bluuebunny/crossref_metadata_2025 huggingface dataset:
Intelligence, motoric and psychological outcomes in children from different ART treatments: a systematic review and meta-analysis
Authors: Djuwantono Tono , Aviani Jenifer Kiem , Permadi Wiryawan , Halim Danny , Achmad Tri Hanggono , Dhamayanti Meita
Published: August 2023

Background

Subtle abnormalities in children’s intelligence, motor skills, and psychology from various assisted reproductive treatments (ARTs) might be underdiagnosed. Understanding the prognosis of intelligence, motor skills, and psychology in children from ART would provide parents with reasonable expectations and enable them to plan relevant support to achieve the optimum potential in ART children.

Methods

We searched PubMed, EMBASE, Ovid, Google Scholar, and Scopus databases until April 13, 2021, to identify relevant studies. Thirty-four studies met the inclusion and exclusion criteria. The meta-analysis employed a standardized mean difference model. The outcome of this study is to compare intelligence quotient (IQ), motoric ability, and behavioral problems between all ARTs, in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) to naturally conceived (NC) children. Subdomains of intelligence based on the Cattell, Horn, and Carroll Model (CHC Model) of cognitive architecture, including fluid reasoning, short-term and working memory, processing speed, visual-spatial ability, long-term memory retrieval, and crystalized intelligence (knowledge), were evaluated and summarized in details. Motor skill was stratified into two domains: gross motoric and fine motoric. Behavioral problem was categorized as externalizing and internalizing behavior.

Results

Meta-analysis showed that verbal intelligence score in IVF toddlers is significantly lower than NC toddlers (p = 0.02); conversely, ICSI toddlers scored significantly higher verbal intelligence score compared to NC toddlers (p = 0.005). Toddlers born after ART had significantly lower non-verbal intelligence score (p = 0.047). IVF toddlers scored significantly lower fine motor score (p = 0.01) compared to naturally conceived toddlers. Based on parent's CBCL, NC toddlers had higher total (p = 0.01) and externalizing behavior (p = 0.001) scores  compared to ART toddlers. Evaluation of full scale IQ and all domains of intelligence in preschool and primary school children revealed that no significant differences exist between ART and NC children. Based on preschool and primary school parents' CBCL, IVF children had significantly lower externalizing behavior score compared to NC children (p = 0.04). Meta-analyses of studies on young adolescents revealed that ART young adolescents scored higher academically than their NC counterparts, including on mathematics (p < 0.00001) and reading or language (p < 0.00001).

Conclusions

Despite differences in certain aspects, this finding suggests that ART is unlikely to cause negative impacts on children’s neurodevelopment.
Aberrant oscillatory activity in neurofibromatosis type 1: an EEG study of resting state and working memory
Authors: Booth Samantha J. , Garg Shruti , Brown Laura J. E. , Green Jonathan , Pobric Gorana , Taylor Jason R.
Published: August 2023

Background

Neurofibromatosis type 1 (NF1) is a genetic neurodevelopmental disorder commonly associated with impaired cognitive function. Despite the well-explored functional roles of neural oscillations in neurotypical populations, only a limited number of studies have investigated oscillatory activity in the NF1 population.

Methods

We compared oscillatory spectral power and theta phase coherence in a paediatric sample with NF1 (N = 16; mean age: 13.03 years; female:n = 7) to an age/sex-matched typically developing control group (N = 16; mean age: 13.34 years; female:n = 7) using electroencephalography measured during rest and during working memory task performance.

Results

Relative to typically developing children, the NF1 group displayed higher resting state slow wave power and a lower peak alpha frequency. Moreover, higher theta power and frontoparietal theta phase coherence were observed in the NF1 group during working memory task performance, but these differences disappeared when controlling for baseline (resting state) activity.

Conclusions

Overall, results suggest that NF1 is characterised by aberrant resting state oscillatory activity that may contribute towards the cognitive impairments experienced in this population.

Trial registration

ClinicalTrials.gov, NCT03310996 (first posted: October 16, 2017).
Why are only some children with autism spectrum disorder misclassified by the social communication questionnaire? An empirical investigation of individual differences in sensitivity and specificity in a clinic-referred sample
Authors: Lee Chimei M. , Altschuler Melody R. , Esler Amy N. , Burrows Catherine A. , Hudock Rebekah L.
Published: August 2023

Background

The Social Communication Questionnaire (SCQ) is a checklist for autism spectrum disorder (ASD) commonly used in research and clinical practice. While the original validation study suggested that the SCQ was an accurate ASD screener with satisfactory sensitivity and specificity, subsequent studies have yielded mixed results, with some revealing low sensitivity, low specificity, and low utility in some settings.

