bluuebunny/crossref_metadata_2025 huggingface dataset:
Public Health Training Centers: More Relevant Than Ever
Authors: Fifolt Matthew , McCormick Lisa C. , Alperin Melissa
Published: March 2023

Interest in and awareness of public health in the United States has grown due to COVID-19; however, state and local health departments have seen a mass exodus of leadership since the beginning of the pandemic. Based on the results of the de Beaumont Foundation’s most recent Public Health Workforce Interests and Needs Survey (PH WINS), nearly one in three public health employees say they are considering leaving the profession due to stress, burnout, and low pay. One viable strategy for ensuring a diverse and competent public health workforce is the national network of Public Health Training Centers (PHTCs). This commentary describes the Public Health Training Center Network, with a specific focus on Region IV, and discusses challenges and opportunities for advancing the public health agenda in the United States. The national PHTC Network continues to provide invaluable services in terms of training, professional development, and experiential learning for the current and future public health workforce. However, increased funding would allow PHTCs to have a greater impact and reach through bridge programs for public health workers and others, additional field placement experiences, and expanded outreach to non-public health professionals in training activities. PHTCs have shown great adaptability over time and can once again pivot to meet the needs of a rapidly changing public health landscape demonstrating that PHTCs are truly more relevant than ever.
Telerehabilitation Initiated Early in Post-Stroke Recovery: A Feasibility Study
Authors: Edwards Dylan , Kumar Sapna , Brinkman Lorie , Ferreira Isabel Cardoso , Esquenazi Alberto , Nguyen Tiffany , Su Michael , Stein Stephanie , May Jaun , Hendrix Allison , Finley Casey , Howard Emily , Cramer Steven C.
Published: March 2023

Background

Enhanced neural plasticity early after stroke suggests the potential to improve outcomes with intensive rehabilitation therapy. Most patients do not get such therapy, however, due to limited access, changing rehabilitation therapy settings, low therapy doses, and poor compliance.

Objective

To examine the feasibility, safety, and potential efficacy of an established telerehabilitation (TR) program after stroke initiated during admission to an inpatient rehabilitation facility (IRF) and completed in the patient’s home.

Methods

Participants with hemiparetic stroke admitted to an IRF received daily TR targeting arm motor function in addition to usual care. Treatment consisted of 36, 70-minute sessions (half supervised by a licensed therapist via videoconference), over a 6-week period, that included functional games, exercise videos, education, and daily assessments.

Results

Sixteen participants of 19 allocated completed the intervention (age 61.3 ± 9.4 years; 6 female; baseline Upper Extremity Fugl–Meyer [UEFM] score 35.9 ± 6.4 points, mean ± SD; NIHSS score 4 (3.75, 5.25), median, IQR; intervention commenced 28.3 ± 13.0 days post-stroke). Compliance was 100%, retention 84%, and patient satisfaction 93%; 2 patients developed COVID-19 and continued TR. Post-intervention UEFM improvement was 18.1 ± 10.9 points ( P < .0001); Box and Blocks, 22.4 ± 9.8 blocks ( P = .0001). Digital motor assessments, acquired daily in the home, were concordant with these gains. The dose of rehabilitation therapy received as usual care during this 6-week interval was 33.9 ± 20.3 hours; adding TR more than doubled this to 73.6 ± 21.8 hours ( P < .0001). Patients enrolled in Philadelphia could be treated remotely by therapists in Los Angeles.

Conclusions

These results support feasibility, safety, and potential efficacy of providing intense TR therapy early after stroke.

Clinical Trial Registration:

clinicaltrials.gov; NCT04657770
Research on manufacturing of three component composite fiber with complex cross-section pattern
Authors: Yang Chongchang , Zhang Junping , Li Fei , Ye He , Yang Yingcui , Feng Pei
Published: March 2023

In this work, a preparation method of three-component composite fibers with complex cross-sectional patterns is proposed, and the fibers with complex cross-sectional patterns are fabricated using melt spinning. Initially, inspired by the shape of a fishbone, a spinning pack with three-component melt channels is designed for spinning fibers with a fishbone cross-sectional pattern. Then, the numerical simulation of the melt flow in the channels of the spinning pack is performed using Polyflow software. The spinning pack structure is optimized by analyzing the flow velocity distribution and shear rate distribution of different components within the spinning pack channels. The results show that smaller velocity fluctuations contribute to the clarity of the cross-sectional pattern. Thereafter, the spinning experiments are carried out based on the optimized spinning pack. The effect of the flow ratio between the three components on the cross-sectional pattern is discussed, and the three-component composite fibers with a clear fishbone cross-sectional pattern is obtained. Finally, in order to further study the effectiveness of the complex cross-sectional pattern fiber preparation proposed in this paper, another spinning pack for fibers with an H-shaped cross-sectional pattern is designed according to the aforementioned method, and spinning experiments are carried out. The SEM images of the cross-sections of fibers with fishbone and H-shaped cross-sectional patterns are obtained, verifying the feasibility of the method proposed in this paper. Moreover, the fibers with complex cross-sectional patterns obtained by this method have a certain anti-counterfeiting effect and can also be blended with other yarns to obtain fabrics with anti-counterfeiting effects.
Effect of antidepressants on psychological comorbidities, disease activity, and quality of life in inflammatory bowel disease: a systematic review and meta-analysis
Authors: Wang Liangfang , Liang Chang , Chen Pingrun , Cao Yubin , Zhang Yan
Published: March 2023

Background:

Patients with inflammatory bowel disease (IBD) are often accompanied by a more significant burden of depression or anxiety, and approximately one-third are prescribed antidepressants. However, previous studies on the efficacy of antidepressants in IBD have shown inconsistent results.

