, Brazil. The population was composed of pulmonary tuberculosis cases reported in the Tuberculosis Patient Control System between 2006 and 2017. Seasonal Trend Decomposition using the Loess decomposition method was used. Spatial and spatiotemporal scanning statistics were applied to identify risk areas. Spatial Variation in Temporal Trends (SVTT) was used to detect risk-prone territories with changes in the temporal trend. Finally, Pearson's Chi-square test was performed to identify factors associated with the epidemiological situation in the municipality.

Results

Between 2006 and 2017, 1760 cases of pulmonary tuberculosis were reported in the municipality. With spatial scanning, four groups of clusters were identified with relative risks (RR) from 0.19 to 0.52, 1.73, 2.07, and 2.68 to 2.72. With the space–time scan, four clusters were also identified with RR of 0.13 (2008–2013), 1.94 (2010–2015), 2.34 (2006 to 2011), and 2.84 (2014–2017). With the SVTT, a cluster was identified with RR 0.11, an internal time trend of growth (+ 0.09%/year), and an external time trend of decrease (− 0.06%/year). Finally, three risk factors and three protective factors that are associated with the epidemiological situation in the municipality were identified, being: race/brown color (OR: 1.26), without education (OR: 1.71), retired (OR: 1.35), 15 years or more of study (OR: 0.73), not having HIV (OR: 0.55) and not having diabetes (OR: 0.35).

Conclusion

The importance of using spatial analysis tools in identifying areas that should be prioritized for TB control is highlighted, and greater attention is necessary for individuals who fit the profile indicated as “at risk” for the disease.
Antiemetic treatment of hyperemesis gravidarum in 1,064 Norwegian women and the impact of European warning on metoclopramide: a retrospective cohort study 2002–2019
Authors: Erdal Hilde , Holst Lone , Heitmann Kristine , Trovik Jone
Published: June 2022

Background

Women suffering from severe nausea and vomiting during pregnancy, hyperemesis gravidarum, have poor quality of life and increased risk of potentially fatal maternal and fetal complications. There is increasing and reassuring knowledge about safety of antiemetics in pregnancy. In 2013, the European Medical Agency (EMA) issued a warning on metoclopramide limiting treatment to maximum five days. Metoclopramide was the most used antiemetic in pregnancy at the time the warning was implemented in the Norwegian hyperemesis guidelines (2014). We aimed at describing changes in the treatment of hyperemesis over time, including changes associated with the EMA warning.

Methods

Retrospective chart review of all women hospitalized for hyperemesis gravidarum with metabolic disturbances between 01/Jan/2002 and 31/Dec/2019 at a university hospital serving nearly 10% of the pregnant population in Norway. Time-series analysis described changes over time and interrupted time series analysis quantified changes in treatment and clinical outcomes related to the EMA warning.

Results

In total, 1,064 women (1.2% of the birthing population) were included. The use of meclizine, prochlorperazine, and ondansetron increased during 2002–2019. This led to a yearly increase in the percentage of women using any antiemetic of 1.5% (95%CI 0.6; 2.4) pre-hospital, 0.6% (95%CI 0.2; 1.1) during hospitalization, and 2.6% (95%CI 1.3; 3.8) at discharge. Overall, only 50% of the women received antiemetics pre-hospital. Following the EMA warning, prehospital use of metoclopramide dropped by 30% (95%CI 25; 36), while use of any antiemetic pre-hospital dropped by 20% (95%CI 5.7; 34). In timely association, we observed a decrease in gestational age (-3.8 days, 98.75%CI 0.6; 7.1) at first admission, as well as indication of increased rate of termination of pregnancy with an absolute increase of 4.8% (98.75%CI 0.9; 8.7) in 2014.

