bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome Trajectory Evaluation (OTE): An Approach to Tackle Research-for-Development’s Long-Causal-Chain Problem
Authors: Douthwaite Boru , Proietti Claudio , Polar Vivian , Thiele Graham
Published: January 2023

This paper develops a novel approach called Outcome Trajectory Evaluation (OTE) in response to the long-causal-chain problem confronting the evaluation of research for development (R4D) projects. OTE strives to tackle four issues resulting from the common practice of evaluating R4D projects based on theory of change developed at the start. The approach was developed iteratively while conducting four evaluations of policy-related outcomes claimed by the CGIAR, a global R4D organization. The first step is to use a middle-range theory (MRT), based on “grand” social science theory, to help delineate and understand the trajectory that generated the set of outcomes being evaluated. The second step is to then identify project contribution to that trajectory. Other types of theory-driven evaluation are single step: they model how projects achieve outcomes without first considering the overarching causal mechanism—the outcome trajectory—from which the outcomes emerged. The use of an MRT allowed us to accrue learning from one evaluation to the next.
A randomized controlled trial comparing ultrasound-guided versus traditional palpatory methods of posterior tibial artery cannulation in adult patients
Authors: Sharma Ankur , Goyal Shilpa , Kumari Kamlesh , Rathod Darshana , Meshram Tanvi , Goel Akhil Dhanesh , Sethi Priyanka , Bhatia Pradeep , Kothari Nikhil
Published: January 2023

Background:

The palpation method of posterior tibial artery cannulation has not yet been compared to ultrasound-guided posterior tibial artery cannulation in adults. This research examined whether using ultrasound to cannulate the posterior tibial artery enhances first-pass cannulation success and lowers total procedure time.

Methods:

In this randomized controlled experiment, 76 adult patients were included who were undergoing surgery under general anesthesia and required artery cannulation. Cannulation of the posterior tibial artery was performed utilizing either an ultrasound-assisted method (group U) or a palpation method (group P). Data were analyzed for cannulation success on the first attempt, number of cannulation attempts, assessment time, cannulation time, and total procedure time.

Results:

The P group had a considerably shorter mean assessment time than the U group [14.29 ± 2.79 s vs 20.89 ± 2.70 s; p < .001]. Moreover, cannulation time was substantially longer in the P (29.20 ± 12.60 s) than in the U group (15.90 ± 6.50 s) (p < .001). The total procedure time remained statistically more in the P group than in the U group (p = 0.007). The rate of successful posterior tibial artery cannulation on the first attempt was comparable between the two groups (63.2% in the U and 55.3% in the P group, respectively; p = .484)].

Conclusions:

The posterior tibial artery may be a suitable alternative to arterial cannulation for individuals with multiple failed attempts or difficult access. The application of ultrasound during posterior tibial artery cannulation in adult patients is safe and feasible and accompanied by a reduction in cannulation and total procedure time. The rate of first-attempt successful posterior tibial artery cannulation was comparable between the two groups.
Mortality Risk Related to Heatwaves in Dezful City, Southwest of Iran
Authors: Aghababaeian Hamidreza , Ostadtaghizadeh Abbas , Ardalan Ali , Asgary Ali , Akbary Mehry , Yekaninejad Mir Saeed , Sharafkhani Rahim , Stephens Carolyn
Published: January 2023

Background:

We aimed to evaluate the impact of heatwaves on daily deaths due to non-accidental, cardiovascular and respiratory causes in the city of Dezful in Iran from 2013 to 2019.

Method:

We collected daily ambient temperature and mortality and defined 2 types of heatwaves by combining daily temperature ⩾90th in each month of the study period or since 30 years with duration ⩾2 and 3 days. We used a distributed lag non-linear model to study the association between each type of heatwave definition, and deaths due to non-accidental, cardiovascular and respiratory causes with lags up to 13 days.

Results:

There was no discernible correlation in this area, despite the fact that heatwaves raised the risk of death from cardiovascular causes and lowered the risk from respiratory causes. On the other hand, the risk of total non-accidental mortality on days with the heatwaves is significantly higher than normal days. In main effects, the heatwaves have a significant relationship with the risk of total non-accidental mortality (in the first heatwave definition, Cumulative Excess Risk (CER) in lag0-2 was 10.4 and in second heatwave definition, CER values in lag0, 0-2, and 0-6 were 12.4, 29.2, and 38.8 respectively). Also, in added effects, heatwaves have a significant relationship with the risk of total non-accidental mortality (in the first heatwave definition, CER in lag0 and 0-2 were 1.79 and 4.11 and in the second heatwave definition, CER values in lag0, 0-2, and 0-6 were 7.76, 18.35 and 24.87 respectively). In addition, heatwaves appeared to contribute to a cumulative excess risk of non-accidental death among the male group as well as the older adults.

