bluuebunny/crossref_metadata_2025 huggingface dataset:
Perinatal posttraumatic stress disorder as a predictor of mother-child bonding quality 8 months after childbirth: a longitudinal study
Authors: Vega-Sanz Maria , Berastegui Ana , Sanchez-Lopez Alvaro
Published: May 2024

Background

Negative childbirth experiences can be related to the onset of perinatal post-traumatic stress symptomatology (P-PTSS), which significantly impacts the mother and the infant. As a response in the face of the discomfort caused by P-PTSS, maladaptive emotion regulation strategies such as brooding can emerge, contributing to the consolidation of post-partum depressive symptoms. Ultimately, both types of symptomatology, P-PTSS and post-partum depression, can act as risk factors for developing mother-child bonding difficulties. Still, this full set of temporal paths has to date remained untested. The present longitudinal study aimed to analyze the risk factors associated with the appearance of P-PTSS after post-partum and to test a path model considering the role of P-PTSS as an indirect predictor of bonding difficulties at eight months of postpartum.

Methods

An initial sample of pregnant women in the third trimester of gestation (N = 594) participated in a longitudinal study comprising two follow-ups at two and eight months of postpartum. The mothers completed online evaluations that included socio-demographic data and measures of psychological variables. A two-step linear regression model was performed to assess the predictive role of the variables proposed as risk factors for P-PTSS, and a path model was formulated to test the pathways of influence of P-PTSS on bonding difficulties.

Results

A history of psychopathology of the mother, the presence of depression during pregnancy, the presence of medical complications in the mother, and the occurrence of traumatic birth experiences all acted as significant predictors of P-PTSS, explaining 29.5% of its variance. Furthermore, the path model tested further confirmed an indirect effect of P-PTSS, triggered by a negative childbirth experience, on subsequent bonding difficulties eight months after labor through its association with higher levels of brooding and, ultimately, postpartum depression levels. A further path showed that bonding difficulties at two months postpartum can persist at eight months postpartum due to the onset of brooding and postpartum depression symptoms.

Conclusion

We identified a set of robust predictors of P-PTSS: the mother’s previous history of depression, perinatal depression during pregnancy, the presence of medical complications in the mother and the occurrence of traumatic birth experiences, which has important implications for prevention. This is particularly relevant, as P-PTSS, when triggered by a negative childbirth experience, further indirectly predicted the development of mother-child bonding difficulties through the mediation of higher use of brooding and symptoms of postpartum depression. These findings can serve as a basis for developing new longitudinal studies to further advance the understanding of perinatal mechanisms of mental health.
Preferences of support and barriers and facilitators to help-seeking in pregnant women with severe fear of childbirth in Sweden: a mixed-method study
Authors: Nordin-Remberger Carita , Wells Michael B. , Woodford Joanne , Lindelöf Karin S. , Johansson Margareta
Published: May 2024

Background

There are few support interventions for women with fear of childbirth tailored towards type of fears and parity. To inform the future development of an acceptable and relevant intervention for women with severe fear of childbirth, primary objectives were to examine: (1) pregnant women’s experiences of and preferences for support and (2) barriers and facilitators to help-seeking. Secondary objectives were to examine if there are any differences based on pregnant women’s parity.

Methods

Pregnant women with a severe fear of childbirth in Sweden completed an online cross-sectional survey between February and September 2022. Severe fear of childbirth was measured using the fear of childbirth scale. Quantitative data were analysed using descriptive and inferential statistics and free answers were analysed using manifest content analysis. A contiguous approach to integration was adopted with qualitative and quantitative findings reported separately.

Results

In total, 609 participants, 364 nulliparous and 245 parous women, had severe fear of childbirth. The main category “A twisting road to walk towards receiving support for fear of childbirth” was explored and described by the generic categories: Longing for support, Struggling to ask for support, and Facilitating aspects of seeking support. Over half (63.5%), of pregnant women without planned or ongoing treatment, wanted support for fear of childbirth. Most (60.2%) pregnant women with ongoing or completed fear of childbirth treatment regarded the treatment as less helpful or not at all helpful. If fear of childbirth treatment was not planned, 35.8% of women would have liked to have received treatment. Barriers to help seeking included stigma surrounding fear of childbirth, previous negative experiences with healthcare contacts, fear of not being believed, fear of not being listened to, and discomfort of having to face their fears. Facilitators to help seeking included receiving respectful professional support that was easily available, flexible, and close to home.

Conclusions

Most pregnant women with severe fear of childbirth felt unsupported during pregnancy. Findings emphasise the need to develop individual and easily accessible psychological support for women with severe fear of childbirth, delivered by trained professionals with an empathetic and respectful attitude.
Treatment outcomes of pediatrics acute myeloid leukemia (AML) and associated factors in the country’s tertiary referral hospital, Ethiopia
Authors: Mamo Wudinesh , Moges Ayalew , Yesuf Subah Abderehim , Mohamedsaid Abdulkadir , Arega Gashaw
Published: May 2024

Background

Pediatric Acute Myeloid Leukemia (AML) is a major cause of morbidity and mortality in children with cancer in Africa and other developing continents. Systemic chemotherapy and effective supportive care have significantly contributed to increased survival rates of pediatric AML in developed countries reaching approximately 70%. There is a paucity of contextual data regarding overall and event-free survival outcomes in children with acute myeloid leukemia in developing countries and most centers in Africa provide palliative care. The objective of this study was to assess the overall survival, event-free survival, and associated factors in pediatric AML patients treated in Ethiopia.

