bluuebunny/crossref_metadata_2025 huggingface dataset:
Antimuscarinics for neurogenic overactive bladder in multiple sclerosis: real-life data
Authors: Andretta Elena , Finazzi Agrò Enrico , Calabrese Massimiliano , Orecchia Luca , Furlan Antonietta , Zuliani Cristina
Published: September 2022

Background:

Antimuscarinics (AMs) represent the mainstay of treatment for storage lower urinary tract symptoms (LUTS) but few data are available on their impact in multiple sclerosis (MS) patients.

Objective:

To assess effectiveness and tolerability of AMs in MS patients with neurogenic detrusor overactivity (NDO).

Methods:

Sixty consecutive outpatients, who started treatment with AMs at one centre, were recruited. The primary endpoint was change in Patient’s Perception of Intensity of Urgency Scale (PPIUS) at 6 months; secondary endpoints were post-void residual urine (PVR) and pads used daily. Incidence and severity of adverse events (AEs) were recorded.

Results:

Significant reduction ( p < 0.001) of mean PPIUS and pads use were detected, as well as a significant increase ( p < 0.001) of PVR (143 ± 42 ml). AEs, recorded in 53% of patients, were frequently multiple and caused suspension of AM in 10% of cases, mainly for xerostomia, which has been the commonest AE (26.6%). Neurological AEs appeared in 11.7% of subjects, mostly with oxybutynin. Worsening/onset of voiding LUTS, reported by 8.3% of MS, resulted to be the unique AE correlated to AM dosage.

Conclusion:

This study suggests that AMs are effective in MS patients, but their use should be tailored on every patient as even low dosages can be poorly tolerated. AEs, including neurological ones, are common.
Seasonal Variations in the Effectiveness of Immersive Virtual Nature
Authors: Litleskare Sigbjørn , Calogiuri Giovanna
Published: September 2022

Aim:

The aim of this study was to assess whether the outcomes of immersive virtual nature (IVN) varies between seasons.

Background:

IVN has received increased interest in recent years due to its potential applications within health and design. However, factors influencing people’s responses to IVN are largely unknown. Seasons affect a variety of human processes and behaviors including levels of affect and blood pressure, also in the context of human–nature interactions. These seasonal variations might influence how people interact and respond to IVN, especially since IVN allow for representations of nature that are not representative of the current real-life season.

Methods:

A secondary analysis of data retrieved from two previous studies, which included three IVN conditions, was conducted. All IVNs represented late spring conditions. Measures included perceived environmental restorativeness, affect, enjoyment, heart rate, and blood pressure. A meta-analytic approach was used to assess whether there were consistent differences between participants who were exposed to the IVN in spring/summer (early June to mid-September) and autumn/winter (mid-September to December) across the three different conditions.

Results:

There was a consistent effect of season only for one component of affect (fatigue), with larger reductions in fatigue when exposed to IVN during autumn/winter compared to spring/summer. No other significant effects of season were observed.

Conclusion:

IVNs are feasible to use across all seasons but might be more effective in reducing the feeling of fatigue during autumn and winter compared to other seasons.
When Rose-Colored Glasses Turn Cloudy: Stressful Life Circumstances and Perceptions of Partner Behavior in Newlywed Marriage
Authors: Neff Lisa A. , Buck April A.
Published: September 2022

Stressful life circumstances can destabilize the couples’ relationships by increasing tensions and hindering positive exchanges between partners. Yet, stress may be linked not only to what individuals do in their relationship but also to what they see, as stress can shift individuals’ attentional focus toward negative stimuli. To test this possibility, the current study examined whether individuals confronting more stressful life events and/or daily hassles are more likely to attentively monitor their partner’s negative relationship behaviors. A daily diary study of 79 newlywed couples revealed that individuals who recently experienced more stressful life events were especially attuned to day-to-day fluctuations in their partner’s negative behaviors, but not their partner’s positive behaviors. Moreover, these individuals generally perceived their partner as enacting more negativity across the diary period compared with individuals who faced fewer stressful events. These findings held when adjusting for several individual difference factors known to predict perceptual biases within relationships.
Experimental verification of different analytical approaches for estimating underwater explosives
Authors: Nowak Piotr R , Gajewski Tomasz , Peksa Piotr , Sielicki Piotr W
Published: September 2022

The clearance of underwater ordnance is one of the most complex tasks entrusted to appropriately trained and equipped soldiers. State-of-the-art knowledge in this area is rarely published and is most often possessed by a narrow group of navy specialists. The aim of this paper was to find a link between the existing mathematical models for the peak pressure of underwater explosion with measurements of small charge detonations for long ranges to the observation point in real life scenarios. We have shown the results of the research in which the underwater explosion tests were presented for different TNT equivalents and standoff distances and thus distance ratios. The curves of pressure versus time of ignition were reported. The measurements were confronted with empirical formulas. The comparison showed large, but expected, differences, since the empirical formulas are advised for smaller distance ratios. Based on the conclusions from the study, the new methodology to identify the loading from underwater explosions based on a database collected was postulated. By creating a survey methodology for ships crew for recording explosion parameters, a large number of events can be registered without a strict setup of the test area. The database obtained can be used by military commanders to identify the explosive hazard in the Baltic Sea region.
Erythema multiforme caused by varicella-zoster virus: A case report
Authors: Zhu Qing , Wang Dongxue , Peng Dandan , Xuan Xiaomei , Zhang Guoqiang
Published: September 2022

