bluuebunny/crossref_metadata_2025 huggingface dataset:
The impacts of colonialism on residents’ perceptions of tourism in Southeastern Nigeria
Authors: Eyisi Afamefuna P , Ololo Nneoma G , Aruomah Maureen O
Published: September 2022

Whilst colonialism remains under-researched as a variable that influences residents’ perceptions of tourism, few researchers have commented on its impacts. This observation explains the need to explore how and why colonialism influences residents’ perceptions of tourism in Nigeria. The paper adopts an ethnographic approach to interact with stakeholders who witnessed colonialism in the country. The analysis shows dissimilarities among participants’ perceptions of colonialism and tourism. The results suggest that for tourism to be sustained and gain residents’ support, the developers and planners need to make residents part of the planning process as this could help change their orientation.
Incidence, prevalence and regional distribution of systemic sclerosis and related interstitial lung Disease: A nationwide retrospective cohort study
Authors: Knarborg Malene , Hyldgaard Charlotte , Bendstrup Elisabeth , Davidsen Jesper R , Løkke Anders , Shaker Saher B , Hilberg Ole
Published: September 2022

Objective

To investigate incidence and prevalence of Systemic Sclerosis (SSc) and association with interstitial lung disease (SSc-ILD) in a nationwide population-based study.

Methods

Patients with an incident diagnosis of SSc in 2000–2016 were identified in the Danish National Patient Registry and categorised based on diagnosis of ILD. Incidence- and prevalence proportions were calculated based on the annual population estimates. A cox proportional hazards model was used to evaluate the association between age, sex, region and marital status and presence of ILD.

Results

In total, 1869 patients with SSc were identified; 275 patients (14.7%) had SSc-ILD. The majority of patients were females (75.5%). The percentage of males was higher in SSc-ILD than in SSc alone (30.9% and 23.4%, p = 0.008). Median time from SSc to ILD diagnosis was 1.4 years (range 0–14.2). ILD was diagnosed from ≤4 years before to ≥7 years after SSc. Development of ILD was associated with male gender (HR 1.75, 95% CI 1.15–2.66), age 41–50 (HR 1.81, 95% CI 1.07–3.05) and residency in the North Denmark Region (HR 1.95, 9 5% CI 1.12–3.40). Mean annual incidence proportion of SSc was 2.9/100,000 and mean annual prevalence proportion was 16.8/100,000. The incidence remained stable, but prevalence proportion increased from 14.1 – 16.5/100,000 in 2000–2008 to 17.9–19.2/100,000 in 2009–2016.

Conclusion

The prevalence of SSc increased during the study period, while the incidence remained stable. The prevalence of SSc-ILD was 14.7% and thus less frequent than expected. Male sex and age between 41 and 50 years were associated with ILD.
Transcranial-Direct-Current-Stimulation Accelerates Motor Recovery After Cortical Infarction in Mice: The Interplay of Structural Cellular Responses and Functional Recovery
Authors: Walter Helene Luise , Pikhovych Anton , Endepols Heike , Rotthues Steffen , Bärmann Johannes , Backes Heiko , Hoehn Mathias , Wiedermann Dirk , Neumaier Bernd , Fink Gereon Rudolf , Rueger Maria Adele , Schroeter Michael
Published: September 2022

Background

Transcranial direct current stimulation (tDCS) promotes recovery after stroke in humans. The underlying mechanisms, however, remain to be elucidated. Animal models suggest tDCS effects on neuroinflammation, stem cell proliferation, neurogenesis, and neural plasticity.

Objective

In a longitudinal study, we employed tDCS in the subacute and chronic phase after experimental focal cerebral ischemia in mice to explore the relationship between functional recovery and cellular processes.

Methods

Mice received photothrombosis in the right motor cortex, verified by Magnetic Resonance Imaging. A composite neuroscore quantified subsequent functional deficits. Mice received tDCS daily: either 5 sessions from day 5 to 9, or 10 sessions with days 12 to 16 in addition. TDCS with anodal or cathodal polarity was compared to sham stimulation. Further imaging to assess proliferation and neuroinflammation was performed by immunohistochemistry at different time points and Positron Emission Tomography at the end of the observation time of 3 weeks.

Results

Cathodal tDCS at 198 kC/m2 (220 A/m2) between days 5 and 9 accelerated functional recovery, increased neurogenesis, decreased microglial activation, and mitigated CD16/32-expression associated with M1-phenotype. Anodal tDCS exerted similar effects on neurogenesis and microglial polarization but not on recovery of function or microglial activation. TDCS on days 12 to 16 after stroke did not induce any further effects, suggesting that the therapeutic time window was closed by then.

