bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterizing people with frequent emergency department visits and substance use: a retrospective cohort study of linked administrative data in Ontario, Alberta, and B.C., Canada
Authors: Moe Jessica , Wang Yueqiao Elle , Schull Michael J. , Dong Kathryn , McGregor Margaret J. , Hohl Corinne M. , Holroyd Brian R. , McGrail Kimberlyn M.
Published: July 2022

Background

Substance use is common among people who visit emergency departments (EDs) frequently. We aimed to characterize subgroups within this cohort to better understand care needs/gaps, and generalizability of characteristics in three Canadian provinces.

Methods

This was a retrospective cohort study (April 1st, 2013 to March 31st, 2016) of ED patients in Ontario, Alberta, and British Columbia (B.C.) We included patients ≥ 18 years with substance use-related healthcare contact during the study period and frequent ED visits, defined as those in the top 10% of ED utilization when all patients were ordered by annual ED visit number. We used linked administrative databases including ED visits and hospitalizations (all provinces); mental heath-related hospitalizations (Ontario and Alberta); and prescriptions, physician services, and mortality (B.C.). We compared to cohorts of people with (1) frequent ED visits and no substance use, and (2) non-frequent ED visits and substance use.

We employed cluster analysis to identify subgroups with distinct visit patterns and clinical characteristics during index year, April 1st, 2014 to March 31st, 2015.

Results

In 2014/15, we identified 19,604, 7,706, and 9,404 people with frequent ED visits and substance use in Ontario, Alberta, and B.C (median 37–43 years; 60.9–63.0% male), whose ED visits and hospitalizations were higher than comparison groups.

In all provinces, cluster analyses identified subgroups with “extreme” and “moderate” frequent visits (median 13–19 versus 4–6 visits/year). “Extreme” versus “moderate” subgroups had more hospitalizations, mental health-related ED visits, general practitioner visits but less continuity with one provider, more commonly left against medical advice, and had higher 365-day mortality in B.C. (9.3% versus 6.6%; versus 10.4% among people with frequent ED visits and no substance use, and 4.3% among people with non-frequent ED visits and substance use). The most common ED diagnosis was acute alcohol intoxication in all subgroups.

Conclusions

Subgroups of people with “extreme” (13–19 visits/year) and “moderate” (4–6 visits/year) frequent ED visits and substance use had similar utilization patterns and characteristics in Ontario, Alberta, and B.C., and the “extreme” subgroup had high mortality. Our findings suggest a need for improved evidence-based substance use disorder management, and strengthened continuity with primary and mental healthcare.
Poor disease knowledge is associated with higher healthcare service use and costs among patients with cirrhosis: an exploratory study
Authors: Valery Patricia C. , Bernardes Christina M. , Hayward Kelly L. , Hartel Gunter , Haynes Katelin , Gordon Louisa G. , Stuart Katherine A. , Wright Penny L. , Johnson Amy , Powell Elizabeth E.
Published: July 2022

Background

Optimal management of cirrhosis is complex, and patients often lack knowledge and skills, which can affect self-management. We assessed patient knowledge about cirrhosis and examined whether knowledge was associated with clinical outcomes, healthcare service use, and healthcare costs. A cross-sectional ‘knowledge survey’ was conducted during 2018–2020. We assessed patient knowledge about cirrhosis and explore whether knowledge was associated with clinical outcomes, healthcare service use, and costs.

Methods

Patients with cirrhosis (n = 123) completed a ‘knowledge survey’. We calculated the proportion of correct answers to eight questions deemed to be “key knowledge” about cirrhosis by an expert panel, and dichotomized patients as ‘good knowledge’/‘poor knowledge’. Clinical data, healthcare costs, and health-related quality of life (SF-36) were available.

Results

58.5% of patients had ‘good knowledge’ about cirrhosis. Higher education level was associated with higher odds of having ‘good knowledge’ about cirrhosis (adjusted-OR = 5.55, 95%CI 2.40–12.84). Compared to patients with ‘poor knowledge’, those with ‘good knowledge’ had a higher health status in the SF-36 physical functioning domain (p = 0.011), fewer cirrhosis-related admissions (adjusted incidence rate ratio [IRR] = 0.59, 95%CI 0.35–0.99) and emergency presentations (adj-IRR = 0.34, 95%CI 0.16–0.72), and more planned 1-day cirrhosis admissions (adj-IRR = 3.96, 95%CI 1.46–10.74). The total cost of cirrhosis admissions was lower for patients with ‘good knowledge’ (adj-IRR = 0.30, 95%CI 0.29–0.30).

Conclusion

Poor disease knowledge is associated with increased use and total cost of healthcare services. Targeted educational interventions to improve patient knowledge may be an effective strategy to promote a more cost-effective use of healthcare services.
Study protocol of a single-arm phase 2 study evaluating the preventive effect of topical hydrocortisone for capecitabine-induced hand-foot syndrome in colorectal cancer patients receiving adjuvant chemotherapy with capecitabine plus oxaliplatin (T-CRACC study)
Authors: Iimura Yohei , Furukawa Naoki , Ishibashi Masaaki , Ahiko Yuka , Tanabe Taro , Aikou Susumu , Shida Dai , Nojima Masanori , Kuroda Seiichiro , Boku Narikazu
Published: July 2022

Backgrounds

Clinical evidence of the preventive effectiveness of medium-class topical corticosteroids for capecitabine-induced hand foot syndrome (HFS) is limited. Although the pathogenesis and mechanism of HFS are unclear, inflammatory reactions are thought to be involved in HFS development. This study aimed to evaluate the preventive effect of medium-class topical corticosteroids (hydrocortisone butyrate 0.1% topical therapy) for capecitabine-induced HFS in patients with colorectal cancer receiving adjuvant chemotherapy with capecitabine plus oxaliplatin.

