bluuebunny/crossref_metadata_2025 huggingface dataset:
Abdominal wall endometriosis in cesarean scar: A case report
Authors: Kyejo Willbroad , Moshi Brenda , Massanga Euphraim , Ntiyakunze Gregory , Mgonja Miriam , Kaguta Munawar , Mdachi Ernest
Published: March 2024

Abdominal wall endometriosis refers to the presence of endometrial tissue within surgical scars, most commonly occurring following gynecological procedures such as cesarean sections. This case report presents a rare case of abdominal wall endometriosis in a cesarean scar. The patient, a 32-year-old woman with a history of two previous cesarean sections, presented with cyclic pain and swelling in the lower abdominal region. Physical examination revealed a tender, well-defined mass within the cesarean scar. Surgical excision of the mass was performed, and histopathological examination confirmed the presence of endometrial tissue. This case highlights the importance of considering abdominal wall endometriosis in the differential diagnosis of patients presenting with cyclic pain or swelling in previous surgical scars. Prompt diagnosis and appropriate management can help alleviate symptoms and prevent complications.
Nephrology Nurses: Essential Professionals in Sustainable Kidney Care
Authors: Thomas Sarah , Kennett Anita , Fullerton Claire , Boyd Helen
Published: March 2024

Purpose:

The increasing frequency of extreme climate events underscores the need for urgent action on climate change. The health care system contributes 4.6% of greenhouse gas emissions (GHGs) in Canada; thus, it is a major contributor to the country’s carbon footprint. Kidney care in particular can involve high amounts of waste (eg, plastic and consumable waste associated with dialysis, transportation, emissions, energy, and water consumption). Therefore, sustainability initiatives within the health care system, and especially in the context of kidney care, have great potential to make a positive impact on planetary health. Here, we outline ways in which nephrology nurses can expand our duty of care to the environment and incorporate sustainability into our work.

Sources of information:

A small advisory group of nephrology nurses in partnership with the Canadian Association of Nurses for the Environment (CANE) assessed ways that sustainable practices can be incorporated into nephrology nursing. Drawing on the Planetary Health Care model used by the Canadian Society of Nephrology: Sustainable Nephrology Action Planning (SNAP) committee, we assessed how the model could be adapted in the context of kidney care using 3 main actionable themes in their work: reducing the demand for health services, matching the supply of health services with demand, and reducing emissions from the supply of health services. We also reviewed and selected real-world examples of initiatives pursued by colleagues.

Key findings:

Through this established framework, we provide recommendations and case examples for nephrology nurses to expand our duty of care to the environment. We describe nursing-led strategies used in Canada to improve environmental sustainability in kidney programs and consider their applicability to other renal programs. In 1 case example, we show how a simple nurse-led initiative at a single dialysis clinic can lower plastic waste and associated costs by $2042.59 per year. More broadly, we provide recommendations and actions for nephrology nurses to improve environmental sustainability in kidney care.

Limitations:

Nurses in Canada have many responsibilities within limited timeframes, making it essential to choose sustainable practices that do not exacerbate burnout and high workloads. For sustainable practices to be successful, nurses must integrate them into their existing workflows.
mHealth App to improve medication adherence among older adult stroke survivors: Development and usability study
Authors: Cao Wenjing , Wang Juan , Wang Yuhui , Hassan Intan Idiana , Kadir Azidah Abdul
Published: March 2024

Background

Effective medication adherence is vital for older adult stroke survivors, yet 20–33% cease treatment within a year post-discharge, increasing risks of recurrent strokes and mortality. A mobile health (mHealth) app could be a novel tool to improve medication adherence among stroke survivors because of its potential to increase patient empowerment. A few stroke-related apps provide information and support to stroke survivors. However, none have focused on medication adherence and documented their development and evaluation process, particularly those focused on this older population.

Objective

This study aims to design and develop a smartphone app called OASapp to improve medication adherence among older adult stroke survivors and evaluate its usability.

Methods

OASapp was developed in a three-phase development process. Phase 1 is the exploration phase (including a cross-sectional survey, a systematic review, a search for stroke apps on the app stores of Apple App Store and Google Play Store, and a nominal group technique). In phase 2, a prototype was designed based on the Health Belief Model and Technology Acceptance Model. In phase 3, Alpha and Beta testing was conducted to validate the app.

Results

Twenty-five features for inclusion in the app were collected in round one, and 14 features remained and were ranked by the participants during nominal group technique. OASapp included five core components (medication management, risk factor management, health information, communication, and stroke map). Users of OASapp were satisfied based on reports from Alpha and Beta testing. The mean Usability Metric for User Experience (UMUX) score was 71.4 points (SD 14.6 points).

