bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehension for Learners Who Are Deafblind: Perspectives From Teachers, Interveners, and Parents
Authors: Brum Christopher , Bruce Susan M.
Published: May 2023

Deafblindness is complex, and there is very limited research on literacy for learners who are deafblind, including on comprehension. This study investigated current practices for comprehension development for learners who are deafblind. Data were collected through a survey and interviews from 63 U.S. participants who were teachers, interveners, and parents. Thematic analysis resulted in the emergence of themes and strategies related to supporting and measuring comprehension during shared reading for learners who are deafblind. Strategies for supporting comprehension include multiple communication forms, customizing the text, repeating, exploring materials, and integrating technology. For measuring comprehension strategies include questioning, completing phrases, commenting and discussing, retelling, sequencing, and extension activities. Implications for research include future investigations on the effectiveness of the strategies currently reported to support and measure comprehension. Implications for practice include developing understanding by supporting communication and access during shared reading while using multiple measures of comprehension.
Doing Ethnographic Research in the Fiji Islands: Research Method and Research Ethics Issues
Authors: James Kieran Edmond
Published: May 2023

The aim of this article is to consider research method and research ethics issues in the unique location of the Fiji Islands. After arguing that Eurocentric, Anglo-American ethics clearance processes, embedded into Global North Universities, are culturally inappropriate, in the Fiji setting, I go on to imagine alternative ethics clearance questions that pick up on and reflect adequately Fiji’s social and economic context. I discuss and explore why traversing relationships, relationships that traverse time and space through giving, receiving, obligation, reimbursement, and forgiveness, often emerge in the Fiji context, and how they can be a local, social equilibrium that benefits both parties. My own research on Fiji soccer history is used to provide illustrations and anecdotes throughout the article.
Medicaroid robotic assisted surgery system: A feasibility study
Authors: Capovilla Giovanni , Tagkalos Evangelos , Froiio Caterina , Hadzijusufovic Edin , Berlth Felix , Grimminger Peter Philipp
Published: May 2023

The hinotori™ surgical robotic system, by Medicaroid (Medicaroid Corporation, Kobe, Japan), is a new robotic system for minimally invasive surgery. We aimed at evaluating its usability and accessibility in a preclinical setting. This was a preclinical feasibility study. Two groups of surgeons, one with three experienced robotic surgeons (group 1) and one with three robotic-surgery naive participants (group 2), performed the following tasks using the hinotori™ system in a simulated preclinical setting: console setup, docking, instrument exchange, undocking, and suturing. Each participant repeated each task three times. The time required for performing each repetition and the count of failed repetitions were the primary outcomes of the study. The subjectively perceived workload in performing the tasks, as measured by the NASA-TLX score, was the secondary outcome. The improvement of participants within the three repetitions as well as a comparison between the performances of group 1 and 2 were evaluated. The time required to perform each task decreased with repetitions for both groups, so did the subjective workload score. The time measures required to perform the tasks and the mental effort scores were comparable between the two groups for the console setup, docking, instrument exchange, and undocking tasks. The NASA-TLX score was also comparable between the two groups for the console setup and the emergency undocking tasks and decreased significantly within all tasks after the third repetition. The incidence of failed repetitions was higher in group 2 for the suturing task, however the difference was not statistically significant. The results confirmed the usability of the hinotori™ system in a preclinical setting for both highly trained surgeons and nonexperienced operators and its accessibility for both long-time users of other systems and first-time users.
The STEM Wage Premium Across the OECD
Authors: Even William E. , Yamashita Takashi , Cummins Phyllis A.
Published: May 2023

Using data from the Program for the International Assessment of Adult Competencies, this paper compares the earnings premium and employment share of jobs in Science, Technology, Engineering and Mathematics (STEM) across 11 member countries of the Organisation for Economic Co-operation and Development. The results reveal that the STEM wage premium is higher in the United States than in any of the other comparison countries, despite the fact that the U.S. has a larger share of workers in STEM jobs. We also find evidence that the premium varies significantly across STEM sub-fields and education levels, and that the premium tends to be higher in countries with lower unionization rates, less employment protection, or a larger share of employment in the public sector.
Vertebral and Basilar Artery Dissection in a Patient With Alport Syndrome
Authors: Talbot-Stetsko Haley K. , Saleh Sara , Brent Ashley , Camelo-Piragua Sandra , Gordon David , Williamson Craig A.
Published: May 2023

Basilar artery occlusion (BAO) is a rare cause of stroke associated with significant morbidity and mortality. It is most frequently thromboembolic in nature, but may be caused by vertebral artery dissection.

We present a case of BAO in a 36-year-old woman with Alport syndrome. She was treated with emergent thrombectomy via the right vertebral artery with return to baseline neurological status. Her clinical status deteriorated later the same day and she was found to have re-occlusion. Repeat thrombectomy was complicated by persistent re-occlusion requiring 7 passes to achieve reperfusion. Unfortunately, her neurological exam remained poor and she was transitioned to comfort care, expiring on admission day 3. An autopsy demonstrated acute dissection of the left vertebral artery, basilar artery, and bilateral posterior cerebral arteries.

