bluuebunny/crossref_metadata_2025 huggingface dataset:
Institutional Betrayal and Race in the Civil Legal System: A Latent Class Analysis with Survivors of Intimate Partner Violence
Authors: Freetly Porter Emma , Mendoza Maria Paula , Deng Miaomiao , Horwitz Sarah D. , Soltys Marika A. , Hattery Angela J.
Published: September 2024

Institutional betrayal, the experience of mistreatment by an institution upon which a person depends, is common for survivors of intimate partner violence; however, it has scarcely been examined within the civil legal system. Past evidence suggests that survivors’ negative experiences with the civil legal system as well as racism may increase their risk for negative outcomes, but few studies directly explore the extent to which these adverse experiences impact survivors’ perceptions of institutional betrayal. The present study is a secondary analysis utilizing a latent class analysis approach to explore underlying patterns among these variables, specifically negative experiences and racism, and their impact on institutional betrayal among a sample of 199 Black and Hispanic survivors of intimate partner violence. The analysis revealed that a two-class Racism Model best fit the data, with one of the two classes tending to endorse most items related to racial discrimination and the other class tending toward low endorsement of these items. Class probabilities were then used to predict participants’ scores on a measure of institutional betrayal. Results provide evidence that experiencing racism may be a risk factor for negative outcomes in the civil legal system, specifically institutional betrayal. Implications and future directions are discussed.
Unveiling English Reading Literacy: Insights from Senior High School Students in Chongqing, China
Authors: Xu Nan , Xiong Shuyue , Kong Yunjun
Published: September 2024

Reading plays a pivotal role in lifelong development, serving as an indispensable foundation for students to thrive. The present study therefore aimed to assess the English reading literacy of senior high school students. A self-developed questionnaire was administered to 427 students from three schools in Chongqing, China. The questionnaire encompassed three dimensions: reading ability, reading character, and teachers’ assistance in enhancing the two domains. Results revealed that the participants exhibited moderate English reading literacy levels, with gender and parental education exerting significant influence on their English reading literacy. Furthermore, teachers primarily focused on improving academic performance rather than fostering well-rounded readership abilities, leading to slight variations regarding the concepts and methodologies employed for cultivating comprehensive literary competence. Individual attributes, family background, teacher-related factors, institutional dynamics, and societal factors significantly impacted the participants’ English reading literacy levels. Consequently, corresponding strategies and suggestions were discussed.
Theory of Planned Behavior as a Theoretical Framework for Exploring Nursing Students’ Intentions for Interprofessional Collaboration: A Qualitative Study
Authors: Przymuszała Piotr , Turalska Martyna , Zielińska-Tomczak Łucja , Chmielewski Artur , Cerbin-Koczorowska Magdalena , Marciniak Ryszard
Published: September 2024

Given the limited and scattered data on nursing students’ behavioral intentions regarding interprofessional collaboration and the factors influencing them, there is a need for comprehensive, theory-driven research on the topic from nursing students’ perspectives. Using a theoretical framework provided by the theory of planned behavior, this study aimed to evaluate the behavioral intentions of Polish nursing students regarding interprofessional collaboration, including their attitudes, subjective norms, and perceived behavioral control. Sixteen nursing students participated in semi-structured interviews. Data were collected on the MS Teams application between February and May 2022 using a thematic guide created following manuals dedicated to the theory. They were thematically analyzed by two researchers using Atlas.ti Software. The results showed that students’ attitudes were mostly positive. The benefits of interprofessional collaboration included positive patient outcomes, exchange of mutual knowledge and expertise, comfort, and improved work atmosphere. The risks originating from human-dependent factors were viewed as a negative aspect. The relevant groups of people influencing their subjective norms comprised nursing community representatives, other medical professionals, patients, and members of society. Perceived behavioral control aspects covered the work organization, lack of incentives for collaboration, atmosphere and habits prevailing in the workplace, and insufficient practical experience and knowledge regarding collaboration. To conclude, although positive attitudes expressed by nursing students seem to constitute a positive predictor of their involvement in interprofessional collaboration, relevant decision-makers should address negative feelings and aspects identified during this study.
Concern about climate change in two protected natural areas of Spain: psychological barriers / La preocupación por el cambio climático en dos espacios naturales protegidos de España: barreras psicológicas
Authors: Corraliza José Antonio , Moll Adrián , Collado Silvia , Sevillano Verónica , Múgica Marta
Published: September 2024

Climate change (CC) has been listed as the greatest risk to humanity, and the most appropriate strategies to address the situation depend largely on how the problem is perceived. The purpose of this study is to analyse social perceptions of CC in two natural areas of Spain (Garajonay and Sierra Espuña). Participants ( N = 334) showed high levels of concern and low levels of scepticism about CC. A factorial model was developed to explain the relationships between variables that affect concern about CC: scepticism, technological optimism, negative self-efficacy, political ideology and perceived signs of CC. The SEM model ( R2 = .65; χ2( df) = 223.65 (131); CFI = .968; RMSEA = .057) shows the strategic importance of considering the variables included (such as CC scepticism and technological optimism) so as to better understand the complex phenomenon of concern about CC.
Predictors of Empowerment Among Undergraduate Nursing Students: A Cross-Sectional Study
Authors: Al niarat Tahany
Published: September 2024

Objective

To predict the factors that influence undergraduate nursing students’ perception of empowerment.

