bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of changes for sebum, skin pore, texture, and redness before and after sleep in oily and nonoily skin
Authors: Jo Da Jung , Shin Joo Young , Na Seong Jin
Published: October 2022

Background

People whose skin type is oily have experienced an esthetic and hygienic discomfort due to the excessive secretion of the sebum during the day and night time, and therefore sebum control is required. In this study, we aimed to find out whether the skin status between the oily and nonoily skin indicates a significant difference before and after sleep.

Materials and methods

Forty Korean males and females whose skin type was oily or nonoily participated in this study. To investigate the difference of the skin between oily and nonoily skin before and after sleep, we measured the sebum, skin pore, texture, and redness on their cheek at baseline and after 4‐h sleep. Moreover, the significant level was determined at p < 0.05.

Results

Parameters of sebum and skin pore significantly increased after 4‐h sleep compared with baseline in the oily and nonoily skin (p < 0.05). Moreover, the increment of sebum and pore parameters in the oily skin was significantly higher than those in the nonoily skin (p < 0.05). In the case of skin texture and redness, parameters of them were significantly changed after 4‐h sleep compared with baseline only in the oily skin (p < 0.05), and there was no significant difference among groups.

Conclusions

We found that the change rates of the sebum secretion and skin pore in oily skin were significantly higher than those in nonoily skin after 4‐h sleep. These results suggest the necessity of the skin care depending on the skin type before sleeping.
A cluster of two psittacosis cases among women farmers exposed to Chlamydia psittaci‐infected domestic poultry in Zhejiang Province, China
Authors: Liu Shelan , Yang Yong , Pang Zhifeng , Liu Ying , Li Huan , Cai Jian , Wu Zhuoying , Luo Yan , Tang Yuhuan , Ying Lihong , Qin Shuwen , Miao Ziping , Zhao Na , Chen Yijuan , Pan Jinren , Li Shijian , Yu Zhao , Ling Feng , Chen Enfu , Chen Zhiping
Published: October 2022

A cluster of Chlamydia psittaci (C. psittaci) cases was reported in Zhejiang Province, China, 2019. This study evaluates the extent of the outbreak and determines the source of infection. Real‐time PCR and sequencing of the ompA gene of C. psittaci were performed to identify the cases, the domesticated poultry and close contacts. The index patient was a 76‐year‐old woman with chronic vertigo, and Case 2 was a 64‐year‐old female farmer with herpes zoster. Both women bought psittaci‐infected chickens or ducks from the same mobile street vendor and raised them for 10 days and 23 days before fever onset. There were no direct contact between the two women. C. psittaci test was positive for the two patients, one sick chicken, three healthy ducks and the vendor's chicken cage. Phylogenetic analysis showed that all seven C. psittaci positive samples carried identical ompA genotype A of C. psittaci. Of all of the patients' 148 close contacts, none tested positive for C. psittaci, or developed acute respiratory symptoms. Both patients were discharged after a 4‐week hospital stay. In conclusion, the source of this cluster was the poultry infected with C. psittaci, which occasionally cause infections in farmers, but inter‐human transmission seems unlikely.
The German-Austrian Philhellenism through the Revolution Press-The Case of Newspapers Ellinika Chronika (Hellenic Chronicles) and O Filos tou Nomou (The Friend of the Law) during the Period 1824-1826
Authors: Antoniades Euripides
Published: October 2022

The Greek Revolution of 1821 was certainly an important milestone in the history of the Greek nation in order to reclaim freedom and create an independent state. This study will attempt to highlight the significance of philhellenism and philhellenes of the diaspora, with a special emphasis on the German Austrian philhellenism, as recorded in the Greek press during the revolution. This article examines a) how two Greek newspapers portray the German-Austrian philhellenism during 1824 – 1826 and b) how this world movement of philhellenism helped during the Greek revolution. The Philhellenic movement was related to the interest of European people in Greece and pre-existed the Greek revolution of 1821. In countries of Western Europe, such as Germany and Britain, interest in classical Greece was nurtured by philosophical, philological and explorative texts and news reporting. More particularly, articles from the Ellinika Chronika (Hellenic Chronicles) and O Filos tou Nomou (The Friend of the Law) newspapers refer to cases of Philhellenes living abroad, and especially the German Austrian axis, will be examined. These items create an important field of study that showcases how the press records history and events happening at the time of the Greek Revolution, 200 years ago.
Comparative Study on Galling and Antiwear Behavior of Polyurethane Based Coatings Reinforced With Pristine and Alkylated MoS2 Nanosheets
Authors: Kashyap Amod , Harsha A.P. , Rawat Sooraj Singh , Barshilia Harish C.
Published: October 2022