Alport syndrome is a type IV collagenopathy most known for causing kidney disease. It may also be associated with vascular fragility as type IV collagen forms a significant component of the vascular basement membrane. There are reports of aortic, coronary, and cervical dissections, but few reports of intracranial dissections in patients with Alport syndrome. While iatrogenic dissection cannot be ruled out, the histological findings in this case are most consistent with spontaneous arterial dissection as the cause of her initial neurologic presentation. This highlights the need for further investigation into the relationship between Alport syndrome and vascular fragility and should alert clinicians to the possibility of intracranial dissection in patients with AS.
Managing a Household During a Pandemic: Cognitive Labor and Parents’ Psychological Well-being
Authors: Petts Richard J. , Carlson Daniel L.
Published: May 2023

Rising domestic burdens for mothers fueled concerns that the COVID-19 pandemic exacerbated gender inequalities in well-being. Yet, survey research has not considered whether and how cognitive labor—planning, organizing, and monitoring family needs—contributed to gendered health disparities during the pandemic. Using data from the Study on U.S. Parents’ Divisions of Labor during COVID-19 (SPDLC) and a stress process perspective, we examine the association between cognitive labor and parents’ psychological well-being, and whether this association (1) differs between mothers and fathers and (2) is moderated by employment status and telecommuting. Mothers performed more cognitive labor during the pandemic than fathers, and cognitive labor was negatively associated with mothers’ psychological well-being—particularly for mothers who never or exclusively telecommuted. Mothers’ psychological well-being was higher when fathers did more cognitive labor, especially among mothers who worked outside the home. Overall, cognitive labor appears to be another stressor that contributed to increased gender inequality.
Accessibility of Water (H2O) and Untouchability in India
Authors: Sinha Kunal
Published: May 2023

Caste has always played an imperative role in shaping and reshaping the trajectories of any development in India. Scheduled Castes, or the lower castes, signify the categories devoid of resources generally confined to the upper caste in the social structure of Indian society. Due to the role of Dr B. R. Ambedkar in drafting the Indian Constitution, some rights and safeguards were granted to the lower castes, which comprise 16.6% of the total Indian population. From the 2001 census to 2011, the Scheduled Castes population increased by 20.8% (Express News Service, 2013). Through their policies, science, technology and innovation have often brought societal transformation by generating various avenues. The opportunity has remarkably influenced people’s habits and way of life. The hate and hate crime associated with the caste identity are practised explicitly and implicitly depending upon the circumstances. The so-called lower caste people are aware of the situation and cannot do anything to change the mindset of the so-called upper caste people.

The paper is not suggestive but engages primarily by referring to the context of discrimination meted out to the Scheduled Castes people for accessibility of water (H2O- two molecules of hydrogen and one molecule of oxygen). The untouchables, or the untouchability associated with them, have been subjected to and made to amalgamate with cultural, social and political status and interaction. Lower caste people are humiliated and killed for touching, entering temples, drawing water (H2O) from upper caste people’s wells, or, for that matter, lower caste children being segregated from other children in the school for the Mid-Day Meals have become so functional and way of life that it does not allow the society to come together and address barbaric mindsets and practices. The paper is based on secondary sources.
Cultivating Cultural Humility to Address the Healthcare Burnout Epidemic–Why It Matters
Authors: Elbanna May F , Thomas Melissa R , Patel Palka R , McHenry Megan S
Published: May 2023

Physician burnout is a major problem that has long been facing our healthcare system. The COVID-19 pandemic has unfortunately deepened this problem and shed the light on the multiple structural shortcomings of our healthcare system that need immediate attention. Demoralization is one of the core features of “physician burnout,” which results from a breakdown of genuine physician-patient interaction. A healthcare system that embraces cultural humility, where we find ourselves rewarded for supporting, uplifting, and respecting our patients’ diverse voices could pave the way for battling burnout. Unlike cultural competency, which suggests that one should know everything about another’s culture (an unfeasible task), cultural humility is a continuum of self-reflection and critique that aims to foster a deep connection between the physician and patient; a connection that sits at the core of the humanistic and multicultural experience of medicine.
A methodology to assess and select seismic fragility curves: Application to the case of Costa Rica
Authors: Navas-Sánchez Laura , Jiménez-Martínez Maribel , González-Rodrigo Beatriz , Hernández-Rubio Orlando , Dávila-Migoya Luis Diego , Orta-Rial Belén , Hidalgo-Leiva Diego
Published: May 2023

Different seismic risk studies have been carried out in the Central American region to quantify the human and economic losses caused by seismic events. The appropriate use of seismic fragility curves (FCs) allows a better approximation of the level of performance of a structural system in the face of seismic hazards. In this respect, an inadequate selection of FCs can lead to a notably unreliable estimation of damages and losses. This research contributes a methodology for assessing and selecting FCs for seismic risk studies from a catalog of existing proposals available in the literature. The methodology has been applied to the case study of Costa Rica, encompassing a bibliographic search, meetings with Central American experts, and the compilation of a catalog with the FCs used in different vulnerability projects. The conclusion drawn is that FCs with very different probabilities of damage are being used in the diverse vulnerability projects for buildings with the same attributes. Moreover, the proposed methodology allows knowing the reliability level of the FCs obtained depending on which class the curve was classified into based on its score. Therefore, it allows the adequacy and uncertainty related to the selected FCs to be established, a subject that researchers should consider in seismic vulnerability and risk studies.
Introduction to a How I Treat series on consultative hematology for inpatients
Authors: Hendrickson Jeanne E. , Ortel Thomas L.
Published: May 2023