Methods

A cross-sectional design was used, and fourth-year nursing students ( n = 164) were selected using convenient sampling. The data collection methods included the Arabic version of self-reported questionnaires: The (LES), (LOGO-II), and (UNSASS).

Results

The results showed a positive correlation between nursing students’ perception of empowerment and their attitudes toward learning. Also, the results showed a strong correlation between students’ perception of empowerment and their academic satisfaction. In addition, in-class teaching was found to be the strongest predictor of students’ perception of empowerment.

Conclusions

Verified the factors that may contribute to promoting the teaching-learning process to focus and stress on them. Teachers and instructors should utilize the available resources in the teaching environment to maximize the learning outcomes. All these factors are not limited and will enhance the nursing students’ perception of empowerment.
Ambiguous Status Relations and Complex Hierarchy among Adolescents
Authors: McMahan Peter
Published: September 2024

Informal status hierarchy is a ubiquitous feature of social life, and it is one that drives dynamics of dominance, influence, exclusion, and stratification. Utilizing data from the National Longitudinal Study of Adolescent to Adult Health, this article shows that friendship nominations among adolescents are sensitive to status distinctions and that this sensitivity can be exploited to infer status relations and the level of ambiguity those relations entail. A measure is developed to uncover latent status structures based on such relations among students, demonstrating the existence of complex hierarchical structures among communities. Differentiating between students’ rank (verticality) and embeddedness (horizontality), the analysis reveals orthogonal processes of stratification: A student’s rank is associated with their social role at the school, whereas their embeddedness is linked to traditional markers of stratification, such as race and income. The analysis demonstrates the theoretical utility of incorporating ambiguity of status relations and provides a flexible set of statistical tools to study relational status hierarchies.
Childhood Socioeconomic Status Affects Dental Pain in Later Life
Authors: Yamamoto T. , Cooray U. , Kusama T. , Kiuchi S. , Abbas H. , Osaka K. , Kondo K. , Aida J.
Published: September 2024

Objectives:

Lower socioeconomic status (SES) is associated with increased dental pain among children. Lower SES in childhood may also contribute to the experience of dental pain among older adults, regardless of the SES in later life. However, this association is still unclear.

Methods:

We used cross-sectional data from the 2019 Japan Gerontological Evaluation Study using self-administrated questionnaires to investigate the causal mediating pathways between childhood SES and dental pain in later life using several SES variables collected at older age as potential mediators. A total of 21,212 physically and cognitively independent participants aged 65 y or older were included in the analysis. The dependent variable was experiencing dental pain during the past 6 mo. The independent variable was the SES at the age of 15 y (low/middle/high). Ten covariates were selected covering demographics and other domains. Education, subjective current income, objective current income, objective current property ownership, and the number of remaining teeth were used as mediators. Prevalence ratios (PRs) and 95% confidence intervals (95% CIs) for dental pain by childhood SES were calculated using a modified Poisson regression model.

Results:

The mean age of the study participants was 74.5 ± 6.2 y, and 47.5% were men. Of these, 6,222 participants (29.3%) experienced dental pain during the past 6 mo, and 8,537 participants (40.2%) were of low childhood SES. Adjusted for covariates and mediators, the participants with middle and high childhood SES had a lower PR of dental pain (PR = 0.93 [95%, CI 0.89–0.98], PR = 0.79 [95% CI, 0.73–0.85], respectively). Almost 40% of the association between childhood SES and dental pain at older age was mediated via SES in later life and the number of teeth.

Conclusions:

This study reemphasizes the importance of support for early-life SES to maintain favorable oral health outcomes at an older age.

Knowledge Transfer Statement:

The results of this study can be used by policymakers to promote policies based on a life-course approach that supports children living in communities with low SES and helps them maintain favorable oral health outcomes into their older age.
COVID-19 vaccine coverage effectiveness among elderly with geographical information system mapping: what about Indonesia?
Authors: Wulan Widya Ratna , Widianawati Evina , wahyuni Anis Tri
Published: September 2024

Background:

The elderly are the next priority after health workers and public service workers get the COVID-19 vaccine to control morbidity and even mortality in the elderly who have a risk factor that is up to 60 times more severe than children.

Objectives:

This study aimed to spatially analyze the effectiveness of COVID-19 vaccine coverage among the elderly in Indonesia with geographic information system (GIS) mapping and to analyze the relationship between COVID-19 vaccine coverage in the elderly with the COVID-19 cure rate.

Design:

This quantitative study used secondary data on COVID-19 vaccination coverage in the elderly group of Central Java Province, Indonesia in 2021.

Methods:

Data were analyzed using a simple linear correlation test to test the relationship between variables with a 1,774,396 elderly sample size, then distributed using mapping of COVID-19 vaccination coverage using a GIS.