Objectives:

To evaluate the effect of antidepressants on depression, anxiety, disease activity, and quality of life (QoL) in IBD patients.

Design:

A systematic review and meta-analysis.

Methods:

We searched MEDLINE via Ovid, EMBASE via Ovid, the Cochrane Library, CINAHL, PsycINFO, Chinese CBM Database, China National Knowledge Infrastructure, VIP, and Wanfang Database from inception to 13th July 2022 without language restrictions.

Results:

In all, 13 studies containing 884 individuals were included. Compared with the control group, antidepressants were superior in reducing depression scores [standardized mean difference (SMD) = −0.791; 95% confidence interval (CI): −1.009 to −0.572; p < 0.001], anxiety scores (SMD = −0.877; 95% CI: −1.203 to −0.552; p < 0.001), and disease activity scores (SMD = −0.323; 95% CI: −0.500 to −0.145; p < 0.001). Antidepressants had a positive effect in reaching clinical remission [risk ratio (RR) = 1.383; 95% CI: 1.176–1.626; p < 0.001]. Higher physical QoL (SMD = 0.578; 95% CI: 0.025–1.130; p = 0.040), social QoL (SMD = 0.626; 95% CI: 0.073–1.180; p = 0.027), and Inflammatory Bowel Disease Questionnaire (SMD = 1.111; 95% CI: 0.710–1.512; p < 0.001) were found in the experimental group. No significant differences were observed in clinical response (RR = 1.014; 95% CI: 0.847–1.214; p = 0.881), psychological QoL (SMD = 0.399; 95% CI: −0.147 to 0.944; p = 0.152), and environmental QoL (SMD = 0.211; 95% CI: −0.331 to 0.753; p = 0.446).

Conclusion:

Antidepressants are effective for ameliorating depression, anxiety, disease activity, and QoL in IBD patients. Due to most studies having a small sample size, further well-designed studies are required.
Synthesis and Characterization of the Diastereomers of HHC and H4CBD
Authors: Collins Arianna , Ramirez Giovanni , Tesfatsion Tesfay , Ray Kyle P , Caudill Scott , Cruces Westley
Published: March 2023

The characterization of any compound is important in the field of chemistry. As the field of cannabinoid chemistry grows so does the need for the characterization of new cannabinoids or rare cannabinoids that gain popularity within the consumer and research fields. Hexahydrocannabinol (HHC) a hydrogenated analogue of Δ9-tetrahydrocannabinol (THC), also found in trace amounts naturally within the Cannabis sativa plant, has been gaining attention and popularity within the cannabis industry. Hexahydrocannabidiol (H4CBD) is a synthetic hydrogenated analogue to cannabidiol (CBD). Identifying the diastereomers of the cannabinoids with instrumentation plays a huge role within the chemistry field adding valuable information of the structure and the parameters for others to identify such cannabinoids. Elucidation and characterization of HHC and H4CBD were performed using current analytical techniques such as 1D and 2D nuclear magnetic resonance (NMR), high performance liquid chromatography (HPLC), and gas chromatography-mass spectrometry (GC-MS), effectively characterizing both the diastereomers of HHC and H4CBD.
Influence of Acute Melatonin Administration on Human Physical Performance: A Systematic Review
Authors: Faria Vinícius Silva , Messias Leonardo Henrique Dalcheco , Pejon Taciane Maria Melges , Beck Wladimir Rafael
Published: March 2023

Context:

Melatonin is an ancient molecule with a wide range of functions in mammals, such as antioxidant, anti-inflammatory, and hypothermic effects among others. However, the influence of acute melatonin administration on human physical performance is debatable.

Objective:

To summarize available data from controlled trials about the effects of acute melatonin administration on human physical performance, especially with respect to strength, power, speed, and short- and long-term continuous exercise.

Data Sources:

A systematic search of the PubMed, Web of Science, Scopus, Embase, and Cochrane databases up to December 10, 2021, was conducted using specified keywords and Boolean operators (“melatonin” AND “exercise OR circuit-based exercise OR plyometric exercise OR exercise tolerance OR exercise test”).

Study Selection:

Only controlled studies in the English language and with humans were accepted.

Study Design:

Systematic review.

Level of Evidence:

Level 1.

Data Extraction:

Participants’ characteristics (sex, age, body mass, height and fat percentage), melatonin dose and administration time, and outcomes from the performance trial were extracted.

Results:

A total of 10 studies were identified after the screening process. Overall, melatonin did not change speed or short-term continuous exercise performances. However, in relation to strength and power, the results are debatable since 5 articles showed no difference, while another 2 pointed to a decrease in performance. In terms of performance improvement, only 1 study reported an increase in balance and another in long-term continuous exercise performance in nonathletes, with no advantage found for athletes.

