bluuebunny/crossref_metadata_2025 huggingface dataset:
A mask between you and me
Authors: Vallee Mickey
Published: March 2022

How do we evaluate the value of a medical mask? And how does the mask acquire its meanings? In this paper, I approach the mask as a media entity: a mediated and mediating thing whose meanings and values arise from within a complex network of relations. The recent political divide regarding mask-wearing has roots in the ambivalence and confusion about their efficacy in the first few months of the pandemic. It remained unclear for some time whether masks protected the wearer or those around them, but nonetheless a global mask-making cottage industry emerged, shaped by DIY and citizen science. The DIY community cleverly leveraged this core ambivalence, foregrounding multivalence, and thereby feeding into a binary ethical obligation: for whom does one wear a mask? The mask was thus baptized into regular usage by the ‘I/You’ utterance that we are now familiar with: ‘I wear my mask to protect you, as you wear your mask to protect me’. This paper reframes the facemask as a complex media entity, one that absorbs its presuppositions, while also being placed into new arrangements by its arrival through an emerging relational network.
A Single-Arm Pilot Study of Multicomponent Psychoeducational Intervention for Postpartum Depression and Anxiety in a Rural Community
Authors: Dadhwal Vatsla , Sagar Rajesh , Choudhary Vandana , Kant Shashi , Perumal Vanamail , Misra Puneet , Bhattacharya Debabani
Published: March 2022

Background:

The prevalence of postpartum depression (PPD) and anxiety (PPA) is rising in India and efforts at generating local evidence for psychological intervention are scanty. We conducted a single-arm pilot study in an Indian rural community to test the impact of multicomponent psychoeducational intervention (MCPI) on women with PPD and PPA.

Methods:

Forty-three women with PPD/PPA/both received MCPI, which comprised three phases with in-person sessions held once weekly for a minimum of six and a maximum of ten weeks. Primary outcome variables were scores on depression and anxiety, assessed using the Edinburg postnatal depression scale and the state and trait anxiety inventory, along with evaluating the compliance rate to the intervention. The Mini-international neuropsychiatric interview (MINI) neuropsychiatric interview was used to confirm the diagnosis of depression and anxiety. Secondary outcome variables assessed were social support, functionality, parental stress, interpersonal violence, and marital satisfaction. We used Cohen’s d effect size method for assessing the mean differences.

Results:

MCPI resulted in the improvement of 72% women (95% CI = 56.3%–84.7%). The overall compliance rate to the intervention was 85.63%, which was higher for responders than nonresponders (92.9% vs. 69.8%; P < 0.001). MCPI resulted in statistically significant improvement in the mean score of depression (P = 0.001, d = 0.95) and anxiety (P = 0.001, d = 1.30). On secondary outcome variables, significant improvement was obtained in the overall present social support (P = 0.001; d = 4.65), present social support from partner (P = 0.027; d = 0.45) and parents (P = 0.001; d = 0.74), future social support from parents (P = 0.001; d = 0.81), the performance of household responsibility (P = 0.001; d = 0.97), lifestyle in the last two weeks (P = 0.001; d = 3.57), parental stress (P = 0.001; d = 1.04), and marital satisfaction (P = 0.014; d = 0.52).

Conclusion:

This pilot study shows that MCPI has a promising role in relieving depression and anxiety. It also improved the perception of social support from partner and parents, functionality, marital satisfaction, and reduced parental stress.
Nursing Students’ Views of the Content of Palliative Care in Undergraduate Education and their Self-assessed Palliative Care Competence—A Nationwide Cross-sectional Study
Authors: Hökkä Minna , Pölkki Tarja , Lehto Juho T.
Published: March 2022

Background: The importance of integrating palliative care (PC) education into undergraduate nursing studies has been recognized. Still, there is considerable variation in the PC education of nurses. Objective: To study the nursing students’ views of the PC contents during the nursing education; students’ self-assessed levels of PC competence; and whether prior education or work experience influence these views. Methods: A cross-sectional study. Data were collected using a questionnaire which was tested for its content and construct validity and internal consistency. The sample consisted of final-year undergraduate nursing students (n = 1331) from Finland. Results: The response rate was 94%. Of the students, 94.4% considered PC education to be quite or very useful, but only 51.9% reported the achieved PC teaching as quite or very good. Teaching on mental symptoms, existential issues and multicultural aspects were considered incomplete. Over half of the students wanted more education on pharmacological- and non-pharmacological pain management. Students with previous education assessed their PC competence as quite or very good more often than other students (70.1% vs. 54%, P < .001), and more often felt that these competencies are relevant to their profession (72.2% vs. 57.6%, P < .001). Conclusion: PC was considered as a useful subject, still only about half of the students reported the received PC education and their competence on PC as sufficient. Previous education or experience may enhance PC competence highlighting the need for divergent teaching. The results identify development needs for the contents of PC education in undergraduate nursing studies.
Tessier's Cleft Number 6 Revisited: A Series of 26 new Cases and Literature Review of 44
Authors: Pellerin Philippe , Tonello Cristiano , da Silva Freitas Renato , Tang Xiao Jun , Alonso Nivaldo
Published: March 2022

Objective

To fix a gray zone left in Tessier's classification of rare clefts with cleft 6 and to give a more comprehensive description of cleft 6 anatomy.

