bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting Completion of Ecological Momentary Assessments Among Substance-Using Women Experiencing Intimate Partner Violence
Authors: Yang Manshu , Schick Melissa R. , Sullivan Tami P. , Weiss Nicole H.
Published: January 2024

Noncompletion of ecological momentary assessment (EMA) surveys is a common issue and may yield bias in results if not properly handled. Using data observed at scheduled times as well as data retrieved later to fill missing responses, this study aims to investigate predictors of EMA completion, including demographic characteristics, time-related factors, and momentary experiences/behaviors. Data were from a 30-day EMA study including 145 women currently experiencing intimate partner violence (IPV) and using substances. The average rate of EMA completion was initially 51.4% at the scheduled times and increased to 72.6% after incorporating data from later-retrieved surveys. Participants who were younger, had more children, or had lower mean levels of negative affect dysregulation showed lower completion rates. At the momentary survey level, more days into the study and afternoon/evening reports (vs. morning reports) were associated with lower completion; lower levels of negative affect dysregulation, less smoking or alcohol use, and experiencing IPV were linked to lower momentary completion. Implications of the results for handling missing data in EMA are discussed and have important ramifications for future research, practice, and theory.
Safety Assessment of Alkane Diols as Used in Cosmetics
Authors: Scott Laura N. , Fiume Monice , Bergfeld Wilma F. , Belsito Donald V. , Hill Ronald A. , Klaassen Curtis D. , Liebler Daniel C. , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Heldreth Bart
Published: January 2024

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of 10 alkane diol ingredients as used in cosmetics. The alkane diols are structurally related to each other as small diols, and most are reported to function in cosmetics as solvents. The Panel reviewed the relevant data for these ingredients, and concluded that seven alkane diols are safe in cosmetics in the present practices of use and concentration described in this safety assessment, but that the available data are insufficient to make a determination of safety for three ingredients, namely 1,4-Butanediol, 2,3-Butanediol, and Octanediol.
Updates on Pityriasis Rubra Pilaris: A Scoping Review
Authors: Zhou Ted , Al Muqrin Abdullah , Abu-Hilal Mohannad
Published: January 2024

Pityriasis rubra pilaris (PRP) is a rare, inflammatory papulosquamous skin disease with unknown exact etiology. Historically, PRP has been challenging to diagnose, especially during the acute phase, and to treat, due to its unclear pathogenesis. To better inform clinical practice, a literature review was conducted employing a broad search strategy to capture PRP-related published studies between January 1, 2012 to October 31, 2022. Two hundred twenty-one studies were identified, which were categorized into 9 themes: (1) potential causes and triggering factors, (2) comorbidities, (3) diagnostic difficulties, (4) genetics, (5) clinical manifestations and laboratory values, (6) treatment, (7) treatment-related adverse events, (8) quality of life, and (9) other. COVID-19 infection, COVID-19 vaccination, and malignancy were the most commonly reported potential triggering factors. Misdiagnosis is very common during the early acute stages. Pathogenesis and genetic studies have further implicated caspase recruitment domain family member 14 (CARD14) mutations in the development of familial PRP (Type V) and have underlined the overlap between psoriasis and PRP. To date, there are currently no specific and validated scoring systems or tools to assess the severity of PRP. While large, randomized trials are still lacking, biologic agents remain the most effective therapy.
Ambivalence of informality: Covid-19 and unmasked precarity in Nollywood
Authors: Simon Godwin Iretomiwa
Published: January 2024

This article explores the impacts of the Covid-19 pandemic on the Nigerian film industry (Nollywood) and the local responses of filmmakers to the precariousness engendered by the pandemic. This research adopts the critical media industry studies framework and relies on interviews with 30 Nollywood filmmakers who provided insights on the impact of the pandemic on labour in Nollywood. Theorizing the Covid-19 dynamics as reflective of the ambivalence of informality, this article submits that although informality was central to Nollywood's industrial structure and sustainability, the pandemic triggered unprecedented tensions associated with those informal practices and highlighted existing precarity which had been largely masked by constant availability of jobs. Accordingly, a significant legacy of the pandemic for the industry is the unprecedented gravitation of industry players towards more formalized industrial structures and practices.
Book review: Ezroj, A. 2021: Carbon Risk and Green Finance
Authors: Duho King Carl Tornam
Published: January 2024

Ezroj, A. 2021: Carbon Risk and Green Finance. Abingdon, Oxon & New York, NY: Routledge. 138 pp. £110.00 (Hardback), £38.99 (Paperback), £27.29 (VitalSource eBook). ISBN: 9780367559915 (Hardback), 9780367559922 (Paperback), 9781003095996 (VitalSource eBook).
Weaving a Dense Web: A (Decolonial) Study into the Contributions of Host Organizations of Development Volunteers in Jalisco, Mexico
Authors: Jablonska-Bayro Joanna , Haas Benjamin
Published: January 2024