Methods

This is a single-center, single-arm, phase 2 study. Patients with colorectal cancer scheduled to receive adjuvant chemotherapy with capecitabine plus oxaliplatin are enrolled, and topical hydrocortisone butyrate 0.1% is applied prophylactically in addition to standard moisturizing therapy. The primary endpoint is the incidence of grade ≥ 2 HFS within three months. The secondary endpoints are the time to onset of HFS, rates of dose reduction, schedule delay, discontinuation caused by capecitabine-induced HFS, and other adverse events. All adverse events are evaluated by clinical pharmacists and attending physicians.

Discussion

This study is expected to contribute to the establishment of new supportive care for preventing HFS, not only for colorectal cancer patients receiving adjuvant chemotherapy, but also for various cancer patients receiving capecitabine-based chemotherapy.

Trial registration: This trial was registered in the Japan Registry of Clinical Trials (jRCT) as jRCTs031220002. Registered 5 April 2022, https://jrct.niph.go.jp/search

Protocol version V.1.0, 16 February 2022.
Dignity and the provision of care and support in ‘old age homes’ in Tamil Nadu, India: a qualitative study
Authors: Burholt Vanessa , Shoemark E. Zoe , Maruthakutti R. , Chaudhary Aabha , Maddock Carol
Published: July 2022

Background

In 2016, Tamil Nadu was the first state in India to develop a set of Minimum Standards for old age homes. The Minimum Standards stipulate that that residents’ dignity and privacy should be respected. However, the concept of dignity is undefined in the Minimum Standards. To date, there has been very little research within old age homes exploring the dignity of residents. This study draws on the concepts of (i) status dignity and (ii) central human functional capabilities, to explore whether old age homes uphold the dignity of residents.

Objectives

The study was designed to obtain insights into human rights issues and experiences of residents, and the article addresses the research question, “to what extent do old age homes in Tamil Nadu support the central human functional capabilities of life, bodily health, bodily integrity and play, and secure dignity for older residents?”.

Method

A cross-sectional qualitative exploratory study design was utilised. Between January and May 2018 face-to-face interviews were conducted using a semi-structured topic guide with 30 older residents and 11 staff from ten care homes located three southern districts in Tamil Nadu, India. Framework analysis of data was structured around four central human functional capabilities.

Results

There was considerable variation in the extent to which the four central human functional capabilities life, bodily integrity, bodily health and play were met. There was evidence that Articles 3, 13, 25 and 24 of the Universal Declaration of Human Rights were contravened in both registered and unregistered facilities. Juxtaposing violations of human rights with good practice demonstrated that old age homes have the potential to protect the dignity of residents.

Conclusion

The Government of India needs to strengthen old age home policies to protect residents. A new legislative framework is required to ensure that all old age homes are accountable to the State. Minimum Standards should include expectations for quality of care and dignity in care that meet the basic needs of residents and provide health care, personal support, and opportunities for leisure, and socializing. Standards should include staff-to-resident ratios and staff training requirements.
Femoral osteomyelitis caused by oral anaerobic bacteria with mixed bacteremia of Campylobacter rectus and Parvimonas micra in a chronic periodontitis patient: a case report
Authors: Itoh Naoya , Akazawa Nana , Ishibana Yuichi , Hamada Shunsuke , Hagiwara Sumitaka , Murakami Hiromi
Published: July 2022

Background

Campylobacterrectus is a gram-negative rod, andParvimonas micrais a gram-positive coccus, both of which are oral anaerobes that cause chronic periodontitis. Chronic periodontitis can cause bacteremia and systemic diseases, including osteomyelitis. Hematogenous osteomyelitis caused by anaerobic bacteria is uncommon, and to date, there have been no reports of mixed bacteremia withC. rectusandP. micra. Here, we report the first case of osteomyelitis of the femur caused by anaerobic bacteria with mixed bacteremia ofC. rectusandP. micracaused by chronic periodontitis.

Case presentation

A 75-year-old man with chronic periodontitis, hyperuricemia, and benign prostatic hyperplasia was admitted to the hospital with a fracture of the left femur. The patient had left thigh pain for 4 weeks prior to admission. Left femoral intramedullary nail fixation was performed, and a large amount of abscess and necrotic tissue was found intraoperatively. The cultures of abscess specimens were identified asP. micra,Fusobacterium nucleatum, andC. rectus.C. rectusandP. micrawere also isolated from blood cultures.C. rectuswas identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16 S ribosomal RNA sequencing. Sulbactam-ampicillin was administered for approximately 1 month, after which it was replaced by oral clavulanic acid-amoxicillin for long-term suppressive treatment.

Conclusions

Only five cases of bloodstream infection withC. rectushave been reported, and this is the first report of mixed bacteremia withP. micra. Clinicians should consider that chronic periodontitis caused by rare oral anaerobic bacteria can cause systemic infections, such as osteomyelitis.
A child with genetic FN1 mutation in the absence of classic glomerulopathy with fibronectin deposits(GFND) findings on biopsy
Authors: Yang Xiao-qing , Shen Tong
Published: July 2022

Background

Glomerulopathy with fibronectin deposits (GFND) is a rare autosomal dominant genetic disorder, and proteinuria and hematuria are the most common clinical manifestations. The pathogenesis of this disease is primarily related to mutation of the fibronectin 1 gene. Unfortunately, without specific treatment, the prognosis remains poor. Here we present a case report that investigates the clinical characteristics, renal pathology, and gene testing of childhood GFND.

