bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors for treatment non-completion among patients with syphilis
Authors: Clarkson-During Abigail , Almirol Ellen , Eller Dylan , Hazra Aniruddha , Stanford Kimberly A.
Published: July 2024

Background:

With recent increases in syphilis, there is growing interest in expanding screening; however, treatment rates have historically been low.

Objectives:

This study examines demographic and clinical factors that may contribute to non-completion of syphilis treatment.

Design:

This is a retrospective comparative cohort study of all patients with syphilis from January through November 2018 at an urban, tertiary care hospital.

Methods:

Demographics and clinical information were extracted from the electronic medical record. Descriptive statistics and odds ratios (ORs) were calculated.

Results:

Of 171 patients with syphilis, 89 (52.0%) completed treatment. Patients ages 40–49 were least likely to complete treatment (OR 0.14; 95% CI 0.03–0.72, p = 0.02) compared to those ages 18–24. Non-heterosexual patients were significantly more likely to complete treatment (OR 3.60; 95% CI 1.13–11.49, p = 0.03) compared to heterosexual patients. Patients diagnosed in the emergency department completed treatment at the lowest rate.

Conclusion:

A major gap in syphilis treatment still exists, which must be addressed to achieve optimal impact from syphilis screening programs.
Evolution of waterborne diseases: A case study of Khyber Pakhtunkhwa, Pakistan
Authors: Atif Muhammad , Ayub Gohar , Shakoor Fazal , Farooq Muhammad , Iqbal Muhammad , Zaman Qamruz , Ilyas Muhammad
Published: July 2024

Objectives:

In Pakistan, the degradation of drinking water quality is exacerbated by the increasing population size and rapid industrialization. Contaminated water serves as the predominant source of numerous diseases, including diarrhea, gastroenteritis, and typhoid. This article explores the evolution of waterborne diseases across 21 districts of the Khyber Pakhtunkhwa province in Pakistan by monitoring changes in the clustering solutions.

Methods:

The data employed in this study were sourced from 21 districts of KP by the Director-General Health Services. Cluster analysis was utilized to uncover patterns in waterborne disease incidence, while principal component analysis was employed to reveal underlying patterns and reduce dimensionality. Additionally, the MONItoring Clusters (MONIC) framework was applied for change detection, facilitating the identification of significant shifts in disease patterns over time and aiding in the understanding of temporal dynamics.

Results:

Our analysis indicates that two clusters survived consistently over time, while other clusters exhibited inconsistency. Profiling of the surviving clusters (C12 → C24 → C32 → C43) suggests a gradual increase in cases of bloody diarrhea in the Swat Valley, Hangu, Karak, and Lakki Marwat regions. Similarly, profiling of the surviving clusters (⊙→ C22 → C34 → C44) suggests an increase in the acute watery diarrhea (non-cholera) and typhoid fever in the regions of Peshawar, Nowshera, and Swabi.

Conclusion:

The findings of this study hold significant importance as they pinpoint the most vulnerable regions for various waterborne diseases. These insights offer valuable guidance to policymakers and health officials, empowering them to implement effective measures for controlling waterborne diseases in the respective regions of Khyber Pakhtunkhwa, Pakistan.
“I was afraid to go to the hospital”: A qualitative analysis and ethical implications of the impacts of COVID-19 on the health and medical care of older adults in Ethiopia
Authors: Mussie Kirubel Manyazewal , Setchell Jenny , Kaba Mirgissa , Elger Bernice Simone
Published: July 2024

Objective:

The COVID-19 pandemic has brought severe health consequences among older adults and posed ethical challenges. The aim of this study was to explore the impacts of COVID-19 on the health and medical care of older adults in Ethiopia and associated ethical implications, regardless of older adults’ COVID-19 infection status.

Methods:

In this qualitative study, we followed an inductive exploratory approach based on reflexive thematic analysis. We conducted semistructured interviews between March 2021 and November 2021 with 20 older adults and 26 health professionals who were selected from healthcare facilities and communities in Ethiopia using purposive and snowball sampling techniques. We audio-recorded, transcribed, translated, and inductively analyzed the interviews using thematic analysis.

Results:

Participants reported that the pandemic compromised the accessibility and quality of both COVID and non-COVID healthcare services for older adults, which negatively impacted older adults’ health conditions and medical care. Moreover, participants elaborated on the health conditions and care of older patients with COVID-19 and highlighted that older COVID-19 patients often have severe health conditions, do not get adequate COVID-19 care, and may receive lower priority for admission to intensive care units compared to younger patients when resources are limited.

Conclusions:

Results of this study showed that practices of COVID-19 care and measures may have led to adverse consequences such as limited availability and access to aged care in Ethiopia, which could have further health consequences on older patients. Our results contribute to a better understanding of ethical issues such as distributive justice and prioritization arising in the healthcare of older patients in times of global pandemic. It is imperative for local and international health policymakers and ethicists to further analyze and address the challenges that compromise the accessibility and continuity of quality care for older persons during a public healthcare crisis.
Access to essential medicines used in the management of noncommunicable diseases in Southern Ethiopia: Analysis using WHO/HAI methodology
Authors: Asmamaw Getahun , Shimelis Tekalign , Tewuhibo Dinksew , Bitew Teshome , Ayenew Wondim
Published: July 2024

Objectives:

This study aims to assess access to essential medicines used in the management of noncommunicable diseases through analysis of the availability, prices, and affordability of these essential medicines in Arba Minch town, Gamo Zone, Southern Ethiopia.