Associate Editors Hendrickson and Ortel edited a How I Treat series on inpatient consultative hematology. In this timely series of articles, the authors present an approach to bleeding, thrombosis, anemia, and quantitative neutrophil abnormalities.
Comparison of the effects of electronic cigarette vapours and tobacco smoke extracts on human neutrophilsin vitro
Authors: Richards Guy A. , Theron Annette J. , van den Bout Iman , Anderson Ronald , Feldman Charles , van Zyl Smit Richard , Chang Ju-Wei , Tintinger Gregory R.
Published: May 2023

Background

Electronic cigarettes (ECs) are electronic aerosol delivery systems composed of nicotine and various chemicals, which are widely used to facilitate smoking cessation. Although ECs are considered safer than cigarettes, they do, however, contain chemical toxicants, some of which may interact with cells of the host's innate immune system of which neutrophils constitute a key component.

Methods

The current study was designed to compare the effects of aqueous EC aerosol extracts (ECEs; with or without nicotine) with those of cigarette smoke extract (CSE) on neutrophil and platelet reactivityin vitro.Neutrophil reactivity is characterised by the generation of reactive oxygen species (ROS), degranulation (elastase release) and the release of extracellular DNA (neutrophil extracellular trap (NET) formation: NETosis), which were measured using chemiluminescence, spectrophotometric and microscopic procedures, respectively. Platelet reactivity was measured according to the magnitude of upregulated expression of the adhesion molecule CD62P on activated cells using a flow cytometric procedure.

Results

Exposure of neutrophils to either ECEs or CSE caused a significant inhibition of ROS generation and elastase release byN-formyl-l-methionyl-l-leucyl-l-phenylalanine (1 µM)-activated neutrophils. Pre-treatment of neutrophils with CSE also resulted in a marked attenuation of phorbol 12-myristate 13-acetate (6.25 nM)-mediated release of extracellular DNA, which was unaffected by the ECEs. Similarly, CSE, but not the ECEs, inhibited the expression of CD62P by platelets activated with ADP (100 µM).

Conclusions

These observations suggest that ECE aerosols may inhibit some of the immuno-protective activities of neutrophils such as ROS production and elastase release by activated cells, the effect of which was not enhanced by inclusion of nicotine. The inhibitory effects of CSE were significantly more pronounced than those of ECEs, especially so for suppression of NET formation and platelet activation. If operativein vivo, these harmful immunosuppressive effects of ECEs may compromise intrinsic pulmonary antimicrobial defence mechanisms, albeit less so than cigarette smoke.
A typology of healthcare pathways after hospital discharge for adults with COVID-19: the evolution of UK services during pandemic conditions
Authors: Houchen-Wolloff Linzy , Overton Charlotte , Ibbetson Andrew , Walters Archie , Hastie Claire , Gill Rhyan , Armstrong Natalie , Singh Sally , Little Paul , Evans Kirby , Pimm John , Marks Michael , Poinasamy Krisnah , Walker Sam , Briggs Andrew , Evans Rachael A.
Published: May 2023

Introduction

Over half of post-COVID-hospitalisation adults have persistent symptoms 2 years after discharge, providing a challenge for individuals and healthcare systems. We therefore aimed to describe a typology of UK healthcare pathways post-hospital discharge as a first step towards understanding clinical effectiveness and cost-effectiveness of different healthcare pathways.

Methods

In 2021, we surveyed hospital sites taking part in the UK Post-hospital COVID-19 (PHOSP-COVID) study. The online survey explored the availability of proactive follow-up, patient selection, involvement of multidisciplinary teams, investigations, assessment and access to mental health and rehabilitation interventions. The typology was defined by a three-stage process: 1) using the survey results to develop a bespoke algorithm to inform a draft classification, 2) a stakeholder event for refinement and 3) finalisation between the Project Advisory Group and research team. The bespoke algorithm was used to map each site onto the classification with further mapping by level of mental health and rehabilitation provision.

Results

70% of hospital sites (45 out of 64) responded to the survey. 82% (37 out of 45) reported delivering a follow-up service after hospital discharge during the first few months of the pandemic. Only 13 out of 37 services (35%) were delivered by permanent staff. The final typology of five categories included no proactive follow-up, and a matrix of four groups based on patient selection (prespecified subgroup/all patients) and complexity of assessment (low/high). The complexity of assessment, rehabilitation and mental health interventions was variable within sites.

