bluuebunny/crossref_metadata_2025 huggingface dataset:
Osteochondral Lesions of the Subtalar Joint: Clinical Outcomes in 11 Patients
Authors: Buck Tristan M.F. , Butler James J. , Azam Mohammad T. , ter Laak Bolk Carlijn , Rikken Quinten G.H. , Weiss Matthew B. , Dahmen Jari , Stufkens Sjoerd A.S. , Kennedy John G. , Kerkhoffs Gino M.M.J.
Published: October 2023

Objective

The purpose of this retrospective case series was to evaluate clinical outcomes following both conservative treatment and arthroscopic bone marrow stimulation (BMS) for the management of symptomatic subtalar osteochondral lesions (OCLs).

Design

All symptomatic subtalar OCLs with a minimum of 12 months follow-up having undergone either a conservative management or arthroscopic procedure were included. Patient-reported outcomes were collected via questionnaires consisting of the Foot and Ankle Outcome Score (FAOS), Numeric Rating Scale (NRS) of pain in rest, during walking, during stair climbing, and during running. In addition, return to sports data, return to work data, reoperations, and complications were collected and assessed. In total, 11 patients across 2 academic institutions were included (3 males, 8 females). The median age was 43 years (interquartile range [IQR]: 32-53).

Results

All patients underwent conservative treatment first; in addition, 9 patients underwent subtalar arthroscopic debridement with or without BMS. The median follow-up time was 15 months (IQR: 14-100). In the surgically treated group, the median NRS scores were 2 (IQR: 1-3) during rest, 3 (IQR: 2-4) during walking, 4 (IQR: 4-5) during stair climbing, 5 (IQR: 4-5) during running and the median FAOS score at final follow-up was 74 (IQR: 65-83). In the conservatively treated patients, the median NRS scores were all 0 (IQR: 0-0) and the median FAOS scores were 90 (IQR: 85-94). In the group of surgical treated patients, 4 were able to return to the same level of sports, 2 returned to a lower level of sports. Both conservatively treated patients returned to the sport and the same level of prior participation. All patients except one in the surgical group returned to work.

Conclusions

This retrospective case series demonstrated that a high number of patients converted to surgery after initial conservative treatment. In addition, debridement and BMS show good clinical outcomes for the management of symptomatic subtalar OCLs at short-term follow-up. No complications nor secondary surgical procedures were noted in the surgically treated group. The high rate of failure of conservative treatment suggests that surgical intervention for symptomatic subtalar OCLs can be the primary treatment strategy; however, further research is warranted in light of the small number of patients.
Psychological needs satisfaction and smartphone addiction among Chinese adolescents: The mediating roles of social anxiety and loneliness
Authors: Sun Ruimei , Li Wanying , Lu Sihan , Gao Qiufeng
Published: October 2023

Objectives

Although previous studies have initially noted that psychological needs satisfaction (PNS) might be a significant risk factor for technology addiction (e.g. online gaming addiction and Internet addiction), specific mechanisms involved in the association between PNS and adolescent smartphone addiction are largely unknown. Based on self-determination theory, this cross-sectional study constructed a multiple mediation model to examine whether PNS will influence adolescent smartphone addiction through the mediating roles of social anxiety and loneliness.

Methods

Eight hundred and ninety-nine Chinese adolescents answered the questionnaire including measures of PNS, social anxiety, loneliness, and smartphone addiction. SPSS 24.0 was used for common method bias test, reliability test, and correlation analysis, and Mplus 7.4 was used to examine the mediating roles of social anxiety and loneliness in the multiple mediation model.

Results

This study found that (1) PNS was negatively associated with adolescent smartphone addiction; (2) loneliness significantly mediated the association between PNS and smartphone addiction while the mediating role of social anxiety in this association was nonsignificant; and (3) social anxiety and loneliness also sequentially mediated this association.

Conclusion

This study further enriched potential mechanisms linking PNS and smartphone addiction among adolescents, which may contribute to intervention and prevention programs for adolescent smartphone addiction from the perspective of improving both PNS and negative emotions including social anxiety and loneliness.
Developing EFL Teachers’ Beliefs and Practices in Relation to Learner Autonomy Through Online Teacher Development Workshops
Authors: Li Xueru
Published: October 2023

The development of autonomy is acknowledged as a significant educational goal in language education, but it seems challenging in many schools. One of the reasons for this discrepancy is the lack of professional development addressing teacher beliefs and practices about learner autonomy (LA) as valid educational concerns. However, in teacher education research, limited attention has been paid to language teachers’ understandings and practices of promoting LA. Hence, this research project aims to develop in-service teachers’ beliefs, understandings, and practices about LA through teacher development workshops. First, an in-depth interview was used to gather five teachers’ beliefs about autonomy and teaching practices in secondary schools. Second, two workshops were conducted based on the literature and the initial interview to develop teachers’ LA-related beliefs, understandings, and practices. Third, a post-workshop evaluation was conducted through a focus group, the written reflection, and the researcher’s self-reflective journals to examine to what extent teachers’ knowledge and beliefs about LA have changed and developed. The findings revealed that the online workshops have made making teachers more aware of the concept of LA and its significance in language learning. Their LA-related beliefs and understandings of their teaching objectives, prior learning experiences, and teaching competence influenced their LA-related classroom practices. Some practical suggestions were provided for designing and implementing professional development workshops.
Women’s Work in South Asia: Reflections on the Past Decade
Authors: Strachan Glenda , Adikaram Arosha S.
Published: October 2023

