bluuebunny/crossref_metadata_2025 huggingface dataset:
Platelet–lymphocyte ratio is a prognostic marker in small cell lung cancer—A systemic review and meta-analysis
Authors: Zhou Hongbin , Li Jiuke , Zhang Yiting , Chen Zhewen , Chen Ying , Ye Sa
Published: January 2023

Aim

The aim of this study was to evaluate the relationship between platelet–lymphocyte ratio (PLR) and prognosis in small cell lung cancer (SCLC) patients.

Method

A comprehensive search was carried out to collect related studies. Two independent investigators extracted the data of hazard ratio (HR) and 95% confidence interval (CI) for overall survival (OS) or progression-free survival (PFS). A random-effect model was applied to analyze the effect of different PLR levels on OS and PFS in SCLC patients. Moreover, subgroup analysis was conducted to seek out the source of heterogeneity.

Results

A total of 26 articles containing 5,592 SCLC patients were included for this meta-analysis. SCLC patients with a high PLR level had a shorter OS compared with patients with a low PLR level, in both univariate (HR = 1.56, 95% CI 1.28–1.90, p < 0.0001) and multivariate (HR = 1.31, 95% CI 1.08–1.59, p = 0.007) models. SCLC patients with a high PLR level had a shorter PFS compared with patients with a low PLR level, in the univariate model (HR = 1.71, 95% CI 1.35–2.16, p < 0.0001), but not in the multivariate model (HR = 1.17, 95% CI 0.95–1.45, p = 0.14). Subgroup analysis showed that a high level of PLR shortened OS in some subgroups, including the Asian subgroup, the younger subgroup, the mixed-stage subgroup, the chemotherapy-dominant subgroup, the high-cutoff-point subgroup, and the retrospective subgroup. PLR level did not affect OS in other subgroups.

Conclusion

PLR was a good predictor for prognosis of SCLC patients, especially in patients received chemotherapy dominant treatments and predicting OS.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022383069.
The way to precision medicine in gynecologic cancers: The first case report of an exceptional response to alpelisib in a PIK3CA-mutated endometrial cancer
Authors: Passarelli Anna , Ventriglia Jole , Pisano Carmela , Cecere Sabrina Chiara , Napoli Marilena Di , Rossetti Sabrina , Tambaro Rosa , Tarotto Luca , Fiore Francesco , Farolfi Alberto , Bartoletti Michele , Pignata Sandro
Published: January 2023

Endometrial cancer (EC) is the most common gynecologic cancer in Europe and its prevalence is increasing. EC includes a biological and clinical heterogeneous group of tumors, usually classified as type I (endometrioid) or type II (non-endometrioid) based on the histopathological characteristics. In 2013, a new molecular classification was proposed by The Cancer Genome Atlas (TCGA) based on the comprehensive molecular profiling of EC. Several molecular somatic alterations have been described in development and progression of EC. Using these molecular features, EC was reclassified into four subgroups: POLE ultra-mutated, MSI hypermutated, copy-number low, and copy-number high that correlate with the prognosis. To this regard, it is widely reported that EC has more frequent mutations in the phosphatidylinositol 3-kinase (PI3K) pathway signaling than any other tumor. PIK3CA is the main significant mutated gene after PTEN alterations. Overall, over 90% of endometrioid tumors have activating PI3K molecular alterations that suggests its critical role in the EC pathogenesis. Thus, the dysregulation of PI3K pathway represents an attractive target in EC treatment. Herein, we report a radiological and clinically meaningful response to a selective PIK3 inhibitor in a patient with extensively pre-treated advanced endometrioid EC harboring a somatic activating PIK3CA hotspot mutation. These evidences provide the rational for translational strategies of the PI3K inhibition and could support the clinical usefulness of PIK3CA genotyping in advanced EC. To our knowledge, this is the first clinical case of PIK3CA-mutated EC successfully treated with alpelisib.
Case Report: Immune checkpoint inhibitor-related vitiligo-like depigmentation in non-melanoma advanced cancer: A report of three cases and a pooled analysis of individual patient data
Authors: Rao Hui , Guo Zheng , Wen Xuejiao , Zeng Xiaoli , Wu Longqiu , Huang Li
Published: January 2023

Background

Vitiligo-like depigmentation is a common skin adverse event in patients receiving immunotherapy for malignant melanoma, but has been rarely reported in patients with non-melanoma malignancies. To better understand this immune-related adverse event, we reviewed a series of cases of immunotherapy induced vitiligo-like depigmentation in patients with cancers other than malignant melanoma.

Case presentation

We report three cases of vitiligo-like depigmentation after immune checkpoint inhibitor treatment in gastric adenocarcinoma, lung adenocarcinoma, and squamous cell carcinoma. The first case was treated with camrelizumab, the second was treated with QL1706 injection and sintilimab, and the third was treated with tislelizumab. Pembrolizumab, nivolumab, and ipilimumab caused the majority of vitiligo-like depigmentation, and all three of our patients experienced similar vitiligo-like depigmentation after taking other immune checkpoint inhibitors.

Methods

Three patients who presented with vitiligo-like depigmentation after treatment with immune checkpoint inhibitors were selected. The clinical features, including radiological and histological examination, and the treatment process were reviewed. Eighteen previously published cases of vitiligo-like depigmentation were also used to analyze the results. The severity of vitiligo-like depigmentation in these cases was graded according to the Common Terminology Criteria for Adverse Events, version 5.0.