Despite increasing interest in the role played by global South receiving organizations of development volunteers, their agency and efforts are rarely investigated in detail. Our qualitative study explores the involvement of receiving partners in international volunteering spaces, using the German Weltwärts programme in Mexico as an example. By applying decolonial theory, and politics and ethics of care lens to our data, we explore how these organizations are ‘weaving’ a dense assistance and safety web around the volunteers. Such assistance is usually not monetized and mainly invisible in the discussion of volunteering for development. Our findings challenge the development discourse and the positionality of northern volunteers within the development architecture.
The experiences of caring for someone with dementia and a learning disability: A qualitative systematic review
Authors: Hughes Michelle , Hanna Kerry , Wiles Akpevwoghene , Taylor Ellie , Giebel Clarissa
Published: January 2024

Background

The life expectancy of people with a learning disability is increasing and with this comes a greater risk of developing dementia. Dementia poses new challenges for both family and formal learning disability carers as they try to support dementia’s progressive nature and quality of life for their care recipient. This qualitative systematic review explores the evidence base of family and formal carers’ experiences and needs of caring for someone with both a learning disability and dementia.

Methods

Six electronic databases (PubMed, PsycINFO, Cochrane Library, Prospero, Scopus, CINAHL), were searched in May 2022, utilising a predefined search strategy. Thirteen papers fulfilled inclusion criteria and were included in in the review.

Results

Thematic synthesis was used to explore and synthesise the qualitative findings of the studies. Four conceptual themes were identified following analysis: Knowledge and skills, Accessing support, Repercussions of dementia for carers, Influences of continuity of caring role.

Conclusion

There are significant training and educational needs for all carers who support the dual diagnosis of dementia and learning disability. Differences between family and formal carers relate to the organisational support and process available to formal carers. Parity across services combined with sufficiently trained carers may support dementia diagnosis and improve quality of care provided. Further research is needed to address environmental, and economic barriers carers face to facilitate ageing in place for their care recipients.
Qualitative Research Methods in the Living Lab: Reflecting upon a Learning and Teaching Approach for Promoting Psychological Literacy
Authors: Fernandes-Jesus Maria , Hamilton Lorna , Heinemeyer Catherine , Parks Jude
Published: January 2024

This report describes and reflects upon an approach to embedding psychological literacy within the core Research Methods curriculum in a small university in the United Kingdom. Psychology students were involved in the ‘Living Lab: Feeding the Campus’ project, an interdisciplinary network of students and staff aiming to find solutions for local issues of direct relevance to students’ lives. The Living Lab focused on understanding and improving the campus food system in the context of ecological justice. Undergraduate psychology students participated through the Qualitative Research Methods, a compulsory second-year module. Psychology students conducted interview studies related to food topics such as poverty, identities and culture, community gardens, waste, sustainable lifestyles, and activism. Students collected data on campus to examine food-related experiences within the university community. Findings are being used to inform changes in the university. In this report, we describe the first iteration of involving psychology students in the Living Lab. Our approach involved an authentic assessment, participation in events and fieldtrips and interdisciplinary collaboration. We combine insights from student feedback with staff reflections on its implementation and impact. Finally, we discuss the potential of using research methods modules as a way to facilitate psychological literacy.
Understanding Automation Failure
Authors: Endsley Mica R.
Published: January 2024

The implementation of automation in many domains has led to well-documented accidents and incidents, resulting from reduced situation awareness that occurs when operators are out-of-loop (OOTL), automation confusion, and automation interaction difficulties. Wickens coined the term lumberjack effect to summarize the finding that while automation works well most of the time in typical or normal situations, the performance problems that occur in novel or unexpected situations also increase the likelihood of catastrophic errors. Skraaning and Jamieson have criticized the lumberjack effect due to a study in which they failed to find it. I show that this claim is unsupported due to a number of methodological limitations in their study and conceptual errors. They also provide a model of automation failure that fails to clearly delineate the many barriers to accidents that are available, instead emphasizing the ways in which automation can fail technically and different types of human error. An alternate automation failure model is presented that provides a broader socio-technical perspective emphasizing the design features, processes, capabilities, organizational policies, and training that support people in improving system safety when automation fails.
Drivers and barriers of patients’ acceptance of video consultation in cancer care
Authors: Nurtsch Angelina , Teufel Martin , Jahre Lisa Maria , Esber André , Rausch Raya , Tewes Mitra , Schöbel Christoph , Palm Stefan , Schuler Martin , Schadendorf Dirk , Skoda Eva-Maria , Bäuerle Alexander
Published: January 2024

Background

Due to digitization in the medical sector, many healthcare interactions are switched to online services. This study assessed the acceptance of video consultations (VCs) in cancer care, and determined drivers and barriers of acceptance.

Methods

A cross-sectional online-based survey study was conducted in Germany from February 2022 to February 2023. Recruitment took place at oncology outpatient clinics, general practitioners, oncology practices and via cancer-related social media channels. Inclusion criteria were a cancer diagnosis, cancer treatment and internet access. Sociodemographic, medical data, eHealth-related data were acquired via an online assessment. The Unified Theory of Acceptance and Use of Technology (UTAUT) model was used to determine the acceptance of VC and its predictors.