Methods

This retrospective study was conducted on Pediatric AML patients treated at Tikur Anbessa Hospital between January 1, 2015, and May 30, 2022. The socio-demographic profile of patients, the clinical characteristics, the biochemical and morphological subtypes of AML were analyzed using SPSS version 25. The Kaplan–Meier survival curve was used to estimate the probabilities of overall and event-free survival. Statistical significance was set at p < 0.05.

Results

A total of 92 children with AML were included in this study. The median age at diagnosis was 7 years (interquartile range: 5–10 years) with a slight male predominance. The median duration of symptoms was one month. Neutropenic fever (56, 86.2%) was the most common complication during treatment. About 29.3% of the patients succumbed to early death. The corresponding 1-year and 3-year OS probabilities were 28.2% and 23% respectively. The median event-free survival time for all pediatric AML patients was one-month (95% CI: 0.77–1.23). The determinants of poorer survival outcomes were FAB subtype, type of protocol used, and signs of CNS involvement (p < 0.05).

Conclusion

The survival rates of children from AML were low in the study setting. More than 25% of AML patients succumbed to early death, and febrile neutropenia was the most common complication. Effective supportive and therapeutic measures should be taken to manage febrile neutropenia and to prevent early death in AML patients.
Incomplete tuberculosis reporting and registration to the surveillance system in southwestern China of Yunnan Province: an inventory survey
Authors: Chen Jinou , Qiu Yubing , Wu Wei , Pan Ying , Yang Rui , Li Ling , Yang Yunbin , Lu Kunyun , Xu Lin
Published: May 2024

Background

The real-world tuberculosis (TB) surveillance data was generally incomplete due to underreporting and underdiagnosis. The inventory study aimed to assess and quantify the incompletion of surveillance systems in southwestern China.

Methods

The inventory study was conducted at randomly selected health facilities (HF) by multi-stage stratified cluster sampling. The participants were included in the period between August of 2020 in province-level and prefecture-level HF, and in the period between June to December of 2020 in other categories of HF respectively. The clinical committee confirmed medical records were matched to the National Notifiable Disease Reporting System (NNDRS) and the Tuberculosis Information Management System (TBIMS) to define the report and register status. The underreporting and under-register rates were evaluated based on the matched data, and factors associated with underreport and under-register were assessed by the 2-level logistic multilevel model (MLM).

Results

We enrolled 7,749 confirmed TB cases in the analysis. The province representative overall underreport rate to NNDRS was 1.6% (95% confidence interval, 95% CI, 1.3 − 1.9), and the overall under-register rate to TBIMS was 9.6% (95% CI, 8.9–10.3). The various underreport and under-register rates were displayed in different stratifications of background TB disease burden, HF level, HF category, and data source of the medical record in HF among prefectures of the province. The intraclass correlation coefficient (ICC) was 0.57 for the underreporting null MLM, indicating the facility-level cluster effect contributes a great share of variation in total variance. The two-level logistic MLM showed the data source of medical records in HF, diagnostic category of TB, and type of TB were associated with underreporting by adjusting other factors (p < 0.05). The ICC for under-register was 0.42, and the HF level, HF category, data source of medical records in HF, diagnostic category of TB and type of TB were associated with under-register by adjusting other factors (p < 0.05).

Conclusion

The inventory study depicted incomplete TB reporting and registering to NNDRS and TBIMS in southwestern China. It implied that surveillance quality improvement would help advance the TB prevention and control strategy.
Epidemiologic profile of inflammatory bowel disease in Eastern Mediterranean Region (EMRO) countries: a systematic review and meta-analysis
Authors: Sanat Zahra Momayez , Vahedi Homayoon , Malekzadeh Reza , Fanni Zeinab
Published: May 2024

Background

Inflammatory bowel disease (IBD) consists of two main types: Crohn’s disease (CD) and ulcerative colitis (UC). The epidemiology of IBD patients has not been comprehensively studied in EMRO countries; therefore, we conducted this meta-analysis to study the epidemiology of this disease in these countries.

Methods

We searched four international databases, namely Scopus, Web of Knowledge (ISI), Medline/PubMed, and ProQuest, from inception up to the end of May 2023. The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guideline was used to carry out this systematic review and meta-analysis investigation. Using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist, the quality of the selected papers was assessed.

Results

Based on the results of this study, the incidence of UC in EMRO countries was 2.65 per 100,000 (95% CI: 1.39–3.90), and the incidence of CD was 1.16 per 100,000 (95% CI: 0.73–1.59). The most commonly involved intestinal segment in CD was the terminal ileum (44.7%, 95% CI: 34.7–55.2), followed by the ileum (29.8%, 95% CI: 22.2–38.6), and colon (18.7%, 95% CI: 10.8–30.4). However, in UC patients, extensive colitis was the most common finding (32.3%, 95% CI: 26.4–38.8), followed by proctosigmoiditis (27.9%, 95% CI: 21.1–35.8), left-sided colitis (27.4%, 95% CI: 22.7–32.7), and proctitis (22.6%, 95% CI: 17.5–28.5).

