bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing how routes to diagnosis vary by the age of patients with cancer: a nationwide register-based cohort study in Denmark
Authors: Danckert B. , Christensen N. L. , Falborg A. Z. , Frederiksen H. , Lyratzopoulos G. , McPhail S. , Pedersen A. F. , Ryg J. , Thomsen L. A. , Vedsted P. , Jensen H.
Published: August 2022

Background

Older patients with cancer have poorer prognosis compared to younger patients. Moreover, prognosis is related to how cancer is identified, and where in the healthcare system patients present, i.e. routes to diagnosis (RtD). We investigated whether RtD varied by patients’ age.

Methods

This population-based national cohort study used Danish registry data. Patients were categorized into age groups and eight mutually exclusive RtD. We employed multinomial logistic regressions adjusted for sex, region, diagnosis year, cohabitation, education, income, immigration status and comorbidities. Screened and non-screened patients were analysed separately.

Results

The study included 137,876 patients. Both younger and older patients with cancer were less likely to get diagnosed after a cancer patient pathways referral from primary care physician compared to middle-aged patients. Older patients were more likely to get diagnosed via unplanned admission, death certificate only, and outpatient admission compared to younger patients. The patterns were similar across comorbidity levels.

Conclusions

RtD varied by age groups, and middle-aged patients were the most likely to get diagnosed after cancer patient pathways with referral from primary care. Emphasis should be put on raising clinicians’ awareness of cancer being the underlying cause of symptoms in both younger patients and in older patients.
Achondroplasia in Latin America: practical recommendations for the multidisciplinary care of pediatric patients
Authors: Llerena Juan , Kim Chong Ae , Fano Virginia , Rosselli Pablo , Collett-Solberg Paulo Ferrez , de Medeiros Paula Frassinetti Vasconcelos , del Pino Mariana , Bertola Débora , Lourenço Charles Marques , Cavalcanti Denise Pontes , Félix Têmis Maria , Rosa-Bellas Antonio , Rossi Norma Teresa , Cortes Fanny , Abreu Flávia , Cavalcanti Nicolette , Ruz Maria Cecilia Hervias , Baratela Wagner
Published: August 2022

Background

Achondroplasia is the most common bone dysplasia associated with disproportionate short stature, and other comorbidities, such as foramen magnum stenosis, thoracolumbar kyphosis, lumbar hyperlordosis, genu varum and spinal compression. Additionally, patients affected with this condition have higher frequency of sleep disorders, ear infections, hearing loss and slowed development milestones. Considering these clinical features, we aimed to summarize the regional experts’ recommendations for the multidisciplinary management of patients with achondroplasia in Latin America, a vast geographic territory with multicultural characteristics and with socio-economical differences of developing countries.

Methods

Latin American experts (from Argentina, Brazil, Chile and Colombia) particiáted of an Advisory Board meeting (October 2019), and had a structured discussion how patients with achondroplasia are followed in their healthcare centers and punctuated gaps and opportunities for regional improvement in the management of achondroplasia.

Results

Practical recommendations have been established for genetic counselling, prenatal diagnosis and planning of delivery in patients with achondroplasia. An outline of strategies was added as follow-up guidelines to specialists according to patient developmental phases, amongst them neurologic, orthopedic, otorhinolaryngologic, nutritional and anthropometric aspects, and related to development milestones. Additionally, the role of physical therapy, physical activity, phonoaudiology and other care related to the quality of life of patients and their families were discussed. Preoperative recommendations to patients with achondroplasia were also included.

Conclusions

This study summarized the main expert recommendations for the health care professionals management of achondroplasia in Latin America, reinforcing that achondroplasia-associated comorbidities are not limited to orthopedic concerns.
Prevalence and risk factors of prehypertension and hypertension in Algeria
Authors: Moussouni Abdellatif , Sidi-yakhlef Adel , Hamdaoui Houari , Aouar Amaria , Belkhatir Djamel
Published: August 2022

Background

Hypertension, also referred to as the silent killer, is known to be one of the most common chronic diseases in the world today. This study aimed to identify the prevalence and risk factors of prehypertension and hypertension among Algerian population.

Methods

This is a descriptive cross-sectional epidemiological study involving individuals aged 18 to 69 years old who were identified in the database of the national survey on non-communicable diseases (NCDs) risk factors conducted in Algeria between 2016 and 2017 using the World Health Organization’s (WHO) STEPwise approach.

Differences in prevalence between normotensives, prehypertensives and hypertensives were assessed using the chi-square test. We also looked at the role of numerous socio-demographic, economic, geographical, and behavioural factors in blood pressure status using a logistic regression model.

Results

The prevalence of prehypertension and hypertension was 36.2% (95% confidence interval: 35.2–37.5%) and 31.6% (95% CI: 30.5–32.7%) respectively. Prehypertension was shown to be substantially higher in males than in women, while hypertension was found to be higher in females compared to men. In addition, both sexes had a rise in the prevalence of blood pressure as they grew older.

A according to multivariate logistic regression analysis, the main common risk factors for prehypertension and hypertension were ageing, obesity, and abdominal obesity. Moreover hypercholesterolemia, and marital status (separated/divorced) were correlated to hypertension.