Results

Of N = 350 cancer patients, 56.0% ( n = 196) reported high acceptance of VC, 28.0% ( n = 98) stated moderate acceptance and 16.0% ( n = 56) indicated low acceptance. Factors influencing acceptance were younger age (β = –.28, p < .001), female gender (β = .35, p = .005), stage of disease (β = .11, p = .032), high digital confidence (β = .14, p = .010), low internet anxiety (β = –.21, p = .001), high digital overload (β = –.12, p = .022), high eHealth literacy (β = .14, p = .028), personal trust (β = –.25, p < .001), internet use (β = .17, p = .002), and the UTAUT predictors: performance expectancy (β = .24, p < .001), effort expectancy (β = .26, p < .001), and social influence (β = .34, p < .001).

Conclusions

Patients’ acceptance of VC in cancer care is high. Drivers and barriers to acceptance identified should be considered for personalized applications. Considering the growing demand for cancer care establishing digital healthcare solutions is justified.
Career and College Readiness Programming of Rural Appalachian School Counselors: A Consensual Qualitative Research Study
Authors: Ault Haley R. , Sexton Kody , Gibbons Melinda M. , Wynn Mary K. , Lange Robert A.
Published: January 2024

Rural Appalachia encompasses a region of the United States represented by unique cultural strengths and systemic challenges. To meet their students’ career and college needs, school counselors working in rural Appalachia must understand the cultural nuances of the region. Consensual qualitative research (CQR) methodology revealed five domains and 20 categories describing how rural Appalachian high school counselors address career and college readiness. We provide implications for career and college programming for use by high school counselors in rural Appalachia.
Morphological Evaluation of Lumbar Facet Joints in Professional Baseball Players
Authors: Manabe Hiroaki , Morimoto Masatoshi , Sugiura Kosuke , Takeuchi Makoto , Tezuka Fumitake , Yamashita Kazuta , Sakai Toshinori , Sairyo Koichi
Published: January 2024

Background:

Many professional baseball players experience low back pain, a major cause of which is lumbar facet joint arthropathy.

Purpose:

To evaluate the relationship between the dominant hand side and facet joint morphology in baseball movement.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Participants were 25 Japanese professional baseball players (11 pitchers and 14 fielders) with low back pain and lower limb symptoms. Player age, hand dominance, and length of professional playing experience were recorded, and the lateral diameter of all lumbar facet joints was determined from the axial computed tomography scans. We defined the facet joints ipsilateral and contralateral to the dominant hand as dominant and nondominant, respectively. The nondominant-to-dominant (N/D) ratio of the lateral diameter was calculated, and differences between the pitchers and fielders were analyzed using the unpaired t test.

Results:

The average player age and length of professional playing experience were 26.9 years (range, 19-37 years) and 7.2 years (range, 1-15 years), respectively. The right hand was dominant in 9 pitchers and 5 fielders, while the left hand was dominant in 2 pitchers and 9 fielders. In pitchers, the average lateral facet joint diameter on the nondominant side was significantly larger than on the dominant side at all vertebral levels except L1 to L2 ( P < .05 for all). The N/D ratio for each facet joint was 1.06 (L1-L2), 1.11 (L2-L3), 1.10 (L3-L4), 1.12 (L4-L5), and 1.12 (L5-S1). In fielders, the average lateral facet joint diameter on the dominant side was significantly larger than on the nondominant side at L3 to L4 ( P < .05), with N/D ratios of 0.98 (L1-L2), 0.96 (L2-L3), 0.94 (L3-L4), 0.97 (L4-L5), and 0.98 (L5-S1). The N/D ratio was significantly larger in pitchers than in fielders at all levels ( P < .05 for all).

Conclusion:

The facet joints of professional baseball players were enlarged asymmetrically, with different tendencies observed between pitchers and fielders. Although pitching and batting are movements that transmit the rotation from the lower limbs to the upper limbs, the effects of rotation and lateral flexion were associated significantly with facet joint hypertrophy.
Comparison of Early Complication Rates After High Tibial Osteotomy Versus Unicompartmental Knee Arthroplasty for Knee Osteoarthritis
Authors: Karasavvidis Theofilos , Fackler Nathan P. , Callan Kylie T. , Lung Brandon E. , Wang Dean
Published: January 2024

Background:

Although both high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) can be utilized to treat unicompartmental osteoarthritis (OA) in select patients, the early complication rates between the 2 procedures are not well understood. Understanding of the complication profiles for both procedures would help clinicians counsel patients with unicompartmental knee OA who may be eligible for either treatment option.

Purpose:

To compare the 30-day complication rates after HTO versus UKA for the treatment of knee OA using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

NSQIP registries between 2006 and 2019 were queried using Current Procedural Terminology codes to identify patients undergoing HTO and UKA for knee OA. Patients >60 years of age were excluded. Patient demographics, preoperative comorbidities, and intraoperative data were collected. Postoperative 30-day complications, including venous thromboembolism (VTE), urinary tract infection (UTI), transfusion, surgical-site infection (SSI), and reoperations were recorded. Complication rates between treatment groups were compared using a multivariate logistic regression model adjusted for sex, age, body mass index, steroid use, respiratory status (smoking/dyspnea/chronic obstructive pulmonary disease), diabetes, and hypertension.