Conclusion

As a result, we were able to establish the traits of IBD patients in EMRO nations. UC patients had a higher incidence than CD patients. The most common regions of involvement in CD and UC patients, respectively, were the colon and pancolitis. Compared to UC patients, CD patients had a higher history of appendectomy.
The association between gender equality and climate adaptation across the globe
Authors: Pinho-Gomes Ana-Catarina , Woodward Mark
Published: May 2024

Introduction

Climate change has a disproportionate impact on women in comparison to men, and women have a key role to play in climate adaptation. However, evidence is lacking on how gender inequalities may be associated with climate vulnerability and ability to respond at country level.

Methods

This ecological study investigated the association between climate adaptation, measured by the Notre Dame Global Adaptation Initiative Country Index (ND-GAIN), and gender equality, measured by the Global Gender Gap Index (GGGI) developed by the World Economic Forum and the Gender Inequality Index (GII) developed by the United Nations. Simple linear regression was used to estimate the associations between the indices and their subdomains for 146 countries.

Results

There was an approximately linear association between the GGGI and climate adaptation. Each 1% increase in gender equality was associated with a 0.6% increase in the ND-GAIN score (the slope was 0.59, with a 95% confidence interval [0.33 to 0.84]). This was driven by a negative association between gender equality and vulnerability (-0.41 [-0.62 to -0.20]), and a positive association between gender equality and readiness (0.77 [0.44 to 1.10]). The strongest associations between gender equality and climate adaptation were observed for the education domain of the GGGI. There was a strong negative linear association between the GII and climate adaptation, which explained most (86%) of the between-country variation in climate adaptation. Each 1% increase in gender inequality was associated with a 0.5% decrease in the ND-GAIN score (-0.54 [-0.57 to -0.50]). The association between gender inequality and readiness was stronger than the association with vulnerability (0.41 [0.37 to 0.44] for vulnerability versus − 0.67 [-0.72 to -0.61] for readiness).

Conclusions

Gender inequality, measured broadly across different domains of life, is associated with climate adaptation at country level, both in terms of vulnerability to impact and readiness to respond.
Exploring food poverty experiences in the German Twitter-Sphere
Authors: Bartelmeß Tina , Schönfeld Mirco , Pfeffer Jürgen
Published: May 2024

Background

This study investigates the subjective perceptions of food poverty in Germany by analysing Twitter discourse using the German-language hashtag #IchBinArmutsbetroffen (#IamPovertyAffected) and examines the extent to which various dimensions of a multidimensional theoretical model of food poverty are represented in the discourse.

Methods

Employing a combination of computational social science and qualitative social research methods, the research identifies, and analyses tweets related to nutrition by applying a hierarchical dictionary search and qualitative content analysis. By examining the narratives and statements of individuals affected by food poverty, the study also investigates the interplay among different subdimensions of this phenomenon.

Results

The analysis of 1,112 tweets revealed that 57.96% focused on the material dimension and 42.04% on the social dimension of food poverty, suggesting a relatively balanced emphasis on material and social aspects of food poverty in the narratives of those affected. The findings reveal that tweets on material food poverty underscore economic challenges and resource scarcity for food. Social food poverty tweets demonstrate widespread deprivation in social participation, leading to isolation, exclusion, and social network loss. Overall, the results elucidate intricate interconnections among subdimensions and multidimensional manifestations of food poverty.

Conclusions

This study contributes methodologically by presenting an approach for extracting food-related textual social media data and empirically by providing novel insights into the perceptions and multifaceted manifestations of food poverty in Germany. The results can aid in a better understanding of the phenomenon of food poverty as it currently manifests in Germany, and in developing targeted social, health-promoting, and political measures that address more effectively the empirically evident multidimensionality of the phenomenon.
Do middle-aged patients with onset of idiopathic scoliosis before the age of 10 years who have reduced pulmonary function have a risk for rapid decline – a comparative study
Authors: Danielsson Aina J , Hällerman Kerstin Löfdahl
Published: May 2024

Back ground

Knowledge concerning pulmonary function in adult patients with onset of idiopathic scoliosis before age 10 is sparse. A long-term follow-up (FU, mean 26 years, > 12 years after treatment) of pulmonary function (PF) in patients treated with brace or surgery due to idiopathic scoliosis with onset before the age of 10 was earlier performed. To evaluate whether a more severe reduction in pulmonary function leads to more rapid deterioration within a four-year period, this study was performed.

Methods

Twenty patients with the most reduced pulmonary function and 19 out of those with normal PF found at the long-term FU were reexamined 4 years later to evaluate further changes in pulmonary function. Patients underwent spirometry and arterial blood gas analysis and answered pulmonary symptom questionnaires.

Results

70% of the reduced pulmonary function group had undergone surgery vs. 26% of the normal group. The mean age (47 vs. 43 years) at this FU and curve size (37° vs. 35°) at the 26-year FU were similar. The decline in forced vital capacity (FVC) % of predicted was similar in both groups over the four-year period, from 67 to 65% in the reduced PF group vs. 96 to 94% in the normal PF group. The total lung capacity (TLC) % of predicted did not change over time in either group. No patient reported worsening dyspnea symptoms. Only one patient in the reduced PF group showed low arterial oxygen tension, 8.4 kPa, not signifying respiratory insufficiency.