Conclusion

Prehypertension and hypertension are high and epidemic in Algeria. Therefore, the urgent quantification and monitoring of their risk factors becomes a necessity to plan appropriate preventive measures, in order to fight against NCDs in general.
Triple primary lung cancer: a case report
Authors: Choi Hye Sook , Sung Ji-Youn
Published: August 2022

Background

The risk of developing lung cancer is increased in smokers, patients with chronic obstructive pulmonary disease, individuals exposed to environmental carcinogens, and those with a history of lung cancer. Automobile exhaust fumes containing carcinogens are a risk factor for lung cancer. However, we go through life unaware of the fact that automobile exhaust is the cause of cancer. Especially, in lung cancer patient, it is important to search out pre-existing risk factors and advice to avoid them, and monitor carefully for recurrence after treatment.

Case presentation

This is the first report of a case with triple lung cancers with different histologic types at different sites, observed in a 76-year-old parking attendant. The first adenocarcinoma and the second squamous cell carcinoma were treated with stereotactic radiosurgery because the patient did not want to undergo surgery. Although the patient stopped intermittent smoking after the diagnosis, he continued working as a parking attendant in the parking lot. After 29 months from the first treatment, the patient developed a third new small cell lung cancer; he was being treated with chemoradiation.

Conclusions

New mass after treatment of lung cancer might be a multiple primary lung cancer rather than metastasis. Thus, precision evaluation is important. This paper highlights the risk factors for lung cancer that are easily overlooked but should not be dismissed, and the necessity of discussion with patients for the surveillance after lung cancer treatment. We should look over carefully the environmental carcinogens already exposed, and counsel to avoid pre-existing lung cancer risk factors at work or residence in patients with lung cancer.
Translation and validation of Sinhala version of modified EORTC QLQ-OH15 in oral cancer patients who receive radiotherapy with or without chemotherapy in Sri Lanka
Authors: Kosgallana Shamini , Jayasekara Prasanna , Abeysinghe Prasad , Hjermstad Marianne , Lalloo Ratilal
Published: August 2022

Background

The recognition of patient-reported outcomes for oral cancer is important in improving patients’ quality of life. The aim of this study was to translate and validate the modified Sinhala version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Oral Health Module (EORTC QLQ-OH15).

Methods

A cross-sectional study was conducted to validate the EORTC QLQ-OH15 that was modified after adding two questions to the original questionnaire. The two questions added were ‘difficulty in opening the mouth wide’ and ‘trouble with talking’ which affect oral health related quality of life (OHRQOL) of oral cancer patients receiving radiotherapy. The Sinhala translated modified EORTC QLQ-OH15 and already validated the core questionnaire EORTC QLQ-C30 were self-completed by 85 adult oral cancer patients who received initial anti-cancer treatment with radiotherapy with or without chemotherapy. Content and face validity were examined by an expert panel. Construct validity was confirmed by using factor analysis, multi-trait scaling analysis, and known group comparison. Reliability was assessed by internal consistency, test–retest reliability by Wilcoxon Signed Ranks Test and intra class correlation coefficient. Responsiveness to change was assessed.

Results

The majority of participants (58%) were aged 50–69 years and 84% were males. Nearly 32% had cancer of the anterior two thirds of the tongue. Of the sample, 66% received chemo radiotherapy. Thirteen items were included for the factor analysis. They were loaded for four factors. Three scales ‘Eating problem’, ‘Gum and Speech problem’ and ‘Soreness’ loaded with 5, 4 and 3 items respectively and single item ‘teeth’ to a one factor with the total variance explained was 72.74%. Mann–Whitney U tests for all three scales were statistically significant confirming the ability of the modified EORTC QLQ-OH15 to detect expected differences in OHRQOL in clinically different groups. Cronbach’s alpha for all the scales were more than 0.8. Wilcoxon Matched Paired Sign Rank Test showed highly significant results (p < 0.05) for all three scales revealing high responsiveness.

Conclusions

The modified Sinhala version of the EORTC QLQ-OH15 is a valid, reliable tool that can be used to measure OHRQOL in oral cancer patients who receive radiotherapy with or without chemotherapy.
Sterilization incentives and associated regret among ever married women in India, NFHS, 2015–16
Authors: Bansal Anjali , Dwivedi Laxmi Kant , Shirisha P.
Published: August 2022

Objective

Sterilization is the only family planning method that involves relatively large amount compensation. So, the study attempts to examine the role of incentives received against the sterilization procedures on the reporting of sterilization regret in India.

Methods

The study used data from the fourth round of National Family Health Survey, 2015–16, which gathered the information on sterilization regret from 1,94,207 ever-married women. Multivariate logistic analysis and predicted probabilities approach was used to study the effect of compensation received on the sterilization regret in India.

Results

Results show that women who have received compensation were 33% less likely to report sterilization regret. It was found that 70% of women who undergone sterilization in public facility didn’t incur any expenditure, rather received incentives. It is observed that women who had undergone operation in private facility spent a large amount than women who had done their operation in public facility. The regret in the private facility mainly results from high out of pocket expenditure on sterilization procedures. Around eight percent of women regretted getting sterilized in a private hospital and received some compensation amount, vis a vis the six percent who regretted undergoing sterilization in public facility and received compensation.

Conclusion

The study calls for a need to standardize the cost of sterilization procedure in India's health facilities. A good alternative for reducing the cost could be Public–Private Partnership.
Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications
Authors: Bilbao Ainhoa , Spanagel Rainer
Published: August 2022

Background

Medical cannabinoids differ in their pharmacology and may have different treatment effects. We aimed to conduct a pharmacology-based systematic review (SR) and meta-analyses of medical cannabinoids for efficacy, retention and adverse events.

