bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Predictive of Early Complications Following Total Ankle Arthroplasty
Authors: Del Balso Christopher , Halai Mansur M. , MacLeod Mark D. , Sanders David W. , Rahman Lawendy Abdel
Published: June 2022

Background:

The safety of outpatient total ankle arthroplasty (TAA), and factors predictive of early complications are poorly understood. The objective of this study was to determine the frequency of early complications in patients undergoing outpatient TAA compared to a matched inpatient TAA cohort. Factors predictive of early complications following TAA are elucidated.

Methods:

A retrospective review of prospectively collected data from the 2011-2018 American College of Surgeons–National Surgical Quality Improvement Program (ACS-NSQIP) database was performed. An unadjusted analysis comparing complication rates in outpatient, and inpatient TAA was performed followed by a propensity score–matched cohort analysis. A multivariate logistic regression model was then used to identify significant independent predictors for complications, reoperation, and readmission following TAA.

Results:

A total of 1487 patients (198 outpatient, 1289 inpatient) undergoing TAA were included in the study. Inpatient TAA was associated with increased 30-day readmission compared with outpatient TAA (3.54% vs 0.51%, P = .032) in a matched cohort analysis. Thirty-eight (2.6%) patients had a minor complication, with 16 (1.1%) patients having a major complication after TAR. Nineteen (1.3%) patients underwent reoperation, and 42 (2.8%) patients were readmitted within 30 days of the index TAR. Multivariate analysis identified factors predictive of early complications to include length of stay (LOS) >2 days, smoking, hypertension, bleeding disorders, and diabetes mellitus.

Conclusion:

From this relatively limited data set, outpatient TAA appears to be safe for management of end-stage ankle arthritis in select patients. Inpatient status was associated with an increased rate of 30-day readmission following TAA. Postoperative length of stay >2 days, smoking, hypertension, bleeding disorders, and diabetes mellitus were identified to be associated with early postoperative complications following TAA in this cohort.

Level of Evidence

Level III, retrospective cohort study.
Optimization of ethylene acrylic acid and low density polyethylene blend in tie-layer
Authors: Zheng Yong , Jiao Yiqing , Park Haewoong , Chen Fei , Jo Byoungcheon
Published: June 2022

Ethylene acrylic acid copolymer (EAA) is widely used as tie-layer in multilayer film structures containing aluminum foil. EAA provides adhesion between the foil and rest of the film structure. It can be used alone or as a blend with low density polyethylene (LDPE), ordinarily between 20 and 50%. However, blending EAA and LDPE does not always produce desirable results. From time to time, a clear film becomes hazy as the EAA content is increased. At the same time, the adhesive strength to foil decreases. This study focuses on elucidating the mechanism behind the high haze and poor adhesion associated with EAA/LDPE blends and on determining factors that can optimize blend performance. The results from this study indicate that immiscibility, not viscosity mismatch, is the dominant factor affecting EAA/LDPE blends. In general, EAA with low acid content is more compatible with LDPE than EAA with high acid content. Processing parameters, such as extruder RPM and melt temperature, can also be selectively used to improve the blend haze or layer adhesion.
Genetic architecture of end-use quality traits in soft white winter wheat
Authors: Aoun Meriem , Carter Arron H. , Morris Craig F. , Kiszonas Alecia M.
Published: June 2022

Background

Genetic improvement of end-use quality is an important objective in wheat breeding programs to meet the requirements of grain markets, millers, and bakers. However, end-use quality phenotyping is expensive and laborious thus, testing is often delayed until advanced generations. To better understand the underlying genetic architecture of end-use quality traits, we investigated the phenotypic and genotypic structure of 14 end-use quality traits in 672 advanced soft white winter wheat breeding lines and cultivars adapted to the Pacific Northwest region of the United States.

Results

This collection of germplasm had continuous distributions for the 14 end-use quality traits with industrially significant differences for all traits. The breeding lines and cultivars were genotyped using genotyping-by-sequencing and 40,518 SNP markers were used for association mapping (GWAS). The GWAS identified 178 marker-trait associations (MTAs) distributed across all wheat chromosomes. A total of 40 MTAs were positioned within genomic regions of previously discovered end-use quality genes/QTL. Among the identified MTAs, 12 markers had large effects and thus could be considered in the larger scheme of selecting and fixing favorable alleles in breeding for end-use quality in soft white wheat germplasm. We also identified 15 loci (two of them with large effects) that can be used for simultaneous breeding of more than a single end-use quality trait. The results highlight the complex nature of the genetic architecture of end-use quality, and the challenges of simultaneously selecting favorable genotypes for a large number of traits. This study also illustrates that some end-use quality traits were mainly controlled by a larger number of small-effect loci and may be more amenable to alternate selection strategies such as genomic selection.

Conclusions

In conclusion, a breeder may be faced with the dilemma of balancing genotypic selection in early generation(s) versus costly phenotyping later on.
Genetic parameters and selection in full-sib families of tall fescue using best linear unbiased prediction (BLUP) analysis
Authors: Pirnajmedin Fatemeh , Majidi Mohammad Mahdi , Taleb Mohammad Hadi , Rostami Davoud
Published: June 2022

Background

Better understanding of genetic structure of economic traits is crucial for identification and selection of superior genotypes in specific breeding programs. Best linear unbiased prediction (BLUP) is the most efficient method in this regard, which is poorly used in forage plant breeding. The present study aimed to assess genetic variation, estimate genetic parameters, and predict breeding values of five essential traits in full sib families (recognized by EST-SSR markers) of tall fescue using REML/BLUP procedure.

