bluuebunny/crossref_metadata_2025 huggingface dataset:
CNVind: an open source cloud-based pipeline for rare CNVs detection in whole exome sequencing data based on the depth of coverage
Authors: Kuśmirek Wiktor , Nowak Robert
Published: March 2022

Background

A typical Copy Number Variations (CNVs) detection process based on the depth of coverage in the Whole Exome Sequencing (WES) data consists of several steps: (I) calculating the depth of coverage in sequencing regions, (II) quality control, (III) normalizing the depth of coverage, (IV) calling CNVs. Previous tools performed one normalization process for each chromosome—all the coverage depths in the sequencing regions from a given chromosome were normalized in a single run.

Methods

Herein, we present the new CNVind tool for calling CNVs, where the normalization process is conducted separately for each of the sequencing regions. The total number of normalizations is equal to the number of sequencing regions in the investigated dataset. For example, when analyzing a dataset composed ofnsequencing regions, CNVind performsnindependent depth of coverage normalizations. Before each normalization, the application selects thekmost correlated sequencing regions with the depth of coverage Pearson’s Correlation as distance metric. Then, the resulting subgroup of$$k+1$$k+1sequencing regions is normalized, the results of allnindependent normalizations are combined; finally, the segmentation and CNV calling process is performed on the resultant dataset.

Results and conclusions

We used WES data from the 1000 Genomes project to evaluate the impact of independent normalization on CNV calling performance and compared the results with state-of-the-art tools: CODEX and exomeCopy. The results proved that independent normalization allows to improve the rare CNVs detection specificity significantly. For example, for the investigated dataset, we reduced the number of FP calls from over 15,000 to around 5000 while maintaining a constant number of TP calls equal to about 150 CNVs. However, independent normalization of each sequencing region is a computationally expensive process, therefore our pipeline is customized and can be easily run in the cloud computing environment, on the computer cluster, or the single CPU server. To our knowledge, the presented application is the first attempt to implement an innovative approach to independent normalization of the depth of WES data coverage.
Transcriptional response of murine microglia in Alzheimer’s disease and inflammation
Authors: Shippy Daniel C. , Watters Jyoti J. , Ulland Tyler K.
Published: March 2022

Background

Alzheimer’s disease (AD) is a neurodegenerative disorder and is the most common cause of late-onset dementia. Microglia, the primary innate immune cells of the central nervous system (CNS), have a complex role in AD neuropathology. In the initial stages of AD, microglia play a role in limiting pathology by removing amyloid-β (Aβ) by phagocytosis. In contrast, microglia also release pro-inflammatory cytokines and chemokines to promote neuroinflammation and exacerbate AD neuropathology. Therefore, investigating microglial gene networks could identify new targets for therapeutic strategies for AD.

Results

We identified 465 differentially expressed genes (DEG) in 5XFAD versus wild-type mice by microarray, 354 DEG in lipopolysaccharide (LPS)-stimulated N9 microglia versus unstimulated control cells using RNA-sequencing (RNA-seq), with 32 DEG common between both datasets. Analyses of the 32 common DEG uncovered numerous molecular functions and pathways involved in Aβ phagocytosis and neuroinflammation associated with AD. Furthermore, multiplex ELISA confirmed the induction of several cytokines and chemokines in LPS-stimulated microglia.

Conclusions

In summary, AD triggered multiple signaling pathways that regulate numerous genes in microglia, contributing to Aβ phagocytosis and neuroinflammation. Overall, these data identified several regulatory factors and biomarkers in microglia that could be useful in further understanding AD neuropathology.
Taxonomic distribution and evolutionary analysis of the equol biosynthesis gene cluster
Authors: Dufault-Thompson Keith , Hall Brantley , Jiang Xiaofang
Published: March 2022

Background

Equol, an isoflavonoid metabolite with possible health benefits in humans, is known to be produced by some human gut bacteria. While the genes encoding the equol production pathway have been characterized in a few bacterial strains, a systematic analysis of the equol production pathway is currently lacking.

Results

This study presents an analysis of the taxonomic distribution and evolutionary history of the gene cluster encoding the equol production pathway. A survey for equol gene clusters within the Genome Taxonomy Database bacterial genomes and human gut metagenomes resulted in the identification of a highly conserved gene cluster found in nine bacterial species from the Eggerthellaceae family. The identified gene clusters from human gut metagenomes revealed potential variations in the equol gene cluster organization and gene content within the equol-producing Eggerthellaceae clades. Subsequent analysis showed that in addition to the four genes directly involved in equol production, multiple other genes were consistently found in the equol gene clusters. These genes were predicted to encode a putative electron transport complex and hydrogenase maturase system, suggesting potential roles for them in the equol production pathway. Analysis of the gene clusters and a phylogenetic reconstruction of a putative NAD kinase gene provided evidence of the recent transfer of the equol gene cluster from a basal Eggerthellaceae species to Slackia_A equolifaciens, Enteroscipio sp000270285, and Lactococcus garvieae 20–92.