Methods

We systematically reviewed (registered at PROSPERO: CRD42021229932) eight databases for randomized controlled trials (RCTs) of dronabinol, nabilone, cannabidiol and nabiximols for chronic pain, spasticity, nausea /vomiting, appetite, ALS, irritable bowel syndrome, MS, Chorea Huntington, epilepsy, dystonia, Parkinsonism, glaucoma, ADHD, anorexia nervosa, anxiety, dementia, depression, schizophrenia, PTSD, sleeping disorders, SUD and Tourette. Main outcomes and measures included patient-relevant/disease-specific outcomes, retention and adverse events. Data were calculated as standardized mean difference (SMD) and ORs with confidence intervals (CI) via random effects. Evidence quality was assessed by the Cochrane Risk of Bias and GRADE tools.

Results

In total, 152 RCTs (12,123 participants) were analysed according to the type of the cannabinoid, outcome and comparator used, resulting in 84 comparisons. Significant therapeutic effects of medical cannabinoids show a large variability in the grade of evidence that depends on the type of cannabinoid. CBD has a significant therapeutic effect for epilepsy (SMD − 0.5[CI − 0.62, − 0.38] high grade) and Parkinsonism (− 0.41[CI − 0.75, − 0.08] moderate grade). There is moderate evidence for dronabinol for chronic pain (− 0.31[CI − 0.46, − 0.15]), appetite (− 0.51[CI − 0.87, − 0.15]) and Tourette (− 1.01[CI − 1.58, − 0.44]) and moderate evidence for nabiximols on chronic pain (− 0.25[− 0.37, − 0.14]), spasticity (− 0.36[CI − 0.54, − 0.19]), sleep (− 0.24[CI − 0.35, − 0.14]) and SUDs (− 0.48[CI − 0.92, − 0.04]). All other significant therapeutic effects have either low, very low, or even no grade of evidence. Cannabinoids produce different adverse events, and there is low to moderate grade of evidence for this conclusion depending on the type of cannabinoid.

Conclusions

Cannabinoids are effective therapeutics for several medical indications if their specific pharmacological properties are considered. We suggest that future systematic studies in the cannabinoid field should be based upon their specific pharmacology.
Injectable magnetic montmorillonite colloidal gel for the postoperative treatment of hepatocellular carcinoma
Authors: Chen Sheng , Song Yonghong , Yan Xu , Dong Liang , Xu Yunjun , Xuan Shouhu , Shu Quan , Cao Baoqiang , Hu Jinlong , Xing Hanye , Wu Wenshu , Zha Zhengbao , Lu Yang
Published: August 2022

Bioactive materials have been extensively developed for the adjuvant therapy of cancer. However, few materials can meet the requirements for the postoperative resection of hepatocellular carcinoma (HCC) due to massive bleeding and high recurrence. In particular, combination therapy for HCC has been highly recommended in clinical practice, including surgical resection, interventional therapy, ablation therapy and chemotherapy. Herein, an injectable magnetic colloidal gel (MCG) was developed by controllable electrostatic attraction between clinically available magnetic montmorillonites and amphoteric gelatin nanoparticles. The optimized MCG exhibited an effective magnetic heating effect, remarkable rheological properties, and high gel network stability, realizing the synergistic treatment of postoperative HCC by stimuli-responsive drug delivery, hemostasis and magnetic hyperthermia. Furthermore, a minimal invasive MCG-induced interventional magnetic hyperthermia therapy (MHT) under ultrasound guidance was realized on hepatic tumor rabbits, providing an alternative therapeutics to treat the postoperative recurrence. Overall, MCG is a clinically available injectable formulation for adjuvant therapy after HCC surgical resection.
Impact of long-COVID on health-related quality of life in Japanese COVID-19 patients
Authors: Tsuzuki Shinya , Miyazato Yusuke , Terada Mari , Morioka Shinichiro , Ohmagari Norio , Beutels Philippe
Published: August 2022

Background

The empirical basis for a quantitative assessment of the disease burden imposed by long-COVID is currently scant. We aimed to inform the disease burden caused by long-COVID in Japan.

Methods

We conducted a cross sectional self-report questionnaire survey. The questionnaire was mailed to 526 eligible patients, who were recovered from acute COVID-19 in April 2021. Answers were classified into two groups; participants who have no symptom and those who have any ongoing prolonged symptoms that lasted longer than four weeks at the time of the survey. We estimated the average treatment effect (ATE) of ongoing prolonged symptoms on EQ-VAS and EQ-5D-3L questionnaire using inverse probability weighting. In addition to symptom prolongation, we investigated whether other factors (including demography, lifestyle, and acute severity) were associated with low EQ-VAS and EQ-5D-3L values, by multivariable linear regression.

Results

349 participants reported no symptoms and 108 reported any symptoms at the time of the survey. The participants who reported any symptoms showed a lower average value on the EQ-VAS (69.9 vs 82.8, respectively) and on the EQ-5D-3L (0.85 vs 0.96, respectively) than those reporting no symptoms considering the ATE of ongoing prolonged symptoms. The ATE of ongoing prolonged symptoms on EQ-VAS was − 12.9 [95% CI − 15.9 to − 9.8], and on the EQ-5D-3L it was − 0.11 [95% CI − 0.13 to − 0.09], implying prolonged symptoms have a negative impact on patients’ EQ-VAS and EQ-5D-3L score. In multivariable linear regression, only having prolonged symptoms was associated with lower scores (− 11.7 [95% CI − 15.0 to − 8.5] for EQ-VAS and − 0.10 [95% CI − 0.13 to − 0.08] for EQ-5D-3L).