Method

Forty-two full-sib families of tall fescue (included of 120 individual genotypes), recognized by EST-SSR markers along with twenty-one their corresponding parental genotypes were assessed for biomass production and agro-morphological traits at three harvests (spring, summer, and autumn) in the field during 4 years (2017–2020).

Results

Considerable genotypic variability was observed for all traits. Low narrow-sense heritability (h2n) for dry forage yield (DFY) at three harvest indicates that non-additive gene actions may play an important role in the inheritance of this trait. Higher h2n of yield related traits and flowering time and also significant genetic correlation of these traits with forage yield, suggests that selection based on these traits may lead to indirect genetic improvement of DFY.

Conclusion

Our results showed the adequacy of REML/BLUP procedure for identification and selection of preferable parental genotypes and progenies with higher breeding values for future breeding programs such as variety development in tall fescue. Parental genotypes 21 M, 1 M, and 20 L were identified as superior and stable genotypes and could also produce the best hybrid combinations when they were mostly used as maternal parent.
Efficacy of AS versus SOX regimen as first-line chemotherapy for gastric cancer patients with peritoneal metastasis: a real-world study
Authors: Zhang Lingyun , Zhang Jiayu , Wang Yan , Li Wei , Yu Shan , Li Qian , Yu Yiyi , Liu Tianshu , Cui Yuehong
Published: June 2022

Background

To compare the prognosis of first-line systemic chemotherapy of AS (Albumin-bound paclitaxel and S-1) versus SOX (S-1 and oxaliplatin) regimen in Chinese gastric cancer patients with peritoneal metastasis.

Methods

This was a real-world study of gastric cancer patients with peritoneal metastasis who have been treated with AS or SOX regimen as first-line chemotherapy. Patients were matched by the method of propensity score matching (PSM). The primary and secondary endpoints were overall survival (OS) and progress-free survival (PFS).

Results

A total of 108 gastric cancer patients with peritoneal metastasis were enrolled after PSM analysis. There was no significant difference between AS and SOX regimen based on gender, age, ascites, treatment cycles, gastric cancer resection, received checkpoint inhibitors, and HER-2 expression after PSM analysis. The median OS (14.13 vs. 11.17 months, p = 0.0356) and median PFS (10.30 vs. 6.70 months, p = 0.0003) of patients who received AS regimen were longer than those treated by SOX regimen as first-line systemic chemotherapy. In sub-group analysis, the median OS and median PFS were longer for patients in AS regimen than SOX regimen in Lauren diffuse type. The occurrence of toxicity between the two groups was shown no significant difference.

Conclusions

The results verified that AS regimen was more effective than SOX chemotherapy in gastric cancer patients with peritoneal metastasis, especially in Lauren diffuse type.
Characterization of multiple soluble immune checkpoints in individuals with different Mycobacterium tuberculosis infection status and dynamic changes during anti-tuberculosis treatment
Authors: Chen Huaxin , Zhou Jingyu , Zhao Xinguo , Liu Qianqian , Shao Lingyun , Zhu Yehan , Ou Qinfang
Published: June 2022

Background

Immune checkpoints are crucial for the maintenance of subtle balance between self-tolerance and effector immune responses, but the role of soluble immune checkpoints (sICs) in Mycobacterium tuberculosis (M. tb) infection remains unknown. We assessed the levels of multiple sICs in individuals with distinct M. tb infection status, and their dynamic changes during anti-tuberculosis treatment.

Methods

We enrolled 24 patients with pulmonary tuberculosis, among which 10 patients were diagnosed with tuberculous pleurisy (TBP), 10 individuals with latent tuberculosis infection (LTBI), and 10 healthy volunteers from Wuxi Fifth People’s Hospital and Huashan Hospital between February 2019 and May 2021. Plasma concentrations of thirteen sICs were measured at enrollment and during anti-tuberculosis treatment using luminex-based multiplex assay. sICs levels in tuberculous pleural effusion (TPE) and their relations to laboratory test markers of TPE were also assessed in TBP patients.

Results

The circulating levels of sPD-1, sPD-L1, sCTLA-4, sBTLA, sGITR, sIDO, sCD28, sCD27 and s4-1BB were upregulated in tuberculosis patients than in healthy controls. A lower sPD-L1 level was found in LTBI individuals than in tuberculosis patients. In TBP patients, the levels of sPD-1, sPD-L2, sCD28, sCD80, sCD27, sTIM-3, sLAG-3, sBTLA, s4-1BB and sIDO increased significantly in TPE than in plasma. In TPE, sBTLA and sLAG-3 correlated positively with the adenosine deaminase level. sIDO and sCD80 correlated positively with the lactate dehydrogenase level and the percentage of lymphocytes in TPE, respectively. Meanwhile, sCD27 correlated negatively with the specific gravity and protein level in TPE. In tuberculosis patients, the circulating levels of sBTLA and sPD-L1 gradually declined during anti-tuberculosis treatment.

