bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a village-based digital health kiosks program: A protocol for a cluster randomized clinical trial
Authors: Cheng Weibin , Zhang Zhang , Hoelzer Samantha , Tang Weiming , Liang Yizhi , Du Yumeng , Xue Hao , Zhou Qiru , Yip Winnie , Ma Xiaochen , Tian Junzhang , Sylvia Sean
Published: October 2022

Background

To address disparities in healthcare quality and access between rural and urban areas in China, reforms emphasize strengthening primary care and digital health utilization. Yet, evidence on digital health approaches in rural areas is lacking.

Objective

This study will evaluate the effectiveness of Guangdong Second Provincial General Hospital's Digital Health Kiosk program, which uses the Dingbei telemedicine platform to connect rural clinicians to physicians in upper-level health facilities and provide access to artificial intelligence-enabled diagnostic support. We hypothesize that our interventions will increase healthcare utilization and patient satisfaction, decrease out-of-pocket costs, and improve health outcomes.

Methods

This cluster randomized control trial will enroll clinics according to a partial factorial design. Clinics will be randomized to either a control arm with clinician medical training, a second arm additionally receiving Dingbei telemedicine training, or a third arm with monetary incentives for patient visits conducted through Dingbei plus all prior interventions. Clinics in the second and third arm will then be orthogonally randomized to a social marketing arm that targets villager awareness of the kiosk program. We will use surveys and Dingbei administrative data to evaluate clinic utilization, revenue, and clinician competency, as well as patient satisfaction and expenses.

Results

We have received ethical approval from Guangdong Second Provincial General Hospital (IRB approval number: GD2H-KY IRB-AF-SC.07-01.1), Peking University (IRB00001052-21007), and the University of North Carolina at Chapel Hill (323385). Study enrollment began April 2022.

Conclusions

This study has the potential to inform future telemedicine approaches and assess telemedicine as a method to address disparities in healthcare access. Trial registration number: ChiCTR2100053872
Optimal Materials Handling Equipment and Defective Product Reduction Skills in Enhance Overall Production Efficiency
Authors: Hama Kareem Jamal Ahmed , Mohammed Blesa Ibrahim , Abdulwahab Sameer Abduljabbar
Published: October 2022

This study examined the extent of optimal materials handling equipment impact on defective product reduction skills to enhance overall production efficiency, taking steel and iron factories as a case study. To achieve this end, the study was performed by using qualitative and quantitative methods of data collection was employed which represented in the questionnaire survey and semi-structured interviews. Questionnaire instrument already has been tested. Findings of the study revealed that optimal materials handling equipment, particularly storage and handling equipment and engineered systems assist significantly in improving defective product reduction skills by facilitating a shorter operating cycle, reduces handling costs, eliminates unproductive handling of materials, reduces idle machine capacity, and eliminates factory hazards. All this, in turn, enabling optimum usage of space and maintains the quality of materials toward enhancing overall production efficiency in terms of facilitating better customer care and ensuring the production of quality products and in a timely. Based on findings, the study recommended manufacturing organizations management in order to succeed in enhancing operational and production efficiency as a whole, it should give a keen interest in optimal materials handling equipment and give them prioritize as a very vital cost center to defective products reduction.
Breast Self-Examination: Knowledge, Practice, and Beliefs Among Females in Jordan
Authors: Ahmad Suhad , Alloubani Aladeen , Abu-Sa’da Ruba , Qutaiba Yasar
Published: October 2022

Introduction

Worldwide, breast cancer is one of the most common types of cancer. It is the leading cause of cancer-related deaths among females in Jordan.

Objective(s)

The current study aimed to evaluate breast cancer knowledge levels and practice and assess health beliefs regarding the model supporting self-breast examination (BSE) in a group of females aged between 20 and 60 in Jordan.

Methods

Descriptive, cross-sectional, correlational design was used; Two hundred females participated in the study, employing convenient sampling. The adjusted version of the Champion's Health Belief Model Scale (CHBMS) was utilized to collect the data.

Results

Most participants were married (F = 128, 64%), and the mean of the participants’ age was (36.18, SD = 10.87). About 73 participants (36.5%) don't practice BSE; however, 53 participants (26.5%) plan to practice BSE in the future monthly. The logistic regression model showed that the impact of confidence as positive predictive value on practicing BSE in the last year ( B = 0.141, p < .001) and this year ( B = 0.130, p < .001) was statistically significant.

Conclusion

Implications for practice include identifying culturally specific barriers and improving health education programs to trigger breast self-examination utilization.
Divergent presentation of anxiety in high-risk groups within the intellectual disability population
Authors: Groves Laura , Moss Joanna , Oliver Chris , Royston Rachel , Waite Jane , Crawford Hayley
Published: October 2022

Background

Anxiety symptomatology is common in individuals with intellectual disability (ID). Symptomatology includes both traditional Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) anxiety disorders and autism spectrum disorder (ASD)-related anxiety traits. Some genetic disorders such as Cornelia de Lange (CdLS) and fragile X syndromes (FXS) are at very high risk of anxiety and afford the opportunity to examine prevalence, profiles and associated person characteristics. However, prevalence and associated characteristics of anxiety in these high-risk groups remain poorly described and understood. The aim of the current study was to examine the prevalence and profile of DSM-5 and ASD-related anxiety symptomatology in individuals with CdLS and FXS and associated behavioural and cognitive characteristics.