Conclusion

Overall, data suggest that non-invasive neuromodulation by tDCS impacts neurogenesis and microglial activation as critical cellular processes influencing functional recovery during the early phase of regeneration from focal cerebral ischemia.
Optimization analysis of combing box for air yarn based on computational fluid dynamics
Authors: Fang HaiFeng , Sun HanLin , Liu Qun , Liu Rui , Wang MingQiang
Published: September 2022

Conventional single card air yarn units create flow vortices in the carding box that affect the fiber structure and thus the yarn performance. Key parameters for airflow characteristics include geometry and spinning parameters (Such as the length of the nozzle, the width of the inlet and outlet, the speed and diameter of the felting roller). This paper proposes to improve the transport channel to reduce eddy currents in the upflow region and to analyze airflow fields using fluid knowledge. This paper examines three designs: a bypass circular channel entrance for air supply, rounded corners at the bottom right in the conveyor channel and combining both modifications. According to the analysis, a nozzle inlet/outlet ratio between 0.5 and 1 gives the lowest swirl and the highest mass flow. Considering the yarn characteristics and the system production efficiency, it is ideal when the barbed roll speed is 8000 rpm and the diameter is about 30 mm. It is possible to dissipate the vortices for three methods.
Breast self-examination and its associated factors among women who attended anti-retroviral therapy clinic in Bahir Dar city administration, North West Ethiopia
Authors: Wondie Betelhem , Aragaw Amanu , Worku Gizachew , Kassie Nigus
Published: September 2022

Objective:

Although breast self-examination has been shown to be the least-expensive, less time-consuming, and non-invasive screening method, still there is a gap in practice. Furthermore, the information among more risky population which attends anti-retroviral therapy is too limited. Therefore, the aim of this study is to assess breast self-examination practices and its associated factors among women who attended the anti-retroviral therapy clinic in Bahir Dar city administration, Northwest Ethiopia.

Methods:

An institution-based cross-sectional study was conducted among 660 women who attended anti-retroviral therapy clinics from March 1 to March 30, 2020. A systematic random sampling technique was used to select study participants. Pre-tested interviewer-administered questionnaires were used to collect data. Data were entered in to EPI data 3.1 and exported to Statistical Package for the Social Sciences version 23.00 software for analysis. A binary logistic regression model was fitted to identify factors associated with self-breast examination. Variables with a p value less than 0.2 in bivariable regression were candidates for multivariable regression. Adjusted odds ratios with a 95% confidence intervals and p values less than 0.05 were used to determine the association between independent and dependent variables. Hosmer–Lemeshow Test was used to determine model fitness.

Result:

Among 641 study participants, 224 (34.9%) have ever practiced breast self-examination. Women who attended college or above (adjusted odds ratio = 4.04, 95% confidence interval (1.65,9.90)), rich (adjusted odds ratio = 6.64, 95% confidence interval (2.72,16.20)), knowledgeable about signs and symptoms of breast cancer (adjusted odds ratio = 5.13, 95% confidence interval ( 2.55,10.31)), risk factors for breast cancer (adjusted odds ratio = 3.62, 95% confidence interval (1.85,7.07)), positive attitude toward breast self-examination (adjusted odds ratio = 2.76,95% confidence interval (1.41,11.84)), family history of breast cancer (adjusted odds ratio = 3.68,95% confidence interval (1.14,11.84)), and knowledge about breast self-examination technique (adjusted odds ratio = 2.64, 95% confidence interval (1.23,5.66)) had higher odds of breast self-examination practice.

Conclusion:

The practice of breast self-examination was low. During their regular visits for other issues, education and information dissemination about the benefits and techniques of self-breast examination is recommended.
Global Pandemic and Entrepreneurial Intention: How Adversity Leads To Entrepreneurship
Authors: Usman Magaji Abdullahi , Sun Xinbo
Published: September 2022

The COVID-19 global pandemic eruption has thrown schedules, preferences, and current networks into disarray, creating inherent uncertainty about what lies ahead. This adversity brought on by covid 19 global pandemic created a displacement event in an individual life that can trigger sudden behavioral changes in an individual that would necessitate the search for several opportunities for making ends meet. However, individuals’ responses to the occurrence of any particular event are influenced by their judgments of whether the event is negative or positive, as well as whether the occurrence of that event can be used to generate income. Thus this study is intended to explore how adversity leads to entrepreneurship during covid 19 global pandemic. Specifically, what can inspire individuals to start a new venture in today’s world that has been severely impacted by the covid 19 global pandemic? This study collects survey data from popular cities in China and analyzed the data using a structural equation model to empirically explore what determines entrepreneurial intention to start a new venture during a global pandemic. The findings show that possible feasibility and necessity have a strong influence on entrepreneurial intention in starting a new venture.
Factors Influencing Ghanaian Public Junior High School Students’ Performance in English Language, Mathematics and Science and its Implications on the National Policy on Progression
Authors: Davis Ernest Kofi , Ntow Forster D. , Beccles Christopher
Published: September 2022

The study examined the factors that influence the performance of students in selected public junior high schools in Ghana using English Language, Mathematics and Science as cases and also to determine whether these observed performances support the continued implementation of the national policy on progression. In all, 98 teachers and 982 Junior High School (JHS) 2 students were randomly selected from three districts in the Central Region of Ghana. Data were analyzed using descriptive statistics (percentages and means) and standard deviation. It was found that the majority of the research participants’ levels of attainment in English Language, Mathematics and Science did not permit automatic progression. Also, it was found that several teacher factors such as the inability to complete the planned curriculum due to numerous co-curricular activities and their challenges in teaching some of the topics may have contributed to the low performance of the students. Recommendations for the need to collect data on students’ performance regularly at the various grade levels through assessment/tests to identify students’ learning difficulties early and offer appropriate interventions to support such learners have been made to further strengthen the progression policy.
Religious Minorities in Secular Autocratic Arab Regimes: The Political Discrimination of Christians in Syria
Authors: Anouti Hani
Published: September 2022

