bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of additional screening examinations for children and adolescents in Germany: a longitudinal retrospective cohort study
Authors: Krüger Kathrin , Lapstich Anne-Marie , Reber Katrin Christiane , Sehlen Stephanie , Liersch Sebastian , Krauth Christian
Published: April 2023

Background

Continuous medical care is particularly important in childhood and adolescence. Since there are gaps in regular care in Germany, various health insurance providers offer to cover additional examinations (e.g., U10, U11, J2) to ensure ongoing paediatrician visits. However, the question arises as to whether these examinations are effective. Thus, the main objective of this study is to determine whether participation in the U10, U11 or J2 examinations leads to more frequent and earlier diagnosis and treatment of age-specific diseases.

Methods

The analyses are based on administrative claims data from a statutory health insurance fund. For each examination, an intervention group (IG) is formed and matched with a corresponding control group (CG). Descriptive analyses include proportion with diagnosis and treatment, average age of diagnosis and treatment initiation. Hypothesis testing is performed using methods appropriate to each. In addition, subgroup analyses and binominal logistic regression models are conducted.

Results

More diagnoses are detected in IG, irrespective of subgroups. Additionally, diagnoses are made slightly earlier on average in IG. In the total samples, more therapies are initiated in IG, and slightly earlier. Considering only diagnosed cases, more therapies are initiated in CG but continue to be started earlier in IG. Regression models show that participation in the examinations has the highest predictive power for detecting a diagnosis. The presence of a chronic disease and sex - male at the U10 and U11 and female at the J2 - are also significantly associated. The models further show that nationality, unemployment of parents and region also have a significant influence in some cases, whereas school-leaving qualification, vocational qualification and income of parents do not. Considering the initiation of treatment in overall samples, the models show similar results, but here the presence of a chronic illness has the highest predictive power.

Conclusion

The results indicate that participation in the examinations leads to significantly more diagnoses and, in the overall samples, significantly more treatments. In addition, diagnoses were made somewhat earlier and therapies were initiated somewhat earlier. In the future, it would be useful to investigate the U10, U11 and J2 examinations over a longer time horizon to determine whether the statistically significant difference found is also clinically relevant, i.e., earlier diagnosis and initiation of therapy lead to prevention of manifestation or progression of the diagnosed diseases and to avoidance of secondary diseases.

Trial registration

German Clinical Trials Register (DRKS), DRKS-ID: DRKS00015280. Prospectively registered on 18 March 2019.
Cross-cultural adaptation, reliability and validation of the Gillette Functional Assessment Questionnaire (FAQ) into Brazilian Portuguese in patients with cerebral palsy
Authors: da Silva Acácia Pinheiro Alvares Fernandes , Bassi-Dibai Daniela , Moreira Brunno Lima , Gava Aline Dalfito , Takahasi Henrique Yuji , Salomão Larissa Gustinelli Pereira Belo , Cacere Marcela , de Freitas Thomaz Fernanda , Dibai-Filho Almir Vieira
Published: April 2023

Background

The purpose of this study was to translate, cross-culturally adapt and validate the Gillette Functional Assessment Questionnaire (FAQ) into Brazilian Portuguese.

Methods

The translation and cross-cultural adaptation was carried out in accordance with international recommendations. The FAQ was applied to a sample of 102 patients diagnosed with cerebral palsy (CP). Construct validity was assessed using Spearman’s correlation coefficient (rho), and the FAQ score was correlated with the Functional Mobility Scale (FMS) and Gross Motor Function Classification Scale (GMFCS). A subsample of 50 patients was used to assess reliability using intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimum detectable difference (MDD). Ceiling and floor effects were also evaluated.

Results

The Brazilian version of the FAQ showed excellent test-retest reliability by the assessment of the physiotherapist (ICC = 0.99) and respondent (ICC = 0.97), as well as excellent inter-examiner reliability (ICC = 0.94). The SEM was 0.23 (physiotherapist), 0.47 (respondent) and 0.64 (inter-examiner), while the MDD was 0.64 (physiotherapist), 1.29 (respondent) and 1.76 (inter-examiner). The classification of gross motor function showed a high correlation with the FAQ applied by the physiotherapist (rho = -0.89) and by the respondent (rho = -0.87). The FMS-5 m was highly correlated with the FAQ applied by the physiotherapist and the respondent (rho = 0.88 and rho = 0.87, respectively). The FMS-50 and FMS-500 presented very high correlation with the FAQ applied by the physiotherapist (rho = 0.91 for both) and high correlation with the FAQ applied by the respondent (rho = 0.89 and rho = 0.88, respectively). The Brazilian version of the FAQ did not present the ceiling and floor effects.

Conclusion

The FAQ presented adequate psychometric properties in patients with CP, indicating that it is possible to use it as a measure of functional gait mobility in Brazil.
A systematic review and meta-analysis of studies exploring prevalence of non-specific anxiety in undergraduate university students
Authors: Ahmed Irtiqa , Hazell Cassie M. , Edwards Bethany , Glazebrook Cris , Davies E. Bethan
Published: April 2023

Background

Anxiety is a common mental health problem in the general population, and is associated with functional impairment and negative impacts upon quality of life. There has been increased concern about university students’ mental health in recent years, with a wide range of non-specific anxiety rates reported worldwide in undergraduate university students. We aimed to explore prevalence of non-specific anxiety in undergraduate university student populations.