Erythema multiforme is a widespread hypersensitivity reaction, its pathogenesis is related to a variety of factors, including drugs and viral and bacterial infections. It is true that erythema multiforme is often caused by viruses while current studies suggest that it is mostly associated with herpes simplex virus infection, rarely associated with varicella-zoster virus infection. Here, we report a 50-year-old man admitted to our hospital because of rashes on the left rib with pain for 9 days and on limbs and hands for 2 days. Laboratory data showed that varicella-zoster virus (VZV-DNA) test was negative in blood by qualitative polymerase chain reaction. Herpes zoster virus IgM (VZV-IgM) enzyme linked immune sorbent assay was negative, and herpes zoster virus IgG (VZV-IgG) enzyme linked immune sorbent assay was positive. Herpes zoster and erythema multiforme was diagnosed. After treatment with antiviral, antiallergic, and topical drugs, the rashes was significantly improved. Our case report contributes to the pathogenesis of erythema multiforme.
A quality improvement initiative for patient knowledge comprehension during the discharge procedure using a novel computer-generated patient-tailored discharge document in cardiology
Authors: de Wit André , de Heide John , Cummins Paul , van Bruchem-van de Scheur Ada , Bhagwandien Rohit , Lenzen Mattie
Published: September 2022

Objective

The duration of hospital admissions has shortened significantly. This challenges healthcare professionals to provide the necessary information and instructions in a limited time. Patient-tailored discharge information may improve the patient's understanding of the discharge information but may also be time-consuming. The objective of this descriptive quality improvement study was to evaluate patient comprehension of discharge information using a novel computer-generated patient-tailored discharge document.

Methods

A prospective pre-post study comparing patient-tailored discharge information with conventional discharge information, for patients undergoing an electrophysiological procedure during two periods of six weeks between January and March 2016. Group I received conventional discharge information ( n  =  55). Group II received a computer-generated, patient-tailored discharge document ( n  =  57). Their comprehension of the discharge information was evaluated using a peer-reviewed questionnaire distributed among patients, comparing groups I and II using Likert scales. Nurses and nurse practitioners evaluated the use of personalized discharge information by means of a short survey.

Results

In terms of discharge information, comprehensibility was equivalent; however, an increase in comprehension was observed in patients seeking a telephone consultation with the cardiology department within one-week post-discharge. A reduction in discharge preparation time and an increased uniformity of discharge information were reported by nurses. Nurse practitioners found the web tool easy to use and time-saving.

Conclusions

In this study, computer-generated patient-tailored discharge information was equivalent to conventional discharge information. A more positive trend was seen for patients who initiated teleconsultation with the hospital within one-week post-discharge. This suggests that for this subgroup the patient-tailored discharge web tool might lead to an improvement in care. However, more research with a larger number of participants is needed to confirm this trend.
“Someone Else Is Behind The Screen”: Visibility, Privacy, and Trust on Geosocial Networking Apps in India
Authors: Pinch Annika , Birnholtz Jeremy , Rawat Shruta , Bhatter Aakanksha , Baruah Dicky , Dange Alpana
Published: September 2022

Queer people increasingly use geosocial networking apps (GSNAs), such as Grindr and Blued, to find connections. These apps play a particularly important role in countries such as India, where being visibly queer can carry social stigma, and same-sex intercourse was criminalized until 2018. A key challenge on these apps is self-disclosing enough information to appear authentic and build trust with other users, without drawing unwanted attention, stigma, and safety threats. Careful consideration of when to share information and what to share is critical, but we have a limited understanding of how users make these decisions. Drawing upon in-depth interviews with 36 queer men in 4 smaller urban environments in and near the state of Maharashtra, India, we sought to understand how queer men think about their visibility while using GSNAs. We find that they are primarily concerned with the visibility of the actual GSNA on their phone, especially given many users in this context live with their families and assumptions common in the West, such as one person per device, may not hold. They also worry about the information they disclose on the app itself given this visibility can lead to dangerous situations. We detail how participants try to resolve the tensions around visibility and discuss our findings in relation to conceptualizations of privacy and signaling theory. We conclude with practical guidelines related to the use of these apps in the Indian context.
Explaining voting participation gaps in local government elections in rural China
Authors: Wu Liyun , Rogers Benjamin , Wang Gang
Published: September 2022

When studying rural elections in China, scholars usually consider voting participation as consistent across the village and township levels. Using a cross-sectional research design based on data collected in 2009–2011 in rural China, this study reveals that voter turnout in village elections is significantly higher than in township elections. This finding is robust across regions and at different economic development levels. In addition, findings from multivariate regression analyses with bootstrapped Brier scores report that perceived fairness of elections and prevalence of low corruption are strong predictors for voter turnout. Gaps in voting participation of local government elections may reflect different political landscapes in rural governance in Chinese villages versus townships.
Incentives for Combining Structure and Process Quality to Improve Outcome in Rheumatic Treatment
Authors: Romeyke Tobias , Noehammer Elisabeth , Stummer Harald
Published: September 2022