Conclusion:

However, the results showed that heatwaves could have detrimental effects on health, even in populations accustomed to the extreme heat. Therefore, early warning systems which monitor heatwaves should provide the necessary warnings to the population, especially the most vulnerable groups.
Metabolomic Alterations in Mammary Glands from Pubertal Mice Fed a High-Fat Diet
Authors: Yan Lin , Rust Bret M , Sundaram Sneha , Bukowski Michael R
Published: January 2023

Dietary malpractice is a risk factor for obesity. This study tested the hypothesis that consumption of a high-fat diet alters mammary metabolome in pubertal mice. We performed untargeted metabolomic analysis of primary metabolism on mammary glands from pubertal mice fed the AIN93G standard diet or a high-fat diet (HFD) for 3 weeks. We identified 97 metabolites for statistical comparisons. The HFD altered the amino acid metabolism considerably. This included elevated expression of branched-chain amino acids, non-essential amino acids (aspartic acid and glutamic acid), and methionine sulfoxide (oxidized methionine) and an alteration in the aminoacyl-tRNA biosynthesis pathway. Furthermore, elevations of fumaric acid and malic acid (both are citrate cycle intermediates) and glyceric acid (its phosphate derivatives are intermediates of glycolysis) in HFD-fed mice suggest an acceleration of both citrate cycle and glycolysis. Lower expression of glycerol, oleic acid, and palmitoleic acid, as well as decreased mammary expression of genes encoding lipid metabolism ( Acaca, Fads1, Fasn, Scd1, and Srebf1) in HFD-fed mice indicate an attenuated lipid metabolism in the presence of adequate dietary fat. In conclusion, consumption of the HFD for 3 weeks alters metabolic profile of pubertal mammary glands. This alteration may affect mammary development and growth in pubertal mice.
Inequality in smoking and related risk factors for smoking in expectant mothers – a nationwide Danish register-based study
Authors: Bendixen Kathrine , Brund René B. K. , Jørgensen Thilde B. , Kristiansen Nanna K. , Kesmodel Ulrik S. , Fonager Kirsten , Heuckendorff Signe
Published: January 2023

Aims:

Foetuses exposed to smoking during pregnancy are disadvantaged due to numerous adverse obstetric outcomes. This study aimed to examine 1) inequality in maternal smoking between subgroups of pregnant women and 2) significant risk factors of maternal smoking.

Methods:

Data were collected from Danish registries. Trends in maternal smoking within each study period, T1 (2000–2002) and T2 (2014–2016), were investigated by Poisson regression calculating prevalence proportion ratios, and trends between study periods were studied by adding an interaction term. The significance of risk factors for maternal smoking (low age, low education, living alone and having a moderate/severe mental health condition) were studied by interaction analysis on the additive scale.

Results:

The prevalence of maternal smoking decreased from 21% in 2000 to 7% in 2016. Decreases were found in all subgroups of maternal age, cohabitation status, educational level and mental health condition. However, large differences in smoking prevalence between subgroups were found, and inequality in maternal smoking increased from 2000 to 2016. The probability of maternal smoking increased with the addition of risk factors, and positive additive interactions were found for almost all combinations of multiple risk factors.

Conclusions:

Our results provide knowledge on risk factors and increasing levels of inequality in maternal smoking which points to a need for targeted interventions in relation to maternal smoking for subgroups of pregnant women in future smoking cessation programmes and in antenatal care.
Learning curves in robot-assisted minimally invasive liver surgery at a high-volume center in Denmark: Report of the first 100 patients and review of literature
Authors: Fukumori Daisuke , Tschuor Christoph , Penninga Luit , Hillingsø Jens , Svendsen Lars Bo , Larsen Peter Nørgaard
Published: January 2023

Background and objective:

Minimally invasive liver surgery is evolving worldwide, and robot-assisted liver surgery (RLS) can deliver obvious benefits for patients. However, so far no large case series have documented the learning curve for RLS.

Methods:

We conducted a retrospective study for robotic liver surgery (RLS) from June 2019 to June 2022 where 100 patients underwent RLS by the same surgical team. Patients’ variables, short-term follow-up, and the learning curve were analyzed. A review of the literature describing the learning curve in RLS was also conducted.

Results:

Mean patient age was 63.1 years. The median operating time was 246 min and median estimated blood loss was 100 mL. Thirty-two patients underwent subsegmentectomy, 18 monosegmentectomies, 25 bisegmentectomies, and 25 major hepatectomies. One patient (1.0%) required conversion to open surgery. Five patients (5%) experienced postoperative major complications, and no mortalities occurred. Median length of hospital stay was 3 days. R0 resection was achieved in 93.4% of the malignant cases. The learning curve consisted of three stages; there were no significant differences in operative time, transfusion rate, or complication rate among the three groups. Postoperative complications were similar in each group despite an increase in surgical difficulty scores. The learning effect was highlighted by significantly shorter hospital stays in cohorts I, II, and III, respectively. The included systematic review suggested that the learning curve for RLS is similar to, or shorter, than that of laparoscopic liver surgery.