Conclusions

We characterized the changing balance of sICs in M. tb infection. And our results revealed the relations of sICs to laboratory test markers and treatment responses in tuberculosis patients, indicating that certain sICs may serve as potential biomarkers for disease surveillance and prognosis of tuberculosis.
Effectiveness of a brief hope intervention for chronic kidney disease patients on the decisional conflict and quality of life: a pilot randomized controlled trial
Authors: Chan Kitty , Wong Frances Kam Yuet , Tam Suet Lai , Kwok Ching Ping , Fung Yuen Ping , Wong Ping Nam
Published: June 2022

Background

Stage 5 chronic kidney disease (CKD) patients often experience decisional conflict when faced with the selection between the initiation of dialysis and conservative care. The study examined the effects of a brief hope intervention (BHI) on the levels of hope, decisional conflict and the quality of life for stage 5 CKD patients.

Methods

This is a single-blinded, randomized controlled trial (ClinicalTrials.gov identifier: NCT03378700). Eligible patients were recruited from the outpatient department renal clinic of a regional hospital. They were randomly assigned to either the intervention or the control group (intervention: n = 35; control: n = 37). All participants underwent a customized pre-dialysis education class, while the intervention group received also BHI. Data were collected prior to the intervention, immediately afterwards, and one month following the intervention. The Generalized Estimating Equation was used to measure the effects in the level of hope, decisional conflict scores (DCS) and Kidney Disease Quality of life (KDQOL-36) scores. Estimated marginal means and standard errors with 95% confidence intervals of these scores were also reported to examine the within group and between group changes.

Results

An increase of the hope score was found from time 1 (29.7, 1.64) to time 3 (34.4, 1.27) in the intervention group. The intervention had a significant effect on the KDQOL-36 sub-scores Mental Component Summary (MCS) (Wald χ2 = 6.763, P = 0.009) and effects of kidney disease (Wald χ2 = 3.617, P = 0.004). There was a reduction in decisional conflict in both arms on the DCS total score (Wald χ2 = 7.885, P = 0.005), but the reduction was significantly greater in the control group (effect size 0.64).

Conclusions

The BHI appeared to increase the level of hope within the intervention arm. Nonetheless, differences across the intervention and control arms were not significant. The KDQOL-36 sub-scores on MCS and Effects of kidney disease were found to have increased and be higher in the intervention group. The DCS total score also showed that hope was associated with reducing decisional conflict.

Trial Registration

ClinicalTrials.gov Protocol Registration, NCT03378700. Registered July 12 2017.
Screening for PTSD during pregnancy: a missed opportunity
Authors: Padin Avelina C. , Stevens Natalie R. , Che Mandy L. , Erondu Ihuoma N. , Perera Marisa J. , Shalowitz Madeleine U.
Published: June 2022

Background

Prenatal posttraumatic stress disorder (PTSD) is often overlooked in obstetric care, despite evidence that untreated PTSD negatively impacts both mother and baby. OB-GYN clinics commonly screen for depression in pregnant patients; however, prenatal PTSD screening is rare. Although the lack of PTSD screening likely leaves a significant portion of pregnant patients with unaddressed mental health needs, the size of this care gap has not been previously investigated.

Methods

This retrospective chart review study included data from 1,402 adult, pregnant patients who completed PTSD (PTSD Checklist-2; PCL) and depression (Edinburgh Postnatal Depression Survey; EPDS) screenings during a routine prenatal care visit. Descriptive statistics identified screening rates for PTSD and depression, and logistic regression analyses identified demographic variables associated with screening outcomes and assessed whether screening results (+ PCL/ + EPDS, + PCL/-EPDS, -PCL/ + EPDS, -PCL/-EPDS) were associated with different provider intervention recommendations.

Results

11.1% of participants screened positive for PTSD alone, 3.8% for depression alone, and 5.4% for both depression and PTSD. Black (OR = 2.24, 95% CI [1.41,3.54]) and Latinx (OR = 1.64, 95% CI [1.01,2.66]) patients were more likely to screen positive for PTSD compared to White patients, while those on public insurance were 1.64 times (95% CI [1.21,2.22]) more likely to screen positive compared to those with private insurance. Patients who screened positive for both depression and PTSD were most likely to receive referrals for behavioral health services (44.6%), followed by -PCL/ + EPDS (32.6%), + PCL/-EPDS (10.5%), and -PCL/-EPDS (3.6%). A similar pattern emerged for psychotropic medication prescriptions.

Conclusions

Over ten percent of pregnant patients in the current study screened positive for PTSD without depression, highlighting a critical mental health need left unaddressed by current obstetric standards of care. Routine PTSD screening during prenatal care alongside strategies aimed at increasing referral resources and access to mental health services are recommended.
Prevalence of amniotomy in Sweden: a nationwide register study
Authors: Tallhage Sofia , Årestedt Kristofer , Schildmeijer Kristina , Oscarsson Marie
Published: June 2022

Background

Amniotomy is a commonly used labor intervention with uncertain evidence, and there are complications connected to the intervention. Yet, the Swedish prevalence of amniotomy is unknown. The aim of the study was therefore to describe the prevalence of amniotomy in Sweden.