The main focus of this article is the political discrimination and/or exclusion of Christian minorities in Syria, with a particular focus on the era of Hafez al-Assad. It begins by analyzing the characteristics of the political regime in the pre- and during Hafez al-Assad era and then tackles and measures the level of state secularization from 1950 until the al-Assad period. Political discrimination against the Christians of Syria will then be measured and identified to understand better how and why secular regimes in the Arab region discriminate against religious minorities at a political level, in this case, the Christians of Syria.
A MIR17HG-derived long noncoding RNA provides an essential chromatin scaffold for protein interaction and myeloma growth
Authors: Morelli Eugenio , Fulciniti Mariateresa , Samur Mehmet K. , Ribeiro Caroline F. , Wert-Lamas Leon , Henninger Jon E. , Gullà Annamaria , Aktas-Samur Anil , Todoerti Katia , Talluri Srikanth , Park Woojun D. , Federico Cinzia , Scionti Francesca , Amodio Nicola , Bianchi Giada , Johnstone Megan , Liu Na , Gramegna Doriana , Maisano Domenico , Russo Nicola A. , Lin Charles , Tai Yu-Tzu , Neri Antonino , Chauhan Dharminder , Hideshima Teru , Shammas Masood A. , Tassone Pierfrancesco , Gryaznov Sergei , Young Richard A. , Anderson Kenneth C. , Novina Carl D. , Loda Massimo , Munshi Nikhil C.
Published: September 2022

Long noncoding RNAs (lncRNAs) can drive tumorigenesis and are susceptible to therapeutic intervention. Here, we used a large-scale CRISPR interference viability screen to interrogate cell-growth dependency to lncRNA genes in multiple myeloma (MM) and identified a prominent role for the miR-17-92 cluster host gene (MIR17HG). We show that an MIR17HG-derived lncRNA, named lnc-17-92, is the main mediator of cell-growth dependency acting in a microRNA- and DROSHA-independent manner. Lnc-17-92 provides a chromatin scaffold for the functional interaction between c-MYC and WDR82, thus promoting the expression of ACACA, which encodes the rate-limiting enzyme of de novo lipogenesis acetyl-coA carboxylase 1. Targeting MIR17HG pre-RNA with clinically applicable antisense molecules disrupts the transcriptional and functional activities of lnc-17-92, causing potent antitumor effects both in vitro and in vivo in 3 preclinical animal models, including a clinically relevant patient-derived xenograft NSG mouse model. This study establishes a novel oncogenic function of MIR17HG and provides potent inhibitors for translation to clinical trials.
Risk factors for aneurysm rupture among Kazakhs: findings from a national tertiary hospital
Authors: Medetov Yerkin , Babi Aisha , Makhambetov Yerbol , Menlibayeva Karashash , Bex Torekhan , Kaliyev Assylbek , Akshulakov Serik
Published: September 2022

Background

Rupture of intracranial aneurysms (RIA) leads to subarachnoid hemorrhage (SAH) with severe consequences. Although risks for RIA are established, the results vary between ethnic groups and were never studied in Kazakhstan. This study aimed to establish the risk factors of RIA in the Kazakh population. 

Methods

Retrospective analysis of 762 patients with single IAs, who attended the neurosurgical center from 2008 until 2018, was conducted. Demographic characteristics, such as age, sex, smoking status, and hypertension were considered. Descriptive and bivariate analyses were performed. A multivariable logistic regression model was built to identify factors correlated with RIA.

Results

The mean age of participants was 48.49 ± 0.44 years old. The majority (68.37%) of IAs have ruptured. Of the ruptured aneurysms, 43.76% were < 6 mm, and 38.39% were located on the anterior cerebral and anterior communicating arteries (ACA). Logistic regression model indicates younger age group (16–40 years), smoking, having stage 3 hypertension, smaller IA size and its location on ACA increase the odds of rupture.

Conclusions

This study has revealed that younger, smoking patients with stage 3 arterial hypertension are at higher risk for RIA. Small aneurysms (< 6 mm) and location on ACA had increased odds of rupture, while larger aneurysms on internal carotid arteries had lower odds.
The experience of chronic pain among adolescents: suffering and attempt to overcome pain?
Authors: Shaygan Maryam , Jaberi Azita
Published: September 2022

Background

Chronic pain (CP) among adolescents has received less attention than adultsandthere is limited qualitative studies about it in Iran. This study explored the experience of CP among adolescents.

Methods

This exploratory qualitative study was conducted in April–October 2019. Participants were 14 adolescent students purposively recruited from schools in Shiraz, Iran. Semi-structured interviews were conducted for data collection and data analysis was done through conventional content analysis.

Findings

Adolescents’ experiences of CP came into nine subcategories and three main categories, namely perceived suffering, attempt to overcome pain, and attempt to find sources of support.

Conclusion

Adolescents with CP experience physical and mental suffering and attempt to manage their pain and its associated suffering through different physical and psychological strategies and using different sources of support such as family, peers, healthcare providers, and school staff.
Falls in community-dwelling women with bipolar disorder: a case–control study
Authors: Stuart Amanda L. , Pasco Julie A. , Berk Michael , Quirk Shae E. , Koivumaa-Honkanen Heli , Honkanen Risto , Mohebbi Mohammadreza , Williams Lana J.
Published: September 2022

Background

Falls are a common occurrence in psychiatric hospital settings, however population-based research among individuals with psychiatric disorders, in particular bipolar disorder (BD) is scant. Thus, we aimed to investigate falls risk in community-dwelling women diagnosed with BD.