Results

Vitiligo-like depigmentation occurred in 13 men (61.90%) and 8 women (38.10%), aged from 46 to 79 years, with an average age of 69.9 years. Of the 21 reviewed cases, vitiligo-like depigmentation was described in lung cancer (13/21, 61.90%), clear cell renal cell carcinoma (2/21, 9.52%), acute myeloid leukemia (1/21, 4.76%), cholangiocarcinoma (1/21, 4.76%), urothelial carcinoma (1/21, 4.76%), oral squamous cell carcinoma (1/21, 4.76%), esophageal squamous cell carcinoma (1/21, 4.76%), and gastric adenocarcinoma (1/21, 4.76%). The severity of vitiligo-like depigmentation after immunotherapy was unrelated to sex, age, cancer type, previous autoimmune diseases, and medication.

Conclusions

Vitiligo-like depigmentation is a non-specific skin adverse event in melanoma immunotherapy, but arises as a direct result of treatment with immune checkpoint inhibitors. Vitiligo-like depigmentation has an irregular location, is not limited to direct sunlight cracks, and has also been reported on hair on the head, eyelashes, and eyebrows. People without any skin or autoimmune diseases can also experience vitiligo-like depigmentation after immunotherapy; the incidence of which is irrespective of sex, age, cancer type, previous autoimmune diseases, and medication.
How to increase COVID-19 vaccine uptake among children? determinants associated with vaccine compliance
Authors: Hoshen Moshe , Shkalim Zemer Vered , Ashkenazi Shai , Grossman Zachi , Gerstein Maya , Yosef Noga , Cohen Moriya , Cohen Herman Avner
Published: January 2023

Objective

Three aims: to elucidate determinants associated with COVID-19 vaccine uptake in children and the association with parental vaccination; to compare rates of PCR-positive SARS-CoV-2 results between vaccinated and unvaccinated children; to estimate the rate of parental COVID-19 vaccination and its association with the vaccination rate of their children.

Methods

We performed a retrospective chart review of all children aged 5–11 years registered at a central district in Israel from November 21st, 2021 to April 30th, 2022, and characterized COVID-19 vaccinated vs. unvaccinated individuals. Data retrieved from the electronic medical files included: demographics [age, gender, sector, socioeconomic status (SES)]; COVID-19 vaccination (first and second doses) and influenza vaccination status; co-morbidities; and parental vaccinations for COVID-19. We divided the population into three distinct demographic groups: non-ultra-orthodox Jews (43,889 children), ultra-orthodox Jews (13,858 children), and Arabs (4,029 children).

Results

Of the 61,776 children included in the study, 20,355 (32.9%) received at least one dose of the COVID-19 vaccine. Vaccination rates were similar amongst males and females and were higher in children aged 9–11 years compared to children aged 5–6 years. Multivariate analysis identified five independent determinants that were significantly (p < 0.001) associated with low vaccination rates: Arab and ultra-orthodox sectors (odds ratios: 0.235 and 0.617, respectively); children aged 5–8 years; children of low SES; and children who had not received previous seasonal influenza vaccination. Relatively high vaccination rates were noted amongst children with the following medical co-morbidities: treatment with biological agents (42.9%); solid tumor transplantation (42.9%); type 1 diabetes mellitus (38.5%), asthma (38.2%), and attention deficit and hyperactivity disorder (ADHD) (37.6%). Regarding the uptake of two vaccine doses among children with co-morbidities, it was highest in those with type 1 diabetes mellitus, heart failure, treatment with biological agents, asthma and obesity.

Conclusion

This study highlights several pediatric sub-populations with low and high vaccine uptake. It is essential to focus on determinants associated with low vaccination rates.
Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment
Authors: Cheah Chooi San , Lee Wendy Wei Li , Suhaini Siti Aisyah , Azidin Abdullah Harith , Khoo Mohammad Shukri , Ismail Noor Akmal Shareela , Ali Adli
Published: January 2023

Introduction

Kawasaki disease (KD) is an acute idiopathic systemic vasculitis with a self- limiting course that predominantly affects children under 5 years old, particularly in the East Asian countries. Nevertheless, to date, the data on KD in Malaysia are limited. This study aimed to evaluate the epidemiology, clinical features, treatment, and outcomes of KD among the pediatric patients admitted to Hospital Canselor Tunku Muhriz (HCTM), Kuala Lumpur, Malaysia.

Method

A retrospective cohort study of 66,500 pediatric patients presented at HCTM from the year 2004 to 2021 was conducted.

Results

62 KD cases out of 66,500 pediatric admissions were reported, with a male-to-female ratio of 1.58 to 1. Majority of KD patients (95.0%) were younger than 5 years old. Prior infection was reported in 5 KD patients (8.1%). Apart from the classical features, manifestations of various organ systems including cardiovascular (16.1%), gastrointestinal (43.5%), neurological (1.61%), musculoskeletal (1.61%), and genitourinary (17.7%) systems were observed. There was a significant association between sterile pyuria and coronary artery aneurysm (CAA) (p < 0.05). Interestingly, abnormal liver parameters (p < 0.05) and incomplete KD (p < 0.05) were significantly related to IVIG resistance.