The present investigation is focused on tribological studies of polyurethane (PU) based coatings doped with nano-MoS2, and MoS2 functionalized with octadecanethiol (i.e., MoS2-ODT) on steel substrate. The PU-based nanocomposite coatings showed enhanced hardness, scratch and galling resistance at room temperature. Tribological tests were carried out under two contact conditions, i.e., sliding contact for galling resistance and reciprocating wear studies. The PU-based nanocomposite coatings showed enhanced galling resistance at room temperature. The reciprocating wear studies showed a significant reduction in friction and wear with the addition of MoS2 and MoS2-ODT nanosheets in the polymer matrix. The PU-MoS2 coating showed a 46% and 77% reduction in coefficient of friction and wear, respectively. However, the PU-MoS2-ODT nanocomposite coatings showed up to 75% and 95% reduction in coefficient of friction and wear, respectively. The PU based nanocomposite coating also showed enhanced galling resistance up to 17.5 MPa, in contrast to 5 MPa of SS 304. Different tools like high-resolution transmission electron microscopy (HRTEM), X-ray diffraction (XRD), Fourier transform infrared radioscopy (FTIR), high resolution scanning electron microscopy (HRSEM), energy dispersive X-ray (EDS), nanoindentation, stereo-zoom, and optical microscopies were used for the characterization and study of MoS2 nanosheets and PU based nanocomposite coatings.
Mechanical Behavior of Variable Nozzle Guide Vane Systems Based on Full-Scale Testing
Authors: Macoretta Giuseppe , Monelli Bernardo Disma , Neri Paolo , Bucciarelli Federico , Giusti Enrico , Checcacci Damaso , Maffulli Gianfranco
Published: October 2022

A full-scale test bench for the analysis of frictional and modal behavior of nozzle guide vanes (NGV) is an advanced tool enabling high design accuracy for these components equipped with an increasing number of turbo-expanders. This subassembly is a key feature enabling operational flexibility for the expander. During the NGVs design, great attention must be paid to the natural frequencies of its kinematic chain, which are influenced by internal clearances and by friction. In this paper, the results of a testing campaign performed on an NGV assembly employing realistic blade geometry are presented together with details concerning the test bench commissioning and setup procedure. The testing campaign involves three different combinations of blade orientation and preload corresponding to typical design conditions of the expander. In addition, two bushing clearance values corresponding to different worn-out conditions were investigated. The measurements of the global friction coefficient based on actuator force detection are summarized. After that, the reconstruction of mode shapes based on experimental modal analysis is explained. The results highlight the importance of loading conditions on the actual value of friction force and their influence on blade natural frequencies. The testing campaign was used to properly validate finite element models to be used for further investigations.
Noninvasive Imaging of a Liquid Jet
Authors: Beringer Courtney K. , Morgan Timothy B. , Kastengren Alan L. , Heindel Theodore J.
Published: October 2022

Liquid jets are found in many applications, from printing to manufacturing to entertainment. This study uses three different noninvasive imaging modalities to compare resulting images of a liquid jet operating at three Reynolds numbers that cover laminar, transitional, and turbulent flow. Selected measurement quantities from each image type are also compared. High-speed backlit (BL) imaging is a simple imaging technique found in many laboratories, and this is compared to two high-speed X-ray imaging techniques, white beam (WB) imaging and focused beam (FB) radiography. BL imaging can provide a wide field of view and is easy to implement, but it only shows the presence or absence of liquid. WB imaging can show detailed contours on the surface of the liquid jet, but the imaging region is much smaller. FB radiography produces a point-source measurement and can provide the quantitative, instantaneous local liquid path length, termed the equivalent path length (EPL). All three techniques provide similar measures of jet thickness, with the FB measurements having less variation. FB measurements can also provide detailed cross sections of the average liquid jet thickness at high spatial resolutions.
Deep learning categorization of infrasound array data
Authors: Bishop Jordan W. , Blom Philip S. , Webster Jeremy , Reichard-Flynn Will , Lin Youzuo
Published: October 2022

We develop a deep learning-based infrasonic detection and categorization methodology that uses convolutional neural networks with self-attention layers to identify stationary and non-stationary signals in infrasound array processing results. Using features extracted from the coherence and direction-of-arrival information from beamforming at different infrasound arrays, our model more reliably detects signals compared with raw waveform data. Using three infrasound stations maintained as part of the International Monitoring System, we construct an analyst-reviewed data set for model training and evaluation. We construct models using a 4-category framework, a generalized noise vs non-noise detection scheme, and a signal-of-interest (SOI) categorization framework that merges short duration stationary and non-stationary categories into a single SOI category. We evaluate these models using a combination of k-fold cross-validation, comparison with an existing “state-of-the-art” detector, and a transportability analysis. Although results are mixed in distinguishing stationary and non-stationary short duration signals, f-scores for the noise vs non-noise and SOI analyses are consistently above 0.96, implying that deep learning-based infrasonic categorization is a highly accurate means of identifying signals-of-interest in infrasonic data records.
Acoustic–seismic coupling model for the Short-Distance detection of Ultra-Low-Altitude aircraft
Authors: Wang Jingye , Jiang Tao
Published: October 2022

When using seismic signals to detect ultra-low-altitude aircraft at short distances, inappropriately designed filters reduce the signal quality and detection accuracy. To solve this problem, continuous acoustic signals generated by standard sound sources were used to induce vibrations in soil. Based on the assumed incidence of spherical wavefronts, we found that frequency bands of strengthened and weakened coupling are caused by interference between acoustic coupled waves and precursory seismic waves. We estimated the seismic properties at the experimental site by scanning various parameters to optimize the similarity coefficient. Based on the model, we discussed the relationship among soil velocities, layer thicknesses, and the amplitude of the coupled signal with frequency and provided a basis for the design of filters for detecting ultra-low-altitude aircraft.
Legionella pneumophila PPIase Mip Interacts with the Bacterial Proteins SspB, Lpc2061, and FlaA and Promotes Flagellation
Authors: Karagöz Mustafa Safa , Ünal Can Murat , Mayer Benjamin E. , Müsken Mathias , Borrero-de Acuña José Manuel , Steinert Michael
Published: October 2022