Method

The present study examined the psychometric properties of the SCQ as well as the individual difference characteristics of 187 individuals with and without autism spectrum disorder (ASD) who were misclassified or accurately classified by the SCQ in a clinic-referred sample.

Results

The SCQ showed suboptimal sensitivity and specificity, regardless of age and sex. Compared to true positives, individuals classified as false positives displayed greater externalizing and internalizing problems, whereas individuals classified as false negatives displayed better social communication and adaptive skills.

Conclusions

The findings suggest that non-autistic developmental and behavioral individual difference characteristics may explain high rates of misclassification using the SCQ. Clinicians and researchers could consider using the SCQ in combination with other tools for young children with internalizing and externalizing symptoms and other more complex clinical presentations.
iDESC: identifying differential expression in single-cell RNA sequencing data with multiple subjects
Authors: Liu Yunqing , Zhao Jiayi , Adams Taylor S. , Wang Ningya , Schupp Jonas C. , Wu Weimiao , McDonough John E. , Chupp Geoffrey L. , Kaminski Naftali , Wang Zuoheng , Yan Xiting
Published: August 2023

Background

Single-cell RNA sequencing (scRNA-seq) technology has enabled assessment of transcriptome-wide changes at single-cell resolution. Due to the heterogeneity in environmental exposure and genetic background across subjects, subject effect contributes to the major source of variation in scRNA-seq data with multiple subjects, which severely confounds cell type specific differential expression (DE) analysis. Moreover, dropout events are prevalent in scRNA-seq data, leading to excessive number of zeroes in the data, which further aggravates the challenge in DE analysis.

Results

We developed iDESC to detect cell type specific DE genes between two groups of subjects in scRNA-seq data. iDESC uses a zero-inflated negative binomial mixed model to consider both subject effect and dropouts. The prevalence of dropout events (dropout rate) was demonstrated to be dependent on gene expression level, which is modeled by pooling information across genes. Subject effect is modeled as a random effect in the log-mean of the negative binomial component. We evaluated and compared the performance of iDESC with eleven existing DE analysis methods. Using simulated data, we demonstrated that iDESC had well-controlled type I error and higher power compared to the existing methods. Applications of those methods with well-controlled type I error to three real scRNA-seq datasets from the same tissue and disease showed that the results of iDESC achieved the best consistency between datasets and the best disease relevance.

Conclusions

iDESC was able to achieve more accurate and robust DE analysis results by separating subject effect from disease effect with consideration of dropouts to identify DE genes, suggesting the importance of considering subject effect and dropouts in the DE analysis of scRNA-seq data with multiple subjects.
Comparison of different volumes spread of erector spinae block in postmastectomy pain syndrome management: a prospective randomized comparative study
Authors: Abdelghaffar Nevert A. , Amer Ghada F.
Published: August 2023

Background

Postmastectomy pain is chronic pain that occurs in females after breast surgeries. In this study, we estimated the vertebral levels reached by two different volumes (20 ml and 30 ml solutions) in the erector spinae block (ESB), as well as assess pain improvement and patient satisfaction in females with postmastectomy pain syndrome.

Methods

Fifty patients were assigned to two groups. The 20 ml group received ESB with 10 ml of bupivacaine 0.5%, 1 ml of 40 mg/ml of methylprednisolone, 2 ml of non-ionic contrast, and 7 ml of saline 0.9%. The 30 ml group received ESB with 15 ml of bupivacaine 0.5%, 1 ml of 40 mg/ml of methylprednisolone, 2 ml of non-ionic contrast, and 12 ml of saline 0.9%.

Results

The mean numbers of the blockade segments were 5.12 ± 0.726 and 6.36 ± 0.569 in the 20 ml and 30 ml groups, respectively (P < 0.001). The T1 to T6 blockade levels were achieved in six patients (24%) in the 20 ml group, versus 23 patients (92%) in the 30 ml group (P < 0.001). The numerical rating scale (NRS) improved in the 30 ml group during the follow-up period, compared to the 20 ml group. The T1 to T6 blockade levels showed better NRS (P < 0.001) and patient satisfaction (P = 0.011) than other blockade levels.

Conclusions

The injection of a 30 ml solution of 0.25% bupivacaine with methylprednisolone in erector spinae block (ESB) may result in better analgesia and higher patient satisfaction in individuals with postmastectomy pain syndrome (PMPS) compared to a 20 ml solution.

Trial registration

ClinicalTrials.gov (NCT05192278) on 14/1/2022.
Hemodynamic impact of ephedrine on hypotension during general anesthesia: a prospective cohort study on middle-aged and older patients
Authors: Uemura Yuta , Kinoshita Michiko , Sakai Yoko , Tanaka Katsuya
Published: August 2023

Background

Ephedrine is a mixed α- and β-agonist vasopressor that is frequently used for the correction of hypotension during general anesthesia. β-responsiveness has been shown to decrease with age; therefore, this study aimed to determine whether aging would reduce the pressor effect of ephedrine on hypotension during general anesthesia.