The study investigates the effects of multidisciplinary treatment for rheumatic treatment regarding (a) financial feasibility based on costs/remuneration in comparison to conventional treatment and (b) Patient reported outcome measures (Proms) to check for effectiveness. For (a), cost data and remuneration with and without multimodal rheumatologic complex treatment (MRCT) is analysed, including cost types. The database encompasses 18,794 treatment cases. For (b), a case study with retrospective patient data analysis ( N = 375, all treated in a specialized German hospital) regarding self-reported quality of life and physical functions is carried out for subjects receiving MRCT. While conventional treatment is fully covered, MRCT is only incentivized for cases with long in-patient treatment, so financial feasibility for hospitals is limited. Patients with MRCT reported significant improvements in quality of life ( p < .001; Nottingham Health Profile) as well as in physical functions (Functional Questionnaire Hannover [FFbH], p < .001) at discharge compared to admission. As short-term MRCT is not fully remunerated, less severe cases may not receive adequate care. Financial incentives should at least cover the costs incentivize the offer and thus ensure patient access to MRCT. Measuring the outcomes of the treatment process by means of Proms can contribute to the internal quality management. It also offers an inter-institutional benchmark to service providers, which can be used as a basis for performing comparative quality measurements and researching effectiveness.
Fecal microbiome in systemic sclerosis, in search for the best candidate for microbiota-targeted therapy for small intestinal bacterial overgrowth control
Authors: Fiorentini Elisa , Russo Edda , Amedei Amedeo , Bellando Randone Silvia
Published: September 2022

Gastrointestinal involvement is a common complication in systemic sclerosis patients and must be suspected and investigated already in the early stages of the disease. Gastrointestinal symptoms and complications—such as gastroesophageal reflux disease, intestinal pseudo-obstruction, malnutrition, diarrhea, constipation, and small intestinal bacterial overgrowth—severely impair systemic sclerosis patients’ quality of life and affect their prognosis. Although some pathogenetic aspects of the gastrointestinal involvement in systemic sclerosis remain unclear, defining the characteristics of the microbiota and its role could help in risk stratification, selection of candidates for microbiota-targeted therapies, prediction of standard treatment efficacy, and prognosis of systemic sclerosis patients. Finally, understanding how to modify the microbiota composition may represent an important therapeutic approach to target gastrointestinal involvement in systemic sclerosis.
Perception of Clinical Authority in LGBTQIA+ Mental Health Service Users: An Exploration Through Projective Storytelling and Experiential Narratives
Authors: Chatterjee Aritra , Dasgupta Manisha
Published: September 2022

Background:

There is a tendency to use projective assessment to single out intrapsychic vulnerabilities of LGBTQIA+ individuals in mental health literature, without giving due weightage to their marginalized contexts. Additionally, their experiences in accessing mental health services are often nonaffirmative due to dominant pathological discourses in mainstream settings, even though scientific-clinical consensus has been explicit about depathologization.

Objectives:

The current study aims to understand implicit perceptions and attitudes toward clinical authority in a sample of 10 self-identified LGBTQIA+ mental health service-users in Kolkata. It also aims to contextualize the same against their lived experiences of mental health-care use.

Methodology:

Qualitative method was used in the current study. Data was collected with the help of sociodemographic questionnaire (for identifying social locations of participants), semi-structured interviews (for eliciting lived experiences of clinical relationships in mental health care), and projective storytelling with the help of TAT Cards 1 and 12M.

Results:

Analysis of projective storytelling reveals predominantly negative perception of clinical authority with prominent themes of being overpowered by authority, dilemma regarding clinical outcome, passivity, sexual violation, and extreme perceived hostility from environment. Such perception is explainable in the light of lived experiences of discrimination in mental health care, personal vulnerabilities, lack of wholesome interpersonal relationships, and being victims of dominant pathologizing discourses in mental health sciences.

Conclusion:

Mental health-care praxis needs to direct its attention to discriminatory experiences of service-users from gender and sexual minorities. Practitioners must be encouraged to develop specific competency in this regard, and be mindful of their own biases and prejudice when interacting with clients. JEL Classification:
RNA-regulatory exosome complex suppresses an apoptotic program to confer erythroid progenitor cell survival in vivo
Authors: Fraga de Andrade Isabela , Johnson Kirby D. , Mehta Charu , Dewey Colin N. , Basu Uttiya , Bresnick Emery H.
Published: September 2022

The RNA-regulatory exosome complex (EC) posttranscriptionally and cotranscriptionally processes and degrades RNAs in a context-dependent manner. Although the EC functions in diverse cell types, its contributions to stem and progenitor cell development are not well understood. Previously, we demonstrated that the transcriptional regulator of erythrocyte development, GATA1, represses EC subunit genes, and the EC maintains erythroid progenitors in vitro. To determine if this mechanism operates in vivo, we used the hematopoietic-specific Vav1-Cre and “conditional by inversion” mouse system to ablate Exosc3, encoding an EC structural subunit. Although Exosc3C/C Cre+ embryos developed normally until embryonic day 14.5, Exosc3 ablation was embryonic lethal and severely reduced erythromyeloid progenitor activity. RNA sequencing analysis of Exosc3-ablated burst-forming unit-erythroid revealed elevated transcripts encoding multiple proapoptotic factors, and the mutant erythroid progenitors exhibited increased apoptosis. We propose that the EC controls an ensemble of apoptosis-regulatory RNAs, thereby promoting erythroid progenitor survival and developmental erythropoiesis in vivo.
The impact of seat height on 1-min sit-to-stand test performance in COPD: a randomised crossover trial
Authors: Zumbrunnen Valerie , Riegler Thomas F. , Haile Sarah R. , Radtke Thomas
Published: September 2022

Study question

Is there a difference in the number of repetitions in the 1-minute sit-to-stand (1MSTS) test using an individually adapted seat height to 90° knee flexion (1MSTSIND), compared with the commonly used standard chair seat height of 46 cm (1MSTSSTD), in people with COPD?