The peptidyl-prolyl-
cis/trans
-isomerase (PPIase) macrophage infectivity potentiator (Mip) contributes to the pathogenicity and fitness of
L. pneumophila
, the causative agent of Legionnaires’ disease. Here, we identified the stringent starvation protein SspB, hypothetical protein Lpc2061, and flagellin FlaA as bacterial interaction partners of Mip.
The Five Core Concepts of Biology as a Framework for Promoting Expert-Like Behaviors in Undergraduates Learning How to Read Primary Scientific Literature
Authors: Chatzikyriakidou Kyriaki , Tacloban Marie Janelle , Concepcion Kassandra , McCartney Melissa
Published: October 2022

A growing body of literature shows that primary scientific literature (PSL) is a valuable and useful tool for science, technology, engineering, and math education. We currently have a relatively limited understanding of how skills relating to reading PSL progress through academic careers, i.e., the process by which expertise in reading PSL develops.
Understanding Primers and Polymerase Chain Reaction by Using a Kinesthetic Paper Model
Authors: Heineman Richard H.
Published: October 2022

Performing a PCR often does not teach students what happens in a PCR. This kinesthetic, hands-on exercise allows students to simulate by hand the steps of a PCR.
pUL36 Deubiquitinase Activity Augments Both the Initiation and the Progression of Lytic Herpes Simplex Virus Infection in IFN-Primed Cells
Authors: Mohnke Jonas , Stark Irmgard , Fischer Mara , Fischer Patrick M. , Schlosser Andreas , Grothey Arnhild , O’Hare Peter , Sodeik Beate , Erhard Florian , Dölken Lars , Hennig Thomas
Published: October 2022

HSV-1 is a ubiquitous human pathogen that is responsible for common cold sores and may also cause life-threatening disease. pUL36 is an essential, conserved herpesvirus protein with N-terminal deubiquitinating (DUB) activity. The DUB is dispensable for HSV-1 replication in cell culture but represents an important viral immune evasin
in vivo
.
An Evolved 5′ Untranslated Region of Alfalfa Mosaic Virus Allows the RNA Transport of Movement-Defective Variants
Authors: Villar-Álvarez David , Pallás Vicente , Elena Santiago F. , Sánchez-Navarro Jesús A.
Published: October 2022

The results obtained in the present work could challenge the view of the role of the virus particle in the systemic transport of plant viruses. In this sense, we show that two different MPs are competent to systemically transport the AMV genome without the requirement of the virus particles, as reported for viruses lacking a CP (e.g.,
Umbravirus
).
Four-Parameter FluoroSpot Assay Reveals That the Varicella Zoster Virus Elicits a Robust Memory T Cell IL-10 Response throughout Childhood
Authors: Nilsson Anna , Höbinger Anna , Jahnmatz Peter , Tiselius Eva , Laestadius Åsa , Melén Erik , Björkander Sophia , Saghafian-Hedengren Shanie
Published: October 2022

Infection with herpesviruses accounts for 35 to 40 billion human cases worldwide. Despite this, little is known about how herpesviruses shape the immune system in the asymptomatic carrier.
Mobile Element Integration Reveals a Chromosome Dimer Resolution System in
Legionellales
Authors: Nicholson Beth , Deecker Shayna R. , Ensminger Alexander W.
Published: October 2022

The maintenance of circular chromosomes depends on the ability to resolve aberrant chromosome dimers after they form. In most proteobacteria, broadly conserved Xer recombinases catalyze single crossovers at short, species-specific
dif
sites located near the replication terminus.
Draft Genome Sequences of Eight Mycobacterium montefiorense Strains Isolated from Salamanders in Captivity
Authors: Komine Takeshi , Ihara Hyogo , Fukano Hanako , Hoshino Yoshihiko , Kurata Osamu , Wada Shinpei
Published: October 2022

Mycobacterium montefiorense
is a nontuberculous mycobacterium that causes infections in fish and salamanders. Here, we report annotated draft genome sequences of eight strains that were isolated in 2014 and 2018 from salamanders reared in an aquarium in Japan.
Whole-Genome Sequence of Limosilactobacillus fermentum Strain DM075, Isolated from the Human Oral Cavity
Authors: Park Do-Young , Hwang Jiyoung , Kim Yunji , Kim Young-Youn , Kim Hye-Sung , Hwang Inseong
Published: October 2022

Here, we report the complete genome sequence of nitric oxide (NO)-producing
Limosilactobacillus fermentum
strain DM075, which was isolated from human tongue coating samples from healthy donors in South Korea. The complete genome sequence of DM075 comprises a single circular 2,204,022-bp genome, with a GC content of 51.0%, and lacks antimicrobial resistance genes.
Nearly Complete Genome Sequence of Raoultella ornithinolytica Strain MQB_Silv_108, Carrying an Uncommon Extended-Spectrum-β-Lactamase-like
bla
BEL
Gene
Authors: Quintela-Baluja Marcos , Jobling Kelly , Graham David W. , Gomez-Lopez Mariano , Romalde Jesus L. , Barros-Velázquez Jorge , Calo-Mata Pilar
Published: October 2022