Results:

A total of 156 patients treated with HTO and 4755 patients treated with UKA for knee OA were identified. Mean patient ages were 46 years for the HTO group and 53.4 years for the UKA group. Operative time was significantly longer in the HTO group versus the UKA group (112 minutes vs 90 minutes; P < .001). Multivariate analyses found no significant differences in VTE (1.3% vs 0.6%), UTI (0.6% vs 0.3%), transfusion (0.6% vs 0.2%), deep SSI (0.6% vs 0.1%), and reoperation (1.3% vs 1%) rates between HTO and UKA groups. The HTO group had a higher rate of superficial SSI compared with the UKA group (2.6% vs 0.6%; P = .006) (adjusted odds ratio, 4.2; 95% CI, 1.4-12.5; P = .01).

Conclusion:

There were no differences in 30-day VTE, UTI, transfusion, deep SSI, and reoperation rates for HTO versus UKA in the treatment of knee OA. HTO was associated with a higher rate of superficial SSI compared with UKA. These findings serve to guide clinicians in counseling patients regarding the early risks after HTO and UKA.
State-of-the-art epoxy vitrimer nanocomposites with graphene, carbon nanotube and silica—fundamentals and applications (radiation shielding, sensing and corrosion resistance)
Authors: Kausar Ayesha , Ahmad Ishaq
Published: January 2024

Recent research is shifting towards adopting recyclable and sustainable plastics instead of traditionally used thermosetting materials. Accordingly, vitrimers behave both as thermoplastics as well as thermosetting polymers. Inimitable vitrimer polymers have been developed with dynamically crosslinked structures enhancing the durability, reprocessing, and mechanical and chemical stability features. This state-of-the-art review discusses vitrimer nanocomposites reinforced with carbonaceous (carbon nanotube, graphene, and graphene oxide) and inorganic (silica, halloysite nanotube) nanofillers has been particularly emphasized. Beneficial structural, microstructural, mechanical strength, modulus, thermal, conducting, reprocessing, engineering, shape memory, self-healing, kinetic, and theoretical topographies have been observed with vitrimers or modified vitrimers (disulfide or ether functional) matrices along with nano-reinforcements towards multifunctional architectures. High-tech vitrimeric nanocomposites show potential regarding electromagnetic shielding, anticorrosion coatings, sensors, joints welding, adhesives, and other sectors. Versatile design compensations, degradability, reprocessability, and methodological features/applications point towards next-generation sustainable materials for modern industries. Hence, this article presents advancements in the field of high performance vitrimeric nanocomposites.
The intrinsic coagulation pathway plays a dominant role in driving hypercoagulability in ANCA-associated vasculitis
Authors: Busch Matthias H. , Ysermans Renée , Aendekerk Joop P. , Timmermans Sjoerd A. M. E. G. , Potjewijd Judith , Damoiseaux Jan G. M. C. , Spronk Henri M. H. , ten Cate Hugo , Reutelingsperger Chris P. , Nagy Magdolna , van Paassen Pieter
Published: January 2024

The risk of a venous thrombotic event (VTE) is increased in patients with antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV); however, a detailed understanding of the underlying mechanisms of hypercoagulability is limited. We assessed prospectively different coagulation parameters in 71 patients with active AAV at baseline and after 6 months of follow-up. D-dimers and fibrinogen were increased in most patients at presentation and remained elevated in half of the patients. Particularly, thrombin-antithrombin (T:AT) complex and activated coagulation factors in complex with their natural inhibitors of the intrinsic coagulation pathway (ie, activated FXII:C1 esterase inhibitor [FXIIa:C1Inh], FXIa:AT, and FXIa:alpha1-antitrypsin [FXIa:α1AT]) were profoundly elevated in patients at baseline. Thrombin formation was dominantly correlated with coagulation factors of the intrinsic pathway (ie, FXIIa:AT, FXIa:AT, FXIa:α1AT, and FXIa:C1Inh) compared to the extrinsic pathway (ie, FVIIa:AT). Hypercoagulability correlated with higher disease activity, ANCA levels, C-reactive protein, serum creatinine, and proteinuria. VTEs were observed in 5 out of 71 (7%) patients within 1 month (interquartile range, 1-5) after inclusion. Baseline T:AT levels were significantly higher in patients with VTE than in those without VTE (P = .044), but other clinical or laboratory markers were comparable between both groups. Hypercoagulability is dominantly characterized by activation of the intrinsic coagulation pathway and elevated D-dimers in active AAV. The driving factors of hypercoagulability are yet to be studied but are most likely related to an interplay of increased disease activity, vascular inflammation, and endothelial damage. Future targets for intervention could include inhibitors of the intrinsic coagulation pathway and compounds specifically reducing the hyperinflammatory state.
Genetic approaches reveal a healthy population and an unexpectedly recent origin for an isolated desert spring fish
Authors: Sidlauskas Brian L. , Mathur Samarth , Aydoğan Hakan , Monzyk Fred R. , Black Andrew N.
Published: January 2024