Conclusion:

Melatonin did not cause any significant change in strength, speed, power, and short-term continuous exercise performances. In fact, it led to reduced strength and power performances in specific tests. On the other hand, melatonin seems to have improved balance and long-term continuous exercise performance, at least in nonathletes. More investigations are required to corroborate these findings.
Effect of Scapular Stabilizer Muscles Strength on Scapular Position
Authors: Micoogullari Mehmet , Uygur S. Fatma , Yosmaoglu H. Baran
Published: March 2023

Background:

Maintaining scapular mechanics is important for upper extremity functionality and posture. Determining the extent to which the scapular stabilizer muscles affect the scapular position may guide the creation of an exercise program for people with scapular dyskinesis.

Hypothesis:

The serratus anterior (SA), upper trapezius (UT), middle trapezius (MT), and lower trapezius (LT) muscles play different roles on scapular position when humeral elevation increase.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 4.

Methods:

A total of 70 women aged 40 to 65 years (mean age, 49 ± 7 years) who met the inclusion criteria were included in the study. Isometric muscle strength of the SA, UT, MT, and LT was evaluated with a handheld dynamometer. For assessment of scapular position, the lateral scapular slide test (LSST) was used. Multiple stepwise regression analysis was used to evaluate scapular parameters.

Results:

There were positive and statistically significant correlations between the isometric muscle strength of the SA, UT, MT, and LT muscles and the values at different humerus positions in the LSST ( P < 0.05). The UT and SA muscles greatly affected the changes in the position of the inferior region of the scapula ( R2 > 24.5%). The LT (11.3%) in neutral position, MT (25.4%) with arm abducted at 45°, and SA (34.5%) with arm abducted 90° had a major effect on the changes in the mediolateral position of the scapula.

Conclusion:

While the LT muscle affects the mediolateral position of the scapula to a large extent, the strength of the MT and SA muscles becomes effective as the shoulder elevation increases. SA and UT muscle strength have a greater effect on the position of the inferior region of the scapula.

Clinical Relevance:

Dyskinesis can be observed at different levels of the scapula; therefore, it is important to determine at which level the dyskinesis is more prominent for each individual and consequently to form a personalized exercise program to increase function and control dyskinesis.
Differences in Short-Term Sport-Specific Functional Recovery After Primary ACL Reconstruction in the Adolescent Athlete
Authors: Kemper W. Craig , Carpenter Connor M. , Wagner K. John , Chen Chien-Cheng , Saleem Laura , Wilson Philip L. , Ellis Henry B.
Published: March 2023

Background:

Although anterior cruciate ligament (ACL) injury rates have been studied extensively, it is unclear whether levels of functional and psychological readiness for return-to-sport after primary ACL reconstruction (ACLR) differ based on an athlete’s primary sport.

Hypothesis:

Youth athletes in different primary sports will demonstrate differences in short-term functional recovery, as well as patient-reported psychological and functional recovery after primary ACLR.

Study Design:

Retrospective cohort study of consecutive patients treated for ACL injury in pediatric sports medicine clinics.

Level of Evidence:

Level 3.

Methods:

Patients included underwent primary ACLR between December 1, 2015 and December 31, 2019 and reported sports participation at the time of injury. Demographic data, sports participation, surgical data, functional testing scores (Y-Balance Test [YBT]), functional and psychological patient-reported outcome measures (PROMs), and timing of return-to-play clearance were reviewed. YBT scores were the primary metric for clearance. Four groups were studied: soccer, football, basketball, and other.

Results:

A total of 220 male and 223 female athletes were included; 65.28% of soccer players were female and 100% of football players were male ( P < 0.01). At initial postoperative YBT testing (6-9 months), soccer players had higher operative ( P < 0.01) and nonoperative ( P < 0.01) leg composite scores when compared with basketball players. No significant differences were found between sports in functional or psychological PROMs at presurgical baseline or 6 months postoperatively. When compared with football, soccer players completed functional clearance in a shorter time from surgery ( P = 0.02). Multivariate analysis showed level of competition as a significant independent variable for clearance in female athletes.

Conclusion:

After primary ACLR, athletes, especially female athletes, demonstrated short-term sport-specific differences in YBT scores. Soccer players attained clearance sooner than football players. Level of competition influenced YBT composite scores in all athletes and time to clearance in female athletes.

Clinical Relevance:

Sport-specific differences in reinjury should be investigated to determine whether changes in return-to-play evaluation should be implemented.
Using an Internal Joint Stabilizer Through a Single Posterior Approach for Elderly Patients With Terrible Triad Injury
Authors: Chiu Yen-Chun , Wu Chin-Hsien , Tsai Kun-Ling , Jou I-Ming , Tu Yuan-Kun , Ma Ching-Hou
Published: March 2023

Introduction

Treating a terrible triad injury of the elbow remains a challenge for orthopedic surgeons, especially in elderly patients due to the poor quality of the surrounding soft tissue and bony structures. In the present study, we propose a treatment protocol using an internal joint stabilizer through a single posterior approach and analyze the clinical results.

Materials and Methods

We retrospectively reviewed 15 elderly patients with terrible triad injuries of the elbow who underwent our treatment protocol from January 2015 to December 2020. The surgery involved a posterior approach, identification of the ulnar nerve, bone and ligament reconstruction, and the application of the internal joint stabilizer. A rehabilitation program was initiated immediately after the operation. Surgery-related complications, elbow range of motion (ROM), and functional outcomes were evaluated.