Methods

This nationwide register-based study included 330,913 women giving birth in 2017–2020. Data were collected from the Swedish Pregnancy Register in which the majority of data is collected via direct transfer from medical records. Prevalence of amniotomy was described for all births, for nulliparous and multiparous women with spontaneous onset of labour, and at the hospital level. Descriptive statistics and chi-square test were used to analyse the data.

Results

For all births, the prevalence of amniotomy was 40.6%. More amniotomies were performed in Robson group 1 compared to Robson group 3; 41.1% vs 32.3% (p < 0.001). The prevalence for all births remained the same during the study period; however, a decrease from 37.5 to 34.1%, was seen in Robson group 1 and Robson group 3 (p < 0.001). Variations in the prevalence between hospitals were reported. The hospitals with the fewest number of births annually had the highest prevalence of amniotomy (45.0%), and the lowest prevalence was reported at the University hospitals (40.4%) (p < 0.001).

Conclusions

Amniotomy is a common labor intervention in Sweden, given that almost half of the laboring women underwent the intervention. Our results, regarding variations in the prevalence between hospitals, could imply a potential for fewer amniotomies in Swedish childbirth care.
Children’s experiences of meals after obesity treatment: a qualitative follow-up four years after a randomized controlled trial
Authors: Neuman Nicklas , Jörnvi Anna , Ek Anna , Nordin Karin , Eli Karin , Nowicka Paulina
Published: June 2022

Background

The practice of eating together, commensality, is rarely explored in the context of childhood obesity treatment. This is noteworthy given long-standing debates about the physical, psychosocial, and societal benefits of meals, especially family meals. Moreover, as children with obesity experience weight bias and stigma both within and outside the home, it is important to examine meals as a locus of social exchange around food and the body. Our study is based on the premises that eating together (i) matters and (ii) occurs in different environments with diverse social organization, where food-related interactions create varying arrangements of individuals, groups, their statuses, and their actions.

Method

The study explores children’s experiences of meals in different social contexts. Thirty-two children (age 8–10 years) living in Sweden were interviewed, 4 years after they entered an obesity intervention trial. Thematic analysis was applied to the data.

Results

We thematized three meal types, with each meal type having two subthemes: (i) “The family meal”, with “Shared routines, rituals, and rules” and “Individual solutions and choices”; (ii) “The school meal”, with “Rules and norms of the school” and “Strategies of the child”; and (iii) “The friend meal”, with “Handling food that was disliked” and “Enjoyment of food”. These three different meal types carried different experiences of and knowledge about how they were socially organized.

Conclusions

While the children spoke about the family and school meals as meaningful, the friend meal stood out as particularly positive. Contrary to our expectations, the children did not express experiences of weight bias or obesity stigma around meals, nor did they speak negatively about parental control of their food intake. Our findings, especially regarding the friend meal, have implications for further research into commensality and social influences on eating among children with obesity, from early childhood into adolescence.
Mental health effects of the Gangwon wildfires
Authors: Hong Ji Sun , Hyun So Yeon , Lee Jung Hyun , Sim Minyoung
Published: June 2022

Background

The April 2019 wildfires in Gangwon Province, South Korea forced the evacuation of 1500 individuals and cost more than $100 million in damages, making it the worst wildfire disaster in Korean history. The purpose of this paper was to investigate the mental health effects on survivors following the wildfires.

Methods

Between April and May 2019, outreach psychological support services were delivered to people impacted by the wildfires. Post-disaster psychological responses using a checklist and the Clinical Global Impression Scale-Severity (CGI-S) were evaluated for 206 wildfires survivors. The CGI-S was administered consequently at 1, 3, and 6 months after baseline measurement.

Results

Among four response categories, somatic responses (76.2%) were most frequently observed among the wildfire survivors. Specifically, insomnia (59.2%), anxiety (50%), chest tightness (34%), grief (33%), flashbacks (33%), and depression (32.5%) were reported by over 30% of the participants. The mean CGI-S scores were significantly decreased at 1 month (mean score = 1.94; SE = 0.09) compared to baseline (mean score = 2.94; SE = 0.08) and remained at the decreased level until 6 months (mean score = 1.66; SE = 0.11). However, participants with flashbacks showed significantly higher CGI-S scores compared to those without flashback at 6 months.

Conclusions

Wildfire survivors have various post-disaster responses, especially somatic responses. While most participants’ mental health improved over time, a few of them may have experienced prolonged psychological distress after 6 months. Flashbacks were particularly associated with continuing distress. These results suggest that the characteristics of responses should be considered in early phase intervention and in follow-up plans for disaster survivors.
Use of reproductive health services among women using long- or short-acting contraceptive methods – a register-based cohort study from Finland
Authors: Saloranta Tuire Helene , Gyllenberg Frida Katrin , But Anna , Gissler Mika , Heikinheimo Oskari , Laine Merja Kristiina
Published: June 2022

Background

Long-acting reversible contraceptives (LARCs) have superior contraceptive efficacy compared to short-acting reversible contraceptives (SARCs) and choosing LARCs over SARC methods reduces the need for abortion care. However, little is known how initiating these methods associates with the subsequent overall need of reproductive health services including family planning services, and visits for gynecological reasons in primary and specialized care.