Design

The material used for the research was a series of 26 clinical cases of patients with assessed cleft 6 and 44 cases found out of a literature review with enough data to be useful. The 70 cases were cross-examined by the authors.

Study Setting

The authors are senior craniofacial surgeons working in high-case load department from university centers where the patients are documented and receive primary as well as secondary treatment and follow-up.

Patients

The patients were selected out of the series of craniofacial deformities taken care of by the authors’ department as rare clefts.

Main Outcome

We describe the full spectrum of cleft 6 as an autonomous entity that could present itself in three subtypes: 6a is the most proximal and could be associated with cleft 8. The subtype 6b is medial toward the zygomatic arch and frequently associated with a bone and teeth appendage (frequently described as a “maxillary duplication”). The subtype 6C goes toward the external ear between the helix crus and the auditory meatus.

Conclusions

The Tessier's opinion is that Treacher Collins syndrome was the association of clefts 6, 7, and 8 and is no longer sustainable in the light of modern genetics. Most of the cleft 6 are misdiagnosed in the literature.
Organizational solidarity in practice in Bolivia and Argentina: Building coalitions of resistance and creativity
Authors: Vieta Marcelo , Heras Ana Inés
Published: March 2022

This article considers organizational solidarity in practice—modes of organizing rooted in solidarity, relationality, coalition-building, and difference. It does so by studying two Latin American illustrative cases: Bolivia’s campesino-indígena movements coalescing traditional practices and urban-neighborhood experiences in order to self- organize socio-political spaces; and Argentina’s worker-led empresas recuperadas por sus trabajadores (worker-recuperated enterprises), where workers have been drawing on working-class self-activity to convert companies to cooperatives and self-manage spaces of production. Via a diverse economies approach, the article begins to inventory, describe, and provisionally theorize the recuperations, rearticulations, and creative proposals for organizing social, cultural, and economic life being forged by these diverse groups. The article ultimately unravels four broad commonalities threading and shaping each case: the neoliberal political economic context, collective memory, horizontal organizing, and coalitional possibilities. Though emerging in different national conjunctures and histories, what these two cases bring to the surface are the resistive and creative dimensions of each organizing experience. They are rooted in deeply relational coalitions linked via solidarity in difference, while drawing on collective memories of the past to recreate and reenvision the present and the future beyond the legacies of colonial histories and capitalist-centered actualities.
Examining the Dynamics of Belonging and Alienation in Higher Education Through Photovoice
Authors: Cornell Josephine , Kessi Shose , Ratele Kopano
Published: March 2022

The higher education system globally is inherently inequitable. Discriminatory practices and oppressive power dynamics are particularly prevalent in the South African higher education landscape, which is characterized by a legacy of colonialism and apartheid. As a result, although students from a wide range of backgrounds are increasingly participating in higher education, many students who do not fit the dominant status quo question their belonging within these spaces. Students’ experiences of alienation within higher education can have profoundly negative physical, pyschosocial, and education outcomes. However, students also display agency in negotiating the exclusionary institutional cultures within their universities and succeed despite these experiences. Photovoice methodology can be a useful tool for critiquing and highlighting such agentic practices, and for foregrounding the voices of students. In this research brief, we reflect on two photovoice projects that sought to examine the complexity of students’ experiences of belonging and alienation in higher education in South Africa. Our findings illustrate that although students may experience alienation on campus, they may also create spaces of belonging, “speak back” to, and challenge the exclusions inherent to campus life.
The Gendered Dimensions of Photovoice in Men’s Health Promotion Research
Authors: Oliffe John L. , Bottorff Joan L.
Published: March 2022

The use of photovoice in men’s health promotion research has grown significantly over the past 15 years. Initially mobilized as an elixir for men’s talk about health practices and illness experiences, participant-produced photographs and accompanying narratives have grown significantly in reach, influence, and application. The current article highlights the gendered dimensions of photovoice in men’s health promotion research across three studies addressing (1) psychosocial prostate cancer care, (2) fathers’ tobacco reduction and smoking cessation, and (3) male suicidality. Insights drawn from the psychosocial prostate cancer care project emphasize the plurality of masculinities, and the implications for health promoters treating the common treatment side effect of erectile dysfunction. The relational nature of gender is central to the fathers’ tobacco reduction and smoking cessation work whereby the well-being of partners and children strongly influenced men’s behavior changes amid guiding adjustments to smoke-free policies. The male suicidality research highlights the unmuting powers of photovoice for making visible the interiority of men’s mental illness, and the destigmatizing potentials for sharing participants’ accompanying narratives. Evident across the three projects are the gendered dimensions of photovoice processes and products for advancing understandings of, and avenues toward, promoting the health of men and their families. After reflecting on these advances, we offer recommendations for future men’s health promotion photovoice work.
Photovoice and Being Intentional About Empowerment
Authors: Liebenberg Linda
Published: March 2022