Methods:

A cross-sectional design was carried out using the World Health Organization/health action international methodology between 2 March and 2 May 2023, within public and private healthcare facilities located in Arba Minch town, Southern Ethiopia. The median price ratio served as a metric. Statistical tests like the Shapiro-Wilk and Kolmogorov-Smirnov were utilized to assess the normal distribution of price data. The Wilcoxon-Mann-Whitney U test was also employed to compare median buyer’s prices (patient prices) between public and private healthcare institutions. Treatment affordability was determined by estimating the number of days’ wages required by the lowest-paid government employee in Ethiopia to afford the prescribed medication regimen.

Results:

Among 23 health facilities surveyed, the pooled availability of essential medicine used in the management of noncommunicable diseases was 18.7% (range: 0%–30.1%), with the public and private facilities contributing 16.3% and 38.3%, respectively. The overall percentage of availability originator brand versions was 1.1% for overall health sectors, 0.6% for public sectors, and 1.2% for private sectors. The overall percent availability of lowest price generics was 36.2% (range: 0%–26.2%; public: 32.0%; private: 37.1%). Only seven lowest price generics satisfied the World Health Organization target of 80% and above. The overall median price of lowest price generic medicines in private was two times higher than in public sectors. The top five median price scorers were amlodipine, furosemide, insulin, beclomethasone, and salbutamol. The Mann-Whitney U test showed that 11.6% of lowest price generics medicines had a statistically significant median price disparity between the public and private sectors ( p < 0.05). The overall percent of unaffordability was found to be 100.0%, (public: 70.4; private: 100.0%).

Conclusions:

This study revealed the limited availability and potential financial burdens on patients seeking essential noncommunicable disease medications. Limited availability suggests the need for better supply chain management and consistent stock availability. The price disparities and affordability challenges identified underscore the necessity for policy interventions such as price regulation and subsidized programs to ensure equitable access to essential noncommunicable disease medications in Arba Minch town, Southern Ethiopia.
In-hospital mortality and associated factors among patients admitted with venous thromboembolism at selected public hospitals of Harar Town, Eastern Ethiopia
Authors: Abraham Dawit , Mishore Kirubel Minsamo , Nigussie Shambel , Jambo Abera , Gashaw Tigist
Published: July 2024

Background:

Venous thromboembolism is the third most common cause of cardiovascular death and is responsible for more than 3 million deaths annually worldwide. Despite high rates of morbidity and mortality associated with venous thromboembolism, limited studies have been conducted on in-hospital mortality and its associated factors in Ethiopia, particularly in study settings.

Objective:

To assess in-hospital mortality and associated factors among patients admitted with venous thromboembolism at selected public hospitals of Harar town, Eastern Ethiopia, from 10 March 2018 to 8 March 2022.

Methods:

A retrospective cohort study design was conducted among 502 patients admitted with venous thromboembolism at Hiwot Fana Comprehensive Specialized Hospital and Jugal General Hospital using a simple random sampling technique. Data extraction formats were used to collect data from patient medical record cards. Then data were coded and entered into EpiData version 3.1 computer programs and exported to SPSS version 26 for analysis. Bivariate and multivariate backward Cox regression analysis was used to verify the associated factors of in-hospital mortality among venous thromboembolism patients. A p-value of less than 0.05 at a 95% confidence interval was used to establish a statistically significant association.

Results:

A total of 502 patient medical record cards with outcome variables were included in the study. More than half of the patients 350 (69.7%) were females. Among the 502 patients who were admitted with venous thromboembolism, 8.2% (95% CI: 5.6–10.6) of patients had in-hospital mortality. DM (AHR = 4.28, 95% CI: 1.80–10.15, p = 0.001) and unfractionated heparin duration (AHR = 10.26, 95% CI: 2.45–43.01, p = 0.001) were statistically significant association with venous thromboembolism mortality.

Conclusion:

Approximately 8.2% of venous thromboembolism patients died in the hospital. Diabetes and heparin were independently associated with higher mortality. Therefore, it is better to give more attention to the patients co-morbid with diabetes mellitus and for unfractionated heparin treatment duration to reduce venous thromboembolism mortality.
What Makes Fake News Appeal to You? Empirical Evidence from the Tweets Related to COVID-19 Vaccines
Authors: Park Minjung , Chai Sangmi
Published: July 2024

Social media has become a popular means for users to accept and share the news. At the same time, however, it has also enabled the wide spread of fake news. The negative impact of fake news on society has been rapidly increased. To mitigate this problem, this study aims to find out the effect of social media users’ types of perception of information toward the acceptance and intention of spreading fake news. We conducted an online experiment with 743 of social media users and showed the following results. First, users respond differently depending on the type of message provider even if the same fake news. Second, users who relied more on experiential information processing system were more likely to accept fake news regardless of their perceived social conformity.
Family Structure and Youth Gender Ideologies in Germany and South Korea
Authors: Alexander Alyssa J. , Dufur Mikaela J. , Cope Michael R. , Jarvis Jonathan A. , Read Amy R.
Published: July 2024