Conclusions

This analysis demonstrates that the highly conserved equol gene cluster is taxonomically restricted to the Eggerthellaceae family of bacteria and provides evidence of the role of horizontal gene transfer in the evolutionary history of these genes. These results provide a foundation for future studies of equol production in the human gut and future efforts related to bioengineering and the use of equol-producing bacteria as probiotics.
Does physical exercise improve or deteriorate treatment of multiple sclerosis with mitoxantrone? Experimental autoimmune encephalomyelitis study in rats
Authors: El-Emam Mohamed A. , El Achy Samar , Abdallah Dalaal M. , El-Abhar Hanan S. , Gowayed Mennatallah A.
Published: March 2022

Background

Mitoxantrone has proved efficacy in treatment of multiple sclerosis (MS). The fact that physical exercise could slow down the progression of disease and improve performance is still a debatable issue, hence; we aimed at studying whether combining mitoxantrone with exercise is of value in the management of MS.

Methods

Thirty-six male rats were divided into sedentary and exercised groups. During a 14-day habituation period rats were subjected to exercise training on a rotarod (30 min/day) before Experimental Autoimmune Encephalomyelitis (EAE) induction and thereafter for 17 consecutive days. On day 13 after induction, EAE groups (exercised &sedentary) were divided into untreated and mitoxantrone treated ones. Disease development was evaluated by motor performance and EAE score. Cerebrospinal fluid (CSF) was used for biochemical analysis. Brain stem and cerebellum were examined histopathological and immunohistochemically.

Results

Exercise training alone did not add a significant value to the studied parameters, except for reducing Foxp3 immunoreactivity in EAE group and caspase-3 in the mitoxantrone treated group. Unexpectedly, exercise worsened the mitoxantrone effect on EAE score, Bcl2 and Bax. Mitoxantrone alone decreased EAE/demyelination/inflammation scores, Foxp3 immunoreactivity, and interleukin-6, while increased the re-myelination marker BDNF without any change in tumor necrosis factor-α. It clearly interrupted the apoptotic pathway in brain stem, but worsened EAE mediated changes of the anti-apoptotic Bcl2 and pro-apoptotic marker Bax in the CSF.

Conclusions

The neuroprotective effect of mitoxantrone was related with remyelination, immunosuppressive and anti-inflammatory potentials. Exercise training did not show added value to mitoxantrone, in contrast, it disrupts the apoptotic pathway.
Linking genome wide RNA sequencing with physio-biochemical and cytological responses to catalogue key genes and metabolic pathways for alkalinity stress tolerance in lentil (Lens culinaris Medikus)
Authors: Singh Dharmendra , Singh Chandan Kumar , Taunk Jyoti , Gaikwad Kishor , Singh Vijayata , Sanwal Satish Kumar , Karwa Sourabh , Singh Deepti , Sharma Parbodh Chander , Yadav Rajendra Kumar , Pal Madan
Published: March 2022

Background

Alkaline soils cause low productivity in crop plants including lentil. Alkalinity adaptation strategies in lentil were revealed when morpho-anatomical and physio-biochemical observations were correlated with transcriptomics analysis in tolerant (PDL-1) and sensitive (L-4076) cultivars at seedling stage.

Results

PDL-1 had lesser salt injury and performed better as compared to L-4076. Latter showed severe wilting symptoms and higher accumulation of Na+and lower K+in roots and shoots. PDL-1 performed better under high alkalinity stress which can be attributed to its higher mitotic index, more accumulation of K+in roots and shoots and less aberrantly dividing cells. Also, antioxidant enzyme activities, osmolytes’ accumulation, relative water content, membrane stability index and abscisic acid were higher in this cultivar. Differentially expressed genes (DEGs) related to these parameters were upregulated in tolerant genotypes compared to the sensitive one. Significantly up-regulated DEGs were found to be involved in abscisic acid (ABA) signalling and secondary metabolites synthesis. ABA responsive genes viz.dehydrin 1, 9-cis-epoxycarotenoid dioxygenase, ABA-responsive protein 18 and BEL1-like homeodomain protein 1 had log2fold change above 4.0. A total of 12,836 simple sequence repeats and 4,438 single nucleotide polymorphisms were identified which can be utilized in molecular studies.

Conclusions

Phyto-hormones biosynthesis—predominantly through ABA signalling, and secondary metabolism are the most potent pathways for alkalinity stress tolerance in lentil. Cultivar PDL-1 exhibited high tolerance towards alkalinity stress and can be used in breeding programmes for improving lentil production under alkalinity stress conditions.
Effect of implementing quality control management in the treatment of severely injured patients: a retrospective cohort study in a level I trauma center in China
Authors: Du Zhe , Wang Tianbing
Published: March 2022

Background

This study aimed to review the impact of quality control management on the treatment of severely injured patients.

Methods

A retrospective analysis was conducted on patients with severe injury (injury severity score [ISS] ≥ 16) between January 1, 2018 and February 1, 2020. The selected patients were stratified as follows. The patients who were admitted prior to the implementation of quality control management—from January 1 to December 31, 2018—were assigned to the PRE group; the POST group included patients who were admitted after the implementation—from February 1, 2019 to February 1, 2020. Quality control management was implemented from January 1, 2019 to January 31, 2019. Parameters were compared to account for differences in terms of demographics, surgical procedures, results of process quality, and 72-h mortality.