Conclusion

OASapp was successfully developed using comprehensive, robust, and theory-based methods and was found to be highly accepted by users. Further research is needed to establish the clinical efficacy of the app so that it can be utilized to improve clinically relevant outcomes.
Criminal Behaviors Among Minorities: A Social Resistance Perspective
Authors: Factor Roni
Published: March 2024

The social resistance framework offers an explanation for high-risk and criminal behaviors among non-dominant minority groups. The study explores the generalizability of the framework to minority groups which are marginalized for different reasons, such as immigration, and deep historical national conflicts, and across several criminal behaviors, by surveying a representative sample of more than 1,000 participants from Israel's majority population and four minority groups—Muslims, Jews of Ethiopian origin, immigrants from the former Soviet Union, and ultra-Orthodox Jews. Negative binomial regressions show that social resistance is positively associated with criminal behaviors, controlling for exposure, demographic characteristics, and previous explanations. Additionally, both levels of social resistance and its association with criminal behaviors vary between the different non-dominant minority groups. The study supports the premises of the framework, showing that social resistance plays a role in criminal behaviors among minority groups which are marginalized for different historical reasons.
Overt and Subtle Discrimination and Psychological Well-Being: Examining the Mediating and Moderating Role of Ethnic-Racial Identity Among Emerging Adults
Authors: Aral Tuğçe , Ceccon Chiara , de Moor Elisabeth L. , Tang Yixin , Osinga Mariëlle , Fishere Mariam , Syed Moin
Published: March 2024

Ethnic-racial identity (ERI) has been reported as mediator and moderator of the relation between discrimination and psychological well-being. However, it remains unclear how different forms of discrimination (i.e., overt and subtle) predict well-being over time, and whether ERI exploration and commitment mediate or moderate this association. This preregistered study explored the associations of overt and subtle discrimination with well-being (i.e., depression, substance use, life satisfaction) in a sample of 323 ethnic-racial minoritized college students ( M age W1 = 18.03, 62.7% female) from longitudinal data collected in the US. Cross-lagged panel models across three waves indicated no associations of overt discrimination, but participants experiencing more subtle discrimination during their transition to college reported more depressive symptoms after four months. Ethnic-racial identity did not function as mediator or moderator. Findings indicate the need for a more nuanced understanding of the role of ERI during emerging adulthood.
Comparison of Outcomes After Primary Versus Salvage Osteochondral Allograft Transplantation for Femoral Condyle Osteochondritis Dissecans Lesions
Authors: Nuelle Clayton W. , Rucinski Kylee , Stannard James P. , Ma Richard , Kfuri Mauricio , Cook James L.
Published: March 2024

Background:

Osteochondral allograft transplantation (OCAT) allows the restoration of femoral condyle osteochondritis dissecans (OCD) lesions using an osteochondral unit. When OCD lesions are irreparable, or treatments have failed, OCAT is an appropriate approach for revision or salvage surgery. Based on its relative availability, cost-effectiveness, lack of donor site morbidity, and advances in preservation methods, OCAT is also an attractive option for primary surgical treatment for femoral condyle OCD.

Hypothesis:

OCAT for large femoral condyle OCD lesions would be highly successful (>90%) based on significant improvements in knee pain and function, with no significant differences between primary and salvage procedure outcomes.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients were enrolled into a registry for assessing outcomes after OCAT. Those patients who underwent OCAT for femoral condyle OCD and had a minimum of 2-year follow-up were included. Reoperations, treatment failures, and patient-reported outcomes were compared between primary and salvage OCAT cohorts.

Results:

A total of 22 consecutive patients were included for analysis, with none lost to the 2-year follow-up (mean, 40.3 months; range, 24-82 months). OCD lesions of the medial femoral condyle (n = 17), lateral femoral condyle (n = 4), or both condyles (n = 1) were analyzed. The mean patient age was 25.3 years (range, 12-50 years), and the mean body mass index was 25.2 kg/m2 (range, 17-42 kg/m2). No statistically significant differences were observed between the primary (n = 11) and salvage (n = 11) OCAT cohorts in patient and surgical characteristics. Also, 91% of patients had successful outcomes at a mean of >3 years after OCAT with 1 revision in the primary OCAT cohort and 1 conversion to total knee arthroplasty in the salvage OCAT cohort. For both primary and salvage OCATs, patient-reported measures of pain and function significantly improved at the 1-year and final follow-up, and >90% of patients reported that they were satisfied and would choose OCAT again for treatment.

Conclusion:

Based on the low treatment failure rates in conjunction with statistically significant and clinically meaningful improvements in patient-reported outcomes, OCAT can be considered an appropriate option for both primary and salvage surgical treatment in patients with irreparable OCD lesions of the femoral condyles.
The scalar mismatch of regional governance: A comparative analysis of hierarchical structures
Authors: Marin Valentina , Molinero Carlos , Arcaute Elsa
Published: March 2024

Self-organisation in territories leads to the emergence of patterns in urban systems that shape the interactions and dependencies between cities, resulting in a hierarchical organisation. Governance follows a hierarchical structure as well, breaking the territory into smaller units for its management. The possible mismatch between these two organisations may lead to a range of problems, ranging from inefficiencies to insufficient and uneven distribution of resources. This paper seeks to develop a methodology to explore and quantify the correspondence between the hierarchical organisation given by the structure of governance and that given by the structure of the urban systems being governed, where Chile is used as a case study. The urban hierarchical structure is defined according to the connectivity of the system given by the road network. This is extracted through a clustering algorithm defined as a percolation process on the Chilean street network, giving rise to urban clusters at different scales. These are then compared to the spatial scales of the politico-administrative system. This is achieved by using measures of pair-wise distance similarity on the dendrograms, such as the cophenetic distance, by looking at the different clustering membership using Jaccard similarity and by analysing the topological diversity defined as the structural entropy. The results show that the urban sub-national structures present high heterogeneity, while the administrative system is highly homogeneous, replicating the same structure of organisation across the national territory. Such contrasting organisational structures present administrative challenges that can give rise to poor decision-making processes and mismanagement, in addition to impairing the efficient functioning of the systems themselves. Our results can help address these challenges, informing how to rebalance such mismatches through planning and political strategies that consider the complex interdependencies of territories across scales.
A century of bruxism research in top-ranking medical journals
Authors: Lobbezoo Frank , Verhoeff Merel C , Ahlberg Jari , Manfredini Daniele , Aarab Ghizlane , Koutris Michail , Svensson Peter , Thymi Magdalini , Visscher Corine M , Lavigne Gilles J
Published: March 2024

