bluuebunny/crossref_metadata_2025 huggingface dataset:
Historical Perspectives on Infant and Child Mortality
Authors: Pozzi Lucia , Raftakis Michail
Published: August 2023

Infant mortality refers to the death of an infant before reaching the age of one, while child mortality refers to the death of a child between the ages of one and four. Infant and child mortality rates have proved to be significant indicators of the health of past populations, and since they are related to several factors (including poverty, inadequate food, and lack of public health or hygiene) that affect the health of a population, they are often seen as indicators of living standards in the past. Even today, they are considered an important factor in measuring the level of child health and overall development in countries. Infant and child mortality and its main determinants have been investigated by scholars of different disciplines, including demographers; social, medical, and economic historians; epidemiologists; and anthropologists. Although infant and child mortality has been steadily declining over the past two centuries, in the past nearly a quarter of all children died within the first year of their lives. The decline in child mortality in most developed countries across Europe, North America, and Australia had halved by the mid-twentieth century, accounting for less than 5 percent of all deaths, while at the beginning of the twenty-first century, about one in two hundred children died before their fifth birthday. However, the fall in child mortality has not been universal: many countries in sub-Saharan Africa and Southeast Asia still today experience large numbers of child deaths. In 2021, for instance, five million children under the age of five died, with the majority dying in the first year. Reductions in child mortality contributed significantly to the overall mortality decline during the late eighteenth, nineteenth, and twentieth centuries and brought about large increases in the life expectancy of historical populations. The decline in infant and child mortality has been attributed to a variety of causes, including biological, socioeconomic, cultural, environmental, and geographical determinants; successive sanitary reforms; improvements in medical science, standards of living, and maternal education; changes in childcare practices; and the decline in fertility.
Devorah Baron
Authors: Pinsker Shachar
Published: August 2023

Devorah Baron (also known as Dvorah or Dvora Baron, b. 1887–d. 1956) was a writer of Hebrew and Yiddish fiction, an editor, and a translator. Today, she is recognized mostly as master of Hebrew short stories who illuminated modernity and gender from a female perspective. Baron was part of a new generation of Hebrew writers who began to write in the early twentieth century, and the only woman to be part of its canon. She was born in Ouzda, a small town near Minsk. Her father, Shabtai Eliezer Baron, was the town’s rabbi, and he raised his daughter in an unusual way, allowing her to study the texts of the traditional yeshiva curriculum that was reserved for men. Baron began publishing stories in the Hebrew and Yiddish press at the age of fifteen (in 1902), just before she left home to acquire a secular education. After spending some years in major Jewish cities in the Pale of Settlement (including Kovno, Mariompol, and Vilna), she immigrated to Ottoman Palestine in December 1910. In Palestine, she met and married Yoseph Aharonovich, who was a Zionist activist and the editor of the journal of Labor Zionism, Ha-Poel ha-Tza’ir (The young laborer). Baron became the editor of the literary supplement of this prominent publication. In 1914, Dvora Baron, her husband, and their daughter Tzipora were exiled to Egypt by the Ottoman authorities. They returned to Palestine only after the end of World War I, in 1919. Throughout this period, she published her early stories in the Hebrew and Yiddish press, but later renounced them, refusing to collect and republish them. From 1923, after Baron and her husband resigned from Ha-Po'el ha-Tza’ir, she confined herself to her apartment in Tel Aviv, which she almost never left until the time of her death in 1956. During this long period of seclusion, Baron wrote what is considered to be the more significant and mature part of her literary work, which consists of some eighty short stories and a few longer novellas, as well as a celebrated translation of Flaubert’s Madame Bovary, (1932), as well as other short stories by various European writers. Baron published her first book collection: Stories (Sipurim) only in 1927. In 1934, she won the prestigious Bialik Prize. She won the Rupin Prize, for her novella For the Time Being (Le-'Et ‘Ata, 1943), which treated the subject of the exile of foreign nationals from the Jewish settlements in Palestine during World War I. Baron’s most comprehensive collection of stories, entitled Parshiyot (Tales, 1951) received broad recognition and multiple honors, including the Brenner Hebrew literary prize. Additional collections of Baron’s work were published in Hebrew during her lifetime and posthumously.
Speciation Continuum
Authors: Stankowski Sean
Published: August 2023

Understanding the origin of species is no easy task. Academic studies of speciation usually take place over a few years, while the process itself usually occurs over evolutionary timescales. How, then, can we possibly hope to understand speciation from start to finish? The idea of a “speciation continuum” has been presented as something of a solution to this problem. Because we are surrounded by many examples of speciation—each providing a snapshot at some point during the transition from populations to species—we can use them to understand the process as a whole. This article will (1) highlight some key references that laid the foundations for continuum thinking in speciation research, (2) explore the origins and definitions of the term “speciation continuum” and (3) highlight some outstanding empirical studies rooted in the speciation continuum.
x- and y-type thioredoxins maintain redox homeostasis on photosystem I acceptor side under fluctuating light
Authors: Okegawa Yuki , Sato Nozomi , Nakakura Rino , Murai Ryota , Sakamoto Wataru , Motohashi Ken
Published: August 2023