Conclusion

The age-related decline in FVC and TLC % of predicted did not differ between those with reduced and those with normal pulmonary function at the 26-year follow-up. Thus, these data do not infer increased rate of decline in the most deteriorated patients.
Efficacy of Danzhixiaoyao tablets combined with methylcobalamin tablets in the treatment of burning mouth syndrome: an open-label, randomized controlled trial
Authors: Gao Ya , Yang Jingwen , Sun Huimin , Zhou Haiwen
Published: May 2024

Objectives

This randomized controlled trial compared the efficacy and tolerability of danzhixiaoyao pills in the accurate treatment of patients with burning mouth syndrome (BMS).

Method

Collect a total of 78 patients (75 female patients and 3 male patients) from the oral mucosa department who were considered eligible fromOctober 2020 to October 2022.The patients were randomized and divided into trial group and control group.The trail group received danzhixiaoyao pills and mecobalamine tablets while the control group was given mecobalamine tablets.The Visual Analogue Scale (VAS), Beck Anxiety Inventory(BAI), Beck Depression Inventory (BDI), Oral Health Impact Profile (OHIP-14), Traditional Chinese medicine(TCM) syndrome integral and adverse reactions were performed at baseline and after 2, 4, and 6 weeks of treatment. Descriptive statistics, including the Wilcoxon rank-sum test and the Chi-square test for median comparisons between different times, were used.

Result

1.After treatment, the VAS, BDI,OHIP-14, and TCM syndrome integral in the trial group had a significant decrease than the control group(P< 0.05).However, there was no statistical difference in the BAI scores between the two groups (P> 0.05). 2.According to the efficacy determination criteria , the total effective rate of the test group was 73.68% , the control group was 52.94% and the recurrence rate was 0. There was a significant difference between the two groups (Z=-2.688, P < 0.05). The results showed that the curative effect of test group was better than that of control group.3. No adverse effects occurred in patients in either group.

Conclusion

Danzhixiaoyao pills has demonstrated to have a positive effect in relieving BMS symptoms and in improving a patient's overall quality of life with no AEs compared with the control group. The efficacy evaluation systems that can be verified and complementary in this study provide a perfect, effective and referential evaluation system for the use of Chinese patent medicine in the treatment of oral mucosal diseases.

Trial Registration

Registry name: Chinese Clinical trail Registry

Registration number: ChiCTR2000038189

Date of Registration: 2020-09-13

Please visit (https://www.chictr.org.cn/showproj.html?proj=61462) to the protocol.
Smoking induced salivary microbiome dysbiosis and is correlated with lipid biomarkers
Authors: Mohammed Layla I. , Razali Rozaimi , Zakaria Zain Zaki , Benslimane Fatiha M. , Cyprian Farhan , Al-Asmakh Maha
Published: May 2024

Background

The oral microbiome plays an essential role in maintaining oral homeostasis and health; smoking significantly affects it, leading to microbial dysbiosis. The study aims to investigate changes in the oral microbiome composition of smokers in the Qatari population and establish a correlation with lipid biomarkers.

Methods

The oral microbiota was profiled from saliva samples of 200 smokers and 100 non-smokers in the Qatari population, and 16s rRNA V3-V4 region were sequenced using the Illumina MiSeq platform. The operational taxonomic units (OTUs) were clustered using QIIME and the statistical analysis was performed by R.

Results

Non-smokers exhibited a more diverse microbiome, with significant alpha and beta diversity differences between the non-smoker and smoker groups. Smokers had a higher abundance of Firmicutes, Bacteroidota, Actinobacteriota, Patescibacteria, and Proteobacteria at the phylum level and of Streptococcus, Prevotella, Veillonella, TM7x, and Porphyromonas at the genus level. In contrast, non-smokers had more Bacteroidota, Firmicutes, Proteobacteria, Fusobacteriota, and Patescibacteria at the phylum level, and Prevotella, Streptococcus, Veillonella, Porphromonas, and Neisseria at the genus level. Notably, Streptococcus was significantly positively correlated with LDL and negatively correlated with HDL. Additionally, Streptococcus salivarius, within the genus Streptococcus, was substantially more abundant in smokers.

Conclusion

This study highlights the significant influence of smoking on the composition of the oral microbiome by enriching anaerobic microbes and depleting aerobic microbes. Moreover, the observed correlation between Streptococcus abundance and the lipid biomarkers suggests a potential link between smokers-induced salivary microbiome dysbiosis and lipid metabolism. Understanding the impact of smoking on altering the oral microbiome composition and its correlation with chemistry tests is essential for developing targeted interventions and strategies to improve oral health and reduce the risk of diseases.
Self-study and online interactive case-based discussion to improve knowledge of medical students in the COVID-19 era
Authors: Oofuvong Maliwan , Prathep Sumidtra , Plansangkate Prae , Tanasansuttiporn Jutarat , Sungworawongpana Chutida , Jitpakdee Wilasinee
Published: May 2024

Background

We aimed to determine whether a new online interactive learning method for fifth-year medical students could improve their knowledge of pre- and postoperative care during the COVID-19 era.