Conclusions:

In our experience, RLS has achieved good clinical results, albeit in the short term. Standardization of training leads to increasing proficiency in RLS with reduced blood loss and low complication rates even in more advanced liver resections. Our study suggests that a minimum of 30 low-to-moderate difficulty robotic procedures should be performed before proceeding to more difficult resections.
Gonococcal Infection of the Glans Skin, a Rare Local Complication of Gonorrhea: A Clinical Study of 13 Cases
Authors: Fan Wenge , Zhang Qingsong , Wei Mei , Zhu Yuan , Zhang Jing , Fan Zhijiang , Jiang Tingwang
Published: January 2023

The study aimed to understand the incidence, site, skin lesion manifestations, and treatment of gonococcal infection of the glans skin. We enrolled men with gonococcal infection of the glans skin and men with gonococcal urethritis from January 2014 to February 2020. Demographic data, site of onset, and skin lesion manifestations were recorded for all patients. Ceftriaxone (1 g) was injected intramuscularly once daily for 5 days in patients with lesions comprising abscesses or nodules. A single dose of ceftriaxone (1 g) was injected intramuscularly in patients with pustules. Incision and drainage were performed in patients with nonruptured abscesses. Thirteen patients had gonococcal infection of the glans skin (0.65%; 95% confidence interval = [0.30, 1.01]) among 1,989 patients with gonococcal urethritis. Mean age was 35.48 ± 2.37 (range = 26–45) years. Nonmarital sexual behavior patterns were genital–genital in eight patients (61.54%) and genital–oral in five patients (38.46%). All skin lesions occurred on the ventral side of the glans. Eleven patients (84.62%) had a single lesion and two (15.38%) had multiple lesions. The lesions manifested as abscesses in five patients (38.46%), nodules in five patients (38.46%), and pustules in three patients (23.08%). All lesions exhibited tenderness. All 13 patients were cured after treatment. The study shows that gonococcal infection of the glans skin is a rare local complication of gonorrhea. Lesions often occur on the ventral side of the glans, presenting as abscesses, nodules, and pustules. Ceftriaxone treatment was effective for gonococcal infection of the glans skin.
The treatment of bilateral popliteal artery entrapment syndrome with nonuniform symptoms: A case report and literature review
Authors: Bi Yan , Guo Facai
Published: January 2023

Popliteal artery entrapment syndrome (PAES) is a rare vascular disease, and cases of bilateral PAES associated with distinct symptoms in each of the affected legs are very rare. In an effort to improve current understanding regarding the presentation and treatment of this condition, a case of bilateral PAES is herein described with a corresponding review of the associated literature. The overall process of diagnosing and treating one patient affected by bilateral PAES was retrospectively assessed to provide comprehensive insight regarding this disease. This patient was diagnosed via contrast-enhanced computed tomography (CT), and right-sided symptomatic PAES was successfully treated via autogenous saphenous venous graft arterial bypass surgery. In contrast, the asymptomatic left-sided PAES in this patient was subject to close follow-up monitoring. Over a 2-year postoperative follow-up period, this patient did not experience any symptoms or complications. As such, autogenous saphenous venous graft arterial bypass surgery represents a safe and efficacious means of treating PAES, whereas surgery may not be required for cases of asymptomatic PAES even in patients with a bilateral presentation.
An exploratory study on barriers and enablers for women leaders in higher education institutions in Mexico
Authors: Maheshwari Greeni , Gonzalez-Tamayo Lizbeth A. , Olarewaju Adeniyi D.
Published: January 2023

Mexico, the second-largest economy in Latin America after Brazil, has a gender gap index score of 76.4% in 2022 compared to 75.7% in 2021 and is ranked 31 out of 146 countries for 2022. Mexico has become one of the world's leaders in gender-political equality, which shows that the gender ceiling is cracking, and it is yet to see if gender parity is achieved in other sectors as well. The women's leadership topic has been widely researched in many countries, but with this changing dimension in the political sector, it is important to know if any changes are happening in the education sector as well. This exploratory research aims to identify what motivates women to take up leadership roles and whether they still experience barriers in higher education institutions (HEIs). This study was conducted with 22 women participants from Mexico's HEIs. The study used a qualitative narrative research design to understand what enablers and barriers are experienced by Mexican female academics. The study identified four key barriers and four enablers that affected women's career and leadership development. Gaining a deeper understanding of the barriers and enablers that affect women's career and leadership development can be used to investigate how culturally appropriate developmental relationships can create ways to overcome the barriers they experience. Further, the study's implications can support human resource development initiatives.
Interpretation of ambiguous trials along with reasoning strategy is related to causal judgements in zero-contingency learning
Authors: Béghin Gaëtan , Markovits Henry
Published: January 2023

The dual strategy model suggests that people can use either a Statistical or a Counterexample reasoning strategy, which reflects two qualitatively different ways of processing information. This model has been shown to capture individual differences in a wide array of tasks, such as contingency learning. Here, we examined whether this extends to individual differences in the interpretation of contingency information where effects are ambiguous. Previous studies, using perceptually complex stimuli, have shown that the way in which participants interpret ambiguous effects predicts causal judgements. In two studies, we attempted to replicate this effect using a small number of clearly identifiable cues. Results show that the interpretation of ambiguous effects as effect present is related to final contingency judgements. In addition, results showed that Statistical reasoners had a stronger tendency to interpret ambiguous effects as effect present than Counterexample reasoners, which mediates the difference in contingency judgements.
Effect of colour–shape associations on visual feature discrimination
Authors: Chen Na , Watanabe Katsumi
Published: January 2023