The development and promotion of legislation and policies promoting gender equity in employment form an essential part of the agenda of international organisations and global forums. However, gender inequity in the labour markets of South Asian countries remains, and the Global Gender Gap Report 2022 predicts that it will take 197 years to achieve gender parity. This article explores some of the changes and challenges of the past 10 years related to gender equity in employment and outlines some of the legislative changes during this time such as the increase in maternity leave and requirement for women on boards. While changes have occurred, many issues of inequity remain. The changes brought about by the government regulations during the pandemic of 2020-2022, including the sudden focus on working from home, has had both positive and negative effects on women’s work and lives.
Is Delayed Anterior Cruciate Ligament Reconstruction Associated With a Risk of New Meniscal Tears? Reevaluating a Longstanding Paradigm
Authors: Gupta Arjun , Badin Daniel , Ortiz-Babilonia Carlos , Davidson Anthony J. , Lee R. Jay
Published: October 2023

Background:

Delayed anterior cruciate ligament (ACL) reconstruction has been associated with an increased risk of meniscal tears. However, studies comparing early versus delayed ACL reconstruction have not clearly demonstrated that meniscal tears diagnosed arthroscopically are new injuries as opposed to concomitant injuries sustained during ACL rupture.

Purpose:

To determine whether and how delay of ACL reconstruction is associated with risk of “new” meniscal tears (defined as those visualized arthroscopically that had not been detected on magnetic resonance imaging [MRI]) in adult and pediatric patients.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We retrospectively identified patients who underwent primary ACL reconstruction between 2013 and 2022 at our institution. To ensure that MRI reflected initial intra-articular pathology, we included only patients who had an MRI scan within 3 weeks after injury (173 pediatric and 369 adult patients). Multivariate Poisson regression was performed to calculate the adjusted relative risk (ARR) of new meniscal tears after delayed (≥8 weeks from injury) operative treatment.

Results:

The mean (± SD) time from injury to MRI was 1.0 ± 0.8 weeks for pediatric patients and 1.1 ± 0.7 weeks for adults. Less than half of the meniscal tears observed arthroscopically had been absent on initial MRI. New medial meniscal tears occurred in 15% of pediatric patients and 16% of adults. New lateral meniscal tears occurred in 48% of pediatric patients and 34% of adults. Among pediatric patients, delayed ACL reconstruction was associated with higher risk of new medial tears (ARR, 3.9; 95% CI, 1.5-10) but not lateral tears (ARR, 0.8; 95% CI, 0.4-1.5). In contrast, adults had no significant increase in risk of meniscal tears associated with operative delay.

Conclusion:

Delayed ACL reconstruction may be acceptable in adults, who may be less active and less injury-prone than children and adolescents.
Response to Bas van Heur, ‘What, where and who is urban studies? On research centres in an unequal world’
Authors: Zipp Samuel
Published: October 2023

Recognizing the unequal distribution of urban studies research should also spur us to think in more depth about the way we understand and communicate about our shared subjects: cities and urbanization.
Based polymer nanoparticles from bee pollen attenuate non-small lung cancer through enhancement of apoptosis and cell cycle arrest in vivo
Authors: Salim Elsayed I. , Mahfouz Magdy E. , Eltonouby Eman A. , Hanafy Nemany A. N. , Hafez Ezar H.
Published: October 2023

Bee pollen extract (BPE)-based polymer nanoparticles (BPENP) were fabricated using bovine serum albumin (BSA) and targeted with folic acid and were further characterized. Mice groups are: Group 1 received saline, whereas Groups 2, 3, 4, 5, and 6 received a single dose of urethane, followed by weekly injections of butylated hydroxy-toluene (BHT). After the BHT injection, the mice in Groups 3, 4, 5, and 6 received BPE, Avastin, BPENP, and BPENP + Avastin, respectively. The number and size of tumors were decreased in Group 6 compared to those in the other groups. The ratios of early and late apoptotic cells in Groups 3, 4, 5, and 6 (42.8%, 41.4%, 26.2%, and 45.4%, respectively) were higher than that in the untreated group. The PCNA-labeling indexes (LI)% in tissues and lesions from Group 6 were lower than those in the other groups; on the other hand, the Caspase-3 LI (%) was higher than those in the other groups. No significant differences in HRAS and MAPK levels were observed between Group 6 and the other groups. However, the level of Bax was significantly increased, whereas those of Bcl2 and P21 were decreased in Group 6 compared to those in Groups 4 and 5. According to the results of the current study's in vivo lung cancer mouse model, adjuvant chemotherapy given in conjunction with a polyphenolic substance derived from bee pollen significantly activates the apoptotic pathways as measured by flow cytometry, immunohistochemistry, and apoptotic genes. It also significantly reduces tumor volume and growth as measured by histopathology.