Methods

Questionnaires and interviews assessing DSM-5 and ASD-related anxiety were conducted with caregivers of individuals with CdLS (n = 49) and FXS (n = 36).

Results

DSM-5 anxiety symptomatology was present in both groups with high co-morbidity across anxiety diagnoses. ASD-related anxiety was also prevalent with specific difficulties related to intolerance of uncertainty identified in both groups. Symptomatology was persistent over the lifespan for both groups. Anxiety type was partially associated with repetitive behaviour but not measures of overall ASD phenomenology in CdLS.

Conclusions

DSM-5 and ASD-related anxiety are common in these high-risk syndromes associated with ID. Prospective syndrome specific presentations and associations, which may implicate specific underlying mechanisms, are discussed. Clinicians should be aware of the risk and difficulties involved in assessment of anxiety in individuals with ID, including atypical types, to ensure these individuals do not “miss” diagnoses and support in general clinical practice.
Isolated comminuted fracture of the cricoid cartilage and narrowing of the airway after a traumatic blunt injury of the neck: a case report
Authors: Mehrabi Saadat , Hosseinpour Reza , Yavari Barhaghtalab Mohammad Javad
Published: October 2022

Background

Blunt trauma to the anterior of the neck may compromise the vital structures like major blood vessels, trachea, larynx, pharynx, thyroid, spine, esophagus, and the cricoid. Laryngeal trauma is rare and accounts for 1% of all neck blunt traumas. Cricoid trauma is also very rare and accounts for half of the laryngeal traumas, and the diagnosis is frequently missed.

Case presentation

A 43-year-old man, with blunt neck trauma after being hardly hit by a crane lifting hook, was referred to the Shahid Beheshti Hospital. The patient complained of dysphonia (hoarseness) and dyspnea. The CT scans showed a comminuted fracture of the left anterior arch of the cricoid cartilage with left-sided mucosal thickening, inflammation, and edema which was extended to the glottis, causing a narrowing of the airway. Direct fiber-optic laryngoscopy revealed swelling and congestion in the epiglottis and swelling at the level of the left vocal cord.

Conclusion

This case report highlights the conservative treatment of isolated cricoid cartilage fracture in the setting of low-energy blunt trauma. The patient was clinically stable and treated conservatively with oxygen therapy and silence therapy (complete silence).
Platform-based food delivery in Paris before and during the pandemic: profile, motivations and mobility patterns of couriers
Authors: Aguilera Anne , Dablanc Laetitia , Krier Camille , Louvet Nicolas
Published: October 2022

Background

Platform-based fast delivery is developing rapidly in many cities across the world, especially in the food sector. Yet knowledge about the characteristics and the activity patterns of delivery couriers is scarce, especially in terms of their mobility behavior.

Methodology

Based on two questionnaire surveys conducted in 2020 and 2021 with 300 and 500 couriers respectively, this article analyses the profiles, motivations and mobility patterns of couriers working in Paris (France), with a focus on the impacts of the pandemic.

Results

First, the analysis of the profiles and motivations of couriers reveals that platform-based delivery is largely a temporary activity performed by young males of foreign origin, and undertaken as a student job or an entry to the labor market. Second, data on mobility patterns confirm that platform-based delivery is a dangerous activity with a high risk of road accidents. Moreover, many couriers break the law in order to increase their income by using motorized two-wheelers that are not legally permitted in France. We also show the use of shared bikes, which seems to be a great support tool for couriers who are starting work in this sector or have a problem with their own bikes. Third, the pandemic prompted many students to become platform-based delivery couriers in order to compensate for the lack of student jobs. It also worsened the working conditions of the majority of platform-based couriers. These findings raise new urban policy challenges and also new avenues for research in terms of topics and methods.
Identification of microRNAs responsive to arbuscular mycorrhizal fungi in Panicum virgatum (switchgrass)
Authors: Johnson Alex C. , Pendergast Thomas H. , Chaluvadi Srinivasa , Bennetzen Jeffrey L. , Devos Katrien M.
Published: October 2022

Background

MicroRNAs (miRNAs) are important post-transcriptional regulators involved in the control of a range of processes, including symbiotic interactions in plants. MiRNA involvement in arbuscular mycorrhizae (AM) symbiosis has been mainly studied in model species, and our study is the first to analyze global miRNA expression in the roots of AM colonized switchgrass (Panicum virgatum), an emerging biofuel feedstock. AM symbiosis helps plants gain mineral nutrition from the soil and may enhance switchgrass biomass production on marginal lands. Our goals were to identify miRNAs and their corresponding target genes that are controlling AM symbiosis in switchgrass.

Results

Through genome-wide analysis of next-generation miRNA sequencing reads generated from switchgrass roots, we identified 122 mature miRNAs, including 28 novel miRNAs. By comparing miRNA expression profiles of AM-inoculated and control switchgrass roots, we identified 15 AM-responsive miRNAs across lowland accession “Alamo”, upland accession “Dacotah”, and two upland/lowland F1 hybrids. We used degradome sequencing to identify target genes of the AM-responsive miRNAs revealing targets of miRNAs residing on both K and N subgenomes. Notably, genes involved in copper ion binding were targeted by downregulated miRNAs, while upregulated miRNAs mainly targeted GRAS family transcription factors.