Plants cope with sudden increases in light intensity through various photoprotective mechanisms. Redox regulation by thioredoxin (Trx) systems also contributes to this process. Whereas the functions of f- and m-type Trxs in response to such fluctuating light conditions have been extensively investigated, those of x- and y-type Trxs are largely unknown. Here, we analyzed the trx x single, trx y1 trx y2 double, and trx x trx y1 trx y2 triple mutants in Arabidopsis (Arabidopsis thaliana). A detailed analysis of photosynthesis revealed changes in photosystem I (PSI) parameters under low light in trx x and trx x trx y1 trx y2. The electron acceptor side of PSI was more reduced in these mutants than in the wild type. This mutant phenotype was more pronounced under fluctuating light conditions. During both low- and high-light phases, the PSI acceptor side was largely limited in trx x and trx x trx y1 trx y2. After fluctuating light treatment, we observed more severe PSI photoinhibition in trx x and trx x trx y1 trx y2 than in the wild type. Furthermore, when grown under fluctuating light conditions, trx x and trx x trx y1 trx y2 plants showed impaired growth and decreased level of PSI subunits. These results suggest that Trx x and Trx y prevent redox imbalance on the PSI acceptor side, which is required to protect PSI from photoinhibition, especially under fluctuating light. We also propose that Trx x and Trx y contribute to maintaining the redox balance even under constant low-light conditions to prepare for sudden increases in light intensity.
A response regulator controls Acinetobacter baumannii virulence by acting as an indole receptor
Authors: Cui Binbin , Guo Quan , Li Xia , Song Shihao , Wang Mingfang , Wang Gerun , Yan Aixin , Zhou Jianuan , Deng Yinyue
Published: August 2023

Indole is an important signal employed by many bacteria to modulate intraspecies signaling and interspecies or interkingdom communication. Our recent study revealed that indole plays a key role in regulating the physiology and virulence of Acinetobacter baumannii. However, it is not clear how A. baumannii perceives and responds to the indole signal in modulating biological functions. Here, we report that indole controls the physiology and virulence of A. baumannii through a previously uncharacterized response regulator designated as AbiR (A1S_1394), which contains a cheY-homologous receiver (REC) domain and a helix-turn-helix (HTH) DNA-binding domain. AbiR controls the same biological functions as the indole signal, and indole-deficient mutant phenotypes were rescued by in trans expression of AbiR. Intriguingly, unlike other response regulators that commonly interact with signal ligands through the REC domain, AbiR binds to indole with a high affinity via an unusual binding region, which is located between its REC and HTH domains. This interaction substantially enhances the activity of AbiR in promoter binding and in modulation of target gene expression. Taken together, our results present a widely conserved regulator that controls bacterial physiology and virulence by sensing the indole signal in a unique mechanism.
Efficacy and management of tocilizumab in polymyalgia rheumatica: results of a multicentre retrospective observational study
Authors: Assaraf Morgane , Chevet Baptiste , Wendling Daniel , Philippe Peggy , Cailliau Emeline , Roux Christian , Dieude Philippe , Ottaviani Sebastien , Avouac Jérôme , Delacour Mathilde , Houvenagel Eric , Sellam Jérémie , Cortet Bernard , Henry Julien , Flipo René-Marc , Devauchelle-Pensec Valérie
Published: August 2023

Objectives

The efficacy of anti-IL-6 receptors such as tocilizumab (TCZ) was demonstrated in patients with PMR in two recent randomized controlled trials. The objective of this multicentre retrospective study was to assess the efficacy of TCZ in PMR patients requiring glucocorticoid (GC)-sparing treatment, as well as different strategies for TCZ withdrawal.

Methods

We conducted a multicentre study in French tertiary healthcare departments for patients with PMR. PMR patients receiving off-label TCZ between 2015 and 2022 were included. The primary endpoint was the proportion of patients tapering to GCs ≤5 mg/day 6 months after the first TCZ infusion. The secondary endpoints were the proportion in whom GC was discontinued during follow-up, and the proportion of patients in whom TCZ was discontinued.

Results

Fifty-three PMR patients were included. Thirty-one patients suffered from active PMR despite conventional synthetic DMARDs. GCs were ≤5 mg/day in 77% of the patients (95% CI 36–89) at 6 months, and in 97% of the patients at 12 months. Six and 12 months after the first TCZ infusion, the proportions of GC-free patients were 22.5% (95% CI 12.7–37.8) and 58.3% (95% CI 43.2–74.1), respectively. Among TCZ withdrawal strategies, TCZ infusion spacing and TCZ dose reduction were more successful (success in 87% and 79% of attempts, respectively) than TCZ discontinuation (success in 52% of attempts; P = 0.012 and P = 0.039, respectively).

Conclusion

In GC-dependent PMR patients, treatment with TCZ led to a drastic decrease in GC dose and remission of PMR. TCZ dose reduction or TCZ infusion spacing are good options to consider in TCZ withdrawal.
Anticipated Pleasure and Displeasure for Future Social and nonsocial Events: A Scale Development Study
Authors: Zhang Rui-Ting , Yang Tian-xiao , Wang Zhao-ying , Yang Ming-yue , Huang Jia , Wang Ya , Lui Simon S Y , Chan Raymond C K
Published: August 2023

Background and Hypothesis

People with schizophrenia (SCZ) or schizotypal traits (ST) have difficulties in anticipating future pleasure and displeasure in social situations. However, no self-report scale has been developed to specifically capture these abilities. This study aimed to develop and validate the Social Affective Forecasting Scale (SAFS), and to examine how anticipated pleasure and displeasure are associated with ST and clinical symptoms in SCZ.