Conclusions

Due to their long duration, long-COVID symptoms represent a substantial disease burden expressed in impact on health-related quality of life.
Health professionals’ licensing: the practice and its predictors among health professional hiring bodies in Ethiopia
Authors: Alemneh Endalkachew Tsedal , Tesfaye Biruk Hailu , Teka Eshetu Cherinet , Ayalew Firew , Wolde Ermias Gebreyohannes , Ashena Wondimu Daniel , Melese Tewodros Abebaw , Biset Fikadie Dagnew , Degefu Bezawit Worku , Kebede Bethlehem Bizuayew , Asemu Yohannes Molla , Gebreyes Meron Yakob , Shewatatek Wudasie Teshome , Mengistu Samuel , Dagnew Tangut , Abebe Yeshiwork Eshetu , Aliyu Matias Azanaw , Endris Fatuma Ahmed , Sahlemariam Eden Workineh , Weldesemayat Genet Kifle
Published: August 2022

Background

Evidence suggests that not all human resource departments have hired their facility staff based on federal licensing standards, with some hiring without an active license. This is common in some, if not all, parts of the country. The paucity of healthcare experts, high turnover rates, employee burnout, and challenges in training and development issues were all key recruiting challenges globally.

Objective

To assess the practice of health professionals’ licensing and its predictors among hiring bodies in Ethiopia, March 24/2021–May 23/2021.

Methods

A cross-sectional study was conducted in privately and publicly funded health facilities throughout Ethiopia. For each region, a stratified sampling strategy was utilized, followed by a simple random sampling method. Documents from the recruiting bodies for health professionals were reviewed. A pretested structured questionnaire and document review tool were used to extract data confidentially. A descriptive analysis of the basic hiring body characteristics was conducted. Hiring body characteristics were analyzed in bivariate and multivariate logistic regression to identify factors associated with best health professionals licensing practice. Data management and analysis were conducted with Epi-Data version 4.4.3.1 and SPSS version 23, respectively.

Results

The analysis included 365 hiring bodies and 4991 files of health professionals (1581 from private and 3410 from public health organizations). Out of 365 hiring bodies studied, 66.3% practiced health professional licensing. A total of 1645 (33%) of the 4991 professionals whose files were reviewed were found to be working without any professional license at all. Furthermore, about 2733 (55%) have an active professional license, and about 603 (12%) were found to work with an expired license. Being a private facility (adjustedOR = 21.6; 95% CI = 8.85–52.55), obtaining supervision from a higher organ (adjustedOR = 19.7; 95%CI: 2.3–169.1), and conducting an internal audit (adjustedOR = 2.7; 95% CI: 1.15–6.34) were predictors of good licensing practice.

Conclusions

The licensing of health practitioners was poorly practiced in Ethiopia as compared to the expected proclamation of the country. A system for detecting fake licenses and controlling revoked licenses does not exist in all regions of the country.
Combined lifestyle, mental health, and mortality in US cancer survivors: a national cohort study
Authors: Liu Zhao-yan , Wang Chen , Zhang Yao-jun , Zhu Hui-lian
Published: August 2022

Background

Adopting healthy lifestyles and staying mentally health are two cost-effective modifiable strategies that cancer survivors can implement in self-management. We aimed to evaluate the independent, mediation, interaction, and joint associations of combined lifestyle and mental health with mortality in cancer survivors.

Methods

We performed a cohort study including 3145 cancer survivors from National Health and Nutrition Examination Survey (2005–2018). A healthy lifestyle score was constructed based on post-diagnosis body mass index, physical activity, diet, smoking, and drinking. Post-diagnosis mental health was assessed by Patient Health Questionnaire (PHQ-9). Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cancer, and non-cancer mortality were computed using Cox proportional hazards regression models.

Results

After 20,900 person-years of follow-up (median, 6.3 years), cancer survivors with higher lifestyle score had decreased mortality, independent of mental health. Compared to participants with lower lifestyle score (0–1), HRs (95% CIs) for all-cause and non-cancer mortality among those with higher lifestyle score (3–5) were 0.68 (0.52–0.89) and 0.69 (0.56–0.85), respectively. 6.2–10.3% of the associations were mediated by mental health. Similar trends were observed among participants categorized by mental health, those with better mental health had lower mortality, independent of lifestyle. Participants with better mental health benefited more from adopting healthy lifestyles, and vice versa. Combinations of higher healthy lifestyle score and better mental health were associated with significant decreased mortality, the lowest mortality was seen in participants with highest healthy lifestyle score and concurrently with best mental health.