Conclusion

Through miRNA analysis and degradome sequencing, we revealed that both upland and lowland switchgrass genotypes as well as upland-lowland hybrids respond to AM by altering miRNA expression. We demonstrated complex GRAS transcription factor regulation by the miR171 family, with some miR171 family members being AM responsive while others remained static. Copper miRNA downregulation was common amongst the genotypes tested and we identified superoxide dismutases and laccases as targets, suggesting that these Cu-miRNAs are likely involved in ROS detoxification and lignin deposition, respectively. Other prominent targets of the Cu miRNAs were blue copper proteins. Overall, the potential effect of AM colonization on lignin deposition pathways in this biofuel crop highlights the importance of considering AM and miRNA in future biofuel crop development strategies.
Correlation scan: identifying genomic regions that affect genetic correlations applied to fertility traits
Authors: Olasege Babatunde S. , Porto-Neto Laercio R. , Tahir Muhammad S. , Gouveia Gabriela C. , Cánovas Angela , Hayes Ben J. , Fortes Marina R. S.
Published: October 2022

Although the genetic correlations between complex traits have been estimated for more than a century, only recently we have started to map and understand the precise localization of the genomic region(s) that underpin these correlations. Reproductive traits are often genetically correlated. Yet, we don’t fully understand the complexities, synergism, or trade-offs between male and female fertility. In this study, we used reproductive traits in two cattle populations (Brahman; BB, Tropical Composite; TC) to develop a novel framework termed correlation scan (CS). This framework was used to identify local regions associated with the genetic correlations between male and female fertility traits. Animals were genotyped with bovine high-density single nucleotide polymorphisms (SNPs) chip assay. The data used consisted of ~1000 individual records measured through frequent ovarian scanning for age at firstcorpus luteum(AGECL) and a laboratory assay for serum levels of insulin growth hormone (IGF1 measured in bulls, IGF1b, or cows, IGF1c). The methodology developed herein used correlations of 500-SNP effects in a 100-SNPs sliding window in each chromosome to identify local genomic regions that either drive or antagonize the genetic correlations between traits. We used Fisher’s Z-statistics through a permutation method to confirm which regions of the genome harboured significant correlations. About 30% of the total genomic regions were identified as driving and antagonizing genetic correlations between male and female fertility traits in the two populations. These regions confirmed the polygenic nature of the traits being studied and pointed to genes of interest. For BB, the most important chromosome in terms of local regions is often located on bovine chromosome (BTA) 14. However, the important regions are spread across few different BTA’s in TC. Quantitative trait loci (QTLs) and functional enrichment analysis revealed many significant windows co-localized with known QTLs related to milk production and fertility traits, especially puberty. In general, the enriched reproductive QTLs driving the genetic correlations between male and female fertility are the same for both cattle populations, while the antagonizing regions were population specific. Moreover, most of the antagonizing regions were mapped to chromosome X. These results suggest regions of chromosome X for further investigation into the trade-offs between male and female fertility. We compared the CS with two other recently proposed methods that map local genomic correlations. Some genomic regions were significant across methods. Yet, many significant regions identified with the CS were overlooked by other methods.
Fruit bagging reduces the postharvest decay and alters the diversity of fruit surface fungal community in ‘Yali’ pear
Authors: Gao Congcong , Zhang Yang , Li Huimin , Gao Qi , Cheng Yudou , Ogunyemi Solabomi Olaitan , Guan Junfeng
Published: October 2022

Background

Fruit bagging is an effective technique for fruit protection in the orchard management. Bagging can create a micro-environment for fruit growth and affect fruit quality during storage, in which the diversity of microorganisms may play an important role. Therefore, various methods including biochemistry, analytical chemistry, and bioinformatics methods were used to reveal the influences of fruit bagging on postharvest fruit quality, physiological characters, decay and surface fungal community of ‘Yali’ pear fruit were investigated in this study.

Results

Fruit bagging significantly decreased the postharvest decay after 15 days of ambient storage. There were no significant differences in fruit firmness, titratable acid and ethylene production rate between the fruit-bagging and non-bagging group after 15 days of storage, while the soluble solids contents (SSC) and respiration rate in non-bagging fruit was significantly higher than that in fruit-bagging after 15 days of storage. Furthermore, the surface microbes of pear were collected and determined by the new generation sequencing technology. The alpha diversity of fungi in non-bagging fruit decreased significantly after 15 days of storage, while there were no significant changes in bagging fruit. Ascomycota and Basidiomycota were the two major phyla detected in the bagging fruit, and the dominant fungal genera were Alternaria (23.7%), Mycosphaerella (17.25%), Vishniacozyma (16.14%), and Aureobasidium (10.51%) after 15 days of storage. For the non-bagging pear, Ascomycota was the only phylum detected, and the dominant genera was Pichia (83.32%) after 15 days of storage. The abundance of Pichia may be regarded as the biomarker to indicate the degree of fruit decay.