Methods

Four databases were searched to identify studies published between 1980 and 2020 which investigated prevalence of non-specific anxiety in undergraduate university students. Each study’s quality was appraised using a checklist. Sub-analyses were undertaken reflecting outcome measure utilized, course of study, location of study, and whether study was before or during the COVID-19 pandemic.

Results

A total of 89 studies – representing approx. 130,090 students—met inclusion criteria. Eighty-three were included in meta-analysis, calculating a weighted mean prevalence of 39.65% (95% CI: 35.72%—43.58%) for non-specific anxiety. Prevalence from diagnostic interview studies ranged from 0.3%-20.8% 12-month prevalence. Prevalence varied by outcome measure used to assess non-specific anxiety, the type of course studied by sample, and by study location. In half the studies, being female was associated with being more likely to have higher non-specific anxiety scores and/or screening above thresholds. Few of the included studies met all quality appraisal criteria.

Conclusion

The results suggest that approximately a third of undergraduate students are experiencing elevated levels of non-specific anxiety. Results from sub-analyses have identified some methodological issues that need consideration in appraising prevalence in this population.
“If your mother does not teach you, the world will…”: a qualitative study of parent-adolescent communication on sexual and reproductive health issues in Border districts of eastern Uganda
Authors: Ndugga Patricia , Kwagala Betty , Wandera Stephen Ojiambo , Kisaakye Peter , Mbonye Martin K. , Ngabirano Fred
Published: April 2023

Background

Adolescents experience a host of sexual and reproductive health (SRH) challenges, with detrimental SRH and socio-economic consequences. These include early sexual debut, sexually transmitted infections including HIV/AIDS, teenage pregnancy, and early childbearing. Parent-adolescent communication about SRH has significant potential to reduce adolescents’ risky sexual behaviors. However, communication between parents and adolescents is limited. This study explored the facilitators and barriers to parent-adolescent communication about sexual and reproductive health.

Methods

We conducted a qualitative study in the border districts of Busia and Tororo in Eastern Uganda. Data collection entailed 8 Focus Group Discussions comprising of parents, adolescents (10–17 years), and 25 key informants. Interviews were audio-recorded, transcribed, and translated into English. Thematic analysis was conducted with the aid of NVIVO 12 software.

Results

Participants acknowledged the key role parents play in communicating SRH matters; however, only a few parents engage in such discussions. Facilitators of parent-adolescent communication were: having a good parent-child relationship which makes parents approachable and motivates children to discuss issues openly, a closer bond between mothers and children which is partly attributed to gender roles and expectations eases communication, and having parents with high education making them more knowledgeable and confident when discussing SRH issues with children. However, the discussions are limited by cultural norms that treat parent-child conversations on SRH as a taboo, parents’ lack of knowledge, and parents busy work schedules made them unavailable to address pertinent SRH issues.

Conclusion

Parents’ ability to communicate with their children is hindered by cultural barriers, busy work schedules, and a lack of knowledge. Engaging all stakeholders including parents to deconstruct sociocultural norms around adolescent SRH, developing the capacity of parents to confidently initiate and convey accurate SRH information, initiation of SRH discussions at early ages, and integrating parent-adolescent communication into parenting interventions, are potential strategies to improve SRH communication between parents and adolescents in high-risk settings such as borders.
Prevalence and associated factors of smoking among chinese adolescents: a school-based cross-sectional study
Authors: Lin Bingliang , Liu Xin , Lu Wenlong , Wu Xiaobing , Li Yanyan , Zhang Ziyang , Fu Rongyin , Zhang Luge , Xiong Jingfan
Published: April 2023

Background

Shenzhen has made great efforts to address the tobacco epidemic in the past decade. This study aims to evaluate the current status of the tobacco epidemic among adolescent in Shenzhen, China.

Methods

The multi-stage random cluster sampling method was used in the school-based cross-sectional study in 2019 and a total of 7,423 junior and high school (both senior and vocational) students were recruited. Information on cigarette use was collected by the electronic questionnaire. Logistic regression analysis was used to examine the associations between current cigarette use and associated factors. ORs with their 95% CIs were reported.

Results

The prevalence of current cigarette use among adolescents was 2.3%, with boys (3.4%) significantly higher than girls (1.0%). Smoking rates in junior high schools, senior high schools, and vocational senior high schools were 1.0%, 2.7%, and 4.1%, respectively. The results of multivariate logistic regression analysis indicated that gender, age, parental smoking, teachers smoking in schools, friends smoking, exposure to tobacco marketing, and misconceptions about cigarette use were associated factors for adolescent smoking behaviour.