Methods

A retrospective cohort study was conducted from June 2020 to May 2022 during the pre- and postoperative care course for fifth-year medical students in a university hospital in southern Thailand. Students in the 2020 cohort received only a 60-minute lecture on spinal anesthesia via Zoom while a 3-step online interactive learning method was used for the 2021 cohort. Step 1: students performed self-study comprised of video lectures and case-based discussion one week before the online class with a pre-test submitted via Google forms. Step 2: an online interactive case-based discussion class was performed via Zoom by two experienced anesthesia staff and a post-test was submitted by the students via Google forms. Step 3: a small group discussion of course evaluation between 13 representatives of students and anesthesia staff was performed via Zoom. A comparison of the post-test and pre-test scores containing 20 multiple choice questions as well as the final exam scores before (2020) and after (2021) the new interactive learning was performed using a t-test.

Results

There were 136 and 117 students in the 2020 and 2021 academic years, respectively. The final mean (SD) exam scores for the 2020 and 2021 academic years were 70.3 (8.4) and 72.5 (9.0), respectively with a mean (95% confidence interval (CI)) difference of 2.2 (4.3, -0.02). In 2021, the mean (95% CI) difference between the post-test and pre-test scores was 5.8 (5.1, 6.5). The student representatives were satisfied with the new learning method and gave insightful comments, which were subsequently implemented in the 2022 academic year course.

Conclusion

The new interactive learning method improved the knowledge of fifth-year medical students attending pre- and postoperative care course during the COVID-19 era. The final exam scores may not be suitable to represent the overall outcomes of the new interactive learning method. Using an online two-way communication method can improve the overall satisfaction and course adaptation during the COVID-19 era.
Integration of case-based learning and three-dimensional printing for tetralogy of fallot instruction in clinical medical undergraduates: a randomized controlled trial
Authors: Zhao Jian , Gong Xin , Ding Jian , Xiong Kepin , Zhuang Kangle , Huang Rui , Li Shu , Miao Huachun
Published: May 2024

Background

Case-based learning (CBL) methods have gained prominence in medical education, proving especially effective for preclinical training in undergraduate medical education. Tetralogy of Fallot (TOF) is a congenital heart disease characterized by four malformations, presenting a challenge in medical education due to the complexity of its anatomical pathology. Three-dimensional printing (3DP), generating physical replicas from data, offers a valuable tool for illustrating intricate anatomical structures and spatial relationships in the classroom. This study explores the integration of 3DP with CBL teaching for clinical medical undergraduates.

Methods

Sixty senior clinical medical undergraduates were randomly assigned to the CBL group and the CBL-3DP group. Computed tomography imaging data from a typical TOF case were exported, processed, and utilized to create four TOF models with a color 3D printer. The CBL group employed CBL teaching methods, while the CBL-3DP group combined CBL with 3D-printed models. Post-class exams and questionnaires assessed the teaching effectiveness of both groups.

Results

The CBL-3DP group exhibited improved performance in post-class examinations, particularly in pathological anatomy and TOF imaging data analysis (P < 0.05). Questionnaire responses from the CBL-3DP group indicated enhanced satisfaction with teaching mode, promotion of diagnostic skills, bolstering of self-assurance in managing TOF cases, and cultivation of critical thinking and clinical reasoning abilities (P < 0.05). These findings underscore the potential of 3D printed models to augment the effectiveness of CBL, aiding students in mastering instructional content and bolstering their interest and self-confidence in learning.

Conclusion

The fusion of CBL with 3D printing models is feasible and effective in TOF instruction to clinical medical undergraduates, and worthy of popularization and application in medical education, especially for courses involving intricate anatomical components.
Psychometric properties of the Persian version of the Engaged teachers Scale (ETS)
Authors: Akbarilakeh Maryam , Ahmady Soleiman , Shademani Farhang Faezeh , Arbabisarjou Azizollah , Taha Mohamed Hassan
Published: May 2024

Background & Aim

Teacher engagement can be defined as the teachers’ effort and attention to teaching professional tasks, adequate emotions and commitment to relationships with students and colleagues in classroom and school. The Engaged Teacher Scale (ETS) is the frequently used scale, measuring teacher engagement developed by Klassen et al., 2013 in the UK, and consists of four dimensions: cognitive engagement (CE), emotional engagement (EE), social engagement with students (SES), and social engagement with colleagues (SEC). Therefore, the aim of this study was to measure the psychometric properties of the Persian version of the Engaged Teachers Scale (ETS).

Materials & methods

A total of 123 teachers who worked at Shahid Beheshti University of Medical Sciences, Tehran, Iran, were included in this study. The study participants were selected using the convenience sampling. The Persian version of a 16-item scale developed by Klassen et al. was validated by this study. Face and Content validity index and reliability were assessed after translation and cultural adaptation, and also construct validity was calculated by confirmatory factor analysis using the PLS22.

Results

Of the 123 study participants, 74 (60.01%) were females and 49 (39.9%) were males. The mean age of the subjects was about 30–40 years. The majority of the study participants were general practitioners (n = 75; 60.9%) and others were from different specialists. Content validity among 15 experts was 0.88. Confirmatory factor analysis for all 16 items loaded across four factors, and this four-factor scale showed a good fit in the Iranian community. Reliability using Cronbach’s alpha was 0.79. The value of root mean square error of approximation (RMSEA) was 0.0094 with the 99% confidence interval, and also the goodness of fit index GFI value was 0.98.

