bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Weight Loss Program on Anthropometric and Laboratory Measurements among Adult Obese Females: An Intervention Study
Authors: Ahmed Ola S , Sos Dalia G , Boulos Dina N. K , El-Damaty Samia I , Samy Maysa A 
Published: October 2021

Abstract

Background
Obesity is a complex disease involving an excessive amount of body fat. It is a medical problem that increases the risk of heart disease, diabetes, high blood pressure and certain cancers. New evidence supports the view that there is a relationship between consuming energy restricted diet during weight loss program on anthropometric measurements, example; weight, waist circumference, hip circumference and fat percentage. Objectives: to study the effect of weight loss program on anthropometric and laboratory measurements of adult obese females. Method: an intervention study was carried out in the obesity management clinics of National Nutritional institute.

Results
our findings demonstrate that energy restriction regimen results in modest effect on anthropometric and laboratory measurements which is statistically highly significant. Conclusion and Recommendation: Prevention of obesity should be a high priority in public health, with particular emphasis on encouraging healthy lifestyles in all age groups, starting from early childhood.
Causes and Associated factors of Operation Cancellation at Cardiothoracic Ain-Shams University Hospital
Authors: El Bokl Shaymaa M , Aboul-Fotouh Aisha M , Habil Ehab S , Saleh Ahmed A , Hassan Azza M 
Published: October 2021

Abstract

Background
Cancellation of elective operations is a sensitive indicator of operating room management. It results in loss of time, resources and affects quality of care. Operating room cancellation of elective operations is defined as cases that appeared in the definitive operative room list that ultimately were not performed on that day.

Objectives
To measure cancellation rate at Cardiothoracic Ain-Shams University hospital, Egypt and to identify causes and factors associated to cancellations.

Methods
Cross-sectional study that included 254 operations in all operating rooms of Cardiothoracic Ain Shams university hospital which provides specialized tertiary level of care.

Results
The overall cancellation rate is 21.7%, The most frequent cause of cancellation is standby operations accounting for 29.4%. Pareto chart shows that vital few causes are “patient prepared as stand by”, “previous long operation”, “change in Patient’s clinical status”, “equipment failure” and “ICU bed unavailable”. These causes are responsible for 80% of cancellations.

Conclusion and Recommendation
The avoidable causes of the problem should be addressed. Policy changes are recommended as well as continuous documentation and analysis of cancellation and its causes. Periodic awareness lectures for health care providers are suggested.
Telegeriatrics during the COVID-19 pandemic
Authors: Wahba Hoda , Emara Tamer , Elbokl Ahmed 
Published: October 2021

Abstract

Background
Ain Shams University Virtual Hospital (AVH) has been offering telemedicine services since 2016. During the COVID-19 pandemic it has become essential to offer healthcare services in a safe way. Telemedicine was the perfect choice worldwide to compensate for the deficiency of physical healthcare services. Limitations especially in the elderly population questioned the feasibility of the telegeriatrics model.

Aim
To study the feasibility and acceptability of the AVH telemedicine model in geriatric patients.

Methodology
A cross-sectional study performed from April to October 2020 recruiting patients above 60 years receiving telemedicine services as part of the telemedicine program delivered via AVH. Data was collected via Google forms that were sent to the patients and physicians via Whats app.

Results
1471 patients were triaged via the Whats app managed by geriatric consultants and 64 received video consultations. 849 patients responded to the surveys from all age groups of which 21.8% were above 60 years. From the responders 19.7% consulted geriatric medicine while the 2.1% consulted other specialties. Most satisfaction domains were 85% and above positive responses with an insignificant difference between age groups. 90% of physicians felt confident in their medical management using telemedicine. Conclusion: telegeriatrics is feasible as it is well accepted, easily used and preferred over clinic visits during the COVID-19 pandemic and after, by patients. Physicians are confident in their management using it.
The effects of feeding benzoic acid and/or live active yeast (Saccharomyces cerevisiae) on beef cattle performance, feeding behavior, and carcass characteristics
Authors: Williams Melissa S , Mandell Ira Brent , Bohrer Benjamin M , Wood Katharine M 
Published: October 2021