Conclusions

This study showed that fruit bagging could significantly reduce postharvest fruit decay and respiration rate of ‘Yali’ pear. Significant differences were found in fungal composition between bagging and non-bagging pear after storage for 0 or 15 days. Fruit bagging maintained the diversity of fungi on the fruit surface, increased the abundance of non-pathogenic fungi, and even antagonistic fungi such as Aureobasidium, Vishniacozyma, and Mycosphaerella. A reduction in the abundance of pathogenic fungi and incidence of postharvest decay during the storage of ‘Yali’ pear were also recorded. In conclusion, fruit-bagging changed the fungal diversity on fruit surface of ‘Yali’ pear, which had significant effect on reducing postharvest fruit decay, and thus prolong the storage period of ‘Yali’ pears. The future thrust of this study will focus on the isolation of fungi or bacteria from pear fruit surface and identify their roles in causing fruit decay and changing fruit quality during storage.
Women’s values and preferences on low-molecular-weight heparin and pregnancy: a mixed-methods systematic review
Authors: León-García Montserrat , Humphries Brittany , Maraboto Andrea , Rabassa Montserrat , Boehmer Kasey R. , Perestelo-Perez Lilisbeth , Xie Feng , Pelayo Irene , Eckman Mark , Bates Shannon , Selva Anna , Alonso-Coello Pablo
Published: October 2022

Background

Venous thromboembolism (VTE) in pregnancy is an important cause of maternal morbidity and mortality. Low-molecular-weight heparin (LMWH) is the cornerstone of prophylaxis and treatment of thrombotic events during pregnancy. LMWH has fewer adverse effects than other anticoagulants, does not cross the placenta, and is safe for the fetus. However, the use of LMWH during pregnancy is sensitive to womens’ underlying preferences. The objective of this review is to systematically assess women’s values and preferences research evidence on this topic.

Methods

We searched four electronic databases from inception to March 2022, and included studies examining values and preferences of using LMWH among pregnant women at risk of VTE. We followed a convergent integrated mixed-methods design to compare and contrast quantitative outcomes (utility and non-utility measures) and qualitative findings. We assessed the certainty of the values and preferences evidence with the GRADE approach for quantitative findings, and with GRADE-CERqual for qualitative evidence. Results were presented in a conjoint display.

Results

We screened 3,393 references and identified seven eligible studies. The mixed methods analysis resulted in four themes. Datasets confirmed each other in that: 1) the majority of women consider that benefits of treatment outweigh the inconveniences of daily injections; and 2) main concerns around medication are safety and injections administration. Quantitative outcomes expanded on the qualitative findings in that: 3) participants who perceived a higher risk of VTE were more willing to take LMWH. Finally, we found a discrepancy between the datasets around: 4) the amount of information preferred to make the decision; however, qualitative data expanded to clarify that women prefer making informed decisions and receive support from their clinician in their decision-making process.

Conclusions

We are moderately confident that in the context of pregnancy, using LMWH is preferred by women given its net beneficial balance. Integrating data from different sources of evidence, and representing them in a jointly manner helps to identify patient’s values and preferences. Our results may inform clinical practice guidelines and support shared decision-making process in the clinical encounter for the management of VTE in the context of pregnancy.
Midwives’ knowledge and practice of Respectful Maternity Care: a survey from Iran
Authors: Moridi Maryam , Pazandeh Farzaneh , Potrata Barbara
Published: October 2022

Background

In the past decade, countries worldwide aimed to evaluate the quality of childbirth care and reduce the high rates of disrespect and abuse during childbirth. Few studies have attempted to identify providers’ characteristics associated with respectful maternity care quantitatively. This study aims to evaluate midwives’ knowledge and practice of respectful maternity care (RMC).

Methods

A cross-sectional study was carried out in 15 teaching and non-teaching hospitals in Tehran, Iran. The hospitals were selected by using a cluster sampling design. Midwives’ Knowledge and Practice of Respectful Maternity Care scale (MKP-RMC) was administered to 250 midwives working in maternity units at study hospitals. The data were analysed by statistics package for social science (SPSS, version 21.0, Chicago, IL).

Results

Findings demonstrated that the mean score for knowledge and practice of midwives were 20.96 ± 3.54 and 101.64 ± 11.49, respectively. Also, in both knowledge and practice scales, midwives had the highest score in “providing safe care’ domain and the lowest score in “preventing mistreatment” domain.

Conclusion

Our findings showed that for Iranian midwives, providing care to preserve mothers’ and their babies’ wellbeing is more critical than preventing maternal mistreatment, resulting from the importance of the care provision in the Iranian healthcare system. Promoting midwives’ knowledge and practice through developing a tailored educational program to prevent mistreatment and providing emotional support alongside physical care is recommended.
Overview and clinical significance of multiple mutations in individual genes in hepatocellular carcinoma
Authors: Imamura Taisuke , Okamura Yukiyasu , Ohshima Keiichi , Uesaka Katsuhiko , Sugiura Teiichi , Ito Takaaki , Yamamoto Yusuke , Ashida Ryo , Ohgi Katsuhisa , Otsuka Shimpei , Ohnami Sumiko , Nagashima Takeshi , Hatakeyama Keiichi , Sugino Takashi , Urakami Kenichi , Akiyama Yasuto , Yamaguchi Ken
Published: October 2022

Background

Multiple mutation (MM) within a single gene has recently been reported as a mechanism involved in carcinogenesis. The present study investigated the clinical significance of MMs in hepatocellular carcinoma (HCC).