Conclusions

The prevalence of current smoking was relatively low among adolescent in Shenzhen, China. Personal characteristics, family, and school were associated with current adolescent smokers.
Assessing exposure to outdoor advertisement for products high in fat, salt and sugar (HFSS); is self-reported exposure a useful exposure metric?
Authors: Scott Lauren J. , Toumpakari Zoi , Nobles James , Sillero-Rejon Carlos , Jago Russell , Cummins Steven , Blake Sarah , Horwood Jeremy , Vocht Frank de
Published: April 2023

Background

Exposure to advertising of unhealthy commodities such as fast-food and gambling is recognised as a risk factor for developing non-communicable diseases. Assessment of the impact of such advertisement and the evaluation of the impact of any policies to restrict such advertisements on public health are reliant on the quality of the exposure assessment. A straightforward method for assessing exposure is to ask people whether they noticed any such advertisements in their neighbourhoods. However, the validity of this method is unclear. We assessed the associations between measured exposure to outdoor advertising, self-reported exposure, and self-reported consumption.

Methods

We collected exposure information in January-March 2022 using two methods: (i) through a resident survey investigating advertising and consumption of unhealthy products, distributed across Bristol and neighbouring South Gloucestershire, and (ii) through in-person auditing. Self-reported exposure was obtained from the resident survey (N = 2,560) and measured exposure from photos obtained for all Council owned advertisement sites (N = 973 bus stops). Both data sources were geographically linked at lower-super-output-area level. Reporting ratios (RRs), 95% confidence intervals (CIs), and Cohen’s kappas, are presented.

Results

24% of advertisements displayed food and/or drink advertising. Bristol respondents in neighbourhoods displaying food/drink adverts were more likely to also report seeing these adverts compared to those in neighbourhoods without food/drink adverts (59% vs. 51%, RR = 1.15, 95%CI 1.01–1.31). There was no such association in South Gloucestershire (26% vs. 32%, RR = 0.82, 95%CI 0.58–1.14). Respondents in both Bristol and South Gloucestershire who recalled seeing advertising for unhealthy food and drink products were more likely to consume them (e.g. for fast-food: 22% vs. 11%, RR = 2.01, 95%CI 1.68–2.42). There was no such association between measured food and drink adverts in respondents’ local areas and self-reported consumption of HFSS product (90.1% vs. 90.7%, RR = 0.99, 95%CI 0.96–1.03).

Conclusions

Self-reported outdoor advertisement exposure is correlated with measured exposure, making this a useful methodology for population studies. It has the added advantage that it correlates with consumption. However, given that measurement error can be significant and self-reported exposure is known to be susceptible to various biases, inferences from studies using this exposure metric should be made with caution.
Subjective valuation of Iranian women for screening for gene-related diseases: a case of breast cancer
Authors: Meshkani Zahra , Moradi Najmeh , Aboutorabi Ali , Jafari Abdosaleh , Shams Roshanak
Published: April 2023

Background

About 5–10% of breast cancer cases are attributed to a gene mutation. To perform preventive interventions for women with a gene mutation, genetic screening BRCA tests have recently been implemented in Iran. The present study aimed to determine Iranian women’s subjective valuation for screening BRCA tests for early detection of breast cancer to help policymakers to make decisions about genetic screening tests for breast cancer and to know the applicants.

Methods

An online survey was completed by women older than 30 years old in Tehran, the capital of Iran in 2021. A hypothetical scenario about genetic screening tests for breast cancer was defined. The subjective valuation for the tests was assessed by a willingness to pay (WTP) using the contingent valuation method (CVM) by payment card. Demographics, history of breast cancers, knowledge, and physiological variables were considered as independent variables, and a logistic regression model assessed the relationship between WTP and the variables.

Results

660 women were included. 88% of participants intended to participate in BRCA genetic screening for breast cancer if it were free. The mean WTP for the tests was about $ 20. Based on the logistic regression, income, family history of breast or ovarian cancer, and positive attitude were associated with WTP.

Conclusions

Iranian women were willing to intend for genetic screening BRCA tests and pay for them as well. The result of the present study is of great importance for policy makers when it comes to funding and determining co-payments for BRCA genetic screening tests. To achieve a high participation rate of women in breast cancer screening plans, a positive attitude should be promoted as a psychological factor. Educational and informative programs can help.
The association of conspiracy beliefs and the uptake of COVID-19 vaccination: a cross-sectional study
Authors: Kowalska-Duplaga Kinga , Duplaga Mariusz
Published: April 2023