Methods

Women with BD (cases, n = 119) were recruited from health care settings located in southeast Victoria, Australia. Age-matched controls (n = 357, ratio 3:1) without BD were participants in the Geelong Osteoporosis Study drawn from the same geographical region. Lifetime history of BD was identified by semi-structured clinical interview (SCID-IV/NP). Previous 12-month falls data were obtained via questionnaire. Information on mobility, alcohol use, general health, medication use, blood pressure, body mass index, socioeconomic status and use of a walking aid was collected. Generalised Estimating Equations, binary and ordinal logistic regression were used to determine the odds ratio (OR) and 95% confidence interval (CI) for falls following adjustment for confounders.

Results

During the 12-month period, 34 (28.6%, median age 48.4 yr) cases and 70 (19.6%, median age 49.1 yr) controls reported one fall; 22 (18.5%) cases and 18 (5.0%) controls reported ≥ two falls (p < 0.001). Cases had 2.5-fold increased odds of at least one fall and 2.9-fold increased likelihood of increasing falls categories (0 vs. 1 vs. 2 +), compared to controls [adjOR 2.5, 95%CI (1.8, 3.4), adjOR OR 2.9, 95%CI (2.0, 4.1)].

Conclusion

Risk of falls was greater among women with BD. Balance training could be a research and clinical focus for falls prevention programs among women with bipolar disorder to prevent the detrimental outcomes associated with falling.
Acute exposure to air pollutants increase the risk of acute glaucoma
Authors: Li Liping , Zhu Yixiang , Han Binze , Chen Renjie , Man Xiaofei , Sun Xinghuai , Kan Haidong , Lei Yuan
Published: September 2022

Background

Ambient air pollution is related to the onset and progression of ocular disease. However, the effect of air pollutants on the acute glaucoma remains unclear.

Objective

To investigate the effect of air pollutants on the incidence of acute glaucoma (acute angle closure glaucoma and glaucomatocyclitic crisis) among adults.

Methods

We conducted a time-stratified case-crossover study based on the data of glaucoma outpatients from January, 2015 to Dec, 2021 in Shanghai, China. A conditional logistic regression model combined with a polynomial distributed lag model was applied for the statistical analysis. Each case serves as its own referent by comparing exposures on the day of the outpatient visit to the exposures on the other 3–4 control days on the same week, month and year. To fully capture the delayed effect of air pollution, we used a maximum lag of 7 days in main model.

Results

A total of 14,385 acute glaucoma outpatients were included in this study. We found exposure to PM2.5, PM10, nitrogen dioxide (NO2) and carbon monoxide (CO) significantly increased the odds of outpatient visit for acute glaucoma. Wherein the odds of acute glaucoma related to PM2.5 and NO2 were higher and more sustained, with OR of 1.07 (95%CI: 1.03–1.11) and 1.12 (95% CI: 1.08–1.17) for an IQR increase over lag 0–3 days, than PM10 and CO over lag 0–1 days (OR:1.03; 95% CI: 1.01–1.05; OR: 1.04; 95% CI: 1.01–1.07).

Conclusions

This case-crossover study provided first-hand evidence that air pollutants, especially PM2.5 and NO2, significantly increased risk of acute glaucoma.
On the role of financial support programs in mitigating the SARS-CoV-2 spread in Brazil
Authors: Albani Vinicius V. L. , Albani Roseane A. S. , Bobko Nara , Massad Eduardo , Zubelli Jorge P.
Published: September 2022

Background

During 2020, there were no effective treatments or vaccines against SARS-CoV-2. The most common disease contention measures were social distance (social isolation), the use of face masks and lockdowns. In the beginning, numerous countries have succeeded to control and reduce COVID-19 infections at a high economic cost. Thus, to alleviate such side effects, many countries have implemented socioeconomic programs to fund individuals that lost their jobs and to help endangered businesses to survive.

Methods

We assess the role of a socioeconomic program, so-called “Auxilio Emergencial” (AE), during 2020 as a measure to mitigate the Coronavirus Disease 2019 (COVID-19) outbreak in Brazil. For each Brazilian State, we estimate the time-dependent reproduction number from daily reports of COVID-19 infections and deaths using a Susceptible-Exposed-Infected-Recovered-like (SEIR-like) model. Then, we analyse the correlations between the reproduction number, the amount of individuals receiving governmental aid, and the index of social isolation based on mobile phone information.

Results

We observed significant positive correlation values between the average values by the AE and median values of an index accounting for individual mobility. We also observed significantly negative correlation values between the reproduction number and this index on individual mobility. Using the simulations of a susceptible-exposed-infected-removed-like model, if the AE was not operational during the first wave of COVID-19 infections, the accumulated number of infections and deaths could be 6.5 (90% CI: 1.3–21) and 7.9 (90% CI: 1.5–23) times higher, respectively, in comparison with the actual implementation of AE.