Case presentation

A two-year-old child was brought to our hospital for “persistent hematuria for 1 year and 10 months.” The disease onset was at the age of 4 months, with persistent microscopic hematuria accompanied by intermittent gross hematuria, occasionally with proteinuria, and without hypertension or renal failure. The chief complaint was intermittent gross hematuria, without massive proteinuria, hypertension, or renal failure. Family history: The child’s mother had microscopic hematuria, his maternal aunt had nephrotic syndrome due to focal segmental glomerulosclerosis, and his maternal grandmother had end-stage renal disease. No significant pathological changes were found in the renal pathological biopsy of the child under a light microscope. Under the electron microscope, the basement membrane was found to be of uneven thickness, ranging from 150 to 400 nm. The stratum compactum of the basement membrane was thickened, with a small part showing tear-like and cobweb-like morphology. No electron-dense deposits were found. The renal tubular epithelial cells were vacuolated, and there were no unique pathological changes in the renal interstitium. Immunofluorescence showed that IgG, IgM, IgA, C3, and C1q were all negative. Alport syndrome was preliminarily considered. However, exome sequencing revealed a mutated site in the fibronectin 1 gene. The child’s mother was the carrier of the pathogenic gene and the final diagnosis was GFND.

Conclusions

Fibronectin deposition is a typical pathological change in GFND, and the disease progresses slowly to end-stage renal disease. There is no specific treatment so far, and the prognosis is poor. The early onset of childhood patients may not show typical renal pathological changes, but only changes in the thickness of basement membrane, etc. Genome sequencing technology may helpful for the early diagnosis of GFND.
Post‐dural puncture headache: a prospective study on incidence, risk factors, and clinical characterization of 285 consecutive procedures
Authors: Al-Hashel Jasem , Rady Azza , Massoud Fathi , Ismail Ismail Ibrahim
Published: July 2022

Background

Lumbar puncture (LP) is a common and relatively safe neurological procedure. It can be complicated by post-dural puncture headache (PDPH) after both diagnostic and therapeutic procedures. The aim of this study is to identify the incidence, risk factors and clinical characterization of PDPH in the inpatient setting of the main tertiary neurology hospital in Kuwait.

Methods

We conducted a prospective observational cohort study that included patients who were admitted to neurology department at Ibn Sina hospital, Kuwait, from January 1, 2019 to December 31, 2020, on whom, LP was performed for diagnostic and/or therapeutic reasons. Multivariate logistic regression analysis was performed to evaluate the association between PDPH and different clinical parameters.

Results

A total of 285 patients were included; 225 females (78.9%), mean age of 32.9 ± 11.7 years. PDPH was reported by 84 patients (29.5%), with mean headache onset of 1.7 ± 0.8 days, and mean duration of 2.4 ± 2.1 days. The commonest headache type was dull aching in 49 patients (58.3%). Headache severity was mild to moderate in 64 patients (76.2%), with mean NRS of 4.1 ± 0.9. Most PDPH (99.3%) resolved with conservative medical management, with only 2 patients (0.7%) requiring epidural blood patch. In multivariate logistic regression model, there was a statistically significant correlation between development of PDPH and young age (p = 0.001), female gender (p = 0 .001), low BMI (p < 0 .001), pre-LP headache (p = 0.001), history of previous PDPH (p = 0.001), and number of LP attempts (p < 0.001). PDPH was statistically significantly higher in patients with optic neuritis (p = 0.009), and cerebral venous thrombosis (p = 0.007), and lower in patients with peripheral neuropathy (p = 0.011) and spinal muscular atrophy (p = 0.042).

Conclusions

Findings from clinical practice in the main tertiary neurology hospital in Kuwait were in line with literature findings. Younger age, female gender, lower BMI, pre-procedural headache, previous history of PDPH, and number of LP attempts were found to be independent risk factors for developing PDPH. To our knowledge, this study represents the first comprehensive description of PDPH in a population from the Arabian Gulf Region.
A Golden Thread approach to transforming Maternal and Child Health in Singapore
Authors: Yap Fabian , Loy See Ling , Ku Chee Wai , Chua Mei Chien , Godfrey Keith M. , Chan Jerry Kok Yen
Published: July 2022