Although gender ideologies influence many outcomes, research shows they often fluctuate across the life course. Family structure transitions are one mechanism through which gender ideologies change. Divorced and single adults report more egalitarian ideologies than stably married adults. Little research has examined whether children in these families experience similar gender ideologies. Based on parental role modeling, we would expect children in non-traditional families to exhibit more egalitarian gender ideologies. We examine family structure and youth gender ideologies in two contexts, essentially two case studies: Germany and South Korea. Using Starting Cohort 3—Grade 5 ( N = 4,021) and Starting Cohort 4—Grade 9 ( N = 9,913) of the Germany National Educational Panel Study (NEPS) and Cohorts 1 ( N = 2,844) and 2 ( N = 3,449) of the Korea Youth Panel Survey (KYPS), we uncover counterintuitive findings that youth gender ideologies do not vary across family structures. Child gender is the most salient predictor of gender ideologies across contexts.
Comparison of Clinical Outcomes After Medial Patellofemoral Ligament Reconstruction With Allograft Versus Autograft: A Matched-Cohort Analysis
Authors: Henstenburg Jeffrey , Pezzulo Joshua D. , Farronato Dominic M. , Johnson Emma B. , Bodnar John , Petrucelli Philip , Dodson Christopher , Freedman Kevin B. , Cohen Steven B. , Hammoud Sommer
Published: July 2024

Background:

Disruption of the medial patellofemoral ligament (MPFL) may lead to recurrent lateral patellar dislocation and patellofemoral chondral injury. Despite significant previous work investigating numerous performance parameters, the optimal graft choice for MPFL reconstruction for patellar instability remains unclear.

Purpose:

To compare functional outcomes scores, subjective recurrent instability, and revision rates between autograft and allograft in MPFL reconstruction.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who underwent MPFL reconstruction with autograft between 2013 and 2018 were identified. A 2:1 comparison group of patients who underwent MPFL reconstruction with allograft was matched by sex, age (±3 years), and body mass index (BMI) (±3 kg/m2). Patient characteristics, preoperative radiograph measurements, and intraoperative data were compared between the groups, as were patient-reported outcome measures, including International Knee Documentation Committee (IKDC) score, Lysholm score, Single Assessment Numerical Evaluation (SANE), and visual analog scale (VAS) for pain. Subjective recurrent instability and revision rate were also compared between groups.

Results:

The autograft group was composed of 30 patients (13 male, 17 female) with a mean age of 24.4 years and mean BMI of 25.0 kg/m2, and the allograft group was composed of 60 matched patients (25 male, 35 female) with a mean age of 24.1 years and mean BMI of 25.1 kg/m2. The autograft and allograft groups reported similar IKDC scores (73.0 vs 73.7; P = .678), Lysholm scores (77.5 vs 80.7; P = .514), SANE (72.0 vs 75.8; P = .236), and VAS pain (30.7 vs 26.6; P = .482), as well as similar rates of postoperative patellar subluxations (20.0% vs 19.3%; P = .867) and dislocations (10.0% vs 15.0%; P = .805).

Conclusion:

Both allograft and autograft were found to be viable options for MPFL reconstruction. There were no significant group differences in failure rates, patient-reported outcomes, pain, or complications between autograft and allograft MPFL reconstruction in this series.
“We Still Have a Long Way to Go”: How State Education Leaders’ Understanding and Engagement Shapes English Learner Identification of Indigenous Students
Authors: Umansky Ilana M. , Itoh Taiyo
Published: July 2024

Federal law defines English learner (EL) eligibility differently for Indigenous, compared to non-Indigenous, students, allowing for broader entry into the EL category, along with its accompanying resources and services. We interviewed EL leaders from 25 state departments of education to learn about their level of understanding of the differentiated definition and their work to interpret and implement it. Drawing upon and expanding recent conceptual frameworks, we explored how EL leaders’ knowledge about and engagement with EL constituents influence their ability to interpret and implement policy in equity-expansive ways. We found that many EL leaders had little understanding of the federal law and weak engagement with Indigenous Tribes and communities, both of which limited their work. In states where leaders had deeper knowledge and engagement, they were more actively interpreting and implementing federal law, particularly with the aim of increasing Indigenous EL-classified students’ access to heritage language and culturally-sustaining programs.
Stroke-heart syndrome: Incidence and clinical outcomes of cardiac complications following intracerebral haemorrhage
Authors: Hoad Katie L , Jones Helen , Miller Gemma , Abdul-Rahim Azmil H , Lip Gregory YH , Buckley Benjamin JR
Published: July 2024

Introduction:

Newly diagnosed cardiovascular complications following an ischaemic stroke, termed stroke-heart syndrome, are common and associated with worse outcomes. Little is known regarding stroke-heart syndrome in relation to intracerebral haemorrhage (ICH). This study aimed to investigate the incidence and 5-year major adverse cardiovascular events (MACE; acute myocardial infarction, ischaemic stroke, all-cause mortality and recurrent ICH) of newly diagnosed cardiovascular complications following incident ICH, using a global federated database.