Abstract
Fifty-nine Angus-cross finishing steers were used to evaluate benzoic acid, active dry yeast (Saccharomyces cerevisiae), or a combination of benzoic acid and active dry yeast when supplemented in a high-grain finishing diet on live animal performance, feeding behavior, and carcass characteristics. Steers were fed a high-grain diet for the final 106 d of finishing. Treatments were as follows: no additional supplementation (CON), 0.5% benzoic acid (ACD), 3 g per head per day active dry S. cerevisiae (YST), or both 0.5% benzoic acid and 3 g/head per day S. cerevisiae (AY). Steers were weighed every 14 d, and ultrasound was performed for rib and rump fat thickness at the beginning (day 1), middle (day 57), and end (day 99) of the experiment. Insert feeding stations were used to collect individual feeding behavior data and DMI daily throughout. Blood samples were collected on days 21 and 22 and days 99–101 to assess plane of nutrition and metabolism. Ruminal fluid samples were collected by oral gavage 4 wk prior to slaughter. Carcass characteristics were examined at a federally inspected slaughter facility. Data were analyzed using PROC GLIMMIX of SAS with initial body weight (BW) as a covariate. Benzoic acid supplementation increased (P = 0.002) overall dry matter intake (DMI) compared to YST and CON steers, which may be due to a faster eating rate (P ≤ 0.008). Animal performance parameters (BW, average daily gain, feed conversion, and ultrasound fat depth) were not different (P ≥ 0.11) among treatment groups. Aspartate aminotransferase concentration was greatest (P ≤ 0.01) for YST steers, which may have been reflected in numerically greater liver abscesses. Carcass traits did not differ (P ≥ 0.33) among treatment groups. Ruminal pH was greater (P = 0.006) for ACD steers than AY steers (pH of 6.16 vs. 5.66, respectively), which indicated that there may be an interactive effect between benzoic acid and active dry yeast. To summarize, steers fed a high-grain finishing diet supplemented with benzoic acid, active dry yeast, or both benzoic acid and active dry yeast had similar growth performance and carcass characteristics compared to those without supplementation. However, the addition of benzoic acid alone increased DMI, variation in DMI, eating rate, and ruminal pH. Future studies are warranted to further investigate the impacts of benzoic acid on the ruminal environment of feedlot cattle.
Temporal and spatial trends in human visceral leishmaniasis in an endemic area in Northeast Brazil and their association with social vulnerability
Authors: Andrade Acácio W F , Souza Carlos D F , Carmo Rodrigo F 
Published: October 2021

ABSTRACT

Background
Visceral leishmaniasis is a neglected tropical disease of great importance to public health due to its wide distribution and close relationship with social and economic conditions. This study aimed to analyse the spatiotemporal dynamics of human visceral leishmaniasis (HVL) in an endemic state in the Northeast Region of Brazil and its spatial correlation with the Social Vulnerability Index (SVI) and the Municipal Human Development Index (MHDI).

Methods
The study included all confirmed cases of HVL in Bahia from 2010 to 2017. A joinpoint regression model was used for trend analysis. Incidence rates were smoothed by a local empirical Bayesian model. Global and local Moran indices and space–time scan statistics were used for identification of spatial clusters. Bivariate and multivariate analyses were carried out to investigate the relationship between HVL incidence and the SVI and MHDI.

Results
Cases of HVL demonstrated stationary behaviour during the period analysed. A significant association was observed between the HVL incidence rate and social vulnerability, with high-risk clusters concentrated in the central region of the state.

Conclusions
HVL has a strong correlation with social vulnerability in the state of Bahia. This study may provide assistance in planning actions and organizing health services to combat HVL.
Phylogenetic Diversity and Phenotypic Characterization of Phlyctema vagabunda (syn. Neofabraea alba) and Neofabraea kienholzii Causing Postharvest Bull’s Eye Rot of Apple in Northern Italy
Authors: Amaral Carneiro Greice , Walcher Magdalena , Storti Alberto , Baric Sanja 
Published: October 2021