Maternal and child health (MCH) in Singapore is entering a new phase, with challenges different to those faced 50 years ago. The advancement of medical technologies and access to MCH resources have led to a dramatic fall in maternal and infant mortality rates. However, there has been a steep rise in the rates of obesity and related metabolic diseases. Alongside this is an emerging mental wellness challenge, with one in ten women experience depression across pre-, during and post-pregnancy. Maternal obesity and mental disorders before and during pregnancy not only increase a woman’s risk of pregnancy complications, but also result in increased risks in the offspring of childhood obesity, behavioral disorders and later life metabolic disease, catalyzing vicious cycles of disease. Thus, there is a pressing need to transform the current MCH system to address a burgeoning metabolic and mental health challenge for Singapore. Initiating interventions during preconception and continuing into the postpartum has the potential to confer long-term maternal-child benefits, promoting virtuous cycles of health. However, the current MCH system emphasizes antenatal care and lacks focus on the equally, if not more important, preconception, postpartum and inter-pregnancy stages. We describe a new model-of-care framework that integrates a life-course approach to health across preconception, pregnancy and postpartum phases, with the social-ecological model comprising individual, interpersonal, institutional, community and policy as the major targets for health promotion interventions. This “golden thread” approach is being established at the Singapore KK Women’s and Children’s Hospital (KKH), to address both metabolic and mental health challenges to achieve the goal of a thriving, healthy nation. This new model-of-care is set up in KKH as a pilot program known as Healthy Early Life Moments in Singapore (HELMS). HELMS will reach out to women planning to conceive through coordinated interventions across preconception, pregnancy and postpartum periods. A mobile health platform is being developed to facilitate interventions and engage participants in the program through a digital, personalized and interactive approach. This new model-of-care is designed to secure a population with healthy life cycles, by influencing each life-course, early-in-life, to provide the best start for generations to come.
Prognostic factors associated with 18FDG-PET/CT in esophageal squamous cell carcinoma after trimodality treatment
Authors: Feng Wei-Hsiang , Chen Ying-Yi , Kuo Yen‐Shou , Lin Kuan-Hsun , Tsai Yuan-Ming , Wu Ti-Hui , Huang Hsu-Kai , Huang Tsai-Wang
Published: July 2022

Purpose

This study aimed to determine the pathological complete response (pCR), overall survival (OS), and disease-free survival (DFS) in patients with locally advanced esophageal squamous cell carcinoma (ESCC) using post-neoadjuvant chemoradiotherapy (nCRT) F-18-fluorodeoxyglucose (18FDG).

Methods

This is a retrospective study of patients with locally advanced ESCC receiving nCRT and then esophagectomy between January 2011 and December 2018 in the Tri-Service General Hospital, Taipei, Taiwan. A total of 50 patients were enrolled in the study. Survival analysis was performed using the Kaplan–Meier method and Cox proportional hazards model. Univariate and multivariate analysis were used to determine the independent prognostic factors.

Results

Fifty patients were enrolled in the study, and 18 had pathological complete response. Post-nCRT SUVmax ≥ 3 is a poor prognostic factor associated with overall survival (HR: 3.665, P = 0.013) and disease-free survival (HR: 3.417, P = 0.011). Poor prognosis was found in the non-pCR plus post-nCRT SUVmax ≥ 3 group compared with pCR plus post-nCRT SUVmax < 3 group.

Conclusions

SUVmax ≥ 3 is a poor prognostic factor in esophageal squamous cell carcinoma after trimodality treatment, even in patients having pathological complete response.
Impact of pectoralis muscle loss on cardiac outcome and survival in Cancer patients who received anthracycline based chemotherapy: retrospective study
Authors: Toama Wael , Wiederin Jason , Shanley Ryan , Jewett Patricia , Gu Christina , Shenoy Chetan , Nijjar Prabhjot S. , Blaes Anne H.
Published: July 2022

Introduction

The impact of pectoralis muscle mass index (PMI) on cardiac events is not well studied in cancer patients, especially in those who have received chemotherapy with high potential cardiac toxicity such as anthracyclines.

Methods

Individuals aged ≥18 years with a diagnosis of breast cancer, sarcoma, or lymphoma who received anthracycline-based chemotherapy at the University of Minnesota MHealth Fairview between 2009 and 2014. Eligible patients had to have two CT scans: a baseline CT scan within 6 months prior to chemotherapy and a follow-up CT scan within 2 years after treatment. The PMI was calculated as the right pectoralis muscle area indexed to height squared. Multivariable linear regression was used to analyze factors associated with PMI at follow-up, overall mortality, and major cardiac events (MACE).

Results

A total of 474 patients (breast cancer 192; lymphoma 184; sarcoma 98) participated with a median age of 61 years at the time of baseline CT scan; 161 (34%) were male. Almost all patients received anthracyclines except 12% who received trastuzumab only. The median baseline PMI was 5.8 cm2/m2 (4.9, 7.7) which decreased 10.5% after chemotherapy, to 5.2 cm2/m2 (4.4, 6.4). Baseline PMI was not significantly associated with OS, but we detected lower risks of MACE with larger PMI at baseline. Greater baseline PMI was associated with greater follow-up PMI, but also with greater relative PMI loss. Female gender, older age, and history of smoking were also associated with greater PMI losses.

Conclusion

Greater pre-treatment pectoralis muscle index in patients treated with anthracyclines have a lower risk of MACE. Early identification of sarcopenia using PMI could trigger proactive engagement for intervention and risk-stratified therapies.
Psychoactive substances use before suicide: detailed analysis of all cases that occurred in the Brazilian Federal District in a 10-years period
Authors: Gomes Juliano de Andrade , de Souza Diego Mendes , Oliveira Karina Diniz , Gallassi Andrea Donatti
Published: July 2022

Background

Psychoactive substances (PASs) are an important risk factor for suicide. This study investigated the sociodemographic characteristics, data related to the suicidal behavior, the methods employed, the circumstances of the events, and the use of PASs before dying in all suicides that occurred between 2005–2014 in the Brazilian Federal District, comparing cases with positive and negative detection for PASs in the post-mortem analysis to identify groups at greatest risk.

Methods

A population-based, observational, cross-sectional study with an analytical aspect was conducted with suicides cases collected from local police, which toxicological examination was performed (headspace gas chromatographic-mass spectrometry-HS-GC/MS) for detection of ethanol and methanol in blood samples; immunoassay for other substances (cocaine, marijuana, benzodiazepine).