Discussion

The presence of family history, immunological disorder, and previous infection in our KD patients suggested that there is a possibility of genetic, immunological, and infectious roles in the pathophysiology of KD. IVIG resistance is more likely to occur in KD patients with hepatic dysfunction or incomplete KD presentation. These findings highlighted the significant contribution of laboratory parameters to the prognosis of KD, prompting more in-depth research on the KD scoring systems and their relevance in this country.
Quercetin as a possible complementary agent for early-stage COVID-19: Concluding results of a randomized clinical trial
Authors: Di Pierro Francesco , Khan Amjad , Iqtadar Somia , Mumtaz Sami Ullah , Chaudhry Muhammad Nabeel Akbar , Bertuccioli Alexander , Derosa Giuseppe , Maffioli Pamela , Togni Stefano , Riva Antonella , Allegrini Pietro , Recchia Martino , Zerbinati Nicola
Published: January 2023

Background: Quercetin, a natural polyphenol with demonstrated broad-spectrum antiviral, anti-inflammatory, and antioxidant properties, has been proposed as an adjuvant for early-stage coronavirus disease 2019 (COVID-19) infection.

Objective: To explore the possible therapeutic effect of quercetin in outpatients with early-stage mild to moderate symptoms of COVID-19.

Methods: This was an open-label randomized controlled clinical trial conducted at the department of medicine, King Edward Medical University, Lahore, PK. Patients were randomized to receive either standard of care (SC) plus an oral quercetin supplement (500 mg Quercetin Phytosome®, 1st week, TDS: 2nd week, BDS) (n = 50, quercetin group) or SC alone (n = 50, control group).

Results: After one week of treatment, patients in the quercetin group showed a speedy recovery from COVID-19 as compared to the control group, i.e., 34 patients (vs. 12 in the control group) tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (p = 0.0004), and 26 patients (vs. 12 in the control group) had their COVID-19-associated acute symptoms resolved (p = 0.0051). Patients in the quercetin group also showed a significant fall in the serum lactate dehydrogenase (LDH) mean values i.e., from 406.56 ± 183.92 to 257.74 ± 110.73 U/L, p = 0.0001. Quercetin was well-tolerated by all the 50 patients, and no side effects were reported.

Conclusion: Our results, suggest the possible therapeutic role of quercetin in early-stage COVID-19, including speedy clearance of SARS-CoV-2, early resolution of the acute symptoms and modulation of the host’s hyperinflammatory response.

Clinical Trial Registration:clinicaltrials.gov, identifier NCT04861298
Double-armed cone-shaped flexoelectric transducer
Authors: Zheng Jianfeng , Liang Ke , Lin Zhenyuan , Di Hao , Cheng Yong
Published: January 2023

Compared with a single energy harvester, this tuning fork double-armed cone-shaped flexure transducer can fundamentally solve the problems of high resonance frequency, low output efficiency, and narrow bandwidth of the flexure transducer. Since the transducer limits the clamping losses of the cantilever beam, it provides sufficient stiffness-mass balance to lower the resonance frequency of the system and extend the bandwidth. The tapered structure provides sufficient strain gradient for the flexoelectric effect, improving the output efficiency of the whole system. The vibration frequency of the tuning fork structure and the derivation of the bandwidth formula are analyzed theoretically, and then the electrode width and thickness of the cone structure are studied through simulation to analyze the transducer output response, resonant frequency, bandwidth, and output impedance.
Approximate solutions to shallow water wave equations by the homotopy perturbation method coupled with Mohand transform
Authors: Liu Yue , Zhang Yanni , Pang Jing
Published: January 2023

In this paper, the Mohand transform-based homotopy perturbation method is proposed to solve two-dimensional linear and non-linear shallow water wave equations. This approach has been proved suitable for a broad variety of non-linear differential equations in science and engineering. The variation trend of the water surface elevation at different time levels and depths are given by some graphs. Moreover, the obtained solutions are compared with the existing results, which show higher efficiency and fewer computations than other approaches studied in the literature.
Transcriptomic analysis of seed development in Paysonia auriculata (Brassicaceae) identifies genes involved in hydroxy fatty acid biosynthesis
Authors: Hu Hao , Swift Armond , Mauro-Herrera Margarita , Borrone James , Borja Guadalupe , Doust Andrew N.
Published: January 2023

Paysonia auriculata (Brassicaceae) produces multiple hydroxy fatty acids as major components of the seed oil. We tracked the changes in seed oil composition and gene expression during development, starting 14 days after flowers had been pollinated. Seed oil changes showed initially higher levels of saturated and unsaturated fatty acids (FAs) but little accumulation of hydroxy fatty acids (HFAs). Starting 21 days after pollination (DAP) HFA content sharply increased, and reached almost 30% at 28 DAP. Total seed oil also increased from a low of approximately 2% at 14 DAP to a high of approximately 20% by 42 DAP. We identified almost all of the fatty acid synthesis and modification genes that are known from Arabidopsis, and, in addition, a strong candidate for the hydroxylase gene that mediates the hydroxylation of fatty acids to produce valuable hydroxy fatty acids (HFAs) in this species. The gene expression network revealed is very similar to that of the emerging oil crop, Physaria fendleri, in the sister genus to Paysonia. Phylogenetic analyses indicate the hydroxylase enzyme, FAH12, evolved only once in Paysonia and Physaria, and that the enzyme is closely related to FAD2 enzymes. Phylogenetic analyses of FAD2 and FAH12 in the Brassicaceae and outgroup genera suggest that the branch leading to the hydroxylase clade of Paysonia and Physaria is under relaxed selection, compared with the strong purifying selection found across the FAD2 lineages.
Chromium toxicity, speciation, and remediation strategies in soil-plant interface: A critical review
Authors: Zulfiqar Usman , Haider Fasih Ullah , Ahmad Muhammad , Hussain Saddam , Maqsood Muhammad Faisal , Ishfaq Muhammad , Shahzad Babar , Waqas Muhammad Mohsin , Ali Basharat , Tayyab Muhammad Noaman , Ahmad Syed Amjad , Khan Ilyas , Eldin Sayed M.
Published: January 2023