Conclusions

For the first time, in this cohort study with a nationally representative sample of US cancer survivors, we comprehensively explored the complex associations of lifestyle, mental health, and mortality. Evidence derived from this study may give much confidence to cancer survivors and healthcare providers that, changing one’s lifestyle and/or staying mentally healthy after cancer diagnosis can improve survival.
Lkb1 aggravates diffuse large B-cell lymphoma by promoting the function of Treg cells and immune escape
Authors: Su Xiuhua , Sun Tao , Li Meng , Xia Yuan , Li Mingying , Wang Dongmei , Lu Fei , Ye Jingjing , Ji Chunyan
Published: August 2022

Background

Regulatory T cells (Tregs) induce immune responses and may contribute to immune escape in tumors. Accumulation of Tregs in tumors represents a critical barrier to anti-tumor immunity and immunotherapy. However, conflicting results describing the role of Tregs in lymphoma warrant further investigation. The precise features and mechanisms underlying the alteration in Tregs in diffuse large B-cell lymphoma (DLBCL) are not well understood yet. In this study, we analyzed the mechanism underlying the observed alterations in Tregs in DLBCL and examined the effect of Lkb1 expression on the immunosuppressive function of human Tregs.

Methods

Flow cytometry and immunofluorescence were used to analyze the proportion of Tregs and effector Tregs in the peripheral blood and lymph nodes of patients with DLBCL and control group. In vitro culture assays were used to analyze the immunosuppressive function of Tregs in the two groups. Transcriptome sequencing was performed to analyze the differentially expressed genes in the two groups, and the transcription level and protein expression of Lkb1 in the two groups were detected using RT-PCR and WES microprotein technology. Lentiviral vectors were constructed to explore the functional changes of Tregs with stable upregulation and downregulation of Lkb1. Finally, a humanized murine lymphoma model was established to study the function of Lkb1 in Tregs in the pathogenesis of DLBCL.

Results

The number of Tregs was found to be dramatically increased in peripheral blood and tumor tissue in DLBCL patients compared with that in healthy controls, and decreased after treatment. Tregs from DLBCL patients exhibited multiple enhanced functions, including increased inhibition of CD8+cytotoxic T cells (CTL) against tumor cells, enhanced suppression of CD8+CTL secretion of granular enzyme, and suppression of CD8+CTL degranulation. Lkb1 was found to be upregulated in Tregs of DLBCL patients. Furthermore, Lkb1 contributes to Treg immunosuppressive function in DLBCL by regulating the mevalonate pathway. Finally, deletion of Lkb1 in Tregs suppressed tumor growth and promoted anti-tumor immunity in a DLBCL murine model.

Conclusions

These findings confirmed that Lkb1-regulated Tregs are critical for immune escape in DLBCL, which emphasizes that Lkb1 is a potential target for the immunotherapy of DLBCL.
Geographical clustering and geographically weighted regression analysis of home delivery and its determinants in developing regions of Ethiopia: a spatial analysis
Authors: Aychiluhm Setognal Birara , Melaku Mequannent Sharew , Mare Kusse Urmale , Tadesse Abay Woday , Mulaw Getahun Fentaw
Published: August 2022

Background

Nearly three-fourths of pregnant women in Ethiopia give birth at home. However, the spatial pattern and spatial variables linked to home delivery in developing regions of Ethiopia have not yet been discovered. Thus, this study aimed to explore the geographical variation of home delivery and its determinants among women living in emerging (Afar, Somali, Gambella, and Benishangul-Gumuz) regions of Ethiopia, using geographically weighted regression analysis.

Methods

Data were retrieved from the Demographic and Health Survey program's official database (http://dhsprogram.com). In this study, a sample of 441 reproductive-age women in Ethiopia's four emerging regions was used. Global and local statistical analyses and mapping were performed using ArcGIS version 10.6. A Bernoulli model was applied to analyze the purely spatial cluster discovery of home delivery. GWR version 4 was used to model spatial regression analysis.

Results

The prevalence of home delivery in the emerging regions of Ethiopia was 76.9% (95% CI: 72.7%, 80.6%) and the spatial distribution of home delivery was clustered with global Moran’s I = 0.245. Getis-Ord analysis detected high-home birth practice among women in western parts of the Benishangul Gumz region, the Eastern part of the Gambela region, and the Southern and Central parts of the Afar region. Non-attendance of antenatal care, living in a male-headed household, perception of distance to a health facility as a big problem, residing in a rural area, and having a husband with no education significantly influenced home delivery in geographically weighted regression analysis.

Conclusions

More than three-fourths of mothers in the developing regions of Ethiopia gave birth at home, where high-risk locations have been identified and the spatial distribution has been clustered. Thus, strengthening programs targeted to improve antenatal care service utilization and women’s empowerment is important in reducing home birth practice in the study area. Besides, supporting the existing health extension programs on community-based health education through home-to-home visits is also crucial in reaching women residing in rural settings.
Involvement of the Wnt pathway in BVDV cytopathogenic strain replication in primary bovine cells
Authors: La Polla Rémi , Testard Marie-Claire , Garcia Océane , Goumaidi Abdelghafar , Legras-Lachuer Catherine , de Saint-Vis Blandine
Published: August 2022

Background

Bovine viral diarrhea virus 1 (BVDV-1) of the pestivirus genus is an economically crippling virus in the cattle industry; this positive RNA virus causes mucosal disease resulting in reproductive losses and other disease syndromes. The pathogenesis mechanism of the disease caused by BVDV infection is not well understood; for a better understanding of in vivo host BVDV-1 interactions, we conducted a transcriptomic study of infected cells at different times post-infection.

Methods

We compared the permissiveness and cellular response of a BVDV-1 cytopathogenic strain on Madin-Darby Bovine Kidney cells (MDBK) and bovine lung primary cells, a model closer to in vivo infection. Then a RNAseq analysis was realized on the infected bovine lung primary cells, at 10 hpi and 30 hpi (hours post-infection), to identify transcriptomic signatures.