Results

This study included 599 patients (PRE group: 212 males and 86 females; POST group: 228 males and 73 females; P = 0.20). The extent of document completion was 97.3 and 100% in the PRE and POST groups, respectively (P < 0.001). There was no delay in the arrival of the trauma surgeons or the multidisciplinary team after implementation. However, following implementation of quality control management, there was a significant reduction in the duration of basic diagnostics, time until receipt of laboratory data, time until first computed tomography scan, time until intubation, and time until an emergency operation (P < 0.05). The deaths were caused by severe head injury (PRE: 5.4%, POST: 4%), hemorrhagic shock (PRE: 2.4%, POST: 0.7%), multiple-organ failure (PRE: 1.0%, POST: 0.3%), or other causes (PRE: 0.7%, POST: 0.0%). The 72-h mortality decreased after the implementation of quality control management (PRE vs. POST groups: 9.4 vs. 5.0%, P = 0.04).

Conclusions

The implementation of quality control management resulted in decreased time to critical interventions, improved patient care efficiency, and reduced early mortality. We recommend that this approach be replicated at other trauma centers in China.
Late antibody-mediated rejection in a kidney transplant recipient: COVID 19 induced?
Authors: Nourié Nicole , Nassereddine Hussein , Mouawad Sarah , Chebbou Louaa , Ghaleb Rita , Abbas Fatmeh , Azar Hiba
Published: March 2022

Background

Antibody-mediated rejection (AMR) was described in kidney transplant patients after viral infections, such as the cytomegalovirus. Very few cases were recently reported after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, probably in the context of lowering of immunosuppressive therapy. To date, no direct immunological link was proved to explain a connection between the coronavirus disease 19 (COVID-19) infection and antibody-mediated rejection (AMR) if it exists.

Case presentation

Here we try to find this association by presenting the case of a low immunological risk patient who presented, six years post-transplant, with c4d negative antibody mediated rejection due to an anti-HLA-C17 de novo donor specific antibody (DSA) after contracting the coronavirus disease 19.

The HLA-Cw17 activated the antibody-dependent cell-mediated cytotoxicity via the KIR2DS1 positive NK cells.

Discussion and conclusions

This case report may prove a direct role for COVID-19 infection in AMRs in the kidney transplant recipients, leading us to closely monitor kidney transplant recipients, especially if they have “at-risk” donor antigens.
Recurrent ligneous conjunctivitis after cataract surgery in a 67-year-old male patient: a case report
Authors: Maamri Amine , Zemova Elena , Moslemani Kayed , Flockerzi Fidelis , Seitz Berthold
Published: March 2022

Background

Ligneous conjunctivitis is a rare form of chronic pseudomembranous conjunctivitis which usually starts during infancy. We report on an unsual case of recurrent ligneous conjunctivitis after cataract surgery in a 67-year-old male patient.

Methods

The equipment used for the slit-lamp images was a Haag Streit slit lamp BX900 Sn 00,406 with 16 × magnifications. The used batch number of the camera was sn00406 and the software was from the company CCS Pawlowski Merge Eye. There were no filters used. The images were saved with a resolution of 300 DPI. Neither downstream nor averaging was used to enhance the resolution of the image in the case presentation section or the figure legend.

The equipment used for the cross-sectional histologic images was a Zeiss Axioskop 40 microscope with an objective lens Zeiss A-Plan × 20/0.45 (Zoom 6.3 × TV 2/3″″C). The used camera was AxioCam MRc5 and the software was ZEN 3.2. The cross-sectional histologic images were saved with a resolution of 2584 × 1936 Pixels. Neither downstream nor averaging was used to enhance the resolution of the image in the case presentation section or the figure legend.

Case presentation

This is a rare case report of ligneous conjunctivitis in a 67-year-old male patient who presented a recurrent conjunctival granuloma after five excisions following cataract surgery in his left eye. We performed a tumor excision with free conjunctival autograft. The histology showed a fibrin crust including macrophages, granulocytes, lymphocytes, and reactively altered squamous cell nests. These findings were consistent with a ″pseudomembrane in conjunctivitis lignosa″. We administered a topical combination of plasminactivator, heparin, cortisone and cyclosporine.

Conclusion

This treatment with the combination of plasminactivator, heparin, cortisone and cyclosporine has proven to be effective in preventing the recurrence of ligneous conjunctivitis.
Developing dynamic defocus curve for evaluating dynamic vision accommodative function
Authors: Wu Tingyi , Wang Yuexin , Wei Shanshan , Guo Yining , Li Xuemin
Published: March 2022

Background

To assess dynamic visual acuity (DVA) under different defocus statuses and explore the assessment of dynamic vision accommodation.

Methods

Twenty subjects (6 males and 14 females) aged 18 to 35 were recruited. Nonmydriatic subjective refraction (sphere and cylinder) and accommodative tests including negative relative accommodation (NRA), positive relative accommodation (PRA), binocular cross cylinder (BCC) and accommodative facility using a flipper were performed. Binocular static visual acuity (SVA) and DVA at 40 degrees per second (dps) were measured under different defocus statuses (+1.5D to -4D in -0.5D steps) based on the refractive error fully corrected. Static and dynamic defocus curves were plotted. The area under the curve (AUC) and corrected dynamic vision accommodation (CDVAc) were calculated.