Results

The mean follow-up period was 21.7 months (range, 16-36 months). ROM at the final follow-up was 130° in extension to flexion and 164° in pronation to supination. The mean Mayo Elbow Performance Score was 94 at the final follow-up. Major complications included breaking of the internal joint stabilizer in 2 patients, transient numbness over the ulnar nerve territory in one, and local infection due to irritation of the internal joint stabilizer in one.

Conclusions

Although the current study involved only a small number of patients and the protocol comprised two stages of operation, we believe that such a technique may be a valuable alternative for the treatment of these difficult cases.

Level of Clinical Evidence

4.
Tracing data for systematic reviews and meta-analyses in the advanced age of digital and social media
Authors: Gamage Nishadi , Ranasinghe Priyanga , Jayawardena Ranil
Published: March 2023

Background

When conducting reviews, obtaining unreported information by contacting corresponding authors via traditional methods of correspondence, such as email/postage has become increasingly challenging.

Objective/s

The current study aimed to identify the different non-traditional sources and approaches to obtain unreported data from respective authors of primary studies eligible for systematic reviews and meta-analyses.

Methods

Unreported data were obtained initially through traditional methods (email/telephone, searching forward citations of the articles, review of other publications of the same research team and perusal of authors’ institutional profiles). The second stage included communication through digital/social media, which comprised Facebook, ResearchGate, WhatsApp, Viber, LinkedIn, and the online Global Health Data Exchange (GHDx).

Results

During data extraction, 41 individual data items were missing/unreported, and we were able to identify 36 (87.8%) during data tracing, using both traditional ( n = 10, 27.8%) and digital and social media-based ( n = 26, 72.2%) methods. These 26 data items were identified through the following methods, (a) Facebook ( n = 6), (b) ResearchGate ( n = 3), (c) WhatsApp ( n = 3), (d) Viber ( n = 1), (e) LinkedIn ( n = 1) and GHDx database ( n = 12).

Conclusion

Digital/social media platforms were found to be more successful to obtain unreported data. We believe that a combination of both methods is likely to yield the best results in tracing missing data for systematic reviews. Journals should consider including social media links and non-institutional research profiles in addition to traditional methods for correspondence.
Differential prognosis of single and multiple TP53 abnormalities in high-count MBL and untreated CLL
Authors: Griffin Rosalie , Wiedmeier-Nutor Julia E. , Parikh Sameer A. , McCabe Chantal E. , O'Brien Daniel R. , Boddicker Nicholas J. , Kleinstern Geffen , Rabe Kari G. , Bruins Laura , Brown Sochilt , Bonolo de Campos Cecilia , Ding Wei , Leis Jose F. , Hampel Paul J. , Call Timothy G. , Van Dyke Daniel L. , Kay Neil E. , Cerhan James R. , Yan Huihuang , Slager Susan L. , Braggio Esteban
Published: March 2023

TP53 aberrations, including mutations and deletion of 17p13, are important adverse prognostic markers in chronic lymphocytic leukemia (CLL) but are less studied in high count monoclonal B-cell lymphocytosis (HCMBL), an asymptomatic pre-malignant stage of CLL. Here we estimated the prevalence and impact of TP53 aberrations in 1,230 newly diagnosed treatment-naïve individuals (849 CLL, 381 HCMBL). We defined TP53 state as: wild-type (no TP53 mutations and normal 17p), single-hit (del(17p) or one TP53 mutation), or multi-hit (TP53 mutation and del(17p), TP53 mutation and loss of heterozygosity, or multiple TP53 mutations). Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for time to first treatment and overall survival by TP53 state. We found 64 (7.5%) CLL patients and 17 (4.5%) HCMBL individuals had TP53 mutations with variant allele fraction >10%. Del(17p) was present in 58 (6.8%) of CLL and 11 (2.9%) of HCMBL cases. Most individuals had wild-type (N=1,128, 91.7%) TP53 state, followed by multi-hit (N=55, 4.5%) and then single-hit (N=47, 3.8%) TP53 state. The risk of shorter time to therapy and death increased with the number of TP53 abnormalities. Compared to wild-type patients, multi-hit patients had 3-fold and single-hit patients had 1.5-fold increased risk of requiring therapy. Multi-hit patients also had 2.9-fold increased risk of death compared to wild-type. These results remained stable after accounting for other known poor prognostic factors. Both TP53 mutations and del(17p) may provide important prognostic information for HCMBL and CLL that would be missed if only one were measured.
Distribution, remobilization and accumulation of organic contaminants by flood events in a meso-scaled catchment system
Authors: Schwanen Christina A. , Müller Jan , Schulte Philipp , Schwarzbauer Jan
Published: March 2023

Background

Extreme weather events and natural disasters such as floods can cause severe damage and impacts on catchment systems covering natural as well as urban, industrial or agricultural areas. Thus, floods often lead to the acute and unusual release of organic pollutants, as well as the remobilization of legacy contaminations or old burdens. Floodplains are then of major relevance for the accumulation of pollutants. Accordingly, various floodplains distributed throughout the course of the Rur River were sampled immediately after two flood events in January/February and July 2021. The main objective was to address the general lack of knowledge on indirect effects of flooding and the corresponding distribution and accumulation of organic pollutants regarding different dimensions and dynamics of flood events.