Results

RNAseq analysis on BVDV-1 infected bovine primary cells showed 2,759 and 5,376 differentially expressed genes at respectively 10 hpi and 30 hpi with an absolute Fold Change  ≥ 2. Among the different pathways deregulated, data analysis revealed a deregulation of Wnt signaling pathway, a conserved process that play a critical role in embryogenesis, cellular proliferation, and differentiation as well as in viral responses against viruses such as Influenza or Hepatitis C. We demonstrated here that the deregulation of the Wnt/βcatenin signaling pathway plays a role in viral replication of BVDV cp strain. Interestingly, we showed that the inhibition of this Wnt pathway using two inhibitors, FZM1 and iCRT14, induced a delay in onset of the establishment of a cytopathic effect of primary cells.

Conclusions

Thereby, this study highlighted a role of the Wnt signaling pathway in the BVDV-1 viral replication in bovine cells, suggesting an interesting option to explore as a new therapeutic target.
Sleep disturbance, dyspnea, and anxiety following total joint arthroplasty: an observational study
Authors: George Steven Z. , Bolognesi Michael P. , Ryan Sean P. , Horn Maggie E.
Published: August 2022

Background

Patient-Reported Outcomes Measurement Information System (PROMIS) domains for sleep disturbance, anxiety, and dyspnea have been under-reported for total joint arthroplasty (TJA). The aims of this study were to report postoperative differences for these domains based on TJA location and chronic pain state. We also investigated whether these domains were associated with physical function and pain interference outcomes.

Methods

This was a retrospective, observational study of patients who underwent hip, knee, or shoulder TJA (primary and revision surgeries) at a single academic tertiary referral center. A subset of these patients completed an email-based survey for chronic pain grade (Chronic Pain Grade Scale-Revised) and sleep disturbance, anxiety, dyspnea, physical function, and pain interference (PROMIS short forms). Pre-operative and operative data were extracted from the electronic health record. Data analysis investigated PROMIS domains for differences in TJA location and chronic pain grade. Hierarchical linear regression determined associations of these domains with physical function and pain interference.

Results

A total of 2638 individuals provided informed consent and completed the email survey. In the ANOVA models for sleep disturbance, anxiety, and dyspnea, there was no location by chronic pain grade interaction (p > 0.05) and no difference based on TJA location (p > 0.05). There were differences for chronic pain grade (p < 0.01). The poorest postoperative outcome score for each domain was associated with high impact chronic pain. Furthermore, sleep disturbance and dyspnea had the strongest associations with physical function and pain interference (p < 0.01).

Conclusions

Sleep disturbance, anxiety, and dyspnea did not vary based on TJA location, but were associated with postoperative chronic pain grade. Sleep disturbance and dyspnea were strongly associated with commonly reported outcomes of physical function and pain interference. These findings provide guidance for those interested in expanding TJA outcome assessment to include sleep disturbance, anxiety, and/or dyspnea.
Infective endocarditis by HACEK: a review
Authors: Khaledi Mansoor , Sameni Fatemeh , Afkhami Hamed , Hemmati Jaber , Asareh Zadegan Dezfuli Aram , Sanae Mohammad-Javad , Validi Majid
Published: August 2022

Infective endocarditis (IE) is a severe disease that is still associated with high mortality despite recent advances in diagnosis and treatment. HACEK organisms (Haemophilus spp., Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae) are gram-negative bacteria that are part of the normal flora of the mouth and upper respiratory tract in humans. These organisms cause a wide range of infections, of which IE is one of the most notable. In order to control and prevent endocarditis caused by HACEK, measures such as oral hygiene and the use of prophylactic drugs should be used for people at risk, including people with underlying heart disease and people with artificial valves. This review is a summary of the main aspects of IE focusing on HACEK organisms.
When the infectious environment meets the AD brain
Authors: Ganz Tal , Fainstein Nina , Ben-Hur Tamir
Published: August 2022

Background

The Amyloid theory of Alzheimer’s disease (AD) suggests that the deposition of Amyloid β (Aβ) in the brain triggers a chain of events, involving the deposition of phosphorylated Tau and other misfolded proteins, leading to neurodegeneration via neuroinflammation, oxidative stress, and neurovascular factors. The infectious theory linked various infectious agents with the development of AD, raising the possibility that they serve as etiological causes of the disease. Are these theories mutually exclusive, or do they coincide?

Main body

In this review, we will discuss how the two theories converge. We present a model by which (1) the systemic infectious burden accelerates the development of AD brain pathology via bacterial Amyloids and other pathogen-associated molecular patterns (PAMPs), and (2) the developing AD brain pathology increases its susceptibility to the neurotoxicity of infectious agents -derived PAMPs, which drive neurodegeneration via activated microglia.

Conclusions

The reciprocal effects of amyloid deposition and systemic infectious burden may lead to a vicious cycle fueling Alzheimer’s disease pathogenesis.
The application, character, and effectiveness of person‐centred care with service‐users, and the community within the discipline of podiatry: a scoping review
Authors: Abey Sally , Anil Krithika , Hendy Philip , Demain Sara
Published: August 2022

Background

The concept of person‐centred care is embedded within healthcare policy, focusing on long‐term conditions and multimorbidity. The evidence that person‐centred care is being operationalised effectively across all areas of healthcare is limited. The aim of this scoping review was to explore the application, features, and effectiveness of person‐centred care with service‐users, carers, and the community within podiatry.