Study Design

Study 1 recruited a main sample of 666 college students and a validation sample of 927 college students to complete the SAFS and other measurements for anhedonia. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), parallel analysis, and measurement invariance analysis were conducted. Study 2 recruited 2655 college students, 47 people with SCZ and 47 matched controls to complete the SAFS. Correlation analysis, regression analysis, and independent t-tests were performed.

Study Results

Both EFA and CFA indicated a 4-factor model which was supported by parallel analysis in the validation sample. The SAFS showed good internal consistency, convergent validity, and strong invariance across sex. Interpersonal features of ST and negative symptoms in SCZ were associated with reduced anticipated pleasure for positive social events.

Conclusions

The SAFS appears to be a reliable scale for evaluating anticipated pleasure and displeasure for future social and nonsocial events, and can be applied to study social anhedonia in individuals with ST and individuals with SCZ.
Inhibition of CK2α accelerates skin wound healing by promoting endothelial cell proliferation through the Hedgehog signaling pathway
Authors: Zhu Junjie , Chen Peng , Liang Jiaojiao , Wu Zhaohang , Jin Haiqun , Xu Tianpeng , Zheng Yeyi , Ma Hongfang , Cong Weitao , Wang Xu , Guan Xueqiang
Published: August 2023

Diabetes is a chronic disease characterized by perturbed glucose and lipid metabolism, resulting in high blood glucose levels. Many complications induced by endothelial dysfunction can cause disability and even death of diabetic patients. Here, we found that the protein level of casein kinase 2α (CK2α) was increased in the endothelium of mice with type I diabetes (T1D) induced by streptozotocin (STZ) injection. Although a potential correlation between the protein level of CK2α and endothelial dysfunction in diabetes was established, the contribution of CK2α to the progression of endothelial dysfunction in diabetes remained largely unknown. By using CX4945 (a selective CK2α antagonist) and Si‐csnk2a1 (small interfering RNA targeting CK2α), we found that inhibition of CK2α accelerated skin wound healing in T1D mice by promoting proliferation of endothelial cells. Administration of CX4945 or Si‐csnk2a1 rescued the impaired Hedgehog signaling pathway in high glucose‐treated human umbilical vein endothelial cells (HUVECs). Exploration of the underlying molecular mechanism revealed that the protective effect of CK2α inhibition on angiogenesis, which contributes to skin wound healing in diabetic mice, was blocked by administration of GANT61 (an inhibitor targeting the Hedgehog signaling pathway). Our findings establish CK2α as a regulator of endothelial dysfunction in diabetes and demonstrate that inhibition of CK2α accelerates skin wound healing in T1D mice by promoting endothelial cell proliferation via the Hedgehog signaling pathway.
The Effect of CytoSorb on Inflammatory Markers in Critically Ill Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials*
Authors: Heymann Marc , Schorer Raoul , Putzu Alessandro
Published: August 2023

OBJECTIVES:

The effectiveness of CytoSorb at removing inflammatory mediators in critically ill patients is controversial.

DATA SOURCES:

Electronic databases were searched from inception to May 2023.

STUDY SELECTION:

Randomized controlled trials reporting the effects of CytoSorb therapy on inflammatory parameters in critically ill patients with hyperinflammatory conditions were included.

DATA EXTRACTION:

Two authors screened articles for eligibility, extracted data, and assessed the risk of bias, conflicts of interest, and certainty of evidence (CoE). The primary outcome was interleukin (IL)-6 at 1 day after initiation of the therapy. Secondary outcomes included various inflammatory markers at 1, 2, 3, and 5 days and mortality. Data were pooled if at least three trials reported the outcome of interest. We conducted meta-analyses of the data using a random-effects model.

DATA SYNTHESIS:

Seventeen trials (n= 855) were included. Fourteen trials were judged to have notable concern about conflicts of interest. Seven trials were performed in medical ICU patients with hyperinflammatory conditions and 10 in complex cardiovascular surgery under cardiopulmonary bypass. Hemoadsorption with CytoSorb was not associated with lower IL-6 at 1 day (mean difference −5.98 [95% CI, −30.44 to 18.48] pg/mL), 2 days, 3 days, or 5 days after initiation of the treatment, as well as the concentration of procalcitionin. The levels of C-reactive protein were not lower with CytoSorb at 1, 2, and 3 days. The use of CytoSorb was associated with higher mortality at latest follow-up (relative risk = 1.22 [95% CI, 1.02–1.45]) and at 30 days. CoE ranged from low to very low.