Methods

We followed altogether 5839 non-sterilized women aged 15–44 years initiating free-of-charge LARC methods (n = 1689), initiating or switching SARC methods (n = 1524), or continuing with the same SARC method (n = 2626) at primary care family planning clinics in the City of Vantaa, Finland, 2013–2014 for 2 years using Finnish national health registers.

We assessed the use of reproductive health services, namely attending public primary or specialized health care for gynecological reasons or attending the family planning clinics by applying unadjusted and adjusted negative binomial regression models on visit counts.

Results

A total of 11,290 visits accumulated during the two-year follow-up: 7260 (64.3%) at family planning clinics, 3385 (30.0%) for gynecological reasons in primary, and 645 (5.7%) in specialized health care. Altogether 3804 (52.4%) visits at the family planning clinics were for routine checkup, and 3456 (47.6%) for other reasons. Women initiating LARC methods used reproductive health services for reasons other than routine checkups similarly as women initiating or switching SARC methods (adjusted incidence rate ratio 0.93, 95% CI 0.82–1.05), while women continuing with SARC methods used the services less frequently (0.65, 0.59–0.72). Women initiating free-of-charge LARC and those continuing with the same SARC method used services less for abortion care than women initiating or switching SARC
(adjusted incidence rate ratios 0.05, 95% CI 0.03–0.08 and 0.16, 95% CI 0.11–0.24, respectively).

Conclusions

While women initiating LARC methods have lower need for abortion care compared to women initiating SARC methods, women initiating both LARC and SARC methods have similar overall need for reproductive health services. In contrast, women continuing with their SARC method need reproductive health services less than women initiating LARC or a new SARC method. These service needs should be acknowledged when planning and organizing family planning services, and when promoting long-acting reversible contraception.
Evaluation of cinnamaldehyde mucoadhesive patches on minor recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled clinical trial
Authors: Molania Tahere , Malekzadeh Shafaroudi Ali , Saeedi Majid , Moosazadeh Mahmood , Valipour Faeze , Rostamkalaei Seyyed Sohrab , Salehabadi Negareh , Salehi Maede
Published: June 2022

Background & objective

The use of herbal medicines to treat common oral diseases increases rapidly. Recurrent aphthous stomatitis is one of the most common oral mucosal diseases, which has an unclear etiology and could lead to severe pain and dysfunction. Cinnamaldehyde is a major component of cinnamon bark oil. Biological properties of cinnamaldehyde, such as antioxidant, antitumor, antifungal, cytotoxic, and anti-mutational characteristics, have been identified. Considering the prevalence of recurrent aphthous stomatitis and the importance of using herbal resources for treatment, the present study aimed to evaluate the effect of mucosal adhesive patches containing Cinnamaldehyde on minor recurrent aphthous stomatitis lesions.

Material & methods

In this randomized, double-blind clinical trial, patients were divided into two groups. The intervention group received three daily mucosal adhesive patches to be used in the morning, afternoon, and night. The control group also did the same with a placebo. To evaluate the healing and determine the diameter of the lesions, patients were clinically examined on days zero, 3, 5, and 7. The VAS scale evaluated pain at baseline and after each meal for seven days. The Fisher's exact test, t-test, Shapiro Wilk test, Friedman test, and the Mann–Whitney test were used to analyze the data using the SPSS 20 software.

Results

There was no statistically significant difference in the mean diameter of the inflammatory lesion and pain intensity in the two groups in the baseline (p > 0.05). However, the ulcer size was significantly reduced in the cinnamaldehyde group on the third, fifth, and seventh days of the study. Except for baseline, the mean pain intensity significantly decreased in the cinnamaldehyde group compared to the placebo group (p < 0.05).

Conclusion

Cinnamaldehyde mucoadhesive patches effectively reduced and improved aphthous lesions and pain intensity in patients and can be considered a treatment for RAS. Registration number: IRCT20180312039060N2—First registration date: 20/07/2018. The present study was registered as a retrospective study.
Oral health status and its associated factors among post-stroke inpatients: a cross-sectional study in Hungary
Authors: Moldvai Júlia , Orsós Mercédesz , Herczeg Eszter , Uhrin Eszter , Kivovics Márton , Németh Orsolya
Published: June 2022

Background

Post-stroke inpatients are at risk of poor oral health for a number of reasons. The aim of this study was to assess the oral health status of post-stroke patients and also to explore the factors that may influence it.

Methods

This cross-sectional study was organised at National Institute for Medical Rehabilitation in Hungary. Altogether 410 post-stroke patients were enrolled in the survey. Personal medical history and functional assessment was obtained from the final medical reports of the patients. The clinical examination and data collection were conducted according to the World Health Organization (2013) criteria. Socio-demographic background and behaviours related to oral health were assessed using a questionnaire. The dental status was explained by the number of Decayed, Missing and Filled Teeth (DMFT). The association of socio-demographic factors, stroke and functional assessment with oral health status and behaviour was evaluated. Chi-square test, Fisher’s exact test, Welch test, Mann–Whitney U test, Kruskal–Wallis test, ANOVA model and correlation analysis were used to analyse our data. The level of significance was set at p < 0.05.