Results:

The relationship between COVID-19 vaccine dose-2 elderly coverage cure rate showed a strong relationship ( r = 0.677) and a positive pattern. The coefficient value with a determination of 0.459 means that the regression line equation obtained can explain 45.90% of the variation in the COVID-19 cure rate. There was a significant relationship between COVID-19 vaccine elderly coverage and the COVID-19 cure rate ( p-value = 0.005).

Conclusion:

Clinicians and public health workers should continue to encourage elderly vaccination at all recommended doses for eligible individuals.
From Freight to Future: Enhancing Philippines Logistics for Economic Competitiveness
Authors: Banomyong Ruth
Published: September 2024

The purpose of this article is to evaluate the performance of logistics service providers (LSPs) in the Philippines, emphasising their impact on economic development and competitiveness. Utilising data collected from 126 respondents affiliated with the Philippines International Sea freight Forwarder Association and the Air cargo Forwarders of the Philippines Inc., the study identifies key performance indicators, including cost, time and reliability. The findings reveal that while LSPs in the Philippines maintain acceptable performance levels, significant challenges remain, particularly in domestic logistics. The study highlights that delays in customs processes and infrastructure inadequacies are major impediments to optimal logistics performance. Comparative analysis with other ASEAN countries shows that the Philippines lags in certain areas, particularly in delivery reliability and logistics infrastructure quality. The research also explores human resource issues, noting a high turnover rate and reliance on on-the-job training. Policy implications suggest the need for enhanced infrastructure, better regulatory frameworks and targeted human resource development to boost logistics performance. This study offers valuable insights for policy-makers and industry stakeholders aiming to improve the efficiency and competitiveness of the Philippines’ logistics services.

JEL Codes: F0, F2
Insurance Development, Global Economic Policy Uncertainty and Geopolitical Risk: The Asymmetric Relationship Evidence from ASEAN-5
Authors: Lim Soyoung , Kyophilavong Phouphet , Soukchalern Phongsili
Published: September 2024

Academia and governments have shown interest in studying the influence of the global economic policy uncertainty index (GEPU) and the geopolitical risk index (GPR) on insurance development. Several empirical studies have been conducted to examine the influence of GEPU and GPR on insurance development. Nevertheless, the empirical results failed to achieve consensus. This study aims to study the asymmetric impacts of the GEPU and the GPR on insurance sector development in ASEAN from 1990 to 2020. We used the linear panel autoregressive distributed lag (PARDL) approach and the asymmetric panel autoregressive distributed lag (PNARDL) approach. The results from the linear panel ARDL showed that GEPU and GPR had an impact on non-life insurance (NI), but both variables did not have an impact on life insurance (LI). Furthermore, the asymmetric panel ARDL showed no significant impact of positive shocks from GEPU had a positive impact on LI and NI, but the negative shocks from GEPU only had a positive impact on NI. Positive and negative shocks from GEPU lead to an increase in the NI. Interestingly, we found that the positive shocks of GPR led to an increase in NI, but positive or negative shocks of GPR did not have an impact on LI. Policymakers in ASEAN should closely look at the GEPU and the GPR for insurance policy development.

JEL Codes: E6, G0
Calculating power for multilevel implementation trials in mental health: Meaningful effect sizes, intraclass correlation coefficients, and proportions of variance explained by covariates
Authors: Williams Nathaniel J. , Cardamone Nicholas C. , Beidas Rinad S. , Marcus Steven C.
Published: September 2024

Background

Despite the ubiquity of multilevel sampling, design, and analysis in mental health implementation trials, few resources are available that provide reference values of design parameters (e.g., effect size, intraclass correlation coefficient [ICC], and proportion of variance explained by covariates [covariate R2]) needed to accurately determine sample size. The aim of this study was to provide empirical reference values for these parameters by aggregating data on implementation and clinical outcomes from multilevel implementation trials, including cluster randomized trials and individually randomized repeated measures trials, in mental health. The compendium of design parameters presented here represents plausible values that implementation scientists can use to guide sample size calculations for future trials.

Method

We searched NIH RePORTER for all federally funded, multilevel implementation trials addressing mental health populations and settings from 2010 to 2020. For all continuous and binary implementation and clinical outcomes included in eligible trials, we generated values of effect size, ICC, and covariate R2 at each level via secondary analysis of trial data or via extraction of estimates from analyses in published research reports. Effect sizes were calculated as Cohen d; ICCs were generated via one-way random effects ANOVAs; covariate R2 estimates were calculated using the reduction in variance approach.

Results

Seventeen trials were eligible, reporting on 53 implementation and clinical outcomes and 81 contrasts between implementation conditions. Tables of effect size, ICC, and covariate R2 are provided to guide implementation researchers in power analyses for designing multilevel implementation trials in mental health settings, including two- and three-level cluster randomized designs and unit-randomized repeated-measures designs.