CONCLUSIONS:

The use of CytoSorb hemoadsorption in a mixed population of critically ill patients with hyperinflammatory conditions does not exhibit a consistent decrease in IL-6 and other inflammatory parameters within the first 5 days of treatment. The significant uncertainty surrounding these findings highlights the need for further investigations.
Antiphospholipid Syndrome: Thrombotic and Vascular Complications
Authors: Windisch Stephen , Ash Julia Y. , Frishman William H.
Published: August 2023

Antiphospholipid syndrome is a rare, autoimmune thrombophilia defined by vascular thrombosis and pregnancy morbidity, in the setting of documented persistent antiphospholipid antibodies including the lupus anticoagulant, anticardiolipin antibodies, or anti-β2 glycoprotein I antibodies. The presence of antiphospholipid antibodies can be completely asymptomatic, or they can lead to clinical manifestations as severe as catastrophic antiphospholipid syndrome, which involves widespread coagulopathy over a very short period of time. The degree of risk associated with antiphospholipid syndrome depends on the characteristics of the antiphospholipid antibody profile and on the presence of additional thrombotic risk factors. The current standard treatment for unprovoked thrombosis is long-term warfarin. Treatment to prevent recurrent obstetric complications is low-dose aspirin and prophylactic heparin in pregnant patients. The use of direct oral anticoagulants in patients with antiphospholipid syndrome is still being debated. Their use is generally contraindicated, especially in high-risk patients, such as those with all 3 antiphospholipid antibodies present, but they may potentially be of some use in some low-risk patients.
COVID-19 Associated Myocarditis: Prevalence, Pathophysiology, Diagnosis, and Management
Authors: Yan Ji , Hong Jiang
Published: August 2023

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been a pandemic and affected public health greatly. While COVID-19 primarily damages the lungs, leading to cough, sore throat, pneumonia, or acute respiratory distress syndrome, it also infects other organs and tissues, including the cardiovascular system. In particular, myocarditis is a well-recognized severe complication of COVID-19 infection and could result in adverse outcomes. Angiotensin-Converting Enzyme2 is thought to play a pivotal role in SARS-CoV-2 infection, and immune overresponse causes overwhelming damage to the host’s myocardium. Direct viral infection and injury do take a part as well, but more evidence is needed to strengthen this proposal. The clinical abnormalities include elevated cardiac biomarkers and electrocardiogram changes and impaired cardiac function that might be presented in echocardiography and cardiovascular magnetic resonance imaging. If necessary, the endomyocardial biopsy would give more forceful information to diagnosis and aid in treatment. Comparisons between COVID-19 myocarditis and other viral myocarditis are also discussed briefly.
Characterization of Auricular Growth within the Pediatric Population Using Computed Tomography Scan Measurements
Authors: Leto Barone Angelo A. , Farley Gabrielle , Vieira Alves Vinicius P. , Bredemeier Nina O. , Hogan Elise , Madzia Jules , Woodyard Kiersten , Schwentker Ann R. , Fleck Robert J.
Published: August 2023

Background:

In patients with microtia, auricular reconstruction is ideally performed promptly to prevent impaired socialization during formative childhood years. The earliest viable age for reconstruction is widely accepted from 7–10 years of age, as full auricular size is achieved around age 8, with some variability dependent on sex. This retrospective study aims to provide an auricular growth curve that accounts for age and sex, enhancing the individualized approach to ear reconstruction.

Methods:

A total of 319 images of unaffected patients who underwent computed tomography angiography of the head and neck were reviewed, with bilateral cartilage height and width measured according to a consensus-standardized image measurement protocol. Means and SDs of cartilage height and width were calculated for both sexes, and analysis of ear growth was performed through plotting the mean cartilage height, width, and width:height ratio over time.

Results:

Cartilage height and width differed significantly between male and female groups. Maximum cartilage height was reached at age 11 for female and at age 12 for male patients, whereas maximum cartilage width was reached at ages 10 and 8, respectively. On average, the width:height ratio for female group was 0.58. For male group, the average width:height ratio was 0.59.

Conclusions:

An auricular growth map was designed using computed tomography measurements demonstrating maximum auricular size at age 11 and 12 respectively for female and male patients, with both sexes having a width:height ratio maintained at approximately 0.6 throughout growth.
Emergency Department Observation Unit Patients Want Evaluation and Treatment for Hypercholesterolemia: A Health Belief Model Study
Authors: Ashburn Nicklaus P. , Snavely Anna C. , Stanek Laurie S. , Shapiro Michael D. , Rikhi Rishi R. , Chado Michael A. , Stopyra Jason P. , Mahler Simon A.
Published: August 2023

Background:

Hypercholesterolemia (HCL) is common among emergency department (ED) and ED observation unit (EDOU) patients with chest pain but is not typically addressed in these settings. The objective of this study was to assess patient attitudes towards EDOU-based HCL care using the Health Belief Model.

Methods:

We conducted a cross-sectional survey study among 100 EDOU patients ≥18 years-old evaluated for chest pain in the EDOU of a tertiary care center from September 1, 2020, to November 01, 2021. Five-point Likert-scale surveys were used to assess each Health Belief Model domain: Cues to Action, Perceived Susceptibility, Perceived Barriers, Perceived Self-Efficacy, and Perceived Benefits. Responses were categorized as agree or do not agree.

Results:

The participants were 49.0% (49/100) female, 39.0% (39/100) non-white, and had a mean age of 59.0 ± 12.4 years. Most (83.0% [83/100, 95% confidence interval (CI), 74.2%-89.8%]) agreed the EDOU is an appropriate place for HCL education and 52.0% (52/100, 95% CI, 41.8%-62.1%) were interested in talking with their EDOU care team about HCL. Regarding Perceived Susceptibility, 88.0% (88/100, 95% CI, 80.0%-93.6%) believed HCL to be bad for their health, while 41.0% (41/100, 95% CI, 31.3%-51.3%) believed medication costs could be a barrier. For Perceived Self-Efficacy, 76.0% (76/100, 95% CI, 66.4%-84.0%) were receptive to taking medications. Overall, 95.0% (95/100, 95% CI, 88.7%-98.4%) believed managing HCL would benefit their health.