Background:

Bruxism is a jaw-muscle activity characterized by teeth grinding and clenching. While many of its negative consequences (e.g., jaw-muscle pain, tooth fractures) are of particular interest to dentists, new insights underline the need for physicians to be knowledgeable about bruxism. In order to facilitate transfer of knowledge across disciplines, our objective was to assess what top-ranking medical journals have published on bruxism. Besides, we tested the insights described there against current science regarding the definition, assessment, epidemiology, etiology, consequences, comorbidities, and management of bruxism.

Results:

In the past century, the four top-ranking medical journals have provided their readership with various bits and pieces of information on bruxism. While some of these insights have withstood the test of time, others are somewhat outdated. Further, the identified publications provide an incomplete picture of what physicians should know. The present article helps reduce this knowledge gap.

Conclusion:

The role of the physician with regard to bruxism focuses mainly on its assessment and management, while insight into risk factors and comorbid conditions of bruxism is essential to high-level patient care. It is hoped that this article will contribute to improve the long-needed interdisciplinary collaboration between physicians and dentists regarding the assessment and management of bruxing patients.
Blood Flow Restriction Training for Meniscus Repair Surgery
Authors: Yamanashi Yuki , Allahabadi Sachin , Ma C. Benjamin , Arriaga Ivan
Published: March 2024

Background:

Blood flow restriction (BFR) is a training tool that involves wearing a tourniquet or occlusive device during exercise. Data support that low-load training with BFR may produce muscle hypertrophy similar to standard high-load training. Because of the weight-bearing and range of motion (ROM) restrictions after meniscal repair, patients encounter substantial atrophy of lower extremity musculature. We perform BFR for these patients to limit atrophy postoperatively with the goal of facilitating their return to prior function and sports.

Indications:

We incorporate BFR in the postoperative rehabilitation protocol for patients undergoing meniscal repair not involving the root. Patients with the following are excluded: acute or severe cardiac disease, peripheral vascular disease, blood pressure over systolic 180 mm Hg or diastolic 100 mm Hg, hemophilia, thrombophlebitis or history of deep vein thrombosis, severe anemia, and sickle cell disease.

Technique Description:

An automated BFR device calculates the patient’s limb occlusion pressure (LOP) and titrates to 50% to 80% of LOP for lower extremity exercises. Exercise parameters typically consist of 4 sets of each exercise, totaling 75 repetitions, with 30-second interset rest. Patients undergo a standard 3-phase postoperative rehabilitation protocol. Phase I (weeks 0-6): Patients are nonweightbearing, may be either footflat weightbearing or partial weightbearing at the surgeon’s, with ROM restricted 0 to 90 in a hinge knee brace throughout the phase. Exercises include quadriceps sets with neuromuscular electrical stimulation and straight leg raises and short/long arcs quadriceps. Phase II (weeks 7-8): Patients progress to weightbearing and ROM as tolerated and begin exercises including double mini squats, hamstring curls, double leg press, and double leg heel raises. Phase III: (weeks 9+): Patients perform double and single leg bridges, double leg bridges on ball with knee band, squats, single leg press, and single leg heel raises, all with the goal of returning to sports.

Results:

Prior systematic review data demonstrate low-load training with BFR increases muscle strength and induces hypertrophy relative to low-load training alone. No significant differences for Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales between BFR training group and control group.

Discussion:

BFR training may facilitate postoperative recovery in patients undergoing meniscal repair surgery by helping mitigate muscular atrophy.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
The airway epithelium: an orchestrator of inflammation, a key structural barrier and a therapeutic target in severe asthma
Authors: Russell Richard J. , Boulet Louis-Philippe , Brightling Christopher E. , Pavord Ian D. , Porsbjerg Celeste , Dorscheid Del , Sverrild Asger
Published: March 2024

Asthma is a disease of heterogeneous pathology, typically characterised by excessive inflammatory and bronchoconstrictor responses to the environment. The clinical expression of the disease is a consequence of the interaction between environmental factors and host factors over time, including genetic susceptibility, immune dysregulation and airway remodelling. As a critical interface between the host and the environment, the airway epithelium plays an important role in maintaining homeostasis in the face of environmental challenges. Disruption of epithelial integrity is a key factor contributing to multiple processes underlying asthma pathology. In this review, we first discuss the unmet need in asthma management and provide an overview of the structure and function of the airway epithelium. We then focus on key pathophysiological changes that occur in the airway epithelium, including epithelial barrier disruption, immune hyperreactivity, remodelling, mucus hypersecretion and mucus plugging, highlighting how these processes manifest clinically and how they might be targeted by current and novel therapeutics.
ERS International Congress 2023: highlights from the Respiratory Clinical Care and Physiology Assembly
Authors: Gonsard Apolline , Mekov Evgeni , Barron Sarah , Castellana Giorgio , Khurtsidze Elene , Vontetsianos Angelos , Pennati Francesca , Sivapalan Pradeesh , Latimer Lorna E. , Marillier Mathieu , Hui Chi-Yan , Kaltsakas Georgios , Kolekar Shailesh , Vagheggini Guido , Vicente Cláudia , Drummond David , Poberezhets Vitalii , Bayat Sam , Franssen Frits M.E. , Vogiatzis Ioannis , Gille Thomas
Published: March 2024