In recent decades, environmental pollution with chromium (Cr) has gained significant attention. Although chromium (Cr) can exist in a variety of different oxidation states and is a polyvalent element, only trivalent chromium [Cr(III)] and hexavalent chromium [Cr(VI)] are found frequently in the natural environment. In the current review, we summarize the biogeochemical procedures that regulate Cr(VI) mobilization, accumulation, bioavailability, toxicity in soils, and probable risks to ecosystem are also highlighted. Plants growing in Cr(VI)-contaminated soils show reduced growth and development with lower agricultural production and quality. Furthermore, Cr(VI) exposure causes oxidative stress due to the production of free radicals which modifies plant morpho-physiological and biochemical processes at tissue and cellular levels. However, plants may develop extensive cellular and physiological defensive mechanisms in response to Cr(VI) toxicity to ensure their survival. To cope with Cr(VI) toxicity, plants either avoid absorbing Cr(VI) from the soil or turn on the detoxifying mechanism, which involves producing antioxidants (both enzymatic and non-enzymatic) for scavenging of reactive oxygen species (ROS). Moreover, this review also highlights recent knowledge of remediation approaches i.e., bioremediation/phytoremediation, or remediation by using microbes exogenous use of organic amendments (biochar, manure, and compost), and nano-remediation supplements, which significantly remediate Cr(VI)-contaminated soil/water and lessen possible health and environmental challenges. Future research needs and knowledge gaps are also covered. The review’s observations should aid in the development of creative and useful methods for limiting Cr(VI) bioavailability, toxicity and sustainably managing Cr(VI)-polluted soils/water, by clear understanding of mechanistic basis of Cr(VI) toxicity, signaling pathways, and tolerance mechanisms; hence reducing its hazards to the environment.
Multi-omics approach reveals the contribution of OsSEH1 to rice cold tolerance
Authors: Gu Shuang , Zhuang Jia , Zhang Zhe , Chen Wanchun , Xu Hai , Zhao Minghui , Ma Dianrong
Published: January 2023

As low environmental temperature adversely affects the growth, development and geographical distribution, plants have evolved multiple mechanisms involving changing physiological and metabolic processes to adapt to cold stress. In this study, we revealed that nucleoporin-coding gene OsSEH1 was a positive regulator of cold stress in rice. Physiological assays showed that the activity of antioxidant enzymes showed a significant difference between osseh1 knock-out lines and wild type under cold stress. Metabolome analysis revealed that the contents of large-scale flavonoids serving as ROS scavengers were lower in osseh1 mutants compared with wild type under cold stress. Transcriptome analysis indicated that the DEGs between osseh1 knock-out lines and wild type plants were enriched in defense response, regulation of hormone levels and oxidation-reduction process. Integration of transcriptomic and metabolic profiling revealed that OsSEH1 plays a role in the oxidation-reduction process by coordinately regulating genes expression and metabolite accumulation involved in phenylpropanoid and flavonoid biosynthetic pathway. In addition, Exogenous ABA application assays indicated that osseh1 lines had hypersensitive phenotypes compared with wild type plants, suggesting that OsSEH1 may mediate cold tolerance by regulating ABA levels.
The experience of tobacco withdrawal symptoms among current smokers and ex-smokers in the general population: Findings from nationwide China Health Literacy Survey during 2018-19
Authors: Cui Zi-yang , Li Ying-hua , Liu Zhao , Li Li , Nie Xue-qiong , Zhou Xin-mei , Cheng An-qi , Li Jin-xuan , Qin Rui , Wei Xiao-wen , Zhao Liang , Ladmore Daniella , Pesola Francesca , Chung Kian Fan , Chen Zheng-ming , Hajek Peter , Xiao Dan , Wang Chen
Published: January 2023

Objective

To clarify the extent to which smokers in the general population experience tobacco withdrawal symptoms and whether such experience differs in those who continue to smoke and those who stopped smoking.

Methods

We included relevant questions in the nationally-representative China Health Literacy Survey (CHLS) conducted in 2018–2019. Among 87,028 participants, there were 22,115 ever-smokers aged 20–69 years who provided information on their smoking history and their experience of tobacco withdrawal symptoms. Multivariate logistic regressions were conducted to explore the association between withdrawal symptoms and other variables.

Results

Among ever-smokers, there were 19,643 (88.8%) current smokers and 2,472 (11.2%) ex-smokers. Among current smokers, 61.3% reported having tried to quit smoking in the past. Overall, 61.1% of current smokers reported experiencing withdrawal symptoms: 69.9% of those who tried to quit smoking in the past and 47.5% of those who did not. A lower proportion of ex-smokers experienced withdrawal symptoms (46.3%) and the difference remained significant after controlling for demographic characteristics (OR = 1.76, 95% CI 1.62–1.93, P < 0.001). The most commonly reported withdrawal symptoms in both current smokers and ex-smokers were craving, restlessness and anxiety. In the multivariable-adjusted analyses, those who experienced withdrawal symptoms when they tried to quit smoking (OR: 2.05, 95% CI: 1.86–2.27) were less likely to successfully quit.