The COVID-19 pandemic revealed that health denialism might be an important determinant of adherence to preventive measures during epidemic challenges. Conspiracy beliefs seem to be one of the most visible manifestations of denialism in society. Despite intensive efforts to promote COVID-19 vaccinations, the number of citizens reluctant to get vaccinated was very large in many countries. The main aim of this study was the analysis of the association between the acceptance of the COVID-19 vaccination and conspiracy beliefs among adult Internet users in Poland. The analysis was based on data from a survey performed on a sample of 2008 respondents in October 2021. Uni- and multivariable logistic regression models were applied to evaluate the association between attitudes towards COVID-19 vaccination and generic conspiracist, vaccine-conspiracy, and COVID-19-related conspiracy beliefs. In the multivariable model, the effect of conspiracy beliefs was adjusted for the level of vaccine hesitancy, future anxiety, political sympathies, and socio-demographic variables. Univariate regression models showed that COVID-19 vaccination acceptance is significantly lower among respondents with higher levels of all three types of conspiracy beliefs. In the multivariable model, the effect of COVID-19-related and vaccine conspiracy beliefs, but not generic conspiracist beliefs, was maintained after adjusting for vaccine hesitancy. We conclude that conspiracy beliefs should be treated as a potential indicator of lower adherence to preventive measures during epidemic challenges. The respondents revealing a high level of conspirational thinking are a potential group for intensified actions which employ health educational and motivational interventions.
Identifying chronic obstructive pulmonary disease from integrative omics and clustering in lung tissue
Authors: Hobbs Brian D , Morrow Jarrett D , Wang Xu-Wen , Liu Yang-Yu , DeMeo Dawn L , Hersh Craig P , Celli Bartolome R , Bueno Raphael , Criner Gerard J , Silverman Edwin K , Cho Michael H
Published: April 2023

Background

Chronic obstructive pulmonary disease (COPD) is a highly morbid and heterogenous disease. While COPD is defined by spirometry, many COPD characteristics are seen in cigarette smokers with normal spirometry. The extent to which COPD and COPD heterogeneity is captured in omics of lung tissue is not known.

Methods

We clustered gene expression and methylation data in 78 lung tissue samples from former smokers with normal lung function or severe COPD. We applied two integrative omics clustering methods: (1) Similarity Network Fusion (SNF) and (2) Entropy-Based Consensus Clustering (ECC).

Results

SNF clusters were not significantly different by the percentage of COPD cases (48.8% vs. 68.6%, p = 0.13), though were different according to median forced expiratory volume in one second (FEV1) % predicted (82 vs. 31, p = 0.017). In contrast, the ECC clusters showed stronger evidence of separation by COPD case status (48.2% vs. 81.8%, p = 0.013) and similar stratification by median FEV1% predicted (82 vs. 30.5, p = 0.0059). ECC clusters using both gene expression and methylation were identical to the ECC clustering solution generated using methylation data alone. Both methods selected clusters with differentially expressed transcripts enriched for interleukin signaling and immunoregulatory interactions between lymphoid and non-lymphoid cells.

Conclusions

Unsupervised clustering analysis from integrated gene expression and methylation data in lung tissue resulted in clusters with modest concordance with COPD, though were enriched in pathways potentially contributing to COPD-related pathology and heterogeneity.
Anterior variable-angle locked plating versus tension band wiring of simple and complex patella fractures – a biomechanical investigation
Authors: Stoffel Karl , Zderic Ivan , Pastor Torsten , Woodburn William , Castle Richard , Penman Jessica , Saura-Sanchez Eladio , Gueorguiev Boyko , Sommer Christoph
Published: April 2023

Background

The aim of this study was to investigate the biomechanical performance of novel anterior variable-angle locking plates versus tension band wiring used for fixation of simple and complex patella fractures.

Methods

Sixteen pairs of human cadaveric knees were used to simulate two-part simple transverse AO/OTA 34-C1 and five-part complex AO/OTA 34-C3 patella fractures. The complex fracture pattern was characterized with a medial and a lateral proximal fragment, together with an inferomedial, an inferolateral and an inferior fragment mimicking comminution around the distal patella pole. Eight pairs with simple fractures were split for fixation via either tension band wiring (TBW) through two parallel cannulated screws or anterior variable-angle locked plating, whereas other eight pairs with complex fractures were split for either TBW through two parallel cannulated screws plus circumferential cerclage wiring, or anterior variable-angle locked plating using a cortical caudo-cranial polar screw. Each specimen was tested over 5000 cycles with a range of motion from 90° flexion to full extension by pulling on the quadriceps tendon. Interfragmentary movements were captured by motion tracking.

Results

For both fracture types, the longitudinal and shear articular displacements, measured between the proximal and distal fragments at the central patella aspect between 1000 and 5000 cycles, together with the relative rotations of these fragments around the mediolateral axis were all significantly smaller following anterior variable-angle locked plating versus TBW, p ≤ 0.01.

Conclusions

From a biomechanical perspective, anterior locked plating of both simple and complex patella fractures resulted in less interfragmentary displacement under extended cyclic loading.
Comparison of the efficacy of ETS with different segments for palmar, axillary and plantar hyperhidrosis
Authors: Hong Ziqiang , Wu Xusheng , Sheng Yannan , Cui Baiqiang , Bai Xiangdou , Lu Yingjie , Cheng Tao , Jin Dacheng , Gou Yunjiu
Published: April 2023

Background

To compare the near and long-term outcomes of endoscopic thoracic sympathectomy (ETS) for palmar, axillary and plantar hyperhidrosis.

Methods

We retrospectively analyzed the clinical data of 218 patients with hyperhidrosis who were admitted to the Department of Thoracic Surgery of Gansu Provincial People’s Hospital for surgical treatment from April 2014 to August 2021. The patients were divided into three groups according to the method of ETS and the perioperative clinical data and postoperative follow-up data were collected to compare the near and long term outcomes of the three groups.