Methods

Seventy-five patients aged ≥ 45 years were included in this study, with 25 patients allocated to each of the three age groups: 45–64 years, 65–74 years, and ≥ 75 years. All patients received propofol, remifentanil, and rocuronium for the induction of general anesthesia, followed by desflurane and remifentanil. Cardiac output (CO) was estimated using esCCO technology. Ephedrine (0.1 mg/kg) was administered for the correction of hypotension. The primary and secondary outcome measures were changes in the mean arterial pressure (MAP) and CO, respectively, at 5 min after the administration of ephedrine. 

Results

The administration of ephedrine significantly increased MAP (p < 0.001, mean difference: 8.34 [95% confidence interval (CI), 5.95–10.75] mmHg) and CO (p < 0.001, mean difference: 7.43 [95% CI, 5.20–9.65] %) across all groups. However, analysis of variance revealed that the degree of elevation of MAP (F [2, 72] = 0.546, p = 0.581, η2 = 0.015 [95% CI, 0.000–0.089]) and CO (F [2, 72] = 2.023, p = 0.140, η2 = 0.053 [95% CI, 0.000–0.162]) did not differ significantly among the groups. Similarly, Spearman’s rank correlation and multiple regression analysis revealed no significant relation between age and the changes in MAP or CO after the administration of ephedrine.

Conclusion

The administration of ephedrine significantly increased MAP and CO; however, no significant correlation with age was observed in patients aged > 45 years. These findings suggest that ephedrine is effective for the correction of hypotension during general anesthesia, even in elderly patients.

Trial registration

UMIN-CTR (UMIN000045038; 02/08/2021).
Monitoring the burden of COVID-19 and impact of hospital transfer policies on Australian aged-care residents in residential aged-care facilities in 2020
Authors: Nair Shruti Premshankar , Quigley Ashley L , Moa Aye , Chughtai Abrar Ahmad , Macintyre Chandini Raina
Published: August 2023

Background

Residential aged-care facilities in Australia emerged as the high-risk setting the COVID-19 outbreaks due to community transmission. The vulnerable aged-care residents of these facilities suffered due to low hospital transfers and high mortality and morbidity rates. This study aimed to monitor and report the burden of COVID-19 in residential aged-care facilities across Australia and the impact of hospital transfer policies on resident hospitalisation during the first year of the pandemic.

Methods

We conducted a retrospective cohort study by collecting data from weekly aged-care outbreak reports published by open sources and official government sources between 1st March and 20th November 2020. A comprehensive line list of outbreaks was created using open-source data. The line list included the name of the facility, location, COVID-19 cases among residents, & staff, resident hospitalisations, mode of transmission, number of resident deaths, and state policies involving resident hospitalisation. We also searched the websites of these facilities to collect data on their COVID-19 policies for the residents, staff, and visitors. Statistical analyses were performed on the data obtained.

Results

126 aged-care COVID-19 outbreaks were identified in Australia during the study period. The incidence rate of COVID-19 infections among aged-care residents in Australia was (1118.5 per 100,000 resident population) which is 10 times higher than the general population (107.6 per 100,000 population). The hospitalisation rate for aged-care residents in Australia was 0.93 per 100,000 population. The hospitalisation rate of aged-care residents in Victoria was 3.14 per 100,000 population despite having the highest COVID-19 cases. Excluding South Australia, all states followed ad-hoc case-by-case hospital transfer policies for aged-care residents.

Conclusion

This study documented a higher risk of COVID-19 infection for aged-care residents and workers but found low hospitalisation rates among residents across Australia. The hospitalisation rates in Victoria were higher than the national average but low when considering the COVID-19 infection rates in the state. The hospitalisation rates could have been impacted due to the state hospital transfer policies at that time. Immediate transfer of infected residents to hospitals may improve their survival and reduce the risk of infection to the other residents, as healthcare settings have more advanced infection control measures and are well-equipped with trained staff and resources.
Clinical burden of invasive Escherichia coli disease among older adult patients treated in hospitals in the United States
Authors: Hernandez-Pastor Luis , Geurtsen Jeroen , Baugh Bryan , El Khoury Antoine C. , Kalu Nnanya , Gauthier-Loiselle Marjolaine , Bungay Rebecca , Cloutier Martin , Sarnecki Michal , Saade Elie
Published: August 2023

Background

Invasive extraintestinal pathogenic Escherichia coli disease (IED) can lead to severe outcomes, particularly among older adults. However, the clinical burden of IED in the U.S. has not been well characterized.