Conclusions

Researchers can use the empirical reference values reported in this study to develop meaningful sample size determinations for multilevel implementation trials in mental health. Discussion focuses on the application of the reference values reported in this study.
Representing contemporary paramedic practice in Canada: Development of the national competency framework for paramedics
Authors: Batt Alan M. , Bolster Jennifer L. , Lysko Meghan , Poirier Pierre , Cassista Derek , Austin Michael , Cameron Cheryl , Donnelly Elizabeth A. , Donelon Becky , Dunn Noël , Johnston William , Lanos Chelsea , Leyenaar Matthew S. , Lunn Tyne M. , Mason Paige , Osinga Mary , Steary Dugg , Teed Sean , Vacon Charlene , Tavares Walter
Published: September 2024

Paramedicine is a domain of practice and health profession that specialises in the provision of health and social care across a range of settings including, but not limited to, emergency and primary care. Paramedics work in a variety of clinical settings such as paramedics services, hospitals, and clinics, in the community as well as non-clinical roles, such as education, leadership, policy work, public health and research. A previous competency framework for paramedics in Canada had become increasingly poorly aligned with contemporary practice. We sought to develop a competency framework that represents contemporary paramedic practice in Canada. This project was guided by a conceptual framework informed by systems thinking and used a six-step model for developing competency frameworks. We engaged paramedics from across Canada in working groups to explore various contexts of paramedic practice. We gathered data using multiple methods and coded this data into activity statements. We grouped these statements and developed or expanded corresponding professional activities through five drafts of the framework from 2022 to 2024. A technical committee reviewed and edited the draft framework throughout the process, culminating in a public review period from January to March 2024, and a subsequent final version of the National Competency Framework for Paramedics (NCFP). The National Competency Framework for Paramedics reflects contemporary paramedic practice in Canada. It describes the professional activities of paramedics organised under five domains - Person-Centred Care; Collaborative Care; Safe Care; Self-Care; and Professional Care. Paramedics perform these activities across multiple contexts of practice by enacting a variety of roles depending on the event. By exploring the variety of practice contexts and the expectations of paramedics across Canada, the NCFP provides a holistic, contemporary description of paramedic practice in Canada, providing a foundation for professional practice in a variety of settings. The five domains provide a comprehensive representation of paramedic practice helping to ensure care is ultimately and sufficiently aligned with the needs of the community and settings in which paramedics can practice. The NCFP can be used to inform education programmes to better prepare paramedics for complex, interprofessional health and social care practice now and as practice continues to evolve.
CD9 promotes TβR2–TβR1 association driving the transition of human dermal fibroblasts to myofibroblast under hypoxia
Authors: Huang Wanqi , Zhang Ze , Li Xin , Zheng Qingqing , Wu Chao , Liu Luojia , Chen Ying , Zhang Jiaping , Jiang Xupin
Published: September 2024

Background

During wound healing, fibroblast to myofibroblast transition is required for wound contraction and remodeling. While hypoxia is an important biophysical factor in wound microenvironment, the exact regulatory mechanism underlying hypoxia and fibroblast-to-myofibroblast transition remains unclear. We previously found that tetraspanin CD9 plays an important role in oxygen sensing and wound healing. Herein, we investigated the effects of physiological hypoxia on fibroblast-to-myofibroblast transition and the biological function and mechanism of CD9 in it.

Methods

Human skin fibroblasts (HSF) and mouse dermis wounds model were established under physiological hypoxia (2% O2). The cell viability and contractility of HSF under hypoxia were evaluated by CCK8 and collagen gel retraction, respectively. The expression and distribution of fibroblast-to-myofibroblast transition markers and CD9 in HSF were detected by Western blotting and immunofluorescence. CD9 slicing and overexpressing HSFs were constructed to determine the role of CD9 by small interfering RNA and recombinant adenovirus vector. The association of TβR2 and TβR1 was measured by immunoprecipitation to explore the regulatory mechanism. Additionally, further validation was conducted on mouse dermis wounds model through histological analysis.

Results

Enhanced fibroblast-to-myofibroblast transition and upregulated CD9 expression was observed under hypoxia in vitro and in vivo. Besides, reversal of fibroblast-to-myofibroblast transition under hypoxia was observed when silencing CD9, suggesting that CD9 played a key role in this hypoxia-induced transition. Moreover, hypoxia increased fibroblast-to-myofibroblast transition by activating TGF-β1/Smad2/3 signaling, especially increased interaction of TβR2 and TβR1. Ultimately, CD9 was determined to directly affect TβR1–TβR2 association in hypoxic fibroblast.

Conclusion

Collectively, these findings suggest that CD9 promotes TβR2–TβR1 association, thus driving the transition of human dermal fibroblasts to myofibroblast under hypoxia.
Epidemiological linkage between migraine and diabetes mellitus: a systematic review and meta-analysis
Authors: Ha Woo-Seok , Nguyen Vinh Khang , Chu Min Kyung
Published: September 2024

Background

This study aimed to elucidate the nature and extent of the associations between diabetes mellitus (DM) and migraine through a systematic review and meta-analysis.

Methods

We searched the PubMed, Web of Science, and Scopus databases without a specified start date until June 2, 2024. Cross-sectional and cohort studies analyzing the risk of migraine in individuals with DM and vice versa were included. Studies without at least age and sex adjustments were excluded. Data were extracted to calculate odds ratios (ORs) and hazard ratios (HRs). Risk of bias was assessed using the Newcastle–Ottawa Quality Assessment Scale.