Conclusions

Our results suggest that the AE implemented in Brazil had a significant influence on social isolation by allowing those in need to stay at home, which would reduce the expected numbers of infections and deaths.
Use of the behaviour change wheel to improve everyday person-centred conversations on physical activity across healthcare
Authors: Reid Hamish , Smith Ralph , Williamson Wilby , Baldock James , Caterson Jessica , Kluzek Stefan , Jones Natasha , Copeland Robert
Published: September 2022

Background

An implementation gap exists between the evidence supporting physical activity in the prevention and management of long-term medical conditions and clinical practice. Person-centred conversations, i.e. focussing on the values, preferences and aspirations of each individual, are required from healthcare professionals. However, many currently lack the capability, opportunity, and motivation to have these conversations. This study uses the Behaviour Change Wheel (BCW) to inform the development of practical and educational resources to help bridge this gap.

Methods

The BCW provides a theoretical approach to enable the systematic development of behaviour change interventions. Authors followed the described eight-step process, considered results from a scoping review, consulted clinical working groups, tested and developed ideas across clinical pathways, and agreed on solutions to each stage by consensus.

Results

The behavioural diagnosis identified healthcare professionals’ initiation of person-centred conversations on physical activity at all appropriate opportunities in routine medical care as a suitable primary target for interventions. Six intervention functions and five policy categories met the APEASE criteria. We mapped 17 Behavioural Change Techniques onto BCW intervention functions to define intervention strategies.

Conclusions

This study uses the BCW to outline a coherent approach for intervention development to improve healthcare professionals’ frequency and quality of conversations on physical activity across clinical practice. Time-sensitive and role-specific resources might help healthcare professionals understand the focus of their intervention. Educational resources aimed at healthcare professionals and patients could have mutual benefit, should fit into existing care pathways and support professional development. A trusted information source with single-point access via the internet is likely to improve accessibility. Future evaluation of resources built and coded using this framework is required to establish the effectiveness of this approach and help improve understanding of what works to change conversations around physical activity in clinical practice.
Exercise adherence Mobile app for Knee Osteoarthritis: protocol for the MappKO randomised controlled trial
Authors: Hinman Rana S. , Nelligan Rachel K. , Campbell Penny K. , Kimp Alexander J. , Graham Bridget , Merolli Mark , McManus Fiona , Lamb Karen E. , Bennell Kim L.
Published: September 2022

Background

In people with knee osteoarthritis (OA), ongoing exercise participation, particularly with strengthening exercises, is central to management. Patient adherence to prescribed exercise typically declines once consultations with a clinician have ceased. Mobile applications (apps) can incorporate behaviour change techniques that may assist adherence, potentially optimising clinical outcomes.

Methods

This is a two-arm, pragmatic, superiority randomised trial. One hundred and eighty two Australians with chronic knee pain (clinical knee OA) and who have at least a mild level of physical dysfunction are being recruited. Participants are randomly allocated i) exercise (physiotherapist-prescribed exercise) or; ii) exercise plus app (physiotherapist-prescribed exercise plus access to the ‘My Exercise Messages’ mobile app). Exercise care comprises two videoconferencing consultations with a physiotherapist over two weeks (30 min each) for a strengthening exercise program, which is then conducted independently at home for 24 weeks without any further physiotherapist consultations. Participants are also provided with exercise resources to facilitate home-based exercise. Those randomised to exercise plus app will download the app after completing the two weeks of physiotherapy consultations and will be instructed by research staff to use the app for the 24 weeks of unsupervised home-based exercises. The app works by tracking completion of weekly exercise sessions, providing regular messages to facilitate weekly exercise and providing personalised messages to help overcome individual barriers to exercise participation. The two primary outcomes are i) self-reported physical function; and ii) number of days strengthening exercises were performed (previous fortnight), with a primary endpoint of 26 weeks and a secondary endpoint of 14 weeks. Secondary outcomes include knee pain severity; knee-related quality of life; global change; exercise program satisfaction; exercise self-efficacy; physical activity; sport and recreation function; another measure of exercise adherence; and willingness to undergo joint replacement. Process measures are also included.

Discussion

Findings will determine if a theory-informed mobile app improves exercise adherence and physical function in people with knee OA who have received a home-based strengthening program.

Trial Registration

Australian New Zealand Clinical Trials Registry, ACTRN12621000724875. Prospectively registered 9/06/2021.
Enterococcus faecalis rnc gene modulates its susceptibility to disinfection agents: a novel approach against biofilm
Authors: Xia Mengying , Zhuo Niya , Ren Shirui , Zhang Hongyu , Yang Yingming , Lei Lei , Hu Tao
Published: September 2022

Background

Enterococcus faecalis(E. faecalis) plays an important role in the failure of root canal treatment and refractory periapical periodontitis. As an important virulence factor ofE. faecalis, extracellular polysaccharide (EPS) serves as a matrix to wrap bacteria and form biofilms. The homologousrncgene, encoding Ribonuclease III, has been reported as a regulator of EPS synthesis. In order to develop novel anti-biofilm targets, we investigated the effects of therncgene on the biological characteristics ofE. faecalis, and compared the biofilm tolerance towards the typical root canal irrigation agents and traditional Chinese medicine fluid Pudilan.

Methods

E. faecalis rncgene overexpression (rnc+) and low-expression (rnc−) strains were constructed. The growth curves ofE. faecalisATCC29212,rnc+, andrnc− strains were obtained to study the regulatory effect of therncgene onE. faecalis. Scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM), and crystal violet staining assays were performed to evaluate the morphology and composition ofE. faecalisbiofilms. Furthermore, the wild-type and mutant biofilms were treated with 5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and Pudilan. The residual viabilities ofE. faecalisbiofilms were evaluated using crystal violet staining and colony counting assays.