Raoultella ornithinolytica
has become increasingly important in human diseases. Here, we report the nearly complete genome sequence of a multidrug-resistant strain,
R. ornithinolytica
MQB_Silv_108, which was isolated from the effluent from a domestic wastewater treatment plant in Spain. Therefore, its release into the environment poses a possible exposure risk for humans and animals.
Phylogenetic Association and Genetic Factors in Cold Stress Tolerance in Campylobacter jejuni
Authors: Hur Jeong In , Kim Jinshil , Ryu Sangryeol , Jeon Byeonghwa
Published: October 2022

The tolerance of foodborne pathogens to environmental stresses significantly affects food safety. Several studies have demonstrated that
C. jejuni
survives extended exposures to low temperatures, but the mechanisms of cold stress tolerance are not fully understood.
Supplemental Material: Validation of earthquake ground-motion models in southern California, USA, using precariously balanced rocks
Authors: Rood Anna H. , al. et
Published: October 2022

All the fragility, fragility age, and hazard validation results in color for each precariously balanced rock, and all the input and output cosmogenic-nuclide exposure dating data.
Neuroendocrine Control of Hyperglutamatergic States in Brain Pathologies: the Effects of Glucocorticoids
Authors: Gulyaeva N. V.
Published: October 2022

Neuroendocrine control mediated by glucocorticoids is important
for maintaining the normal functioning of the brain and the balance
between the excitation and inhibition systems. Glucocorticoids regulate
the state of the brain glutamatergic system both directly, through receptors
on glutamatergic synapses, and indirectly. The dysfunction of the
hypothalamic–pituitary–adrenal (HPA) axis and its inability to optimally
regulate glutamatergic synaptic plasticity leads to the development
of neuropsychiatric diseases, while hyperglutamatergic conditions
can play a key role in their pathogenesis. Impaired glucocorticoid
control of glutamatergic processes underlies cognitive and emotional
disorders, epilepsy and a number of other cerebral pathologies,
being a common mechanism for the development of many brain diseases
and their comorbidities. In this regard, the study of the mechanisms
of interaction between the HPA axis and brain glutamatergic system
is of priority translational significance.
Thyroid-Stimulating Hormone Receptor: the Role in the Development of Thyroid Pathology and Its Correction
Authors: Fokina E. F. , Shpakov A. O.
Published: October 2022

One of the key elements responsible for the thyroid response
to thyroid-stimulating hormone (TSH) is the TSH receptor (TSHR),
which belongs to the G protein-coupled receptor superfamily. Binding
of TSH or stimulatory autoantibodies to the TSHR extracellular domain
triggers multiple signaling pathways in target cells that are mediated
through various types of G proteins and β-arrestins. Inhibitory
autoantibodies, in contrast, suppress TSHR activity, inducing hypothyroid states.
Activating mutations lead to constitutively active TSHR forms and
can trigger cancer. Therefore, the TSHR is one of the key targets
for the regulation of thyroid function and thyroid status, as well
as correction of diseases caused by changes in TSHR activity (autoimmune
hyper- and hypothyroidism, Graves’ ophthalmopathy, thyroid cancer).
TSH preparations are extremely rarely used in medicine due to their
immunogenicity and severe side effects. Most promising is the development
of low-molecular allosteric TSHR regulators with an activity of
full and inverse agonists and neutral antagonists, which are able
to penetrate into the allosteric site located in the TSHR transmembrane
domain and specifically bind to it, thus controlling the ability
of the receptor to interact with G proteins and β-arrestins. Allosteric
regulators do not affect the binding of TSH and autoantibodies to
the receptor, which enables mild and selective regulation of thyroid function,
while avoiding critical changes in TSH and thyroid hormone levels.
The present review addresses the current state of the problem of
regulating TSHR activity, including the possibility of using ligands
of its allosteric sites.
Building a network of sentinel centres for the care of women in an abortion situation: advances in Latin America and the Caribbean
Authors: Gomez Ponce de Leon Rodolfo , Baccaro Luiz Francisco , Rubio Schweizer Gonzalo , Bahamondes Valeria , Messina Analia , de Francisco Luis Andres , Serruya Jacob Suzanne
Published: October 2022