Results

Gas Chromatography/Mass Spectrometry (GC/MS) based non-target screenings revealed the presence of several lipophilic to moderate polar organic pollutant groups, including PAHs (polycyclic aromatic hydrocarbons), hopanes, PCBs (polychlorinated biphenyls), LABs (linear alkylbenzenes) and various other industrial substances. These substances are indicators of petrogenic pollution, historical and current industry in the catchment area, and of wastewater and urban pollution, respectively. In general, concentrations detected after the extreme summer flood were higher than in winter. This points to additional emission sources due to substantially higher discharges and consequently more severe flooding in July. The main tributaries also had a major influence on the input and concentrations of organic pollutants at the receiving Rur River. Further on, structural features such as dams and reservoirs, but also (re)naturalized areas were clearly recognizable in the flood-related dispersion of organic pollutants. Interestingly, LAB contamination was similar after both flood events regardless of the specific dimension.

Conclusions

Flood dimension and frequency are of great relevance for the distribution, remobilization and accumulation of organic contaminants. However, special attention should be given to the introduction of wastewater pollutants for any flood extent. Overall, organic indicators are therefore very useful to obtain information on specific distribution patterns and the influence of tributaries or structural measures, providing an important basis for the assessment of short- and long-term environmental risks and hazards.
EPO regulates neuronal differentiation of adult human neural-crest derived stem cells in a sex-specific manner
Authors: Niemann Tarek , Greiner Johannes F.W. , Kaltschmidt Christian , Kaltschmidt Barbara
Published: March 2023

Background

Sexual differences in the biology of human stem cells are increasingly recognized to influence their proliferation, differentiation and maturation. Especially in neurodegenerative diseases such as Alzheimers disease (AD), Parkinson’s disease (PD) or ischemic stroke, sex is a key player for disease progression and recovery of damaged tissue. Recently, the glycoprotein hormone erythropoietin (EPO) has been implicated as a regulator of neuronal differentiation and maturation in female rats.

Methods

In this study, we used adult human neural crest-derived stem cells (NCSCs) as a model system for exploring potential sex specific effects of EPO on human neuronal differentiation. We started with expression validation of the specific EPO receptor (EPOR) by performing PCR analysis in the NCSCs. Next, EPO mediated activation of nuclear factor-κB (NF-κB) via Immunocytochemistry (ICC) was performed, followed by investigating the sex-specific effects of EPO on neuronal differentiation by determining morphological changes in axonal growth and neurite formation accompanied by ICC.

Results

Undifferentiated male and female NCSCs showed a ubiquitous expression of the EPO receptor (EPOR). EPO treatment resulted in a statistically profound (male p = 0.0022, female p = 0.0012) nuclear translocation of NF-κB RELA in undifferentiated NCSCs of both sexes. But after one week of neuronal differentiation, we could show a highly significant (p = 0,0079) increase of nuclear NF-κB RELA in females only. In contrast, we observed a strong decrease (p = 0,0022) of RELA activation in male neuronal progenitors. Extending the view on the role of sex during human neuronal differentiation, here we demonstrate a significant increase of axon lengths in female NCSCs-derived neurons upon EPO-treatment (+ EPO: 167,73 (SD = 41,66) µm, w/o EPO: 77,68 (SD = 18,31) µm) compared to their male counterparts (+ EPO: 68,37 (SD = 11,97) µm, w/o EPO: 70,23 (SD = 12,89) µm).

Conclusion

Our present findings therefore show for the first time an EPO-driven sexual dimorphism in neuronal differentiation of human neural-crest derived stem cells and emphasize sex-specific variability as a crucial parameter in stem cell biology and for treating neurodegenerative diseases.
A realist evaluation of the feasibility of a randomised controlled trial of a digital music and movement intervention for older people living in care homes
Authors: Ofosu E.F , De Nys L , Connelly J , Ryde G.C , Whittaker A.C
Published: March 2023

Background

Low physical activity in care home residents brings about negative mental health consequences, such as higher levels of depression and loneliness. With advancements in communication technology, particularly during the COVID-19 pandemic, the feasibility and effectiveness of a randomised controlled trial (RCT) of a digital Physical Activity (PA) resource in care homes deserve more research attention. A realist evaluation was used to uncover influencing factors of a feasibility study implementation to inform how a digital music and movement programme would work and under what circumstances this would be most effective.

Methods

Participants were 49 older adults (aged 65 years +) recruited across ten care homes in Scotland. Surveys were administered at baseline and post-intervention comprising psychometric questionnaires on multidimensional health markers validated in older adults with possible cognitive impairment. The intervention comprised 12 weeks of four prescribed digitally delivered movement (n = 3) and music-only (n = 1) sessions per week. An activity coordinator delivered these online resources in the care home. Post-intervention focus groups with staff and interviews with a sub-sample of participants were conducted to gain qualitative data on the acceptability of the intervention.

Results

Thirty three care home residents started the intervention, but only 18 residents (84% female) completed both pre- and post-intervention assessments. Activity coordinators (AC) offered 57% of the prescribed sessions, with an average residents’ adherence of 60%. Delivery of the intervention did not go as planned due to Covid restrictions in care homes and delivery challenges, including (1) motivation and engagement, (2) changes in cognitive impairment and disabilities of the participants, (3) death or hospitalisation of the participants and (4) limited staffing and technology resources to deliver the programme as intended.

Despite this, group participation and encouragement of residents supported the delivery and acceptance of the intervention, with ACs and residents reporting improved mood, physical health, job satisfaction and social support. Improvements with large effect sizes were found for anxiety, depression, loneliness, perceived stress and sleep satisfaction, but no changes in fear of falling, domains of general health or appetite.