Results

There were 197 eligible patients at follow-up, 60 patients in the R4 cut-off group, 95 patients in the R3 + R4 cut-off group and 42 patients in the R4 + R5 cut-off group. There were no statistically significant differences in baseline indicators such as sex, age and positive family history among the three groups (P > 0.05). There was no statistically significant difference between the three groups in terms of operative time (P = 0.148), intraoperative bleeding (P = 0.308) and postoperative hospital stay (P = 0.407). Postoperatively, all three groups showed significant relief of palmar hyperhidrosis symptoms, with the R3 + R4 group having an advantage in terms of relief of axillary hyperhidrosis symptoms, patient satisfaction and quality of life index at 6 months postoperatively and the R4 + R5 group having an advantage in terms of relief of plantar hyperhidrosis symptoms. The difference in compensatory hyperhidrosis at 12 months postoperatively was not statistically significant among the three groups (P = 0.867), but the incidence was higher in the R3 + R4 and R4 + R5 groups than that in the R4 group.

Conclusion

Patients with simple palmar hyperhidrosis can first consider R4 cut-off treatment; R3 + R4 cut-off is more effective in treating palmar hyperhidrosis combined with axillary hyperhidrosis; R4 + R5 cut-off is more effective in treating palmar hyperhidrosis combined with plantar hyperhidrosis. However, patients need to be informed that R3 + R4 and R4 + R5 dissection may increase the risk of severe compensatory hyperhidrosis after surgery.
CT-based radiographic measurements and effectiveness estimates of full-endoscopic surgery in thoracic myelopathy caused by ossification of ligamentum flavum
Authors: He Jia-lin , Du Qian , Hu Wan-dong , Xin Zhi-jun , Shao Xin-xin , Liao Wen-bo
Published: April 2023

Background

Evaluate the effectiveness of posterior percutaneous full-endoscopic technique for patients with thoracic myelopathy caused by ossification of ligamentum flavum (TOLF).

Methods

A prospective study was conducted for 16 patients with TOLF, who were treated with posterior endoscopic technique from 2017 to 2019. The sagittal and cross-sectional CT images are used to measure the area of ossified ligamentum and evaluate the decompression of surgery, respectively. The effectiveness was evaluated with visual analog scale (VAS), modified Japanese Orthopedic Association scale (mJOA), The Oswestry Disability Index (ODI), and Macnab efficacy evaluation.

Results

The average area of TOLF on sagittal and cross-sectional CT images in the 16 patients was (116.62 ± 32.72) mm2 and (141.59 ± 27.25) mm2 preoperatively, (15.99 ± 12.54) mm2 and (11.72 ± 8.64) mm2 at 3 days after the operation, (16.78 ± 11.49) mm2 and (10.82 ± 7.57) mm2 postoperative 1 year, respectively. The invasive proportion of spinal canal at preoperative sagittal and cross-sectional CT images was (48.10 ± 10.04) % and (57.58 ± 11.37) %, which decreased to (6.83 ± 4.48) % and (4.40 ± 3.01) % at the final follow-up. The average score of mJOA, VAS and ODI improved. The excellent and good rate was 87.50% according to Macnab evaluation. Compared with preoperative, differences in areas of TOLF, proportions of spinal canal, and clinical assessments of postoperative 3 days and 1 year were all statistically significant. Two cases of dural tear were observed.

Conclusion

Endoscopic surgery has a good clinical effect on TOLF, which has the advantage of less trauma to the paraspinal muscles and no impact on the spinal structure. The CT-based radiographic measurements can quantitatively evaluate the degree of spinal canal stenosis in TOLF.
Antibiotic stewardship implementation at the largest solid organ transplantation center in Asia: a retrospective cohort study
Authors: Shafiekhani Mojtaba , Shabani-Borujeni Mojtaba , Karimian Ava , MomeniTabar Mohammad Javad , Zare Zahra , Arabsheybani Sara , Vazin Afsaneh
Published: April 2023

Background

Using Antimicrobial stewardship programs (ASP) to monitor the use of antibiotics can lead to improved antibiotic use and reduced costs.

Methods

This retrospective cohort study was done at Shiraz Organ Transplant Center, the largest transplant center in Asia. Antimicrobial use, cost, clinical outcomes, and antibiotic resistance pattern were evaluated before and after ASP.

Results

This study included 2791 patients, 1154 of whom were related to the time before ASP and 1637 to the time after ASP. During the period of the research, a total of 4051 interventions were done. The use of all classes of antibiotics was significantly reduced by ASP, with 329 DDD/100PD before the intervention compared to 201 DDD/100PD after it (p = 0.04). In addition, the overall cost of antibiotics purchased was much lower after the ASP measures were implemented ($43.10 per PD) than before implementation of the ASP measures ($60.60 per PD) (p = 0.03). After the implementation of ASP, the number of MDR isolates was significantly reduced.

Conclusion

The results of our study showed that the implementation of ASP significantly reduced the number and costs of antibiotics and also the number of resistant pathogens, but did not affect the patients’ length of stay.
Risk factors for systemic inflammatory response syndrome after endoscopic lithotripsy for upper urinary calculi
Authors: Ye Siming , Wang Wei , Yu Zhenliang , Luo Jie
Published: April 2023

Background

To explore the risk factors for systemic inflammatory response syndrome (SIRS) after endoscopic lithotripsy for upper urinary calculi.