Methods

The scoping review was based upon Arksey and Malley's five stage framework. The following databases were searched between January 2010 and March 2021: AMED, CINAHL, Embase, Cochrane library, SocINDEX, British Education Index, Business Source Complete, MEDLINE (EBSCO), and the EThOS ‘Global electronic thesis and dissertation’ repository, Prospero, and reference lists of included papers. Primary research articles were included if they reported on a person‐centred care focused intervention with podiatry. Research terms were developed, appropriate databases identified, and an initial search resulted in 622 papers which, following removal of duplicates and critical appraisal, resulted in 18 eligible papers. Data extracted involved the types of person‐centred care utilised, intervention details, motivations for engaging in person‐centred care interventions, and intervention barriers and challenges.

Results

Eighteen articles were included in the review. The main type of person‐centred care utilised was patient/carer activities around self‐management. None of the studies considered the role of the podiatrist as a person‐centred care agent. The data on interventions generated the following themes ‘service facilitated person‐centred care’ where a change has been made to service delivery, ‘direct clinician delivery’ where the intervention is delivered by the clinician with the patient present and ‘patient instigated participation’ where patient motivation is required to engage with an activity beyond the consultation. Outcome measures associated with quality of care and effectiveness were absent.

Conclusion

There is a lack of congruency between the concept of person‐centred care and how it is operationalised. A whole system approach that considers commissioning, organisational leadership, the role of the practitioners and patients has not been considered. There is immense scope for the podiatrist to play an important part in the personalised‐care agenda, but currently research that can evidence the effectiveness of person‐centred care in podiatry is absent.

Review registration

Open Science Framework (osf.io/egjsd).
Attitudes and experiences towards the application of motivational interviewing by podiatrists working with people with diabetes at high‐risk of developing foot ulcers: a mixed‐methods study
Authors: Jongebloed‐Westra M. , Bode C. , Bente B. E. , de Jonge J. M. , ten Klooster P. M. , Koffijberg H. , Exterkate S. H. , van Netten J. J. , van Gemert‐Pijnen J. E. W. C.
Published: August 2022

Background

Podiatrists are key professionals in promoting adequate foot self‐care for people with diabetes at high‐risk of developing foot ulcers. However, merely informing patients about the advantages of foot self‐care is insufficient to realise behavioural change. Motivational interviewing (MI) is a promising person‐centred communication style that could help to create a working alliance between healthcare providers and patient to improve foot self‐care. This study aims to observe and analyse the application of MI in consultations carried out by MI‐trained and non‐MI‐trained podiatrists with their patients, and explore podiatrists' attitudes and experiences towards MI.

Methods

Eighteen podiatrists (median age: 28.5 years, 10 female and 8 male) followed a three‐day basic training in MI and 4 podiatrists (median age: 38.5 years, 4 female) were not trained in MI. To observe and rate the MI‐fidelity in daily clinical practice, audio recordings from the MI‐trained and non‐MI‐trained podiatrists were scored with the Motivational Interviewing Treatment Integrity code. Individual, semi‐structed, in‐depth interviews were conducted with the MI‐trained podiatrists to explore their attitudes towards and experiences with MI. These data sources were triangulated to describe the effect of training podiatrists in MI for their clinical practice.

Results

The MI‐trained podiatrists scored significantly higher than the non‐MI‐trained podiatrists on two of four global MI‐related communication skills (empathy, p = 0.008 and change talk, p = 0.008), on one of five core MI‐adherent behaviours (affirmation, p = 0.041) and on one of the other behaviour counts (simple reflections, p = 0.008). The podiatrists mainly reported their attitudes and experiences regarding partnership and cultivating change talk, during the interviews. In addition, they also mentioned facilitators and barriers to using MI and indicated whether they experienced MI as having added value.

Conclusions

The MI‐trained podiatrists used the principles of MI at a solid beginner proficiency level in their clinical practice in comparison to the non‐MI‐trained podiatrists, who did not reach this level. This achievement is in accordance with the basic MI‐training they received. This multi‐method study reveals that podiatrists can be effectively trained in applying MI in daily clinical practice.

Trial registration

Netherlands Trial Register NL7710. Registered: 6 May 2019.
Cutis verticis gyrata and Noonan syndrome: report of two cases with pathogenetic variant in SOS1 gene
Authors: Mercadante Francesca , Piro Ettore , Busè Martina , Salzano Emanuela , Ferrara Arturo , Serra Gregorio , Passarello Cristina , Corsello Giovanni , Piccione Maria
Published: August 2022

Background

Noonan and Noonan-like syndromes are multisystem genetic disorders, mainly with autosomal dominant trasmission, caused by mutations in several genes. Missense pathogenetic variants of SOS1 gene are the second most common cause of Noonan syndrome (NS) and account approximately for 13% to 17% of cases. Subjects carrying a pathogenetic variant in SOS1 gene tend to exhibit a distinctive phenotype that is characterized by ectodermal abnormalities.Cutis verticis gyrata(CVG) is a rare disease, congenital or acquired, characterized by the redundancy of skin on scalp, forming thick skin folds and grooves of similar aspect to cerebral cortex gyri. Several references in the literature have reported association between nonessential primary form of CVG and NS.