The intent of Photovoice is to produce research in collaboration with communities, ensuring that research is relevant to community needs and critically facilitates change required to address these needs. Accordingly, Photovoice extends research for knowledge production, emphasizing research for social change. Consequently, Photovoice stands to make an important contribution to relevant and impactful knowledge production with health promotion research. However, if the intent of Photovoice as reflected in its theoretical underpinnings is not accounted for from the outset, the value of the approach may not be fully realized. This article considers what the theoretical underpinnings of Photovoice are, how this relates to issues of power and empowerment theory, and how voice can be better ensured within a process that is intentional about empowerment and representation.
China's “Wolf Warrior Diplomacy”: The Interaction of Formal Diplomacy and Cyber-Nationalism
Authors: Sullivan Jonathan , Wang Weixiang
Published: March 2022

For all the popular interest in “wolf warrior diplomacy,” scant attention has been paid to the internal logics and mechanics of representative communications, notably the intersection with grassroots cyber-nationalism. Centring the connections between official and unofficial actors, we situate Chinese diplomatic communications within the domestic nationalist cyberspace cultures that demand and nourish the “dare to fight” orientation of formal Chinese diplomacy on the international stage. We argue that there is a synergistic interaction between officials and popular nationalism that creates bottom-up incentives to adopt a “wolf warrior” posture, distinct from simultaneous top-down pressures from the central leadership under Xi Jinping to appropriately represent China's “confident rise.” We show through case studies involving MoFA spokesperson and archetypal “wolf warrior” Zhao Lijian, that this interaction extends to sharing unofficial content and ideas in a mutually reinforcing cycle that facilitates a harder edge to diplomatic communications.
Trial by fire: How physicians responding to the COVID-19 pandemic illuminated the need for digital credentials
Authors: Brogan James , Goodier Henry , Nijjar Manreet , Rose Christian
Published: March 2022

The current credentialing process for physicians struggled to accommodate fluctuating regional demands for providers during the severe acute respiratory syndrome coronavirus 2 pandemic. This hurdle highlighted existing inefficiencies and difficulties facing healthcare systems across the world and led us to explore how credentialing can be improved using digital technologies. We explain how this is a critical moment to make the shift from physical to digital credentials by specifying how a digital credentialing system could simplify onboarding for providers, enable secure expansion of telehealth services, and enhance information exchange.
Risk Factors for Postoperative Pneumonia in the Elderly Following Hip Fracture Surgery: A Systematic Review and Meta-Analysis
Authors: Lee Sang Hee , Kim Ki Uk
Published: March 2022

Introduction: Pneumonia is a serious complication following hip fracture surgery in older people. However, the prevalence and risk factors of postoperative pneumonia (POP) are not well-established. This study identified pre- and peri-operative factors associated with the development of POP following hip fracture surgery.

Methods: We searched the Cochrane library, PubMed, and Embase databases for relevant articles published up to June 2021. Studies involving older patients who underwent hip fracture surgery were considered if they detailed the demographic or surgical characteristics of the participants. For all analyses, the pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated.

Results: A total of 24 studies (288819 participants) were included. The overall prevalence of POP following hip fracture surgery was 5.0%. There were 36 risk factors for POP, and the meta-analysis included the five most common: delayed surgery (OR: 1.84, 95% CI: 1.29-2.63), low serum albumin (OR: 2.34, 95% CI: .82-6.73), chronic respiratory diseases (OR: 2.42, 95% CI: 1.82-3.24), increased age (OR: 1.25, 95% CI:1.11-1.40), and male sex (OR: 2.22, 95% CI: 2.00-2.47).

Conclusions: The prevalence of POP was 5.0% following hip fracture surgery in the elderly. Older age, male sex, chronic respiratory diseases, delayed surgery, and low serum albumin were significant risk factors. Clinicians treating hip fracture patients must remain be aware of these risk factors.
Licious’s Response to the COVID-19 Pandemic: A Step Towards Crisis Communication?
Authors: Kabra Shradha , Dass Sumanjit
Published: March 2022

The novel COVID-19 pandemic has left the global economy in shambles and is negatively affecting India’s economy across industries. In order to tide over the crisis, companies need to take swift and effective decisions. The present case study focuses upon Bengaluru-based online meat and seafood company Licious that is functioning contrary to the dire state of fast-moving consumer goods (FMCG) and e-commerce companies which have shrunk during the nationwide lockdown. To battle the crisis that ails the meat industry, Vivek Gupta, Founder of Licious, took swift decisions and communicated effectively that helped him to build and renew trust with his stakeholders. This case specially focuses upon the various crisis communication strategies adopted by Gupta to create an effective engagement and experience with his stakeholders.
Substitution of ‘small’ divalent cations (e.g. Mg) for Si and Al in the nepheline tetrahedral framework: 2. The occurrence of Mg-rich nepheline and kalsilite
Authors: Oliveira Ítalo Lopes de , Henderson C. Michael B.
Published: March 2022