Previous reports have already estimated the overall number of abortions and the number of unsafe abortions in Latin America. Conversely, there are few reliable data from this region to inform public policies aiming to meet women’s needs. In this context, the Latin American Centre of Perinatology (Centro Latinoamericano de Perinatología (CLAP)) created a network specialising in the care of women in an abortion situation (CLAP MUSA-Network) in an attempt to strengthen healthcare surveillance in Latin America by using the Perinatal Information System (Sistema Informático Perinatal (SIP)). This system was developed by the CLAP with a special module named SIP Abortion (SIP-A), a data collection tool designed by Latin American experts to be routinely used in cases of legal and incomplete abortions. The SIP-A follows the standards established by WHO, allowing investigators to systematise information, generate local reports and monitor changes after training and follow-up interventions based on national guidelines. This network promotes collaborative work between institutions to strengthen epidemiological surveillance, cooperative investigation and development of a critical mass of professionals skilled in sexual and reproductive health. Currently, 29 sentinel centres from 13 countries jointly work exchanging information to improve surveillance of healthcare indicators of women in an abortion situation. Latin America was the first region in the world to have a network of sentinel centres that continuously monitors healthcare provision to these women. Data collected by this network are already being used to design, implement and evaluate public policies.
Prevalence and socioeconomic determinants of the double burden of malnutrition in mother–child pairs in Latin America and the Caribbean
Authors: Otten Hannah Susann , Seferidi Paraskevi
Published: October 2022

Background

The double burden of malnutrition (DBM), which refers to the coexistence of overnutrition and undernutrition among populations, households or individuals, is a growing problem in low/middle-income countries. The Latin America and the Caribbean (LAC) region has been particularly affected by the DBM, following a nutrition transition and a rapid increase in overweight, obesity and diet-related disease, while high levels of undernutrition persist. This study aims to describe the prevalence of four different DBM definitions in mother–child pairs across nine LAC countries and investigate the socioeconomic determinants of overweight mothers with at least one stunted child (SCOM).

Methods

We used cross-sectional data from the Demographic and Health Surveys for all analyses. We used descriptive statistics to obtain prevalence rates and conducted multiple logistic regression analyses to investigate the association between SCOM households and socioeconomic determinants, including wealth index, maternal education, place of residency and whether the mother was working, adjusted for a range of variables.

Results

Overweight/obese mothers with at least one anaemic child were the most common type of DBM, with a prevalence of 19.39%, followed by SCOM with a prevalence of 10.44%. Statistically significant socioeconomic predictors of SCOM were households with a lower wealth index, lower maternal education and living in rural areas.

Conclusion

This study showed that the overall prevalence of most DBM definitions examined was high, which points to the need for urgent interventions in the LAC region. The unique set of socioeconomic predictors of SCOM identified in this study calls for future double-duty policies that simultaneously target food affordability, nutrition education and access to healthy food.
Environmental and behavioural exposure pathways associated with diarrhoea and enteric pathogen detection in 5-month-old, periurban Kenyan infants: a cross-sectional study
Authors: Baker Kelly K , Mumma Jane Awiti Odhiambo , Simiyu Sheillah , Sewell Daniel , Tsai Kevin , Anderson John David , MacDougall Amy , Dreibelbis Robert , Cumming Oliver
Published: October 2022

Objectives

The aim of this study was to test whether household environmental hygiene and behavioural conditions moderated associations between diarrhoea and enteric pathogen detection in infants 5 months of age in Kenya and pathogen sources, including latrine access, domestic animal co-habitation and public food sources.

Design

Cross-sectional study utilising enrolment survey data of households participating in the Safe Start cluster-randomised controlled trial .

Setting

Kisumu, Kenya.

Participants

A total of 898 caregivers with 5-month (22 week ± 1 week) aged infants were enrolled in the study and completed the enrolment survey.

Primary and secondary outcome measures

Outcomes were (1) caregiver-reported 7-day diarrhoea prevalence and (2) count of types of enteric viruses, bacteria and parasites in infant stool. Exposures and effect modifiers included water access and treatment, cohabitation with domestic animals, sanitation access, handwashing practices, supplemental feeding, access to refrigeration and flooring.

Results

Reported handwashing after handling animals (adjusted odds ratio (aOR)=0.20; 95% CI=0.06 to 0.50) and before eating (aOR=0.44; 95% CI=0.26 to 0.73) were strongly associated with lower risk of caregiver-reported diarrhoea, while cohabitation with animals (aOR=1.54; 95% CI=1.01 to 2.34) living in a household with vinyl-covered dirt floors (aOR=0.60; 95% CI=0.45 to 0.87) were strongly associated with pathogen codetection in infants. Caregiver handwashing after child (p=0.02) or self-defecation (p=0.03) moderated the relationship between shared sanitation access and infant exposure to pathogens, specifically private latrine access was protective against pathogen exposure of infants in households, where caregivers washed hands after defecation. In the absence of handwashing, access to private sanitation posed no benefits over shared latrines for protecting infants from exposure.

Conclusion

Our evidence highlights eliminating animal cohabitation and improving flooring, postdefecation and food-related handwashing, and safety and use of cow milk sources as interventions to prevent enteric pathogen exposure of young infants in Kenya.

Trial registration number

NCT03468114
Extent of disability among paediatric Japanese encephalitis survivors and predictors of poor outcome: a retrospective cohort study in North India
Authors: Srivastava Neha , Deval Hirawati , Mittal Mahima , Deoshatwar Avinash , Bondre Vijay P , Kant Rajni , Yadav Rajaram
Published: October 2022

Objective

To determine the Japanese encephalitis (JE)-associated long-term functional and neurological outcomes, the extent of reduced social participation and predictors of poor outcomes among paediatric JE survivors.

Design

A retrospective cohort study.

Setting

Laboratory-confirmed JE-positive paediatric cases (<16 years of age) hospitalised at the paediatric ward of Baba Raghav Das Medical College, Gorakhpur, India, between 1 January 2017 and 31 December 2017, were followed up after 6–12 months of hospital discharge.