Results

Eight cross-sectional studies (131,361 patients with DM and 1,005,604 patients with migraine) and four cohort studies (103,205 patients with DM patients and 32,197 patients with migraine) were included. Meta-analyses of the cross-sectional studies showed no significant overall association between DM and migraine. Subgroup analyses revealed that type 1 diabetes reduced the odds of having migraine (OR 0.48, 95% confidence interval [CI] 0.30–0.77), while migraine without aura (MO) increased the odds of having DM (OR 1.19, 95% CI 1.02–1.39). The cohort studies indicated that DM decreased the risk of developing migraine (HR 0.83, 95% CI 0.76–0.90), and a history of migraine increased the risk of developing DM (HR 1.09, 95% CI 1.01–1.17).

Conclusions

DM, particularly type 1 diabetes, is negatively associated with migraine occurrence, whereas migraine, especially MO, is positively associated with DM occurrence. However, most of the results remained at a low or very low level of evidence, indicating the need for further research.
Improved polygenic risk prediction in migraine-first patients
Authors: Torok Dora , Petschner Peter , Baksa Daniel , Juhasz Gabriella
Published: September 2024

Background

Recent meta-analyses estimated 14.6% and 11.2% SNP-based heritability of migraine, compared to twin-heritability estimates of 30–60%. This study aimed to investigate heritability estimates in “migraine-first” individuals, patients for whom G43 (migraine with or without aura) was their first medical diagnosis in their lifetime.

Findings

Using data from the UK Biobank (N = 199,929), genome-wide association studies (GWAS) were conducted on 6,139 migraine-first patients and 193,790 healthy controls. SNP-based heritability was estimated using SumHer, yielding 19.37% (± 0.019) for all SNPs and 21.31% (± 0.019) for HapMap3 variants, substantially surpassing previous estimates. Key risk loci included PRDM16, FHL5, ASTN2, STAT6/LRP1, and SLC24A3, and pathway analyses highlighted retinol metabolism and steroid hormone biosynthesis as important pathways in these patients.

Conclusions

The findings underscore that excluding comorbidities at onset time can enhance heritability estimates and genetic signal detection, significantly reducing the extent of “missing heritability” in migraine.
A novel protein SPECC1-415aa encoded by N6-methyladenosine modified circSPECC1 regulates the sensitivity of glioblastoma to TMZ
Authors: Wei Cheng , Peng Dazhao , Jing Boyuan , Wang Bo , Li Zesheng , Yu Runze , Zhang Shu , Cai Jinquan , Zhang Zhenyu , Zhang Jianning , Han Lei
Published: September 2024

Background

Circular RNAs (circRNAs) can influence a variety of biological functions and act as a significant role in the progression and recurrence of glioblastoma (GBM). However, few coding circRNAs have been discovered in cancer, and their role in GBM is still unknown. The aim of this study was to identify coding circRNAs and explore their potential roles in the progression and recurrence of GBM.

Methods

CircSPECC1 was screened via circRNAs microarray of primary and recurrent GBM samples. To ascertain the characteristics and coding ability of circSPECC1, we conducted a number of experiments. Afterward, through in vivo and in vitro experiments, we investigated the biological functions of circSPECC1 and its encoded novel protein (SPECC1-415aa) in GBM, as well as their effects on TMZ sensitivity.

Results

By analyzing primary and recurrent GBM samples via circRNAs microarray, circSPECC1 was found to be a downregulated circRNA with coding potential in recurrent GBM compared with primary GBM. CircSPECC1 suppressed the proliferation, migration, invasion, and colony formation abilities of GBM cells by encoding a new protein known as SPECC1-415aa. CircSPECC1 restored TMZ sensitivity in TMZ-resistant GBM cells by encoding the new protein SPECC1-415aa. The m6A reader protein IGF2BP1 can bind to circSPECC1 to promote its expression and stability. Mechanistically, SPECC1-415aa can bind to ANXA2 and competitively inhibit the binding of ANXA2 to EGFR, thus resulting in the inhibition of the phosphorylation of EGFR (Tyr845) and its downstream pathway protein AKT (Ser473). In vivo experiments showed that the overexpression of circSPECC1 could combine with TMZ to treat TMZ-resistant GBM, thereby restoring the sensitivity of TMZ-resistant GBM to TMZ.

Conclusions

CircSPECC1 was downregulated in recurrent GBM compared with primary GBM. The m6A reader protein IGF2BP1 could promote the expression and stability of circSPECC1. The sequence of SPECC1-415aa, which is encoded by circSPECC1, can inhibit the binding of ANXA2 to EGFR by competitively binding to ANXA2 and inhibiting the phosphorylation of EGFR and AKT, thereby restoring the sensitivity of TMZ-resistant GBM cells to TMZ.
GenRCA: a user-friendly rare codon analysis tool for comprehensive evaluation of codon usage preferences based on coding sequences in genomes
Authors: Fan Kunjie , Li Yuanyuan , Chen Zhiwei , Fan Long
Published: September 2024

Background

The study of codon usage bias is important for understanding gene expression, evolution and gene design, providing critical insights into the molecular processes that govern the function and regulation of genes. Codon Usage Bias (CUB) indices are valuable metrics for understanding codon usage patterns across different organisms without extensive experiments. Considering that there is no one-fits-all index for all species, a comprehensive platform supporting the calculation and analysis of multiple CUB indices for codon optimization is greatly needed.