Methods

We conducted a single-centre, single-blinded, randomised crossover trial in people with COPD between August 2020 and March 2021 at a specialised rehabilitation clinic in Switzerland. After a learning 1MSTS test, all participants performed two 1MSTS tests in random order on consecutive days. Participants were blinded, as they did not receive detailed information on the testing protocols.

Results

49 individuals with COPD (47% female) participated. In a regression model adjusted for sequence period and subject, 1MSTS test performance was lower on 1MSTSINDcompared to 1MSTSSTD(−0.78 repetitions, 95% CI −1.47 to −0.11). In a second regression model additionally including the knee angle and an interaction term (1MSTSIND×knee angle), the interaction term was significant: 0.18 (95% CI 0.05 to 0.30). The limits of agreement were between −5.5 and 4 repetitions.

Conclusion

Although we observed a statistically significant difference between 1MSTSINDand 1MSTSSTDon a population level, the difference is negligible. Further studies may be needed to determine whether individual adaptation of seat height is needed for very tall or short people to ensure a valid assessment of 1MSTS test performance in COPD.
Effects of functional training with blood occlusion on the irisin, follistatin, and myostatin myokines in elderly men
Authors: Pazokian Fatemeh , Amani-Shalamzari Sadegh , Rajabi Hamid
Published: September 2022

Background

This study aimed to determine the efficacy of functional training with and without blood flow restriction (BFR) on muscle hypertrophy indices and strength in older men.

Methods

Thirty older adults (67.7 ± 5.8 years) were randomly assigned to three groups: functional training (FT), functional training with BFR (FTBFR), and control (C). Participants in experimental groups were trained in three sessions per week for six weeks. They performed 11 whole body exercises, in 2–4 sets of 10 repetitions. FTBFR group wore pneumatic cuffs on their extremities that began with 50% of estimated arterial occlusion pressure which increased by 10% every two weeks. Blood samples were obtained, and static strength tests were evaluated at baseline and after the training program. A One-Way Analysis of Covariance was used to interpret the data.

Results

A significant increase in follistatin levels (p = 0.002) and reduction in myostatin levels (p = 0.001) were observed in FT and FTBFR groups; there was a considerable increase in the F:M ratio in both training groups (p = 0.001), whereas it decreased in C group. These changes were accompanied by significant improvements in handgrip (p = 0.001) and shoulder girdle (p = 0.001) strength in both experimental groups, especially in the FTBFR group. However, the levels of irisin were not statistically changed following interventions (p = 0.561).

Conclusion

The findings showed that FT was effective in increasing circulating biomarkers involved in hypertrophy in older adults while adding BFR to FT had a slight increase in these biomarkers but had a tremendous increase in muscle strength.
Pupil-linked arousal with very light exercise: pattern of pupil dilation during graded exercise
Authors: Kuwamizu Ryuta , Yamazaki Yudai , Aoike Naoki , Ochi Genta , Suwabe Kazuya , Soya Hideaki
Published: September 2022

Although it has been hypothesized that moderate to vigorous exercise immediately modulates cognition via ascending arousal system activation, such activation during very-light to light exercise has remained uncertain. Here, we aimed to uncover the exact exercise intensity necessary for ascending arousal system activation using pupillometry. The pupil diameter, psychological arousal, and ventilation during graded exercise of 26 young males were analyzed based on %$${\dot{V}}_{{\text{O}}_{\text{2peak}}}$$

V
˙

O
2peak

. Pupils dilated with very-light exercise compared to rest, stabilized, and then drastically increased again with moderate exercise and above. Pupil dilation with very-light exercise was positively correlated with increases in psychological arousal. Thus, we have shown that there are two phases of pupil dilation during graded exercise: one with very-light exercise coinciding with psychological arousal response, and the other with moderate exercise or above similar to the ventilation increase pattern. This unique pupil dilation pattern provides physiological evidence of ascending arousal system activation with very-light exercise.
Long-term exercise training down-regulates m6A RNA demethylase FTO expression in the hippocampus and hypothalamus: an effective intervention for epigenetic modification
Authors: Liu Shu-Jing , Cai Tong-Hui , Fang Chun-Lu , Lin Shao-Zhang , Yang Wen-Qi , Wei Yuan , Zhou Fu , Liu Ling , Luo Yuan , Guo Zi-Yi , Zhao Ge , Li Ya-Ping , Li Liang-Ming
Published: September 2022

Background

Exercise boosts the health of some brain parts, such as the hippocampus and hypothalamus. Several studies show that long-term exercise improves spatial learning and memory, enhances hypothalamic leptin sensitivity, and regulates energy balance. However, the effect of exercise on the hippocampus and hypothalamus is not fully understood. The study aimed to find epigenetic modifications or changes in gene expression of the hippocampus and hypothalamus due to exercise.