Non-synesthetes exhibit a tendency to associate specific shapes with particular colours (i.e., circle-red, triangle-yellow, and square-blue). Here, we used two Go/No-go tasks to examine the congruency priming effect of colour–shape associations on recognition efficiency of colour and shape features. At the beginning of each trial, a target colour or shape word was introduced, followed by a coloured-shape visual stimulus. Participants were required to press a key to a target stimulus (“go” cues), while withholding their responses to a non-target stimulus (“no-go” cues). The targets were presented either visually (visual word, Experiment 1) or auditorily (spoken word, Experiment 2). Results showed a congruency effect of colour–shape associations on recognition efficiency for colour and shape features in both experiments. Response times were shorter in congruent than in incongruent conditions, that a target could be recognised faster when it was presented with the congruent visual features than with incongruent ones, irrespective of the presentation form (visual or auditory). These results suggest that colour–shape associations can be strong to influence visual recognition of colour and shape features.
Diagnostic and therapeutic value of biomarkers in urosepsis
Authors: Wu Yuyun , Wang Guang , Huang Ziye , Yang Bowei , Yang Tongxin , Liu Jianhe , Li Pei , Li Jiongming
Published: January 2023

Urosepsis is sepsis caused by urogenital tract infection and is one of the most common critical illnesses in urology. If urosepsis is not diagnosed early, it can rapidly progress and worsen, leading to increased mortality. In recent years, with the increase of urinary tract surgery, the incidence of urosepsis continues to rise, posing a serious threat to patients. Early diagnosis of urosepsis, timely and effective treatment can greatly reduce the mortality of patients. Biomarkers such as WBC, NLR, PCT, IL-6, CRP, lactate, and LncRNA all play specific roles in the early diagnosis or prognosis of urosepsis. In addition to the abnormal increase of WBC, we should be more alert to the rapid decline of WBC. NLR values were superior to WBC counts alone in predicting infection severity. Compared with several other biomarkers, PCT values can differentiate between bacterial and non-bacterial sepsis. IL-6 always has high sensitivity and specificity for the diagnosis of sepsis, and CRP also has high sensitivity and specificity for the diagnosis of urosepsis. Lactic acid is closely related to the prognosis of patients with urosepsis. LncRNAs may be potential biomarkers of urosepsis. This article summarizes the main biomarkers, hoping to provide a reference for the timely diagnosis and evaluation of urosepsis.
Pediatric anterior cruciate ligament tears and associated lesions: Epidemiology, diagnostic process, and imaging
Authors: Duart Julio , Rigamonti Luca , Bigoni Marco , Kocher Mininder S
Published: January 2023

The incidence of anterior cruciate ligament injuries in skeletally immature patients has increased in recent years. The gold standard treatment of this type of trauma in children is not yet established. Conservative management may underestimate the risk of new meniscal and chondral tears; on the other hand, a more interventional approach may expose the patient to iatrogenic damage to the growth plate. A correct approach to the skeletally immature patient with knee trauma is therefore essential to guide the decision-making process. This review article aims to present an update on the epidemiology and diagnostic process of pediatric patients with anterior cruciate ligament tears and possible associated injuries.

Level of Evidence: V.
Compliance between registered nurses’ clinical judgment and documentation in homecare for older patients with COPD: A multiple case study
Authors: Øfsti Ruth , Devik Siri Andreassen , Enmarker Ingela , Olsen Rose Mari
Published: January 2023

Registered nurses (RNs) play a crucial role in the clinical judgment (CJ) and documentation of the health conditions and the healthcare of patients diagnosed with chronic obstructive pulmonary disease (COPD). Using a multiple case study approach, the aim of the present study was to explore and describe RNs’ CJ in homecare visits for older patients with COPD as they appeared in the electronic patient records (EPRs) and how well the content corresponded to what the RNs explained verbally was important to report. Data were collected through observations of 16 homecare visits, interviews with RNs, and retrospective reviews of EPRs. The study is reported in accordance with COREQ. Quantitative and qualitative content analysis revealed that the RNs’ CJs in homecare visits were represented only to a small extent in the documentation in the EPRs. The documentation was mainly about procedures and tasks performed and did not correspond to what the RNs explained verbally was important to report. This knowledge contributes to improvements to ensure patient safety in this research field.
International evidence-based guidelines on hypertension and type 2 diabetes mellitus: A systematic review
Authors: Melichova Juliana , Sivco Patrik , Rusnak Martin , Phuong Truc Pham , Majdan Marek
Published: January 2023

This systematic review provides a high-quality, comprehensive summary of recommendations on hypertension (HT) and type 2 diabetes mellitus (T2DM), accentuating patient blood pressure, HbA1c levels, patterns of drug treatment, management, and screening of these diseases. The overall objective of the review is to support adapting existing clinical practice guidelines in Indonesia, Vietnam, and Myanmar. The database PubMed and the web search engines Google and Google Scholar were searched from October to December 2019 for evidence-based guidelines covering the overall disease management in Europe, the United States of America, and low and middle-income countries (Indonesia, Vietnam, and Myanmar—IVM later on). Nine studies were selected for the review, seven concerning HT and five T2DM. Guidelines in IVM and Europe identified HT as increased blood pressure (BP; ≥140/90 mmHg). IVM guidelines also recommended commencing drug treatment if lifestyle interventions were not successful. Four international HT guidelines recommended monitoring BP every few months, and the other three guidelines gave recommendations based on the patient’s current BP levels. All five T2DM guidelines recommended target HbA1c levels below 7%–6.5%, but only IVM guidelines included re-examination every 3–6 months. Metformin was recommended as the first choice of medical treatment, if not contraindicated. Amid the guidelines’ recommendations, there were no major variations in the Class of recommendation and Level of evidence (except IVM guidelines where COR and LOE were missing). Revision and completion of IVM guidelines by this grading system would enhance evidence-based and informed decisions in clinical care.
Restoring resilience through joy: The pursuit of happiness in the midst of unprecedented times
Authors: Ekpe Leslie , Sherman Ashley , Ofoegbu Ezinne D
Published: January 2023