Conclusions:

This Health Belief Model-based survey indicates high patient interest in EDOU-initiated HCL care. Patients reported high rates of Perceived Susceptibility, Self-Efficacy, and Benefits and a minority found HCL therapy costs a barrier.
Opsoclonus and ocular flutter: evaluation and management
Authors: Grossman Scott N. , Rucker Janet C.
Published: August 2023

Purpose of review

Opsoclonus and ocular flutter are saccadic intrusions characterized by spontaneous, back-to-back, fast eye movements (saccades) that oscillate about the midline of central visual fixation without intervening inter-saccadic intervals. When this type of movement occurs exclusively in the horizontal plane, it is called ocular flutter. When it occurs in multiple planes (i.e. horizontal, vertical, and torsional) it is called opsoclonus. The most common etiologic categories are parainfectious and paraneoplastic diseases. Less common are toxic-metabolic, traumatic, or idiopathic origins. The mechanism of these movements relates to dysfunction of brainstem and cerebellar machinery involved in the generation of saccades. In this review, we discuss the characteristics of opsoclonus and ocular flutter, describe approaches to clinical evaluation and management of the patient with opsoclonus and ocular flutter, and review approaches to therapeutic intervention.

Recent findings

Recent publications demonstrated eye position-dependent opsoclonus present only in left gaze, which may be related to dysfunction of frontal eye fields or structures in the cerebellar vermis.

Opsoclonus and ocular flutter originate from a broad array of neuropathologies and have value from both a neuroanatomic and etiologic perspective.
Factors influencing antibiotic prescribing by nurse practitioners: A quantitative pilot study using the theory of planned behavior
Authors: Patel Pinki , Hou Cindy , Manning Mary Lou
Published: August 2023

Background:

The overuse of antibiotics contributes to the development of antibiotic resistance (AR) and exposes patients to potential antibiotic-related harm. Nurse practitioners (NPs) are well positioned to optimize antibiotic use; however, little is known about the factors influencing NP prescribing behaviors.

Purpose:

Describe the knowledge, attitude, subjective norms, and perceived behavioral control in prescribing antibiotics among NPs practicing at a large university-affiliated health care system in the northeast United States.

Methodology:

This was a cross-sectional online anonymous survey using the Theory of Planned Behavior. Descriptive statistics were used to describe the sample. Nonparametric tests were used to examine differences in the dependent variables by demographic characteristics.

Results:

One hundred seventy-four of 618 NPs (28%) completed the survey. Almost all considered AR a problem in the United States, but only half considered it a problem in their health care setting. More than half indicated they prescribed antibiotics less than 25% of the time in daily practice. Most were confident in making antibiotic prescribing decisions. There was a positive relationship between years of experience as NPs and their confidence in making antibiotic prescribing decisions (p < .003) and an inverse relationship between years of experience as NPs and asking for advice from physicians or pharmacists when prescribing antibiotics (p < .002).

Conclusion/Implications:

With increasing numbers of NPs managing infectious diseases and prescribing antibiotics, these findings will inform interventions to support appropriate prescribing behaviors.
Effects of family centered nursing model on children with primary nephrotic syndrome: A systematic review and meta-analysis
Authors: Yu Miaolei , Zhu Shuzhen
Published: August 2023

Background:

Family-centered nursing model has been widely used in the care of children patients, but there is still a lack of research on the care of children with primary nephrotic syndrome (PNS). Therefore, the aim of this study was to comprehensively evaluate the effects of family-centered nursing on children with PNS.

Methods:

The electronic databases included China National Knowledge Internet, Wanfang Data Knowledge Service Platform, VIP, PubMed, Web of Science, Cochrane Library, and Embase, were searched to collect randomized controlled trials on family-centered nursing model in the treatment of children with PNS. Fixed effect models or fixed effect models were used to analyze the outcomes. The primary outcomes were length of hospital stay and nursing satisfaction, and the second outcomes were quality of life (QoL) and behavioral problems.

Results:

A total of 12 studies involving 996 pediatric patients were included, of which 500 children received family centered care and 496 children received routine care. The results showed that family centered nursing model could significantly improve the QoL of children with PNS (P < .05), increase the nursing satisfaction of family members (P < .0001, SMD = 7.37, 95%CI = 4.15–13.08), reduce the time of hospitalization (P < .0001, standard mean difference [SMD] = −2.30, 95%CI = −2.57 to −2.03), and decrease the scores of psychosomatic disorders and impulsivity hyperactivity in children with PNS (P < .0001, SMD = −3.13, 95%CI = −4.12 to −2.15; P < .0001, SMD = −3.29, 95%CI = −4.29 to −2.28). However, there was no significant statistical difference in the impact on the scores of conduct problems, learning problems, anxiety, and hyperactivity (P > .05).

Conclusion:

Family-centered nursing model can improve the QoL of children with PNS, increase the nursing satisfaction of family members and reduce the length of hospital stay, but further research need to verify its impact on behavioral problems.
Acupuncture-adjuvant therapies for treating perimenopausal depression: A network meta-analysis
Authors: Zheng Lifang , Sun Zhanling , Liu Chenghao , Zhang Jiamin , Jin Yabei , Jin Huifang
Published: August 2023

Background:

The issues related to the treatment of perimenopausal depression (PMD) are the side effects of antidepressants and hormone replacement therapy. The aim of this study was to assess the efficiency and safety of acupuncture and moxibustion in PMD patients.