Patients and methods:

A retrospective cohort study was conducted using anonymised electronic medical records. Patients aged ⩾ 18 years with non-traumatic ICH and 5-year follow-up were included. Patients with newly diagnosed cardiovascular complications within 4-weeks following the initial ICH were 1:1 propensity score-matched with patients without new-onset cardiovascular complications. Each cardiovascular complications were investigated as a composite stroke-heart syndrome cohort and separately for associated MACE. Cox hazard regression models were used to determine 5-year incidence of MACE.

Results:

Before propensity score matching, 171,489 patients with non-traumatic ICH, 15% ( n = 26,449) experienced ⩾1 newly diagnosed cardiovascular complication within 4 weeks. After matching, patients with ICH and cardiovascular complications were associated with a significantly higher risk of 5-year MACE (HR 1.35 [95% CI 1.32–1.38]), and in each composite compared to matched controls. There was no significant risk of rehospitalisation over 5-year follow-up [HR 0.90 [0.73–1.13]). The risk of MACE was significantly higher in patients with newly diagnosed cardiovascular complications.

Discussion and conclusions:

Newly diagnosed cardiovascular complications following ICH (i.e. stroke-heart syndrome) were common and associated with a significantly worsened 5-year prognosis.
Levelling Up, affective governance and tensions within ‘pride in place’
Authors: Howcroft Michael , Marsh Nicky , Owen Joseph
Published: July 2024

The ‘pride in place’ mission of the UK Government’s Levelling Up agenda has foregrounded the importance of feelings in local and national development strategies. While pride in place gestures to the emotional symptoms of geographical inequality and the so-called left behind, it does not address their structural causes. This article explores how the lens of pride, and the affective governance it demands, has been used to reimagine place in UK policy. We argue that governance has taken a therapeutic and palliative turn, and that the pride in place mission obscures ideological inconsistencies in policymaking. The article explains how the government’s narrow conception of pride as a mechanism of affective governance illustrates tensions in places at different scales: between national and local issues; between public and private spheres; and between individual and collective identities. It claims that a more meaningful understanding of pride must be predicated on people’s collective capacity for felt and emotional responses. Crucially, any metrics for pride must capture that complexity to help restore social infrastructure in places.
Inhibition of insulin degrading enzyme suppresses osteoclast hyperactivity via enhancing Nrf2-dependent antioxidant response in glucocorticoid-induced osteonecrosis of the femoral head
Authors: Yuan Tao , Wang Haojue , Wang Yi , Dong Shankun , Ge Jianxun , Li Ziqing , Sun Shui
Published: July 2024

Background

Osteoclast hyperactivation due to the pathological overproduction of reactive oxygen species (ROS) stimulated by glucocorticoids (GCs) is one of the key drivers behind glucocorticoid-induced osteonecrosis of the femoral head (GIONFH). The insulin degrading enzyme (IDE), a conserved Zn2+ metallo-endopeptidase, facilitates the DNA binding of glucocorticoid receptor and plays a substantial role in steroid hormone-related signaling pathways. However, the potential role of IDE in the pathogenesis of GIONFH is yet undefined.

Methods

In this study, we employed network pharmacology and bioinformatics analysis to explore the impact of IDE inhibition on GIONFH with 6bK as an inhibitory agent. Further evidence was collected through in vitro osteoclastogenesis experiments and in vivo evaluations involving methylprednisolone (MPS)-induced GIONFH mouse model.

Results

Enrichment analysis indicated a potential role of 6bK in redox regulation amid GIONFH development. In vitro findings revealed that 6bK could attenuate GCs-stimulated overactivation of osteoclast differentiation by interfering with the transcription and expression of key osteoclastic genes (Traf6, Nfatc1, and Ctsk). The use of an H2DCFDA probe and subsequent WB assays introduced the inhibitory effects of 6bK on osteoclastogenesis, linked with the activation of the nuclear factor erythroid-derived 2-like 2 (Nrf2)-mediated antioxidant system. Furthermore, Micro-CT scans validated that 6bK could alleviate GIONFH in MPS-induced mouse models.

Conclusions

Our findings suggest that 6bK suppresses osteoclast hyperactivity in GCs-rich environment. This is achieved by reducing the accumulation of intracellular ROS via promoting the Nrf2-mediated antioxidant system, thus implying that IDE could be a promising therapeutic target for GIONFH.
OsABA3 is Crucial for Plant Survival and Resistance to Multiple Stresses in Rice
Authors: Ni Haoling , Wu Wenshi , Yan Yanmin , Fang Yiyuan , Wang Changjian , Chen Jiayi , Chen Shali , Wang Kaini , Xu Chunjue , Tang Xiaoyan , Wu Jianxin
Published: July 2024