Conclusion

The Persian version of ETS had good validity and reliability in Iran and could be a useful tool for measuring the teacher engagement factors of faculty members that can be used by teachers and educational administrators.
Objectivizing issues in the diagnosis of complex rare diseases: lessons learned from testing existing diagnosis support systems on ciliopathies
Authors: Faviez Carole , Chen Xiaoyi , Garcelon Nicolas , Zaidan Mohamad , Billot Katy , Petzold Friederike , Faour Hassan , Douillet Maxime , Rozet Jean-Michel , Cormier-Daire Valérie , Attié-Bitach Tania , Lyonnet Stanislas , Saunier Sophie , Burgun Anita
Published: May 2024

Background

There are approximately 8,000 different rare diseases that affect roughly 400 million people worldwide. Many of them suffer from delayed diagnosis. Ciliopathies are rare monogenic disorders characterized by a significant phenotypic and genetic heterogeneity that raises an important challenge for clinical diagnosis. Diagnosis support systems (DSS) applied to electronic health record (EHR) data may help identify undiagnosed patients, which is of paramount importance to improve patients’ care. Our objective was to evaluate three online-accessible rare disease DSSs using phenotypes derived from EHRs for the diagnosis of ciliopathies.

Methods

Two datasets of ciliopathy cases, either proven or suspected, and two datasets of controls were used to evaluate the DSSs. Patient phenotypes were automatically extracted from their EHRs and converted to Human Phenotype Ontology terms. We tested the ability of the DSSs to diagnose cases in contrast to controls based on Orphanet ontology.

Results

A total of 79 cases and 38 controls were selected. Performances of the DSSs on ciliopathy real world data (best DSS with area under the ROC curve = 0.72) were not as good as published performances on the test set used in the DSS development phase. None of these systems obtained results which could be described as “expert-level”. Patients with multisystemic symptoms were generally easier to diagnose than patients with isolated symptoms. Diseases easily confused with ciliopathy generally affected multiple organs and had overlapping phenotypes. Four challenges need to be considered to improve the performances: to make the DSSs interoperable with EHR systems, to validate the performances in real-life settings, to deal with data quality, and to leverage methods and resources for rare and complex diseases.

Conclusion

Our study provides insights into the complexities of diagnosing highly heterogenous rare diseases and offers lessons derived from evaluation existing DSSs in real-world settings. These insights are not only beneficial for ciliopathy diagnosis but also hold relevance for the enhancement of DSS for various complex rare disorders, by guiding the development of more clinically relevant rare disease DSSs, that could support early diagnosis and finally make more patients eligible for treatment.
Exposure of cattle to tick-borne encephalitis virus in the historical endemic zone in north-eastern France
Authors: Mathews-Martin Laure , Gonzalez Gaëlle , Dheilly Nolwenn M. , Amaral-Moraes Rayane , Dumarest Marine , Helle Teheipuaura , Migne Camille , Caillot Christophe , Lacour Sandrine A. , Pérelle Sylvie , Beck Cécile , Metras Raphaëlle , Bournez Laure
Published: May 2024

Background

Tick-borne encephalitis (TBE) is a severe human neuroinfection caused by TBE virus (TBEV). TBEV is transmitted by tick bites and by the consumption of unpasteurized dairy products from infected asymptomatic ruminants. In France, several food-borne transmission events have been reported since 2020, raising the question of the level of exposure of domestic ungulates to TBEV. In this study, our objectives were (i) to estimate TBEV seroprevalence and quantify antibodies titres in cattle in the historical endemic area of TBEV in France using the micro virus neutralisation test (MNT) and (ii) to compare the performance of two veterinary cELISA kits with MNT for detecting anti-TBEV antibodies in cattle in various epidemiological contexts. A total of 344 cattle sera from four grid cells of 100 km² in Alsace-Lorraine (endemic region) and 84 from western France, assumed to be TBEV-free, were investigated.

Results

In Alsace-Lorraine, cattle were exposed to the virus with an overall estimated seroprevalence of 57.6% (95% CI: 52.1–62.8%, n = 344), varying locally from 29.9% (95% CI: 21.0–40.0%) to 92.1% (95% CI: 84.5–96.8%). Seroprevalence did not increase with age, with one- to three-year-old cattle being as highly exposed as older ones, suggesting a short-life duration of antibodies. The proportion of sera with MNT titres lower than 1:40 per grid cell decreased with increased seroprevalence. Both cELISA kits showed high specificity (> 90%) and low sensitivity (less than 78.1%) compared with MNT. Sensitivity was lower for sera with neutralising antibodies titres below 1:40, suggesting that sensitivity of these tests varied with local virus circulation intensity.

Conclusions

Our results highlight that cattle were highly exposed to TBEV. Screening strategy and serological tests should be carefully chosen according to the purpose of the serological study and with regard to the limitations of each method.
Assessing lameness prevalence and associated risk factors in crossbred dairy cows across diverse management environments
Authors: Patoliya Priyanka , Kataktalware Mukund A. , Raval Kathan , Devi G. Letha , Sivaram Muniandy , Praveen Selladurai , Meena Priyanka , Jeyakumar Sakhtivel , Mech Anjumoni , Ramesha Kerekoppa P.
Published: May 2024

Background

A thorough understanding of lameness prevalence is essential for evaluating the impact of this condition on the dairy industry and assessing the effectiveness of preventive strategies designed to minimize its occurrence. Therefore, this cross-sectional study aimed to ascertain the prevalence of lameness and identify potential risk factors associated with lameness in Holstein Friesian crossbred cows across both commercial and smallholder dairy production systems in Bengaluru Rural District of Karnataka, India.