Results

Mean age of stroke patients was 59.21(Standard Deviation [SD] 14.74) years. Mean DMFT score was 20.13 (8.08), including 3.28 (4.24) decayed teeth, 15.02 (10.29) missing teeth and 1.83 (2.94) filled teeth score. Factors that influenced the oral health status were gender, age, occupational status, level of education, type and risk factors for stroke. Significant correlation was found between the Functional Independence Measure and oral health-related behaviours with patients brushing their teeth once a month showing the lowest value.

Conclusion

According to the results, low socio-demographic and economic status, low level of education and the Functional Independence Measure score, unemployment, the combination of risk factors for stroke and residual dysfunctions are associated with poor oral health status. The data indicate that a series of changes are needed, for special attention and care in oral health for patients who have had a stroke. Based on the findings of this research, a new model of prevention and care can be developed, with an interdisciplinary collaboration, to promote the quality of life of these individuals.
Intravenous fluid therapy: a multi-national, cross-sectional survey of common medical student resources
Authors: Ding Jack B. , Varkey Thomas C.
Published: June 2022

Background

Inappropriate prescription of intravenous fluid therapy is highly prevalent in hospitals, with up to 1 in 5 patients suffering from preventable, additional morbidity. Since trainee physicians are frequently responsible for prescribing intravenous fluids, it is possible that common medical student resources do not sufficiently cover the topic. There is a paucity of recent literature on this issue, which this study was designed to address.

Methods

Two original evaluation tools were created by the authors to evaluate reference books, official guidelines, and online reference sources commonly used by medical students in the United States of America, Australia, and the United Kingdom on their coverage of foundational and clinically relevant principles of intravenous fluid prescription. The choice of student resources was guided by a literature search and personal experience. A total of 10 resources was assessed.

Results

Resources were generally deficit in their coverage of basic intravenous fluid topics. The total points each topic accumulated ranged from 0.5 (5%) to 7.5 (75%), with the median score being 4.5 (45%), on a scale from 0 to 10 points.

Conclusions

Popular medical student resources poorly cover intravenous fluid therapy topics. This may be contributing to inadequate fluid prescribing practices.
Antecedents of unfinished nursing care: a systematic review of the literature
Authors: Chiappinotto Stefania , Papastavrou Evridiki , Efstathiou Georgios , Andreou Panayiota , Stemmer Renate , Ströhm Christina , Schubert Maria , de Wolf-Linder Susanne , Longhini Jessica , Palese Alvisa
Published: June 2022

Background

Unfinished Nursing Care (UNC) concept, that express the condition when nurses are forced to delay or omit required nursing care, has been largely investigated as tasks left undone, missed care, and implicit rationing of nursing care. However, no summary of the available evidence regarding UNC antecedents has been published. The aim of this study is to identify and summarise antecedents of UNC as documented in primary studies to date.

Methods

A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. MEDLINE, CINAHL, SCOPUS, and PROSPERO databases were searched for quantitative studies reporting the relationships between antecedents and UNC published after 2004 up to 21 January 2020. The reference lists of secondary studies have been scrutinised to identify additional studies. Two reviewers independently identified studies and evaluated them for their eligibility and disagreements were resolved by the research team. The quality appraisal was based on the Joanna Briggs Institute Critical Appraisal tools, according to the study designs. A data extraction grid was piloted and then used to extract data. The antecedents that emerged were thematically categorised with an inductive approach.

Results

Fifty-eight studies were included; among them, 54 were cross-sectional, three were cohort studies, and one was a quasi-experimental study. They were conducted mainly in the United States and in hospital settings. The UNC antecedents have been investigated to date at the (a) unit (e.g., workloads, non-nursing tasks), (b) nurse (e.g., age, gender), and (c) patient levels (clinical instability).

Conclusions

At the unit level, it is highly recommended to provide an adequate staff level, strategies to deal with unpredictable workloads, and to promote good practice environments to reduce or minimise UNC. By contrast, at the nurse and patient levels, there were no clear trends regarding modifiable factors that could decrease the occurrence of UNC. The map of antecedents that emerged can be used to design interventional studies aimed at changing research from merely descriptive to that which evaluates the effectiveness of interventions.
Satisfaction with access to health services among foreign-born population in Finland: a survey-based study
Authors: Kieseppä Valentina , García Velázquez Regina , Vehko Tuulikki , Kuusio Hannamaria
Published: June 2022

Background

Many European studies have shown migrants to be less satisfied with health care and find it less accessible than the general populations. The aim of this study was to compare satisfaction with access to health care between migrants from different regions of origin and the general population of Finland.

Methods

This study uses data from two comprehensive survey samples on health and wellbeing of the foreign-born and the general population living in Finland. Three aspects of satisfaction with health care access were measured and predicted by region of origin using logistic regression.

Results

Foreign-born population was slightly more dissatisfied with all aspects of the access to health care as compared to the general population. In all aspects of access, migrants from the Middle East and Africa were least likely to be satisfied.