Results

The results showed that the increase in the suicide rate was 10 × greater than the population growth, and 44% of the individuals used PASs before suicide. Individuals are more likely to die by suicide at home, be male, have tried before, and change their behavior days before death; they choose to hang as the method and are influenced by alcohol.

Conclusion

Identifying what sociodemographic characteristics are associated with a fatal suicide attempt among individuals who use PASs and those who do not use and those who have/do not have mental disorders and what methods are employed could be employed as a path to better interventions. Thus, prevention actions could be planned and directed to individuals with greater risk.
Determinants of compulsory hospitalisation at admission and in the course of inpatient treatment in people with mental disorders—a retrospective analysis of health records of the four psychiatric hospitals of the city of Cologne
Authors: Peters Sönke Johann , Schmitz-Buhl Mario , Karasch Olaf , Zielasek Jürgen , Gouzoulis-Mayfrank Euphrosyne
Published: July 2022

Background

We aimed to identify differences in predictors of involuntary psychiatric hospitalisation depending on whether the inpatient stay was involuntary right from the beginning since admission or changed from voluntary to involuntary in the course of in-patient treatment.

Methods

We conducted an analysis of 1,773 mental health records of all cases treated under the Mental Health Act in the city of Cologne in the year 2011. 79.4% cases were admitted involuntarily and 20.6% were initially admitted on their own will and were detained later during the course of in-patient stay. We compared the clinical, sociodemographic, socioeconomic and environmental socioeconomic data (ESED) of the two groups. Finally, we employed two different machine learning decision-tree algorithms, Chi-squared Automatic Interaction Detection (CHAID) and Random Forest.

Results

Most of the investigated variables did not differ and those with significant differences showed consistently low effect sizes. In the CHAID analysis, the first node split was determined by the hospital the patient was treated at. The diagnosis of a psychotic disorder, an affective disorder, age, and previous outpatient treatment as well as the purchasing power per 100 inhabitants in the living area of the patients also played a role in the model. In the Random Forest, age and the treating hospital had the highest impact on the accuracy and decrease in Gini of the model. However, both models achieved a poor balanced accuracy. Overall, the decision-tree analyses did not yield a solid, causally interpretable prediction model.

Conclusion

Cases with detention at admission and cases with detention in the course of in-patient treatment were largely similar in respect to the investigated variables. Our findings give no indication for possible differential preventive measures against coercion for the two subgroups. There is no need or rationale to differentiate the two subgroups in future studies.
Any overlap between orthorexia nervosa and obsessive–compulsive disorder in Lebanese adults? Results of a cross-sectional study and validation of the 12-item and 4-item obsessive–compulsive inventory (OCI-12 and OCI-4)
Authors: Hallit Souheil , Azzi Vanessa , Malaeb Diana , Obeid Sahar
Published: July 2022

Background

Orthorexia Nervosa (ON), a compulsive obsession with vigorous eating, has increasingly caught researchers' attention. Although Orthorexia Nervosa has not been labeled an eating disorder, research about ON highlighted a strong link with anorexia nervosa or obsessive–compulsive disorder (OCD). Therefore, this study aimed to (1) validate the Arabic version of the Obsession-Compulsion Inventory (OCI-12 and OCI-4) and (2) check if there is an overlap between ON and OCD among a sample of Lebanese adults.

Methods

This cross-sectional study involved 487 Lebanese participants between July and August 2021. The Dusseldorf Orthorexia Scale (DOS) was used to assess ON; scores between 25 and 29 indicate probable ON, whereas scores ≥ 30 indicate ON tendencies. A confirmatory factor analysis (CFA) was carried out using SPSS AMOS v.24 on the OCI-12 and OCI-4 scales’ items. The root mean square error of approximation (RMSEA) statistic, the Tucker Lewis Index (TLI) and the comparative fit index (CFI) were used to evaluate the goodness-of-fit of the model.

Results

The CFA results indicated an excellent fit of the model: the Maximum Likelihood Chi-Square = 147.73 and Degrees of Freedom = 48, which gave a χ2/df = 3.08, TLI = 0.934, CFI = 0.952, and RMSEA = 0.065 [95% CI 0.054–0.078]. The fit indices of the one-factor structure of the OCI-4 were excellent as well: χ2/df = 6.15/2 = 3.08, TLI = 0.95, CFI = 0.98 and RMSEA = 0.065 [95% CI 0.007–0.127]. The Area Under the Curve was 0.600 [95% CI 0.524–0.674]. There was no cutoff value that showed good sensitivity or specificity at the same time. At the DOS cutoff of 25, sensitivity was 19.1%, whereas the specificity was 90.6%. The positive and negative predictive values (PPV and NPV) at this cutoff value were 24.4% and 88.7% respectively. At the DOS cutoff of 30, sensitivity was 8.8%, whereas the specificity was 94.3%. The PPV and NPV at this cutoff value were 10.6% and 92.5% respectively.

The results showed that higher total OCD scores (Beta = 0.15) were significantly associated with more ON tendencies. Moreover, higher OCD washing scores (Beta = 0.52), physical activity index (Beta = 0.06), and Body Mass Index (Beta = 0.17) were significantly associated with more ON tendencies.