Methods

Two hundred twenty-three surgically resected HCCs were subjected to gene expression profiling and whole-exome sequencing.

Results

MMs in individual genes were detected in 178 samples (MM tumors: 79.8%). The remaining samples all carried a single mutation (SM tumors: 20.2%). Recurrence-free survival in the MM group was significantly worse in comparison to the SM group (P = 0.012). A Cox proportional hazard analysis revealed that MM tumor was an independent predictor for worse a prognosis (hazard ratio, 1.72; 95% confidence interval, 1.01–3.17; P = 0.045). MMs were frequently observed across in various genes, especially MUC16 (15% of samples had at least one mutation in the gene) and CTNNB1 (14%). Although the MUC16 mRNA expression of MUC16 wild-type and MUC16 SM tumors did not differ to a statistically significant extent, the expression in MUC16 MM tumors was significantly enhanced in comparison to MUC16 SM tumors (P < 0.001). In MUC16, MMs were associated with viral hepatitis, higher tumor marker levels and vascular invasion. The MUC16 MMs group showed significantly worse recurrence-free survival in comparison to the MUC16 SM group (P = 0.022), while no significant difference was observed between the MUC16 SM group and the MUC16 wild-type group (P = 0.324).

Conclusions

MM was a relatively common event that may occur selectively in specific oncogenes and is involved in aggressive malignant behavior.
Differential response to topical lubrication in patient with dry eye disease, based on age
Authors: Chen Yingxin , Wu Yajun , Gao Minghong , Gao Ruiyao , Zhang Kai
Published: October 2022

Background

To compare the Ocular surface disease index (OSDI) score, Schirmer I test (SIT), fluorescein break up time (FBUT) and fluorescence staining (FLCS) score of dry eye patients at different ages.

Methods

90 eyes of 90 patients with mild to moderate dry eye from September 2020 to September 2021 were retrospectively included and were divided into young group (20–39 years, n = 29), middle-age group (40–59 years, n = 30), and elder group (> 60 years, n = 31). Patients were given a 28-day topical lubricating ocular surface and repair-promoting drugs combined with local physical therapy. Patients were followed up at 7, 14 and 28 days. The OSDI score, SIT, FBUT and FLCS score were examined.

Results

There were differences between the OSDI score in three groups at each time point (all P < 0.001). SIT were different among the three groups (F = 350.61, P < 0.001), and a time effect was found (F = 80.87, P < 0.001). SIT at 14 and 28 days after treatment in middle-age and elder groups were lower than young group (all P < 0.001). SIT at 7, 14 and 28 days in elder group were lower than middle-age group (all P < 0.001). FLCS score was lower at 28 days than other time points (all P < 0.001).

Conclusion

Dry eye patients are given a 28-day topical lubricating ocular surface and repair-promoting drugs combined with local physical therapy, which can promote tear secretion, film stability, and the recovery of corneal integrity. Age affects the treatment effect of mild to moderate dry eye, among which tear secretion is the most significant.
Impact of pet dog or cat exposure during childhood on mental illness during adolescence: a cohort study
Authors: Gadomski Anne , Scribani Melissa B. , Tallman Nancy , Krupa Nicole , Jenkins Paul , Wissow Lawrence S.
Published: October 2022

Background

In our prior study of 643 children, ages 4–11 years, children with pet dogs had lower anxiety scores than children without pet dogs. This follow-up study examines whether exposure to pet dogs or cats during childhood reduces the risk of adolescent mental health (MH) disorders.

Methods

Using a retrospective cohort study design, we merged our prior study database with electronic medical record (EMR) data to create an analytic database. Common MH diagnoses (anxiety, depression, ADHD) occurring from the time of prior study enrollment to 10/27/21 were identified using ICD-9 and ICD-10 codes. We used proportional hazards regression to compare time to MH diagnoses, between youths with and without pets. From 4/1/20 to 10/27/21, parents and youth in the prior study were interviewed about the amount of time the youth was exposed to a pet and how attached s/he was to the pet. Exposure included having a pet dog at baseline, cumulative exposure to a pet dog or cat during follow-up, and level of pet attachment. The main outcomes were anxiety diagnosis, any MH diagnosis, and MH diagnosis associated with a psychotropic prescription.

Results

EMR review identified 571 youths with mean age of 14 years (range 11–19), 53% were male, 58% had a pet dog at baseline. During follow-up (mean of 7.8 years), 191 children received a MH diagnosis: 99 were diagnosed with anxiety (52%), 61 with ADHD (32%), 21 with depression (11%), 10 with combined MH diagnoses (5%). After adjusting for significant confounders, having a pet dog at baseline was associated with lower risk of any MH diagnosis (HR = 0.74, p = .04) but not for anxiety or MH diagnosis with a psychotropic prescription. Among the 241 (42%) youths contacted for follow-up, parent-reported cumulative exposure to pet dogs was borderline negatively associated with occurrence of any MH diagnosis (HR = 0.74, p = .06). Cumulative exposure to the most attached pet (dog or cat) was negatively associated with anxiety diagnosis (HR = 0.57, p = .006) and any MH diagnosis (HR = 0.64, p = .013).