Conclusion

This realist evaluation suggested that this digitally delivered movement and music intervention is feasible. From the findings, the initial programme theory was refined for future implementation of an RCT in other care homes but future research exploring how to tailor the intervention to those with cognitive impairment and/or lacking capacity to consent is needed.

Trial registration

Retrospectively registered at ClinicalTrials.gov NCT05559203.
Incidence trends of oral cavity, oropharyngeal, hypopharyngeal and laryngeal cancers among males in Taiwan, 1980–2019: a population-based cancer registry study
Authors: Tsai Yu-Shiun , Chen Yong-Chen , Chen Tzu-I , Lee Yu-Kwang , Chiang Chun-Ju , You San-Lin , Hsu Wan-Lun , Liao Li-Jen
Published: March 2023

In a country with a high prevalence of cigarette smoking, betel chewing, and alcohol drinking, cancers of the oral cavity, nasopharynx, and larynx were the fourth, twelfth and seventeenth leading causes of cancer death, respectively, for men in 2020. We analyzed patients with head and neck cancer from 1980 to 2019 from the Taiwan Cancer Registration Database and discussed the annual average percent change, average percent change, age period, and birth cohort. Obvious period effects and birth effects are seen in oral, oropharyngeal, and hypopharyngeal cancer; however, the most significant period effect was seen between 1990 and 2009, which mainly reflects the consumption of betel nuts per capita. In addition, the period effect lessens after 2010 in oral cancer and hypopharyngeal cancers, while oropharyngeal cancers remain an obvious period effect, which results from the rising prevalence of HPV. Due to the high prevalence rate of betel quid chewing and cigarette smoking in the 1990s, the government executed several acts. As a result, the age-adjusted incidence rates of oral, oropharyngeal, and hypopharyngeal cancers have flattened since 2010, which can be explained by the declining cigarette smoking rate. The strict policy indeed shows an obvious effect on the head and neck cancer incidence rates, and we expect to see a further decline in the future.
Association of sleep apnea and depressive symptoms among US adults: a cross-sectional study
Authors: Li Mei , Zou Xue , Lu Hongbin , Li Fang , Xin Yang , Zhang Wenwen , Li Bo , Wang Ying
Published: March 2023

Background

Sleep apnea exerts adverse health effects due to inflammation and metabolic disruption. It is associated with metabolic diseases. However, the evidence of its relationship with depression is inconsistent. Therefore, this study aimed to investigate the relationship between sleep apnea and depressive symptoms in adults in the United States.

Methods

This study utilized data from the National Health and Nutrition Examination Survey (NHANES), wherein the data from 2005 to 2018 of 9,817 individuals were obtained. Sleep apnea was self-reported by the participants using a questionnaire on sleep disorders. The 9-item Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms. We implemented multivariable logistic regression and stratified analyses to assess the correlation between sleep apnea and depressive symptoms.

Results

A total of 515 (6.6%) participants among 7,853 non-sleep apnea participants and 269 (13.7%) subjects among 1,964 sleep apnea participants had a depression score ≥ 10, they were deemed to have depressive symptoms. The multivariable regression model, showed that individuals with sleep apnea were 1.36-fold more likely to experience depressive symptoms when adjusted for potential covariates (odds ratios [OR] with 95% confidence intervals of 2.36 [1.71–3.25]), and a positive correlation between depressive symptoms and sleep apnea severity was found. The stratified analyses, revealed that sleep apnea was related to an increased incidence of depressive symptoms in most subgroups, except for those with coronary heart disease. Further, there was no interaction between sleep apnea and the covariates.

Conclusions

Adults with sleep apnea in the US have a relatively high prevalence of depressive symptoms. and the severity of sleep apnea positively correlated with the depressive symptoms.
Effects of music therapy as an alternative treatment on depression in children and adolescents with ADHD by activating serotonin and improving stress coping ability
Authors: Park Jong-In , Lee In-Ho , Lee Seung-Jea , Kwon Ryeo-Won , Choo Eon-Ah , Nam Hyun-Woo , Lee Jeong-Beom
Published: March 2023

Objective

The objective of this study was to determine the effect of music therapy as an alternative treatment on depression in children and adolescents with attention-deficit hyperactivity disorder (ADHD) by activating serotonin (5-HT) and improving stress coping ability.

Methods

This study is designed based on randomization method. A total of 36 subjects participated in the experiment, consisting of an ADHD control group (n = 18) and ADHD music therapy group (n = 18). The ADHD control group received standard care, while the ADHD music therapy group received music therapy and standard care. The ADHD music therapy group received both active music therapy (improvisation) and receptive music therapy (music listening) for 50 minutes, twice a week, for 3 months: a total of 24 times. From a neurophysiological perspective, changes in depression and stress were tracked by measuring 5-HT secretion, cortisol expression, blood pressure (BP), heart rate (HR), and CDI and DHQ psychological scales.

Results

The ADHD music therapy group’s 5-HT secretion increased (p < 0.001), whereas cortisol expression (p < 0.001), BP (p < 0.001) and HR (p < 0.001) decreased. The CDI and DHQ psychological scales also showed positive changes (p < 0.01 and p < 0.001, respectively). However, the ADHD Con G’s (who did not receive music therapy) 5-HT secretion did not increase, whereas cortisol expression, BP, and HR did not decrease. In addition, the CDI and DHQ psychological scales did not display positive changes.