Results

The results demonstrated that therncgene could promote bacterial growth and EPS synthesis, causing the EPS-barren biofilm morphology and low EPS/bacteria ratio. Both thernc+ andrnc− biofilms showed increased susceptibility to the root canal irrigation agents. The 5% NaOCl group showed the highest biofilm removing effect followed by Pudilan and 2% CHX. The colony counting results showed almost complete removal of bacteria in the 5% NaOCl, 2% CHX, and Chinese medicine agents’ groups.

Conclusions

This study concluded that therncgene could positively regulate bacterial proliferation, EPS synthesis, and biofilm formation inE. faecalis. Therncmutation caused an increase in the disinfectant sensitivity of biofilm, indicating a potential anti-biofilm target. In addition, Pudilan exhibited an excellent ability to removeE. faecalisbiofilm.
Changes in on-time vaccination following the introduction of an electronic immunization registry, Tanzania 2016-2018: interrupted time-series analysis
Authors: Dolan Samantha B. , Burstein Roy , Shearer Jessica C. , Bulula Ngwegwe , Lyons Hil , Carnahan Emily , Beylerian Emily , Thompson Jenny , Puttkammer Nancy , Lober William B. , Liu Shan , Gilbert Skye S. , Werner Laurie , Ryman Tove K.
Published: September 2022

Background

Digital health interventions (DHI) have the potential to improve the management and utilization of health information to optimize health care worker performance and provision of care. Despite the proliferation of DHI projects in low-and middle-income countries, few have been evaluated in an effort to understand their impact on health systems and health-related outcomes. Although more evidence is needed on their impact and effectiveness, the use of DHIs among immunization programs has become more widespread and shows promise for improving vaccination uptake and adherence to immunization schedules.

Methods

Our aim was to assess the impact of an electronic immunization registry (EIR) using an interrupted time-series analysis to analyze the effect on proportion of on-time vaccinations following introduction of an EIR in Tanzania. We hypothesized that the introduction of the EIR would lead to statistically significant changes in vaccination timeliness at 3, 6, and > 6 months post-introduction.

Results

For our primary analysis, we observed a decrease in the proportion of on-time vaccinations following EIR introduction. In contrast, our sensitivity analysis estimated improvements in timeliness among those children with complete vaccination records. However, we must emphasize caution interpreting these findings as they are likely affected by implementation challenges.

Conclusions

This study highlights the complexities of using digitized individual-level routine health information system data for evaluation and research purposes. EIRs have the potential to improve vaccination timeliness, but analyses using EIR data can be complicated by data quality issues and inconsistent data entry leading to difficulties interpreting findings.
Prevention and control of non-communicable diseases in antenatal, intrapartum, and postnatal care: a systematic scoping review of clinical practice guidelines since 2011
Authors: Jung Jenny , Karwal Eshreena K. , McDonald Steve , Turner Tari , Chou Doris , Vogel Joshua P.
Published: September 2022

Background

Non-communicable diseases (NCDs) are a leading cause of maternal mortality and morbidity worldwide. The World Health Organization is developing new recommendations focusing on the management of NCDs for pregnant, intrapartum, and postnatal women. Thus, to support the development of new guidelines and recommendations, we aimed to determine the availability, focus, and scope of recommendations of current guidelines for the management of NCDs during pregnancy, intrapartum, and postnatal period.

Methods

PubMed, Global Index Medicus, TRIP, and Guideline International Network databases were searched on 31 May 2021, to identify any NCD-related guidelines published between 2011 and 2021 with no language or country restrictions. Websites of 165 professional organizations were also searched. Characteristics of included guidelines were analyzed, and recommendations were extracted from guidelines of five high-priority NCD conditions (diabetes, chronic hypertension, respiratory conditions, hemoglobinopathies and sickle cell disease, and mental and substance use disorders).

Results

From 6026 citations and 165 websites, 405 guidelines were included of which 132 (33%) were pregnancy-specific and 285 (88%) were developed in high-income countries. Among pregnancy-specific guidelines, the most common conditions for which recommendations were provided were gestational diabetes, circulatory diseases, thyroid disorders, and hypertensive disorders of pregnancy. For the five high-priority conditions, 47 guidelines were identified which provided 1834 recommendations, largely focused on antenatal care interventions (62%) such as early detection, screening tools, pharmacological treatment, and lifestyle education. Postnatal recommendations largely covered postnatal clinical assessments, lifestyle education, and breastfeeding. Health system recommendations largely covered multidisciplinary care teams and strengthening referral pathways.