The coronavirus (COVID-19) pandemic presented numerous threats to the Black community. These unprecedented times called for many individuals to extend beyond what once was the “norm” to make ends meet. It is not enough that Black people were dying at a disproportionate rate (Krieger, 2020); the virus further entrenched racism and destitution, with Black people four times more likely to die from COVID-19 than white people due to inequalities in healthcare, education, and policy decision-making. Despite a pandemic that ravaged Black communities with brutal, life-threatening circumstances and months of protesting institutional injustices and extrajudicial police brutality, Black people still found joy in moments of unrest.
Basic understandings of possibility
Authors: Poli Roberto
Published: January 2023

Three basic acceptations of the possible are presented: the epistemological, the ontological, and the metaphysical. The latter two are presented in some details. They could be distinguished as the processual unfolding of conditions (the ontological reading) and the vision of the process as given and fully completed within each present moment (the metaphysical reading). The ontological dimension can be further distinguished into two different unfoldings of real processes: as the horizontal (temporal) accumulation of determinations and as the vertical (through strata of reality) emergence of both higher entities and higher determinations.
Bundles and mailings: Science fiction fandom and the amateur press association
Authors: Straw Will
Published: January 2023

This article is concerned with the fanzines published within science fiction fandom from the 1930s onwards. Its focus is on the “amateur press association” (or “apa”) an organizational form for the distribution of fanzines among member-publishers. One variation of the apa is the club-based amateur press association, which emerged in the 1960s as a way of joining fanzine publishing to the in-person sociability of the science fiction club. The status of apa relative to other forms of communication within science fiction fandom is analyzed.
Application of Nonlinear Lamb Wave Mixing Method for Residual Stress Measurement in Metal Plate
Authors: Jiao Jingpin , Li Li , Gao Xiang , Cheng Quan , He Cunfu , Wu Bin
Published: January 2023

Harmonic nonlinear ultrasound can offer high sensitivity for residual stress measurements; however, it cannot be used for local stress measurements at a point in space and exhibits nonlinear distortions in the experimental system. This paper presents a feasibility study on the measurement of residual stress in a metal plate using a nonlinear Lamb wave-mixing technique. The resonant conditions for two Lamb waves to generate a mixing frequency wave are obtained via theoretical analysis. Finite element simulations are performed to investigate the nonlinear interactions between the two Lamb waves. Results show that two incident A0 waves interact in regions of material nonlinearity and generate a rightward S0 wave at the sum frequency. Residual stress measurement experiments are conducted on steel plate specimens using the collinear Lamb wave-mixing technique. By setting different delays for two transmitters, the generated sum-frequency component at different spatial locations is measured. Experimental results show that the spatial distribution of the amplitude of the sum-frequency component agrees well with the spatial distribution of the residual stress measured using X-rays. The proposed collinear Lamb wave-mixing method is effective for measuring the distribution of residual stress in metal plates.
Primary cerebral epithelioid angiosarcoma: a case report
Authors: Kuang Renzhao , Li Shun , Wang Yuanchuan
Published: January 2023

Background

Primary cerebral epithelioid angiosarcoma (PCEA) is a rare malignant tumor of the central nervous system. To the best of our knowledge, only three cases have been reported in the English language literature thus far.

Case presentation

Here, we report a fourth case in a 73-year-old man admitted for headache. Radiological examination revealed a mass in the right occipital lobe, which was removed by right occipital craniotomy. Histopathological examination revealed epithelioid angiosarcoma. The patient received radiotherapy after resection but survived for only nine months due to recurrence of the tumor and his declining further surgery.

Conclusions

In this report, we add to the knowledge base on this exceedingly rare tumor, review the small number of relevant cases published previously, and analyze and summarize the clinical and pathological characteristics, treatment options and prognosis of this cancer.
Arabic translation and validation of a pediatric sleep questionnaire to assess the prevalence of sleep-disordered breathing among Saudi pre-school children
Authors: Masoud Ahmed I , Mosli Rana H
Published: January 2023

Objectives

 (1) To translate to Arabic a validated pediatric sleep questionnaire, (2) To assess the validity and reliability of the translated questionnaire, and (3) To assess the prevalence of sleep-disordered breathing (SDB) among a group of pre-school children in Jeddah, Saudi Arabia.

Methods

 Using forward and back-translation, a set of 6 hierarchically arranged questions that comprise the Gozal sleep questionnaire was translated into Arabic. Validity was assessed using face validity and content validity for consistency and clarity, using both item-level and scale-level content validity indices (I-CVI, S-CVI). Consent forms were sent to 1783 mothers recruited from 8 different pre-schools in Jeddah between October 2017 and April 2018, and 209 signed and returned the consent forms. Out of this sample, 34 mothers were contacted to assess internal consistency using Cronbach's alpha, and test-retest reliability using Interclass correlation coefficient (ICC). Finally, all 209 mothers were contacted to answer the questionnaire to obtain the prevalence of SDB.