Conclusions

In conclusion, the application of music therapy as an alternative treatment for ADHD children and adolescents showed positive neurophysiological and psychological effects. Therefore, this study would like to propose a new alternative to medicine for preventing and treating depression through various uses of music therapy.
Oral health providers’ views of oral health promotion in Jazan, Saudi Arabia: a qualitative study
Authors: Shubayr Mosa Ali , Kruger Estie , Tennant Marc
Published: March 2023

Background

Oral health promotion (OHP) is a crucial aspect of dental care, as it aims to improve and protect oral health of individuals. This study aimed to qualitatively explore views of oral health providers in Jazan, Saudi Arabia, on their perceptions of their responsibilities for OHP, as well as the barriers and potential opportunities for implementing health promotion in dental practice.

Methods

A convenience sample of 11 oral health providers from Ministry of Health (MOH) facilities were recruited and participated in virtual one-on-one semi-structured interviews, which were transcribed and analyzed using inductive thematic analysis with N-Vivo software.

Results

The results showed that the providers recognized the significant role and responsibility of OHP in improving oral health. However, several barriers hindered their OHP efforts, including a lack of training, funding, time, and a lack of interest in OHP. Potential opportunities for improvement included increasing recruitment of new oral health providers and educators, developing more training programs for providers and the community, and expanding support in terms of finances and logistics.

Conclusion

The findings of the study suggest that oral health providers are aware of OHP, but that both patients and organizations will need to shift their behaviours and perspectives for OHP to be successfully implemented. Further research on OHP in the Kingdom of Saudi Arabia (KSA) is needed to validate these findings.
Facilitators and barriers to the delivery of palliative care to patients with Parkinson’s disease: a qualitative study of the perceptions and experiences of stakeholders using the socio-ecological model
Authors: Chen Yiping , Zhang Ru , Lou Yan , Li Wei , Yang Hui
Published: March 2023

Objective

Palliative care (PC) can improve the quality of life of Parkinson’s disease (PD) patients and their carers. However, the impact of PC services on patients with PD remains unclear. This research was conducted to identify the barriers and facilitators influencing PC services for patients with PD based on the Social Ecological Model (SEM) framework.

Methods

This research was conducted through semi-structured interviews, employing SEM to organize themes and identify potential solutions across multiple levels.

Results

A total of 29 interviewees (5 PD clinicians, 7 PD registered nurses, 8 patients, 5 caregivers, and 4 policy makers) completed the interviews. Facilitators and barriers were identified according to the levels of the SEM. Several facilitators were identified, i.e., (1) individual level: the critical needs among PD patients and their relatives and the desire for PC knowledge among health professionals; (2) interpersonal level: social support; (3) organizational level: the investments towards systematization of PC; and nurses are the bridge between patients and doctors; (4) community level: the convenience of community services; and hospital-community-family-based services; (5) culture and policy level: existing policy.

Conclusion

The social-ecological model proposed in this study helps illuminate the complex and multilevel factors that may influence PC delivery to PD patients.
Endometriosis leads to central nervous system-wide glial activation in a mouse model of endometriosis
Authors: Bashir Shah Tauseef , Redden Catherine R. , Raj Kishori , Arcanjo Rachel B. , Stasiak Sandra , Li Quanxi , Steelman Andrew J. , Nowak Romana A.
Published: March 2023

Background

Chronic pelvic pain (CPP) is a common symptom of endometriosis. Women with endometriosis are also at a high risk of suffering from anxiety, depression, and other psychological disorders. Recent studies indicate that endometriosis can affect the central nervous system (CNS). Changes in the functional activity of neurons, functional magnetic resonance imaging signals, and gene expression have been reported in the brains of rat and mouse models of endometriosis. The majority of the studies thus far have focused on neuronal changes, whereas changes in the glial cells in different brain regions have not been studied.

Methods

Endometriosis was induced in female mice (45-day-old; n = 6–11/timepoint) by syngeneic transfer of donor uterine tissue into the peritoneal cavity of recipient animals. Brains, spines, and endometriotic lesions were collected for analysis at 4, 8, 16, and 32 days post-induction. Sham surgery mice were used as controls (n = 6/timepoint). The pain was assessed using behavioral tests. Using immunohistochemistry for microglia marker ionized calcium-binding adapter molecule-1 (IBA1) and machine learning “Weka trainable segmentation” plugin in Fiji, we evaluated the morphological changes in microglia in different brain regions. Changes in glial fibrillary acidic protein (GFAP) for astrocytes, tumor necrosis factor (TNF), and interleukin-6 (IL6) were also evaluated.

Results

We observed an increase in microglial soma size in the cortex, hippocampus, thalamus, and hypothalamus of mice with endometriosis compared to sham controls on days 8, 16, and 32. The percentage of IBA1 and GFAP-positive area was increased in the cortex, hippocampus, thalamus, and hypothalamus in mice with endometriosis compared to sham controls on day 16. The number of microglia and astrocytes did not differ between endometriosis and sham control groups. We observed increased TNF and IL6 expression when expression levels from all brain regions were combined. Mice with endometriosis displayed reduced burrowing behavior and hyperalgesia in the abdomen and hind-paw.

Conclusion

We believe this is the first report of central nervous system-wide glial activation in a mouse model of endometriosis. These results have significant implications for understanding chronic pain associated with endometriosis and other issues such as anxiety and depression in women with endometriosis.