Conclusions

This study provides a robust assessment of currently available guidelines and mapping of recommendations on NCD management within maternal health services, which will inform the scope of the World Health Organization’s future guideline development activities. This study identified a need to develop guidelines that consider NCDs holistically, with an integrated approach to antenatal, intrapartum, and postnatal care, and that are relevant for resource-limited contexts. Any such guidelines should consider what interventions are most essential to improving outcomes for women with NCDs and their newborns, and how variations in quality of NCD-related care can be addressed.
The effect of obesity and subsequent weight reduction on cardiac structure and function in dogs
Authors: Partington C. , Hodgkiss-Geere H. , Woods G. R. T. , Dukes-McEwan J. , Flanagan J. , Biourge V. , German A. J.
Published: September 2022

Background

In people, the cardiovascular effects of obesity include systemic hypertension, cardiac remodelling and both systolic and diastolic dysfunction, whilst weight reduction can reverse myocardial remodelling and reduce risk of subsequent cardiovascular disease. To date, variable results are reported in studies of the effect of obesity and controlled weight reduction on cardiovascular morphology and function in dogs. This prospective study aimed to assess cardiac function, heart rate variability, cardiac biomarkers and body composition before and after weight reduction in pet dogs with obesity. Twenty-four client-owned dogs referred for weight management due to obesity were recruited. To assess the cardiac effects of obesity, body composition analysis (by dual energy X-ray absorptiometry, DEXA) and cardiovascular assessment (echocardiography, Doppler blood pressure, electrocardiography, cardiac biomarkers) were performed prior to weight management. Twelve dogs completed the study and reached target weight, receiving a further cardiovascular assessment and DEXA. A Wilcoxon-signed rank test was used to compare each variable pre- and post- weight reduction.

Results

Median (interquartile range) duration of weight loss was 224 days (124–245 days), percentage weight loss was 23% (18–31%) of starting weight. Median change in body fat mass was -50% (-44% to -55%;P = 0.004), whilst median change in lean mass was -7% (+ 1% to -18%,P = 0.083).

Before weight reduction, diastolic dysfunction (evidence of impaired relaxation in all dogs), increased left ventricular wall thickness and mildly elevated systolic blood pressure (14/24 ≥ 160 mmHg, median 165 mmHg (140–183)) were common features in dogs with obesity. However, systolic left ventricular wall dimensions were the only variables that changed after weight reduction, with a decrease in both the systolic interventricular septum (P = 0.029) and systolic left ventricular free wall (P = 0.017). There was no evidence of decreased heart rate variability in dogs with obesity (P = 0.367), and no change in cardiac biomarker concentrations with weight reduction (N-terminal proBNP,P = 0.262; cardiac troponin IP = 0.657).

Conclusions

Canine obesity results in diastolic dysfunction and left ventricular hypertrophy, the latter of which improves with significant weight and fat mass reduction. Further studies are required to clarify the clinical consequences of these findings.
Generalized tuberculosis due to Mycobacterium caprae in a red fox phylogenetically related to livestock breakdowns
Authors: Pérez de Val Bernat , Perea Claudia , Estruch Josep , Solano-Manrique Carlos , Riera Carles , Sanz Albert , Vidal Enric , Velarde Roser
Published: September 2022

Background

Tuberculosis (TB) due to Mycobacterium caprae is endemic in goat herds and free-ranging wild boars in Spain, causing infections in other livestock or wild animals to a lesser extent. TB infection in foxes is infrequently reported and they are usually considered spillover hosts of TB.

Case presentation

A blind, depressed and severely emaciated red fox (Vulpes vulpes) was admitted to a rehabilitation center. After clinical examination it was humanely sacrificed. At necropsy, generalized TB lesions were observed that were subsequently confirmed by histopathology along with a co-infection with canine distemper virus. M. caprae was isolated from mycobacterial culture and spoligotype SB0415 was identified. Whole genome sequencing (WGS) of the isolated M. caprae was carried out and single nucleotide polymorphisms (SNP) were compared with other sequences of M. caprae isolated from livestock and wildlife of the same area throughout the last decade.

Conclusions

This is the first reported case of TB due to M. caprae in a fox in the Iberian Peninsula. WGS and SNP analysis, together with spatial-temporal investigations, associated this case with recent M. caprae outbreaks in cattle and goat herds of the area. The results indicated transmission of M. caprae between livestock and the fox, suggesting that this species may occasionally play a role in the epidemiology of animal TB.
ROR2, a driver of “phenotype switching” in melanoma?
Authors: Lopez-Bergami Pablo
Published: September 2022

Receptor tyrosine kinase-like orphan receptor 2 (ROR2) is a receptor for the Wnt5a ligand that was shown to play a dual role in cancer. ROR2 was shown to either suppress or promote tumor progression in different tumor types by regulating the same biological processes (i.e. proliferation, invasion) in opposite ways. We have recently observed that ROR2 plays multiple and somewhat contradictory roles in melanoma where it impairs cell proliferation but promotes migration, EMT and chemoresistance. In the present article, ROR2 is proposed to be a major driver of “phenotype switching” in melanoma that can tilt the cellular behavior toward proliferative or invasive phenotypes. This function of ROR2 has therapeutic implications since it would provide an opportunity for targeting specific phenotypes such as invasive and drug-resistant ones by inhibiting ROR2.
Community perception of barriers and facilitators to institutional delivery care-seeking behavior in Northwest Ethiopia: a qualitative study
Authors: Nigusie Adane , Azale Telake , Yitayal Mezgebu , Derseh Lemma
Published: September 2022

Background

Institutional delivery care-seeking behavior is considered a crucial step in preventing maternal and child death. However, the barriers and facilitators related to institutional delivery care-seeking behavior in the study area were not studied very in-depth. Hence, the current study aimed to explore barriers and enablers of institutional delivery care-seeking behavior in Northwest Ethiopia.