Methods

The research encompassed six commercial dairy farms and 139 smallholder dairy farms, involving a total of 617 Holstein Friesian crossbred cattle. On-site surveys were conducted at the farms, employing a meticulously designed questionnaire. Lameness in dairy cattle was assessed subjectively using a locomotion scoring system. Both bivariate and binary logistic regression models were employed for risk assessment, while principal components analysis (PCA) was conducted to address the high dimensionality of the data and capture the underlying structure of the explanatory variables.

Results

The overall lameness prevalence of 21.9% in commercial dairy farms and 4.6% in smallholder dairy farms. Various factors such as age, body weight, parity, body condition score (BCS), floor type, hock and knee injuries, animal hygiene, provision of hoof trimming, and the presence of hoof lesions were found to be significantly associated with lameness. Binary logistic regression analysis indicated that the odds of lameness in crossbred cows increased with higher parity, decreased BCS, presence of hard flooring, poor animal hygiene, and the existence of hoof lesions. These factors were identified as potential risk factors for lameness in dairy cows. Principal component analysis unveiled five components explaining 71.32% of the total variance in commercial farms and 61.21% in smallholder dairy farms. The extracted components demonstrated higher loadings of housing and management factors (such as hoof trimming and provision of footbath) and animal-level factors (including parity, age, and BCS) in relation to lameness in dairy cows.

Conclusions

The findings suggest that principal component analysis effectively reduces the dimensionality of risk factors. Addressing these identified risk factors for lameness is crucial for the strategic management of lameness in dairy cows. Future research in India should investigate the effectiveness of management interventions targeted at the identified risk factors in preventing lameness in dairy cattle across diverse environments.
Optimizing enzyme properties to enhance dihydroxyacetone production via methylglyoxal biosensor development
Authors: Zhang Kaibo , Li Mengying , Wang Jinsheng , Huang Guozhong , Ma Kang , Peng Jiani , Lin Haoyue , Zhang Chunjie , Wang Honglei , Zhan Tao , Sun Zhe , Zhang Xueli
Published: May 2024

Background

Dihydroxyacetone (DHA) stands as a crucial chemical material extensively utilized in the cosmetics industry. DHA production through the dephosphorylation of dihydroxyacetone phosphate, an intermediate product of the glycolysis pathway in Escherichia coli, presents a prospective alternative for industrial production. However, insights into the pivotal enzyme, dihydroxyacetone phosphate dephosphorylase (HdpA), remain limited for informed engineering. Consequently, the development of an efficient tool for high-throughput screening of HdpA hypermutants becomes imperative.

Results

This study introduces a methylglyoxal biosensor, based on the formaldehyde-responding regulator FrmR, for the selection of HdpA. Initial modifications involved the insertion of the FrmR binding site upstream of the −35 region and into the spacer region between the −10 and −35 regions of the constitutive promoter J23110. Although the hybrid promoter retained constitutive expression, expression of FrmR led to complete repression. The addition of 350 μM methylglyoxal promptly alleviated FrmR inhibition, enhancing promoter activity by more than 40-fold. The methylglyoxal biosensor system exhibited a gradual increase in fluorescence intensity with methylglyoxal concentrations ranging from 10 to 500 μM. Notably, the biosensor system responded to methylglyoxal spontaneously converted from added DHA, facilitating the separation of DHA producing and non-producing strains through flow cytometry sorting. Subsequently, the methylglyoxal biosensor was successfully applied to screen a library of HdpA mutants, identifying two strains harboring specific mutants 267G > T and D110G/G151C that showed improved DHA production by 68% and 114%, respectively. Expressing of these two HdpA mutants directly in a DHA-producing strain also increased DHA production from 1.45 to 1.92 and 2.29 g/L, respectively, demonstrating the enhanced enzyme properties of the HdpA mutants.

Conclusions

The methylglyoxal biosensor offers a novel strategy for constructing genetically encoded biosensors and serves as a robust platform for indirectly determining DHA levels by responding to methylglyoxal. This property enables efficiently screening of HdpA hypermutants to enhance DHA production.
Insecticide susceptibility status of Anopheles albimanus populations in historical malaria foci in Quintana Roo, Mexico
Authors: Escobar Denis , González-Olvera Gabriela , Gómez-Rivera Ángel S. , Navarrete-Carballo Juan , Mis-Ávila Pedro , Baack-Valle Raquel , Escalante Guillermo , Reyes-Cabrera Gerardo , Correa-Morales Fabian , Che-Mendoza Azael , Vazquez-Prokopec Gonzalo , Lenhart Audrey , Manrique-Saide Pablo
Published: May 2024

Background

Mexico has experienced a significant reduction in malaria cases over the past two decades. Certification of localities as malaria-free areas (MFAs) has been proposed as a steppingstone before elimination is achieved throughout the country. The Mexican state of Quintana Roo is a candidate for MFA certification. Monitoring the status of insecticide susceptibility of major vectors is crucial for MFA certification. This study describes the susceptibility status of Anopheles albimanus, main malaria vector, from historically important malaria foci in Quintana Roo, using both phenotypic and genotypic approaches.