Graphical Abstract
Identification of Wolbachia new strains from Aedes aegypti mosquitoes, the vector of dengue fever in Jeddah Province
Authors: Somia E. Sharawi , Ullah Ihsan , Alyahya Hanan S. , Mahyoub Jazem A.
Published: October 2023

Wolbachia are endosymbiotic bacteria found within many arthropods, including insects. A variety of benefits are provided by these bacteria to human and insect hosts, including protection from viruses and parasites and the ability to kill males. In this study, Wolbachia was identified in Aedes aegypti present in Jeddah, Saudi Arabia. A population of mosquitoes was collected from eight different areas, processed, and tested for Wolbachia using 16 S rRNA specific to Wolbachia bacteria and Wolbachia surface protein (wsp) under optimized PCR conditions. In five ecologically diverse sites to determine Wolbachia prevalence, we identified eleven diverse novel resident Wolbachia strains within Ae. Aegypti for the first time in Jeddah, Saudi Arabia. Future studies to evaluate the possible use of Wolbachia as a control agent in Aedes sp. in Saudi Arabia are necessary. Wolbachia prevalence rates and strain characterization through Sanger sequencing with multilocus sequence typing (MLST) and phylogenetic analysis revealed significant diversity. In developing biocontrol strategies, it is beneficial to consider the implications of resident Wolbachia strains.
Metagenomic analysis of microbiological changes on the ocular surface of diabetic children and adolescents with a dry eye
Authors: Chen Zhangling , Xiao Ying , Jia Yan , Lin Qiurong , Qian Yu , Cui Lipu , Xiang Zhaoyu , Li Mingfang , Yang Chenhao , Zou Haidong
Published: October 2023

Background

Microbiome changes on the ocular surface may cause dry eyes. A metagenome assay was used to compare the microbiome composition and function of the ocular surface between diabetic children and adolescents with dry eye, diabetic children and adolescents without dry eye, and normal children.

Materials and methods

Twenty children and adolescents aged 8 to 16 with diabetes were selected from the Shanghai Children and Adolescent Diabetes Eye Study. Ten healthy children and adolescents belonging to the same age group were selected from the outpatient clinic during the same period. The participants were classified into the dry eye group (DM-DE group, n = 10), the non-dry eye group (DM-NDE group, n = 10) and the normal group (NDM group, n = 10). A conjunctival sac swab was collected for metagenomic sequencing, and the relationship between the microbiome composition and functional gene differences on the ocular surface with dry eye was studied.

Results

The classification composition and metabolic function of the microorganisms on the ocular surface of children in the 3 groups were analyzed. It was found that children’s ocular microbiota was composed of bacteria, viruses and fungi. There were significant differences in α diversity and β diversity of microbial composition of ocular surface between DM-DE group and NDM group(P<0.05). There were significant differences in α and β diversity of metabolic pathways between the two groups(P<0.05). The functional pathways of ocular surface microorganisms in diabetic children with dry eyes were mainly derived from human disease, antibiotic resistance genes, carbohydrate, coenzyme and lipid transport and metabolism-related functional genes; In normal children, the functional pathways were mainly derived from replication, recombination, repair, signal transduction and defense-related functional genes.

Conclusion

The DM-DE group have unique microbial composition and functional metabolic pathways. The dominant species and unique metabolic pathways of the ocular surface in the DM-DE group may be involved in the pathogenesis of dry eye in diabetic children.
Anti-HBc: a significant host predictor of spontaneous HBsAg seroclearance in chronic hepatitis B patients - a retrospective longitudinal study
Authors: Kan Karin , Wong Danny Ka-Ho , Hui Rex Wan-Hin , Seto Wai Kay , Yuen Man-Fung , Mak Lung-Yi
Published: October 2023

Background and Aim

: In chronic hepatitis B infection (CHB), seroclearance of hepatitis B surface antigen (HBsAg) is associated with favourable clinical outcomes compared to those with persistent HBsAg seropositivity, and thus considered as a desired treatment endpoint. This current study explores the possibility of serum antibody to hepatitis B core antigen (anti-HBc) as a potential predictive factor of HBsAg seroclearance.

Methods

This is a retrospective study that analyzed the plasma samples of CHB patients using the LUMIPULSE® G1200 analyzer. The longitudinal anti-HBc level between patients who subsequently achieved HBsAg seroclearance (S-losers) and those with persistent HBsAg-positivity (controls) were compared at multiple time points before the event.

Results

A total of 240 subjects (120 S-losers and 120 controls; age- and gender-matched) were included (mean age 56.42 ± 10.81, 65% male). Compared to controls, S-losers had significantly lower plasma anti-HBc levels prior to HBsAg seroclearance, with a significant trend of declining plasma anti-HBc 8–5 years prior to HBsAg seroclearance (p < 0.01), while such trend was not observed in controls. ROC curve analysis revealed that plasma anti-HBc at multiple time points before HBsAg seroclearance return AUC greater than 0.7. Plasma anti-HBc level at the cut-off value of 82.50 COI was 68.3% sensitive and 90% specific for HBsAg seroclearance within 1 year. Combining with quantitative HBsAg < 100 IU/mL, anti-HBc < 82.5 COI identified 88.2% patients who would develop HBsAg seroclearance within 1 year.