Conclusions

The clinical picture of the tobacco withdrawal syndrome is the same in current smokers and in ex-smokers, but ex-smokers are less likely to have experienced it. The experience of discomfort when unable to smoke is common and seems likely to be a major factor contributing to maintaining smoking behavior not just among individuals seeking help with quitting smoking, but among smokers generally.
Exploring the association between circulating trace elements, metabolic risk factors, and the adherence to a Mediterranean diet among children and adolescents with obesity
Authors: González-Domínguez Álvaro , Domínguez-Riscart Jesús , Millán-Martínez María , Lechuga-Sancho Alfonso María , González-Domínguez Raúl
Published: January 2023

Diet is one of the most important modifiable lifestyle factors for preventing and treating obesity. In this respect, the Mediterranean diet (MD) has proven to be a rich source of a myriad of micronutrients with positive repercussions on human health. Herein, we studied an observational cohort of children and adolescents with obesity (N = 26) to explore the association between circulating blood trace elements and the degree of MD adherence, as assessed through the KIDMED questionnaire. Participants with higher MD adherence showed better glycemic/insulinemic control and a healthier lipid profile, as well as raised plasma levels of selenium, zinc, cobalt, molybdenum, and arsenic, and increased erythroid content of selenium. Interestingly, we found that these MD-related mineral alterations were closely correlated with the characteristic metabolic complications behind childhood obesity, namely hyperglycemia, hyperinsulinemia, and dyslipidemia (p < 0.05, |r| > 0.35). These findings highlight the pivotal role that dietary trace elements may play in the pathogenesis of obesity and related disorders.
Mapping intervention components from a randomized controlled trial to scale-up of an early life nutrition and movement intervention: The INFANT program
Authors: Marshall Sarah , Johnson Brittany J. , Hesketh Kylie D. , Campbell Karen J. , Fraser Kylie , Love Penelope , Denney-Wilson Elizabeth , Salmon Jo , McCallum Zoe , Laws Rachel
Published: January 2023

Introduction

Early life parent-focused interventions can effectively improve infant and child nutrition and movement (physical activity and sedentary behavior) as well as parents' health behaviors. Scale-up of such interventions to real-world settings is essential for population-wide benefits. When progressing to scale-up, intervention components may be modified to reflect contextual factors and promote feasibility of scale-up. The INFANT program, an efficacious early life nutrition and movement behavioral intervention began as a randomized controlled trial (RCT), was modified after a small-scale translation, and is currently being scaled-up in Victoria, Australia. This study mapped and compared discrete intervention components of both the original RCT and the scaled-up version of INFANT to examine modifications for scaling up.

Methods

Discrete intervention components, specifically the target behaviors (child-related and parent-related behaviors), delivery features and behavior change techniques (BCTs) from the RCT and the scaled-up program were coded and mapped using established frameworks and taxonomies. Publications and unpublished materials (e.g., facilitator notes, handouts, videos, app) were coded. Coding was performed independently in duplicate, with final coding validated in a meeting with interventionists. Interventionists reported the rationale for modifications made.

Results

The INFANT RCT and scaled-up version targeted the same obesity prevention-related nutrition and movement behaviors. Key modified delivery features at scale-up included reduced number of sessions, a broader range of professionals facilitating groups, the addition of a mobile app for parents replacing hard-copy materials and tangible tools (e.g., pedometers), and broadening of content (e.g., early feeding, updated 24-h movement guidelines). BCTs used across the RCT and scale-up sessions were unchanged. However, the BCTs identified in the between-session support materials were almost double for the scale-up compared with the RCT, primarily due to the reduced number of sessions and the app's capacity to include more content.

Conclusions

INFANT is one of few early life nutrition and movement behavioral interventions being delivered at scale. With INFANT as an example, this study provides critical understanding about what and why intervention components were altered as the RCT was scaled-up. Unpacking these intervention modifications provides important insights for scale-up feasibility, outcome effects, and how to optimize implementation strategies for population-level benefits.
A mixed-method analysis to identify the current focus, trends, and gaps in health science research in Saudi Arabia
Authors: AL-Shammary Asma Ayyed , Hassan Sehar un-Nisa , Alshammari Fahad Saud , Alshammari Modi Rataan Rifai
Published: January 2023

Background

The identification of current gaps in high-impact medical research in Saudi Arabia has international significance due to the trend of collaborative research in the field of health and medicine and the focus on knowledge-sharing. The purpose of this study is to assess the current focus, gaps, and priorities in health research in Saudi Arabia.

Methods

We employed a mixed-method research approach to achieve research objectives. (1) a systematic review of scientific research studies that are published between January 2020 to January 2022 in the top fifty Q1 medical science journals (2) a cross-sectional survey collected data from professionals employed in various organizations including the Ministry of Health (MoH), Ministry of Education (MoE), health organizations and universities, and the health industry. The close-ended survey questions inquired about the broad and specific areas of ongoing health research projects by these researchers and organizations in Saudi Arabia.