Preharvest sprouting (PHS) is a serious problem in rice production as it leads to reductions in grain yield and quality. However, the underlying mechanism of PHS in rice remains unclear. In this study, we identified and characterized a preharvest sprouting and seedling lethal (phssl) mutant. The heterozygous phssl/+ mutant exhibited normal plant development, but severe PHS in paddy fields. However, the homozygous phssl mutant was seedling lethal. Gene cloning and genetic analysis revealed that a point mutation in OsABA3 was responsible for the mutant phenotypes. OsABA3 encodes a molybdenum cofactor (Moco) sulfurase. The activities of the sulfureted Moco-dependent enzymes such as aldehyde oxidase (AO) and xanthine dehydrogenase (XDH) were barely detectable in the phssl mutant. As the final step of abscisic acid (ABA) de novo biosynthesis is catalyzed by AO, it indicated that ABA biosynthesis was interrupted in the phssl mutant. Exogenous application of ABA almost recovered seed dormancy of the phssl mutant. The knock-out (ko) mutants of OsABA3 generated by CRISPR-Cas9 assay, were also seedling lethal, and the heterozygous mutants were similar to the phssl/+ mutant showing reduced seed dormancy and severe PHS in paddy fields. In contrast, the OsABA3 overexpressing (OE) plants displayed a significant increase in seed dormancy and enhanced plant resistance to PHS. The AO and XDH activities were abolished in the ko mutants, whereas they were increased in the OE plants. Notably, the Moco-dependent enzymes including nitrate reductase (NR) and sulfite oxidase (SO) showed reduced activities in the OE plants. Moreover, the OE plants exhibited enhanced resistances to osmotic stress and bacterial blight, and flowered earlier without any reduction in grain yield. Taken together, this study uncovered the crucial functions of OsABA3 in Moco sulfuration, plant development, and stress resistance, and suggested that OsABA3 is a promising target gene for rice breeding.
Sarcopenic obesity and pre-sarcopenia contribute to frailty in community-dwelling Italian older people: data from the FRASNET study
Authors: Damanti Sarah , Citterio Lorena , Zagato Laura , Brioni Elena , Magnaghi Cristiano , Simonini Marco , De Lorenzo Rebecca , Ruggiero Mariapia , Santoro Simona , Senini Eleonora , Messina Marco , Vitali Giordano , Manunta Paolo , Manfredi Angelo A. , Lanzani Chiara , Querini Patrizia Rovere
Published: July 2024

Background

The ageing process is characterized by a change of body composition with an increase of fat mass and a reduction of muscle mass. Above a certain threshold these alterations configure a condition named sarcopenic obesity (SO). SO is associated with physical frailty in Asian and Brazilian populations. SO impacts on physical frailty in other ethnic groups but its influence on general frailty which is multidimensional and includes cognitive, social and physical factors, remain insufficiently explored in the Italian population.

Methods

Frailty was measured in community dwelling Italian older adults enrolled in the FRASNET study with the frailty index (FI). The FI quantifies frailty as the ratio of the number of present health deficits to the total number of health deficits considered. Regression analyses were performed to assess the association between body composition categories and frailty. Classification and regression tree models were run to evaluate the frailty predictors.

Results

One Thousand One Hundred Fourteen participants of the FRASNET study were included in the present analysis. The sample was composed for the 60.5% by females and its median age was 72 years. The median FI score was 0.11 (IQR 0.07–0.20); 234 individuals (21%) were frail (FI ≥ 0.25). SO (B 0.074, 95% C.I. 0.05–0.1, p < 0.001) and pre-sarcopenia (without obesity B 0.03, 95% C.I, 0.007–0.044, p < 0.001, with obesity B 0.11, 95% C.I. 0.05–0.16, p < 0.001) were associated with frailty. Fat mass percentage predicted frailty in people aged 65–70 years whereas, muscle strength predicted general frailty in people aged 70–81 years.

Conclusion

Pre-sarcopenia and SO represent potentially treatable predictors of frailty.
The effect of exercise referral schemes and self-management strategies on use of prescription analgesics among community-dwelling older adults: registry linkage with randomised controlled trials
Authors: Svensson Nanna Herning , Thorlund Jonas Bloch , Olsen Pia Øllgaard , Søndergaard Jens , Wehberg Sonja , Andersen Helene Støttrup , Caserotti Paolo , Thilsing Trine
Published: July 2024

Background and objective

Exercise referral schemes and self-management strategies have shown positive effects on patient-reported and objectively measured outcomes, such as increased functional capacity and physical activity level. However, the impact of these interventions on analgesic use remains uncertain. We hypothesised that exercise referral schemes, either utilised alone or in combination with self-management strategies, is more effective in reducing use of prescription analgesics compared with a self-management strategy only.

Subjects and methods

We utilised data from two completed randomised controlled trials, namely The Welfare Innovation in Primary Prevention (n = 121) and The SITLESS project (n = 338), and information from the national Danish health registries, including the National Prescription Registry. The two trials have investigated the effectiveness of interventions, which include exercise referral schemes and self-management strategies, on various aspects such as physical function and levels of physical activity among community-dwelling older adults. The studies were conducted in the period 2015–2020 and comprised older adults aged 65+ years, living in three different Danish municipalities. Participants were recruited through nationally regulated preventive home-visits. To estimate changes in use of prescription analgesics over time, a linear fixed effects regression model was applied. The outcome measure was the mean total yearly defined daily dose of analgesics.