Results

The study showed that the dynamic defocus curve fitted the cubic curve properly (p<0.001). DVA was significantly worse than SVA at all defocused statuses (p<0.001), and the difference was more significant at greater defocus diopters. Single factor analysis indicated that CDVAc was significantly correlated with NRA-PRA (p=0.012) and AUCdynamic (p<0.001). Significant associations were observed between AUCdynamic and PRA (p=0.013) as well as NRA-PRA (p=0.021). Meanwhile, DVA was positively correlated with PRA at 0D, -1.0D, -1.5D, -2.5D and -3.0D (p<0.05) and with NRA-PRA at 0D, -1.0D, -1.5D, -2.0D and -2.5D (p<0.05). Multiple factor regression analysis indicated that CDVAc (0D ~ -3.5D) and SVA (+1.5D ~ +1.0D & -2.5D ~ -4.0D) were significant influential factors for defocused DVA (p<0.05).

Conclusions

Our study demonstrated that DVA had a defocus curve similar to that of SVA. CDVAc was feasible for the assessment of dynamic vision accommodative function. The dynamic defocus curve test could efficiently be applied in the evaluation of dynamic visual performance under different defocus statuses.
Ecological momentary intervention to enhance emotion regulation in healthcare workers via smartphone: a randomized controlled trial protocol
Authors: Castilla Diana , Navarro-Haro María Vicenta , Suso-Ribera Carlos , Díaz-García Amanda , Zaragoza Irene , García-Palacios Azucena
Published: March 2022

Background

CUIDA-TE is an APP that offers transdiagnostic cognitive behavioral therapy focused on enhancing emotion regulation. As a novelty, it incorporates ecological momentary interventions (EMI), which can provide psychological support in real time, when suffering arises. The main goal of the study is to evaluate the efficacy of CUIDA-TE to improve emotion regulation in healthcare workers, a population that has been particularly emotionally impacted by the COVID-19 pandemic.

Methods

In this three-arm, randomized controlled trial (RCT) the study sample will be composed of a minimum of 174 healthcare workers. They will be randomly assigned to a 2-month EMI group (CUIDA-TE APP, n ≥ 58), a 2-month ecological momentary assessment (EMA) only group (MONITOR EMOCIONAL APP, n ≥ 58), or a wait-list control group (no daily monitoring nor intervention, n ≥ 58). CUIDA-TE will provide EMI if EMA reveals emotional problems, poor sleep quality/quantity, burnout, stress, or low perceived self-efficacy when regulating emotions. Depression will be the primary outcome. Secondary outcomes will include emotion regulation, quality of life, and resilience. Treatment acceptance and usability will also be measured. Primary and secondary outcomes will be obtained at pre- and post-intervention measurements, and at the 3-month follow-up for all groups.

Discussion

To our knowledge, this is the first RCT that evaluates the efficacy of an APP-based EMI to improve emotion regulation skills in healthcare workers. This type of intervention might ultimately help disseminate treatments and reach a larger number of individuals than traditional face-to-face individual therapies.

Trial registration

ClinicalTrial.gov: NCT04958941 Registered 7 Jun 2021.

Study status

Participant recruitment has not started.
Barriers and facilitators for treatment-seeking in adults with a depressive or anxiety disorder in a Western-European health care setting: a qualitative study
Authors: Waumans Ruth C. , Muntingh Anna D. T. , Draisma Stasja , Huijbregts Klaas M. , van Balkom Anton J. L. M. , Batelaan Neeltje M.
Published: March 2022

Background

Previous research on barriers and facilitators regarding treatment-seeking of adults with depressive and anxiety disorders has been primarily conducted in the Anglosphere. This study aims to gain insight into treatment-seeking behaviour of adults with depressive and anxiety disorders in a European healthcare system.

Methods

In-depth semi-structured interviews were conducted with 24 participants, aged ≥18 years and diagnosed with an anxiety disorder and/or depressive disorder according to DSM-IV. Participants were purposively sampled from an outpatient department for mental health care in the Netherlands. The seven steps of framework analysis were used to identify relevant themes emerging from the interviews.

Results

Data analysis suggested an interplay between individual aspects, personal social system, healthcare system and sociocultural context influences. Amongst the most relevant themes were mental health illiteracy, stigma, a negative attitude toward professional help, the influence of significant others and general practitioner, and waiting time. Financial barriers were not of relevance.

Conclusions

Even in a country with a well-developed mental health care system and in absence of financial barriers, there are many barriers to treatment-seeking in adult patients with depressive and anxiety disorders. National campaigns to increase awareness and decrease stigma in the general population, and to empower the social environment might reduce the treatment gap.
Investigating the associations between irritability and hot and cool executive functioning in those with ADHD
Authors: Colonna Silvia , Eyre Olga , Agha Sharifah Shameem , Thapar Anita , van Goozen Stephanie , Langley Kate
Published: March 2022

Background

Irritability is especially pertinent to those with Attention Deficit Hyperactivity Disorder (ADHD) as it is highly prevalent and associated with a more severe clinical presentation and poorer longitudinal outcomes. Preliminary evidence suggests that top-down cognitive processes taking place in emotional contexts (i.e., hot executive functions) as opposed to those evoked in abstract scenarios (i.e., cool executive functions) may be relevant to the presentation of irritability in ADHD. This study explored the cognitive mechanisms underlying irritability in young people with ADHD, hypothesising that irritability would be associated with hot, but not cool, executive function impairments.