Methods

A descriptive phenomenological qualitative inquiry was used. The data was collected by using a piloted interview guide. We collected data using in-depth interviews among women and men; and key informant interviews from the Female health development army and health extension workers in November and December 2019. Framework analysis was utilized for the analysis of the data.

Results

This study found out the potential factors which hinder and facilitate institutional delivery. The barriers to institutional delivery included the belief that pregnancy and childbirth are normal and business of women’s, women’s preference of home delivery with traditional attendants, family influence, fear of bad behavior of health care workers, and lack of resources. The facilitators were free maternal services (ambulance services and maternity services), having the experience of safe childbirth at health facilities, and women’s health development army linkage with health extension workers.

Conclusion

This study provides evidence that low-risk perception of home delivery, socio-cultural influences, service provision modalities, and financial factors were the determinants of institutional delivery service use. Therefore, a stage-matched intervention shall be designed to improve the uptake of institutional delivery service use.
The wild life of ticks: Using passive surveillance to determine the distribution and wildlife host range of ticks and the exotic Haemaphysalis longicornis, 2010–2021
Authors: Thompson Alec T. , White Seth A. , Doub Emily E. , Sharma Prisha , Frierson Kenna , Dominguez Kristen , Shaw David , Weaver Dustin , Vigil Stacey L. , Bonilla Denise L. , Ruder Mark G. , Yabsley Michael J.
Published: September 2022

Background

We conducted a large-scale, passive regional survey of ticks associated with wildlife of the eastern United States. Our primary goals were to better assess the current geographical distribution of exoticHaemaphysalis longicornisand to identify potential wild mammalian and avian host species. However, this large-scale survey also provided valuable information regarding the distribution and host associations for many other important tick species that utilize wildlife as hosts.

Methods

Ticks were opportunistically collected by cooperating state and federal wildlife agencies. All ticks were placed in the supplied vials and host information was recorded, including host species, age, sex, examination date, location (at least county and state), and estimated tick burden. All ticks were identified to species using morphology, and suspectH. longicorniswere confirmed through molecular techniques.

Results

In total, 1940 hosts were examined from across 369 counties from 23 states in the eastern USA. From these submissions, 20,626 ticks were collected and identified belonging to 11 different species. Our passive surveillance efforts detected exoticH. longicornisfrom nine host species from eight states. Notably, some of the earliest detections ofH. longicornisin the USA were collected from wildlife through this passive surveillance network. In addition, numerous new county reports were generated forAmblyomma americanum,Amblyomma maculatum,Dermacentor albipictus,Dermacentor variabilis, andIxodes scapularis.

Conclusions

This study provided data on ticks collected from animals from 23 different states in the eastern USA between 2010 and 2021, with the primary goal of better characterizing the distribution and host associations of the exotic tickH. longicornis;however, new distribution data on tick species of veterinary or medical importance were also obtained. Collectively, our passive surveillance has detected numerous new county reports forH. longicornisas well asI. scapularis.Our study utilizing passive wildlife surveillance for ticks across the eastern USA is an effective method for surveying a diversity of wildlife host species, allowing us to better collect data on current tick distributions relevant to human and animal health.
The SELFI Study: Iodine Excess and Thyroid Dysfunction in Women Undergoing Oil-Soluble Contrast Hysterosalpingography
Authors: Mathews Divya M , Peart Jane M , Sim Robert G , Johnson Neil P , O'Sullivan Susannah , Derraik José G B , Hofman Paul L
Published: September 2022

Context

Hysterosalpingography (HSG) with oil-soluble contrast medium (OSCM) improves pregnancy rates. However, OSCM has high iodine content and long half-life, leading to potential iodine excess.

Objective

This work aimed to determine the pattern of iodine excess after OSCM HSG and the effect on thyroid function.

Methods

A prospective cohort study was conducted of 196 consecutive consenting eligible women without overt hypothyroidism or hyperthyroidism. All completed the study with compliance greater than 95%. Participants underwent OSCM HSG (Auckland, 2019-2021) with serial monitoring of thyrotropin (TSH), free thyroxine (FT4), and urine iodine concentration (UIC) for 24 weeks. The main outcome measure was the development of subclinical hypothyroidism (SCH), defined as a nonpregnant TSH greater than 4 mIU/L with normal FT4 (11-22 pmol/L) in those with normal baseline thyroid function.

Results

Iodine excess (UIC ≥ 300 μg/L) was almost universal (98%) with UIC peaking usually by 4 weeks. There was marked iodine excess, with 90% and 17% of participants having UIC greater than or equal to 1000 μg/L and greater than 10 000 μg/L, respectively. Iodine excess was prolonged with 67% having a UIC greater than or equal to 1000 μg/L for at least 3 months. SCH developed in 38%; the majority (96%) were mild (TSH 4-10 mIU/L) and most developed SCH by week 4 (75%). Three participants met the current treatment guidelines (TSH > 10 mIU/L). Thyroxine treatment of mild SCH tended to improve pregnancy success (P = .063). Hyperthyroidism (TSH < 0.3 mIU/L) occurred in 9 participants (5%).

Conclusion

OSCM HSG resulted in marked and prolonged iodine excess. SCH occurred frequently with late-onset hyperthyroidism occasionally. Regular thyroid function tests are required for 6 months following this procedure.