Conclusion

The present results suggest that ON, as measured by the DOS, shares more common features with disordered eating and cannot adequately predict the presence of OCD symptoms.
Effects of exposure to glyphosate on oxidative stress, inflammation, and lung function in maize farmers, Northern Thailand
Authors: Sidthilaw Sutthinee , Sapbamrer Ratana , Pothirat Chaicharn , Wunnapuk Klintean , Khacha-ananda Supakit
Published: July 2022

Background

Glyphosate is a herbicide which is commonly used in agricultural areas. However, previous studies on glyphosate exposure in farmers and their health are still scarce.

Methods

A longitudinal pre-post study was performed among maize farmers. Information from questionnaires, urine and blood samples, and lung function were collected a day before and a day after glyphosate application in the morning. The urine samples were analyzed using liquid chromatography-tandem mass spectrometry to detect glyphosate levels. Serum samples were analyzed to detect malondialdehyde (MDA), glutathione (GHS), and C-reactive protein (CRP) levels using thiobarbituric acid, dithiobisnitrobenzoic acid, and nephelometry, respectively. Lung function performances were measured using a spirometer.

Results

A total of 180 maize farmers met the study inclusion criteria. After glyphosate application, it was found that increased urinary glyphosate levels contributed to increased serum MDA (β = 0.024, 95% CI = 0.000, 0.0047) and decreased serum GHS (β = -0.022, 95% CI = -0.037, -0.007), FEV1 (β = -0.134, 95% CI = -0.168, -0.100), FEV1/FVC (β = -0.062, 95% CI = -0.082, -0.042) and PEF (β = -0.952, 95% CI = -1.169, -0.735).

Conclusions

Exposure to glyphosate during glyphosate application had significant effects on oxidative stress and lung function in maize farmers.
Comparison of blood loss between tranexamic acid-soaked absorbable Gelfoam and topical retrograde injection via drainage catheter plus clamping in cervical laminoplasty surgery
Authors: Chen Chong , Ye Yong-yu , Chen Yi-fan , Yang Xiao-xi , Liang Jin-qian , Liang Guo-yan , Zheng Xiao-qing , Chang Yun-bing
Published: July 2022

Background

To compare the safety and efficacy of tranexamic acid (TXA)-soaked absorbable Gelfoam and the retrograde injection of TXA through a drain with drain-clamping in degenerative cervical laminoplasty patients.

Methods

Patients were assigned into either TXA retrograde injection (TXA-RI), TXA-soaked absorbable Gelfoam (TXA-Gel), or control groups. The demographics, operative measurements, volume and length of drainage, length of hospital stay, complete blood cell count, coagulopathy, postoperative complications, and blood transfusion were recorded.

Results

We enrolled 133 patients, with 44, 44, and 45 in the TXA-RI, TXA-Gel, and control groups, respectively. The baseline characteristics did not differ significantly among the three groups. The TXA-RI group exhibited a lower volume and length of postoperative drainage compared to the TXA-Gel and control groups (126.60 ± 31.27 vs. 156.60 ± 38.63 and 275.45 ± 75.27 mL; 49.45 ± 9.70 vs 58.70 ± 10.46 and 89.31 ± 8.50 hours, all P < 0.01). The TXA-RI group also had significantly shorter hospital stays compared to the control group (5.31 ± 1.18 vs 7.50 ± 1.25 days, P < 0.05) and higher hemoglobin and hematocrit levels (12.58 ± 1.67 vs 11.28 ± 1.76 g/dL; 36.62 ± 3.66% vs 33.82 ± 3.57%, both P < 0.05) at hospital discharge. In the TXA-RI and TXA-Gel groups, the D-dimmer (DD) and fibrinogen (FIB) were significantly lower than those in the control group after surgery (P < 0.05). None of the patients required blood transfusion. No complications, including thromboembolic events, were reported.

Conclusion

Topical retrograde injection of TXA through a drain with drain-clamping at the conclusion of unilateral posterior cervical expansive open-door laminoplasty may effectively reduce postoperative blood loss and the length of hospital stays without increasing postoperative complications.
Pre- and peri-operative clinical information, physiological observations and outcome measures following flexible ureterorenoscopy (FURS), for the treatment of kidney stones. A single-centre observational clinical pilot-study in 51 patients
Authors: Hughes Stephen Fôn , Moyes Alyson Jayne , Jones Kevin , Bell Christopher , Duckett Abigail , Moussa Ahmed , Shergill Iqbal
Published: July 2022

Background

Kidney stone disease contributes to a significant proportion of routine urological practice and remains a common cause of worldwide morbidity. The main aim of this clinical-pilot study was to investigate the effect of flexible ureterorenoscopy (FURS) on pre- and peri-operative clinical information, physiological observations and outcome measures.

Methods

Included were 51 patients (31 males, 20 females), who underwent elective FURS, for the treatment of kidney stones.

Pre-operative and peri-operative clinical information, and post-operative physiological observations and outcome measures were collected using a standard case report form. Pre-operative clinical information included age, gender, BMI, previous history of stone formation and hypertension. Pre-operative stone information included the size (mm), Hounsfield units (HU), laterality and intra-renal anatomical location. Peri-operative surgical details included surgical time in minutes; Laser use; Duration and energy of laser; and post-operative stenting. The physiological outcomes measured included systolic and diastolic blood pressure (mmHg), Likert pain score, temperature, heart rate (bpm) and respiration rate (bpm).

Following initial descriptive analysis, a series of Pearson’s correlation coefficient tests were performed to investigate the relationship between surgical factors other variable factors.