Results

 Using face validity and content validity, the translated questionnaire proved to be valid with perfect I-CVI and S-CVI. Internal consistency (Cronbach’s Alpha 0.64–0.89) and test-retest reliability (ICC=0.87, p<0.001) showed the translated questionnaire to have good to favorable reliability. Depending on the severity of SDB, the prevalence of SDB was 7.7%, 5.7%, and 3.8% for mild, moderate and severe cut-off values respectively.

Conclusion

A validated pediatric sleep questionnaire to assess SDB was translated into Arabic and the translation proved to be valid and reliable. The prevalence of SDB was found to be very comparable to other areas in the world.
Early life climate and adulthood mental health: how birth seasonality influences depressive symptoms in adults
Authors: Zhou Hao , Peng-Li Danni , Chen Juan , Sun Dong , Wan Bin
Published: January 2023

Background

Early life in-utero can have long-term influence on the mental health status of individuals in adulthood, such as depression. Age, gender, socio-economic status, education, and geography are demographic factors shown to be particularly vulnerable towards the development of depressive symptoms. In addition, climate risks on depression include sunlight, rain, and temperature. However, whether climate factors in early life have a long-term influence on depression related to demographic vulnerability remains unknown. Here, the present study explored the association between birth seasonality and adulthood depressive symptoms.

Methods

We employed data from the project of Chinese Labour-forces Dynamic Survey (CLDS) 2016, containing the epidemiological data of depressive symptoms with a probability proportional to size cluster and random cluster sampling method in 29 provinces of China. A final sample size of 16,185 participants was included. Birth seasonality included spring (March, April, and May), summer (June, July, and August), autumn (September, October, and November), and winter (December, January, and February).

Results

We found that born in Autumn peaked lowest rate of having depressive symptoms (16.8%) and born in Summer (vs. Autumn) had a significant higher ratio (OR = 1.14, 95%CI = 1.02, 1.29) when controlling for demographic variables. In addition, demographic odds ratio of having depressive symptoms differed between people born in different seasons, particular for age and geography.

Conclusion

Our findings suggest that birth seasonality influences the sensitive link of depressive symptoms with age and geography. It implicates early life climate environment may play a role in the development of adulthood depressive symptoms.
Skull metastasis is a poor prognostic factor for prostate cancer patients with bone metastasis: a retrospective study based on a Chinese population
Authors: Xiong Tianyu , Jiang Mingxin , Ye Xiaobo , Zhu Guangyi , Cao Fang , Cui Yun , Yang Minfu , Niu Yinong
Published: January 2023

Background

Skull is a relatively rare metastasis site for prostate cancer (PCa). There is no evidence regarding the prognostic indication of skull metastasis (SM) in PCa patients. In this study, we analyzed the prognostic value of SM for metastatic PCa patients receiving androgen deprivation therapy (ADT).

Methods

107 consecutive patients were included from September 2008 to August 2021. All patients were administered with standard ADT. Abiraterone plus glucocorticoid and/or docetaxel chemotherapy were given after failure to castration-resistant prostate cancer. Clinical parameters and follow-up prognostic data were retrospectively analyzed. The association of clinical and pathological parameters with SM were analyzed. The progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan–Meier analysis and Cox regression analyses.

Results

Patients with SM (n = 26) had significantly higher biopsy Gleason scores, higher clinical T stage, higher prostate-specific antigen level at diagnosis, and were more likely to have high-burden metastasis and lymph node metastasis, compared with those without SM (n = 81). They also showed significantly lower level of hemoglobin, albumin and serum calcium, along with higher level of alkaline phosphatase. SM was significantly associated with shorter medium PFS (9.4 vs. 18.3 months, p < 0.001) and OS (22.2 vs. 58.2 months, p < 0.001). Cox analysis demonstrated that SM was an independent risk factor for shorter PFS (hazard ratio 2.327 [1.429–3.789], p = 0.001) and shorter OS (hazard ratio 2.810 [1.615–4.899], p < 0.001).

Conclusion

In this study, we found that SM was significantly correlated with more aggressive disease and indicated poor prognosis in PCa patients with bone metastasis. Our study may provide useful reference for the risk stratification of PCa patients.
The association between healthy beverage index and sarcopenic obesity among women with overweight and obesity: a cross-sectional study
Authors: Rasaei Niloufar , Ghaffarian-Ensaf Rasool , Gholami Fatemeh , Shiraseb Farideh , Khadem Alireza , Fatemi Seyedeh Fatemeh , Mirzaei Khadijeh
Published: January 2023

Introduction

Sarcopenic obesity is related to changes in body composition, loss of muscle mass, and raised adipose tissue. Beverage patterns are effective with changes in health status. Therefore, the aim of this study was to investigate the association between sarcopenic obesity (SO) and the healthy beverage index (HBI) in women with overweight and obesity.