Methods

This retrospective study included patients with upper urinary calculi who underwent endoscopic lithotripsy in the First Affiliated Hospital of Zhejiang University between June 2018 and May 2020.

Results

A total of 724 patients with upper urinary calculi were included. One hundred and fifty-three patients developed SIRS after the operation. The occurrence of SIRS was higher after percutaneous nephrolithotomy (PCNL) compared with ureteroscopy (URS) (24.6% vs. 8.6%, P < 0.001) and after flexible ureteroscopy compared with ureteroscopy (fURS) (17.9% vs. 8.6%, P = 0.042). In the univariable analyses, preoperative infection history (P < 0.001), positive preoperative urine culture (P < 0.001), history of kidney operation on the affected side (P = 0.049), staghorn calculi (P < 0.001), stone long diameter (P = 0.015), stone limited to the kidney (P = 0.006), PCNL (P = 0.001), operative time (P = 0.020), and percutaneous nephroscope channel (P = 0.015) were associated with SIRS. The multivariable analysis showed that positive preoperative urine culture [odds ratio (OR) = 2.23, 95% confidence interval (CI): 1.18–4.24, P = 0.014] and operative methods (PCNL vs. URS, OR = 2.59, 95% CI: 1.15–5.82, P = 0.012) were independently associated with SIRS.

Conclusion

Positive preoperative urine culture and PCNL are independent risk factors for SIRS after endoscopic lithotripsy for upper urinary calculi.
METTL3 enhances dentinogenesis differentiation of dental pulp stem cells via increasing GDF6 and STC1 mRNA stability
Authors: Pan Yue , Liu Ying , Cui Dixin , Yu Sihan , Zhou Yachuan , Zhou Xin , Du Wei , Zheng Liwei , Wan Mian
Published: April 2023

Background

The dentinogenesis differentiation of dental pulp stem cells (DPSCs) is controlled by the spatio-temporal expression of differentiation related genes. RNA N6-methyladenosine (m6A) methylation, one of the most abundant internal epigenetic modification in mRNA, influences various events in RNA processing, stem cell pluripotency and differentiation. Methyltransferase like 3 (METTL3), one of the essential regulators, involves in the process of dentin formation and root development, while mechanism of METTL3-mediated RNA m6A methylation in DPSC dentinogenesis differentiation is still unclear.

Methods

Immunofluorescence staining and MeRIP-seq were performed to establish m6A modification profile in dentinogenesis differentiation. Lentivirus were used to knockdown or overexpression of METTL3. The dentinogenesis differentiation was analyzed by alkaline phosphatase, alizarin red staining and real time RT-PCR. RNA stability assay was determined by actinomycin D. A direct pulp capping model was established with rat molars to reveal the role of METTL3 in tertiary dentin formation.

Results

Dynamic characteristics of RNA m6A methylation in dentinogenesis differentiation were demonstrated by MeRIP-seq. Methyltransferases (METTL3 and METTL14) and demethylases (FTO and ALKBH5) were gradually up-regulated during dentinogenesis process. Methyltransferase METTL3 was selected for further study. Knockdown of METTL3 impaired the DPSCs dentinogenesis differentiation, and overexpression of METTL3 promoted the differentiation. METTL3-mediated m6A regulated the mRNA stabiliy of GDF6 and STC1. Furthermore, overexpression of METTL3 promoted tertiary dentin formation in direct pulp capping model.

Conclusion

The modification of m6A showed dynamic characteristics during DPSCs dentinogenesis differentiation. METTL3-mediated m6A regulated in dentinogenesis differentiation through affecting the mRNA stability of GDF6 and STC1. METTL3 overexpression promoted tertiary dentin formation in vitro, suggesting its promising application in vital pulp therapy (VPT).
Associations with physical activity, sedentary behavior, and premenstrual syndrome among Chinese female college students
Authors: Shi Yuqing , Shi Mengyao , Liu Chang , Sui Lu , Zhao Ying , Fan Xiang
Published: April 2023

Purpose

Premenstrual syndrome refers to a set of distressing symptoms experienced before the menstrual flow, which can affect female students’ behavior, cognitive abilities, mental health status, and academic performance. Identifying modifiable risk factors is essential to reduce the prevalence college students’ premenstrual syndrome. We examined associations between premenstrual syndrome and physical activity and sedentary behavior in Chinese female college students.

Methods

In this cross-sectional study, 315 female college students volunteered to participate at a university in Shanghai, China. We measured physical activity and sedentary behavior using the ActiGraph GT3X-BT and assessed premenstrual syndrome using the Premenstrual Symptoms Screening Tool. The data were statistically analyzed using SPSS 24.0 software, and the primary analysis methods included Kruskal-Wallis test and logistic regression analysis.