Bull’s eye rot, caused by Phlyctema vagabunda and Neofabraea species, is one of the most important postharvest diseases of apple. South Tyrol (northern Italy) is the largest continuous apple-producing area in Europe, with approximately 1 million tons being produced yearly and conserved in technologically advanced storage facilities for several months. Still, studies on the pathogen species causing postharvest bull’s eye rot of apple, as well as their diversity and biology, are lacking for this region. Therefore, the main purpose of the present work was to identify and characterize fungal isolates obtained from decayed apple fruit with symptoms of bull’s eye rot that were collected in 2018 and 2019 in different packinghouses in South Tyrol. Among more than 1,000 fungal isolates that were obtained, 419 could be assigned to the genera Phlyctema and/or Neofabraea based on rot symptoms on apple fruit and colony morphology on potato dextrose agar. A smaller subset of 101 representative isolates was further analyzed by DNA sequencing of the internal transcribed spacer region. Furthermore, partial segments of the β-tubulin gene, the translation elongation factor 1α gene, and the 16S mitochondrial ribosomal RNA gene were studied. The phylogenetic analyses, including sequences of reference species, showed that P. vagabunda is the dominant species associated with bull’s eye rot of apple in the study area, whereas Neofabraea kienholzii was found only on a small number of apple fruit samples. The combination of multilocus sequence data revealed 11 unique genotypes that belonged to P. vagabunda and four to N. kienholzii. To the best of our knowledge, this study is the first to report N. kienholzii as a postharvest pathogen of apple in Italy. Finally, a pathogenicity test demonstrated different degrees of virulence among selected isolates of P. vagabunda and N. kienholzii on the cultivar Golden Delicious. The present study emphasizes the importance of accurate species identification, because different species may vary in their biological and pathogenic characteristics, and consequently require distinct disease management strategies, both in the field and during the postharvest stages. [Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
COVID-19 and X-linked agammaglobulinemia (XLA) – insights from a monogenic antibody deficiency
Authors: Ponsford Mark J. , Shillitoe Benjamin M.J. , Humphreys Ian R. , Gennery Andrew R. , Jolles Stephen 
Published: October 2021

Purpose of review
The clinical outcomes from COVID-19 in monogenic causes of predominant antibody deficiency have pivotal implications for our understanding of the antiviral contribution of humoral immunity. This review summarizes the lessons learned from COVID-19 infection in X-linked agammaglobulinemia (XLA) due to genetic defects in Bruton's tyrosine kinase (BTK).

Recent findings
Key molecular pathways underlying the development of severe COVID-19 are emerging, highlighting the possible contribution of BTK to hyperinflammation. SARS-CoV-2 specific T-cell responses and complement activation appear insufficient to achieve viral clearance in some B-cell deficient individuals. Whilst appearing efficacious in this group, use of convalescent plasma has been recently associated with the evolution of viral escape variants. Early data suggests individuals with XLA can mount a viral-specific T-cell vaccine response, however, the clinical significance of this is still emerging.

Summary
In contrast to reports made early in the pandemic, we show XLA patients remain susceptible to severe disease. Persistent infection was common and is likely to carry a significant symptom burden and risk of novel variant evolution. COVID-19 infection in this vulnerable, antibody deficient group due to genetic, therapeutic or disease causes may require prompt and specific intervention for both patient and societal benefit.
Surgeons Consider Initial Nonoperative Treatment With Potential for Future Conversion to Reverse Arthroplasty a Reasonable Option for Older, Relatively Infirm, and Less-Active Patients
Authors: Shu Ryan , Crijns Tom , Ring David , Fatehi Amirreza ,   on behalf of the Science of Variation Group
Published: October 2021

Objectives:
Two recent developments favor initial nonoperative treatment of proximal humerus fractures among the older, relatively infirm, less-active patients that represent most patients with such fractures: (1) evidence of minimal benefit of open reduction, internal fixation over nonoperative treatment, and (2) evidence of the effectiveness of the reverse total shoulder arthroplasty. As one step in determining the feasibility of a strategy of initial nonoperative treatment of proximal humerus fracture among older, relatively infirm, less-active people, we performed a survey-based experiment to measure factors associated with surgeon recommendation for initial nonoperative treatment.

Methods:
Members of the Science of Variation Group viewed 8 hypothetical patients with radiographs of complex proximal humeral fractures and 7 randomized patient variables. For each scenario, surgeons were asked whether they would recommend (1) initial nonoperative treatment with bailout reverse arthroplasty or (2) immediate reverse arthroplasty.

Results:
The mean percentage of recommendations for initial nonoperative treatment was 63%, with wide variation by surgeon (range 0%–100%). In multilevel mixed-effects logistic regression, recommendation for initial nonoperative treatment was associated with specific radiographs, older age, having a comorbidity, being homebound, surgical subspecialists, and more than 20 years in practice.