Conclusion

Cumulative exposure to a highly attached pet dog or cat is associated with reduced risk of adolescent MH disorders.
Reliability and predictive validity of two scales of self-rated health in China: results from China Health and Retirement Longitudinal Study (CHARLS)
Authors: Pan Yuwei , Pikhartova Jitka , Bobak Martin , Pikhart Hynek
Published: October 2022

Background

Despite the widespread use of the single item self-rated health (SRH) question, its reliability has never been evaluated in Chinese population.

Methods

We used data from the China Health and Retirement Longitudinal Study, waves 1–4 (2011–2019). In wave 1, the same SRH question was asked twice, separated by other questions, on a subset of 4533 subjects, allowing us to examine the test–retest reliability of SRH. In addition, two versions of SRH questions (the WHO and US versions) were asked (n = 11,429). Kappa (κ), weighted kappa ($${\kappa}_{w}$$

κ
w

), and polychoric correlation coefficient (ρ) were used for reliability assessment. Cox proportional-hazards models were estimated to assess the predictive validity of SRH measurement for mortality over 7 years of follow up. To do so, relative index of inequality (RII) and slope index of inequality (SII) were estimated for each SRH scale.

Results

There was moderate to substantial test–retest reliability (κ = 0.54, $${\kappa}_{w}$$

κ
w

=0.63) of SRH; 31% of respondents who used the same scale twice changed their ratings after answering other questions. There was strong positive association between the two SRH measured by the two scales (ρ > 0.8). Compared with excellent/very good SRH, adjusted hazard ratios (HR) of death are 2.30 (95% CI, 1.70–3.13) for the US version and 1.86 (95% CI, 1.33–2.60) for the WHO version. Using slope indices of inequality, the WHO version estimated slightly larger mortality differences (RII = 3.50, SII = 15.53) than the US version (RII = 3.25, SII = 14.80).

Conclusions

In Chinese middle-aged and older population, the reliability of SRH is generally good, although the two commonly used versions of SRH scales could not be compared directly. Both indices predict mortality, with similar predictive validity.
Prognostic value of lymphocyte count for in-hospital mortality in patients with severe AECOPD
Authors: Hu Yanlu , Long Huanyu , Cao Yang , Guo Yanfei
Published: October 2022

Background

Patients with severe acute exacerbations of chronic obstructive pulmonary disease often have a poor prognosis. Biomarkers can help clinicians personalize the assessment of different patients and mitigate mortality. The present study sought to determine if the lymphocyte count could act as a risk factor for mortality in individuals with severe AECOPD.

Methods

A retrospective study was carried out with 458 cases who had severe AECOPD. For analysis, patients were divided into two groups on the basis of lymphocyte count: < 0.8 × 109/L and ≥ 0.8 × 109/L.

Results

Patients who fulfilled the criteria for inclusion were enrolled, namely 458 with a mean age of 78.2 ± 8.2 years. Of these patients, 175 had a low lymphocyte count. Compared to patients with normal lymphocyte counts, those with low counts were older (79.2 ± 7.4 vs. 77.5 ± 8.6 years, p = 0.036), had lower activities of daily living scores on admission (35.9 ± 27.6 vs. 47.5 ± 17.1, p < 0.001), and had a greater need for home oxygen therapy (84.6 vs. 72.1%, p = 0.002). Patients with low lymphocytes had higher mortality rates during hospitalization (17.1 vs. 7.1%, p = 0.001), longer hospital stay (median [IQR] 16 days [12–26] vs. 14 days [10–20], p = 0.002) and longer time on mechanical ventilation (median [IQR] 11.6 days [5.8–18.7] vs. 10.9 days [3.8–11.6], p < 0.001). The logistic regression analysis showed lymphocyte count < 0.8 × 109/L was an independent risk factor associated with in-hospital mortality (OR 2.74, 95%CI 1.33–5.66, p = 0.006).

Conclusion

Lymphocyte count could act as a predictor of mortality in patients with severe AECOPD.
Virtual reality reduces pain in palliative care–A feasibility trial
Authors: Guenther Miriam , Görlich Dennis , Bernhardt Florian , Pogatzki-Zahn Esther , Dasch Burkhard , Krueger Janina , Lenz Philipp
Published: October 2022

Background

Effective symptom control is a stated goal of palliative care (PC) to improve quality of life for terminally ill patients. Virtual reality (VR) provides temporary escapes from pharmacologically resistant pain and allows for experiences and journeys patients may not access in any other way. Enabling wishes through virtual worlds may also offer additional benefits such as controlling psychological and physical symptoms.

Aims

We investigated the feasibility of a single VR experience as a viable, satisfying, and effective tool for end-of-life pain relief for inpatients presenting palliative needs.

Design

This is an observational, single-arm and national single-center feasibility trial.

Methods

A one-time VR experience with a selection of several videos and games was offered to 45 inpatients receiving PC at Muenster University Hospital. Patients with brain tumors, brain metastases, seizures, motion sickness, claustrophobia, vertigo, hearing or visual impairment, or unable to consent were excluded. Primary outcome measured patient reported pain on a visual analogue scale (VAS). We also measured Karnofsky performance status, health-related quality of life (HRQOL) using the EQ-5D-5 L questionnaire, and the Pain Out Questionnaire for postoperative pain.