Results

The literature search on databases identified Science Direct (n = 741), Pub Med (n = 244) and Google Scholar (n = 15,600). After screening, (n = 26) original studies were selected for detailed evaluation and synthesis. Among these (n = 7) studied infectious diseases, (n = 7) cancer, and cardiac disease (n = 5). These studies focused on the etiology, treatment management and therapy outcomes of these health conditions. The survey was completed by (n = 384) respondents from these organizations. Most of the ongoing research projects focus on clinical sciences (27%) followed by basic sciences (24%) and public health research (24%) and a limited number of researchers were involved in healthcare management (2%) and informatics (2%). Most research focused on kidney and liver disorders (80%), obesity (74%), diabetes (74%), hormonal diseases (64%), and infectious disease (66%); it is equally important to design and fund research in some of the neglected areas including reproductive health (3%), physical and mental disabilities (1%).

Conclusion

Findings suggest that current gaps in original research from Saudi Arabia are in healthcare service quality, reproductive health, physical and mental disabilities and health informatics. Researchers and funding agencies and international collaborative projects should prioritize these areas.
Knowledge, perceived risk, and attitudes towards COVID-19 protective measures amongst ethnic minorities in the UK: A cross-sectional study
Authors: Cook Erica Jane , Elliott Elizabeth , Donald Louisa , Gaitan Alfredo , Randhawa Gurch , Cartwright Sally , Waqar Muhammad , Egbutah Chimeme , Nduka Ifunanya , Guppy Andy , Ali Nasreen
Published: January 2023

Background

Minority ethnic groups are at increased risk of COVID-19 related mortality or morbidity yet continue to have a disproportionally lower uptake of the vaccine. The importance of adherence to prevention and control measures to keep vulnerable populations and their families safe therefore remains crucial. This research sought to examine the knowledge, perceived risk, and attitudes toward COVID-19 among an ethnically diverse community.

Methods

A cross-sectional self-administered questionnaire was implemented to survey ethnic minority participants purposefully recruited from Luton, an ethnically diverse town in the southeast of England. The questionnaire was structured to assess participants knowledge, perceived risk, attitudes toward protective measures as well as the sources of information about COVID-19. The questionnaire was administered online via Qualtrics with the link shared through social media platforms such as Facebook, Twitter, and WhatsApp. Questionnaires were also printed into brochures and disseminated via community researchers and community links to individuals alongside religious, community and outreach organisations. Data were analysed using appropriate statistical techniques, with the significance threshold for all analyses assumed at p = 0.05.

Findings

1,058 participants (634; 60% females) with a median age of 38 (IQR, 22) completed the survey. National TV and social networks were the most frequently accessed sources of COVID-19 related information; however, healthcare professionals, whilst not widely accessed, were viewed as the most trusted. Knowledge of transmission routes and perceived susceptibility were significant predictors of attitudes toward health-protective practises.

Conclusion/recommendation

Improving the local information provision, including using tailored communication strategies that draw on trusted sources, including healthcare professionals, could facilitate understanding of risk and promote adherence to health-protective actions.
COVID-19 vaccine confidence project for perinatal women (CCPP)—Development of a stepped-care model to address COVID-19 vaccine hesitancy in low and middle-income countries
Authors: Ransing Ramdas , Raghuveer Pracheth , Mhamunkar Aman , Kukreti Prerna , Puri Manju , Patil Suvarna , Pavithra Hegde , Padma Kumari , Kumar Praveen , Ananthathirtha Kavya , Goel Manish Kumar , Deshpande Smita N.
Published: January 2023

Background

COVID-19 vaccine hesitancy (CVH) is common among perinatal women in low and middle-income countries (LMICs), but it is often unaddressed. This could be due to a lack of feasible, scalable, and acceptable interventions and models for CVH in LMICs. Our study aimed to develop a CVH intervention model that can be implemented in LMICs using existing human healthcare resources.

Methods

A literature review was conducted on aspects of vaccine hesitancy, pre-existing interventions, and models for addressing vaccine hesitancy (COVID-19 and non-COVID-19). The lead authors (RR and PKuk) formed a team consisting of vaccinators, experts, and stakeholders. Members shared their perspectives and proposals for various models and interventions that could be implemented in LMICs. A CVH intervention model was developed using a logic model, a WHO implementation toolkit, experts' feedback, and consensus.

Results

A consensus was reached to develop a COVID-19 Vaccine Confidence Project for Perinatal Women (CCPP), which is a primary health care worker (HCWs)-based stepped-care model. The CCPP model includes HCW training, integration into ongoing COVID-19 vaccination programs, CVH screening, CVH intervention, and referral services suitable for implementation in LMICs.

Conclusion

The CCPP project/model provides a practical approach that can help in the early detection and management of CVH. The model can be tailored to different healthcare settings to improve COVID-19 vaccine uptake among perinatal women in LMICs.
The cost of firearm violent crime in British Columbia, Canada
Authors: Rajabali Fahra , Turcotte Kate , Zheng Alex , Pauls Nick , Nguyen Tony , Kalman Evelyn , Covic Vedrana , Pike Ian
Published: January 2023

Introduction

This study aimed to quantify the total cost of violent firearm-related offenses in British Columbia in 2016 Canadian dollars over a five-year period, 2012 to 2016. The purposes of this study were to estimate the direct costs to the health care system and indirect costs to society for violent firearm injuries and deaths; and to estimate criminal justice system costs pertaining to firearm incidents.