Methods

Male C57BL/6 mice were randomly divided into sedentary and exercise groups. All mice in the exercise group were subjected to treadmill exercise 5 days per week for 1 h each day. After the 12-week exercise intervention, the hippocampus and hypothalamus tissue were used for RNA-sequencing or molecular biology experiments.

Results

In both groups, numerous differentially expressed genes of the hippocampus (up-regulated: 53, down-regulated: 49) and hypothalamus (up-regulated: 24, down-regulated: 40) were observed. In the exercise group, increased level of N6-methyladenosine (m6A) was observed in the hippocampus and hypothalamus (p < 0.05). Furthermore, the fat mass and obesity-associated gene (FTO) of the hippocampus and hypothalamus were down-regulated in the exercise group (p < 0.001). In addition, the Fto co-expression genes of the mouse brain were studied and analyzed using database to determine the potential roles of exercise-downregulated FTO in the brain.

Conclusion

The findings demonstrate that long-term exercise might elevates the levels of m6A-tagged transcripts in the hippocampus and hypothalamus via down-regulation of FTO. Hence, exercise might be an effective intervention for epigenetic modification.
Posttraumatic growth inventory: challenges with its validation among French cancer patients
Authors: Dubuy Yseulys , Sébille Véronique , Bourdon Marianne , Hardouin Jean-Benoit , Blanchin Myriam
Published: September 2022

Background

The Posttraumatic growth inventory (PTGI) aims to assess the positive psychological changes that individuals can perceive after a traumatic life event such as a cancer diagnosis. Several French translations of the PTGI have been proposed, but comprehensive data on their psychometric properties are lacking. This study aimed to provide a more complete assessment of the psychometric properties of one of the most used PTGI translations in early-stage breast cancer and melanoma patients.

Methods

A sample of 379 patients completed the PTGI two years after their cancer diagnosis. A confirmatory analysis was first performed to determine whether the initial five-factor structure of the PTGI was adequate for this French version. As issues were identified in the translation and in the questionnaire structure, we performed an exploratory analysis to determine the most suitable structure for this questionnaire. Validity and reliability of the evidenced structured were then assessed.

Results

The exploratory analysis evidenced a four-factor structure close to the initial structure: four of the five initial domains were recovered, and items from the unrecovered domain were split into the other domains. This new structure showed good internal consistency and acceptable validity.

Conclusions

This study highlights that the process of translation and cross-cultural validation of questionnaires is crucial to obtain valid and reliable psychometric instruments. We advise French psycho-oncology researchers and psychotherapists to (i) use the revised translation of Lelorain et al. (2010) proposed in this manuscript and (ii) use the four scores newly evidenced with a grouping of two response categories.
Sensitivity analyses for data missing at random versus missing not at random using latent growth modelling: a practical guide for randomised controlled trials
Authors: Staudt Andreas , Freyer-Adam Jennis , Ittermann Till , Meyer Christian , Bischof Gallus , John Ulrich , Baumann Sophie
Published: September 2022

Background

Missing data are ubiquitous in randomised controlled trials. Although sensitivity analyses for different missing data mechanisms (missing at random vs. missing not at random) are widely recommended, they are rarely conducted in practice. The aim of the present study was to demonstrate sensitivity analyses for different assumptions regarding the missing data mechanism for randomised controlled trials using latent growth modelling (LGM).

Methods

Data from a randomised controlled brief alcohol intervention trial was used. The sample included 1646 adults (56% female; mean age = 31.0 years) from the general population who had received up to three individualized alcohol feedback letters or assessment-only. Follow-up interviews were conducted after 12 and 36 months via telephone. The main outcome for the analysis was change in alcohol use over time. A three-step LGM approach was used. First, evidence about the process that generated the missing data was accumulated by analysing the extent of missing values in both study conditions, missing data patterns, and baseline variables that predicted participation in the two follow-up assessments using logistic regression. Second, growth models were calculated to analyse intervention effects over time. These models assumed that data were missing at random and applied full-information maximum likelihood estimation. Third, the findings were safeguarded by incorporating model components to account for the possibility that data were missing not at random. For that purpose, Diggle-Kenward selection, Wu-Carroll shared parameter and pattern mixture models were implemented.

Results

Although the true data generating process remained unknown, the evidence was unequivocal: both the intervention and control group reduced their alcohol use over time, but no significant group differences emerged. There was no clear evidence for intervention efficacy, neither in the growth models that assumed the missing data to be at random nor those that assumed the missing data to be not at random.

Conclusion

The illustrated approach allows the assessment of how sensitive conclusions about the efficacy of an intervention are to different assumptions regarding the missing data mechanism. For researchers familiar with LGM, it is a valuable statistical supplement to safeguard their findings against the possibility of nonignorable missingness.