Conclusions

As the satisfaction with access was lowest among migrant groups which are likely to have higher needs for at least some health services in comparison to the general population, these results are alarming. More research is needed to identify the potential development points in the health care system of Finland.
Engineering plants with carbon nanotubes: a sustainable agriculture approach
Authors: Safdar Mahpara , Kim Woochan , Park Sunho , Gwon Yonghyun , Kim Yeon-Ok , Kim Jangho
Published: June 2022

Sustainable agriculture is an important conception to meet the growing food demand of the global population. The increased need for adequate and safe food, as well as the ongoing ecological destruction associated with conventional agriculture practices are key global challenges. Nanomaterials are being developed in the agriculture sector to improve the growth and protection of crops. Among the various engineered nanomaterials, carbon nanotubes (CNTs) are one of the most promising carbon-based nanomaterials owing to their attractive physiochemical properties such as small size, high surface area, and superior mechanical and thermal strength, offering better opportunities for agriculture sector applications. This review provides basic information about CNTs, including their history; classification; and electrical, thermal, and mechanical properties, with a focus on their applications in the agriculture field. Furthermore, the mechanisms of the uptake and translocation of CNTs in plants and their defense mechanisms against environmental stresses are discussed. Finally, the major shortcomings, threats, and challenges of CNTs are assessed to provide a broad and clear view of the potential and future directions for CNT-based agriculture applications to achieve the goal of sustainability.
Traditional Chinese medicine active ingredients-based selenium nanoparticles regulate antioxidant selenoproteins for spinal cord injury treatment
Authors: Rao Siyuan , Lin Yongpeng , Lin Rui , Liu Jinggong , Wang Hongshen , Hu Weixiong , Chen Bolai , Chen Tianfeng
Published: June 2022

Background

As Traditional Chinese Medicine (TCM) drugs, Huangqi and Danshen are always applied in combination for spinal cord injury (SCI) treatment based on the compatibility theory of TCM. Astragalus Polysaccharidesis (APS) and Tanshinone IIA (TSIIA) are the main active ingredients of Huangqi and Danshen, and they both possess neuroprotective effects through antioxidant activities. However, low solubility and poor bioavailability have greatly limited their application. In recent years, selenium nanoparticles (SeNPs) have drawn enormous attention as potential delivery carrier for antioxidant drugs.

Results

In this study, TCM active ingredients-based SeNPs surface decorated with APS and loaded with TSIIA (TSIIA@SeNPs-APS) were successfully synthesized under the guidance of the compatibility theory of TCM. Such design improved the bioavailability of APS and TSIIA with the benefits of high stability, efficient delivery and highly therapeutic efficacy for SCI treatment illustrated by an improvement of the antioxidant protective effects of APS and TSIIA. The in vivo experiments indicated that TSIIA@SeNPs-APS displayed high efficiency of cellular uptake and long retention time in PC12 cells. Furthermore, TSIIA@SeNPs-APS had a satisfactory protective effect against oxidative stress-induced cytotoxicity in PC12 cells by inhibiting excessive reactive oxygen species (ROS) production, so as to alleviate mitochondrial dysfunction to reduce cell apoptosis and S phase cell cycle arrest, and finally promote cell survival. The in vivo experiments indicated that TSIIA@SeNPs-APS can protect spinal cord neurons of SCI rats by enhancing GSH-Px activity and decreasing MDA content, which was possibly via the metabolism of TSIIA@SeNPs-APS to SeCys2and regulating antioxidant selenoproteins to resist oxidative stress-induced damage.

Conclusions

TSIIA@SeNPs-APS exhibited promising therapeutic effects in the anti-oxidation therapy of SCI, which paved the way for developing the synergistic effect of TCM active ingredients by nanotechnology to improve the efficacy as well as establishing novel treatments for oxidative stress-related diseases associated with Se metabolism and selenoproteins regulation.
Biomimetic doxorubicin/ginsenoside co-loading nanosystem for chemoimmunotherapy of acute myeloid leukemia
Authors: Chen Mo , Qiao Yingyu , Cao Jie , Ta La , Ci Tianyuan , Ke Xue
Published: June 2022

Background

Acute myeloid leukemia (AML) showed limited clinical therapeutic efficiency with chemotherapy for its multi-distributed lesions and hard-to-kill leukemia cells deep in the bone marrow.

Results

Here, a biomimetic nanosystem (DR@PLip) based on platelet membrane (PM) coating and doxorubicin (DOX)/ginsenoside (Rg3) co-loading was developed to potentiate the local-to-systemic chemoimmunotherapy for AML. The PM was designed for long-term circulation and better leukemia cells targeting. The participation of Rg3 was proved to enhance the tumor sensitivity to DOX, thus initiating the anti-tumor immune activation and effectively combating the leukemia cells hiding in the bone marrow.

Conclusions

In conclusion, the strategy that combining immediate chemotherapy with long-term immunotherapy achieved improved therapeutic efficiency and prolonged survival, which provided a new perspective for the clinical treatment of AML.
Network pharmacology and molecular docking approach to elucidate the mechanisms of Liuwei Dihuang pill in diabetic osteoporosis
Authors: Lu Zhaoqi , Huang Minling , Lin Haixiong , Wang Gaoxiang , Li Huilin
Published: June 2022

Background

Diabetic osteoporosis (DOP) is one of the chronic complications of diabetes mellitus, but without a standardized treatment plan till now. Liuwei Dihuang pill (LDP) has gradually exerted a remarkable effect on DOP in recent years; its specific mechanism is not clear yet.