Methods

Our sample included 219 individuals with ADHD. A composite irritability score was derived extracting items from a parent interview, with scores ranging from 0 to 5. Associations were investigated using linear regression analyses, between irritability and four hot tasks measuring sensitivity to risk, risk-taking behaviour following reward or punishment, acceptance of reward delay and reaction to unfair behaviour from others, and two cool tasks measuring set-shifting and motor inhibition.

Results

As hypothesised, there were no significant associations between irritability and cool executive functions in those with ADHD; however, contrary to expectations, there was also no significant evidence that hot executive functions were associated with irritability.

Conclusions

These results, in a large well characterised sample and using a comprehensive task battery, suggest that the variation in irritability in those with ADHD may not be associated with differences in hot or cool executive function performance.
Is patient activation a mediator of the effect of a health promoting intervention in adults at high risk of type 2 diabetes? A longitudinal path model analysis within a randomised trial
Authors: Frydenberg Morten , Maindal Helle Terkildsen , Fletcher Adam , Juul Lise
Published: March 2022

Background

Exploring mediators of preventive intervention effects has important implications for the planning of complex interventions. Our aim was to assess the extent to which knowledge, skills and confidence to manage health, here measured as “patient activation”, was a mediator of the effect of the intervention “Live your life without diabetes” on weight, waist circumference and systolic blood pressure at 12 months follow-up in adults at high risk of type 2 diabetes.

Methods

Autoregressive path models with three time points of measurement, and contemporaneous and constant b paths were used in a randomised controlled trial (RCT). The RCT took place in a Danish municipal healthcare center and included 127 individuals aged 28 to 70 years with fasting plasma glucose: 6.1–6.9 mmol/l and/or glycated haemoglobin (HbA1c): 42.0–47.9 mmol/mol. Participants were randomised to routine care (n = 64), or intervention (n = 63). The intervention group received an empirical and theory-based intervention delivered over four two-h group sessions during five weeks, and two further sessions after one and six months. The outcomes were weight, waist circumference and systolic blood pressure, and the mediator was patient activation, measured by the self-reported Patient Activation Measure (PAM). Data for the present study was derived from questionnaires and clinical measures from baseline, three- and 12-months follow-up.

Results

Mediated effects via PAM on: weight: − 0.09 kg (95% CI − 0.38 to 0.20) out of the total effect − 1.09 kg (95% CI − 3.05 to 0.87); waist circumference: − 0.04 cm (95% CI − 0.36 to 0.28) out of the total effect − 1.86 cm (95% CI − 4.10 to 0.39); and systolic blood pressure: − 0.31 mmHg (− 1.10 to 0.49) out of the total effect − 2.73 mmHg (95% CI − 6.34 to 0.87).

Conclusion

We found no mediating effects of patient activation as a single variable of the intervention “Live your life without diabetes” on weight, waist circumference and systolic blood pressure at 12 months follow-up in adults at high risk of type 2 diabetes. Our study demonstrates an analytic approach for estimating mediating effects in complex interventions that comply with the criteria on temporal ordered data. Future studies should include possible interacting variables.
Clinical and functional outcomes of isolated posterior cruciate ligament reconstruction in patients over the age of 40 years
Authors: Liu Chia-Hung , Chiu Chih-Hao , Chang Shih-Sheng , Yeh Wen-Ling , Chen Alvin Chao-Yu , Hsu Kuo-Yao , Weng Chun-Jui , Chan Yi-Sheng
Published: March 2022

Background

To assess clinical and functional outcomes of patients aged 40 years or older receiving PCL reconstruction surgery.

Methods

All patients older than 40 years with isolated PCL rupture who underwent PCL reconstruction surgery were enrolled into the retrospective study. Associated meniscal injuries, osteochondral lesions, postoperative complications, and the rate of return to the preinjury level of activity were extracted. Outcomes included International Knee Documentation Committee (IKDC) subjective score, Lysholm score, and Tegner activity score. The minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) were used to evaluate the clinically relevant value of PCL reconstruction in this population.

Results

In total, 41 patients with a mean age of 51.7 years were included. The mean follow-up time was 32.8 months. Associated lesions included meniscal injuries (48.8%) and osteochondral lesions (97.6%). Improvement in the IKDC score (from 46.5 preoperatively to 79.0 postoperatively, p < 0.0001), Lysholm score (from 65.5 to 88.3, p < 0.0001), and Tegner activity score (from 2.3 to 4.0, p < 0.0001) was recorded. The clinically relevant value based on the MCID showed that 34 of 41 patients (82.9%) had a ΔIKDC score exceeding 16.8; all patients (100%) showed a ΔLysholm score exceeding 8.9; and 35 of 41 patients (85.4%) showed a ΔTegner activity score exceeding 0.5. Regarding the PASS, none of the patients had an IKDC score exceeding 75.9 preoperatively, whereas 27 of 41 patients (65.9%) had a score of more than 75.9 postoperatively. All patient had ≥ grade II knee instability preoperatively. Postoperatively, 36 patients (87.8%) had no significant joint translation, and 5 patients (12.2%) had grade I instability. Twenty-one patients (51.2%) returned to their preinjury level of activity. Five patients (12.2%) developed Ahlbäck grade I radiographic osteoarthritis. No rerupture or other major perioperative complications were reported.