Conclusion

Plasma anti-HBc level began to decline 10 years prior to HBsAg seroclearance and can serve as a potential predictor for subsequent HBsAg seroclearance.
Influence of medical care tasks on subjective burden and gain among older adults’ family caregivers: structural equation modeling for testing the role of formal and informal support
Authors: Sugihara Yoko , Sugisawa Hidehiro
Published: October 2023

Background

The number of caregivers performing medical care tasks at home for older adults is expected to increase. Family caregivers, who are not healthcare professionals, are likely to find these activities difficult and burdensome. However, appropriate support may decrease the negative and increase the positive aspects of caregiving. This study investigated direct associations between caregivers providing medical care at home and their negative and positive appraisals of caregiving (burden and gain), indirect associations through healthcare professional support and informal support, and whether the associations between medical care tasks and caregivers’ appraisals of caregiving differed based on the support received.

Methods

Interview surveys were conducted in 2013, 2016, and 2019 in a Tokyo Metropolitan Area city with family caregivers of community-dwelling older adults who were certified as requiring care in Japan’s long-term care insurance system. This study analyzed the combined data from each survey (n = 983). Structural equation modeling (SEM) analysis was utilized to examine direct associations between providing medical care and caregiver appraisals and indirect relationships through healthcare professional support and informal support. The modulating effects of these forms of support on the relationship between medical care and caregiver appraisals were assessed using multigroup SEM analyses.

Results

Approximately 9% of family caregivers provided medical care at home. The results of SEM analyses, controlled for care recipients’ physical and cognitive difficulties; caregivers’ age, sex, and economic condition; and survey year, revealed no direct associations between providing medical care and caregivers’ sense of burden and gain. They also did not reveal any indirect effects through either healthcare professional support or informal support. However, the results of multigroup SEM analyses indicated that caregivers providing medical care who used home-visit services by physicians and/or nurses, compared to those who did not, tended to exhibit a greater sense of gain.

Conclusions

These results suggest that family caregivers providing medical care at home can positively change their appraisals of caregiving if they receive appropriate support. Home medical care services provided by healthcare professionals can effectively support caregivers. Developing strategies and policies to make medical care services at home more accessible to caregivers is crucial.
Correlation of balance posturographic parameters during quiet standing with the berg balance scale in patients with parkinson’s disease
Authors: Bao Wei , Tan Yuyan , Yang Ying , Chen Kai , Liu Jun
Published: October 2023

Background

Parkinson’s disease (PD) is often clinically associated with posture instability and more easily falling. The Berg balance scale is a clinical indicator commonly used to subjectively evaluate a patient’s balance ability. Meanwhile, computerized force platforms have been used in research on postural control. The various parameters obtained from posturography are interpreted to assess balance ability. The present study aims to explore the correlations between posturographic variables and the BBS, and furthermore to efficiently evaluate postural instability and fall risk of early and moderate PD patients.

Methods

A total of 46 PD patients were involved in the experiment. Patients were asked to perform BBS tests and force platform tests under eye open (EO) and eye closed (EC) conditions. The recorded COP signal was analyzed with the time domain statistical method, the frequency domain method of Power Spectral Density (PSD), and structural methods of Stabilogram Diffusion Analysis (SDA), Sway Density Plot (SDP) to retrieve different posturographic variables. The correlation between posturographic variables under EO and EC conditions with BBS was compared statistically. The significantly correlated posturographic parameters were then applied to analyze posturographic differences between different groups: faller vs. non-faller (patients with/without a history of falls in the past 12 months).

Results

Among the different posturographic parameters, the prediction ellipse area, the slope of the regression line at a high-frequency band of PSD in the medial-lateral (ML) direction, the crossover point of the regression lines of SDA in the anterior-posterior (AP) direction, and the distance between successive peaks of SDP had significant correlations with BBS. These selected BBS-related parameters also showed significant differences between faller and non-faller. The selected posturographic parameters can be used as effective indicators to evaluate the balance ability of Parkinson’s disease patients.
An endometrium of type C along with an endometrial thickness of < 8 mm are risk factors for ectopic pregnancy after stimulated cycles with fresh embryo transfer
Authors: Zhao Ying , Xu Aizhuang , Liu Dong’e , Liu Nenghui , Li Yumei , Yao Zhongyuan , Tian Fen , Tang Hongying , Li Yanping
Published: October 2023

Background

The study investigated whether specific ultrasonographically observed endometrial features (including endometrium type and thickness) were linked to ectopic pregnancy after stimulated cycles with fresh embryo transfer.

Method

Of 6246 pregnancy cycles after fresh embryo transfer, 6076 resulted in intrauterine pregnancy and 170 in ectopic pregnancy. The primary outcome of the study was ectopic pregnancy, with the main variables being endometrium type and endometrial thickness. Univariate and subsequent multiple-stepwise logistic regression analyses were used to identify the risk factors of ectopic pregnancy.

Results

1. Compared with patients with an endometrial thickness ≥ 8 mm, the adjusted odds ratio for those with an endometrial thickness < 8 mm was 3.368 (P < 0.001). The adjusted odds ratio for women with a type-C endometrium was 1.897 (P = 0.019) compared with non-type C. 2. A larger dose of gonadotropin used during controlled ovarian hyperstimulation was a protective factor against ectopic pregnancy (P = 0.008). 3. The GnRH antagonist protocol (P = 0.007) was a risk factor for ectopic pregnancy, compared with the use of GnRH agonists.