Foskett Spring in Oregon’s desert harbors a historically threatened population of Western Speckled Dace (Rhinichthys klamathensis). Though recently delisted, the dace’s recruitment depends upon regular removal of encroaching vegetation. Previous studies assumed that Foskett Dace separated from others in the Warner Valley about 10,000 years ago, thereby framing an enigma about the population’s surprising ability to persist for so long in a tiny habitat easily overrun by plants. To investigate that persistence and the effectiveness of interventions to augment population size, we assessed genetic diversity among daces inhabiting Foskett Spring, a refuge at Dace Spring, and three nearby streams. Analysis revealed a robust effective population size (Ne) of nearly 5000 within Foskett Spring, though Ne in the Dace Spring refuge is just 10% of that value. Heterozygosity is slightly lower than expected based on random mating at all five sites, indicating mild inbreeding, but not at a level of concern. These results confirm the genetic health of Foskett Dace. Unexpectedly, genetic differentiation reveals closer similarity between Foskett Dace and a newly discovered population from Nevada’s Coleman Creek than between Foskett Dace and dace elsewhere in Oregon. Demographic modeling inferred Coleman Creek as the ancestral source of Foskett Dace fewer than 1000 years ago, much more recently than previously suspected and possibly coincident with the arrival of large herbivores whose grazing may have maintained open water suitable for reproduction. These results solve the enigma of persistence by greatly shortening the duration over which Foskett Dace have inhabited their isolated spring.
Genome-wide identification and analysis of the GGCT gene family in wheat
Authors: Zhang Long , Sun Wanting , Gao Weidong , Zhang Yanyan , Zhang Peipei , Liu Yuan , Chen Tao , Yang Delong
Published: January 2024

Background

γ-glutamylcyclotransferase (GGCT), an enzyme to maintain glutathione homeostasis, plays a vital role in the response to plant growth and development as well as the adaptation to various stresses. Although the GGCT gene family analysis has been conducted in Arabidopsis and rice, the family genes have not yet been well identified and analyzed at the genome-wide level in wheat (Triticum aestivum L.).

Results

In the present study, 20 TaGGCT genes were identified in the wheat genome and widely distributed on chromosomes 2A, 2B, 2D, 3A, 4A, 5A, 5B, 5D, 6A, 6B, 6D, 7A, 7B, and 7D. Phylogenetic and structural analyses showed that these TaGGCT genes could be classified into three subfamilies: ChaC, GGGACT, and GGCT-PS. They exhibited similar motif compositions and distribution patterns in the same subgroup. Gene duplication analysis suggested that the expansion of TaGGCT family genes was facilitated by segmental duplications and tandem repeats in the wheat evolutionary events. Identification of diverse cis-acting response elements in TaGGCT promoters indicated their potential fundamental roles in response to plant development and abiotic stresses. The analysis of transcriptome data combined with RT-qPCR results revealed that the TaGGCTs genes exhibited ubiquitous expression across plant organs, with highly expressed in roots, stems, and developing grains. Most TaGGCT genes were up-regulated after 6 h under 20% PEG6000 and ABA treatments. Association analysis revealed that two haplotypes of TaGGCT20 gene displayed significantly different Thousand-kernel weight (TKW), Kernel length (KL), and Kernel width (KW) in wheat. The geographical and annual distribution of the two haplotypes of TaGGCT20 gene further revealed that the frequency of the favorable haplotype TaGGCT20-Hap-I was positively selected in the historical breeding process of wheat.

Conclusion

This study investigated the genome-wide identification, structure, evolution, and expression analysis of TaGGCT genes in wheat. The motifs of TaGGCTs were highly conserved throughout the evolutionary history of wheat. Most TaGGCT genes were highly expressed in roots, stems, and developing grains, and involved in the response to drought stresses. Two haplotypes were developed in the TaGGCT20 gene, where TaGGCT20-Hap-I, as a favorable haplotype, was significantly associated with higher TKW, KL, and KW in wheat, suggesting that the haplotype is used as a function marker for the selection in grain yield in wheat breeding.
The role of family support in the self-rated health of older adults in eastern Nepal: findings from a cross-sectional study
Authors: Shrestha Aman , Ghimire Saruna , Kinney Jennifer , Mehta Ranju , Mistry Sabuj Kanti , Saito Shoko , Rayamajhee Binod , Sharma Deepak , Mehta Suresh , Yadav Uday Narayan
Published: January 2024

Background

Nepal’s low fertility rate and increasing life expectancy have resulted in a burgeoning older population. For millennia, filial piety shaped family cohesion and helped Nepali older adults achieve positive outcomes, but recently, it has been eroding. Furthermore, there are not enough institutional support options or alternatives to family-based care to deal with the biosocial needs of older adults. This study explored the association between family support and self-rated health among Nepali older adults.

Methods

A community-based cross-sectional survey in eastern Nepal’s two districts, Sunsari and Morang, interviewed 847 older adults (≥ 60 years). The final analytical sample was 844. Participants were asked whether they received assistance with various aspects of daily life and activities of daily living from their families. Multivariable logistic regression examined the association between family support and self-rated health.

Results

Participants who received support with various aspects of daily life had 43% higher odds of good health, but after adjusting for control variables, the result only approached statistical significance (p = 0.087). Those who received family assistance with activities of daily living had nearly four times higher odds (OR: 3.93; 95% CI: 2.58 – 5.98) of reporting good health than participants who lacked this support.