Results

Among the 221 female college students who met the inclusion criteria, 148 (67.0%) had PMS while 73 (33.3%) did not. After controlling for confounding variables, moderate physical activity and moderate to vigorous intensity physical activity were significantly associated with premenstrual syndrome. There was no correlation between light-intensity physical activity, sedentary behavior, and premenstrual syndrome in the study.

Conclusion

Premenstrual syndrome is prevalent among Chinese female college students. Moderate physical activity and moderate-to-vigorous physical activity can be effective in reducing PMS symptoms.
Process of developing a cervical cancer education program for female university students in a Health and Physical Education teacher training course: an action research
Authors: Yako-Suketomo Hiroko , Katayama Kayoko , Ogihara Atsushi , Asai-Sato Mikiko
Published: April 2023

Background

The purpose of this study was to develop a cervical cancer education program for students and evaluate the process for female students of an HPE teacher education university who were training to become Japanese Health and Physical Education teachers.

Methods

This study used Action Research (AR) methodology. In developing program, we analyzed the description of the teaching material development process, the lectures, and the students’ report contents, which was the main activity in the program development. Thirty five third- and fourth-year students majoring in health promotion at a Health and Physical Education teacher education university, which trains Health and Physical Education teachers in Tokyo, Japan, participated in this study.

Results

After a review of the prototype version of the cervical cancer education material, six out of nine reviewers determined that it can be published. In the revised cervical cancer education materials, messages from students, university lecturers, and gynecologists have been added as a column in the section on 'how to prevent cervical cancer. Analysis of the contents of the texts (16,792 characters in total) of 35 student reports resulted in the generation of 51 codes, 3 categories, and 15 subcategories.

Conclusions

This study reflects the intentions of female university students to contribute their knowledge to the development of educational materials on cervical cancer, which, alongside the lectures, have deepened the knowledge and awareness of cervical cancer. Based on this, the teaching material development process, lectures by experts, and students’ mindset after learning about cervical cancer is reported in this study. There is a need for more educational programs on cervical cancer that are implemented through the education of female university students.
Understanding coping strategies of mothers living with HIV who care for children living with HIV: a qualitative study in Indonesia
Authors: Fauk Nelsensius Klau , Gesesew Hailay Abrha , Mwanri Lillian , Hawke Karen , Merry Maria Silvia , Asa Gregorius Abanit , Ward Paul Russell
Published: April 2023

HIV infection and its sequelae continue to be a significant challenge among women and their families in developing countries despite the progress that has been made in the prevention and treatment of HIV. This paper describes the strategies employed by mothers with HIV to cope with the various challenges experienced following their own and their children’s HIV diagnosis. This paper uses previously unpublished data collected for a study that sought to explore the mental health challenges and coping strategies of mothers living with HIV (MLHIV) (n = 23) who have children living with HIV (CLHIV). Data collection was conducted using in-depth interviews, and participants were recruited using the snowball sampling technique. The concept of meaning-making was used to guide the conceptualisation, analysis, and discussion of the findings. Our analysis showed that meaning-making such as the awareness of how important mothers were to their children/CLHIV and families and religious meaning were used by participants to cope with HIV-related and mental health challenges they faced. The meaning of mother-child relationship which was supported and maintained through the provision of time, attention and fulfillment of CLHIV’s needs were also coping strategies employed by these women. Additional coping strategies used were to link their CLHIV to groups and activities of CLHIV. The connections made through these links enabled their children to know other CLHIV, build relationships, and share experiences. These findings are useful evidence that can inform policies and practices and indicate the need for the development of intervention programs that address the needs of MLHIV and their families to cope with HIV-related challenges of their children. Future large-scale studies involving MLHIV who have CLHIV are recommended to have a comprehensive understanding of strategies they employ to cope with HIV-related challenging circumstances and mental health issues that they continue to face.
More than blood: app-tracking reveals variability in heavy menstrual bleeding construct
Authors: Shea Amanda A. , Wever Fiorella , Ventola Cécile , Thornburg Jonathan , Vitzthum Virginia J.
Published: April 2023

Background

Heavy menstrual bleeding (HMB) is associated with impaired quality of life and may signal serious health problems. Unresolved challenges in measuring menstrual bleeding and identifying HMB have hampered research and clinical care. Self-reported bleeding histories are commonly used but these may be influenced by recall bias, personal beliefs regarding “normal” flow volume, and the experience of other physical symptoms or disruptions to daily life. The potential usefulness of menstrual-tracking mobile applications, which allow real-time user-entered data recording, for assessing HMB has not been studied. We evaluated recall bias in reported period duration, the relationship of tracked period duration and daily flow volume to subsequently reported period heaviness, variation in quality of life associated with increasing period heaviness, and the advantages and limitations of using app-tracked data for clinical and research purposes.

Methods

An online questionnaire was distributed to current users of Clue, a commercially available menstrual health tracking app, asking them to characterize their last period. We compared responses to the user’s corresponding Clue app-tracked data. The study sample comprised 6546 U.S.-based users (aged 18–45 years).