Participants

126 patients were included in the study; median age was 7.5 years (range: 1.5–15 years), and 74 (58.73%) were male.

Outcome measures

Functional outcome defined by Liverpool Outcome Score (LOS) dichotomised into poor (LOS=1–2) and good (LOS=3–5) outcome groups compared for demographic, clinical and biochemical parameters for prognostic factors of poor outcomes. Social participation of patients scaled on Child and Adolescent Scale of Participation score 2–5.

Results

About 94 of 126 (74.6%) children developed neurological sequelae at different levels of severity. Age-expected social participation was compromised in 90 out of 118 children. In multivariate logistic regression analysis, a combination of parameters, JE unvaccinated status (OR: 61.03, 95% CI (14.10 to 264); p<0.001), low Glasgow Coma Score (GCS) at admission (≤8) (OR: 8.6, 95% CI (1.3 to 57.1); p=0.026), malnutrition (OR: 13.56, 95% CI (2.77 to 66.46); p=0.001) and requirement of endotracheal intubation (OR: 5.43, 95% CI (1.20 to 24.44); p=0.027) statistically significantly predicted the poor outcome with 77.8% sensitivity and 94.6% specificity. The goodness-of-fit test showed that the model fit well (Hosmer-Lemeshow goodness-of-fit test) (χ2=3.13, p=0.988), and area under the receiver operating characteristic curve was 0.950.

Conclusion

This study estimates the burden of JE-presenting post-discharge deaths (15.4%) and disability (63.08%). Those who did not receive JE vaccine, were suffering from malnutrition, had GCS ≤8 at admission and required endotracheal intubation had poorer outcomes.
Data-informed stepped care to improve youth engagement in HIV care in Kenya: a protocol for a cluster randomised trial of a health service intervention
Authors: Kohler Pamela , Agot Kawango , Njuguna Irene N , Dyer Jessica , Badia Jacinta , Jiang Wenwen , Beima-Sofie Kristin , Chhun Nok , Inwani Irene , Shah Seema K , Richardson Barbra A , Chaktoura Nahida , John-Stewart Grace
Published: October 2022

Introduction

Adolescents and youth living with HIV (AYLHIV) have lower retention in care, adherence to treatment, and viral suppression compared with adults. Stepped care is a process by which clients are assigned to increasingly intensive services or ‘steps’ according to level of need. Differentiated care, in which stable clients access less frequent services, can be combined with stepped care to align needs and preferences of youth to promote optimal engagement in care.

Methods and analysis

This hybrid type I effectiveness implementation cluster randomised trial aims to evaluate a data-informed stepped care (DiSC) intervention for AYLHIV. AYLHIV ages 10–24 receiving care at 24 HIV treatment facilities in Kisumu, Homabay and Migori counties in Kenya will be enrolled. Twelve facilities will be randomised to the DiSC intervention, and 12 will provide standard care. A clinical assignment tool developed by the study team will be used at intervention sites to assign AYLHIV to one of four steps based on risk for loss to follow-up: differentiated care, standard care, counselling services or intensive support services. The primary clinical outcome is retention in care, specifically missed visits (failure to return within 30 days for any visit) and 12-month loss to follow-up. Implementation outcomes are based on the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. Proportions of missed visits will be compared using mixed effect models clustered by facility and participant.

Ethics and dissemination

This study has been approved by the University of Washington Institutional Review Board (STUDY00011096), Maseno University Ethical Review Committee (MUERC/00917/20) and the Kenya National Commission for Science, Technology and Innovation (444824). AYLHIV provide written informed consent when legally permitted, or assent with caregiver permission for minors. Study staff will work with a Community Advisory Board, including youth members, to disseminate results via discussions, presentations, journal publications and local or international conferences.

Trial registration number

NCT05007717.
Challenges and ways of coping of parturient women with chronic hepatitis B in Ghana during COVID-19 pandemic: a qualitative inquiry
Authors: Lanyo Theresa Norpeli , Ani-Amponsah Mary , Adjei Charles Ampong
Published: October 2022

Objective

To explore the psychosocial concerns and ways of coping of pregnant women with chronic hepatitis B infection in Ghana.

Setting

Participants were selected from public health facilities in the Tema Metropolis.

Design

Exploratory descriptive qualitative design was employed.

Participants

Fourteen pregnant women were purposively selected to participate in face-to-face interviews. The data were analysed using the content analysis procedure.

Results

The participants' psychosocial concerns and coping strategies were diverse. A significant number of the participants were concerned about the impact their hepatitis B seropositivity would have on their relationships, finances, and general well-being. Specifically, they feared that their social network, especially their spouses, would perceive them as having led a promiscuous lifestyle in the past to acquire hepatitis B infection. Also, fear of transmitting the infection to their infants and the effects of the infection on their infants later in life were identified as major concerns by nearly all participants. The participants further reported feelings of distress and diminished self-esteem. These psychosocial afflictions reported were attributed to lack of pre-test counselling during the antenatal care period. However, the participants coped using different strategies, including avoidance/denial, spirituality, and alternative treatment use.