Methods:

Databases, namely PubMed, Cochrane Library, Web of Science, EMBASE, CNKI, CBM, VIP, and WanFang, were reviewed for related randomized controlled trials dated between database inception and November 22, 2022. The primary outcomes were the efficacy rate and the Hamilton Depression Scale score. The secondary outcomes were the levels of follicle-stimulating hormone, luteinizing hormone, and estradiol and the Kupperman score. Odds ratios (ORs) were generated as the effect size for dichotomous outcomes, while the standard mean difference (SMD) ± standard deviation was used for continuous outcomes. Matrices were developed to demonstrate pairwise comparisons of regimens related to each endpoint. Utilizing Review Manager (RevMan) 5.3, Stata 16.0 and SPSS 21, data were analyzed.

Results:

In total, 27 studies involving 2269 PMD patients and 8 therapeutic measures were incorporated into the network meta-analysis (NMA). The NMA showed that warm acupuncture (OR = 1.55, 95% CI: 1.00–2.44), electroacupuncture (OR = 1.34, 95% CI: 1.00–1.8), abdominal acupuncture (OR = 1.19, 95% CI: 0.73–1.96), and common acupuncture (OR = 1.4, 95% CI: 0.9–2.17) were more effective than fluoxetine + menopausal hormone treatment in the treatment of PMD. The NMA also showed that, based on the Hamilton Depression Scale score, warm acupuncture was more effective than the other 4 acupuncture-related treatments, i.e., electroacupuncture (SMD = −1.22, 95% CI: −2.34 to −0.09), thread embedding (SMD = −1.31, 95% CI: −2.21 to −0.40), abdominal acupuncture (SMD = −1.33, 95% CI: −2.42 to −0.24), and common acupuncture (SMD = −1.46, 95% CI: −2.26 to −0.66). The cumulative ranking probability (SUCRA) showed that warm acupuncture (99.6%) was the best treatment method.

Conclusions:

The findings of this network meta-analysis may help patients and therapists choose the best acupuncture therapy for treating perimenopausal depression patients and furnish reliable evidence for guidelines.
Diagnostic value of serum human epididymis protein 4, carbohydrate antigen 125 and their combination in endometrial cancer: A meta-analysis
Authors: Wu Qi , Bai Su-ning , Song Li-yun , Wu Wen-fei , Han Li-na
Published: August 2023

Background:

To systematically analyze the value of human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA125) in the diagnosis of endometrial cancer, so as to provide evidence-based medical evidence for the selection of serum tumor markers in the early screening of endometrial cancer.

Methods:

We comprehensively searched relevant literature in the Cochrane Library, EMBASE, PubMed, Web of Science, CNKI, VIP, WanFang, and CBM from the date of establishment to November 31, 2021. Quality assessment of diagnostic accuracy studies 2 was applied to evaluate the quality of the included literature. We used Stata 16.0 to calculate the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) and plot summary receiver operating characteristic curve, as well as to assess diagnostic accuracy using the area under the curve (AUC).

Results:

A total of 25 studies, including 1980 patients and 2345 controls, were included in this meta-analysis. The pooled SEN, SPE, PLR, NLR, DOR, and AUC of HE4 were 0.58 (95% CI 0.52–0.63), 0.95 (95% CI 0.92–0.97), 11.57 (95% CI 6.88–19.48), 0.45 (95% CI 0.39–0.51), 25.92 (95% CI 14.84–45.26), and 0.80 (95% CI 0.76–0.83), respectively. The pooled SEN, SPE, PLR, NLR, DOR, and AUC of CA125 were 0.41 (95% CI 0.34–0.49), 0.91 (95% CI 0.85–0.95), 4.55 (95% CI 2.73–7.58), 0.65 (95% CI 0.57–0.74), 7.03 (95% CI 3.92–12.62), and 0.68 (95% CI 0.64–0.72), respectively. The pooled SEN, SPE, PLR, NLR, DOR, and AUC of HE4 + CA125 were 0.67 (95% CI 0.60–0.73), 0.92 (95% CI 0.87–0.95), 8.59 (95% CI 5.32–13.86), 0.36 (95% CI 0.30–0.44), 23.80 (95% CI 13.86–40.86), and 0.85 (95% CI 0.82–0.88), respectively.

Conclusion:

This Meta-analysis found that HE4 alone or in combination with CA125 showed better diagnostic efficacy than CA125, regardless of clinical stage and pathological type. HE4 + CA125 had slightly higher diagnostic efficiency than HE4, but did not show significant advantages. While the studies were heterogeneous, the credibility of the findings needs to be further confirmed by more homogeneous, prospective, and large sample size studies.
Investigation of Beclin 1 and TNF-α expressions in preeclampsia placentas: Immunohistochemical study
Authors: Öcal Ece , Toprak Veysel , Akalin Senem Alkan , Aşir Firat , Deveci Engin
Published: August 2023

Background:

Preeclampsia is a pregnancy complication Aim of this study was to investigate expression of Beclin1 and tumor necrosis factor (TNF)-α in normotensive and preeclamptic placentas of pregnant women patients.