Conclusion

(1) An endometrial thickness < 8 mm coupled with a type C endometrium significantly increased the risk of ectopic pregnancy after fresh embryo transfer. (2) A thin endometrial thickness and a type C endometrium could be further related to an abnormal endometrial receptivity/peristaltic wave. (3) Patients at a high risk of ectopic pregnancy should therefore be given special attention, with early diagnosis during the peri-transplantation period may assist in the prevention of ectopic pregnancy.
Epigenomic perturbation of novel EGFR enhancers reduces the proliferative and invasive capacity of glioblastoma and increases sensitivity to temozolomide
Authors: Vincent Craig A. , Nissen Itzel , Dakhel Soran , Hörnblad Andreas , Remeseiro Silvia
Published: October 2023

Background

Glioblastoma (GB) is the most aggressive of all primary brain tumours and due to its highly invasive nature, surgical resection is nearly impossible. Patients typically rely on radiotherapy with concurrent temozolomide (TMZ) treatment and face a median survival of ~ 14 months. Alterations in the Epidermal Growth Factor Receptor gene (EGFR) are common in GB tumours, but therapies targeting EGFR have not shown significant clinical efficacy.

Methods

Here, we investigated the influence of the EGFR regulatory genome on GB cells and identified novel EGFR enhancers located near the GB-associated SNP rs723527. We used CRISPR/Cas9-based approaches to target the EGFR enhancer regions, generating multiple modified GB cell lines, which enabled us to study the functional response to enhancer perturbation.

Results

Epigenomic perturbation of the EGFR regulatory region decreases EGFR expression and reduces the proliferative and invasive capacity of glioblastoma cells, which also undergo a metabolic reprogramming in favour of mitochondrial respiration and present increased apoptosis. Moreover, EGFR enhancer-perturbation increases the sensitivity of GB cells to TMZ, the first-choice chemotherapeutic agent to treat glioblastoma.

Conclusions

Our findings demonstrate how epigenomic perturbation of EGFR enhancers can ameliorate the aggressiveness of glioblastoma cells and enhance the efficacy of TMZ treatment. This study demonstrates how CRISPR/Cas9-based perturbation of enhancers can be used to modulate the expression of key cancer genes, which can help improve the effectiveness of existing cancer treatments and potentially the prognosis of difficult-to-treat cancers such as glioblastoma.
Phosphorylation of EZH2 differs HER2-positive breast cancer invasiveness in a site-specific manner
Authors: Yu Feng , Li Lili , Zhang Mengwen , Sun Shanshan
Published: October 2023

HER2-positive breast cancer (BC) invasiveness and drug-resistance issue is the critical treatment obstacle recently. We investigated the total and phosphorylated status EZH2 expression in database and BC tissue microarray. We demonstrated for the first time that EZH2 is distributed both in cytoplasm and nucleus of breast cancer cells in a phosphorylation site-specific manner. High expressed-EZH2 cases more frequently had an advanced clinical stage (lymph node metastasis) and aggressive features than EZH2-low cases, potentially indicating the high risk of HER2-positive BC (p < 0.05). Notably, highly expressed phosphorylated EZH2 is differently located in cytoplasm or nucleus in a site-specific manner in breast cancer cells. Nucleus-located pEZH2-S21 is expressed in invasive and lymph node metastatic HER2-positive BC cases (p = 0.144, p = 0.001). Cytoplasmic pEZH2-T487 is correlated with HER2 positive status (p = 0.014).

In conclusion, high expression of nucleus-located EZH2 might be a predictor of invasive BC. Activation of phosphorylated EZH2-S21 site in nucleus would be a potential predictor of HER2-positve BC and poor efficacy of HER2-target therapy. These results point to a PRC2-independent non-epigenetic mechanism and therapeutic strategy of EZH2 in HER2-positive BC.
Prescription drugs with potential for misuse in Irish prisons: analysis of national prison prescribing trends, by gender and history of opioid use disorder, 2012 to 2020
Authors: Durand Louise , Keenan Eamon , O’Reilly Deirdre , Bennett Kathleen , O’Hara Andy , Cousins Gráinne
Published: October 2023

Background

Pharmacotherapy is essential for the delivery of an equivalent standard of care in prison. Prescribing can be challenging due to the complex health needs of prisoners and the risk of misuse of prescription drugs. This study examines prescribing trends for drugs with potential for misuse (opioids, benzodiazepines, Z-drugs, and gabapentinoids) in Irish prisons and whether trends vary by gender and history of opioid use disorder (OUD).

Methods

A repeated cross-sectional study between 2012 and 2020 using electronic prescribing records from the Irish Prison Services, covering all prisons in the Republic of Ireland was carried out. Prescribing rates per 1,000 prison population were calculated. Negative binomial (presenting adjusted rate ratios (ARR) per year and 95% confidence intervals) and joinpoint regressions were used to estimate time trends adjusting for gender, and for gender specific analyses of prescribing trends over time by history of OUD.