Conclusions:
These findings suggest that surgeons may consider initial nonoperative treatment with potential for future conversion to reverse arthroplasty an acceptable treatment option, particularly for older, less-active, more infirm individuals, and relatively less displaced fractures with little comminution.
In vivo 3-Dimensional Kinematics Study of the Healthy Cervical Spine Based on CBCT Combined with 3D-3D Registration Technology
Authors: Tang Benyu , Yao Haoqun , Wang Shaobai , Zhong Yanlong , Cao Kai , Wan Zongmiao 
Published: October 2021

Study Design.
A cervical biomechanical study.

Objective.
We sought to demonstrate the three-dimensional (3D) intervertebral motion characteristics of the cervical spine in healthy volunteers using cone beam computed tomography (CBCT) combined with 3D-3D registration technology.

Summary of Background Data.
No previous studies have used CBCT combined with 3D-3D registration technology to successfully documented in vivo 3D intervertebral six-degrees-of-freedom (6-DOF) motions of the cervical spine.

Methods.
Twenty healthy subjects underwent cervical (C1–C7) CBCT scans in seven functional positions. Segmented 3D vertebral body models were established according to the cervical CBCT images. A 3D-to-3D registration was then performed for each vertebral body in the different positions to calculate the 3D segmental motion characteristics in vivo.

Results.
During flexion–extension, the range-of-motion (ROM) of C1–C2 and C4–C5 was significantly greater than the other segments. The average coupled axial rotation and lateral bending of each segment were between 0.6° and 3.2°. The average coupling translations in all directions were between 0.2 and 2.1 mm. During axial rotation, the ROM of C1–C2 was 65.8 ± 5.9°, which accounted for approximately 70% of all axial rotation. The motion and displacement of C1–C2 coupled lateral bending were 11.4 ± 5.2° and 8.3 ± 1.9 mm, respectively. During lateral bending, the ROM of C3–C4 was significantly greater than C1–C2, C5–C6, and C6–C7. The coupled axial rotation of C1–C2 was 34.4 ± 8.1°, and the coupled lateral translation was 3.8 ± 0.5 mm. The coupled superoinferior and anteroposterior translation of each cervical segment were between 0.1 and 0.6 mm.

Conclusion.
CBCT combined with 3D-3D registration was used to accurately measure and record the ROMs of lateral bending, axial rotation, and flexion–extension in cervical vertebrae under physiological-load conditions. Our findings may contribute to the diagnosis of cervical spinal disease, the development of new surgical techniques, and the restoration of normal, cervical segmental movement.

Level of Evidence: 3
Scheuermann Kyphosis Patients Have a Similar Revision and Infection Rate to Adolescent Idiopathic Scoliosis Patients
Authors: Sarwahi Vishal , Hasan Sayyida , Koutsogiannis Petros , Dzaugis Peter , Vora Rushabh , Molloy Sean , Benton Adam , Yu Haiming , Khoyratty Sara , Lo Yungtai , Amaral Terry , Lui Darren 
Published: October 2021

Study Design.
Multicenter retrospective review.

Objective.
This study aims to address major postoperative complications associated with Scheuermann kyphosis (SK) when compared with adolescent idiopathic scoliosis (AIS) in a large population matched by demographic characteristics, levels fused and operative technique.

Summary of Background Data.
Prior studies have found that SK patients are 3.86 times more likely to experience major postoperative complications than in AIS. Historically, however, these studies have often had populations that were significantly different between the two groups in terms of disease severity, demographics, and small sample sizes.

Methods.
AIS patients were compared to SK patients between 2006 and 2018 contemporaneously. All surgeries were conducted by six surgeons among two institutions. Complications and revisions were calculated. A sub-analysis comparing SK and AIS patients by age, sex, and levels-fused in one-to-one matched pairs was performed as well as a sub-analysis matched by levels fused only in one-to-one matched pairs.