Methods

Adult mosquito collections were carried out at three localities: Palmar (Municipality of Othon P. Blanco), Buenavista (Bacalar) and Puerto Morelos (Puerto Morelos). Outdoor human-landing catches were performed by pairs of trained staff from 18:00 to 22:00 during 3-night periods at each locality during the rainy season of 2022. Wild-caught female mosquitoes were exposed to diagnostic doses of deltamethrin, permethrin, malathion, pirimiphos-methyl or bendiocarb using CDC bottle bioassays. Mortality was registered at the diagnostic time and recovery was assessed 24 h after exposure. Molecular analyses targeting the Voltage-Gated Sodium Channel (vgsc) gene and acetylcholinesterase (ace-1) gene were used to screen for target site polymorphisms. An SNP analysis was carried out to identify mutations at position 995 in the vgsc gene and at position 280 in the ace-1 gene.

Results

A total of 2828 anophelines were collected. The main species identified were Anopheles albimanus (82%) and Anopheles vestitipennis (16%). Mortalities in the CDC bottle bioassay ranged from 99% to 100% for all the insecticides and mosquito species. Sequence analysis was performed on 35 An. albimanus across the three localities; of those, 25 were analysed for vgsc and 10 for ace-1 mutations. All individuals showed wild type alleles.

Conclusion

The results demonstrated that An. albimanus populations from historical malaria foci in Quintana Roo are susceptible to the main insecticides used by the Ministry of Health.
Non-communicable diseases and its risk factors among the transgender population in Kerala: a cross-sectional study
Authors: Fernandez Bhavya , Gaitonde Rakhal
Published: May 2024

Background

Non-communicable diseases (NCDs) are high on the priority list of the Kerala government, and exploring the extent to which transgender and gender diverse (TGD) community members benefit from the services of national programmes for NCDs can provide valuable insights on improving the inclusivity of the health system as it moves towards Universal Health Coverage. This study was conducted to explore the prevalence of NCD risk factors as well as facilitators and barriers to NCD management among the TGD population in Kerala.

Methods

A multiple methods study, including a cross-sectional survey of 120 self-identifying TGD people that included an adaptation of the WHO STEPS questionnaire, as well as in-depth interviews with thirteen individuals, was conducted in three districts of Kerala to explore the barriers and facilitators to NCD prevention and management.

Results

The results are presented using the key dimensions emerging out of the Diederichsen framework. A range of discrimination faced by TGD people in Kerala traps them in situations of low educational outcomes with consequent disadvantages in the job market when they search for livelihoods. This results in a large proportion of our sample living away from families (69 percent), and finding themselves in precarious jobs including sex work (only 33 percent had a regular job), with all these aforementioned factors converging to marginalise their social position. This social position leads to differential risk exposures such as increased exposure to modifiable risk factors like alcohol (40 percent were current alcohol users) and tobacco use (40.8 percent currently used tobacco) and ultimately metabolic risk factors too (30 and 18 percent were hypertensive and diabetic respectively). Due to their differential vulnerabilities such as the discrimination that TGD people are subjected to (41.7 percent had faced discrimination at a healthcare centre in the past one year), those with higher exposure to risk factors often find it hard to bring about behavioural modifications and are often not able to access the services they require.

Conclusions

The disadvantaged social position of TGD people and associated structural issues result in exacerbated biological risks, including those for NCDs. Ignoring these social determinants while designing health programmes is likely to lead to sub-optimal outcomes.
Effect of DPP-4i inhibitors on renal function in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials
Authors: Gong Yong , Bai Xueyan , Zhang Donglei , Yang Xingsheng , Qin Zheng , Yang Yu , Zhou Yilun , Meng Jie , Liu Xin
Published: May 2024

Aims

About 20–40% patients with type 2 diabetes mellitus (T2DM) had an increased risk of developing diabetic nephropathy (DN). Dipeptidyl peptidase-4 inhibitors (DPP-4i) were recommended for treatment of T2DM, while the impact of DPP-4i on renal function remained unclear. This study aimed to explore the effect of DPP-4i on renal parameter of estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) in T2DM.

Methods

A systematic search was performed across PubMed, Embase and Cochrane Library. A fixed or random-effects model was used for quantitative synthesis according to the heterogeneity, which was assessed with I2 index. Sensitivity analysis and publication bias were performed with standard methods, respectively.

Results

A total of 17 randomized controlled trials were identified. Administration of DPP-4i produced no significant effect on eGFR (WMD, -0.92 mL/min/1.73m2, 95% CI, -2.04 to 0.19) in diabetic condition. DPP-4i produced a favorable effect on attenuating ACR (WMD, -2.76 mg/g, 95% CI, -5.23 to -0.29) in patients with T2DM. The pooled estimate was stable based on the sensitivity test. No publication bias was observed according to Begg’s and Egger’s tests.

Conclusions

Treatment with DPP-4i preserved the renal parameter of eGFR in diabetic condition. Available evidences suggested that administration of DPP-4i produced a favorable effect on attenuating ACR in patients with T2DM.

International Prospective Register for Systematic Review (PROSPERO) number

CRD.42020144642.