Conclusions

Given the important role of family support in Nepali older adults’ health, government programs and policies should create a conducive environment to foster family-based care until more comprehensive policies for older adults’ care can be put into effect. The results of this study can also help shape the global aging environment by highlighting the need for family support in older care, particularly in low-income nations with declining traditional care systems and weak social security policies.
Effectiveness and safety of azvudine in older adults with mild and moderate COVID-19: a retrospective observational study
Authors: Zhou Zhiguo , Zheng He , Xiao Gui’e , Xie Xiangping , Rang Jiaxi , Peng Danhong
Published: January 2024

Background

Azvudine has clinical benefits and acceptable safety against COVID-19, including in patients with comorbidities, but there is a lack of available data for its use in older adult patients. This study explored the effectiveness and safety of azvudine in older adults with mild or moderate COVID-19.

Methods

This retrospective cohort study included patients aged ≥80 diagnosed with COVID-19 at the Central Hospital of Shaoyang between October and November 2022. According to the therapies they received, the eligible patients were divided into the azvudine, nirmatrelvir/ritonavir, and standard-of-care (SOC) groups. The outcomes were the proportion of patients progressing to severe COVID-19, time to nucleic acid negative conversion (NANC), and the 5-, 7-, 10-, and 14-day NANC rates from admission.

Results

The study included 55 patients treated with azvudine (n = 14), nirmatrelvir/ritonavir (n = 18), and SOC (n = 23). The median time from symptom onset to NANC of the azvudine, nirmatrelvir/ritonavir, and SOC groups was 14 (range, 6–25), 15 (range, 11–24), and 19 (range, 18–23) days, respectively. The median time from treatment initiation to NANC of the azvudine and nirmatrelvir/ritonavir groups was 8 (range, 4–20) and 9 (range, 5–16) days, respectively. The median length of hospital stay in the three groups was 10.5 (range, 5–23), 13.5 (range, 10–21), and 17 (range, 10–23) days, respectively. No treatment-related adverse events or serious adverse events were reported.

Conclusion

Azvudine showed satisfactory effectiveness and acceptable safety in older adults with mild or moderate COVID-19. Therefore, azvudine could be a treatment option for this special patient population.
Sustained effort network for treatment of status epilepticus/European academy of neurology registry on adult refractory status epilepticus (SENSE-II/AROUSE)
Authors: Damien Charlotte , Leitinger Markus , Kellinghaus Christoph , Strzelczyk Adam , De Stefano Pia , Beier Christoph P. , Sutter Raoul , Kämppi Leena , Strbian Daniel , Taubøll Erik , Rosenow Felix , Helbok Raimund , Rüegg Stephan , Damian Maxwell , Trinka Eugen , Gaspard Nicolas
Published: January 2024

Background

Status Epilepticus (SE) is a common neurological emergency associated with a high rate of functional decline and mortality. Large randomized trials have addressed the early phases of treatment for convulsive SE. However, evidence regarding third-line anesthetic treatment and the treatment of nonconvulsive status epilepticus (NCSE) is scarce. One trial addressing management of refractory SE with deep general anesthesia was terminated early due to insufficient recruitment. Multicenter prospective registries, including the Sustained Effort Network for treatment of Status Epilepticus (SENSE), have shed some light on these questions, but many answers are still lacking, such as the influence exerted by distinct EEG patterns in NCSE on the outcome. We therefore initiated a new prospective multicenter observational registry to collect clinical and EEG data that combined may further help in clinical decision-making and defining SE.

Methods

Sustained effort network for treatment of status epilepticus/European Academy of Neurology Registry on refractory Status Epilepticus (SENSE-II/AROUSE) is a prospective, multicenter registry for patients treated for SE. The primary objectives are to document patient and SE characteristics, treatment modalities, EEG, neuroimaging data, and outcome of consecutive adults admitted for SE treatment in each of the participating centers and to identify factors associated with outcome and refractoriness. To reach sufficient statistical power for multivariate analysis, a cohort size of 3000 patients is targeted.

Discussion

The data collected for the registry will provide both valuable EEG data and information about specific treatment steps in different patient groups with SE. Eventually, the data will support clinical decision-making and may further guide the planning of clinical trials. Finally, it could help to redefine NCSE and its management.

Trial registration

NCT number: NCT05839418.
Factors and a model to predict three-month mortality in patients with acute fatty liver of pregnancy from two medical centers
Authors: Peng QiaoZhen , Zhu TeXuan , Huang JingRui , Liu YueLan , Huang Jian , Zhang WeiShe
Published: January 2024

Background

Acute fatty liver of pregnancy (AFLP) is an uncommon but potentially life-threatening complication. Lacking of prognostic factors and models renders prediction of outcomes difficult. This study aims to explore factors and develop a prognostic model to predict three-month mortality of AFLP.

Methods

This retrospective study included 78 consecutive patients fulfilling both clinical and laboratory criteria and Swansea criteria for diagnosis of AFLP. Univariate and multivariate cox regression analyses were used to identify predictive factors of mortality. Predictive efficacy of prognostic index for AFLP (PI-AFLP) was compared with the other four liver disease models using receiver operating characteristic (ROC) curve.