Natural nepheline usually contains very small amounts of MgO (<0.1 wt.%), although these examples are mainly from Mg-poor alkaline igneous rocks such as nepheline syenites. However, this work shows that nepheline and kalsilite with much higher MgO concentrations can occur in the groundmass of strongly SiO2-undersaturated, feldspar-free, mafic volcanic rocks (i.e. olivine-rich foidites). Furthermore, a strong positive correlation is evident between their Mg and Fe contents. The occurrence of Mg-rich nepheline and kalsilite seems to be related to their derivation from Mg-rich magmas when compared to most of the host rocks investigated to date. Additionally, the physicochemical conditions of crystallisation seem to have an important role in the incorporation of ‘small’ divalent cations by these minerals. The prevalence of Mg-rich nepheline and kalsilite as late magmatic phases and the divergent Mg and Fe relationships for phenocrysts and ‘quenched’ groundmass crystals support this hypothesis. The positive correlation between Mg and Fe contents reflects their strong geochemical affinity and the entrance of Fe3+, Fe2+ and Mg2+ cations into the same crystallographic site of nepheline and kalsilite structures. The calculation of atomic formulae and stoichiometry parameters for nepheline-group minerals where data for the T2+ cations (e.g. Mg2+) are incorporated gives more reliable compositional parameters (see Paper 1). Calculated excess silica values (Si′) are affected significantly when the coupled substitution 2Al3+ = Mg2+ + Si4+ is considered. Thus, specific analyses of ‘small’ divalent cations are essential to obtain more realistic values of excess Si′, in particular, for nepheline and kalsilite that crystallised from Mg-rich, Si-poor, mafic–ultramafic alkaline lavas.
Scalable Moiré Lattice with Oriented TMD Monolayers
Authors: Chuang Meng-Hsi , Chen Chun-An , Liu Po-Yen , Zhang Xin-Quan , Yeh Nai-Yu , Shih Hao-Jen , Lee Yi-Hsien
Published: March 2022

Moiré lattice in artificially stacked monolayers of two-dimensional (2D) materials effectively modulates the electronic structures of materials, which is widely highlighted. Formation of the electronic Moiré superlattice promises the prospect of uniformity among different moiré cells across the lattice, enabling a new platform for novel properties, such as unconventional superconductivity, and scalable quantum emitters. Recently, epitaxial growth of the monolayer transition metal dichalcogenide (TMD) is achieved on the sapphire substrate by chemical vapor deposition (CVD) to realize scalable growth of highly-oriented monolayers. However, fabrication of the scalable Moiré lattice remains challenging due to the lack of essential manipulation of the well-aligned monolayers for clean interface quality and precise twisting angle control. Here, scalable and highly-oriented monolayers of TMD are realized on the sapphire substrates by using the customized CVD process. Controlled growth of the epitaxial monolayers is achieved by promoting the rotation of the nuclei-like domains in the initial growth stage, enabling aligned domains for further grain growth in the steady-state stage. A full coverage and distribution of the highly-oriented domains are verified by second-harmonic generation (SHG) microscopy. By developing the method for clean monolayer manipulation, hetero-stacked bilayer (epi-WS2/epi-MoS2) is fabricated with the specific angular alignment of the two major oriented monolayers at the edge direction of 0°/ ± 60°. On account of the optimization for scalable Moiré lattice with a high-quality interface, the observation of interlayer exciton at low temperature illustrates the feasibility of scalable Moiré superlattice based on the oriented monolayers.
Brief lifestyle interventions for prediabetes in primary care: a service evaluation
Authors: Thatcher Rhys , Gregory Nicholas , Cheung Wai Yee , Dunseath Gareth J. , Parsons Sharon N. , Goodwin Mark , Luzio Stephen D.
Published: March 2022

Background

The increasing number of cases of prediabetes in the UK is concerning, particularly in Wales where there is no standard programme of support. The aim of the current service evaluation was to examine the effectiveness of brief lifestyle interventions on glucose tolerance in people at risk of developing type 2 diabetes.

Methods

In this pragmatic service evaluation clinical data on people deemed at risk of developing type 2 diabetes were evaluated from two GP clusters. Patients (n = 1207) received a single 15 to 30-min, face-to-face, consultation with a health care practitioner. Interventions were assessed by changes in HbA1c and distribution across the HbA1c ranges 12 months following intervention. Statistical significance of reversion to normoglycaemia and development of diabetes were assessed through comparison with expected rates without intervention.

Results

Between baseline and 12-month follow-up HbA1c fell from 43.85 ± 1.57 mmol/mol (6.16 ± 0.14%) to 41.63 ± 3.84 mmol/mol (5.96 ± 0.35%), a decrease of 2.22 mmol/mol (0.20%) (95% CI 2.01 (0.18%), 2.42 (0.22%); p < 0.0001). The proportion of people with normal glucose tolerance at 12 months (0.50 95%CI 0.47, 0.52) was significantly larger than the lower (0.06 (p < 0.0001) and the upper (0.19 (p < 0.0001)) estimates based on no intervention.

Conclusion

Results indicate significant improvement in glucose tolerance across GP clusters. The brief intervention has the potential to offer a robust and effective option to support people at risk of developing type 2 diabetes. Further research in the form of a randomised trial is needed to confirm this and identify those likely to benefit most from this intervention.
Combined systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) predicts chemotherapy response and prognosis in locally advanced gastric cancer patients receiving neoadjuvant chemotherapy with PD-1 antibody sintilimab and XELOX: a prospective study
Authors: Ding Ping’an , Guo Honghai , Sun Chenyu , Yang Peigang , Kim Na Hyun , Tian Yuan , Liu Yang , Liu Pengpeng , Li Yong , Zhao Qun
Published: March 2022

Background

Previous studies have confirmed that systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) can predict the prognosis and chemotherapy efficacy of various malignant tumors. However, to the best of our knowledge, no study investigated the SII combined with PNI score to predict the efficacy of anti-programmed death 1 (anti-PD-1) antibody sintilimab and XELOX regimen (capecitabine plus oxaliplatin) in the treatment of locally advanced gastric cancer. This study aims to evaluate the predictive value of pre-treatment SII-PNI score on the sensitivity of sintilimab immunotherapy combined with XELOX chemotherapy in patients with locally advanced gastric cancer.

