Using qualitative systems mapping to analyze the linkages between the behavioral and social (BeSD) determinants of routine childhood immunization in LMICs.

Background: Designing effective immunization programs requires a strong understanding of how the factors affecting vaccine uptake interplay. In this review, we analyze the relationships between the Behavioral and Social Drivers (BeSD) of routine immunization using qualitative systems mapping (QSM).

Methods: In this review, we analyzed 92 experimental and quasi-experimental impact evaluations (IEs) from 11 LMICs that were published between 2010 and 2020.

Real-Time Pain Control Education After Outpatient General Surgery: A Randomized Controlled Trial.

Introduction: Opioid-related morbidity and mortality continue to rise with surgery often serving as the first exposure to opioids for patients. Few interventions focus on real-time education in the outpatient setting while patients are experiencing pain. The effect of short-messaging service (SMS) surveys with real-time opioid-use education (SMSE) and without (SMS) on outpatient postoperative opioid use was studied.

Analyzing the usage of theories of change for routine immunization programs -- a review of impact evaluations from LMICs.

Background: In this article we analyzed the extent of the usage of Theories of Change (TOCs) and causal pathways in the evaluation of immunization programs to identify the challenges to generating evidence on how interventions improve immunization.

Methods: We analyzed the use of the TOC in impact evaluations (IEs) of immunization interventions published after 2010, and its associated articles. The review includes studies from Evidence Gap Map and Yale review that were conducted in May and March of 2020, respectively.

Interventions addressing routine childhood immunization and its behavioral and social drivers.

Introduction: Despite the advances in vaccination, there are still several challenges in reaching millions of children in low- and middle-income countries (LMICs). In this review, we present an extensive summary of the various strategies used for improving routine immunization in LMICs to aid program implementers in designing vaccination interventions.

Methods: Experimental and quasi-experimental impact evaluations conducted in LMICs evaluating the effectiveness of interventions in improving routine immunization of children aged 0-5 years or the intermediate outcomes were included from 3ie's review of systematic reviews.

Challenges With Robot-Assisted Surgery Setup for Complex Minimally Invasive Upper Gastrointestinal Surgery.

Background: The utilization of robot-assisted approaches to surgery has increased significantly over the last two decades. This has introduced novel complexities into the operating room environment, requiring management of new challenges and workflow adaptation. This study aimed to analyze challenges in the surgical setup for complex upper gastrointestinal robot-assisted surgery (UGI-RAS) and identify opportunities for solutions.

Displacement of Zygomatic Implant in Infratemporal Region in a Case of COVID-19-Associated Mucormycosis.

Reconstruction of maxillary defects can be carried out using a variety of treatment modalities. The choice of modality depends on numerous factors, including the size and extent of the defect, patient characteristics, and existing comorbidities. One of the various options is reconstruction and rehabilitation using a fixed prosthesis supported over a zygomatic implant.

Effective interventions for improving routine childhood immunisation in low and middle-income countries: a systematic review of systematic reviews.

Objective: An umbrella review providing a comprehensive synthesis of the interventions that are effective in providing routine immunisation outcomes for children in low and middle-income countries (L&MICs).

Design: A systematic review of systematic reviews, or an umbrella review.

Data Sources: We comprehensively searched 11 academic databases and 23 grey literature sources.

The 1.7 Å crystal structure of the C5a peptidase from Streptococcus agalactiae (ScpB) reveals an active site competent for catalysis.

A 1.7 Å structure is presented for an active form of the virulence factor ScpB, the C5a peptidase from Streptococcus agalactiae. The previously reported structure of the ScpB active site mutant exhibited a large separation (~20 Å) between the catalytic His and Ser residues.

Use of community engagement interventions to improve child immunisation in low- and middle-income countries: A systematic review and meta-analysis.

Immunisation is one of the most cost-effective interventions to prevent and control life-threatening infectious diseases. Nonetheless, rates of routine vaccination of children in low- and middle-income countries (LMICs) are strikingly low or stagnant. In 2019, an estimated 19.

X-ray diffraction data for the C5a-peptidase mutant with modified activity and specificity.

The Streptococcal C5a peptidase (ScpA) specifically inactivates the human complement factor hC5a, a potent anaphylatoxin recently identified as a therapeutic target for treatment of COVID-19 infections. Engineering of ScpA to enhance its potential as a therapeutic will require detailed examination of the basis for its highly selective activity. The emerging view of ScpA and related subtilases is that selection of their substrates is a dynamic two-step process involving flexibility in the domains around the active site and in the C-ter of the substrate.

Improving routine childhood immunisation outcomes in low-income and middle-income countries: an evidence gap map.

Objective: To support evidence-informed decision-making, we created an evidence gap map to characterise the evidence base on the effectiveness of interventions in improving routine childhood immunisation outcomes in low-income and middle-income countries (LMICs).

Methods: We developed an intervention-outcome matrix with 38 interventions and 43 outcomes. We searched academic databases and grey literature sources for relevant impact evaluations (IEs) and systematic reviews (SRs).

Use of community engagement interventions to improve child immunisation in low-income and middle-income countries: a systematic review and meta-analysis.