Methods

Human and economic costs to the health care system and productivity losses were calculated using health administrative datasets such as B.C. Vital Statistics and Discharge Abstract Database. Criminal justice system costs pertaining to firearm incidents were estimated by applying weighted average costs to aggregate expenditures using methodology consistent with that used by Statistics Canada.

Results

There was a total of 108 deaths and 245 hospitalizations resulting from violent firearm injuries. The total estimated cost of all violent firearm crime averaged $294,378,985 per year; human costs averaged $188,416,841 per year, where health care costs averaged $3,910,317 per year, productivity losses from workforce and household averaged $17,299,054 and $4,559,470 per year, respectively, and loss of life averaged $162,648,000; and $105,021,145 in criminal justice system costs, and $941,000 in programming costs.

Conclusion

This study clearly demonstrates the significant cost of violent firearm injury in British Columbia and the impacts on the health care system, criminal justice system, and to society at large, particularly within the criminal justice system where the costs were significantly higher than health care.
The mental health of Asian American adolescents and young adults amid the rise of anti-Asian racism
Authors: Huynh James , Chien Jessie , Nguyen Amy T. , Honda Delanie , Cho Emily EunYoung , Xiong Maliya , Doan Tran T. , Ngo Thoai D.
Published: January 2023

Objectives

We describe the perceptions and experiences of anti-Asian racism and violence and depression severity prior to and during the COVID-19 pandemic among a sample of Asian American (AA) adolescents and young adults.

Methods

We used data from the Young Asian American Health Survey (YAAHS), an online-recruited sample of AA adolescents (ages 13–17) and young adults (ages 18–29 years) conducted during May 2021 to March 2022. We presented descriptive statistics examining the univariate distribution and bivariate relationships of depression severity, sociodemographic characteristics, and experiences and perceptions of anti-Asian violence.

Results

Our sample (n = 176) comprised AA adolescents and young adults from 17 Asian ethnicities. A quarter said that the frequency and/or severity of their personal experiences of anti-Asian harassment had increased since the pandemic started. 76% indicated feeling less safe now than before the pandemic. Two-thirds reported that their depressive symptoms have increased since the pandemic started. Participants who reported feeling less safe now than before the pandemic were more likely to report increased personal experiences with anti-Asian harassment and increased depression severity since the pandemic started than those who reported feeling as safe or safer before the pandemic (p < 0.01 for both).

Discussion

Findings illustrate AA adolescent and young adults are experiencing multiple health and social crises stemming from increased anti-Asian racism during the COVID-19 pandemic. We urge policymakers to strengthen data systems that connect racial discrimination and mental health and to institute prevention measures and anti-racist mental health services that are age- and culturally-appropriate for AA adolescent and young adults.
Digital maturity and its determinants in General Practice: A cross-sectional study in 20 countries
Authors: Teixeira Fábia , Li Edmond , Laranjo Liliana , Collins Claire , Irving Greg , Fernandez Maria Jose , Car Josip , Ungan Mehmet , Petek Davorina , Hoffman Robert , Majeed Azeem , Nessler Katarzyna , Lingner Heidrun , Jimenez Geronimo , Darzi Ara , Jácome Cristina , Neves Ana Luísa
Published: January 2023

Background

The extent to which digital technologies are employed to promote the delivery of high-quality healthcare is known as Digital Maturity. Individual and systemic digital maturity are both necessary to ensure a successful, scalable and sustainable digital transformation in healthcare. However, digital maturity in primary care has been scarcely evaluated.

Objectives

This study assessed the digital maturity in General Practice (GP) globally and evaluated its association with participants' demographic characteristics, practice characteristics and features of Electronic Health Records (EHRs) use.

Methods

GPs across 20 countries completed an online questionnaire between June and September 2020. Demographic data, practice characteristics, and features of EHRs use were collected. Digital maturity was evaluated through a framework based on usage, resources and abilities (divided in this study in its collective and individual components), interoperability, general evaluation methods and impact of digital technologies. Each dimension was rated as 1 or 0. The digital maturity score was calculated as the sum of the six dimensions and ranged between 0 to 6 (maximum digital maturity). Multivariable linear regression was used to model the total score, while multivariable logistic regression was used to model the probability of meeting each dimension of the score.

Results

One thousand six hundred GPs (61% female, 68% Europeans) participated. GPs had a median digital maturity of 4 (P25–P75: 3–5). Positive associations with digital maturity were found with: male gender [B = 0.18 (95% CI 0.01; 0.36)], use of EHRs for longer periods [B = 0.45 (95% CI 0.35; 0.54)] and higher frequencies of access to EHRs [B = 0.33 (95% CI 0.17; 0.48)]. Practicing in a rural setting was negatively associated with digital maturity [B = −0.25 (95%CI −0.43; −0.08)]. Usage (90%) was the most acknowledged dimension while interoperability (47%) and use of best practice general evaluation methods (28%) were the least. Shorter durations of EHRs use were negatively associated with all digital maturity dimensions (aOR from 0.09 to 0.77).