Results

A total of 10,371 individuals were prescribed opioid agonist treatment (OAT), opioids, benzodiazepines, Z-drugs or gabapentinoids during study period. History of OUD was higher in women, with a median rate of 597 per 1,000 female prisoners, compared to 161 per 1,000 male prisoners. Prescribing time trends, adjusted for gender, showed prescribing rates decreased over time for prescription opioids (ARR 0.82, 95% CI 0.80–0.85), benzodiazepines (ARR 0.99, 95% CI 0.98–0.999), Z-drugs (ARR 0.90, 95% CI 0.88–0.92), but increased for gabapentinoids (ARR 1.07, 95% CI 1.05–1.08). However, prescribing rates declined for each drug class between 2019 and 2020. Women were significantly more likely to be prescribed benzodiazepines, Z-drugs and gabapentinoids relative to men. Gender-specific analyses found that men with OUD, relative to men without, were more likely to be prescribed benzodiazepines (ARR 1.49, 95% CI 1.41–1.58), Z-drugs (ARR 10.09, 95% CI 9.0-11.31), gabapentinoids (ARR 2.81, 95% CI 2.66–2.97). For women, history of OUD was associated with reduced gabapentinoid prescribing (ARR 0.33, 95% CI 0.28–0.39).

Conclusions

While the observed reductions in prescription opioid, benzodiazepine and Z-drug prescribing is consistent with guidance for safe prescribing in prisons, the increase in gabapentinoid (primarily pregabalin) prescribing and the high level of prescribing to women is concerning. Our findings suggest targeted interventions may be needed to address prescribing in women, and men with a history of OUD.
Evaluating the association of vitamin D3, parathyroid hormone, and C-reactive protein serum levels in patients with an acute psychotic episode: a cross-sectional study in tertiary centre in Iran
Authors: Arya Shahrzad , Kamyab Amirhossein , Sanatkar Seyed Amir , Pourmehdiardebili Mohammad , Ebrahimi Alireza , Kamyab Parnia , Alavi Kaveh , Zarei Zhina , Ahmadkhaniha Hamid Reza
Published: October 2023

Background

The high impact of vitamin D on brain development and its relationship with inflammatory markers in the clinical course of psychiatric disorders have compelled researchers to investigate the potential association between vitamin D levels, C-reactive protein (CRP) levels, and the incidence of mental disorders. In the present study, we aimed to compare the serum levels of vitamin D and its related markers, including calcium, phosphorus, and parathyroid hormone (PTH), along with CRP, in 3 groups of patients with acute psychotic episodes, including schizophrenia, bipolar disorder, and methamphetamine-induced psychosis, with a standard control group of the Iranian population.

Methods

This descriptive cross-sectional study was conducted at a psychiatric hospital in Tehran, Iran, and involved a total of 185 subjects. The subjects included four groups: acute phase of schizophrenia (n = 49), acute manic episodes of bipolar disorder (n = 43), methamphetamine-induced psychotic disorder (n = 46), and control group (n = 47). Among 138 patients in acute psychotic episodes, 33 patients were in their first episode of psychosis, while 105 patients were in acute exacerbation of their chronic psychotic disorders. The Brief Psychiatric Rating Scale (BPRS) was measured by an expert attending psychiatrist for all patients. Then, serum levels of calcium, phosphorus, parathormone, vitamin D, and CRP were assessed in all study groups.

Results

Among our 185 study subjects, it was observed that individuals with higher education levels and those who were married had a lower prevalence of mental disorders. In all patient groups, the serum levels of CRP were significantly higher, and PTH levels were significantly lower than in the control group (p < 0.001). The serum levels of calcium, phosphorus, and vitamin D were not statistically significantly different between the patient and control groups of the study. In chronic psychotic patients, CRP levels were significantly higher (p < 0.031), and vitamin D levels were significantly lower (p < 0.044) compared to first-episode psychotic patients.

Conclusion

This study suggests that CRP levels are significantly higher and PHT level is significantly lower in acute psychotic patients. Moreover, vitamin D levels were significantly lower in chronic psychotic patients compared to first-episode psychotic patients.
Cultivating community-based participatory research (CBPR) to respond to the COVID-19 pandemic: an illustrative example of partnership and topic prioritization in the food services industry
Authors: Hoerger Michael , Kim Seowoo , Mossman Brenna , Alonzi Sarah , Xu Kenneth , Coward John C. , Whalen Kathleen , Nauman Elizabeth , Miller Jonice , De La Cerda Tracey , Peyser Tristen , Dunn Addison , Zapolin Dana , Rivera Dulcé , Murugesan Navya , Baker Courtney N.
Published: October 2023

Background

As an illustrative example of COVID-19 pandemic community-based participatory research (CBPR), we describe a community-academic partnership to prioritize future research most important to people experiencing high occupational exposure to COVID-19 – food service workers. Food service workers face key challenges surrounding (1) health and safety precautions, (2) stress and mental health, and (3) the long-term pandemic impact.

Method

Using CBPR methodologies, academic scientists partnered with community stakeholders to develop the research aims, methods, and measures, and interpret and disseminate results. We conducted a survey, three focus groups, and a rapid qualitative assessment to understand the three areas of concern and prioritize future research.

Results

The survey showed that food service employers mainly supported basic droplet protections (soap, hand sanitizer, gloves), rather than comprehensive airborne protections (high-quality masks, air quality monitoring, air cleaning). Food service workers faced challenging decisions surrounding isolation, quarantine, testing, masking, vaccines, and in-home transmission, described anxiety, depression, and substance use as top mental health concerns, and described long-term physical and financial concerns. Focus groups provided qualitative examples of concerns experienced by food service workers and narrowed topic prioritization. The rapid qualitative assessment identified key needs and opportunities, with help reducing in-home COVID-19 transmission identified as a top priority. COVID-19 mitigation scientists offered recommendations for reducing in-home transmission.