Methods:

Twenty normotensive and 20 preeclamptic patients placentas were dissected for paraffin- wax processing. Placental samples were embedded in parafin blocks. Sections were stained with Hematoxylin-Eosin staining and TNF-α and Beclin1 immunostaining.

Results:

In control group, root and floating villi were normal in histological perspectives, syncytial node number was low, vessels were normal with connective tissue. No hemorrhage was observed in the intervillous area. In preeclampsia group, decidual cell degeneration and fibrinoid accumulation increased. Vascular dilatation and congestion with mononuclear cell infiltration were observed. Beclin1 reaction was generally negative in control group. In preeclampsia group, Beclin1 reaction was increased in decidual cells, syncytial nodes and bridges and in chorionic villi and in some Hoffbauer cells. In control group, TNF-α expression was mainly negative but only in some decidual cells. In preeclampsia, TNF-α reaction was observed in degenerated decidua cells, in leukocytes and in villi.

Conclusion:

In preeclampsia placentas, degenerated decidua cells and inflammation increased. It was thought that Beclin1 and TNF-α signals could be used as a marker in affecting the fetal structure of blood flow in preeclamptic placentas.
Contribution of age at diagnosis to cancer-specific survival of nasopharyngeal carcinoma patients receiving radiotherapy
Authors: Zhang Wei-Ming , Mo Qi-Yan , Zhu Xiao-Dong
Published: August 2023

To assess age as a continuous variable for the prognosis of patients with nasopharyngeal carcinoma (NPC) receiving radiotherapy. Patients diagnosed with NPC between 2004 and 2016 were extracted from the Surveillance, Epidemiology, and End Results database. The X-tile was used to calculate the optimal cutoff values for age at diagnosis. Age at diagnosis was divided into subgroups based on the cutoff values. Cancer-specific survival (CSS) between age subgroups was assessed using the Kaplan–Meier method. The age cutoff values for CSS were 42 and 70 years. The 5-year CSS was 85.8%, 73.8%, and 67.1% for the ≤42, 43 to 70, and >70 subgroups. Multivariate regression analysis revealed that race, pathology, T stage, N stage, and age were independent prognostic factors. A nomogram based on the prognostic factors showed that the area under the receiver operating characteristic curve was 0.723 (95% confidence interval, 0.697–0.749). The calibration plots showed good agreement for the 5-year CSS between the predicted and actual observations. All patients were divided into 3 groups according to risk score stratification. Kaplan–Meier survival analyses showed that patients in the low-risk cohort had a greater 5-year CSS than those in the medium- and high-risk cohorts (P < .05). Age subgroups of ≤42, 43 to 70, and >70 years may be useful for determining the prognosis of patients with NPC.
Practice Perspectives on Care Coordination in Rural Settings
Authors: Kapp Julie M. , Underwood Beau , Ressel Kristi , Quinn Kathleen
Published: August 2023

Purpose:

Social needs and nonmedical health determinants are increasingly incorporated into care coordination models. However, little is known about the practice of operationalizing enhanced care coordination, particularly in rural settings. The objective of this study was to determine care coordination practices in rural settings that integrate social services with health care.

Primary Practice Settings:

Staff and administrators in rural Missouri health and health care settings were interviewed about their organization's implementation of enhanced care coordination practices.

Methodology and Sample:

This is a mixed-methods study; 16 key informant structured interviews were conducted across 14 organizations.

Results:

Organizations reported a median care coordination population of 800 (range: 50–21,500) across a median of 11 case managers (range: 3–375). The percentage of organizations reporting social determinants of health services included the following: 100% transportation, 86% mental health, 79% food, 71% housing, and 50% dental. Implementation of the essential indicators of care coordination quality ranged from 41.7% to 100%. We report organizations' innovative solutions to care coordination barriers.

Implications for Case Management Practice:

This study contributes to a very limited literature on the practice of rural care coordination by assessing the quality of care provided compared with a recommended standard. This study also contributes an in-depth reporting on the variety of service models being implemented. Finally, this study uniquely contributes innovative interprofessional examples of enhanced care coordination initiatives. These examples may provide inspiration for rural health care organizations. As the care coordination landscape evolves to include social determinants of health, there remain important fundamental barriers to ensuring quality of care.
Adult attachment in couples facing stage IV lung cancer: associations with patient quality-of-life outcomes and sense of life completion
Authors: Kroll Juliet L. , Jones Morgan , Chen Aileen B. , Yang Chunyi Claire , Carmack Cindy L. , Cohen Lorenzo , Milbury Kathrin
Published: August 2023

Background:

Adult attachment insecurity is associated with poor psychosocial and cancer-related symptom outcomes in patients with cancer; however, there is a paucity of research around the role of the spousal caregivers' attachment in patient quality of life (QOL) at the end of life (EOL). Attachment styles may be particularly relevant for couples coping with prolonged metastatic disease, where the threat of death or disease progression is highly salient.

Methods:

We conducted secondary analyses on a sample of patients with stage IV non–small cell lung cancer and their spouses. Participants separately completed questionnaires of attachment style (ECR-S), relationship closeness (PAIR), illness-related communication (holding back one's fear of death or disease progression), and cancer-related distress (IES). Patients additionally completed questionnaires on sense of life completion and QOL at EOL (QUAL-E Completion Subscale and Overall QOL Item) and symptom burden (MDASI-LC).