Case presentation

we report two cases of newborns with CVG and phenotype suggestive for NS who have been diagnosed to harbour the same pathogenetic variant in SOS1 gene.

Conclusions

previously described patients with NS presenting CVG had received only clinical diagnosis. Therefore we report the first patients with CVG in which the clinical suspicion of NS is confirmed by molecolar analysis.
Covid-19 in Egyptian hemodialysis and kidney transplant children: retrospective analysis of single center experience
Authors: Fadel Fatina I. , Sabry Samar , Mawla Mohamed A. Abdel , Galal Rasha Essam Eldin , Salah Doaa M. , Helmy Rasha , Ramadan Yasmen , Elzayat Wessam , Abdelfattah May , Abd Alazem Eman Abobakr
Published: August 2022

Background

Chronic kidney disease stage 5 (CKD 5) populations have peculiar risk for severe Covid-19 infection. Moreover; pediatric data are sparse and lacking. The aim of this study is to report our experience in CKD 5 children treated by hemodialysis (CKD 5D) and CKD 5 children after kidney transplantation (KTR) during one year of Covid-19 pandemic.

Methods

Retrospective analysis of 57 CKD 5 children with Covid-19 like symptoms during 1 year pandemic was performed. A cohort of 19 confirmed patients (13 CKD 5D and 6 KTR) was analyzed in details as regard clinical, laboratory, radiological criteria, management and their short term outcome.

Results

Conclusion

Pediatric patients on regular HD (CKD 5D) are at higher risk and worse outcome of Covid-19 infection than KT recipients (KTR). Pre-existing HTN and shorter duration after KT are potential risk factors. Reversible AGD after KT and CVC related infections in HD patients are additional presenting features of Covid-19 infection.
Effect of acupuncture with donepezil based on syndrome differentiation on cognitive function in patients with mild-to-moderate Alzheimer’s disease: a study protocol for a multicenter randomized controlled trial
Authors: Fu Qin-Hui , Pei Jian , Zhou Hou-guang , Wang Tao , Zhan Yi-jun , Tao Lin , Xu Jia , Zhou Qian , Wang Liao-yao
Published: August 2022

Background

There has been a rapid increase in the worldwide prevalence of Alzheimer’s disease (AD). Previous studies have shown that acupuncture can improve neurological and cognitive function; however, the utility of applying acupuncture in patients with AD remains unclear. This study protocol describes a clinical trial for evaluating the efficacy and safety of acupuncture based on syndrome differentiation with donepezil hydrochloride on cognitive function in patients with AD.

Methods/design

This multicenter randomized controlled trial commenced on February 1, 2019, at the Shanghai Longhua Hospital of TCM, Shanghai Huashan Hospital of Fudan University, and Shanghai Mental Health Center, and will conclude on June 30, 2022. The study will recruit 184 patients randomly divided into an acupuncture group or a control group at a 1:1 ratio. All participants will receive donepezil hydrochloride (5 mg/day), and those in the acupuncture group will receive acupuncture based on syndrome differentiation with donepezil for 12 weeks. The primary outcome will be the post-treatment change in the Alzheimer’s Disease Assessment Scale-cognition score at 12 weeks. The secondary outcomes will be the efficacy scores of the Minimum Mental State Examination, Alzheimer’s Disease Cooperative Research Activity-Daily Life, and Quality of Life-Alzheimer’s Disease. All assessments will be performed at baseline, after treatment (week 12), and at follow-up (weeks 24 and 36).

Discussion

This trial may provide high-quality evidence for the efficacy of acupuncture in the treatment of AD. The results of this study will be published in peer-reviewed journals.

Trial registration

ClinicalTrials.govNCT03810794. Registered on 17 January 2019.
HIAYA CHAT study protocol: a randomized controlled trial of a health insurance education intervention for newly diagnosed adolescent and young adult cancer patients
Authors: Mann Karely , Waters Austin R. , Park Elyse R. , Perez Giselle K. , Vaca Lopez Perla L. , Kaddas Heydon K. , Warner Echo L. , Ray Nicole , Tsukamoto Tomoko , Allen Karlie , Haaland Ben , Fair Douglas B. , Lewis Mark A. , Kirchhoff Anne C.
Published: August 2022

Background

For adolescent and young adult (AYA) cancer patients aged 18 to 39 years, health insurance literacy is crucial for an effective use of the health care system. AYAs often face high out-of-pocket costs or have unmet health care needs due to costs. Improving health insurance literacy could help AYAs obtain appropriate and affordable health care. This protocol illustrates a randomized controlled trial testing a virtual health insurance education intervention among AYA patients.

Methods

This is a two-arm multisite randomized controlled trial. A total of 80 AYAs diagnosed with cancer in the Mountain West region will be allocated to either usual navigation care or tailored health insurance education intervention with a patient navigator that includes usual care. All participants will complete a baseline and follow-up survey 5 months apart. The primary outcomes are feasibility (number enrolled and number of sessions completed) and acceptability (5-point scale on survey measuring satisfaction of the intervention). The secondary outcomes are preliminary efficacy measured by the Health Insurance Literacy Measure and the COmprehensive Score for financial Toxicity.

Discussion

This trial makes a timely contribution to test the feasibility and acceptability of a virtual AYA-centered health insurance education program.

Trial registration

ClinicalTrials.gov NCT04448678. Registered on June 26, 2020