Methods

This cross-sectional study conducted on 210 overweight and obese (BMI ≥25 kg/m2) women aged 18–56 years. The measurement of skeletal muscle mass (SMM) and fat mass (FM) done by bioelectric impedance analyzer (BIA) (Inbody Co., Seoul, Korea) based on guidelines. The two lowest quintiles SMM and the two highest quintiles FM and body mass index (BMI) ≥30 are considered sarcopenic obesity in women. A validated and reliable semi-quantitative food-frequency questionnaire (FFQ) was used to evaluate the beverage dietary data. and RFS and NRFS was calculated. Biochemical assessments were quantified by standard approaches, and physical activity were evaluated by international physical activity questionnaire (IPAQ).

Result

In this cross-sectional study, 210 overweight and obese females took part (18–56) years old). The studies were carried out using binary logistic regression. After controlling for a wide variety of confounding variables such as age, energy intake, physical activity, education, and economic status, we found a negative association between HBI and risk of SO (OR = 0.29, 95% CI = 0.35 to 1.01, P = 0.05).

Conclusion

We observed that the odds of SO was reduced by 69% in participants with higher HBI score. More well-designed studies need to confirm our findings.
Perspectives on Deprescribing in long-term care: qualitative findings from nurses, aides, residents, and proxies
Authors: Little Milta O. , Hecker Emily J. , Colon-Emeric Cathleen S. , Herndon Laurie , McConnell Eleanor S. , Xue Tingzhong Michelle , Berry Sarah D.
Published: January 2023

Background

Deprescribing initiatives in the long-term care (LTC) setting are often unsuccessful or not sustained. Prior research has considered how physicians and pharmacists feel about deprescribing, yet little is known about the perspectives of frontline nursing staff and residents. Our aim was to elicit perspectives from LTC nursing staff, patients, and proxies regarding their experiences and preferences for deprescribing in order to inform future deprescribing efforts in LTC.

Methods

This study was a qualitative analysis of interviews with nurses, nurse aides, a nurse practitioner, residents, and proxies (family member and/or responsible party) from three LTC facilities. The research team used semi-structured interviews. Guides were designed to inform an injury prevention intervention. Interviews were recorded and transcribed. A qualitative framework analysis was used to summarize themes related to deprescribing. The full study team reviewed the summary to identify actionable, clinical implications.

Results

Twenty-six interviews with 28 participants were completed, including 11 nurse aides, three residents, seven proxies, one nurse practitioner, and six nurses. Three themes emerged that were consistent across facilities: 1) build trust with team members, including residents and proxies; 2) identify motivating factors that lead to resident, proxy, nurse practitioner, and staff acceptance of deprescribing; 3) standardize supportive processes to encourage deprescribing. These themes suggest several actionable steps to improve deprescribing initiatives including: 1) tell stories about successful deprescribing, 2) provide deprescribing education to frontline staff, 3) align medication risk/benefit discussions with what matters most to the resident, 4) standardize deprescribing monitoring protocols, 5) standardize interprofessional team huddles and care plan meetings to include deprescribing conversations, and 6) strengthen non-pharmacologic treatment programs.

Conclusions

By interviewing LTC stakeholders, we identified three important themes regarding successful deprescribing: Trust, Motivating Factors, and Supportive Processes. These themes may translate into actionable steps for clinicians and researchers to improve and sustain person-centered deprescribing initiatives.

Trial registration

NCT04242186
Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study
Authors: Morelli Daniela Moraes , Rubinstein Fernando , Santero Marilina , Gibbons Luz , Moyano Daniela , Nejamis Analia , Beratarrechea Andrea
Published: January 2023

Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of the implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.

Materials and methods

A quasi-experimental pre-post uncontrolled study was conducted in 19 primary care centers and hospitals in the province of Corrientes, Argentina. We included persons with T2DM, age >  = 18 years with access to a mobile phone. The multicomponent intervention included a mobile app with a diabetes registry, a clinical decision support tool for providers and a text messaging intervention for patients.

Results and discussion

One thousand sixty-five participants were included, 72.8% had less than 12 years of formal education and 53.5% lacked health coverage. Comorbidities were hypertension (60.8%) and overweight/obesity (88.2%). During follow-up there was a significant increase in the proportion of participants who underwent laboratory check-ups (HbA1c 20.3%-64.4%; p < 0.01) and foot exams (62.1%-87.2%; p < 0.01). No changes were observed at 12 and 24 months in the proportion of participants with poor metabolic control. The proportion of participants with uncontrolled blood pressure (≥ 140/90 mmHg) decreased from 47.2% at baseline to 30.8% at 24 months in those with a follow-up visit.

Conclusion

The DP was innovative by integrating digital health interventions in the public primary care level. The study showed improvements in quality indicators related with diabetes care processes and in blood pressure control.
Entomological drivers of uneven malaria transmission in urban lowland areas in Bouaké, Côte d’Ivoire
Authors: Dahoui Milossé M. C. , Adou Kouassi A. , Coulibaly Baba , Niamien Koffi L. , Koné Aboubacar , Cornelie Sylvie , Zoh Dounin D. , Assouho Konan F. , Moiroux Nicolas , Adja Akré M. , Fournet Florence
Published: January 2023

Background

The use of urban lowlands for agriculture contributes to the food security of city- dwellers, but promotes malaria transmission. The objective of the study was to characterize the entomological drivers of malaria transmission in two lowlands (N’Gattakro and Odiennekourani) in the city of Bouaké, Côte d’Ivoire.