Trial registration

The PRINT trial was prospectively registered at the German Clinical Trials Register (DRKS00014274, date of registration: 12th March 2018).
Barriers and facilitators for implementation of a digital referral algorithm for inflammatory arthritis - a qualitative assessment in patients and caregivers
Authors: van Delft Elke , Bos Ruben , Pennings Patricia , Hazes Mieke , Lopes Barreto Deirisa , Weel-Koenders Angelique
Published: September 2022

Purpose

Difficulty to recognize inflammatory rheumatic diseases (IRD) in a primary care setting leads to late referral to secondary care. An evidence-based digital referral algorithm can support early referral, yet implementation in daily practice only succeeds with support of end users. We aim to understand the context of implementing a digital referral algorithm and explore the potential barriers and facilitators to implementation.

Methods

This qualitative study comprised focus groups and an online survey. Focus groups were performed with patients from outpatient rheumatology clinics. Surveys were sent out to general practitioners and rheumatologists distributed over The Netherlands. The presented digital referral algorithm originates from the JOINT referral study. Thematic analysis was used with inductive and deductive approaches.

Results

In total 26 patients participated distributed over three focus groups, and 215 caregivers (104 rheumatologists, 111 general practitioners) filled out the survey. Both patients and caregivers endorse the need for early referral, and recognize the perceived benefit of the digital algorithm. Potential barriers include the complexity of currently included questions, and the outcome lacking information on what to do with no risk of IRD. In order for implementation to be successful, the inclusivity, accessibility, content and outcome of the algorithm are considered important themes.

Conclusion

Successful implementation of a digital referral algorithm needs a systematic multi-facetted approach, considering the barriers and facilitators for implementation as discussed. Since the majority of identified barriers and facilitators was overlapping between all stakeholders, findings from this study can reliably inform further decision strategies for successful implementation.
Maternal mental health and breastfeeding amidst the Covid-19 pandemic: cross-sectional study in Catalonia (Spain)
Authors: Nicolás-López Marta , González-Álvarez Pablo , Sala de la Concepción Anna , Giralt-López Maria , Lorente Beatriz , Velasco Inés , Wichner Paula Sol Ventura , Ginovart Gemma
Published: September 2022

Background

Covid-19 pandemic became an unexpected stressor for the entire population and, particularly, for pregnant women and lactating mothers. The alarming infectious risk together with the lockdown period could affect the emotional state of mothers-to-be, as well as breastfeeding rates, mother-baby bonding, or neonatal weight gain. The aim of this study is to describe the impact of this world health emergency in mother-baby pairs right after the first wave of Sars-Cov-2 pandemic (from March to May 2020).

Study design

A prospective observational study was carried out in mother–child dyads from those women who gave birth between June and August 2020 in a tertiary hospital. 91 mother-baby pairs were initially enrolled and 56 of them completed the follow-up. The study design had two separate steps: i) Step one: A clinical interview plus three psychometric tests (EPDS: Edinburgh Postnatal Depression Scale, PBQ: Postpartum Bonding Questionnaire and STAI-S: State-Trait Anxiety Inventory); ii) Step two: mother–child dyads were followed using a round of three brief telephone interviews (conducted at the newborn’s 7, 14 and 28 days of age) to accurately depict the newborn’s outcome in the neonatal period.

Results

In terms of maternal mental health, 25% of the sample screens positively in the EPDS, requiring further evaluation to rule out depressive symptoms. STAI-state and PBQ detect no abnormalities in either anxiety levels or mother–child bonding in our sample, as 100% of the mothers score below the cut-off points in each test (34 and 26 respectively). When comparing feeding practices (breast/bottle feeding) in 2020 to those practices during pre-pandemic years (2017–2019), a significant increase in breastfeeding was found in pandemic times. All newborns in the sample showed an adequate weight gain during their first month of life.

Conclusion

Women and newborns in our sample did not experience an increase in adverse outcomes in the neonatal period in terms of maternal mental health, breastfeeding rates, bonding and further neonatal development.
Women’s knowledge, attitudes and views of preconception health and intervention delivery methods: a cross-sectional survey
Authors: Daly Michael P. , White James , Sanders Julia , Kipping Ruth R.
Published: September 2022

Background

Several preconception exposures have been associated with adverse pregnancy, birth and postpartum outcomes. However, few studies have investigated women’s knowledge of and attitudes towards preconception health, and the acceptability of potential intervention methods.

Methods

Seven primary care centres in the West of England posted questionnaires to 4330 female patients aged 18 to 48 years. Without providing examples, we asked women to list maternal preconception exposures that might affect infant and maternal outcomes, and assessed their knowledge of nine literature-derived risk factors. Attitudes towards preconception health (interest, intentions, self-efficacy and perceived awareness and importance) and the acceptability of intervention delivery methods were also assessed. Multivariable multilevel regression examined participant characteristics associated with these outcomes.

Results

Of those who received questionnaires, 835 (19.3%) responded. Women were most aware of the preconception risk factors of diet (86.0%) and physical activity (79.2%). Few were aware of weight (40.1%), folic acid (32.9%), abuse (6.3%), advanced age (5.9%) and interpregnancy intervals (0.2%), and none mentioned interpregnancy weight change or excess iron intake. After adjusting for demographic and reproductive covariates, women aged 18–24-years (compared to 40–48-year-olds) and nulligravid women were less aware of the benefit of preconception folic acid supplementation (adjusted odds ratios (aOR) for age: 4.30 [2.10–8.80], gravidity: aOR 2.48 [1.70–3.62]). Younger women were more interested in learning more about preconception health (aOR 0.37 [0.21–0.63]) but nulligravid women were less interested in this (aOR 1.79 [1.30–2.46]). Women with the lowest household incomes (versus the highest) were less aware of preconception weight as a risk factor (aOR: 3.11 [1.65–5.84]) and rated the importance of preconception health lower (aOR 3.38 [1.90–6.00]). The most acceptable information delivery methods were websites/apps (99.5%), printed healthcare materials (98.6%), family/partners (96.3%), schools (94.4%), television (91.9%), pregnancy tests (91.0%) and doctors, midwives and nurses (86.8–97.0%). Dentists (23.9%) and hairdressers/beauticians (18.1%) were the least acceptable.