Results

We analyzed data from 21 women (52.5%) and 19 men (47.5%) at an average age of 51.9 (SD: 15.81) years. The mean Karnofsky score among the sample was 45.5 (SD: 14.97) and the HRQOL was 41.9 (SD: 23.08). While no serious side effects were reported during the intervention, three patients experienced nausea (7%), two headaches (5%), and three reported dry eyes (7%) afterwards. Significant pain reduction (baseline VAS 2.25 (SD: 0.4399)) was demonstrated during (VAS 0.7 (SD: 0.2983, p < 0.0001)), immediately after (VAS 0.9 (SD: 0.3354, p = 0.0001)) and one hour after the intervention (VAS 1.15 (SD: 0.4163, p = 0.0004)). More than 80% rated the VR experience as very good or good (85%, n = 34) and intended to make use of the device again (82.5%, n = 33). However, two participants (5%) also expressed sadness by becoming aware of old memories and previous opportunities that are gone.

Discussion

The present pilot study suggests that VR seems to be a feasible and effective tool for pain relief in PC. Its use encompasses the approach of a total pain and symptom therapy and enhances patients’ dignity and autonomy. Future research ought to include if and to what extent VR could reduce the necessity of pharmacological pain relief.
Effect of Educational intervention based on Health Belief Model on promoting preventive behaviours of urinary tract infections in mothers with children under 6-Years of age
Authors: Bazargani Zahra , Sarikhani Fatemeh , Darenjani Sadegh Karami , Amirkhani Mehdi , Harsini Pooyan Afzali , Khani Jeihooni Ali
Published: October 2022

Background

Children are one of the most vulnerable social groups to infectious diseases, and prevention of urinary tract infections in children is very important; therefore, the present study aimed to investigate the effect of education based on health belief model (HBM) on promoting preventive behaviours of urinary tract infection in mothers with children under 6-years of age.

Methods

This quasi-experimental study was conducted on 150 women with children under 6 years of age referred to health centers in Fasa city, Iran in 2021. Subjects were selected using simple sampling method and were randomly divided into intervention (n = 75) and control (n = 75) groups. The educational intervention for the experimental group consisted of 6 virtual training sessions of 40–50 min using lecture, question and answer, group discussion and video clips. Two virtual follow-up sessions were also held one month and two months after the educational intervention. Three months after the educational intervention, both experimental and control groups completed the questionnaire. Data were analysed by using SPSS 22 through Chi-square, independent t-test, and paired t-test (p > 0.05).

Results

Before the intervention, based on independent t-test and paired t-test, the mean score of HBM constructs were not significantly different between the control and intervention groups (P > 0.05). However, while perceived barriers significantly decreased (P < 0.05) after the intervention, the mean score of knowledge, ‌ perceived sensitivity and severity, perceived benefits, ‌ self-efficacy, cues to action, and performance significantly increased (P < 0.05) after the intervention.

Conclusion

Considering the effect of training preventive behaviours of urinary tract infection based on HBM, application of the model as an effective and cost-effective method along with other methods is recommended for educational programs of mothers with children under 6 years of age.
Association between serum vitamin C and HPV infection in American women: a cross-sectional study
Authors: Zheng Chunqin , Zheng Zhixiang , Chen Weiqiang
Published: October 2022

Background

Evidence regarding the relationship between serum vitamin C levels and human papillomavirus (HPV) infection is limited. Therefore, this study aimed to investigate whether serum vitamin C levels are independently associated with HPV infection.

Methods

Data for this cross-sectional study were obtained from the National Health and Nutrition Examination Survey 2003–2006. A total of 2174 women, 18–59 years of age, were enrolled in this study. The associations between serum vitamin C levels (continuous and categorical forms) and cervicovaginal HPV infection were estimated using weighted logistic regression.

Results

The adjusted binary logistic regression showed that serum vitamin C was not associated with the risk of HPV infection after adjusting for age, race, poverty income ratio, alcohol consumption, smoking, body mass index, education, and health condition (odds ratio [OR] 0.998, 95% confidence interval [CI] 0.994–1.001). Serum vitamin C levels were converted from a continuous variable to a categorical variable for the analysis. Compared with the vitamin C deficiency and hypovitaminosis groups, there was a negative correlation between vitamin C and HPV infection when vitamin C was adequate (OR 0.7, 95% CI: 0.52–0.94); however, when the serum vitamin C level was inadequate and saturated, this negative correlation was weaker or nonexistent (OR 0.76, 95% CI 0.56–1.03 and OR 0.76, 95% CI 0.55–1.04, respectively). A nonlinear relationship was detected between vitamin C level and HPV infection. Furthermore, we performed subgroup analysis of different models and found that serum vitamin C concentration was negatively associated with HPV infection in women ≥ 25 years of age; however, in women < 25 years of age, serum vitamin C levels were not associated with HPV infection.