Discussion

We describe the first typology of post-hospitalisation COVID-19 healthcare pathways to enable modelling of clinical effectiveness and cost-effectiveness to inform future policy. Our results highlight the heterogeneity and vulnerability of healthcare services after COVID-19 hospitalisation.
Exercise responses and mental health symptoms in COVID-19 survivors with dyspnoea
Authors: Milne Kathryn M. , Cowan Juthaporn , Schaeffer Michele R. , Voduc Nha , Corrales-Medina Vicente , Lavoie Kim L. , Chirinos Julio A. , Puyat Joseph H. , Abdallah Sara J. , Guenette Jordan A.
Published: May 2023

Objectives

Dyspnoea is a common persistent symptom post-coronavirus disease 2019 (COVID-19) illness. However, the mechanisms underlying dyspnoea in the post-COVID-19 syndrome remain unclear. The aim of our study was to examine dyspnoea quality and intensity, burden of mental health symptoms, and differences in exercise responses in people with and without persistent dyspnoea following COVID-19.

Methods

49 participants with mild-to-critical COVID-19 were included in this cross-sectional study 4 months after acute illness. Between-group comparisons were made in those with and without persistent dyspnoea (defined as modified Medical Research Council dyspnoea score ≥1). Participants completed standardised dyspnoea and mental health symptom questionnaires, pulmonary function tests, and incremental cardiopulmonary exercise testing.

Results

Exertional dyspnoea intensity and unpleasantness were increased in the dyspnoea group. The dyspnoea group described dyspnoea qualities of suffocating and tightness at peak exercise (p<0.05). Ventilatory equivalent for carbon dioxide (VʹE/VʹCO2) nadir was higher (32±5versus28±3, p<0.001) and anaerobic threshold was lower (41±12versus49±11% predicted maximum oxygen uptake, p=0.04) in the dyspnoea group, indicating ventilatory inefficiency and deconditioning in this group. The dyspnoea group experienced greater symptoms of anxiety, depression and post-traumatic stress (all p<0.05). A subset of participants demonstrated gas-exchange and breathing pattern abnormalities suggestive of dysfunctional breathing.

Conclusions

People with persistent dyspnoea following COVID-19 experience a specific dyspnoea quality phenotype. Dyspnoea post-COVID-19 is related to abnormal pulmonary gas exchange and deconditioning and is linked to increased symptoms of anxiety, depression and post-traumatic stress.
Immunoprofiling bronchoalveolar lavage cells reveals multifaceted smoking-associated immune dysfunction
Authors: Smith Randall , Yendamuri Sai , Vedire Yeshwanth , Rosario Spencer , Zollo Robert , Washington Deschana , Sass Stephanie , Ivanick Nathaniel M. , Reid Mary , Barbi Joseph
Published: May 2023

Background

Bronchoalveolar lavage (BAL) is an underutilised tool in the search for pulmonary disease biomarkers. While leukocytes with effector and suppressor function play important roles in airway immunity and tumours, it remains unclear if frequencies and phenotypes of BAL leukocytes can be useful parameters in lung cancer studies and clinical trials. We therefore explored the utility of BAL leukocytes as a source of biomarkers interrogating the impact of smoking, a major lung cancer risk determinant, on pulmonary immunity.

Methods

In this “test case” observational study, BAL samples from 119 donors undergoing lung cancer screening and biopsy procedures were evaluated by conventional and spectral flow cytometry to exemplify the comprehensive immune analyses possible with this biospecimen. Proportions of major leukocyte populations and phenotypic markers levels were found. Multivariate linear rank sum analysis considering age, sex, cancer diagnosis and smoking status was performed.

Results

Significantly increased frequencies of myeloid-derived suppressor cells and PD-L1-expressing macrophages were found in current and former smokers compared to never-smokers. While cytotoxic CD8 T-cells and conventional CD4 helper T-cell frequencies were significantly reduced in current and former smokers, expression of immune checkpoints PD-1 and LAG-3 as well as Tregs proportions were increased. Lastly, the cellularity, viability and stability of several immune readouts under cryostorage suggested BAL samples are useful for correlative end-points in clinical trials.

Conclusions

Smoking is associated with heightened markers of immune dysfunction, readily assayable in BAL, that may reflect a permissive environment for cancer development and progression in the airway.
High use of short-acting β2-agonists in COPD is associated with an increased risk of exacerbations and mortality
Authors: Janson Christer , Wiklund Fredrik , Telg Gunilla , Stratelis Georgios , Sandelowsky Hanna
Published: May 2023

Background

Short-acting β2-agonist (SABA) overuse has been associated with an increased risk of exacerbations in asthma; however, less is known about SABA use in COPD. Our aim was to describe SABA use and investigate potential associations between high SABA use and the risk of future exacerbations and mortality in COPD.

Methods

This observational study identified COPD patients in primary care medical records in Sweden. Data were linked to the National Patient Registry, the Prescribed Drug Registry and the Cause of Death Registry. The index date was 12 months after the date of COPD diagnosis. During a 12-month prior to index baseline period, information on SABA use was collected. Patients were followed with respect to exacerbations and mortality for 12 months post index.