Conclusions

Our findings demonstrate a need to promote awareness of preconception risk factors and motivation for preconception health changes, particularly amongst younger and nulligravid women and women with lower incomes. Interventions to improve preconception health should focus on communication from healthcare professionals, schools, family members, and digital media.
Thin bronchoscopic cryobiopsy using a nasobronchial tube
Authors: Oki Masahide , Saka Hideo , Kogure Yoshihito , Niwa Hideyuki , Ishida Akane , Yamada Arisa , Torii Atsushi , Kitagawa Chiyoe
Published: September 2022

Background

Transbronchial lung cryobiopsy is useful when diagnosing lung lesions. However, prevention of associated bleeding complications is essential. This study aimed to evaluate the safety and efficacy of our novel bronchoscopic cryobiopsy technique, which uses a long nasobronchial tube to prevent blood flooding the central airway.

Methods

Patients with localized or diffuse lung lesions were prospectively enrolled and underwent cryobiopsy using a 1.9 mm diameter cryoprobe and a 4.0 mm diameter thin bronchoscope under conscious sedation. For cryobiopsy, a long silicone tube (inner diameter, 5.0 mm) was advanced through the nose to the target bronchus, then wedged to drain blood under thin-tube bronchoscopic control. The primary endpoint was the frequency of bleeding complications.

Results

Of the 80 patients initially enrolled, 73 that underwent at least one cryobiopsy were ultimately included. Mild bleeding during cryobiopsy occurred in 58 patients (79.5%), but there was no moderate or severe bleeding. Other complications occurred in four patients (two pneumothorax, one pneumomediastinum, and one pneumonia). Tube dislocation was noted in eight patients (11%). Cryobiopsy specimens were significantly larger than forceps biopsy specimens (9.0 mm2 vs. 2.7 mm2, P < .001) and allowed specific diagnoses in 50 patients (68.5%).

Conclusions

Thin bronchoscopic cryobiopsy using a nasobronchial tube in consciously sedated patients is safe and effective.

Trial registration Date of registration: 24/06/2019. UMIN-Clinical Trials Registry; Identifier: UMIN000037156 https://www.umin.ac.jp/ctr/index.htm
Atorvastatin lowers serum calcium levels in lithium-users: results from a randomized controlled trial
Authors: Soh Jocelyn Fotso , Bodenstein Katie , Yu Oriana Hoi Yun , Linnaranta Outi , Renaud Suzane , Mahdanian Artin , Su Chien-Lin , Mucsi Istvan , Mulsant Benoit , Herrmann Nathan , Rajji Tarek , Beaulieu Serge , Sekhon Harmehr , Rej Soham
Published: September 2022

Background

Although lithium is considered the gold-standard treatment for bipolar disorder (BD), it is associated with a variety of major endocrine and metabolic side effects, including parathyroid hormone (PTH) dependent hypercalcemia. Aside from surgery and medication discontinuation, there are limited treatments for hypercalcemia. This paper will assess data from a randomized controlled trial (RCT).

Methods

This is a secondary analysis of an RCT that explored the effects of atorvastatin (n = 27) versus placebo (n = 33) on lithium-induced nephrogenic diabetes insipidus (NDI) in patients with BD and major depressive disorder (MDD) using lithium (n = 60), over a 12-week period. This secondary analysis will explore serum calcium levels and thyroid stimulating hormone (TSH) measured at baseline, week 4, and week 12.

Results

At 12-weeks follow-up while adjusting results for baseline, linear regression analyses found that corrected serum calcium levels were significantly lower in the treatment group (mean (M) = 2.30 mmol/L, standard deviation (SD) = 0.07) compared to the placebo group (M = 2.33 mmol/L, SD = 0.07) (β = − 0.03 (95% C.I.; − 0.0662, − 0.0035), p = 0.03) for lithium users. There were no significant changes in TSH.

Conclusion

In lithium users with relatively normal calcium levels, receiving atorvastatin was associated with a decrease in serum calcium levels. Although exciting, this is a preliminary finding that needs further investigation with hypercalcemic patients. Future RCTs could examine whether atorvastatin can treat PTH dependent hypercalcemia due to lithium and other causes.
The effect of amine-free initiator system and polymerization type on long-term color stability of resin cements: an in-vitro study
Authors: Kavut İdris , Uğur Mehmet
Published: September 2022

Background

This in vitro study evaluated the effect of amine-free initiator system and polymerization type on long-term color change of amine-free light-cure and dual-cure resin cements.