Conclusions

The COVID-19 pandemic has forced food service workers to experience complex decisions about health and safety, stress and mental health concerns, and longer-term concerns. Challenging health decisions included attempting to avoid an airborne infectious illness when employers were mainly only concerned with droplet precautions and trying to decide protocols for testing and isolation without clear guidance, free tests, or paid sick leave. Key mental health concerns were anxiety, depression, and substance use. Longer-term challenges included Long COVID, lack of mental healthcare access, and financial instability. Food service workers suggest the need for more research aimed at reducing in-home COVID-19 transmission and supporting long-term mental health, physical health, and financial concerns. This research provides an illustrative example of how to cultivate community-based partnerships to respond to immediate and critical issues affecting populations most burdened by public health crises.
Psychometric properties of the Romanian version of the female sexual function index (FSFI-RO)
Authors: Daescu Ana-Maria Cristina , Dehelean Liana , Navolan Dan-Bogdan , Pop Gheorghe Nicusor , Stoian Dana Liana
Published: October 2023

Background

Female sexual dysfunction (FSD) is a highly prevalent health disorder and no self-report questionnaire on female sexual function is available in Romanian. Therefore we considered the Female Sexual Function Index (FSFI) to be the most appropriate due to its excellent psychometric properties. The FSFI is a measuring scale with 19 items that assess the six domains of female sexual function: desire, arousal, lubrication, orgasm, satisfaction and pain. The paper aims to analyze the psychometric reliability and validity of the FSFI-RO (Romanian Version of the Female Sexual Function Index).

Methods

385 women (aged 18 to 51) enrolled in the present study. To assess the presence of FSD we used the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria for sexual dysfunction. Then we categorized the participants into two groups: the FSD group (41%) and the healthy control group (59%). Women were then asked to fill out a form that included sociodemographic information and the FSFI-RO questionnaire. A sample of 50 women agreed to re-answer FSFI-RO in a 4-week interval in order to evaluate the test-retest validity of the questionnaire. The data were summarized using descriptive statistics: the test-retest reliability was measured by the intraclass correlation coefficient (ICC); Cronbach’s alpha was employed to evaluate the internal consistency of the Romanian version of the FSFI, and validity was assessed by the content and construct validity.

Results

The results showed high test-retest reliability, with ICC from 0.942 to 0.991 in the domains and 0.987 in the total score. Regarding the internal consistency of the FSFI-RO, Cronbach’s α coefficients were found to be high (α = 0.944). Convergent construct validity proved to be moderate to high in desire, arousal, lubrication, orgasm and, satisfaction domains, and weak correlation in the pain domain. Regarding the discriminant construct validity, the scores for each domain and the total score showed statistically significant differences between the FSD group and the control group.

Conclusions

The FSFI-RO showed similar psychometric properties to those of the original version, therefore being a reliable and valid instrument that can be used in Romanian-speaking women.
Undergraduate research implementation in physiotherapy: a hands-on and real experience of a randomised controlled trial
Authors: Sancho Igor , Araolaza-Arrieta Maialen , Villanueva-Ruiz Iker , Arbillaga-Etxarri Ane
Published: October 2023

Background

Evidence-based practice (EBP) is the gold standard approach in physiotherapy, and it is essential that students are aware that it is the appropriate way to provide the patient with the best possible treatment. Undergraduate research (UR) can positively influence learning outcomes and research competencies related to EBP compared to traditional methods of higher education. The aim of this study was to evaluate the effect of implementing a research-based activity (i.e., active participation in a randomised controlled trial [RCT]) in the UR programme on the learning and acquisition of research methodology-related competencies by first-year physiotherapy students.

Methods

Students in the first academic year of the Bachelor´s Degree in Physiotherapy of University of Deusto (Donostia-San Sebastian, Spain) who were enrolled in the subject ‘Introduction to Research Methodology’ were invited to take part in a real RCT which consisted of three groups: intervention, placebo, and control group. While the RCT was carried out, researchers and/or participants roles were combined among students during the semester. At the end, a questionnaire that included open and closed questions was used to evaluate the effectiveness of the UR strategies used in students´ acquisition of theoretical knowledge, research competencies, self-efficacy of RCT skills and procedures. Lecturers also completed the questionnaire to evaluate their experience.

Results

From the 114 students enrolled in the subject, 102 participated in the RCT and 110 answered the final questionnaire. Regarding the development of research competencies, UR had a positive or very positive impact on critical thinking (67% and 18%, respectively) and in the assessment of methodological quality (66% and 23%, respectively). Furthermore, most students reported that the implementation of the RCT facilitated their knowledge of placebo, detection of bias, development of critical thinking and a better understanding of methodological issues in research. Lecturers reported an additional burden that was difficult to reconcile with daily duties.

Conclusion

The novel UR program provided students with a new opportunity to improve their knowledge of RCT procedures, thus making the learning process more meaningful. Therefore, ways of teaching and learning focused on improving research and inquiry attitudes should be considered and integrated into the health care curriculum, especially in physiotherapy programs, to ensure the transfer of EBP for the provision of the best care.