Results

Of the 19 794 COPD patients included (mean age 69.1 years, 53.3% females), 15.5% and 7.0% had collected ≥3 or ≥6 SABA canisters during the baseline period, respectively. A higher level of SABA use (≥6 canisters) was independently associated with a higher risk of both moderate and severe exacerbations (hazard ratio (HR) 1.28 (95% CI 1.17‒1.40) and 1.76 (95% CI 1.50‒2.06), respectively) during follow-up. In total, 673 (3.4%) patients died during the 12-month follow-up period. An independent association was found between high SABA use and overall mortality (HR 1.60, 95% CI 1.07‒2.39). This association, however, was not found in patients using inhaled corticosteroids as maintenance treatment.

Conclusion

In COPD patients in Sweden, high SABA use is relatively common and associated with a higher risk of exacerbations and all-cause mortality.
Patient attitudes to nebulised antibiotics in the treatment of bronchiectasis: a mixed-methods study
Authors: Davison John , Robinson-Barella Anna , Davies Gareth , Campos-Hinojosa Marina , Collins Camille , Husband Andy , Okeowo Daniel , Hester Katy L.M. , Lee Richard , Rapley Tim , De Soyza Anthony
Published: May 2023

Background

Regular daily nebulised antibiotics are widely used in managing bronchiectasis. This patient population typically has severe bronchiectasis requiring multiple other medications. Given that little is known about patients’ views and preferences for such therapies, this was the focus of our study.

Methods

To explore patient lived-experience using nebulised antibiotics, focus groups and semi-structured interviews were conducted with patients and carers; these were audio-recorded and transcribed to enable thematic analysis. QSR NVivo software facilitated data management. The themes developed from the qualitative data analysis were then used to co-design a questionnaire to capture attitudes and preferences towards nebulised therapy. Questionnaires were completed by patients and statistical analysis was performed. Ethical approval was obtained (13/WS/0036).

Results

The study's focus groups comprised 13 patients and carers, and 101 patients completed the questionnaire. Patients described nebulised therapy as an imposition on their daily routine, in turn affecting reported rates of adherence. Results demonstrated that 10% of all patients using nebulised antibiotics found these hard/very hard to administer. Further, 53% of participants strongly agreed/agreed that they would prefer an antibiotic delivered by an inhaler over a nebuliser, if it were as effective at preventing exacerbations. Notably, only 10% of participants wished to remain on nebulised therapy.

Conclusions

Inhaled antibiotics deliveredviadry powder devices were deemed quicker and easier to use by patients. Providing they were at least as effective as current nebulised treatments, patients deemed inhaled antibiotics to be a preferable treatment option.
An undifferentiated cause of rhabdomyolysis: a case report
Authors: Patil Pallavi , Davidson Jennifer , Patel Sundip
Published: May 2023

Background

Rhabdomyolysis can occur secondary to infections, trauma, or myotoxic substances. Rhabdomyolysis secondary to autoimmune myositis occurs rarely. Distinguishing autoimmune rhabdomyolysis from rhabdomyolysis secondary to other causes is paramount in considering the long-term management of autoimmune rhabdomyolysis. It is further important to continue close follow-up and further testing to completely understand the extent of this disease as diagnoses may be ever-changing.

Case presentation

A previously healthy female presented to the hospital with myalgias and myoglobinuria following a respiratory infection treated with azithromycin and promethazine. Labs demonstrating elevated creatine kinase (CK) prompted treatment for rhabdomyolysis and rheumatology consultation. The patient was given 3 l of intravenous (IV) 0.9% sodium chloride in the Emergency Department. Upon admission, the patient was placed on a continuous IV drip of 0.9% sodium chloride running at 300 cc/hour for all 8 days of her hospital admission. The rheumatology autoantibody panel pointed towards autoimmune myositis as a potential cause of her rhabdomyolysis. The patient was discharged to follow up with rheumatology for further testing.

Conclusion

Autoimmune myositis, although less common than other etiologies of rhabdomyolysis, is important to consider as the long-term management of autoimmune myositis includes the use of immunosuppressants, antimalarials, or IV immunoglobulins, which may be inappropriate for other etiologies of rhabdomyolysis.
Low impact of polyploidization on the transcriptome of synthetic allohexaploid wheat
Authors: Banouh Meriem , Armisen David , Bouguennec Annaig , Huneau Cécile , Sow Mamadou Dia , Pont Caroline , Salse Jérôme , Civáň Peter
Published: May 2023

Background

Bread wheat is a recent allohexaploid (genomic constitution AABBDD) that emerged through a hybridization between tetraploidTriticum turgidum(AABB) and diploidAegilops tauschii(DD) less than 10,000 years ago. The hexaploidization can be re-created artificially, producing synthetic wheat that has been used to study immediate genomic responses to polyploidization. The scale of the consequences of polyploidization, and their mechanism of establishment, remain uncertain.

Results

Here we sampled several synthetic wheats from alternative parental genotypes and reciprocal crosses, and examined transcriptomes from two different tissues and successive generations. We did not detect any massive reprogramming in gene expression, with only around 1% of expressed genes showing significant differences compared to their lower-ploidy parents. Most of this differential expression is located on the D subgenome, without consistency in the direction of the expression change. Homoeolog expression bias in synthetic wheat is similar to the pattern observed in the parents. Both differential expression and homoeolog bias are tissue-specific. While up to three families of transposable elements became upregulated in wheat synthetics, their position and distance are not significantly associated with expression changes in proximal genes.