Conclusion

To achieve optimal psychological and social well-being of pregnant women with chronic hepatitis B, it is important that their unique challenges are considered in their care and treatment cascade. Explicitly, protocols for supportive care addressing the specific needs of pregnant women with chronic hepatitis B should be implemented in the study setting
Protocol for a systematic review and meta-analysis of minimal important differences for generic multiattribute utility instruments
Authors: Henson Glen James , Taylor Bruce V , van der Mei Ingrid , Claflin Suzi B , Simpson-Yap Steve , Palmer Andrew J , Xia Qing , Antony Benny , Singh Ambrish , Campbell Julie A
Published: October 2022

Introduction

Generic multiattribute utility instruments (MAUIs) are efficient tools for determining and enumerating health-related quality of life. MAUIs accomplish this by generating health state utilities (HSUs) via algorithms. Minimal important differences (MIDs) assist with the interpretation of HSUs by estimating minimum changes that are clinically significant. The overall goal of the proposed systematic review and meta-analysis is the development of comprehensive guidelines for MID estimation.

Methods and analysis

This protocol defines a systematic review and meta-analysis of MIDs for generic MAUIs. The proposed research will involve a comprehensive investigation of 10 databases (EconLit, IDEAs database, INAHTA database, Medline, PsycINFO, Embase, Emcare, JBIEBP and CINAHL) from 1 June 2022 to 7 June 2022, and will be performed and reported in accordance with several validated guidelines, principally the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of papers, considered for inclusion in the review, will be appraised using the COnsensus-based Standards for the selection of health Measurement INstruments, inter alia.

Narrative analysis will involve identifying the characteristics of MIDs including methods of calculation, sources of heterogeneity, and validation. Meta-analysis will also be conducted. The descriptive element of meta-analysis will involve the generation of I2statistics and Galbraith plots of MID heterogeneity. Together with narrative analysis, this will allow sources of MID heterogeniety to be identified. A multilevel mixed model, estimated via restricted maximum likelihood estimation, will be constructed for the purposes of meta-regression. Meta-regression will attempt to enumerate the effects of sources of heterogeneity on MID estimates. Meta-analysis will be concluded with pooling of MIDs via a linear random-effects model.

Ethics and dissemination

Ethics approval is not required for this review, as it will aggregate data from published literature. Methods of dissemination will include publication in a peer-reviewed journal, as well as presentation at conferences and seminars.

PROSPERO registration number

CRD42021261821.
Effectiveness of community-based rehabilitation (CBR) centres for improving physical fitness for community-dwelling older adults: a systematic review protocol
Authors: Xin Wei , Xu Dan , Dou Zulin , Jacques Angela , Umbella Josephine , Hill Anne-Marie
Published: October 2022

Introduction

The increasing ageing population has become a substantial challenge for both healthcare and social services in many Asian countries. There is a high incidence of chronic diseases and comorbidities in older populations, leading to impairments and functional disability. Functional disability may result in loss of independence, reduced quality of life and increased care needs. Community-based rehabilitation (CBR) provides rehabilitation to improve physical, mental and social outcomes. However, there is limited evidence regarding the effectiveness of CBR for improving older adults’ physical fitness. The aim of this systematic review is to synthesise the evidence for the effectiveness of interventions delivered by CBR centres on physical fitness of community-dwelling older adults in Asian countries.

Methods and analysis

A search on four English databases (CINAHL, Medline, Scopus and Proquest) and two Chinese databases (China National Knowledge Internet and Wanfang Database) will be conducted from inception to 15 November 2021. Both English and Chinese publications will be included. Studies conducted in Asian countries using either experimental or quasi-experimental designs, with any type of control group, will be included. The primary outcomes are physical fitness (capacity to perform activities and tasks). Secondary outcomes are performance of activities of daily living and health-related quality of life. The quality of all included studies will be assessed using the Joanna Briggs Institute standardised critical appraisal tools. Two reviewers will independently complete study screening, selection, quality appraisal and data extraction. Quantitative data where possible will be pooled in statistical meta-analysis. All statistical analyses will be performed using Review Manager (Rev Man) V.5.3 software.

Ethics and dissemination

Ethical approval is not required for this review. Findings of the review will be disseminated electronically through a peer-reviewed publication and conference presentations. This review will provide high-quality evidence for CBR in Asian countries with growing ageing populations. Clinical and research recommendations will provide guidance for policy makers and clinical programmes in Asian healthcare systems. Findings will also inform healthcare systems in other countries that use CBR.

PROSPERO registration number

CRD42021292088.
Performance of HPV testing, Pap smear and VIA in women attending cervical cancer screening in Kilimanjaro region, Northern Tanzania: a cross-sectional study nested in a cohort
Authors: Mremi Alex , Mchome Bariki , Mlay Joseph , Schledermann Doris , Blaakær Jan , Rasch Vibeke
Published: October 2022

Objective

There is a concern about performance of the screening approaches, where information on the quality of novel and affordable screening approaches that will perform well in remote areas is warranted. This lack of information makes it difficult to prioritise resource use in efforts to improve cervical cancer outcomes. We aimed to compare the diagnostic value of human papillomavirus (HPV) testing on self-collected samples, Pap smear and visual inspection of the cervix with acetic acid (VIA) tests for detection of high-grade cervical intraepithelial neoplasia or worse (CIN2+).