Methods

Sixty disk-shaped specimens (10 × 1 mm) were prepared from six different amine-free resin cements; NX3 Nexus light-cure (LC) and dual-cure (DC), Variolink Veneer (LC) and Variolink II (DC), Relyx Veneer (LC) and Rely X Ultimate (DC). A feldspathic porcelain specimen (12 × 14 × 0.8 mm) was obtained from a CAD/CAM block (Cerec Blocks; Sirona Dental Systems GmbH, Bensheim, Germany) for color testing. The feldspathic specimen was placed on the resin cement disk and all measurements were performed without cementation. A spectrophotometer was used for color measurements. Specimens were subjected to thermal aging (5 °C and 55 °C; 5000 and 20,000 cycles). Specific color coordinate differences (ΔL, Δa, and Δb) and the total color differences (ΔE00) were calculated after immersion in distilled water for different periods. Normality of data distribution was tested by using the Kolmogorov–Smirnov test. Data were statistically in a model of repeated measures, using multivariate tests and Tukey’s multiple comparison tests at a significance level of p < 0.05.

Results

∆E00 values of resin cements were influenced by cycle periods, significantly (p < 0.05). The highest ΔE00 values for long term were obtained in the NX3 (DC) (3.49 ± 0.87) and the lowest in the NX3 (LC) (1.41 ± 0.81). NX3 (LC), Variolink (DC), RELY X (LC) resin cements showed clinically acceptable color change after long-term aging (∆E00 < 1.8).

Conclusion

Light-cure resin cements should be preferred for long-term color stability of full ceramic restorations.
Jordanian women’s (studying or working in medical fields) awareness in terms of the use of dental imaging during pregnancy
Authors: Oglat Ammar A. , Hasan Hanan
Published: September 2022

Background

The anxiety among pregnant women about the imaging of teeth during pregnancy may have an adverse effect on the oral health of both the mother and the fetus too. This research study was conducted to evaluate women’s knowledge of the utilization of dental imaging during pregnancy.

Methods

In this research, structured questionnaires were distributed electronically through social media. The questionnaires contained questions focused on the women’s (studying or working in medical fields) awareness regarding the ionizing radiation protection that takes place during dental imaging, the safest period for dental imaging, the sort of radiographs that can be required, and the chance of radiation-induced malignant tumor and malformation of the fetal as a result of dental imaging.

Results

Overall, 984 participants completed questionnaires that were analyzed after being received. Most of the participants (n = 637; 64.7%) were < 30 years of age. The greater number of the participants (66.8%) had fair knowledge of dental imaging. 25.4% mentioned that pregnant women are able to do dental imaging during the first trimester. And approximately half of the participants thought that cone-beam computed tomography and panoramic images must not be carried out during pregnancy. Moreover, nearly the same percentage of them also believed that the risk of inborn malformation is high due to dental imaging.

Conclusions

The results refer to a low awareness among people who have medical knowledge regarding dental radiograph protection during pregnancy. This needs to be paid attention to among students, graduates, and workers in medical fields by focusing on the courses and lectures related to dental imaging protection during pregnancy.
Evaluation of medical decision support systems (DDX generators) using real medical cases of varying complexity and origin
Authors: Fritz P. , Kleinhans A. , Raoufi R. , Sediqi A. , Schmid N. , Schricker S. , Schanz M. , Fritz-Kuisle C. , Dalquen P. , Firooz H. , Stauch G. , Alscher M. D.
Published: September 2022

Background

Medical decision support systems (CDSSs) are increasingly used in medicine, but their utility in daily medical practice is difficult to evaluate. One variant of CDSS is a generator of differential diagnoses (DDx generator). We performed a feasibility study on three different, publicly available data sets of medical cases in order to identify the frequency in which two different DDx generators provide helpful information (either by providing a list of differential diagnosis or recognizing the expert diagnosis if available) for a given case report.

Methods

Used data sets weren = 105 cases from a web-based forum of telemedicine with real life cases from Afghanistan (Afghan data set; AD),n = 124 cases discussed in a web-based medical forum (Coliquio data set; CD). Both websites are restricted for medical professionals only. The third data set consisted 50 special case reports published in the New England Journal of Medicine (NEJM). After keyword extraction, data were entered into two different DDx generators (IsabelHealth (IH), Memem7 (M7)) to examine differences in target diagnosis recognition and physician-rated usefulness between DDx generators.

Results

Both DDx generators detected the target diagnosis equally successfully (all cases: M7, 83/170 (49%); IH 90/170 (53%), NEJM: M7, 28/50 (56%); IH, 34/50 (68%); differences n.s.). Differences occurred in AD, where detection of an expert diagnosis was less successful with IH than with M7 (29.7% vs. 54.1%,p = 0.003). In contrast, in CD IH performed significantly better than M7 (73.9% vs. 32.6%,p = 0.021). Congruent identification of target diagnosis occurred in only 46/170 (27.1%) of cases. However, a qualitative analysis of the DDx results revealed useful complements from using the two systems in parallel.

Conclusion

Both DDx systems IsabelHealth and Memem7 provided substantial help in finding a helpful list of differential diagnoses or identifying the target diagnosis either in standard cases or complicated and rare cases. Our pilot study highlights the need for different levels of complexity and types of real-world medical test cases, as there are significant differences between DDx generators away from traditional case reports. Combining different results from DDx generators seems to be a possible approach for future review and use of the systems.