Results

AFLP-related three-month mortality of two medical centers was 14.10% (11/78). International normalised ratio (INR, hazard ratio [HR] = 3.446; 95% confidence interval [CI], 1.324–8.970), total bilirubin (TBIL, HR = 1.005; 95% CI, 1.000-1.010), creatine (Scr, HR = 1.007; 95% CI, 1.001–1.013), low platelet (PLT, HR = 0.964; 95% CI, 0.931–0.997) at 72 h postpartum were confirmed as significant predictors of mortality. Artificial liver support (ALS, HR = 0.123; 95% CI, 0.012–1.254) was confirmed as an effective measure to improve severe patients’ prognosis. Predictive accuracy of PI-AFLP was 0.874. Area under the receiver operating characteristic curves (AUCs) of liver disease models for end-stage liver disease (MELD), MELD-Na, integrated MELD (iMELD) and pregnancy-specific liver disease (PSLD) were 0.781, 0.774, 0.744 and 0.643, respectively.

Conclusion

TBIL, INR, Scr and PLT at 72 h postpartum are significant predictors of three-month mortality in AFLP patients. ALS is an effective measure to improve severe patients’ prognosis. PI-AFLP calculated by TBIL, INR, Scr, PLT and ALS was a sensitive and specific model to predict mortality of AFLP.
The value of CT shape quantification in predicting pathological classification of lung adenocarcinoma
Authors: guo Mingjie , Cao Zhan , Huang Zhichao , Hu Shaowen , Xiao Yafei , Ding Qianzhou , Liu Yalong , An Xiaokang , Zheng Xianjie , Zhang Shuanglin , Zhang Guoyu
Published: January 2024

Objective

To evaluate whether quantification of lung GGN shape is useful in predicting pathological categorization of lung adenocarcinoma and guiding the clinic.

Methods

98 patients with primary lung adenocarcinoma were pathologically confirmed and CT was performed preoperatively, and all lesions were pathologically ≤ 30 mm in size. On CT images, we measured the maximum area of the lesion’s cross-section (MA). The longest diameter of the tumor (LD) was marked with points A and B, and the perpendicular diameter (PD) was marked with points C and D, which was the longest diameter perpendicular to AB. and D, which was the longest diameter perpendicular to AB. We took angles A and B as big angle A (BiA) and small angle A (SmA). We measured the MA, LD, and PD, and for analysis we derived the LD/PD ratio and the BiA/SmA ratio. The data were analysed using the chi-square test, t-test, ROC analysis, and binary logistic regression analysis.

Results

Precursor glandular lesions (PGL) and microinvasive adenocarcinoma (MIA) were distinguished from invasive adenocarcinoma (IAC) by the BiA/SmA ratio and LD, two independent factors (p = 0.007, p = 0.018). Lung adenocarcinoma pathological categorization was indicated by the BiA/SmA ratio of 1.35 and the LD of 11.56 mm with sensitivity of 81.36% and 71.79%, respectively; specificity of 71.79% and 74.36%, respectively; and AUC of 0.8357 (95% CI: 0.7558–0.9157, p < 0.001), 0.8666 (95% CI: 0.7866–0.9465, p < 0.001), respectively. In predicting the pathological categorization of lung adenocarcinoma, the area under the ROC curve of the BiA/SmA ratio combined with LD was 0.9231 (95% CI: 0.8700-0.9762, p < 0.001), with a sensitivity of 81.36% and a specificity of 89.74%.

Conclusions

Quantification of lung GGN morphology by the BiA/SmA ratio combined with LD could be helpful in predicting pathological classification of lung adenocarcinoma.
Diagnostic status and epidemiological characteristics of community-acquired bacterial meningitis in children from 2019 to 2020: a multicenter retrospective study
Authors: Liu Juan-Juan , Xu Zhi-Wei , Xu Hui-Qing , Zhu Jia-Jun , Zhang Jie-Ning , Fang Sheng , Yuan Sheng-Fu , Ge He-Jia , Li Hai-Jing , Lou Wen-Ji , Chen Li-Hua , Gao Feng , Chen Ying-Hu
Published: January 2024

Community-acquired bacterial meningitis (CABM) is the main cause of morbidity and mortality in children. The epidemiology of CABM is regional and highly dynamic. To clarify the diagnostic status and epidemiological characteristics of children with CABM in this region, and pay attention to the disease burden, so as to provide evidence for the prevention and treatment of CABM. By retrospective case analysis, the clinical data of 918 CABM cases in children aged 0–14 years in Zhejiang Province from January, 2019 to December, 2020 were collected. The etiological diagnosis rate of CABM in children was 23.1%, the annual incidence rate 4.42–6.15/100,000, the annual mortality rate 0.06–0.09/100,000,the cure and improvement rate 94.4%, and the case fatality rate 1.4%. The total incidence of neuroimaging abnormalities was 20.6%. The median length of stay for CABM children was 20(16) days, with an average cost of 21,531(24,835) yuan. In addition, the incidence rate was decreased with age. Escherichia coli(E.coli) and group B Streptococcus agalactiae(GBS) were the principal pathogens in CABM infant<3 months(43.3%, 34.1%), and Streptococcus pneumoniae(S. pneumoniae) was the most common pathogen in children ≥ 3 months(33.9%). In conclusion, the annual incidence and mortality of CABM in children aged 0–14 years in Zhejiang Province are at intermediate and low level. The distribution of CABM incidence and pathogen spectrum are different in age; the incidence of abnormal neuroimaging is high; and the economic burden is heavy.
Optimizing HIV case identification among children and understanding remaining gaps in pediatric HIV testing in Kinshasa, DRC
Authors: Ingala Dominique , Bakebua Winnie , Banzadio Fideline , Tshishi Dieudonne , Loando Aime , Mboyo Aimé , Gill Michelle M.
Published: January 2024

Background

It is critical to identify children living with HIV and initiate lifesaving antiretroviral treatment (ART) early. The Pediatric Accelerated Case Finding Effort focused on contact elicitation and HIV testing of ART clients’ biological children. We describe HIV testing and seropositivity rates following the initiative and gaps along the index testing cascade to inform pediatric HIV case finding optimization.