Conclusions

PCL reconstruction is a reliable surgery for middle-aged patients suffering from persistent instability even after failed conservative treatment, with significant improvement in patient-reported outcomes that exceeded MCID in the majority of patients, restoration of subjective instability, and approximately half of the patients returned to preinjury activity levels.

Level of evidence

Level IV, therapeutic case series.
Clinical and radiological evaluation of cage subsidence following oblique lumbar interbody fusion combined with anterolateral fixation
Authors: Zhao Long , Xie Tianhang , Wang Xiandi , Yang Zhiqiang , Pu Xingxiao , Lu Yufei , Zeng Jiancheng
Published: March 2022

Background

Cage subsidence (CS) was previously reported as one of the most common complications following oblique lumbar interbody fusion (OLIF). We aimed to assess the impacts of CS on surgical results following OLIF combined with anterolateral fixation, and determine its radiological characteristics as well as related risk factors.

Methods

Two hundred and forty-two patients who underwent OLIF at L4-5 and with a minimum 12 months follow-up were reviewed. Patients were divided into three groups according to the extent of disk height (DH) decrease during follow-up: no CS (DH decrease ≤ 2 mm), mild CS (2 mm < DH decrease ≤ 4 mm) and severe CS (DH decrease > 4 mm). The clinical and radiological results were compared between groups to evaluate radiological features, clinical effects and risk factors of CS.

Results

CS was identified in 79 (32.6%) patients, including 48 (19.8%) with mild CS and 31 (11.8%) with severe CS. CS was mainly identified within 1 month postoperatively, it did not progress after 3 months postoperatively, and more noted in the caudal endplate (44, 55.7%). In terms of clinical results, patients in the mild CS group were significantly worse than those in the no CS group, and patients in the severe CS group were significantly worse than those in the mild CS group. There was no significant difference in fusion rate between no CS (92.6%, 151/163) and mild CS (83.3%, 40/48) groups. However, significant lower fusion rate was observed in severe CS group (64.5%, 20/31) compared to no CS group. CS related risk factors included osteoporosis (OR = 5.976), DH overdistraction (OR = 1.175), flat disk space (OR = 3.309) and endplate injury (OR = 6.135).

Conclusion

CS following OLIF was an early postoperative complication. Higher magnitudes of CS were associated with worse clinical improvements and lower intervertebral fusion. Osteoporosis and endplate injury were significant risk factors for CS. Additionally, flat disk space and DH over-distraction were also correlated with an increased probability of CS.
Ecological factors influencing parenting self-efficacy among working mothers with a child under 36 month old in South Korea: a cross‐sectional and correlational study
Authors: Song Ju-Eun , Roh Eun Ha , Chae Hyun-Ju , Kim Tiffany
Published: March 2022

Background

Parenting self-efficacy is an essential component for parents to successfully perform their role and is important for mother and child well-being. To support parenting self-efficacy amongst working mothers, it is necessary to understand the factors influencing parenting self-efficacy amongst this group. However, the majority of previous studies regarding factors influencing parenting self-efficacy did not focus on working mothers. Therefore, this study aimed to identify the factors influencing parenting self-efficacy of working mothers using an ecological framework.

Methods

The research design was a cross-sectional, correlational study. The participants were 298 working mothers with a child under 3 years of age, who were recruited from ten nurseries. Data were collected from August 8 to September 22, 2017 using structured questionnaires, including the Parenting Sense of Competency scale, a one-item Short Form Health Survey scale, the Maternal Role Satisfaction scale, the Parenting Stress Inventory, the Work and Parent Role Conflict scale, the Parenting Alliance Inventory, the Social Support scale, and the Childbirth and Parenting Friendly System scale. The study process of this study was approved by the Institutional Review Board. Collected data were analyzed by SPSS 23.0 Win program with descriptive statistics, t-test, one way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression.

Results

Working mothers who were the primary caregiver had higher parenting self-efficacy compared to those who were not the primary caregiver (β = .13,p = .022). At the individual level, the higher maternal role satisfaction, the higher parenting self-efficacy of working mothers (β = .27,p < .001). In the micro-system level, higher parenting support by a spouse was associated with higher parenting self-efficacy of working mothers (β = .19,p = .002).

Conclusions

Educational interventions for increasing the awareness and satisfaction of maternal role and various strategies for fathers' active participation in parenting should be developed. In addition, practical interventions that reduce the burden of parenting while supporting parenting self-efficacy of working mothers who are the primary caregiver should also be considered.
Healthcare resource utilization and direct costs of transfusion-dependent thalassemia patients in Dubai, United Arab Emirates: a retrospective cost-of-illness study
Authors: Alshamsi Shaikha , Hamidi Samer , Narci Hacer Ozgen
Published: March 2022

Background

Patients with transfusion-dependent thalassemia (TDT) require lifelong blood transfusions and iron chelation therapy. Thus, patients afflicted with TDT often have to undergo blood transfusion and iron chelation therapy, which causes a major economic burden on them. However, this topic has not been reported in Dubai, United Arab Emirates (UAE). Hence, this study aimed to evaluate healthcare resource utilization and associated direct costs related to patients with TDT in Dubai, UAE.