Results

A series of significant, positive correlations were observed between; age and surgical time (p = 0.014, r = 0.373); stone size and Hounsfield unit (p = 0.029, r = 0.406); surgical time and duration of laser (p < 0.001, r = 0.702); surgical time and BMI (p = 0.035, r = 0.322); baseline heart rate and Hounsfield unit (p = 0.026, r = − 0.414); base line heart rate and BMI (p = 0.030, r = 0.307).; heart rate at 120-min post FURS and age (p = 0.038, r = − 0.308); baseline pain score and BMI (p = 0.010, r = 0.361); baseline respiration rate and BMI (p = 0.037, r = 0.296); respiration rate at 240-min post FURS and BMI (p = 0.038, r = 0.329); respiration rate at 120 min post FURS and age (p = 0.022, r = − 0.330). Four patients developed post-operative complications (3—UTIs with urinary retention, 1–urosepsis).

Conclusions

We report that following FURS there is an association between various physiological, clinical and surgical parameters. Although these correlations are weak, they warrant further investigation as these may be linked with untoward complications, such as infection that can occur following FURS. This data, however, will need to be validated and reproduced in larger multi-centre studies.
Health behaviors and tooth retention among older adults in China: findings from the 4th Chinese national oral health survey
Authors: Ou Xiaoyan , Zeng Liwei , Zeng Yixuan , Pei Yaolin , Zhang Xiujuan , Wu Wei , Siamdoust Shahrzad , Wu Bei
Published: July 2022

Background

This study aimed to examine the association between oral health behaviors and tooth retention among Chinese older adults.

Methods

Data were used from the 4th Chinese National Oral Health Survey, a nationally representative sample. The sample included 9054 older adults aged 55 to 74. Control variables and oral health behaviors were measured through a questionnaire interview, and the number of remaining teeth and periodontal health were obtained from an oral health examination. A chi-square test was used for univariate analysis. Multivariate Logistic regression was used to explore the association between health behaviors and the number of remaining teeth.

Results

The average number of remaining teeth in the sample was 24.4 ± 7.7. There was a higher proportion of older adults living in urban areas with 20 or more teeth than those living in rural areas (83.2% vs. 79.4%, P < 0.001); and a higher proportion of individuals with high education levels with 20 or more teeth compared to those with low education levels (P < 0.001). Logistic regression models showed that older adults who used toothpicks `(OR = 3.37, 95% CI 2.94–3.85), dental floss (OR = 1.93, 95% CI 1.05–3.53), toothpaste (OR = 3.89, 95% CI 3.14–4.83); and never smoked (OR = 1.43 95% CI 1.20–1.70) were more likely to retain 20 or more natural teeth; whereas older adults who had a dental visit were less likely to retain 20 or more natural teeth (OR = 0.45, 95% CI 0.39–052).

Conclusion

Good oral hygiene practices, never smoking, and regular dental visits focusing on prevention are significantly associated with teeth retention. It is critical to promote a healthy lifestyle and improve prevention-oriented oral health care systems.
Validation of an implant stability measurement device using the percussion response: a clinical research study
Authors: Okuhama Yurie , Nagata Koudai , Kim Hyunjin , Tsuruoka Hayato , Atsumi Mihoko , Kawana Hiromasa
Published: July 2022

Background

Several devices have been developed to measure implant-bone stability as an indicator of successful implant treatment; these include Osstell®, which measures the implant stability quotient (ISQ), and the more recent AnyCheck®, which relies on percussion for the implant stability test (IST). These devices make it possible to measure implant stability. However, no studies have compared the performance of AnyCheck® and Osstell® (i.e., IST and ISQ values) in clinical practice. Therefore, this study aimed to determine the correlation between primary and secondary implant stability using the Osstell® and AnyCheck® devices.

Methods

Ten patients (7 women; age [mean ± standard deviation]: 49.1 ± 13.3 years) with partially edentulous jaws who received a total of 15 implants were included. IST (AnyCheck®) and ISQ (Osstell®) values were measured immediately after implantation and at 1, 2, 3, 4, and 6 weeks post-implantation. Each measurement was performed three times, and the average value was used as the result. The correlation between measurements obtained using the two devices was determined using Spearman's rank correlation coefficient.

Results

The IST values ranged from 79.1 ± 2.87 to 82.4 ± 2.65. The ISQ values ranged from 76.0 ± 2.8 to 80.2 ± 2.35. Spearman's rank correlation coefficient was r = 0.64 immediately after implantation, r = 0.29 at 1 week, r = 0.68 at 2 weeks, r = 0.53 at 3 weeks, r = 0.68 at 4 weeks, and r = 0.56 at 6 weeks. A positive correlation was found in all cases, except at week 1 when the correlation was weak; the IST and ISQ values decreased the most during the first postoperative week and increased during the second week. The IST values were also slightly higher at all measurement points.

Conclusion

The ability to assess implant stability without removing the abutment during healing is essential for determining the timing of loading without the risk of bone resorption. The results of this study suggest that AnyCheck® is useful for determining primary and secondary implant stability.
Evaluation of the effect of different sedative doses of dexmedetomidine on the intestinal motility in clinically healthy donkeys (Equus asinus)
Authors: Abass Marwa , Ibrahim Hussam , Salci Hakan , Hamed Mohamed A
Published: July 2022

Aim

Gastrointestinal effects of different doses of dexmedetomidine in donkeys are still unidentified. The current study aimed to evaluate the impact of different doses of dexmedetomidine on the motility of selected parts of the gastrointestinal tracts in donkeys using transabdominal ultrasonography.