Methods

We registered a prospective clinical study involving 30 locally advanced gastric cancer patients from March 2020 to July 2021. The pre-treatment SII and PNI were calculated from peripheral blood samples, and the cut-off value was calculated by receiver operating characteristic. The SII-PNI score ranged from 0 to 2 and were categorized into the following: score of 2, high SII (≥ 568.5) and low PNI (≤ 52.7); score of 1, either high SII or low PNI; score of 0, no high SII nor low PNI.

Results

All patients were evaluated by RECIST1.1 criteria after four cycles of sintilimab immunotherapy combined with XELOX chemotherapy, including 5 patients with TRG 3 and 25 patients with non-TRG 3. The SII-PNI score of non-TRG 3 patients was significantly lower than that of TRG 3 patients (P = 0.017). The medial progression free survival of patients with low SII-PNI score was significantly better than that of patients with high SII-PNI score (P < 0.001). Multivariate analysis showed that SII-PNI score was an independent prognostic factor for predicting progression-free survival (P = 0.003).

Conclusion

The pre-treatment SII-PNI score is a significant indicator for predicting chemosensitivity of locally advanced patients after sintilimab immunotherapy combined with XELOX chemotherapy, which can help to identify high-risk groups and predict prognosis.

Trial registration: The registered name of the trial is “Prospective clinical study of sintilimab combined with chemotherapy for neoadjuvant therapy in locally advanced gastric cancer”. Its Current Controlled Trials number is ChiCTR2000030414. Its date of registration is 01/03/2020.
Frailty assessment using a novel approach based on combined motor and cardiac functions: a pilot study
Authors: Toosizadeh Nima , Eskandari Maryam , Ehsani Hossein , Parvaneh Saman , Asghari Mehran , Sweitzer Nancy
Published: March 2022

Background

Previous research showed association between frailty and an impaired autonomic nervous system; however, the direct effect of frailty on heart rate (HR) behavior during physical activity is unclear. The purpose of the current study was to determine the association between HR increase and decrease with frailty during a localized upper-extremity function (UEF) task to establish a multimodal frailty test.

Methods

Older adults aged 65 or older were recruited and performed the UEF task of rapid elbow flexion for 20 s with the right arm. Wearable gyroscopes were used to measure forearm and upper-arm motion, and electrocardiography were recorded using leads on the left chest. Using this setup, HR dynamics were measured, including time to peak HR, recovery time, percentage increase in HR during UEF, and percentage decrease in HR during recovery after UEF.

Results

Fifty-six eligible participants were recruited, including 12 non-frail (age = 76.92 ± 7.32 years), and 40 pre-frail (age = 80.53 ± 8.12 years), and four frail individuals (age = 88.25 ± 4.43 years). Analysis of variance models showed that the percentage increase in HR during UEF and percentage decrease in HR during recovery were both 47% smaller in pre-frail/frail older adults compared to non-frails (p < 0.01, effect size = 0.70 and 0.62 for increase and decrease percentages). Using logistic models with both UEF kinematics and HR parameters as independent variables, frailty was predicted with a sensitivity of 0.82 and specificity of 0.83.

Conclusion

Current findings showed evidence of strong association between HR dynamics and frailty. It is suggested that combining kinematics and HR data in a multimodal model may provide a promising objective tool for frailty assessment.
Association between daily activities and fall in older adults: an analysis of longitudinal ageing study in India (2017–18)
Authors: Nagarkar Aarti , Kulkarni Snehal
Published: March 2022

Background

Declining functionality affects an individual’s musculoskeletal integrity increasing the risk of fall and disability. Individuals with severe functional limitations are 5 times more likely to experience a fall. Thus, this paper investigated the association between functional decline and falls in older adults.

Methods

This study uses secondary data from the Longitudinal Aging Study in India (2017–18). A total of 31,477 people over the age of 60 are included in the study. Descriptive statistics and bivariate analysis were performed to determine the association between activities of daily living (ADL), instrumental activities of daily living (IADL) and fall. Adjusted odds ratio was used to determine the association of ADL and IADL with fall while controlling for age, gender, balance and gait impairments.

Results

The study reported 6352 fall episodes in 3270 participants aged 60 and above, over a period of 2 years. More than 30% of participants reported difficulty in ADL and IADL. Age and gender adjusted odds of fall were higher in participants with difficulty in more than 4 ADLs (AOR:1.32; CI:1.08 – 1.67) and in more than 2 IADL (AOR: 1.39; CI:1.02 – 1.89). Similarly, the odds of fall were higher for difficulty in ADL (AOR:1.31; CI:1.11 – 1.73) and IADL (AOR of 1.18; CI:1.07 – 1.29) controlling for gait and balance impairment. Difficulty in pushing-pulling objects (AOR: 1.30; CI: 1.15 – 1.46 & AOR: 1.40; CI: 1.21–1.61) and getting up from the chair (AOR: 1.12; CI:1.01–1.26 & AOR: 1.27; CI: 0.99 – 1.26) was significantly associated with fall when adjusted for age, gender and balance and gait parameters.