It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of laboratory-based science, clinical trials and qualitative research that were presented during the 2023 European Respiratory Society International Congress within the sessions from the five groups of Assembly 1 (Respiratory Clinical Care and Physiology). Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, electronic/mobile health (e-health/m-health), clinical respiratory physiology, exercise and functional imaging.
Deepstacked-AVPs: predicting antiviral peptides using tri-segment evolutionary profile and word embedding based multi-perspective features with deep stacking model
Authors: Akbar Shahid , Raza Ali , Zou Quan
Published: March 2024

Background

Viral infections have been the main health issue in the last decade. Antiviral peptides (AVPs) are a subclass of antimicrobial peptides (AMPs) with substantial potential to protect the human body against various viral diseases. However, there has been significant production of antiviral vaccines and medications. Recently, the development of AVPs as an antiviral agent suggests an effective way to treat virus-affected cells. Recently, the involvement of intelligent machine learning techniques for developing peptide-based therapeutic agents is becoming an increasing interest due to its significant outcomes. The existing wet-laboratory-based drugs are expensive, time-consuming, and cannot effectively perform in screening and predicting the targeted motif of antiviral peptides.

Methods

In this paper, we proposed a novel computational model called Deepstacked-AVPs to discriminate AVPs accurately. The training sequences are numerically encoded using a novel Tri-segmentation-based position-specific scoring matrix (PSSM-TS) and word2vec-based semantic features. Composition/Transition/Distribution-Transition (CTDT) is also employed to represent the physiochemical properties based on structural features. Apart from these, the fused vector is formed using PSSM-TS features, semantic information, and CTDT descriptors to compensate for the limitations of single encoding methods. Information gain (IG) is applied to choose the optimal feature set. The selected features are trained using a stacked-ensemble classifier.

Results

The proposed Deepstacked-AVPs model achieved a predictive accuracy of 96.60%%, an area under the curve (AUC) of 0.98, and a precision-recall (PR) value of 0.97 using training samples. In the case of the independent samples, our model obtained an accuracy of 95.15%, an AUC of 0.97, and a PR value of 0.97.

Conclusion

Our Deepstacked-AVPs model outperformed existing models with a ~ 4% and ~ 2% higher accuracy using training and independent samples, respectively. The reliability and efficacy of the proposed Deepstacked-AVPs model make it a valuable tool for scientists and may perform a beneficial role in pharmaceutical design and research academia.
Multidrug resistance among uropathogenic clonal group A E. Coli isolates from Pakistani women with uncomplicated urinary tract infections
Authors: Khan Ayesha , Saraf Viqar Sayeed , Siddiqui Fariha , Batool Tahira , Noreen Zobia , Javed Sundus , Ahmad Aftab , Alonazi Wadi B. , Ibrahim Muhammad , Pucciarelli Sandra , Bokhari Habib
Published: March 2024

Objective

Multi-drug resistance (MDR) has notably increased in community acquired uropathogens causing urinary tract infections (UTIs), predominantly Escherichia coli. Uropathogenic E. coli causes 80% of uncomplicated community acquired UTIs, particularly in pre-menopausal women. Considering this high prevalence and the potential to spread antimicrobial resistant genes, the current study was conducted to investigate the presence of clinically important strains of E. coli in Pakistani women having uncomplicated cystitis and pyelonephritis. Women belonging to low-income groups were exclusively included in the study. Seventy-four isolates from urine samples were processed, phylotyped, and screened for the presence of two Single Nucleotide Polymorphisms (SNPs) particularly associated with a clinically important clonal group A of E. coli (CgA) followed by antibiotic susceptibility testing and genome sequence analysis.

Results

Phylogroup B2 was most prevalent in patients and 44% of isolates were positive for the presence of CgA specific SNPs in Fumarate hydratase and DNA gyrase subunit B genes. Antibiotic susceptibility testing showed widespread resistance to trimethoprim-sulfamethoxazole and extended-spectrum beta-lactamase production. The infection analysis revealed the phylogroup B2 to be more pathogenic as compared to the other groups. The genome sequence of E. coli strain U17 revealed genes encoding virulence, multidrug resistance, and host colonization mechanisms.