Conclusion

Our study demonstrated notable factors that impact digital maturity and exposed discrepancies in digital transformation across healthcare settings. It provides guidance for policymakers to develop more efficacious interventions to hasten the digital transformation of General Practice.
Imposing calculations: The visibility and invisibility of harm in the Mackenzie Gas Project environmental assessment
Authors: Dokis Carly
Published: January 2023

Environmental assessment is an institutional apparatus through which proponents concede harm associated with extractive projects. Within these processes proponents define the nature and scope of harm, which is made visible through the production of indicators and measurements and made manageable through mitigation measures or economic compensation. That the activities of extractive industries may have effects on surrounding ecologies is rarely in question; proponents of extractive projects regularly concede that their activities will result in negative (but also positive) changes to environments and communities. What is often contested in the course of environmental assessment and regulatory processes is the “significance” of the impacts identified, the nature of the harm caused, and whether or not it is possible or acceptable to accommodate it. Drawing from ethnographic fieldwork conducted in the Sahtu Settlement Area, NWT during the Mackenzie Gas Project environmental assessment, along with regulatory documents and transcripts, this paper examines how proponents and regulatory regimes work to make the impacts of extractive industries visible, and how these logics deviate discursively and materially from many Indigenous peoples' understandings of appropriate relationships between human beings and nature.
Running demands in club, regional, national, and international provincial New Zealand rugby union competitions
Authors: Olsen Peter , Deuchrass Richard , Owen Shaun , Lilley Matt , Jowsey James , Hamlin Michael
Published: January 2023

The demands of national and international professional rugby union matches are well established, however, there has not been a comparative study investigating running demands in New Zealand teams playing in club (amateur), Heartland Championship (semi-professional Div 2), the Mitre 10 Cup (semi-professional Div 1) or Super Rugby (professional) competitions. This information could enable specific training and rehabilitation that programmes to be developed to meet the needs of players in the different competitions. Players wore 10 Hz GPS units during games for one rugby season to determine absolute (m) and relative (m.min−1) measures for total distance, running volume (∼≥7 km·h−1) and high intensity running (∼≥16 km·h−1). There were typically minimal differences (1–2 m.min−1) in running distance measures between amateur level front row forwards and inside backs compared to players in these positions at higher levels of competition. Therefore, amateur players in these positions may find the transition to higher competitions less challenging with respect to running load. In contrast, amateur outside backs and back row forwards may find the increased pace of higher levels of competition more challenging due to typically covering significantly less running and high intensity running distances in amateur games. Differences for half backs were more variable between the levels of competition. Based on our results, it cannot be assumed that amateur rugby has lower running demands than higher competitions or that there is a continuum of increased running demands with increasing competition levels, as some playing positions in the semi-professional (Div 2) (second lowest level of competition) team recorded the largest values for total distance, running and high intensity running. Therefore, the specificity of running demands in a position and competition need to be considered individually for each player when transitioning between competitions. The practice and perception of returning a professional player to amateur club rugby due to the belief that running loads being lower may also be flawed, as we found considerable positional variation in running demands within-and-between competitions.
High and low inferior mesenteric artery ligation in laparoscopic low anterior rectal resections: A retrospective study
Authors: Yu Jun , Chen Yi , Li Tong , Sheng Bo , Zhen Zhuo , Liu Chang , Zhang Jianbo , Yan Qian , Zhu Peng
Published: January 2023

Backgroud

The high or low inferior mesenteric artery (IMA) ligation in rectal cancer remains a great debate. This study retrospectively discussed the outcomes of the perioperative period, defecation and urinary function and long-term prognosis in rectal cancer patients with high or low IMA ligation.

Methods

This study enrolled 220 consecutive rectal cancer cases, including 134 with high IMA ligation and 86 with low ligation. A comparison between the two groups was made for anastomotic leakage, low anterior resection syndrome (LARS), international prostate symptom score (IPSS), 5-year disease-free survival (DFS) and 5-year overall survival (OS).

Results

Low-ligation group had a longer operative time, and larger intraoperative blood loss. No significant difference was noted in anastomotic leakage incidence. In multivariable analysis, the male gender and tumor located at the lower rectum were identified as risk factors for anastomotic leakage. No significant differences were observed between groups in their LARS and IPSS questionnaire responses. The high-ligation vs. the low-ligation 5-year OS and DFS were 78.3% vs. 82.4% and 72.4% vs. 76.6%, respectively, which were not statistically different.

Conclusion

The ligation level of the IMA had no significant effect on the anastomotic leakage incidence, defecation, urinary function, and long-term prognosis.
Osteophyte formation causes neurological symptoms after anterior cervical discectomy and fusion (ACDF): A case report
Authors: Jin Haiming , Luo Jiangtao , Jiang Yuhan , Lin Jinghao , Jiang Junchen , Ren Rufeng , Fang Weiyuan , Wu Yaosen , Wang Xiangyang
Published: January 2023

Spinal surgeons have been drawn to the incidence of osteophytes following intervertebral disc degeneration in clinical practice. However, the production of osteophytes, particularly in the spinal canal, after anterior cervical discectomy and fusion (ACDF) is uncommon. We described a 42-year-old male patient who underwent C4–6 ACDF due to cervical stenosis two years prior in another public hospital in the province. His primary symptoms were significantly relieved, but he developed new pain and weakness in his right leg six months after surgery. The imaging results revealed a large posterior osteophyte at C5/6, compressing the spinal cord anteriorly. Accordingly, we performed cervical open-door laminoplasty to decompress the spinal cord. The patient's clinical symptoms had significantly improved at the one-year follow-up. This case seeks to inform surgeons that cautious, routine follow-ups are necessary for the event that a severe intracanal osteophyte develops at the operated level following ACDF. The comprehensive osteophyte removal and strong fixation at the operative level during ACDF warrant more consideration as these procedures may lower the incidence of new osteophytes. Additionally, surgical procedures may be required.