Conclusion

The results from this United States nationally representative sample supported the hypothesis that there was a U-shaped relationship between serum vitamin C levels and HPV infection. Future studies are warranted to assess the association between vitamin C and HPV persistence and clarify the underlying mechanisms of these associations.
Educating students while recruiting underrepresented populations for Alzheimer’s disease research: the Student Ambassador Program
Authors: DeCaro Renée , O’Connor Maureen K. , DiTerlizzi Christina , Sekyi-Appiah Nana , Polk John , Budson Andrew E.
Published: October 2022

Background

Increasing numbers of patients with Alzheimer’s Disease and related disorders (ADRD) necessitates increasing numbers of clinicians to care for them. Educational programming related to community outreach with older adults may help inspire interest in future ADRD clinical careers, while increasing awareness of ADRD in the community and aiding recruitment of underrepresented participants into research studies.

Method

The Boston University Alzheimer’s Disease Research Center (BU ADRC) created the BU ADRC Student Ambassador Program, where medical students, graduate students, and undergraduates interested in medicine completed a curriculum during the academic year that included six educational and three outreach events, including monthly dementia-focused didactic meetings and outreach focusing on Black participant recruitment. A pre-post program survey design was implemented to assess changes in students’ knowledge of and attitudes toward dementia and related disorders.

Results

Between September 2015 and May 2020, thirty-seven students completed the program. Following program completion, students demonstrated increased knowledge of dementia and willingness to work with patients with dementia, as well as more positive attitudes toward patients and the role of empathy in physician practice. In terms of recruitment benefits, the students helped the BU ADRC reach older adults from underrepresented groups who could serve as participants in future research studies.

Conclusions

The BU ADRC Student Ambassador Program can serve as a model for other clinical research programs who wish to encourage students to consider a career in a specific field. In addition, this model has the potential to increase enrollment of participants to research studies. We discuss limitations of our initial efforts and directions for future work to quantify the anticipated benefits for student education and participant recruitment.
Interventions supporting community nurses in the provision of Oral healthcare to people living at home: a scoping review
Authors: Stark Patrick , McKenna Gerry , Wilson Christine Brown , Tsakos Georgios , Brocklehurst Paul , Lappin Caroline , Quinn Barry , Mitchell Gary
Published: October 2022

Background

Oral health is a critical issue for public health and poor oral health is associated with significant chronic health conditions and lower quality of life. There has been little focus on providing oral health care to people who receive care in their own homes, despite the high risk of poor oral health in older people. Nurses practicing in the community are well placed to deliver this care, but little is known about how to build this capability through education or training interventions.

Methods

A scoping review methodology was employed to find and review studies of oral health interventions involving populations of people receiving care in their own home or those nurses who deliver this care. The research question asked what previous research tells us about oral health interventions delivered by nurses in the community. Data was extracted for four areas: setting and type of intervention, patient outcomes, changes to nursing practice and implementation and process evaluations of interventions.

Results

Two thousand eighty papers were found from the searches, and only nine were ultimately deemed eligible for inclusion in the review. Included studies spanned community nursing for older people (n = 3) and health visiting or community nursing for children and infants (n = 6). Patient outcomes were generally positive, but this is based on a low level of evidence. Changes to practice including increased oral health care administered by nurses were found, but this required professional support to be sustainable.

Conclusions

This review has found that there is a clear gap in the research around interventions designed to be used by community nurses to improve oral health care for people receiving care in their own homes. The results also suggest that any future intervention must make use of a participatory, co-design approach and consider the complex setting of nursing practice in the community and the barriers to delivering this care, such as time pressure and lack of prior experience.
Parvalbumin interneuron-derived tissue-type plasminogen activator shapes perineuronal net structure
Authors: Lépine Matthieu , Douceau Sara , Devienne Gabrielle , Prunotto Paul , Lenoir Sophie , Regnauld Caroline , Pouettre Elsa , Piquet Juliette , Lebouvier Laurent , Hommet Yannick , Maubert Eric , Agin Véronique , Lambolez Bertrand , Cauli Bruno , Ali Carine , Vivien Denis
Published: October 2022

Background

Perineuronal nets (PNNs) are specialized extracellular matrix structures mainly found around fast-spiking parvalbumin (FS-PV) interneurons. In the adult, their degradation alters FS-PV-driven functions, such as brain plasticity and memory, and altered PNN structures have been found in neurodevelopmental and central nervous system disorders such as Alzheimer’s disease, leading to interest in identifying targets able to modify or participate in PNN metabolism. The serine protease tissue-type plasminogen activator (tPA) plays multifaceted roles in brain pathophysiology. However, its cellular expression profile in the brain remains unclear and a possible role in matrix plasticity through PNN remodeling has never been investigated.

Result

By combining a GFP reporter approach, immunohistology, electrophysiology, and single-cell RT-PCR, we discovered that cortical FS-PV interneurons are a source of tPA in vivo. We found that mice specifically lacking tPA in FS-PV interneurons display denser PNNs in the somatosensory cortex, suggesting a role for tPA from FS-PV interneurons in PNN remodeling. In vitro analyses in primary cultures of mouse interneurons also showed that tPA converts plasminogen into active plasmin, which in turn, directly degrades aggrecan, a major structural chondroitin sulfate proteoglycan (CSPG) in PNNs.

Conclusions

We demonstrate that tPA released from FS-PV interneurons in the central nervous system reduces PNN density through CSPG degradation. The discovery of this tPA-dependent PNN remodeling opens interesting insights into the control of brain plasticity.