Results

Here, we release GenRCA, an updated version of our previous Rare Codon Analysis Tool, as a free and user-friendly website for all-inclusive evaluation of codon usage preferences of coding sequences. In this study, we manually reviewed and implemented up to 31 codon preference indices, with 65 expression host organisms covered and batch processing of multiple gene sequences supported, aiming to improve the user experience and provide more comprehensive and efficient analysis.

Conclusions

Our website fills a gap in the availability of comprehensive tools for species-specific CUB calculations, enabling researchers to thoroughly assess the protein expression level based on a comprehensive list of 31 indices and further guide the codon optimization.
Investigating causal links between gallstones, cholecystectomy, and 33 site-specific cancers: a Mendelian randomization post-meta-analysis study
Authors: Teng Fei , Tang Youyin , Lu Zhangyu , Chen Kefei , Chen Zheyu
Published: September 2024

Background and aim

The association between gallstones/cholecystectomy and cancer remains inconclusive in the current literature. This study aimed to explore the causal connections between gallstones/cholecystectomy and cancer risk by utilizing a bidirectional two-sample multivariable Mendelian randomization approach with Genome-Wide Association Studies data.

Methods

Utilizing Genome-Wide Association Studies data from the UK Biobank and FinnGen, this research employed multivariable Mendelian randomization analyses to explore the impact of gallstones and cholecystectomy on the risk of 33 distinct cancer types. Instrumental variables for gallstones and cholecystectomy were carefully selected to ensure robust analyses, and sensitivity and heterogeneity tests were conducted to verify the findings’ validity.

Results

Multivariable Mendelian randomization analysis, incorporating data from more than 450,000 individuals for gallstones and cholecystectomy, revealed nuanced associations with cancer risk. Cholecystectomy was associated with a significantly increased risk of nonmelanoma skin cancer (OR = 1.59, 95% CI: 1.21 to 2.10, P = 0.001), while gallstones were linked to a decreased risk of the same cancer type (OR = 0.63, 95% CI: 0.47 to 0.84, P = 0.002). Interestingly, the analysis also suggested that cholecystectomy may lower the risk of small intestine tumors (OR = 0.18, 95% CI: 0.043 to 0.71, P = 0.015), with gallstones showing an inverse relationship, indicating an increased risk (OR = 6.41, 95% CI: 1.48 to 27.80, P = 0.013).

Conclusions

The multivariable Mendelian randomization analysis highlights the differential impact of gallstones and cholecystectomy on cancer risk, specifically for nonmelanoma skin cancer and small intestine tumors. These results underscore the importance of nuanced clinical management strategies and further research to understand the underlying mechanisms and potential clinical implications of gallstone disease and cholecystectomy on cancer risk.
Association between hydroxychloroquine intake and damage to the outer nuclear layer in eyes without manifest retinal toxicity
Authors: Salameh Nagib , Doumit Carla Abi , Jalkh Edmond , Nehme Joseph
Published: September 2024

Background

Hydroxychloroquine (HCQ) is widely used to treat various autoimmune diseases but carries a risk of retinal toxicity, particularly with prolonged use. Despite advancements, uncertainty persists regarding optimal screening methods. Recent advances in OCT have enabled early detection of retinal damage, with studies suggesting that thinning of specific retinal layers may be an early indicator of toxicity. However, there is a gap in research on outer nuclear layer (ONL) thinning in HCQ users without apparent retinal toxicity. This information is crucial for improving screening and identifying the ONL as a reliable biomarker for screening. Therefore, this study aimed to investigate the association between HCQ intake and ONL damage in eyes without manifest retinal toxicity.

Methods

A case‒control study was conducted at the ophthalmology department of Eye and Ear Hospital International from July 2022 to June 2023. The study included 20 individuals on HCQ and 20 age-matched controls. The data were obtained through chart reviews, and participants underwent comprehensive ophthalmic assessments.

Results

A total of 80 eyes were analyzed. Patients on HCQ exhibited significantly thinner perifoveal, parafoveal, and overall ONL compared to controls (P < .001, P < .012, and P < .004, respectively). Similarly, this association was found in the nasal, inferior, and temporal quadrants of both the inner (region 3: P < .01, region 4: P < .001, and region 5: P < .03) and outer zones (region 7: P < .04, region 8: P < .001, region 9: P < .02), most pronounced in the inferior regions. The cumulative dose was weakly associated with decreased ONL thickness only in the nasal quadrant of the inner zone (region 3: P < .047). Correlation analysis of the initial and most recent OCT scans in the same individuals revealed a weak association with ONL thinning in the central zone (region 1: P < .0048).