Results.
One thousand three hundred twenty two patients were reviewed (1222 AIS; 100 SK). There were 52 (4.3%) complications in the AIS group compared with 20 (20%) complications in the SK group (P < 0.001), with infections and revisions consisting of the majority of complication rates in both cohorts.
When matched by age, sex, and levels fused, there were eight complications in the AIS group and 11 in the SK group (P = 0.63), with infection and revision rates being similar, (P = 0.29) and (P = 0.26) respectively.
When matched by levels fused only, EBL, operative time and complication rates remained similar (P > 0.05).

Conclusion.
Contrary to previously published literature, our analyses indicate that in a matched population, postoperative complication rates (i.e., infection and revision rates) are not significantly different between SK and AIS patients.

Level of Evidence: 4
The Return on Investment of a Province-Wide Quality Improvement Initiative for Reducing In-Hospital Sepsis Rates and Mortality in British Columbia, Canada
Authors: Khowaja Asif Raza , Willms Alexander J. , Krause Christina , Carriere Sarah , Ridout Ben , Kennedy Colleen , Young Eric , Mitton Craig , Kissoon Niranjan , Sweet David D. 
Published: October 2021

OBJECTIVES:
Sepsis is a life-threatening medical emergency. There is a paucity of information on whether quality improvement approaches reduce the in-hospital sepsis caseload or save lives and decrease the healthcare system and society’s cost at the provincial/national levels. This study aimed to assess the outcomes and economic impact of a province-wide quality improvement initiative in Canada.

DESIGN:
Retrospective population-based study with interrupted time series and return on investment analyses.

SETTING:
The sepsis cases and deaths averted over time for British Columbia were calculated and compared with the rest of Canada (excluding Quebec and three territories).

PATIENTS:
Aggregate data were obtained from the Canadian Institute for Health Information on risk-adjusted in-hospital sepsis rates and sepsis mortality in acute care sites across Canada.

INTERVENTIONS:
In 2012, the British Columbia Sepsis Network was formed to reduce sepsis occurrence and mortality through education, knowledge translation, and quality improvement.

MEASUREMENTS AND MAIN RESULTS:
A return on investment analysis compared the financial investment for the British Columbia Sepsis Network with the savings from averted sepsis occurrence and mortality. An estimated 981 sepsis cases and 172 deaths were averted in the post-British Columbia Sepsis Network period (2014–2018). The total cost, including the development and implementation of British Columbia Sepsis Network, was $449,962. Net savings due to cases averted after program costs were considered were $50.6 million in 2018. This translates into a return of $112.5 for every dollar invested.

CONCLUSIONS:
British Columbia Sepsis Network appears to have averted a greater number of sepsis cases and deaths in British Columbia than the national average and yielded a positive return on investment. Our findings strengthen the policy argument for targeted quality improvement initiatives for sepsis care and provide a model of care for other provinces in Canada and elsewhere globally.
Examining Associations Between Food Insecurity, Inhibitory Control, and Body Mass Index in Preschoolers
Authors: Ireland Mariah , Bryant Lindsey M. , Finders Jennifer K. , Duncan Robert J. , Purpura David J. , Schmitt Sara A. 
Published: October 2021

ABSTRACT:

Objective:
This study examines relations between food insecurity, inhibitory control, and body mass index (BMI) in early childhood.

Method:
The sample comes from an evaluation of a state-funded prekindergarten program and includes 126 children (mean age = 4.73 yrs, female = 42%) from families with low incomes. Parents reported on their child's food insecurity. Child inhibitory control was assessed using a performance-based task, and children's height and weight were objectively collected at the same time as the inhibitory control assessment. A regression model was used to test whether inhibitory control moderated the association between food insecurity and BMI. The model included a large battery of covariates and adjusted for clustering at the classroom level. Ad hoc analyses were conducted to examine the robustness of findings to different conceptualizations of food insecurity based on the US Department of Agriculture's categories for severity.

Results:
A significant interaction revealed that inhibitory control moderated the association between food insecurity and children's BMI percentile. Investigation of the simple slopes suggested that greater food insecurity was related to a higher BMI percentile among children who demonstrated stronger inhibitory control. In addition, results from ad hoc analyses examining categories of food insecurity indicated that experiencing very low food security was also related to a higher BMI among children with average and strong inhibitory control.

Conclusion:
This study makes a unique contribution to the existing literature by examining relations among food insecurity, inhibitory control, and BMI during a critical period in children's physical and brain development. Findings have implications for public health efforts to address childhood obesity among populations with low incomes.