Conclusion

During 2002–2019, the overall use of antiemetics in treatment of hyperemesis increased. The EMA-warning on metoclopramide in 2013 temporarily limited pre-hospital antiemetic provision associated with hospitalization at lower gestational length and indication of an increase in termination of pregnancy.
Gastrointestinal/genitourinary perforation and fistula formation with or without bevacizumab in patients with previously irradiated recurrent cervical cancer: a Korean multicenter retrospective study of the Gynecologic Oncology Research Investigators Collaboration (GORILLA) group (GORILLA-1001)
Authors: Hwang Woo Yeon , Chang Suk-Joon , Kim Hee Seung , Kim Nam Kyeong , Kim Tae Hun , Kim Yeorae , Kong Tae Wook , Lee Eun Ji , Park Soo Jin , Shim Seung Hyuk , Son Joo-Hyuk , Suh Dong Hoon , Yang Eun Jung
Published: June 2022

Background

This study aims to evaluate the incidence of and identify risk factors for gastrointestinal (GI) and genitourinary (GU) fistula or perforation formation with or without bevacizumab in patients with recurrent cervical cancer who underwent pelvic radiation therapy (RT).

Methods

Medical records of patients with recurrent cervical cancer who previously underwent pelvic RT between 2007 and 2020 were retrospectively reviewed. Clinicopathological factors were compared between groups that are stratified according to: 1) fistula/perforation (+) versus (-); and 2) bevacizumab plus conventional chemotherapy (BC) versus chemotherapy alone (C). Univariate and multivariate regression analyses were performed to identify risk factors for fistula/perforation. Overall survival (OS) was compared between the different groups.

Results

Of 219 participants, fistula/perforation of any grade occurred in 36 patients (16.4%); 27 fistulas and 9 perforations. Bevacizumab was more frequently used in Bevacizumab was more frequently used ( +) group than fistula/perforation (-) group (p = 0.015). Multivariate analysis showed that bevacizumab administration was the only independent risk factor for fistula or perforation (HR, 3.27; 95% CI, 1.18–9.10; P = 0.023). F/P was observed more frequently in women receiving BC (n = 144) than those receiving C (n = 75) (20.8% vs. 8.0%; P = 0.019). During median follow-up of 33.7 months (1.2–185.6 months), no significant OS difference was observed between fistula/perforation ( +) vs. (-) (hazards ratio [HR], 1.78; median 84.2 months [95% CI, 59.3–109.0] vs. 129.5 months [95% CI, 114.1–144.9]; P = 0.065) or BC vs. C (HR, 1.03; median 119.8 months [95% CI, 97.3–142.3] vs. 115.7 months [95% CI, 96.0–135.4]; P = 0.928).

Conclusions

This study suggests that incorporation of bevacizumab in chemotherapy regimens for treating recurrent cervical cancer in patients who underwent pelvic RT incurs considerable risk for GI/GU fistula or perforation. There were no other independent risk factors for developing GI/GU fistula or perforation in this study population.
Associations of different immune checkpoints-expressing CD4+ Treg/ T cell subsets with disease-free survival in colorectal cancer patients
Authors: Al-Mterin Mohammad A. , Murshed Khaled , Alsalman Alhasan , Abu-Dayeh Ala , Elkord Eyad
Published: June 2022

There are different subsets of T regulatory cells (Tregs), orchestrating critical roles in the regulation of anti-tumor immunity in colorectal cancer (CRC). In this study, we report that a high frequency of circulating CD4+FoxP3+Tregs was associated with poorer disease-free survival (DFS), while their higher frequencies in tumor-infiltrating CD4+Tregs was associated with better DFS. We further investigated such associations with four Tregs/T cells expressing or lacking FoxP3 and Helios(FoxP3±Helios±). For the first time, we report that a high frequency of circulating CD4+FoxP3+Helios+Tregs was associated with poorer DFS, while a high frequency of tumor-infiltrating CD4+FoxP3−Helios−T cells was associated with poorer DFS. In the four FoxP3±Helios±T cell subsets expressing any of the immune checkpoints (ICs) investigated, we found that a high frequency of CD4+FoxP3+Helios−PD-1+Tregs in circulation was associated with worse DFS. We also found that high frequencies of FoxP3+Helios+CTLA-4+Tregs, FoxP3+Helios−CTLA-4+Tregs, and FoxP3−Helios+CTLA-4+CD4+T cells in circulation were associated with worse DFS. In contrast, high frequencies of CD4+TIM-3+T cells, FoxP3+Helios+TIM-3+Tregs, and FoxP3−Helios+TIM-3+CD4+T cells in circulation were associated with longer DFS. Our data show that certain CD4+Treg/T cell subsets could serve as independent predictive biomarkers in CRC patients. Identification of the exact subpopulations contributing to clinical outcomes is critical for prognoses and therapeutic targeting.
Refractive changes and visual quality in patients with corneal edema after cataract surgery
Authors: Díez-Ajenjo Mª Amparo , Luque-Cobija Mª José , Peris-Martínez Cristina , Ortí-Navarro Susana , García-Domene Mª Carmen
Published: June 2022