Conclusion

The thickness of the ONL can significantly decrease in patients taking HCQ, even in the absence of of manifest retinal toxicity. This study is the first to evaluate this association in eyes with negative screening and diagnostic tests for HCQ retinopathy. The findings suggest that ONL thickness could serve as an early diagnostic indicator for HCQ retinal toxicity.
Psychometric properties of the German version of the brief resilience scale in persons with mental disorders
Authors: Broll Jan , Schäfer Sarah K. , Chmitorz Andrea , Meule Adrian , Voderholzer Ulrich , Helmreich Isabella , Lieb Klaus
Published: September 2024

The Brief Resilience Scale (BRS) was developed to assess individual differences in the ability to recover from stress despite adversity and has been translated into several languages. This study aimed to examine the psychometric properties (i.e., item characteristics, reliability, factor structure, measurement invariance, and validity) of the German version of the BRS in persons with mental disorders. A total of N = 5,986 persons admitted to inpatient treatment completed the German version of the BRS and other questionnaires. The discriminating power of the items, the difficulty of the items, and the internal consistency were all sufficient. Moreover, confirmatory factor analysis supported the two–factor structure of the BRS, consistent with the findings of the German validation study in a non–clinical sample. The BRS also had strict measurement invariance across diagnostic groups for mental disorders according to ICD–10. Validity was examined using a network analysis, in which the BRS demonstrated positive correlations with life satisfaction, self–efficacy and optimism and negative correlations with somatic symptoms, anxiety, insomnia, and depression. The BRS can serve as a reliable and valid tool for assessing resilience in clinical settings, facilitating the identification of persons with potentially lower psychosocial resources.
Dissemination of colorectal cancer information among Hispanic patients and their social network
Authors: Ko Linda K. , Jang Sou Hyun , Rodriguez Edgar , Buta Miruna , Ibarra Genoveva , Reuland Daniel
Published: September 2024

Background

Colorectal cancer (CRC) screening decision aids can inform patients about CRC screening benefits, costs, and procedures. Patients who receive the decision aid report wanting to share the information with their families and friends. We evaluated a CRC screening decision aid on Hispanic patients’ communication to their alters and whether patient-alter communication leads to alters’ CRC screening intention.

Methods

We conducted a one-arm pre/post study of Hispanic patients and their alters; patients (n = 42) and their alters (n = 19) were recruited from a clinic site in Yakima County, Washington State. Patients viewed a CRC screening decision aid at the clinic site. Survey data from patients and alters were collected via telephone including patients’ communication with their alters about CRC screening after viewing the decision aid and alters’ intention to be screened for CRC after talking to the patient.

Results

Most participants reported sharing CRC information with their alters after viewing the decision aid, and most alters confirmed they had received CRC information from participants (68%). The decision aid was associated with participants' own intention to undergo CRC screening and with alters' intention to be screened for CRC using a fecal occult blood test (p = 0.014) and sigmoidoscopy (p = 0.011).

Conclusions

Patient decision aids have the potential to increase CRC screening behavior beyond the decision aid recipients to their social network.

Trial registration

Trials Registration Number: NCT04444232 “Retrospectively registered.”
MINISTOP 3.0: Implementation of a mHealth obesity prevention program within Swedish child healthcare – study protocol for a cluster randomized controlled trial
Authors: Thomas Kristin , Löf Marie , Lundgren Maria , Fagerström Maria , Hesketh Kylie D. , Brown Vicki , Häbel Henrike , Delisle Nyström Christine
Published: September 2024

Background

Previously, we have reported on the efficacy and real-world effectiveness of a parent-oriented mobile health intervention (MINISTOP 1.0 and 2.0), which have shown improvements in pre-school children’s lifestyle behaviours. However, there is a need for implementation evidence. The overall aims of this study are to: (i) compare two different implementation strategies for MINISTOP 3.0 (Basic vs. Enhanced) on: acceptability, appropriateness, feasibility, organizational readiness to implement MINISTOP 3.0 within Swedish child healthcare (primary outcomes) as well as reach, costs, and adoption of MINISTOP 3.0 (secondary outcomes); (ii) evaluate cost-effectiveness of MINISTOP 3.0; (iii) explore the sustainability of MINISTOP 3.0; (iv) evaluate the determinants of effectiveness of MINISTOP 3.0 on children’s key lifestyle behaviours; and (v) investigate the long-term effects of MINISTOP 3.0 on children’s body mass index.

Methods

A hybrid type III implementation-effectiveness design will be used. A cluster randomized controlled trial will be conducted to compare the effects of basic versus enhanced implementation strategies on the outcomes at the child healthcare level. A minimum of 50 child healthcare centers across Sweden will participate and we aim to recruit 120 nurses. Child healthcare nurses in both groups will offer the MINISTOP 3.0 app to the families at the 2.5/3-year routine visit. Basic implementation strategies include educational meeting with nurses, formal implementation blueprint, develop/distribute educational materials and enhanced implementation includes all aforementioned strategies plus auditing/providing feedback and ongoing training for nurses. All outcomes will be assessed at baseline and 12 months post-implementation. Implementation outcomes will be assessed quantitatively using questionnaires and sustainability will be assessed qualitatively at 12 months. Children’s key lifestyle behaviours will be collected through a parental questionnaire within the MINISTOP app at baseline and 6 months after they have received the app. Children’s weight/height will be measured at routine visits at 2.5/3 (baseline), 4 and 5 years of age.