Methods

We adopted network pharmacology approaches, including multi-database search, pharmacokinetic screening, network construction analysis, gene ontology enrichment analysis, Kyoto Encyclopedia of Genes and Genomes pathway analysis and molecular docking to elaborate the active components, signaling pathways and potential mechanisms of LDP in the treatment of DOP.

Results

Twenty-seven active ingredients and 55 related disease targets have been found through integrated network pharmacology. Functional enrichment analysis shows that five key active ingredients, including beta-sitosterol, stigmasterol, diosgenin, tetrahydroalstonine, and kadsurenone, may give full scope to insulin secretion estrogen-level raising and angiogenesis in biological process through the pivotal targets. In addition, the underlying effect of PI3K/AKT/FOXO and VEGF pathways is also suggested in the treatment.

Conclusion

Based on systematic network pharmacology methods, we predicted the basic pharmacological effects and potential mechanisms of LDP in the treatment of DOP, revealing that LDP may treat DOP through multiple targets and multiple signaling pathways, which provide evidence for the further study of pharmacological mechanism and broader clinical thinking.
Serum biomarker-based osteoporosis risk prediction and the systemic effects of Trifolium pratense ethanolic extract in a postmenopausal model
Authors: Quah Yixian , Yi-Le Jireh Chan , Park Na-Hye , Lee Yuan Yee , Lee Eon-Bee , Jang Seung-Hee , Kim Min-Jeong , Rhee Man Hee , Lee Seung-Jin , Park Seung-Chun
Published: June 2022

Background

Recent years, a soaring number of marketed Trifolium pratense (red clover) extract products have denoted that a rising number of consumers are turning to natural alternatives to manage postmenopausal symptoms. T. pratense ethanolic extract (TPEE) showed immense potential for their uses in the treatment of menopause complications including osteoporosis and hormone dependent diseases. Early diagnosis of osteoporosis can increase the chance of efficient treatment and reduce fracture risks. Currently, the most common diagnosis of osteoporosis is performed by using dual-energy x-ray absorptiometry (DXA). However, the major limitation of DXA is that it is inaccessible and expensive in rural areas to be used for primary care inspection. Hence, serum biomarkers can serve as a meaningful and accessible data for osteoporosis diagnosis.

Methods

The present study systematically elucidated the anti-osteoporosis and estrogenic activities of TPEE in ovariectomized (OVX) rats by evaluating the bone microstructure, uterus index, serum and bone biomarkers, and osteoblastic and osteoclastic gene expression. Leverage on a pool of serum biomarkers obtained from this study, recursive feature elimination with a cross-validation method (RFECV) was used to select useful biomarkers for osteoporosis prediction. Then, using the key features extracted, we employed five classification algorithms: extreme gradient boosting (XGBoost), random forest, support vector machine, artificial neural network, and decision tree to predict the bone quality in terms of T-score.

Results

TPEE treatments down-regulated nuclear factor kappa-B ligand, alkaline phosphatase, and up-regulated estrogen receptor β gene expression. Additionally, reduced serum C-terminal telopeptides of type 1 collagen level and improvement in the estrogen dependent characteristics of the uterus on the lining of the lumen were observed in the TPEE intervention group. Among the tested classifiers, XGBoost stood out as the best performing classification model with the highest F1-score and lowest standard deviation.

Conclusions

The present study demonstrates that TPEE treatment showed therapeutic benefits in the prevention of osteoporosis at the transcriptional level and maintained the estrogen dependent characteristics of the uterus. Our study revealed that, in the case of limited number of features, RFECV paired with XGBoost model could serve as a powerful tool to readily evaluate and diagnose postmenopausal osteoporosis.
The pleiotropic roles of adipocyte secretome in remodeling breast cancer
Authors: Zhou Xiaomei , Zhang Jun , Lv Wenchang , Zhao Chongru , Xia Yu , Wu Yiping , Zhang Qi
Published: June 2022

Background

Breast cancer is the leading female cancer type and the cause of cancer-related mortality worldwide. Adipocytes possess important functions of energy supply, metabolic regulation, and cytokine release, and are also the matrix cell that supports mammary gland tissue. In breast cancer tumor microenvironment (TME), adipocytes are the prominent stromal cells and are implicated in inflammation, metastatic formation, metabolic remodeling, and cancer susceptibility.

Main body

It is well-established that adipocyte secretome is a reservoir engaged in the regulation of tumor cell behavior by secreting a large number of cytokines (IL-6, IL-8, and chemokines), adipokines (leptin, adiponectin, autotaxin, and resistin), lipid metabolites (free fatty acids and β-hydroxybutyrate), and other exosome-encapsulated substances. These released factors influence the evolution and clinical outcome of breast cancer through complex mechanisms. The progression of breast cancer tumors revolves around the tumor-adipose stromal network, which may contribute to breast cancer aggressiveness by increasing the pro-malignant potential of TME and tumor cells themselves. Most importantly, the secretome alterations of adipocytes are regarded as distinctly important targets for breast cancer diagnosis, treatment, and drug resistance.

Conclusion

Therefore, this review will provide a comprehensive description of the specific adipocyte secretome characteristics and interactions within TME cell populations, which will enable us to better tailor strategies for tumor stratification management and treatment.