Conclusions

This study provides the new insights into the association of fall and risk of functional decline, especially difficulty in pushing and pulling objects and getting up from a chair, can be incorporated in the primary screening of fall risk assessment.
Socioeconomic vulnerability and frailty among community-dwelling older adults: cross-sectional findings from longitudinal aging study in India, 2017–18
Authors: Srivastava Shobhit , Muhammad T.
Published: March 2022

Introduction

The Indian population is rapidly aging with huge proportion of illiterate and socioeconomically disadvantaged people and there is a dearth of research on the relationships between factors of socioeconomic vulnerability and frailty in older people. The present study examined the cross-sectional associations between socioeconomic vulnerability and physical frailty in community-dwelling older individuals in India.

Materials and methods

The data for the study were obtained from the Longitudinal Aging Study in India (LASI), which was conducted in 2017–18. The effective sample size was 14,652 older males and 15,899 older females aged 60 and over. The outcome variable was physical frailty phenotype measured from exhaustion, unintentional weight loss, weak grip strength, low physical activity, and slow walking time. The main explanatory variable was vulnerability status based on education, wealth and caste. The study carried out bivariate analysis to observe the association between vulnerability status and physical frailty. Further, multivariable binary logistic regression analysis was conducted to fulfil the objective of the study.

Results

A proportion of 10.5 and 14.4% of older males and females respectively were in the overall vulnerable category. The prevalence of physical frailty was high among older males from vulnerable population (31.4% vs 26.9%; p < 0.001). The adjusted estimates from multivariate analysis revealed that older adults from vulnerable category had 14% significantly higher odds of being frail in comparison to non-vulnerable category [AOR: 1.14; CI: 1.06,1.24]. The adjusted model further revealed that there were no significant gender differentials in physical frailty among older adults. Model-3 (adjusted model) revealed that older males and females from vulnerable population had 18% [AOR: 1.18; CI: 1.04,1.34] and 8% [AOR: 1.08; CI: 1.01,1.21] significantly higher odds of being physically frail in comparison to older males from non-vulnerable population respectively.

Conclusions

Adverse socioeconomic circumstances such as low education, lower wealth and caste status that are associated with increased prevalence of physical frailty raise urgent questions both for public health practitioners and clinicians. The current findings may help to adapt public policies focusing on screening physical frailty in the clinical settings, especially among vulnerable populations as a marker of a possibly reversible vulnerability to adverse outcomes in old age.
Effects of preservative fluid associated possible donor-derived carbapenem-resistant Klebsiella Pneumoniae infection on kidney transplantation recipients
Authors: Zhang Fei , Zhong Jinbiao , Ding Handong , Liao Guiyi
Published: March 2022

Background

Infections remain a major cause of morbidity and mortality in kidney transplant (KT) recipients. This study aimed to investigate the preservation fluid (PF) samples from deceased donors and report the impacts of possible donor-derived carbapenem-resistant Klebsiella pneumoniae (pdd-CRKP) infections on KT recipients.

Methods

A retrospective study was performed that included all recipients who received kidney transplantation from deceased donors in our hospital between December 2018 and December 2020. A total of 212 patients received kidney transplantation from deceased donors, a total of 206 PF samples were collected, and 20 recipients had a CRKP-positive culture. Both donors and recipients with CRKP-positive PF cultures were divided into two groups, and continuous variables between the two groups were compared using independent-sample t tests and Mann-Whitney tests. Categorical variables were compared using the chi-square test or Fisher’s exact test. The significance level of p values was set at 0.05.

Results

A total of 337 recipients underwent kidney transplantation, including 212 recipients of organs from deceased donors and 110 corresponding deceased donors. A total of 206 PF samples were collected, and 20 recipients had CRKP-positive PF cultures. The donors’ length of ICU stay was a potential risk factor for CRKP positivity in the PF culture (P < 0.05). Fifteen recipients were infected with pdd-CRKP, and the incidence of pdd-CRKP infection was 7.3% (15/206). The use of antibiotics, including ceftazidime-avibactam (CAZ-AVI), was a potential protective factor against death and graft loss in recipients with a CRKP-positive PF culture (P < 0.05).

Conclusions

This study shows that the incidence of pdd-CRKP is high in our centre, recipients with pdd-CRKP infection can still achieve a good prognosis with the use of antimicrobial agents including CAZ-AVI.
Cranial autonomic symptoms in migraine are related to central sensitization: a prospective study of 164 migraine patients at a tertiary headache center
Authors: Danno Daisuke , Wolf Johanna , Ishizaki Kumiko , Kikui Shoji , Hirata Koichi , Takeshima Takao
Published: March 2022

Background

Cranial autonomic symptoms (CASs) during migraine attacks are reported to be quite common regardless of ethnicity. In our previous study investigating 373 migraineurs, we found that 42.4% of them had CASs. The patients with CASs more frequently had cutaneous allodynia than did those without CASs, and we speculated that CASs were associated with central sensitization. The present study searched for substantial evidence on the relationship between CASs and central sensitization in migraine patients.