Results:

For patients, greater attachment avoidance was associated with lower sense of life completion (r = −0.31, P = .009) and lower overall QOL (r = −0.35, P = .003). Greater patient attachment anxiety was also associated with a lower sense of life completion (r = −0.26, P = .034). Greater caregiver attachment avoidance and attachment anxiety were associated with patient reports of lower overall QOL (r = −0.38, P = .001, r = −0.36, P = .002, respectively). In addition, greater caregiver attachment anxiety was associated with greater patient symptom burden (r = 0.24, P = .048) controlling for patient's own attachment anxiety. For both patients and caregivers, greater attachment anxiety was associated with more “holding back” from communicating their fear of death or disease progression with their spouse (r = 0.25, P = .036; r = 0.31, P = .011, respectively). Dyadic analyses revealed a positive association within the couple for attachment avoidance (r = 0.41, P < .01) and anxiety (r = 0.31, P < .01).

Conclusion:

Both spousal caregiver and patient attachment styles are highly relevant to illness communication patterns and patient QOL outcomes.
Evaluation of Newborn Direct Bilirubin As Screening for Cholestatic Liver Disease
Authors: Lerer Rikah , Barash Lily , Nafday Suhas , Kogan Liberman Debora , Ovchinsky Nadia
Published: August 2023

Background:

Biliary atresia (BA) remains the most common indication for pediatric liver transplantation. Early diagnosis is essential for a favorable long-term prognosis for patients with BA. Preliminary data suggests that measurement of direct bilirubin (DB) in newborns may be an effective screening tool for neonatal cholestasis, particularly BA, allowing for early referral and diagnosis. The objective of our study was to establish a cutoff DB value to predict diagnosis of cholestatic liver disease (CLD) with high sensitivity and specificity, as well as, to evaluate whether newborns with elevated DB received appropriate follow-up in our health system.

Methods:

Baseline data were collected on infants born between 2016 and 2019 who had serum total bilirubin and DB drawn in the nursery, and who continued to follow in our health system. Sensitivity, specificity, and positive and negative predictive values were examined using cutoff values of 0.5, 0.6, and 0.7 mg/dL for identifying infants at risk for CLD. Patients’ charts were reviewed to note whether they had follow-up levels drawn by their pediatrician or by the hepatology team within 2 months of age and whether they were diagnosed with CLD.

Results:

Serum total bilirubin and DB levels were drawn from 11 965 infants during their hospitalizations. Three infants from this cohort were diagnosed with CLD: 2 with BA and 1 with Alagille syndrome. DB cutoff values of 0.5, 0.6, and 0.7 mg/dL had sensitivity of 100% and specificity of 96.83% (95% confidence interval [CI], 96.69%-97.53%), 99.08% (95% CI, 98.81%-99.30%), and 99.63% (95% CI, 99.4%-99.7%), respectively. Given that a DB of 0.6 mg/dL had a sensitivity of 100% and specificity of 99%, this value was chosen as the cutoff value to monitor for DB follow-up and diagnosis of CLD. Out of 60 infants who met criteria for DB ≥0.6 mg/dL, only 15 (25%) had a repeat level drawn after nursery discharge; 3 (5%) were eventually diagnosed with CLD.

Conclusions:

A DB cutoff value of 0.6 mg/dL yielded high sensitivity and specificity for identifying patients with CLD. All 3 patients diagnosed with CLD had elevated DB at hospital discharge. The data revealed that the majority (75%) of eligible newborns did not receive follow-up for their elevated DB in the outpatient setting.
Association of sleep quality with fatigue in post Covid-19 patients in an Indian population
Authors: Ghosh Srutarshi , Kumar Anjani , Pandey Sanjay Kumar , Kumar Sanyal
Published: August 2023

Objectives

To assess the quality of sleep in recently recovered Covid-19 and long Covid cases, also to determine its associations with fatigue and pain.

Methods

Post-Covid cases (n = 201) and controls (n = 206) were assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire for sleep quality, Fatigue Severity Scale (FSS) for fatigue, and Numeric Pain Rating Scale (NPRS) for pain in this observational study.

Results

Global PSQI score was higher (p = <0.001) among cases (5.7 ± 5.1, 95%CI 5.0, 6.4) than controls (2.1 ± 2.0, 95%CI 1.8, 2.4). Normal sleep latency was observed in 56(27.9%) patients and 164(79.6%) controls (p < 0.001). FSS score higher (p = <0.001) among cases (16.8 ± 10.2, 95%CI 15.4, 18.2) against controls (10.9 ± 4.1, 95%CI10.3, 11.4). The FSS scores in mild, moderate, and severe Covid were 14.3 ± 8.1, 22.1 ± 10.8, and 22.8 ± 13, respectively (p < 0.001), and higher in the elderly (20.7 ± 12.1) and middle-aged (19.6 ± 10.3) than in younger (13.9 ± 8.3) (p ≤ 0.001) cases. The global PSQI score was positively correlated with the FSS (r = 0.755, p < 0.001) and NPRS scores (r = 0.657, p < 0.001). NPRS score correlated with the FSS score (r = 0.710, p < 0.001). FSS and global PSQI scores were higher in the Long Covid group (p < 0.001).

Conclusion

Significantly poor sleep quality was observed in post-Covid-19 individuals including Long Covid being positively associated with fatigue and pain.