Results

All intervention groups showed a within-group increase in overall analgesic use, though not statistically significantly different from zero. There were no differences in estimated changes in mean total yearly defined daily dose when comparing the intervention groups to the group receiving the least extensive intervention (self-management strategies/control). The findings indicated that exercise referral schemes and self-management strategies, whether administrated individually or in combination, did not result in a reduction in analgesic use over time.
Drug-induced hepatotoxicity and association with slow acetylation variants NAT2*5 and NAT2*6 in Cameroonian patients with tuberculosis and HIV co-infection
Authors: Cho Frederick Nchang , Achidi Eric A. , Enoh Jude Eteneneng , Pallerla Srinivas Reddy , Linh Le Thi Kieu , Tong Hoang Van , Kamgno Joseph , Penlap Véronique Beng , Adegnika Ayola Akim , Lekana-Douki Jean-Bernard , Bouyou-Akotet Marielle Karine , Kahunu Gauthier Mesia , Lutete Gaston Tona , Bates Mathew , Tembo John , Elton Linzy , McHugh Timothy D , Grobusch Martin P , Zumla Alimuddin , Ntoumi Francine , Velavan Thirumalaisamy P.
Published: July 2024

Background

Human immunodeficiency virus (HIV) and tuberculosis (TB) are major contributors to morbidity and mortality in sub-Saharan Africa including Cameroon. Pharmacogenetic variants could serve as predictors of drug-induced hepatotoxicity (DIH), in patients with TB co-infected with HIV. We evaluated the occurrence of DIH and pharmacogenetic variants in Cameroonian patients.

Methods

Treatment-naïve patients with HIV, TB or TB/HIV co-infection were recruited at three hospitals in Cameroon, between September 2018 and November 2019. Appropriate treatment was initiated, and patients followed up for 12 weeks to assess DIH. Pharmacogenetic variants were assessed by allele discrimination TaqMan SNP assays.

Results

Of the 141 treatment naïve patients, the overall incidence of DIH was 38% (53/141). The highest incidence of DIH, 52% (32/61), was observed among HIV patients. Of 32 pharmacogenetic variants, the slow acetylation variants NAT2*5 was associated with a decreased risk of DIH (OR: 0.4; 95%CI: 0.17–0.96; p = 0.038), while NAT2*6 was found to be associated with an increased risk of DIH (OR: 4.2; 95%CI: 1.1–15.2; p = 0.017) among patients treated for TB. Up to 15 SNPs differed in ≥ 5% of allele frequencies among African populations, while 25 SNPs differed in ≥ 5% of the allele frequencies among non-African populations, respectively.

Conclusions

DIH is an important clinical problem in African patients with TB and HIV. The NAT2*5 and NAT2*6 variants were found to be associated with DIH in the Cameroonian population. Prior screening for the slow acetylation variants NAT2*5 and NAT2*6 may prevent DIH in TB and HIV-coinfected patients.
Rheumatoid arthritis and adverse pregnancy outcomes: a bidirectional two-sample mendelian randomization study
Authors: Chang Tongmin , Zhao Zengle , Liu Xiaoyan , Zhang Xuening , Zhang Yuan , Liu Xinjie , Zhang Yuan , Lu Ming
Published: July 2024

Background

There is growing evidence of bidirectional associations between rheumatoid arthritis and adverse pregnancy outcomes (APOs) in observational studies, but little is known about the causal direction of these associations. Therefore, we explored the potential causal relationships between rheumatoid arthritis and APOs using a bidirectional two-sample Mendelian randomization (MR) in European and Asian populations.

Methods

We conducted a bidirectional two-sample Mendelian randomization analysis using available summary statistics from released genome-wide association studies. Summary statistics for instrument–outcome associations were retrieved from two separate databases for rheumatoid arthritis and adverse pregnancy outcomes, respectively. The inverse-variance weighted method was used as the primary MR analysis, and cML-MA-BIC was used as the supplementary analysis. MR-Egger, MR pleiotropy residual sum and outlier (MR-PRESSO), and Cochran Q statistic method were implemented as sensitivity analyses approach to ensure the robustness of the results.

Results

Our study showed that a higher risk of rheumatoid arthritis in the European population was associated with gestational hypertension (OR: 1.04, 95%CI: 1.02–1.06), pre-eclampsia (OR: 1.06, 95%CI: 1.01–1.11), fetal growth restriction (OR: 1.08, 95%CI: 1.04–1.12), preterm delivery (OR:1.04, 95%CI: 1.01–1.07). Furthermore, we found no evidence that APOs had causal effects on rheumatoid arthritis in the reverse MR analysis. No association between rheumatoid arthritis and APOs was found in East Asian population. There was no heterogeneity or horizontal pleiotropy.

Conclusions

This MR analysis provides the positive causal association from rheumatoid arthritis to gestational hypertension, pre-eclampsia, fetal growth restriction and preterm delivery genetically. It highlights the importance of more intensive prenatal care and early intervention among pregnant women with rheumatoid arthritis to prevent potential adverse obstetric outcomes.
Investigation of peripheral inflammatory biomarkers in association with violence in schizophrenia
Authors: Yu Tao , Pei Wenzhi , Xu Chunyuan , Zhang Xulai , Deng Chenchen
Published: July 2024

Background

Violent behavior carried out by patients with schizophrenia (SCZ) is a public health issue of increasing importance that may involve inflammation. Peripheral inflammatory biomarkers, such as the systemic immune inflammation index (SII), the neutrophil lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR) and the monocyte lymphocyte ratio (MLR) are objective, easily accessible and cost-effective measures of inflammation. However, there are sparse studies investigating the role of peripheral inflammatory biomarkers in violence of patients with SCZ.