Conclusions

Our research findings not only validate the significant occurrence of multidrug-resistant clonal group A E. coli (CgA) in premenopausal Pakistani women suffering from cystitis and pyelonephritis but also reveal the presence of genes associated withvirulence, and drug efflux pumps. The detection of highly pathogenic, antimicrobial-resistant phylogroup B2 and CgA E. coli strains is likely to help in understanding the epidemiology of the pathogen and may ultimately help to reduce the impact of these strains on human health. Furthermore, the findings of this study will particularly help to reduce the prevalence of uncomplicated UTIs and the cost associated with their treatment in women belonging to low-income groups.
KAKU4 regulates leaf senescence through modulation of H3K27me3 deposition in the Arabidopsis genome
Authors: Cao Yaxin , Yan Hengyu , Sheng Minghao , Liu Yue , Yu Xinyue , Li Zhongqiu , Xu Wenying , Su Zhen
Published: March 2024

Lamins are the major components of the nuclear lamina, which regulate chromatin structure and gene expression. KAKU4 is a unique nuclear lamina component in the nuclear periphery, modulates nuclear shape and size in Arabidopsis. The knowledge about the regulatory role of KAKU4 in leaf development remains limited. Here we found that knockdown of KAKU4 resulted in an accelerated leaf senescence phenotype, with elevated levels of H2O2 and hormones, particularly SA, JA, and ABA. Our results demonstrated the importance of KAKU4 as a potential negative regulator in age-triggered leaf senescence in Arabidopsis. Furthermore, we conducted combination analyses of transcriptomic and epigenomic data for the kaku4 mutant and WT leaves. The knockdown of KAKU4 lowered H3K27me3 deposition in the up-regulated genes associated with hormone pathways, programmed cell death, and leaf senescence, including SARD1, SAG113/HAI1, PR2, and so forth. In addition, we found the functional crosstalks between KAKU4 and its associated proteins (CRWN1/4, PNET2, GBPL3, etc.) through comparing multiple transcriptome datasets. Overall, our results indicated that KAKU4 may inhibit the expression of a series of genes related to hormone signals and H2O2 metabolism by affecting the deposition of H3K27me3, thereby suppressing leaf senescence.
Family physicians’ preferences for education to support family caregivers: a sequential mixed methods study
Authors: Parmar Jasneet , Hafeez Sara , L’Heureux Tanya , Charles Lesley , Tite Josephine , Tian Peter George J. , Anderson Sharon
Published: March 2024

Background

One in four Canadians is a family caregiver. Family caregivers (carers, care-partners) are relatives or chosen family, friends, or neighbors who provide 75 to 90% of the care for people with physical or mental illness, disabilities, or frailty living in community homes and assist with 15 to 30% of the care in congregate care. However, a recent (2022) Statistics Canada population health study reports 44% of family caregivers are distressed. Family physicians and primary care teams are well-positioned to support family caregivers; yet, family caregiver needs assessments tend to be ad hoc and their most common needs remain unmet. Research recommends training healthcare professionals to enhance their knowledge and skills to support family caregivers.

Methods

The objective of this sequential mixed methods research, a survey followed by qualitative interviews, was to explore family physicians’ desire and preferences for education about supporting family caregivers. 85 family physicians completed the online survey and eight took part in the interviews. Results from the survey and interviews were compared, contrasted, and interpreted together.

Results

Primary care physicians expressed a desire to be better equipped to assess and support FCGs’ needs. Even though most physicians (61%) were very/confident about addressing family caregivers’ needs, 72% were highly/interested in education to support family caregivers of their patients. Topics with the most interest were assessing family caregivers needs in an organized way, assisting family caregivers to access resources, and address system and practice barriers to support family caregivers. The overarching theme running through the interviews was physicians hope for education to help change the patient-focused culture to inclusion of FCGs. The three themes reflect physicians’ conviction about including family caregivers in patient care: We need to take care of their caregivers, Practice and system barriers thwart including family caregivers, and Practical education might help.

Conclusions

This study of family physicians’ preferences for education to support family caregivers will inform the development of education about supporting family caregivers for family physicians and trainees.
Development of the assessment standards of the International Classification of Functioning, Disability, and Health (ICF) Geriatric Core Set through a modified Delphi method
Authors: Zhang Malan , Gao Yan , Xue Jingjing , Li Kun , Zhang Lifang , Yu Jiani , Yan Tiebin , Hou Xiaohui
Published: March 2024

Background

There is currently a lack of functional assessment tools based on the International Classification of Functioning, Disability, and Health (ICF) theoretical framework that are specific for older adults.

Objective

The aim of the present study was to develop Chinese assessment standards of the ICF Geriatric Core Set for functional evaluation of older adults.

Methods

A two-stage study process was conducted to develop the assessment standards of the ICF Geriatric Core Set: establishment of candidate assessment standards, and a modified Delphi consensus process including a pilot survey and two-round formal expert survey. Thirty participants in the field of ICF and geriatric rehabilitation were recruited. The suitability of the assessment standards in the questionnaires was rated using a Likert 5-level scoring method. The arithmetic mean, the full mark ratio and the coefficient of variation (CV) were used as screening indicators for the assessment standards, and modification was made for several standards, in line with the Delphi results and the expert panel discussion.

Results

Thirty-three candidate assessment standards belonging to 17 categories were generated. A total of 26 and 24 experts in the field of ICF and geriatric rehabilitation participated in the two-round survey, respectively. Five standards belonging to four categories entered into the second-round survey directly, five standards belonged to five categories entered with minor modification, and nine standards belonging to seven categories were redesigned based on the literature and discussion of the expert panel. In the second-round survey,15 assessment standards belonging to 15 categories met the screening requirements and four assessment standards belonged to the two remaining categories that needed a criterion and which the expert panel discussed for the final decision.