Methods

This was a prospective cross-sectional study. We studied a new independent cohort of 164 migraineurs who presented to the Tominaga Hospital Headache Center from July 2018 until December 2019. The clinical features of CASs according to the criteria in ICHD-3 (beta) were investigated. We also evaluated central sensitization based on the 25 health-related symptoms utilizing the validated central sensitization inventory (CSI), and each symptom was rated from 0 to 4 resulting a total score of 0–100.

Results

The mean age was 41.8 (range: 20 to 77) years old. One hundred and thirty-one patients (78.9%) were women. Eighty-six of the 164 (52.4%) patients had at least 1 cranial autonomic symptom. The CSI score of the patients with ≥3 CASs reflected a moderate severity and was significantly higher than in those without CASs (41.9 vs. 30.7, p = 0.0005). The score of the patients with ≥1 conspicuous CAS also reflected a moderate severity and was significantly higher than in those without CASs (40.7 vs. 33.2, p = 0.013). The patients in the CSI ≥40 group had lacrimation, aural fullness, nasal blockage, and rhinorrhea, which are cranial autonomic parasympathetic symptoms, significantly more frequently than those in the CSI < 40 group.

Conclusions

Migraine patients with CASs showed significantly greater central sensitization than those without such symptoms. In particular, cranial parasympathetic symptoms were more frequent in centrally sensitized patients than in nonsensitized patients, suggesting that cranial parasympathetic activation may contribute to the maintenance of central sensitization.

Trial registration

This study was retrospectively registered with UMIN-CTR on 29 Aug 2020 (UMIN000041603).
Cytomegalovirus lumbosacral polyradiculitis in patients with long-term use of an oral corticosteroid: a case report
Authors: Yun Jung Hae , Hsiao Ming-Yen , Boudier-Revéret Mathieu , Chang Min Cheol
Published: March 2022

Background

The long-term use of an oral corticosteroid suppresses immunity. Here, we describe a case involving a patient with weakness in the bilateral lower extremities due to cytomegalovirus (CMV) lumbosacral polyradiculitis.

Case presentation

A 64-year-old man visited a university hospital for symmetric motor weakness in both lower extremities (Medical Research Council grade: 2). Symptoms started 1 month before and gradually aggravated. The patient had been taking oral prednisolone for 10 years in order to control pain in multiple joints due to seronegative rheumatoid arthritis. He also had neuropathic pain on the entire right lower extremity and voiding difficulty. Gadolinium-enhanced magnetic resonance imaging revealed enhancement along the entire lumbosacral nerve roots. In the cerebrospinal fluid analysis (CSF), elevated white blood cell (WBC) count (19 cells/μL) and protein level (142.5 mg/dL) were observed. CMV detection by polymerase chain reaction (PCR) was positive. We diagnosed the patient as having lumbosacral polyradiculitis due to CMV. Ganciclovir (250 mg twice daily) was administered intravenously. Two months after initiating Ganciclovir, in the CSF analysis, CM detection by PCR was negative, and no WBC was found.

Conclusion

We reported a patient who had symmetric motor weakness in the bilateral lower extremities induced by CMV lumbosacral polyradiculitis. Its occurrence seems to be related to immunosuppresion due to the long-term use of an oral corticosteroid. When a patient who is taking an oral corticosteroid shows motor weakness in the bilateral lower extremities, CMV lumbosacral polyradiculitis is one of the possible disorders to be differentiated.
CELF1 promotes matrix metalloproteinases gene expression at transcriptional level in lens epithelial cells
Authors: Xiao Jun , Tian Xin , Jin Siyan , He Yanhui , Song Meijiao , Zou He
Published: March 2022

Background

RNA binding proteins (RBPs)-mediated regulation plays important roles in many eye diseases, including the canonical RBP CELF1 in cataract. While the definite molecular regulatory mechanisms of CELF1 on cataract still remain elusive.

Methods

In this study, we overexpressed CELF1 in human cultured lens epithelial SRA01/04 cells and applied whole transcriptome sequencing (RNA-seq) method to analyze the global differences mediated by CELF1. We then analyzed public RNA-seq and CELF1-RNA interactome data to decipher the underlying mechanisms.

Results

The results showed that transcriptome profile was globally changed by CELF1 overexpression (CELF1-OE). Functional analysis revealed CELF1 specifically increased the expression of genes in extracellular matrix disassembly, extracellular matrix organization, and proteolysis, which could be classified into matrix metalloproteinases (MMPs) family. This finding was also validated by RT-qPCR and public mouse early embryonic lens data. Integrating analysis with public CELF1-RNA interactome data revealed that no obvious CELF1-binding peak was found on the transcripts of these genes, indicating an indirectly regulatory role of CELF1 in lens epithelial cells.