Methods

160 inpatients diagnosed with SCZ between January and December 2022 were recruited into this study. Violent behavior and positive symptoms of all participants were evaluated using Modified Overt Aggression Scale (MOAS) and Positive and Negative Syndrome Scale (PANSS), respectively. The partial correlation analysis was performed to examine the relationship of inflammatory indices and positive symptoms. Based on machine learning (ML) algorithms, these different inflammatory indices between groups were used to develop predictive models for violence in SCZ patients.

Results

After controlling for age, SII, NLR, MLR and PANSS positive scores were found to be increased in SCZ patients with violence, compared to patients without violence. SII, NLR and MLR were positively related to positive symptoms in all participants. Positive symptoms partially mediated the effects of peripheral inflammatory indices on violent behavior in SCZ. Among seven ML algorithms, penalized discriminant analysis (pda) had the best performance, with its an area under the receiver operator characteristic curve (AUC) being 0.7082. Subsequently, with the use of pda, we developed predictive models using four inflammatory indices, respectively. SII had the best performance and its AUC was 0.6613.

Conclusions

These findings suggest that inflammation is involved in violent behavior of SCZ patients and positive symptoms partially mediate this association. The models built by peripheral inflammatory indices have a good median performance in predicting violent behavior in SCZ patients.
Analysing the drivers of stunting reduction in twelve sub-saharan African countries using the RIF decomposition approach
Authors: Olakunle Abibatou Agbéké
Published: July 2024

Background

This study examines how significant is the changes in child stunting in Sub-Saharan African countries (SSA). Then, it investigates factors that contributed to the reduction in child stunting in those countries. For each country, we distinguish the contribution of compositional effects and structural effect.

Methods

This paper uses data from Demographic and Health Surveys of 12 sub-Saharan African countries conducted between 2000 and 2020. The z-test to compare two independent proportions was used to assess changes in child stunting and explanatory variables over the period. Recentred influence function (RIF) decomposition method was used to decompose changes in stunting over the year in each country, and to determine the contribution of each variable to the changes.

Results

The prevalence of child stunting declines significantly in 11 countries over the year. The decline varies from 6.8% in Cameroun to 19% in Mali. The average year of education of the child’s mother and father, and the proportion of households with access to an improved drinking water source have contributed to the reduction in child stunting. This result was found in all the countries. Improvements in living standards, child vaccination, antenatal care attendance, delivery to health care centres, maternal education, improved drinking water sources, and improved sanitation make the largest contribution to the composition component, hence reducing child stunting.

Conclusions

This study sheds light on what has contributed to the achieved improvement in child nutritional status and suggests how to possibly accelerate the reduction in undernutrition in countries that lag.
Association between residing in municipalities facing population decline and satisfaction with neighboring healthcare infrastructure in older aged adults
Authors: Ju Yeong Jun , Kim Woorim , Chang Kyujin , Lee Tae Hoon , Lee Soon Young
Published: July 2024

Background

Many municipalities in rural areas of Korea are facing population decline due to the aging population phenomenon. This study examined the relationship between residing in municipalities facing population decline and satisfaction with nearby healthcare infrastructure in older aged adults.

Methods

The 2021 Korea Community Health Survey (KCHS) data were used. Municipalities were classified as those not facing population decline, those at risk, and those facing population decline based on the Population Decline Index. The association between residing in municipalities facing population decline and satisfaction with nearby healthcare infrastructure was examined cross-sectionally using a multi-level logistic regression analysis. Satisfaction with available public transportation was concomitantly examined as it is related to accessing healthcare services.

Results

Of the 58,568 individuals aged 65 years or above analyzed, 27,471 (46.9%) adults were residing in municipalities without population decline, 4,640 (7.9%) adults in municipalities at risk of population decline, and 26,457 (45.2%) in municipalities with population decline. Individuals living in municipalities with population decline were more likely to be dissatisfied with nearby healthcare infrastructure (OR 1.76, 95% CI 1.41–2.20). Similar tendencies were found for public transportation infrastructure (OR 1.67, 95% CI 1.38–2.03).

Conclusions

Individuals residing in municipalities with declining populations are more likely to report dissatisfaction with nearby healthcare infrastructure and public transportation. These findings emphasize the importance of providing adequate medical infrastructure to reduce potential health-related disparities.
Adult child educational attainment and older parents’ psychosocial outcomes during the COVID-19 pandemic
Authors: Romero Karla Renata Flores , Yang Yulin , Green Sharon H. , Gutierrez Sirena , Meza Erika , Torres Jacqueline M.
Published: July 2024

Background

Older adults’ psychosocial outcomes during the COVID-19 pandemic have been inequitable by socio-economic status (SES). However, studies have focused solely on own SES, ignoring emerging evidence of the relationship between adult child SES and late-life health. We evaluated whether adult child educational attainment – a core marker of SES – is associated with older parents’ psychosocial outcomes during the pandemic.