Conclusions

Using the modified Delphi method, the assessment standards of the ICF Geriatric Core Set have been developed.Future work should focus on the reliability and validity of the the assessment standards and their application to the health management of older adults.
Are populations of postpartum women differentially served by community health worker programs: an observational cohort study from Zanzibar, Tanzania
Authors: Olakkengil Michelle , Said Samira , Abdalla Omar , Hofmann Rachel , Hedt-Gauthier Bethany , Fulcher Isabel
Published: March 2024

Background

Although community health worker (CHW) programs focus on improving access to healthcare, some individuals may not receive the intended quality or quantity of an intervention. The objective of this research was to examine if certain populations of pregnant women differentially experience the implementation of a community health worker-led maternal health intervention in Zanzibar.

Methods

We included pregnant women enrolled in the Safer Deliveries (Uzazi Salama) program, which operated in 10 of 11 districts in Zanzibar, Tanzania between January 1, 2017, and June 19, 2019 (N = 33,914). The outcomes of interest were receipt of the entire postpartum intervention (three CHW visits) and time to first postpartum CHW visit (days). Visits by CHWs were done at the women’s home, however, a telehealth option existed for women who were unable to be reached in-person. We conducted statistical tests to investigate the bivariate associations between our outcomes and each demographic and health characteristic. We used multivariate logistic regression to estimate the relationships between covariates and the outcomes and multivariate linear regression to estimate the association between covariates and the average time until first postpartum visit.

Results

Higher parity (OR = 0.85; P = 0.014; 95%CI: 0.75–0.97), unknown or unreported HIV status (OR = 0.64; p < 0.001; 95%CI: 0.53–0.78), and receipt of phone consultations (OR = 0.77; p < 0.001; 95%CI: 0.69–0.87) were associated with a lower odds of receiving all postpartum visits. Similarly, women with an unknown or unreported HIV status (estimated mean difference of 1.81 days; p < 0.001; 95%CI: 1.03–2.59) and those who received a phone consultation (estimated mean difference of 0.83 days; p < 0.001; 95%CI: 0.43–1.23), on average, experienced delays to first visit. In addition, current delivery at a referral hospital was associated with lower odds of receiving a postpartum visit and longer time to first visit compared to delivery at home, cottage hospital, PHCU + , or district hospital. Women from all other districts received their first visit earlier than women from Kaskazini B. There were no differences in the odds of receiving the entire postpartum intervention by sociodemographic variables, including age, education, and poverty assessment indicators.

Conclusion

The results indicate no differences in intervention contact across wealth and education levels, suggesting that the program is effectively reaching women regardless of SES. However, women with other characteristics (e.g., higher parity, unknown or unreported HIV status) had lower odds of receiving the complete intervention. Overall, this work generates knowledge on existing disparities in intervention coverage and enables future programs to develop approaches to achieve equity in health care utilization and outcomes.
Assessing pre-eclampsia awareness among pregnant women in Syria: a cross-sectional study on knowledge and perceptions
Authors: Bohsas Haidara , Alibrahim Hidar , Swed Sarya , Abouainain Yasmeen , Aljabali Ahmed , Masoud Samaa , Saleh Heba Haj , Aldawoud Tony , Taleb Fahima , Alsheikh Raneem Alnassif , Fawaz Hassan , Mourad Danya , Mohamed Waleed Farouk , Aboushady Reham , Hafez Wael
Published: March 2024

Background

Pre-eclampsia (PE) is a major contributor to morbidity and mortality in mothers worldwide. Adequate understanding of this condition improves treatment, control, and prevention. This study evaluated preeclampsia awareness among pregnant women in Syria, and the characteristics related to awareness adequacy.

Methods

This national cross-sectional study was conducted in Syria between 25 October and November 19, 2022. We included pregnant females of all age groups from all Syrian governorates. The questionnaire consisted of sociodemographic characteristics and knowledge of pre-eclampsia and its associated factors, symptoms, and complications.

Results

Overall, 706 participants were involved in this research, with a mean age of 38.22. Only 52.1% of them reported that they had heard of preeclampsia. Among the participants, 56.5% stated that they would not terminate a pregnancy if they were determined to be likely to develop preeclampsia, while nearly 55.2% agreed to continue the pregnancy rather than deliver prematurely even if their where a potential risk on their health risks. Participants who reported a family history of PE or had already experienced PE were more likely to have appropriate preeclampsia knowledge than those who did not (OR = 2.27, OR = 3.18, respectively). Respondents aged 25 to 35 years had the highest knowledge scores, and participants living in cities scored higher knowledge than rural residents.

Conclusion

According to our findings, pregnant women in Syria have a awareness gaps regarding the PE topic. This highlights the need to enhance women’s preeclampsia understanding for better pregnancy outcomes. Education through organizations, the media, and national programs is a significant aspect that promotes an adequate understanding of preeclampsia.
A meta-analysis of the effects of vitamin C supplementation for pregnant smokers on the pulmonary function of their offspring
Authors: Wang Lei , Wei Lina , Wang Zhongtian , Ren Xiaoting , Yang Fushuang , Sun Liping
Published: March 2024

Background

At present, the need for vitamin C supplementation for pregnant smokers has not been fully studied. This study is aimed at investigating whether vitamin C supplementation for pregnant smoking women can improve the pulmonary function of their offspring.