Methods

For this study, a retrospective prevalence-based cost-of-illness analysis based on the UAE healthcare system and patient perspectives was conducted among patients with TDT treated at the Dubai Thalassemia Center in 2019. Information regarding healthcare resource utilization and direct medical costs was collected from the billing system connected to the electronic medical record system. Patients and their families were interviewed for direct non-medical cost estimations.

Results

A total of 255 patients with TDT were included in the study. The mean annual direct medical cost was estimated at AED 131,156 (USD 35,713) (95% CI: 124,735 – 137,578). The main driver of the medical cost for the participants as iron chelation therapy AED 78,372 (95% CI: 72,671 – 84,074) (59.8%), followed by blood transfusions, which accounted for AED 34,223 (95% CI: 32,854 – 35,593) 26.1% of the total direct medical costs. The mean annual direct non-medical costs was AED 2,223 (USD 605) (95% CI: 1,946 – 2,500). Age (p < 0.001), severe serum ferritin levels (p = 0.016), the presence of complications (p < 0.001), and the type of iron chelation therapy (p < 0.001) were significant predictors of higher direct medical costs incurred by the participants.

Conclusion

Transfusion-dependent thalassemia poses a substantial economic burden on the healthcare system, patients, and their families. Our results show that the highest medical cost proportion was due to iron chelation therapy. In this regard, efforts must be made to improve the patients’ acceptance and satisfaction with their iron chelation therapy to increase their compliance and improve the effectiveness of treatment, which could play an essential role in controlling the economic burden of this disease. Moreover, greater support is essential for families that suffer catastrophic out-of-pocket expenses.
Direct financial assistance for improved maternal and child health data: a pilot study supporting the health management information system in Malawi
Authors: Ouedraogo Mariame O. , Tolani Madalitso , Mambulasa Janet , McLaughlin Katie , Bassani Diego G. , McKinnon Britt
Published: March 2022

Background

The health management information system (HMIS) is an integral component of a strong health care system. Despite its importance for decision-making, the quality of HMIS data remains of concern in low- and middle-income countries. To address challenges with the quality of maternal and child health (MCH) data gathered within Malawi’s HMIS, we conducted a pilot study evaluating different support modalities to district-level HMIS offices. We hypothesized that providing regular, direct financial assistance to HMIS offices would enable staff to establish strategies and priorities based on local context, resulting in more accurate, timely, and complete MCH data.

Methods

The pilot intervention was implemented in Mwanza district, while Chikwawa, Neno, and Ntchisi districts served as control sites given support received from other institutions. The intervention consisted of providing direct financial assistance to Mwanza’s HMIS office following the submission of detailed budgets and lists of planned activities. In the control districts, we performed interviews with the HMIS officers to track the HMIS-related activities. We evaluated the intervention by comparing data quality between the post- and pre-intervention periods in the intervention and control districts. Additionally, we conducted interviews with Mwanza’s HMIS office staff to determine the acceptability and appropriateness of the intervention.

Results

Following the 10-month intervention period, we observed improvements in MCH data quality in Mwanza. The availability and completeness of MCH data collected in the registers increased by 22 and 18 percentage points, respectively. The consistency of MCH data between summary reports and electronic HMIS also improved. In contrast, 2/3 control districts noted minimal changes or reductions in data quality after 10 months. The qualitative interviews confirmed that, despite some challenges, the intervention was well received by the participating HMIS office. HMIS staff preferred our strategy to other conventional strategies that fail to give them the independence to make decisions.

Conclusions

This pilot intervention demonstrated an alternative approach to support HMIS offices in their daily efforts to improve data quality. Given the Ministry of Health’s (MoH) interest in strengthening its HMIS, our intervention provides a strategy that the MoH and local and international partners could consider to rapidly improve HMIS data with minimal oversight.
Health facility readiness to care for high risk newborn babies for early childhood development in eastern Uganda
Authors: Namazzi Gertrude , Hildenwall Helena , Ndeezi Grace , Mubiri Paul , Nalwadda Christine , Kakooza-Mwesige Angelina , Waiswa Peter , Tumwine James K.
Published: March 2022

Background

The neonatal mortality rate in Uganda has barely changed over the past decades, estimated at 28/1000 and 27/1000 live births in 2006 and 2016 respectively. The survivors have a higher risk of developing neurodevelopmental disabilities (NDD) due to brain insults from perinatal complications related to poor quality of health services during pregnancy, around the time of birth, and during the postnatal period. This study aimed to assess health facility readiness to care for high risk newborn babies in order to inform programming that fosters early childhood development in eastern Uganda.