Methods

The human landing catch technique was used to capture mosquitoes in houses located at the edge of two lowlands in Bouaké from February to December 2019. Cultivated surfaces were calculated monthly in both lowlands for each crop type (rice and market gardening) using images acquired by a drone. The different mosquito species were identified morphologically and by PCR analysis for the Anopheles gambiae complex. Anopheles infection by Plasmodium parasites was assessed by quantitative PCR. Mosquito diversity, biting behaviour and rhythmicity, and malaria transmission were determined in each lowland and compared.

Results

Anopheles gambiae sensu lato (s.l.) was predominant in N’Gattakro and Culex quinquefasciatus in Odiennekourani. Four Anopheles species were identified: An. gambiae s.l. and Anopheles funestus s.l. in both lowlands, Anopheles pharoensis in N’Gattakro, and Anopheles ziemanni in Odiennekourani. Within the An. gambiae complex, three species were caught: An. gambiae sensu stricto (s.s.), Anopheles coluzzii, and Anopheles arabiensis for the first time in Côte d’Ivoire (30.1%, 69.9% and 0% in N’Gattakro, and 45.1%, 52.6% and 2.4% in Odiennekourani, respectively). Anopheles gambiae s.l. species exhibited a significant exophagic behaviour in N’Gattakro (77.1% of outdoor bites versus 52.2% in Odiennekourani). In N’Gattakro, 12.6% of captures occurred before bedtime (09.00 pm) and after waking up (05.00 am), 15.1% in Odiennekourani. The mean human biting rate was higher in N’Gattakro than in Odiennekourani (61.6 versus 15.5 bites per person per night). Overall, Anopheles infection rate was 0.68%, with 0.539 and 0.029 infected bites per person per night in N’Gattakro and Odiennekourani, respectively.

Conclusion

The risk of malaria in urban agricultural lowland areas is uneven. The role of agricultural developments and irrigation patterns in the production of larval habitat should be explored. The exophagic behaviour of Anopheles vectors raises the question of the residual transmission that needs to be assessed to implement appropriate control strategies.
CAR T cells: engineered immune cells to treat brain cancers and beyond
Authors: Huang Zoufang , Dewanjee Saikat , Chakraborty Pratik , Jha Niraj Kumar , Dey Abhijit , Gangopadhyay Moumita , Chen Xuan-Yu , Wang Jian , Jha Saurabh Kumar
Published: January 2023

Malignant brain tumors rank among the most challenging type of malignancies to manage. The current treatment protocol commonly entails surgery followed by radiotherapy and/or chemotherapy, however, the median patient survival rate is poor. Recent developments in immunotherapy for a variety of tumor types spark optimism that immunological strategies may help patients with brain cancer. Chimeric antigen receptor (CAR) T cells exploit the tumor-targeting specificity of antibodies or receptor ligands to direct the cytolytic capacity of T cells. Several molecules have been discovered as potential targets for immunotherapy-based targeting, including but not limited to EGFRvIII, IL13Rα2, and HER2. The outstanding clinical responses to CAR T cell-based treatments in patients with hematological malignancies have generated interest in using this approach to treat solid tumors. Research results to date support the astounding clinical response rates of CD19-targeted CAR T cells, early clinical experiences in brain tumors demonstrating safety and evidence for disease-modifying activity, and the promise for further advances to ultimately assist patients clinically. However, several variable factors seem to slow down the progress rate regarding treating brain cancers utilizing CAR T cells. The current study offers a thorough analysis of CAR T cells’ promise in treating brain cancer, including design and delivery considerations, current strides in clinical and preclinical research, issues encountered, and potential solutions.
Conversion surgery for advanced hepatocellular carcinoma after combination treatment of lenvatinib and camrelizumab: a case report
Authors: Chen Zhihong , Chen Zhenrong , Fan Wu , Zou Yiping , Zhang Yuanpeng , Shi Ning , Jin Haosheng
Published: January 2023

Background

Hepatocellular carcinoma (HCC) is an aggressive malignancy with high morbidity and mortality. Conversion therapy can improve surgical resection rate and prolong survival time for patients with advanced HCC. We show that combination therapy with lenvatinib and camrelizumab is a novel approach to downstage unresectable HCC.

Case presentation

A 49-year-old man was diagnosed with massive HCC with hilar lymph node and lung metastases. Since radical resection was not feasible, lenvatinib and camrelizumab were administered as first-line therapy. After 10 cycles of camrelizumab and continuous oral administration of lenvatinib, the tumor exhibited striking shrinkage in volume indicating a partial radiological response, accompanied by a reduction in the alpha-fetoprotein levels, followed by salvage resection. Intriguingly, an improvement in predictive biomarkers, like lactate dehydrogenase (LDH) and neutrophil-to-lymphocyte ratio (NLR), was observed. Notably, the pathological examination found high levels of necrosis in the resected tumor, and flow cytometry analysis indicated a significant increase in the ratio of CD5+ and CD5− B lymphocytes in the peripheral blood. After the treatment, the overall survival period was over 24 months, and no recurrence was observed 17-month post-surgery.

Conclusions

A combination of lenvatinib and camrelizumab may be a new conversion therapy for initially unresectable HCC to resectable HCC, thus contributing to improve the disease prognosis. In addition, the combination regimen could cause an activated immune response, and LDH, NLR, and CD5+ B-cell levels might be predictors for immunotherapy efficacy.