Methods

This mixed-methods study involved collecting monthly data on index testing outcomes, including elicitation (identifying biological children < 15 years), HIV testing and linkage to treatment from March 2020 to July 2021 in 35 facilities in Kinshasa. Data were summarized and presented for the first month (as a baseline proxy) and the entire study period. Qualitative data were collected from 14 healthcare workers participating in in-depth interviews and 33 community health workers in four focus group discussions. Audio recordings were transcribed and translated from Lingala or French into English and coded using MAXQDA software. Data were thematically analyzed according pediatric case finding barriers and strategies.

Results

At baseline (March 2020), among 3337 eligible female index clients, 1634 (49.0%) underwent elicitation to identify children with unknown HIV status. By July 2021, all eligible clients (n = 11,734) had contacts identified. Of the contacts, 9871/11,848 (83.3%) were HIV-tested. Of contacts tested, 662 (6.7%) were diagnosed as HIV-positive, with 535 (80.8%) age 5–14 years; 99.5% initiated treatment. Providers attributed gaps in HIV testing primarily to testing refusals for children due to non-disclosure among parents and logistical or financial obstacles to transportation for tracing. COVID-19 movement restrictions and exposure fears also limited provider interactions for testing. Provider-implemented strategies included transport reimbursement, extensive counseling and alternative approaches to child testing for parents in sero-discordant relationships.

Conclusions

Following intensified efforts around pediatric case finding, we found a high HIV positivity yield of 6.7% among previously undiagnosed children, with 81% of them aged ≥5 years. While elicitation improved over time, contact tracing for HIV testing remained the largest gap, missing opportunities to reach 17% of undiagnosed children. Ensuring adequate resources for tracing and HIV testing and supporting disclosure among couples, while emphasizing elicitation of ART clients’ biological children can help to optimize pediatric case finding.
Characterization of newly diagnosed type 1 diabetes in children and adolescents from 2017 to 2022 in China: a single-center analysis
Authors: Wu Shimin , Gao Yuan , Guo Shusen , Fu Lina , Ying Yanqin , Wu Wei , Hou Ling , Liang Yan , Luo Xiaoping
Published: January 2024

Objective

This study investigated the characteristics of newly diagnosed type 1 diabetes mellitus (T1DM) related to autoimmunity and the frequency of diabetic ketoacidosis (DKA) in children and adolescents from 2017–2022 in China.

Research design and methods

Single-center regional data from the Department of Pediatric Endocrinology, Tongji Hospital, were used to compare 88 children and adolescents newly diagnosed with T1DM from 2020 to 2022 (i.e. during the COVID-19 pandemic in China) and 76 children and adolescents diagnosed with T1DM from 2017 to 2019. Auto-antibodies, including glutamic acid decarboxylase-65 and insulin auto-antibodies, were detected by enzyme-linked immunoassays. DKA was defined as a pH < 7.3 and/or a bicarbonate level < 15 mmol/L.

Results

The median age of the 164 children and adolescents newly diagnosed with T1DM from 2017 to 2022 was 7.0 years (interquartile range [IQR]: 3.8–10.0 years; 51.83% male). The mean annual incidence of T1DM was 2.98 per 1,000,000 child years. The estimated frequency of auto-antibody positivity was 51.22% (n = 84), and there was no difference between the 2020–2022 group and 2017–2019 group (55.68% [n = 49] vs. 46.5% [n = 35]; p = 0.219). The frequency of DKA among the entire cohort was 57.93% (n = 95), and peaked in 2020 at 78.9% (15/19 patients). The frequency of DKA was not significantly higher in the 2020–2022 group compared with the 2017–2019 group (60.23% [n = 53] vs. 55.26% [n = 42]; p = 0.521). We found no significant difference in the frequency of DKA between patients who were negative vs. positive for auto-antibodies in the 2020–2022 group (64.10% [n = 25] vs. 57.14% [n = 28], p > 0.05). The C-peptide level and HbA1c (%) were positively correlated with onset age (R1 = 0.389, p < 0.01; R2 = 0.371, p < 0.01), and the estimated mean C-peptide level was 0.26 ng/ml (IQR: 0.2–0.4 ng/ml) in patients with DKA and 0.370 ng/ml (IQR: 0.2–0.6 ng/ml) in patients without DKA (p = 0.044).

Conclusions

This study showed the annual incidence of T1DM was 2.98 per 1,000,000 child years, gradually increased over the study period, and there was no significant increase in T1DM with auto-antibody positivity in children and adolescents newly diagnosed from 2020–2022 in China compared with the previous 3 years. Furthermore, the frequency of DKA was peaked in 2020, and were not significantly different between patients who were negative vs. positive for auto-antibodies.