Methods

Four databases were searched from inception to April 1, 2023 for studies on the effect of vitamin C supplementation to pregnant smokers on the pulmonary function of their offspring. Meanwhile, the reference lists of relevant studies were manually searched. The risk of bias in the included studies was assessed using the Cochrane Collaboration tool, and the data was analyzed using STATA/SE 17.0.

Results

Four randomized controlled trials (RCTs), all of high quality, were enrolled in this meta-analysis, including 787 pregnant women. The offspring of pregnant smokers who received vitamin C supplementation exhibited improved Forced Expiratory Flow between 25 and 75% (FEF25-75), FEF50, FEF75, and Forced Vital Capacity (FVC) compared to those who did not receive vitamin C supplementation. However, there was no statistically significant difference in Forced Expiratory Volume at 0.5 s (FEV0.5) and the ratio of FEV0.5 to FVC between the offspring of pregnant smokers who received vitamin C and the control group.

Conclusion

Vitamin C supplementation for smoking pregnant women may enhance the pulmonary function of their offspring, particularly in FEF25-75, FEF50, FEF75, and FVC. Nevertheless, there are no significant differences in FEV0.5 and the FEV0.5/FVC ratio. These findings suggest that vitamin C supplementation has potential benefits for specific pulmonary function. Further studies are needed to comprehensively assess the effects of vitamin C on pulmonary function in the context of maternal smoking during pregnancy.
Consolidation chemotherapy after definitive concurrent chemoradiotherapy in patients with inoperable esophageal squamous cell carcinoma: a multicenter non-inferiority phase III randomized clinical trial
Authors: Fan Chengcheng , Wang Xu , Zheng Xiaoli , Sun Yanan , Ye Ke , Jiang Yue , Liu Xiao , Xu Wencai , Liu Yang , Yang Yuanyuan , Liu Jinsong , Jiang Qiong , He Chunyu , Wu Xiaoyuan , Nie Xin , Zhang Jingwei , Tan Bo , Wang Wen , Zhang Yougai , Feng Zhuo , Yang Chengliang , Lu Yufei , Liu Hailong , Chen Xijuan , Xu Jing , Liu Fang , Zheng Xuefeng , Wang Jianhua , Wu Shang , Chen Guofu , Zhang Yaowen , Jin Linzhi , Ge Hong
Published: March 2024

Background

Definitive concurrent chemoradiotherapy (dCCRT) is the gold standard for the treatment of locally advanced esophageal squamous cell carcinoma (ESCC). However, the potential benefits of consolidation chemotherapy after dCCRT in patients with esophageal cancer remain debatable. Prospective randomized controlled trials comparing the outcomes of dCCRT with or without consolidation chemotherapy in patients with ESCC are lacking. In this study, we aim to generate evidence regarding consolidation chemotherapy efficacy in patients with locally advanced, inoperable ESCC.

Methods

This is a multicenter, prospective, open-label, phase-III randomized controlled trial comparing non-inferiority of dCCRT alone to consolidation chemotherapy following dCCRT. In total, 600 patients will be enrolled and randomly assigned in a 1:1 ratio to receive either consolidation chemotherapy after dCCRT (Arm A) or dCCRT alone (Arm B). Overall survival will be the primary endpoint, whereas progression-free survival, locoregional progression-free survival, distant metastasis-free survival, and treatment-related toxicity will be the secondary endpoints.

Discussion

This study aid in further understanding the effects of consolidation chemotherapy after dCCRT in patients with locally advanced, inoperable ESCC.

Trial registration

ChiCTR1800017646.
p53/E2F7 axis promotes temozolomide chemoresistance in glioblastoma multiforme
Authors: Meng Jiao , Qian Wei , Yang Zhenkun , Gong Lingli , Xu Daxing , Huang Hongbo , Jiang Xinyi , Pu Zhening , Yin Ying , Zou Jian
Published: March 2024

Background

Glioblastoma multiforme (GBM) is the most aggressive form of brain cancer, and chemoresistance poses a significant challenge to the survival and prognosis of GBM. Although numerous regulatory mechanisms that contribute to chemoresistance have been identified, many questions remain unanswered. This study aims to identify the mechanism of temozolomide (TMZ) resistance in GBM.

Methods

Bioinformatics and antibody-based protein detection were used to examine the expression of E2F7 in gliomas and its correlation with prognosis. Additionally, IC50, cell viability, colony formation, apoptosis, doxorubicin (Dox) uptake, and intracranial transplantation were used to confirm the role of E2F7 in TMZ resistance, using our established TMZ-resistance (TMZ-R) model. Western blot and ChIP experiments provided confirmation of p53-driven regulation of E2F7.

Results

Elevated levels of E2F7 were detected in GBM tissue and were correlated with a poor prognosis for patients. E2F7 was found to be upregulated in TMZ-R tumors, and its high levels were linked to increased chemotherapy resistance by limiting drug uptake and decreasing DNA damage. The expression of E2F7 was also found to be regulated by the activation of p53.