Discussion

This study will provide important implementation evidence with regards to implementing mHealth interventions within Swedish child healthcare at scale and these results have the potential to be generalized to other digital interventions being implemented in child healthcare.

Trial registration

ClinicalTrials.gov, NCT05667753. Registered December 29, 2022.
Exceeding the guideline-recommended maximum daily dose of opioids for long-term treatment of non-cancer pain in Germany – a large retrospective observational study
Authors: Schrader Nils Frederik , Niemann Anja , Weitzel Milena , Speckemeier Christian , Abels Carina , Blase Nikola , Giebel Godwin Denk , Riederer Cordula , Nadstawek Joachim , Straßmeir Wolfgang , Wasem Jürgen , Neusser Silke
Published: September 2024

Background

High-dose long-term opioid therapy (LTOT) has been associated with increased mortality and hospitalizations. Therefore, the evidence-based German guideline on LTOT for chronic non-cancer pain (CNCP) recommends to only exceed the maximum daily dose (MDD) of opioids in exceptional cases. This study aimed to determine the portion of LTOT patients who exceeded the guideline-recommended MDD and identify predictors of exceeding in administrative claims data.

Methods

The retrospective observational analysis of opioid prescriptions in patients receiving LTOT for CNCP was based on administrative claims by a large German statutory health insurance company. Patients with at least two quarters of opioid prescriptions between January 2018 and June 2019 were included and followed up for two years. Predictors were identified by logistic regression. In addition, the number of patients still in opioid therapy and the extent of exceeded MDDs were analyzed over time.

Results

The sample consisted of 113,475 patients. Overall, 10.5% of the patients exceeded the guideline-recommended MDD averaged over the observation period. Strong predictors for exceeding the MDD were receiving opioid prescriptions from > 7 physicians (OR = 7.66, p < .001), receiving predominantly strong opioids (OR = 6.79, p < .001) and receiving opioids for at least one year prior to inclusion (OR = 5.35, p < .001). Within the non-exceeding group, 28.1% discontinued opioid therapy. In contrast, 9.9% of patients in the exceeding group discontinued opioid therapy, whereas the vast majority remained on treatment until the end of the observation period. Furthermore, a slight increase in prescribed doses was observed over time.

Conclusions

The results indicate that a moderate proportion of patients exceeded the guideline-recommended MDD. However, certain patient groups were more likely to receive high doses. This applied in particular to those who were already on treatment at the time of inclusion and continued to receive opioids until the end of the observation period. Further research should examine whether the continuous opioid therapy among the patients with exceeding the guideline-recommended MDD might be related to specific indications, a lack of therapeutic options or avoidance of withdrawal.

Trial registration

German Clinical Trials Register (drks.de/search/en). Identifier: DRKS00024854. Registered 28 April 2021.
Integrating early child development into an existing health and nutrition program: evidence from a cluster-randomized controlled trial
Authors: Hemlock Caitlin , Galasso Emanuela , Weber Ann M. , Randriamiarisoa Tsirery Christian , Col Mathilde , Dieci Maria , Ratsifandrihamanana Lisy , Fernald Lia C.H.
Published: September 2024

Introduction

In low-resource settings, introducing child health programs into community services may compete for caregiver time. We analyzed the impact of a new early childhood development (ECD) program in rural Madagascar on family attendance at other health services and of adding at-home play materials on program attendance.

Methods

We randomized 75 communities where community health workers (CHWs) implement an existing child health and nutrition program (Projet d’Amélioration des Résultats Nutritionnels or PARN), the status quo. We offered two 6-month cycles of 12 ECD sessions to eligible caregiver-child dyads (6–30 months) in 25 sites [T]; we added take-home play materials in Cycle 2 to 25 sites [T+]. We used differences-in-differences with administrative data to analyze the effect of offering ECD sessions on monthly PARN attendance (T+/T vs. C) among age-eligible children and the impact of toy boxes/libraries on monthly ECD session attendance (T + vs. T). We used random intercept models to analyze characteristics associated with program registration.

Results

We analyzed data for 9,408 dyads; 30% and 32% registered for the program in Cycle 1 and 2 (respectively). On average, CHWs delivered 11.4 sessions (SD: 1.5). Children from wealthier households who already attended PARN sessions were more likely to register, and we found no effect of T or T + on PARN attendance. Adding play materials did not affect monthly ECD session attendance. Children from more populated sites were less likely to participate in both ECD and PARN sessions.

Conclusions

Integrating new services for ECD into the health system was feasible and did not reduce dyad participation in existing services. Investment in health services in more populated areas is needed to provide coverage to all eligible children. Novel strategies should be explored to engage the most vulnerable children in new and existing health services.

Trial registration

AEA Social Science Registry (AEARCTR-0004704) on November 15, 2019 (prospective registration) and ClinicalTrials.gov (NCT05129696) on November 22, 2021 (retrospective registration).