Conclusions

Our study demonstrated that CELF1-OE promotes transcriptional level of MMP genes; and this regulation may be completed by other ways except for binding to RNA targets. These results suggest that CELF1-OE is implicated in the development of lens, which is associated with cataract and expands our understanding of CELF1 regulatory roles as an RNA binding protein.
Utility of endoscopic retrograde cholangiopancreatography in management of pediatric pancreaticobiliary disease
Authors: Makita Satoshi , Amano Hizuru , Kawashima Hiroki , Hinoki Akinari , Shirota Chiyoe , Tainaka Takahisa , Sumida Wataru , Yokota Kazuki , Okamoto Masamune , Takimoto Aitaro , Yasui Akihiro , Nakagawa Yoichi , Uchida Hiroo
Published: March 2022

Background

The purpose of this study was to evaluate the utility of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients with pancreaticobiliary diseases.

Methods

A retrospective review was performed on patients who underwent ERCP for the treatment of biliary tract disease and detailed examination of pancreatitis at our institution from January 1999 to December 2020.

Results

ERCP was performed for congenital biliary dilatation (CBD) (n = 42), choledocholithiasis (n = 9), common bile duct stenosis (n = 1), and several types of pancreatitis (n = 13). The only severe complication of ERCP was common bile duct injury. Three (5.8%) of 52 biliary diseases failed to be treated by ERCP. All patients with pancreatic disease were correctly diagnosed and treated.

Conclusions

Endoscopic biliary drainage with a temporary stent was adequate for symptomatic relief in CBD. Stenting of the pancreatic duct was useful for improving the angulation and drainage of the pancreatic duct. ERCP was useful for understanding the anatomy of the pancreatic duct and revealing potential treatments. Therefore, ERCP and transendoscopic therapy are sufficiently feasible in pediatric patients and should be actively introduced for the investigation and treatment of pancreaticobiliary diseases.
How did the first COVID-19 lockdown affect persons with concurrent mental health and substance use disorders in Norway? A qualitative study
Authors: Leonhardt Marja , Brodahl Morten , Cogan Nicola , Lien Lars
Published: March 2022

Background

The outbreak of COVID-19 with its severe social restrictions touched the daily life of most people. While everyday social life becomes difficult for citizens with economic and cultural capital, it becomes even worse for vulnerable groups such as persons with mental health and substance use disorders, who are particularly vulnerable to social exclusion. The aim of this study is to investigate how the first COVID-19 lockdown affected the everyday life and health of persons with co-occurring mental health and substance use disorders.

Methods

This qualitative study reports data from 17 individual interviews and one focus group of five participants, all with a self-reported mental health and substance use disorder. Interviews were conducted based on a semi-structured interview guide in September and October 2020 in a medium-sized local authority in Norway. Data were analysed using thematic analysis. A reference group of people with varied knowledge and experiences of the phenomenon were involved in study design, recruitment, data generation and analysis.

Results

The analysis identified four interrelated main themes, describing how the first lockdown affected the everyday life and health of persons suffering from a mental health and substance use disorder: (1) The COVID-19 outbreak as a perceived challenge, (2) A decline in mental health and well-being, (3) Increased substance use challenges, and (4) Diverse experiences with health and social services. The results show that people with a co-occurring disorder have challenges with digital tools and/or do not have the appropriate equipment. Further, participants were not concerned about becoming infected themselves, but infecting others.

Conclusions

Persons with a mental health and substance use disorder face major challenges during the COVID-19 pandemic. There is a need to maintain continuous low-threshold services especially directed towards persons with co-occurring disorders during the pandemic. Furthermore, it is important to improve the digital skills of every service user or offer alternatives to digital consultations and meetings.
Understanding occupational safety and health surveillance: expert consensus on components, attributes and example measures for an evaluation framework
Authors: Yang Liu , Branscum Adam , Kincl Laurel
Published: March 2022

Background

Occupational safety and health (OSH) surveillance systems track work-related fatalities, injuries and illnesses as well as the presence of workplace hazards and exposures to inform prevention efforts. Periodic evaluation is critical to the improvement of these systems to meet the demand for more timely, complete, accurate and efficient data processing and analysis. Despite the existence of general guidance for public health surveillance evaluation, no tailored guidance exists for evaluating OSH surveillance systems to date. This study utilized the Delphi technique to collect consensus among experts in the United States on surveillance elements (components, attributes and measures) to inform the development of a tailored evaluation framework.

Methods

A Delphi study approach with three survey rounds invited an expert panel to rate and comment on potential OSH surveillance evaluation framework elements, resulting in an optimal list of elements through the panel’s consensus. Additionally, experts completed a review of OSH surveillance systems they worked with and answered questions regarding the development of an evaluation framework. Descriptive statistics of the ratings were compiled for the Delphi process. Major themes from experts’ comments were further identified using content analysis to inform contextual information underlying their choices.

Results

Fifty-four potential experts across the United States were contacted to participate in the Delphi study. Ten experts began the first survey round with eight then seven experts continuing in the subsequent rounds, respectively. A total of 64 surveillance components, 31 attributes, and 116 example measures were selected into the final list through panel consensus, with 134 (63.5%) reaching high consensus. Major themes regarding current OSH surveillance focused on resources and feasibility, data collection, flexibility, and the inter-relatedness among elements.

Conclusions

A Delphi process identified tailored OSH surveillance elements and major themes regarding OSH surveillance. The identified elements can serve as a preliminary guide for evaluating OSH surveillance systems. A more detailed evaluation framework is under development to incorporate these elements into a standard yet flexible approach to OSH surveillance evaluation.