Background

To assess visual quality and stabilization of refractive changes in corneal edema patients after cataract surgery, using visual acuity (VA) and contrast sensitivity measurements.

Methods

Sixty-one eyes were analysed, twenty-three with and thirty-eight without corneal edema. Uncorrected and corrected distance VA (UDVA and CDVA) were determined with an EDTRS chart, the contrast sensitivity function (CSF) under photopic and mesopic illumination conditions with a CVS-1000e chart, clinical refraction, and corneal topography. Measurements were taken preoperatively, 1–2 days, 1 and 3-months after surgery. Clinical refraction was converted to vector notation (M, J0, J45) and SPSS v26.0 was used for data analysis.

Results

An improvement of VA was observed through the postoperative period; changes between visits were significant for CDVA in both groups and for UDVA in the edema sample. Significant astigmatic changes (J0,J45) between visits were not observed, but M values showed a hyperopic tendency in the edema group and a myopic shift in the control group that did not change between visits, with statistically significant differences between groups. Controls had significantly better contrast sensitivity at high spatial frequencies. Under mesopic conditions, global contrast sensitivity losses were observed in the edema group, which improved between visits in the middle frequency range.

Conclusion

Corneal edema patients had a significant reduction of CDVA, and frequency-selective sensitivity losses that evidence a visual quality loss. Clinical refraction may improve visual quality, but in edema patients these losses are related to corneal changes, which did not change at three months after surgery.
Factors associated with COVID-19 Infection among a national population of individuals with schizophrenia or schizoaffective disorder in the United States
Authors: Liberman Joshua N. , Pesa Jacqueline , Petrillo Mary Pat , Ruetsch Charles
Published: June 2022

Background

Individuals with schizophrenia are a vulnerable and under-served population who are also at risk for severe morbidity and mortality following COVID-19 infection. Our research was designed to identify factors that put individuals with schizophrenia at increased risk of COVID-19 infection.

Methods

This study was a retrospective cohort analysis of medical and pharmacy claims among 493,796 individuals residing in the United States with schizophrenia or schizoaffective disorder, between January 1, 2019 and June 30, 2020. A confirmed diagnosis of COVID-19 infection by September 30, 2020 was regressed on demographics, social determinants, comorbidity, and pre-pandemic (December 2019 – February 2020) healthcare utilization characteristics.

Results

A total of 35,249 (7.1%) individuals were diagnosed with COVID-19. Elevated odds of COVID-19 infection were associated with age, increasing consistently from 40-49 years (OR: 1.16) to 80+ years (OR:5.92), male sex (OR: 1.08), Medicaid (OR: 2.17) or Medicare (OR: 1.23) insurance, African American race (OR: 1.42), Hispanic ethnicity (OR: 1.23), and higher Charlson Comorbidity Index. Select psychiatric comorbidities (depressive disorder, adjustment disorder, bipolar disorder, anxiety, and sleep-wake disorder) were associated with elevated odds of infection, while alcohol use disorder and PTSD were associated with lower odds. A pre-pandemic psychiatry (OR:0.56) or community mental health center (OR:0.55) visit were associated with lower odds as was antipsychotic treatment with long-acting injectable antipsychotic (OR: 0.72) and oral antipsychotic (OR: 0.62).