Methods

We used data from the Survey of Health, Aging, and Retirement in Europe (SHARE) 2004–2018 and the SHARE Corona Surveys (SCS) 2020 and 2021. We included 40,392 respondents ≥ 65 years who had pre-pandemic information on adult child educational attainment and self-reported psychosocial outcomes during the pandemic, including self-assessments of worsened psychosocial outcomes compared to the pre-pandemic period. We used generalized estimating equations with a Poisson distribution and a log link, adjusted for respondent and family-level characteristics, including respondents’ own educational attainment.

Results

Older adults whose adult children averaged levels of educational attainment at or above (vs. below) their country-specific mean had a lower prevalence of feeling nervous (Prevalence Ratio [PR]: 0.94, 95% Confidence Interval [CI]: 0.90, 0.97), sad or depressed (PR: 0.94, 95% CI: 0.91, 0.98), and having sleep problems (PR: 0.94, 95% CI: 0.90, 0.97) during the pandemic. Additionally, higher adult child educational attainment was associated with a lower risk of perceiving worsened feelings of nervousness (PR: 0.95, 95% CI: 0.90, 1.01) and worsened sleep problems (PR: 0.91, 95% CI: 0.82, 1.01) as compared to the pre-pandemic. In stratified models, protective associations were observed only in countries experiencing “high” levels of COVID-19 intensity at the time of the survey. All of these results are derived from adjusted models.

Conclusions

Adult child SES may have “upward” spillover effects on the psychosocial wellbeing of older parents during periods of societal duress like the pandemic.
Adverse and benevolent childhood experiences among adults in the United Kingdom: a latent class analysis
Authors: Cain Shannon M. , Rooney Emily A. , Cacace Samantha , Post Abigail , Russell Kirsten , Rasmussen Susan , Baker Justin C. , Cramer Robert J.
Published: July 2024

Background

Adverse childhood experiences (ACEs) are important factors for population mental and physical health. While considerable public health literature demonstrates the global relevance of ACEs, more recent research shows that benevolent childhood experiences (BCEs) might be important to consider in their direct and mitigating roles for psychological distress and other mental health outcomes. There is little evidence of latent class examinations involving both ACEs and BCEs among adults in western nations. The present study sought to replicate and extend prior literature by: (1) assessing the extent to which past latent class groupings reproduce in present samples, and (2) analyzing the association of latent classes of childhood experiences with psychological distress and suicidal thoughts and behaviours (STBs). We examined psychological distress (i.e., depression, anxiety, post-traumatic stress, general wellbeing) and STBs (i.e., suicidal ideation, self-harm ideation and behaviour, entrapment, and defeat).

Method

Data were drawn from two nationwide cross-sectional online survey studies in the United Kingdom. The first sample (N = 488) was drawn from a study on suicidal behaviour, and the second sample (N = 447) was from a study concerning risk for interpersonal violence.

Results

Results largely replicated an existing four class solution of childhood experiences: Class 1 (Moderate ACEs/High BCEs; 17.6%), Class 2 (High ACEs/Moderate BCEs; 15.3%), Class 3 (Low ACEs/High BCEs; 48.3%), and Class 4 (Low ACEs/Moderate BCEs; 18.8%). Class 2 (High ACEs/Moderate BCEs) was associated with consistently worse psychological distress and STBs. Classes containing high BCEs (1 and 3) were characterized by generally lower levels of psychological distress and STBs.

Conclusions

Results affirm the potential value for jointly considering ACEs and BCEs to understand psychological distress and STBs. ACEs and BCEs may serve foundational roles in theories of suicide. The protective role of BCEs hypothesized in resiliency theory may be supported. Prevention practice and research implications are discussed.
Effect of different physical activity interventions on perinatal depression: a systematic review and network meta-analysis
Authors: Shuai Yu , Wu Jinlong , Li Chenmu , Li Dong
Published: July 2024

Background

Perinatal depression can have profound impacts on both families and society. Exercise therapy is gradually becoming a widely used adjunct treatment for perinatal depression. Some studies have already focused on the relationship between physical activity and perinatal depression (PND). However, there is currently a lack of systematic and comprehensive evidence to address the crucial question of making optimal choices among different forms of physical activity. This study aims to compare and rank different physical activity intervention strategies and identify the most effective one for perinatal depression.

Methods

Four databases, namely PubMed, Cochrane Library, Embase, and Web of Science, were searched for randomized controlled trials assessing the impact of physical activity interventions on perinatal depression. The search covered the period from the inception of the databases until May 2024. Two researchers independently conducted literature screening, data extraction, and quality assessment. Network meta-analysis was performed using Stata 15.1.

Results

A total of 48 studies were included in the analysis. The results indicate that relaxation therapy has the most effective outcome in reducing perinatal depression (SUCRA = 99.4%). Following that is mind-body exercise (SUCRA = 80.6%). Traditional aerobics and aquatic sports were also effective interventions (SUCRA = 70.9% and 67.1%, respectively).

Conclusion

Our study suggests that integrated mental and physical (MAP) training such as relaxation therapy and mind-body exercise show better performance in reducing perinatal depression. Additionally, while exercise has proven to be effective, the challenge lies in finding ways to encourage people to maintain a consistent exercise routine.

Trial registration

This study has been registered on PROSPERO (CRD 42,023,469,537).