Methods

A cross sectional study of 6 hospitals and 10 higher level health centers that offer comprehensive maternal and newborn care was carried out in February 2020 in eastern Uganda. A World Health Organization Service Availability and Readiness Assessment tool (SARA) was adapted and used to assess the health facility readiness to manage maternal and neonatal conditions that are related to NDD. In addition, 201 mothers of high risk newborn babies were interviewed on their satisfaction with health services received. Readiness scores were derived from percentage average facilities with available infrastructure and essential medical commodities to manage neonatal complications. Descriptive statistics were computed for client satisfaction with service provision, and p values used to compare private not for profit to public health facilities.

Results

There was limited availability in numbers and skilled human resource especially the neonatal nurses. Hospitals and health centers scored least in preterm and hypothermia care, with averages of 38% and 18% respectively. The highest scores were in essential newborn care, with readiness of 78% and 85% for hospitals and health centers, followed by resuscitation at 78% and 77%, respectively. There were no guidelines on positive interaction with newborn babies to foster neurodevelopment. The main cause of admission to neonatal care units was birth asphyxia followed by prematurity, indicative of intrapartum care challenges. The overall client satisfaction with health services was higher in private not for profit facilities at 91% compared to public hospitals at 73%, p = 0.017.

Conclusion

Health facility readiness was inadequate in management of preterm complications. Efforts should, therefore, be geared to improving availability of inputs and quality of emergency obstetric and newborn care in order to manage high risk newborns and reduce the burden of NDD in this setting.
Supplementation of melatonin to cooling and freezing extenders improves canine spermatozoa quality measures
Authors: Divar Mohammad Reza , Azari Mehdi , Mogheiseh Asghar , Ghahramani Sadegh
Published: March 2022

Background

Sperm freezing and cold storage are the two most common assisted reproductive technologies in the canine breeding industry. The freeze-thawing process causes significant detrimental changes in both sperm cell structure and function. Previous research has confirmed that excessive accumulation of un-scavenged free radicals (oxidative stress) plays an important role in the cryopreservation-induced damage to sperm cells. Also, the gradual accumulation of the free radicals during cold storage leads to a decline in the sperm quality markers. Melatonin is an endogenous neurohormone synthesized from tryptophan amino acid by pineal glands. Besides its several well-known physiologic roles, melatonin has a significant antioxidant potential through direct free radical scavenging properties. Therefore, the current study was designed to evaluate the potential in vitro protective properties of melatonin (0.5, 1, and 2 mM) on canine sperm cells after freezing or during long-term cold storage (9 days, 5 °C) on most important sperm in vitro fertility markers.

Results

Melatonin at 0.5, 1- or 2-mM concentrations could preserve significantly higher sperm total motility after 4 days of cold storage. However, only the 1- and 2 mM melatonin concentrations could result in better TM and PM values after 7 days of cold storage. Furthermore, melatonin supplementation could preserve higher sperm viability and acrosome integrity after 7 days of storage. Also, it could have significant protective effects on the cooled sperm DNA integrity. In the freezing section of the current research, melatonin at either 1- or 2-mM concentrations could not improve the sperm post-thaw TM and PM, whereas they improved sperm DNA integrity. Also, the post-thaw plasma membrane functional integrity and sperm velocity parameters were not affected by the treatment. Although DMSO (Dimethyl Sulfoxide) as the melatonin solvent could reduce the level of sperm lipid peroxidation and even improve the post-thaw sperm DNA integrity compared to the negative control, it reduced the post-thaw sperm progressive motility. However, the negative effects were reversed by concurrent melatonin supplementation at 1- and 2-mM concentrations.

Conclusion

The addition of 1- or 2-mM melatonin to the canine sperm freezing and cooling media could improve sperm motility, viability, acrosome, and DNA integrity.
The effects of genital myiasis on the diversity of the vaginal microbiota in female Bactrian camels
Authors: Zhi Likang , Ai Dongdong , Yong Ming , Bao Huar , Han Baoxiang , Sun Bo , Tu Ya , Er Demtu
Published: March 2022

Background

Genital myasis is one of the most important diseases that affects the reproductive organs of Bactrian camels in which can cause serious mechanical damage to the vaginal tissue. The accumulation of bacteria in the vagina of female camels can affect their health and reproductive ability. The effect of this damage is commonly manifested in the vaginal flora and vaginal mucosal immune system. Therefore, this investigation is a study of the diversity of the vaginal flora and the differences between healthy Bactrian camels and those suffering from genital myiasis.

Results

Vaginal microbiota samples were collected from two groups of female Bactrian camels of the same age. An Illumina MiSeq was used to sequence the 16S rRNA V3-V4 hypervariable sequence in the samples. The results showed that the vaginal microflora of the infected camels had a significantly greater operational taxonomic unit (OTU) value. According to the assessment of the alpha diversity index and the vaginal pH, the diversity index of the infected camel flora was higher than that of the normal camel flora, and the vaginal pH was lower than that of the normal camels (p < 0.01). There were no significant differences between the two groups in the abundance of dominant genera in the Bactrian camel vagina (P > 0.05), indicating that the certain stability is maintained.

Conclusions

Overall, this comparison revealed the differences and similarities between the vaginal microbiota of Bactrian camels in various health statues. In addition, these data provide a reference point for understanding the types of bacteria that cause genital myiasis affecting the healthy development of Bactrian camels.