Discussion

While only a few genes change their expression pattern after polyploidization, they can be involved in agronomically important pathways. Alternative parental combinations can lead to opposite changes on the same subset of D-located genes, which is relevant for harnessing new diversity in wheat breeding. Tissue specificity of the polyploidization-triggered expression changes indicates the remodelling of transcriptomes in synthetic wheat is plastic and likely caused by regulome interactions rather than permanent changes. We discuss the pitfalls of transcriptomic comparisons across ploidy levels that can inflate the de-regulation signal.

Conclusions

Transcriptomic response to polyploidization in synthetic AABBDD wheat is modest and much lower than some previous estimates. Homoeolog expression bias in wheat allohexaploids is mostly attributed to parental legacy, with polyploidy having a mild balancing effect.
AST/ALT ratio, APRI, and FIB-4 compared to FibroScan for the assessment of liver fibrosis in patients with chronic hepatitis B in Bandar Abbas, Hormozgan, Iran
Authors: Moosavy Seyed Hamid , Eftekhar Ebrahim , Davoodian Parivash , Nejatizadeh Abdolazim , Shadman Mohammad , Zare Shahram , Nazarnezhad Mirza Ali
Published: May 2023

Background

Chronic hepatitis B (CHB) is a significant risk factor for liver-related disorders. Hepatic fibrosis staging by liver biopsy in these patients can lead to complications. This study aimed to compare aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, AST to platelet ratio index (APRI), and fibrosis-4 (FIB-4) with FibroScan results for the evaluation of hepatic fibrosis in CHB patients.

Methods

This cross-sectional study included patients with CHB referred to the outpatient clinics of Bandar Abbas, Hormozgan, Iran, in 2021. The age and sex of the participants were noted. FibroScan evaluation was done for all subjects. Moreover, AST, ALT, and platelet counts were measured in their blood samples within one month of the FibroScan evaluation.

Results

Of the 267 CHB patients evaluated in the present study (mean age: 45.45 ± 18.16 years), 173 (64.8%) were male. According to FibroScan results, 65 CHB patients (24.3%) had F1, 53 (19.9%) F2, 38 (14.2%) F3, and 20 (7.5%) F4 liver fibrosis. There was a significant correlation between FibroScan results and the three indices of AST/ALT ratio, APRI, and FIB-4 (P < 0.001), with the strongest correlation between FibroScan results and APRI (r = 0.682). With an area under the receiver operating characteristic (AUROC) curve of 0.852 (95% confidence interval [CI] 0.807; 0.897, P < 0.001), APRI ≥ 0.527 had the best diagnostic accuracy (77.15%) for the detection of any grade of liver fibrosis. Although the AUROC curve of APRI and FIB-4 was similar (0.864) for distinguishing between F3/F4 and F0-F2 of liver fibrosis, FIB-4 had the best diagnostic accuracy (82.02%).

Conclusions

APRI can rule out 95.4% of F3/F4 of liver fibrosis and rule in any grade of liver fibrosis in CHB patients by 90.78%. Therefore, APRI appears to be the best substitute for FibroScan in the assessment of liver fibrosis in patients with CHB.
COVID-19 vaccine hesitancy and social contact patterns in Pakistan: results from a national cross-sectional survey
Authors: Quaife Matthew , Torres-Rueda Sergio , Dobreva Zlatina , van Zandvoort Kevin , Jarvis Christopher I. , Gimma Amy , Zulfiqar Wahaj , Khalid Muhammad , Vassall Anna
Published: May 2023

Background

Vaccination is a key tool against COVID-19. However, in many settings it is not clear how acceptable COVID-19 vaccination is among the general population, or how hesitancy correlates with risk of disease acquisition. In this study we conducted a nationally representative survey in Pakistan to measure vaccination perceptions and social contacts in the context of COVID-19 control measures and vaccination programmes.

Methods

We conducted a vaccine perception and social contact survey with 3,658 respondents across five provinces in Pakistan, between 31 May and 29 June 2021. Respondents were asked a series of vaccine perceptions questions, to report all direct physical and non-physical contacts made the previous day, and a number of other questions regarding the social and economic impact of COVID-19 and control measures. We examined variation in perceptions and contact patterns by geographic and demographic factors. We describe knowledge, experiences and perceived risks of COVID-19. We explored variation in contact patterns by individual characteristics and vaccine hesitancy, and compared to patterns from non-pandemic periods.

Results

Self-reported adherence to self-isolation guidelines was poor, and 51% of respondents did not know where to access a COVID-19 test. Although 48.1% of participants agreed that they would get a vaccine if offered, vaccine hesitancy was higher than in previous surveys, and greatest in Sindh and Baluchistan provinces and among respondents of lower socioeconomic status. Participants reported a median of 5 contacts the previous day (IQR: 3–5, mean 14.0, 95%CI: 13.2, 14.9). There were no substantial differences in the number of contacts reported by individual characteristics, but contacts varied substantially among respondents reporting more or less vaccine hesitancy. Contacts were highly assortative, particularly outside the household where 97% of men's contacts were with other men. We estimate that social contacts were 9% lower than before the COVID-19 pandemic.