Trial registration

Australian New Zealand Clinical Registry: ACTRN12622000263796p (14/02/2022).
Self-assessment of residents in breaking bad news; skills and barriers
Authors: Mansoursamaei Maryam , Ghanbari Jolfaei Atefeh , Zandi Mehdi , Mansoursamaei Ali , Salehian Razieh
Published: October 2023

Introduction

Breaking bad news (BBN) is inevitable in medicine and is one of the most important and difficult professional tasks of physicians. The main aims of this study are to evaluate residents’ practice of BBN and identify perceived barriers to its implementation.

Methods

In this cross-sectional study in 2021, 240 residents from medical, surgical, and emergency medicine departments completed the demographic questionnaire, the Persian SPIKES questionnaire (P-SPIKES), and the researchers-made questionnaire of Barriers to Breaking Bad News (BBBN). In addition, they were asked about their previous experience, previous training, and their perceived level of competence in BBN.

Results

46.5% and 36.84% of residents rated their perceived competence in BBN and managing the patient’s emotions during BBN as good or very good, respectively. The most difficult aspects of BBN for residents were expressing upsetting information (78.1%) and not disappointing the patient while being honest (58.3%). The mean and standard deviation of the score of the P- SPIKES was 55.92 ± 6.84. The most common SPIKES item was not giving bad news by phone (98.9%). The SPIKES total score was only related to age (positive relationship). The most commonly reported barriers to BBN were concerns about controlling the patient’s emotions (61%) and the aggressiveness of the patient or companions (52.6%). A significant proportion of participants identified lack of training (28%) and insufficient skills (21.9%) as significant barriers to BBN.

Conclusions

The skill of residents in BBN is insufficient in some aspects and points to the need for BBN training courses during residency. BBN is difficult for residents in some aspects and residents may perceive barriers. To overcome the existing barriers and increase residents’ confidence in BBN, strategies such as incorporating BBN training into residency educational curricula and communication skills are recommended.
Expectations for safety of nursing home residents and their family members during the COVID-19 pandemic: a qualitative study
Authors: Cui Baojuan , Li Hui , Cheng Yan , Wang Jinmei , Sun Qiangsan , Jia Yuxiu
Published: October 2023

Background

COVID-19 has spread worldwide. Older adults are at the greatest risk of contracting and dying from the virus. Nursing homes are densely populated places for older adults who are generally vulnerable and at high-risk. Although Chinese nursing homes have been trying to protect their residents, the needs and expectations of the residents and their families have been ignored. This study aimed to promote the safety of NH residents, including their physical and psychological safety, and to meet their expectations during the COVID-19 pandemic in China.

Methods

Data were collected through face-to-face semi-structured interviews with nursing home residents and focus group online interviews with family members between June 2021 and February 2022. Data analysis was performed using inductive content analysis.

Results

16 residents and 24 family members were interviewed. Four themes with 10 sub-themes were identified from the participants’ descriptions. Their expectations were mainly focused on prevention and control measures for COVID-19, medical capacity of nursing homes, health literacy and expectations for some aged care policies.

Conclusions

In the face of concerns about the impact of COVID-19 on nursing homes, we sought to bring firsthand perspectives to the forefront by interviewing residents and their family members about their expectations for safety to address this issue. Our findings provide important areas on which should be focused and may improve the sense of gain, happiness, and security of nursing home residents during the COVID-19 pandemic.
Impact of a teaching strategy to promote evidence-based practice on nursing students’ knowledge and confidence in simulated clinical intervention choices
Authors: Estalella Itziar , Román Óscar , Reichenberger Theo Norbert , Maquibar Amaia
Published: October 2023

Background

Nurses self-efficacy, confidence and their competency for evidence-based practice have a relevant impact in the quality of care provided to patients. However, the implementation of evidence-based practice continues to be limited to date and the relationship between these elements has not been thoroughly understood. Thus, the aim of this study was to analyze the impact on confidence levels of a teaching strategy to promote evidence incorporation into clinical decisions made by student nurses in hypothetical scenarios. Besides, students’ satisfaction with the new teaching strategy was assessed.

Methods

The teaching strategy was asynchronous, on-line and based on multiple-choice questionnaires related to decision making on an intensive care unit patient. Confidence levels were assessed by introducing the scoring tool confidence-based marking. Changes between pre- and post-tests in correct answers, confidence levels and expected-observed ranges of accuracy at each level of certainty were analyzed through non-parametric McNemar’s sign tests for paired-samples differences. To assess students’ satisfaction with the teaching strategy, a mixed-methods approach was followed. Descriptive statistical methods and Qualitative Content Analysis were followed respectively in order to analyze students’ satisfaction.

Results

A total of 165 students completed the assignment, 101 answered the satisfaction survey and 7 participated in the interviews. Statistically significant better scoring and higher confidence levels were found in the post-intervention. Statistically significant differences in expected-observed ranges of accuracy were found for the three levels of certainty. Students were highly satisfied with the proposed task. In the qualitative analysis one category was elaborated which illustrated the students’ perceived added value of this new assignment.

Conclusions

On-line teaching strategies based on clinical scenarios that focus on evidence-based decision-making have the potential to increase the confidence of nursing students. Additionally, interventions designed by teams incorporating clinical nurses, university librarians and academic nurses have the potential to bridge the evidence-practice gap in nursing education.