Materials and methods

An experimental crossover study was conducted on 30 healthy donkeys of both sexes (15 males and 15 females; 160 ± 60 kg). With a two-week washout period, each donkey received an injection of either a normal saline solution or three different doses of dexmedetomidine (3, 5, and 7 μg/kg, respectively). All medications were administered intravenously in equal volumes. The contractility of selected intestinal segments (duodenum, jejunum, left colon, right colon, and cecum) was measured 3 min before administration (zero time) and at 15, 30, 45, 60, 90, and 120 minutes after administration.

Results

Small and large intestinal motility was within the normal ranges before IV injection of normal isotonic saline or dexmedetomidine at a dose of 3, 5, and 7 μg/kg.

Two Way Repeated Measures ANOVA output of the data displayed a statistically significant the between time and treatments for the contractility of each of the duodenum (P = 0.0029), jejunum (P = 0.0033), left colon (P = 0.0073), right colon (P = 0.0035), and cecum (P = 0.0026), implying that the impact of treatment on the gastric motility varied among different time points. The simple main effect analysis revealed that the IV dexmedetomidine at 3, 5, and 7 μg/kg doses significantly inhibited (P ≤ 0.01) the bowel contractility compared to the administration of isotonic saline.

Conclusion

Dose-dependent inhibitory effect of dexmedetomidine on intestinal motility was reported in donkeys following intravenous administration. This inhibitory effect on intestinal motility should be considered in clinical practice.
Polygenic risk for type 2 diabetes, lifestyle, metabolic health, and cardiovascular disease: a prospective UK Biobank study
Authors: Yun Jae-Seung , Jung Sang-Hyuk , Shivakumar Manu , Xiao Brenda , Khera Amit V. , Won Hong-Hee , Kim Dokyoon
Published: July 2022

Background

Few studies have examined associations between genetic risk for type 2 diabetes (T2D), lifestyle, clinical risk factors, and cardiovascular disease (CVD). We aimed to investigate the association of and potential interactions among genetic risk for T2D, lifestyle behavior, and metabolic risk factors with CVD.

Methods

A total of 345,217 unrelated participants of white British descent were included in analyses. Genetic risk for T2D was estimated as a genome-wide polygenic risk score constructed from > 6 million genetic variants. A favorable lifestyle was defined in terms of four modifiable lifestyle components, and metabolic health status was determined according to the presence of metabolic syndrome components.

Results

During a median follow-up of 8.9 years, 21,865 CVD cases (6.3%) were identified. Compared with the low genetic risk group, participants at high genetic risk for T2D had higher rates of overall CVD events, CVD subtypes (coronary artery disease, peripheral artery disease, heart failure, and atrial fibrillation/flutter), and CVD mortality. Individuals at very high genetic risk for T2D had a 35% higher risk of CVD than those with low genetic risk (HR 1.35 [95% CI 1.19 to 1.53]). A significant gradient of increased CVD risk was observed across genetic risk, lifestyle, and metabolic health status (Pfor trend > 0.001). Those with favorable lifestyle and metabolically healthy status had significantly reduced risk of CVD events regardless of T2D genetic risk. This risk reduction was more apparent in young participants (≤ 50 years).

Conclusions

Genetic risk for T2D was associated with increased risks of overall CVD, various CVD subtypes, and fatal CVD. Engaging in a healthy lifestyle and maintaining metabolic health may reduce subsequent risk of CVD regardless of genetic risk for T2D.
Heterogeneity in prevalence of subclinical Plasmodium falciparum and Plasmodium vivax infections but no parasite genomic clustering in the Chittagong Hill Tracts, Bangladesh
Authors: Huwe Tiffany , Kibria Mohammad Golam , Johora Fatema Tuj , Phru Ching Swe , Jahan Nusrat , Hossain Mohammad Sharif , Khan Wasif Ali , Price Ric N. , Ley Benedikt , Alam Mohammad Shafiul , Koepfli Cristian
Published: July 2022

Background

Malaria remains endemic in Bangladesh, with the majority of cases occurring in forested, mountainous region in the Chittagong Hill Tracts (CHT). This area is home to Bengali and diverse groups of indigenous people (Pahari) residing largely in mono-ethnic villages.

Methods

1002 individuals of the 9 most prominent Pahari and the Bengali population were randomly selected and screened by RDT and qPCR. Parasites were genotyped by msp2 and deep sequencing of 5 amplicons (ama1-D3, cpmp, cpp, csp, and msp7) for Plasmodium falciparum (n = 20), and by microsatellite (MS) typing of ten loci and amplicon sequencing of msp1 for Plasmodium vivax (n = 21). Population structure was analysed using STRUCTURE software. Identity-by-state (IBS) was calculated as a measure of parasite relatedness and used to generate relatedness networks.

Results

The prevalence of P. falciparum and P. vivax infection was 0.7% by RDT (P. falciparum 6/1002; P. vivax 0/1002, mixed: 1/1002) and 4% by qPCR (P. falciparum 21/1002; P. vivax 16/1002, mixed: 5/1002). Infections were highly clustered, with 64% (27/42) of infections occurring in only two Pahari groups, the Khumi and Mro. Diversity was high; expected heterozygosity was 0.93 for P. falciparum and 0.81 for P. vivax. 85.7% (18/21) of P. vivax and 25% (5/20) of P. falciparum infections were polyclonal. No population structure was evident for either species, suggesting high transmission and gene flow among Pahari groups.

Conclusions

High subclinical infection prevalence and genetic diversity mirror ongoing transmission. Control activities should be specifically directed to Pahari groups at greatest risk.