Conclusions

Although the perceived risk of COVID-19 in Pakistan is low in the general population, around half of participants in this survey indicated they would get vaccinated if offered. Vaccine impact studies which do not account for correlation between social contacts and vaccine hesitancy may incorrectly estimate the impact of vaccines, for example, if unvaccinated people have more contacts.
Diagnosis and treatment of filamentary keratitis in a patient with Demodex infestation––an overlooked risk factor: a case report
Authors: Chen Jin , Yao Qinke , Chen Junzhao , Li Yimin
Published: May 2023

Background

Filamentary keratitis is an ocular condition that is tricky to handle for the difficulty to find the underlying cause. Here we report a case of filamentary keratitis associated with Demodex infestation which highlights the importance of Demodex mites as an easily-overlooked risk factor.

Case presentation

A 63-year-old woman had recurrent symptoms of foreign body sensation and sometimes painful feelings in her left eye soon after her surgical correction of ptosis in this eye. She was then diagnosed as conjunctivitis and given antibiotic eye drops. After one week, the patient complained of aggravation of symptoms with small corneal filaments in the left eye under slit-lamp examination. Despite the removal of filaments and addition of topical corticosteroids and bandage contact lenses, the patient’s condition persisted with enlarged filaments and severe ocular discomfort. 3 days later, eyelashes with cylindrical dandruff were noticed and Demodex infestation was confirmed by microscopic examination of these eyelashes at our clinic this time. She was asked to use tea tree oil lid scrub twice daily. After 3 weeks, her filamentary keratitis was resolved with a dramatic improvement in symptoms and signs. And no recurrence of filamentary keratitis was noticed during the one-year follow-up.

Conclusions

In this case, filamentary keratitis was resolved only with treatment of Demodex infestation while conventional treatment failed. Considering the fact that Demodex infestation is a common but easily overlooked condition, it may be suggestive to take Demodex infestation into account as a risk factor of filamentary keratitis, especially in refractory cases.
The effect of cognitive behavioral therapy on depression and anxiety of women with polycystic ovary syndrome: a randomized controlled trial
Authors: Majidzadeh Sheida , Mirghafourvand Mojgan , Farvareshi Mahmoud , Yavarikia Parisa
Published: May 2023

Introduction

Women’s mental health has a significant impact on the health of society. Due to the prevalence of mental health problems in women with PCOS, this study aimed to determine the effect of cognitive behavioral therapy on depression and anxiety (primary outcomes) and quality of life (secondary outcomes) in women with polycystic ovary syndrome.

Methods

This randomized controlled trial was performed on 84 patients with PCOS referred to Al-Zahra Hospital in Tabriz-Iran, 2021. Participants were randomly assigned to intervention (n = 42) and control (n = 42) groups. Counseling with cognitive behavioral therapy was provided in 8 sessions of 60–90 min weekly in groups with 5 to 7 people in each group for the intervention group. Spielberger State-Trait Anxiety, Beck Depression, and Quality of Life Questionnaire for women with polycystic ovary syndrome (PCOSQ) were used to collect data. Independent t-test and ANCOVA were used to compare the outcomes between the two groups.

Results

After the intervention, based on ANCOVA test with adjusting the baseline values, mean scores of depression (mean difference (MD): -18.6; 95% confidence interval (95% CI): -19.4 to -17.8: P < 0.001), trait anxiety (MD: -15.0; 95% CI: -16.0 to -13.9; P < 0.001), and state anxiety (MD: -15.3; 95% CI: -16.2 to -14.3; P < 0.001), were significantly lower in the intervention group compared to the control group. The mean score of quality of life (MD: 19.25; 95% CI: 17.66 to 20.84; P < 0.001) was significantly higher in the intervention group compared to the control group.

Conclusion

This study showed that CBT was effective in reducing depression and anxiety and improving the quality of life. Therefore it is recommended that health care providers use this approach to improve the mental health and quality of life of women with PCOS.

Trial registration

Iranian Registry of Clinical Trials (IRCT): IRCT20110826007418N7. Date of registration: 25/10/2021. URL: https://en.irct.ir/trial/57348; Date of first registration: 25/10/2021.
Patients’ experiences with a community fruit and vegetable box program prescribed by their health provider
Authors: Johnson Jennifer K. , Vingilis Evelyn , Terry Amanda L.
Published: May 2023

Background

Food insecurity is “the state of being without reliable access to a sufficient quantity of affordable, nutritious food”. Observational studies have associated food insecurity with many negative health effects including the development and exacerbations of chronic diseases, higher health care use and increased mortality. Health care providers prescribing food is a growing area of interest and research, however it is not known how patients feel about receiving fruit and vegetable prescriptions (FVRx) from their health provider versus other means of food provision. This pilot study was conducted to explore the experiences and opinions of Canadian adults with food insecurity who were recipients of a FVRx box program prescribed by their health provider.

Methods

Potential participants were recruited to 3 focus groups using flyers included in their monthly food box. Questions were kept open to encourage participation of all group members. The focus groups were audiotaped, transcribed verbatim, and analyzed by the research team using descriptive qualitative research methodology.