Conclusions

The high expression of E2F7, regulated by activated p53, confers chemoresistance to GBM cells by inhibiting drug uptake and DNA damage. These findings highlight the significant connection between sustained p53 activation and GBM chemoresistance, offering the potential for new strategies to overcome this resistance.
Apolipoprotein A-IV concentrations and cancer in a large cohort of chronic kidney disease patients: results from the GCKD study
Authors: Kollerits Barbara , Gruber Simon , Steinbrenner Inga , Schwaiger Johannes P. , Weissensteiner Hansi , Schönherr Sebastian , Forer Lukas , Kotsis Fruzsina , Schultheiss Ulla T. , Meiselbach Heike , Wanner Christoph , Eckardt Kai-Uwe , Kronenberg Florian ,   for the GCKD Investigators, Schneider Markus P. , Schiffer Mario , Prokosch Hans-Ulrich , Bärthlein Barbara , Beck Andreas , Reis André , Ekici Arif B. , Becker Susanne , Alberth-Schmidt Ulrike , Weigel Anke , Marschall Sabine , Schefler Eugenia , Walz Gerd , Köttgen Anna , Schultheiß Ulla T. , Meder Simone , Mitsch Erna , Reinhard Ursula , Floege Jürgen , Saritas Turgay , Gross Alice , Schaeffner Elke , Baid-Agrawal Seema , Theisen Kerstin , Haller Hermann , Zeier Martin , Sommerer Claudia , Aykac Mehtap , Wolf Gunter , Busch Martin , Steiner Andy , Sitter Thomas , Krane Vera , Börner-Klein Antje , Bauer Britta , Oefner Peter , Gronwald Wolfram , Schmid Matthias , Nadal Jennifer
Published: March 2024

Background

Chronic kidney disease (CKD) is highly connected to inflammation and oxidative stress. Both favour the development of cancer in CKD patients. Serum apolipoprotein A-IV (apoA-IV) concentrations are influenced by kidney function and are an early marker of kidney impairment. Besides others, it has antioxidant and anti-inflammatory properties. Proteomic studies and small case–control studies identified low apoA-IV as a biomarker for various forms of cancer; however, prospective studies are lacking. We therefore investigated whether serum apoA-IV is associated with cancer in the German Chronic Kidney Disease (GCKD) study.

Methods

These analyses include 5039 Caucasian patients from the prospective GCKD cohort study followed for 6.5 years. Main inclusion criteria were an eGFR of 30–60 mL/min/1.73m2 or an eGFR > 60 mL/min/1.73m2 in the presence of overt proteinuria.

Results

Mean apoA-IV concentrations of the entire cohort were 28.9 ± 9.8 mg/dL (median 27.6 mg/dL). 615 patients had a history of cancer before the enrolment into the study. ApoA-IV concentrations above the median were associated with a lower odds for a history of cancer (OR = 0.79, p = 0.02 when adjusted age, sex, smoking, diabetes, BMI, albuminuria, statin intake, and eGFRcreatinine). During follow-up 368 patients developed an incident cancer event and those with apoA-IV above the median had a lower risk (HR = 0.72, 95%CI 0.57–0.90, P = 0.004). Finally, 62 patients died from such an incident cancer event and each 10 mg/dL higher apoA-IV concentrations were associated with a lower risk for fatal cancer (HR = 0.62, 95%CI 0.44–0.88, P = 0.007).

Conclusions

Our data indicate an association of high apoA-IV concentrations with reduced frequencies of a history of cancer as well as incident fatal and non-fatal cancer events in a large cohort of patients with CKD.

Graphical Abstract
Exploration of the relationship between tumor-infiltrating lymphocyte score and histological grade in breast cancer
Authors: Kang Deyong , Wang Chuan , Han Zhonghua , Zheng Liqin , Guo Wenhui , Fu Fangmeng , Qiu Lida , Han Xiahui , He Jiajia , Li Lianhuang , Chen Jianxin
Published: March 2024

Background

The histological grade is an important factor in the prognosis of invasive breast cancer and is vital to accurately identify the histological grade and reclassify of Grade2 status in breast cancer patients.

Methods

In this study, data were collected from 556 invasive breast cancer patients, and then randomly divided into training cohort (n = 335) and validation cohort (n = 221). All patients were divided into actual low risk group (Grade1) and high risk group (Grade2/3) based on traditional histological grade, and tumor-infiltrating lymphocyte score (TILs-score) obtained from multiphoton images, and the TILs assessment method proposed by International Immuno-Oncology Biomarker Working Group (TILs-WG) were also used to differentiate between high risk group and low risk group of histological grade in patients with invasive breast cancer. Furthermore, TILs-score was used to reclassify Grade2 (G2) into G2 /Low risk and G2/High risk. The coefficients for each TILs in the training cohort were retrieved using ridge regression and TILs-score was created based on the coefficients of the three kinds of TILs.

Results

Statistical analysis shows that TILs-score is significantly correlated with histological grade, and is an independent predictor of histological grade (odds ratio [OR], 2.548; 95%CI, 1.648–3.941; P < 0.0001), but TILs-WG is not an independent predictive factor for grade (P > 0.05 in the univariate analysis). Moreover, the risk of G2/High risk group is higher than that of G2/Low risk group, and the survival rate of patients with G2/Low risk is similar to that of Grade1, while the survival rate of patients with G2/High risk is even worse than that of patients with G3.

Conclusion

Our results suggest that TILs-score can be used to predict the histological grade of breast cancer and potentially to guide the therapeutic management of breast cancer patients.