Graphical Abstract
The association between abdominal obesity and femoral neck bone mineral density in older adults
Authors: Chen Jun , Zhu Liming , Yao Xiaocong , Zhu Zhongxin
Published: March 2023

Background

The relationship between obesity and osteoporosis is complex, with contradictory findings reported. Our aim was to evaluate the association between waist circumference (WC), as an easy-to-determine clinical index of abdominal obesity, and femoral neck bone mineral density (BMD) among older adults, using the National Health and Nutrition Examination Survey (NHANES) database.

Methods

Data of five NHANES cycles (2005–2010, 2013–2014, and 2017–2018), including 5801 adults aged ≥ 60 years, were used in the analysis. Weighted multiple regression analyses were performed to evaluate the association between WC and femoral neck BMD. Weighted generalized additive models and smooth curve fitting were further performed to characterize nonlinearities in the association.

Results

There was a positive association between WC and femoral neck BMD in non-adjusted models. After adjusting for body mass index (BMI), the association became negative. On subgroup analysis stratified by sex, this negative association only existed for men. An inverted U-shaped curve relationship between WC and femoral neck BMD was further identified, with an inflection point at a WC of 95 cm for both men and women.

Conclusions

Abdominal obesity is a negative predictor of bone health among older adults, independent of BMI. The association between WC and femoral neck BMD followed an inverted U-shaped curve.
Hyperoxemia after reperfusion in cardiac arrest patients: a potential dose–response association with 30-day survival
Authors: Awad Akil , Nordberg Per , Jonsson Martin , Hofmann Robin , Ringh Mattias , Hollenberg Jacob , Olson Jens , Joelsson-Alm Eva
Published: March 2023

Background

Hyperoxemia may aggravate reperfusion brain injury after cardiac arrest. The aim of this study was to study the associations between different levels of hyperoxemia in the reperfusion period after cardiac arrest and 30-day survival.

Methods

Nationwide observational study using data from four compulsory Swedish registries. Adult in- and out-of-hospital cardiac arrest patients admitted to an ICU, requiring mechanical ventilation, between January 2010 and March 2021, were included. The partial oxygen pressure (PaO2) was collected in a standardized way at ICU admission (± one hour) according to the simplified acute physiology score 3 reflecting the time interval with oxygen treatment from return of spontaneous circulation to ICU admission. Subsequently, patients were divided into groups based on the registered PaO2 at ICU admission. Hyperoxemia was categorized into mild (13.4–20 kPa), moderate (20.1–30 kPa) severe (30.1–40 kPa) and extreme (> 40 kPa), and normoxemia as PaO2 8–13.3 kPa. Hypoxemia was defined as PaO2 < 8 kPa. Primary outcome was 30-day survival and relative risks (RR) were estimated by multivariable modified Poisson regression.

Results

In total, 9735 patients were included of which 4344 (44.6%) were hyperoxemic at ICU admission. Among these, 2217 were classified as mild, 1091 as moderate, 507 as severe, and 529 as extreme hyperoxemia. Normoxemia was present in 4366 (44.8%) patients and 1025 (10.5%) had hypoxemia. Compared to the normoxemia group, the adjusted RR for 30-day survival in the whole hyperoxemia group was 0.87 (95% CI 0.82–0.91). The corresponding results for the different hyperoxemia subgroups were; mild 0.91 (95% CI 0.85–0.97), moderate 0.88 (95% CI 0.82–0.95), severe 0.79 (95% CI 0.7–0.89), and extreme 0.68 (95% CI 0.58–0.79). Adjusted 30-day survival for the hypoxemia compared to normoxemia group was 0.83 (95% CI 0.74–0.92). Similar associations were seen in both out-of-hospital and in-hospital cardiac arrests.

Conclusion

In this nationwide observational study comprising both in- and out-of-hospital cardiac arrest patients, hyperoxemia at ICU admission was associated with lower 30-day survival.
Identification and characterisation of the haemozoin of Haemonchus contortus
Authors: Liu Lu , Zhang Zongshan , Liu Hui , Zhu Shengnan , Zhou Taoxun , Wang Chunqun , Hu Min
Published: March 2023

Background

Most haematophagous organisms constantly suck the host’s haemoglobin, which produces toxic free haem. This toxic haem aggregation into the nontoxic crystallisation complex known as haemozoin represents one of the most important detoxification pathways in living organisms, but very little is known about the features of haemozoin in parasitic nematodes. Here, we identified and characterised the haemozoin of an economically significant blood-sucking nematode, Haemonchus contortus.

Methods

Using electron microscopy, spectrophotometry analyses and biochemical approaches, haemozoin crystallisation was identified and characterised in parasitic fourth-stage larvae (L4s) and/or adult worms as well as L4s of in vitro culture.

Results

The haemozoin was formed in intestinal lipid droplets of the parasitic L4s and adult worms. The characterisation of the haemozoin showed regularly spherical structures and had a 400-nm absorption peak. Furthermore, the haemozoin in in vitro cultured L4s was associated with the culture time and concentration of red blood cells added into the medium, and its formation could be inhibited by chloroquine-derived drugs.

Conclusions

This work provides detailed insight into the haemozoin formation of H. contortus and should have important implications for developing novel therapeutic targets against this parasite or related haematophagous organisms.

Graphical abstract