Results

Participants described shame and frustration trying to obtain enough food through local food banks. In comparison, they perceived their team dietitian, family physician or addictions physician as directly helping them with their health by prescribing food. The boxed fruit and vegetables were prepared in many ways and often shared to reduce waste and to reduce the food insecurity of extended family members. Positive effects of the FVRx on physical and mental health were reported. Participants believed that follow up with their health provider helped support them and their behavioural changes towards better nutrition. Limitations of the program included lack of choice, non-flexible pick-up times and the program being limited to 6 months. Being able to choose their own fruit and vegetables, instead of receiving a set box, was suggested by most to help meal planning and to increase autonomy.

Conclusions

Health providers prescribing FVRx boxes to adult patients with food insecurity was positively received in this study. Evaluation of similar programs in other regions in Canada and internationally, and comparison of food prescriptions to basic income guarantee programs is recommended.
An application of social marketing for promoting HIV testing in Iran
Authors: Alipour Fatemeh , Shams Mohsen , Maleki Mostafa , Mousavizadeh Ali
Published: May 2023

Background

It has been estimated that 60,000 Iranians have been infected with HIV/AIDS and only 36% of them are aware of their status. This study aimed to design, implement and evaluate a social marketing campaign to promote HIV testing in Boyer-Ahmad County, Kohgiluyeh, and Boyer-Ahmad Province, southwest of Iran.

Materials and methods

This study was a quasi-experimental pretest-posttest without a control group, developed based on a social marketing assessment and response tool. To design the intervention formative research was conducted, comprised of four focus group discussion sessions with 42 participants of the target community along with seven in-depth semi-structured personal interviews with health care providers involved in the HIV/AIDS Program. Data analysis was done manually using content analysis and the main content was formulated for the campaign. Afterward, the slogan and messages of the campaign were developed. The campaign’s materials including banners, posters, pamphlets, referral forms, and short messages were designed, pretested, and revised. Ultimately, the campaign was conducted for one month in October 2019. To determine the effectiveness of the campaign, the rate of referrals to the Center for Behavioral Health Counseling Services (CBHCS), for three months before and after the campaign, was compared.

Results

Qualitative findings identified that the majority of the interviewees mentioned that the main reasons for the low rate of referrals to get tested for HIV were lack of awareness and information about HIV/AIDS and its diagnosis as well as the free and confidential tests available from the CBHCS. Moreover, the stigma associated with HIV/AIDS was another important reason for low referrals for testing. The rate of referrals for HIV testing in the three months leading up to the campaign was 18, 32, and 23 people, and three months after the campaign was 64, 81, and 44 individuals; respectively. The results of the multivariate analysis demonstrated that the campaign had increased the rates of referrals for HIV testing through its significant influence on females, and individuals with academic degrees.

Conclusion

It can be concluded that the social marketing campaign was successful in persuading people to get tested for HIV.
Effects of air pollution control policies on intracerebral hemorrhage mortality among residents in Tianjin, China
Authors: Xu Jiahui , Yin Xiaolin , Jiang Tingting , Wang Shiyu , Wang Dezheng
Published: May 2023

Background

Exposure to air pollution is an important risk factor for intracerebral hemorrhage (ICH), which is a major cause of death worldwide. However, the relationship between ICH mortality and air quality improvement has been poorly studied. This study aims to evaluate the impact of the air pollution control policies in the Beijing-Tianjin-Hebei region on ICH mortality among Tianjin residents.

Methods

This study used an interrupted time series analysis. We fitted autoregressive integrated moving average (ARIMA) models to assess the changes in ICH deaths before and after the interventions of air pollution control policies based on the data of ICH deaths in Tianjin collected by the Tianjin Center for Disease Control and Prevention.

Results

Between 2009 and 2020, there were 63,944 ICH deaths in Tianjin, and there was an overall decreasing trend in ICH mortality. The intervention conducted in June 2014 resulted in a statistically significant (p = 0.03) long-term trend change, reducing the number of deaths from ICH by 0.69 (95% confidence interval [CI]: -1.30 to -0.07) per month. The intervention in October 2017 resulted in a statistically significant (p = 0.04) immediate decrease of 25.74 (95% CI: -50.62 to -0.85) deaths from ICH in that month. The intervention in December 2017 caused a statistically significant (p = 0.04) immediate reduction of 26.58 (95% CI: -52.02 to -1.14) deaths from ICH in that month. The intervention in March 2018 resulted in a statistically significant (p = 0.02) immediate decrease of 30.40 (95% CI: -56.41 to -4.40) deaths from ICH in that month. No significant differences were observed in the changes of male ICH mortality after any of the four interventions. However, female ICH deaths showed statistically significant long-term trend change after the intervention in June 2014 and immediate changes after the interventions in December 2017 and March 2018. Overall, the interventions prevented an estimated 5984.76 deaths due to ICH.

Conclusion

During the study period, some interventions of air pollution control policies were significantly associated with the reductions in the number of deaths from ICH among residents in Tianjin. ICH survivors and females were more sensitive to the protective effects of the interventions. Interventions for air pollution control can achieve public health gains in cities with high levels of air pollution.