Results

Increasing reported heaviness was associated with increasing app-tracked period length and days of heavy flow, impaired quality-of-life (especially body pain severity), and disrupted activities. Of those reporting having had a heavy/very heavy period, ~ 18% had not tracked any heavy flow, but their period length and quality-of-life indicators were similar to those who had tracked heavy flow. Sexual/romantic activities were the most affected across all flow volumes. Compared to app-tracked data, 44% recalled their exact period length; 83% recalled within ± 1 day. Overestimation was more common than underestimation. However, those with longer app-tracked periods were more likely to underestimate period length by ≥ 2 days, a pattern which could contribute to under-diagnosis of HMB.

Conclusion

Period heaviness is a complex construct that encapsulates flow volume and, for many, several other bleeding-associated experiences (period length, bodily impairments, disruptions of daily activities). Even very precise flow volume assessments cannot capture the multi-faceted nature of HMB as experienced by the individual. Real-time app-tracking facilitates quick daily recording of several aspects of bleeding-associated experiences. This more reliable and detailed characterization of bleeding patterns and experiences can potentially increase understanding of menstrual bleeding variability and, if needed, help to guide treatment.
The association of physician assistant/associate demographic and practice characteristics with perceptions of value of certification
Authors: Kozikowski Andrzej , Morton-Rias Dawn , Puckett Kasey , Jeffery Colette , Mauldin Sheila , Goodman Joshua
Published: April 2023

Background

To determine physician assistant/associate (PA) perceptions of the value of certification and explore how they vary across demographic and practice characteristics.

Methods

We conducted a cross-sectional online survey between March and April 2020 with PAs participating in the longitudinal pilot program for recertification administered by the National Commission on Certification of Physician Assistants (NCCPA). The survey was distributed to 18,147 PAs, of which 10,965 participated (60.4% response rate). In addition to descriptive statistics, chi-square tests were conducted on demographics and specialty to examine if perceptions of value of certification (1 global and 10 items measuring specific domains) were associated with a particular PA profile. A series of fully adjusted multivariate logistic regressions were performed, exploring the relationship between PA characteristics and the value of certification items.

Results

Most PAs strongly agreed/agreed that certification helps with fulfilling licensure requirements (9,578/10,893; 87.9%), helps with updating medical knowledge (9,372/10,897; 86.0%), and provides objective evidence of continued competence (8,875/10,902; 81.4%). The items receiving the lowest percentage of responses for strongly agreeing/agreeing were for certification providing no value (1,925/10,887; 17.7%), helping with professional liability insurance (5,076/10,889; 46.6%), and competing with other providers for clinical positions (5,661/10,905; 51.9%). Age 55 and older and practicing in dermatology and psychiatry were among the strongest predictors of less favorable views. PAs from underrepresented in medicine (URiM) backgrounds had more positive perceptions.

Conclusions

Overall, the findings indicate that PAs value certification; however, perceptions varied by demographics and specialties. PAs who were younger, from URiM backgrounds, and practicing in primary care specialties had among the most favorable perspectives. Continued feedback monitoring is critical in ensuring certification is relevant and meaningful in supporting PAs across demographics and specialties. Measuring PA perceptions of the value of certification is essential to understanding how to support the PA profession's current and future credentialing needs and those who license and hire PAs.
The influence of demographic, health and psychosocial factors on patient uptake of the English NHS diabetes prevention programme
Authors: Reeves David , Woodham Adrine Ablitt , French David , Bower Peter , Holland Fiona , Kontopantelis Evangelos , Cotterill Sarah
Published: April 2023

Background

The prevention of type 2 diabetes (T2DM) is a major concern for health services around the world. The English NHS Diabetes Prevention Programme (NHS-DPP) offers a group face-to-face behaviour change intervention, based around exercise and diet, to adults with non-diabetic hyperglycaemia (NDH), referred from primary care. Previous analysis of the first 100,000 referrals revealed just over half of those referred to the NHS-DPP took up a place. This study aimed to identify the demographic, health and psychosocial factors associated with NHS-DPP uptake to help inform the development of interventions to improve uptake and address inequities between population groups.

Methods

Drawing on the Behavioral Model of Health Services Utilization we developed a survey questionnaire to collect data on a wide range of demographic, health and psychosocial factors that might influence uptake of the NHS-DPP. We distributed this questionnaire to a cross-sectional random sample of 597 patients referred to the NHS-DPP across 17 general practices, chosen for variation. Multivariable regression analysis was used to identify factors associated with NHS-DPP uptake.

Results

325 out of 597 questionnaires were completed (54%). Only a third of responders took up the offer of a place. The best performing model for uptake (AUC = 0.78) consisted of four factors: older age; beliefs concerning personal vulnerability to T2DM; self-efficacy for reducing T2DM risk; and the efficacy of the NHS-DPP. After accounting for these, demographic and health-related factors played only a minor role.

Conclusion

Unlike fixed demographic characteristics, psychosocial perceptions may be amenable to change. NHS-DPP uptake rates may be improved by targeting the beliefs of patients about their risk of developing T2DM, their ability to carry out and sustain behaviours to reduce this risk, and the efficacy of the NHS-DPP in providing the necessary understanding and skills required. The recently introduced digital version of the NHS DPP could help address the even lower uptake amongst younger adults. Such changes could facilitate proportional access from across different demographic strata.