Conclusions

Among individuals with schizophrenia, risk of COVID-19 infection was substantially higher among those with fewer economic resources, with greater medical and psychiatric comorbidity burden, and those who resided in African American or Hispanic communities. In contrast, individuals actively engaged in psychiatric treatment had substantially lower likelihood of infection. These results provide insights for healthcare providers that can translate into improved identification of at-risk individuals and interventions to reduce the risk and consequences of COVID-19 infection.
Usefulness of the Rapid Office Strain Assessment (ROSA) tool in detecting differences before and after an ergonomics intervention
Authors: de Barros Fernanda Cabegi , Moriguchi Cristiane Shinohara , Chaves Thaís Cristina , Andrews David M. , Sonne Michael , de Oliveira Sato Tatiana
Published: June 2022

Background

Most ergonomics studies on office workstations evaluate the effects of an intervention only by subjective measures such as musculoskeletal pain and discomfort. Limited evidence has been provided regarding risk factor reduction in office environments through standardized methods assessments. The Rapid Office Strain Assessment (ROSA) tool can provide an estimation of risk factor exposure for office workers as a means by which the outcome of interventions can be quantified.

Purpose

The aim of the study was to evaluate if ROSA scores reflect changes in risk factors after an ergonomics intervention among office workers.

Methods

Office workers (n = 60) were divided into two groups. The experimental group received a workstation intervention and the control group received no intervention. Changes in ROSA scores were compared before and after the intervention in both groups.

Results

Statistically significant reductions in the ROSA final and section scores occurred after the intervention in the experimental group with (mean reduction of 2.9, 0.8 and 1.6 points for sections A, B and C, respectively). In contrast, no differences were detected in the control group (mean increase of 0.1 point for sections A and C and mean reduction of 0.1 point for Section B).

Conclusions

These findings show that ROSA scores reflect changes in risk factors after an ergonomics intervention in an office environment. Consequently, this tool can be used for identifying and controlling risk factors among computer workers, before and after interventions.
Using allogenous structural bone graft for uncontained tibial bone defects ≥ 10 mm in depth in primary total knee arthroplasty
Authors: Iwase Dai , Metoki Yukie , Kusumoto Yasuaki , Aikawa Jun , Fukushima Kensuke , Takano Shotaro , Mukai Manabu , Uchida Kentaro , Inoue Gen , Takaso Masashi
Published: June 2022

Background

In primary total knee arthroplasty (TKA), tibial bone defects ≥ 10 mm in depth often become uncontained defects, a condition most surgeons find challenging to treat. Although the allogenous bone graft is a useful method, complications such as infection and nonunion are likely to occur. There are several reports on the use of allogenous bone graft in revision TKA; however, few studies have investigated its use in primary TKA. We performed primary TKA using the allogenous bone graft as a structural bone graft to treat uncontained defects ≥ 10 mm in depth. This study aimed to assess the clinical and radiographical results after primary TKA with allogenous structural bone graft (ASBG).

Methods

Seventeen patients (mean age, 69.2 years) with a follow-up period of at least 7 years, were retrospectively reviewed. All cases had been treated for medial bone defects using the ipsilateral medial tibial allogenous bone. Clinical evaluation included the assessment of the knee and function scores and knee angle, and the hip-knee-ankle (HKA) angle, bone union, and radiolucent line (RL) were assessed radiologically.

Results

The mean depth of the medial tibial defects after tibia cutting was 16.8 mm. Nonunion occurred in one case, and RL occurred in another. We observed a significant difference when the preoperative knee score and HKA angle of patients was compared with that at 1 year postoperatively and the final evaluation. No major complications were observed.

Conclusion

The ASBG technique produced favorable surgical outcomes and may be an acceptable procedure for managing uncontained tibial bone defects ≥ 10 mm in depth in primary TKA.