Objective: To support evidence informed decision-making, we systematically examine the effectiveness and cost-effectiveness of community engagement interventions on routine childhood immunisation outcomes in low-income and middle-income countries (LMICs) and identify contextual, design and implementation features associated with effectiveness.

Design: Mixed-methods systematic review and meta-analysis.

Data Sources: 21 databases of academic and grey literature and 12 additional websites were searched in May 2019 and May 2020.

Designing appropriate, acceptable and feasible community-engagement approaches to improve routine immunisation outcomes in low- and middle-income countries: A synthesis of 3ie-supported formative evaluations.

Introduction: As global child vaccination coverage has plateaued, understanding how to increase routine child vaccination rates further is key to avoiding preventable disease and death. To analyse how community engagement strategies can increase child vaccination, we synthesise the results from formative evaluations of interventions that aimed to increase vaccination coverage in Ethiopia, Myanmar, Nigeria, and Pakistan.

Methods: This paper uses an inductive qualitative approach to synthesise the results from the six evaluations, gathering lessons for designing context appropriate interventions that are feasible to implement and acceptable to providers, communities, and caregivers.

Exosite binding modulates the specificity of the immunomodulatory enzyme ScpA, a C5a inactivating bacterial protease.

The C5a peptidase from (ScpA) is a highly specific enzyme with potential therapeutic value. ScpA is a good model for studying determinants of specificity in the multidomain immunomodulatory enzymes (IMEs), which comprise a large family of bacterial surface proteases. The surface exposed region of ScpA has 5 main domains which includes 3 C-terminal Fn3-like domains (Fn1, Fn2 and Fn3) (Kagawa et al.

Operative approach and case volume are associated with negative resection margins for adrenocortical carcinoma.

Background: Surgical resection with negative margins is the treatment of choice for adrenocortical carcinoma (ACC). This study was undertaken to determine factors associated with negative resection margins.

Methods: National Cancer Database was queried from 2010 to 2016 to identify patients with AJCC/ENSAT Stage I-III ACC who underwent adrenalectomy.

Adrenocortical Carcinoma: The Value of Lymphadenectomy.

Background: Adrenocortical carcinoma (ACC) staging does not account for the number of positive nodes. The prognostic value of quantitative metastatic nodal burden is unknown.

Methods: The National Cancer Database was retrospectively queried from 2004-2016 to identify patients with Stage I-III ACC undergoing adrenalectomy.

Predictive Impact of Metastatic Lymph Node Burden on Distant Metastasis Across Papillary Thyroid Cancer Variants.

While numerous factors determine prognosis in papillary thyroid carcinoma (PTC), distant metastasis (M1) represents one of the most dire. Escalating nodal burden and aggressive histology may contribute to higher metastatic risk, but this relationship is poorly defined and challenging to anticipate. We evaluate the predictive impact of these histological features on predicting distant metastases at initial presentation.

Factors Associated with Non-Operative Management of Resectable Adrenocortical Carcinoma.

Introduction: Surgery is the initial treatment of choice for patients with resectable adrenocortical carcinoma (ACC). We sought to determine factors associated with non-operative management of resectable ACC.

Methods: 2004-2016 National Cancer Database (NCDB) was queried to identify patients with AJCC/ENSAT Stage I-III ACC.

Enzyme kinetic and binding studies identify determinants of specificity for the immunomodulatory enzyme ScpA, a C5a inactivating bacterial protease.

The Streptococcal C5a peptidase (ScpA) specifically inactivates the human complement factor hC5a, a potent anaphylatoxin recently identified as a therapeutic target for treatment of COVID-19 infections. Biologics used to modulate hC5a are predominantly monoclonal antibodies. Here we present data to support an alternative therapeutic approach based on the specific inactivation of hC5a by ScpA in studies using recombinant hC5a (rhC5a).

Incidental parathyroidectomy in thyroidectomy and central neck dissection.

Background: Although higher thyroidectomy volume has been linked with lower complication rates, its association with incidental parathyroidectomy remains less studied. The volume relationship is even less clear for central neck dissection, where individual parathyroid glands are at greater risk.

Methods: Patients undergoing thyroidectomy with or without central neck dissection were evaluated for incidental parathyroidectomy, hypoparathyroidism, and hypocalcemia.

A model for the institutional adoption of innovative surgical techniques.

Background: Surgeons have the responsibility to continuously enhance surgical practice. Standardized processes for institutions to validate and approve the introduction of innovative surgical techniques do not exist. The objective of this work was to develop a model for the introduction of innovative surgical techniques, which assists the innovating surgeons and institution with safe implementation.

Crowdfunding Campaigns and Thyroid Surgery: Who, What, Where, and How Much?

Background: Crowdfunding has become a unique response to the challenge of health care expenses, yet it has been rarely studied by the medical community. We looked to describe the scope of crowdfunding in thyroid surgery and analyze the factors that contribute toward a successful campaign.

Methods: In November 2018, active campaigns were retrieved from a popular crowdfunding Web site using search terms thyroidectomy and thyroid surgery and filtered to include only campaigns that originated in the United States.