Design

A combined cross-sectional and cohort study.

Setting

Three primary healthcare centres in Kilimanjaro region, Tanzania.

Participants

1620 women undergoing cervical cancer screening from December 2018 to September 2021. Inclusion criteria were being aged 25–60 years, and no history of premalignant or cervical cancer. Exclusion criteria were overt signs of cancer and previous hysterectomy.

Interventions

Participants underwent HPV self-sampling with Evalyn Brush and Care HPV kit assay was used to determine prevalence of high-risk HPV infection. Women with positive HPV test were together with a random sample of HPV negative women scheduled for follow-up where VIA was performed, and Pap smear and cervical biopsies obtained.

Results

Of 1620 women enrolled, 229 (14.1%) were HPV positive and 222 of these attended follow-up together with 290 (20.8%) women with negative HPV test. On VIA, 17.6% were positive. On Pap smear, 8.0% were classified as high-grade squamous intraepithelial lesion. The sensitivity and specificity, respectively, of the various tests, compared with histopathology for the detection of CIN2+ were: HPV test 62.5%, 59.3%; Pap smear 82.8%, 82.1% and; VIA 48.4%, 56.8%. When combined, the sensitivity and specificity for HPV and Pap smear were 90.6%, 70.6% while HPV and VIA were 65.6% and 75.5% for the detection of CIN2+.

Conclusions

The performance of care HPV testing on self-collected samples opens the possibility of increasing coverage and early detection in resource-constrained settings.
Effects of a multidisciplinary intervention to promote physical activity in patients with stroke undergoing rehabilitation: study protocol for the ActivePAS pilot randomised controlled trial
Authors: Kanai Masashi , Nozoe Masafumi , Ohtsubo Takuro , Ueno Katsuhiro , Nakayama Mai , Yamashita Masashi , Kamiya Kentaro
Published: October 2022

Introduction

Physical activity after stroke is related to functional recovery and outcomes. To optimise physical activity adapted to a patient’s walking ability and characteristics, multidisciplinary support and interventions are required. The Activate Physical Activity for Stroke pilot randomised controlled trial aims to assess the safety and feasibility of a multidisciplinary intervention that promotes physical activity in patients who had a stroke undergoing rehabilitation.

Methods and analysis

This single-centre, randomised controlled trial will enrol 32 patients who had a stroke undergoing rehabilitation. Patients who had a stroke with the ability to walk 50 m with at least hand assistance, regardless of the use of braces or walking aids, and aged≥20 years will be randomly allocated to a multidisciplinary intervention group or control group. Patients in the intervention group will receive instructions for the self-monitoring of hospitalised physical activity and support to promote physical activity by multidisciplinary staff. The primary outcome of the present study is the safety (adverse events) and feasibility (retention and completion rates) of the multidisciplinary intervention. We assess physical activity using a triaxial accelerometer (UW-204NFC, A&D Company) as one of the secondary outcomes.

Ethics and dissemination

The present study has been approved by the Research Ethics Committee of Konan Women’s University and the Ethics Committee of Nishi-Kinen Port Island Rehabilitation Hospital. We will disseminate the results of the present study through a peer-reviewed manuscript and presentations at international conferences.

Trial registration number

UMIN000046731.
Severity of obstructive coronary artery stenosis after pre-eclampsia
Authors: Ray Joel G , Austin Peter C , Park Alison L , Cohen Eyal , Fang Jiming , Chu Anna
Published: October 2022

Introduction

Women with a history of pre-eclampsia are at higher risk of premature coronary artery disease. Assessment of obstructive coronary artery stenosis by invasive coronary angiography has not been evaluated after pre-eclampsia.

Methods

A population-based cohort study was completed in Ontario, Canada, where there is universal healthcare and collection of angiographic data. Included were women with a live birth or stillbirth from 2002 to 2020, and without known heart disease. One birth was randomly selected per woman. The main exposure compared women with versus without pre-eclampsia. The primary outcome was angiographically established obstructive coronary artery stenosis, assessed starting 42 days after the index birth. Cause-specific hazard models accounting for competing risks generated HRs, adjusted for age, parity, income, rurality, diabetes, chronic hypertension, renal disease, substance use and dyslipidaemia.

Results

Among 42 252 women ever with pre-eclampsia and 1359 122 never with pre-eclampsia, mean age was 31.1 years and 30.6 years, respectively. After 9 years of follow-up, obstructive coronary artery stenosis occurred in 186 women with pre-eclampsia (4.53 per 10 000 person-years) versus 1237 women without pre-eclampsia (0.97 per 10 000 person-years)—an unadjusted HR 4.41 (95% CI 3.78 to 5.14) and adjusted HR 2.07 (95% CI 1.77 to 2.43). Relative to those with neither, the adjusted HR for coronary stenosis was highest in women with pre-eclampsia and preterm birth (3.11, 95% CI 2.51 to 3.87), or pre-eclampsia and stillbirth (2.80, 95% CI 1.05 to 7.47).

Conclusions

Pre-eclampsia is associated with a greater risk of premature-onset obstructive coronary artery stenosis, especially when it is complicated by a preterm birth or a stillbirth.