Methods

IED encounters among patients ≥ 60 years old were identified using the PINC AI™ Healthcare Database (10/01/2015–03/31/2020) by either a positive E. coli culture in blood or another normally sterile body site and ≥ 1 sign of systemic inflammatory response syndrome or signs of sepsis, or a positive E. coli culture in urine with urinary tract infection and signs of sepsis. Medical resource utilization, clinical outcomes, and E. coli isolate characteristics were descriptively reported during the first IED encounter and during the following year (observation period).

Results

Overall, 19,773 patients with IED were included (mean age: 76.8 years; 67.4% female; 78.5% with signs of sepsis). Most encounters involved community-onset IED (94.3%) and required hospitalization (96.5%; mean duration: 6.9 days), with 32.4% of patients being admitted to the intensive care unit (mean duration: 3.7 days). Most E. coli isolates were resistant to ≥ 1 antibiotic category (61.7%) and 34.4% were resistant to ≥ 3 antibiotic categories. Following their first IED encounter, 34.8% of patients were transferred to a skilled nursing/intermediate care facility, whereas 6.8% had died. During the observation period, 36.8% of patients were rehospitalized, 2.4% had IED recurrence, and in-hospital death increased to 10.9%.

Conclusions

IED is associated with substantial clinical burden at first encounter with considerable long-term consequences. Findings demonstrate the need for increased IED awareness and highlight potential benefits of prevention.
Prevalence and trends of advanced HIV disease among antiretroviral therapy-naïve and antiretroviral therapy-experienced patients in South Africa between 2010-2021: a systematic review and meta-analysis
Authors: Kitenge Marcel K. , Fatti Geoffrey , Eshun-Wilson Ingrid , Aluko Omololu , Nyasulu Peter
Published: August 2023

Background

Despite the significant progress made in South Africa in getting millions of individuals living with HIV into care, many patients still present or re-enter care with Advanced HIV Disease (AHD). We aimed to estimate the prevalence of AHD among ART-naive and ART-experienced patients in South Africa using studies published between January 2010 and May 2022.

Methods

We searched for relevant data on PubMed, CINAHL, Scopus and other sources, with a geographical filters limited to South Africa, up to May 31, 2022. Two reviewers conducted all screening, eligibility assessment, data extraction, and critical appraisal. We synthesized the data using the inverse-variance heterogeneity model and Freeman-Tukey transformation. We assessed heterogeneity using the I2 statistic and publication bias using the Egger and Begg’s test.

Results

We identified 2,496 records, of which 53 met the eligibility criteria, involving 11,545,460 individuals. The pooled prevalence of AHD among ART-naive and ART-experienced patients was 43.45% (95% CI 40.1–46.8%, n = 53 studies) and 58.6% (95% CI 55.7 to 61.5%, n = 2) respectively. The time trend analysis showed a decline of 2% in the prevalence of AHD among ART-naive patients per year. However, given the high heterogeneity between studies, the pooled prevalence should be interpreted with caution.

Conclusion

Despite HIV’s evolution to a chronic disease, our findings show that the burden of AHD remains high among both ART-naive and ART-experienced patients in South Africa. This emphasizes the importance of regular measurement of CD4 cell count as an essential component of HIV care. In addition, providing innovative adherence support and interventions to retain ART patients in effective care is a crucial priority for those on ART.
Amantadine for NeuroenhaNcement in acutE patients Study - a protocol for a prospective pilot proof of concept phase IIb study in intensive and intermediate care unit patients (ANNES)
Authors: Hofmann Anna , Blum Corinna , Single Constanze , Adeyemi Kamal , Schwarz Patricia , Siokas Vasileios , Rattay Tim W. , Häberle Helene A. , Riessen Reimer , Brendel Bettina , Haug Iris , Bösel Ruth , Zago Manola , Martus Peter , Ziemann Ulf , Mengel Annerose , Feil Katharina
Published: August 2023

Background

Persisting coma is a common complication in (neuro)intensive care in neurological disease such as acute ischemic stroke, intracerebral hemorrhage or subarachnoid hemorrhage. Amantadine acts as a nicotinic receptor antagonist, dopamine receptor agonist and non-competitive N-Methyl-D-aspartate receptor antagonist. Amantadine is a long-known drug, originally approved for treatment of influenza A and Parkinson`s Disease. It has been proven effective in improving vigilance after traumatic brain injury. The underlying mechanisms remain largely unknown, albeit anti-glutamatergic and dopaminergic effects might be most relevant. With limited evidence of amantadine efficacy in non-traumatic pathologies, the aim of our study is to assess the effects of amantadine for neuroenhancement in non-traumatic neurointensive patients with persisting coma.

Methods

An investigator-initiated, monocenter, phase IIb proof of concept open-label pilot study will be carried out. Based on the Simon design, 43 adult (neuro)intensive care patients who meet the clinical criteria of persisting coma not otherwise explained and < 8 points on the Glasgow Coma Scale (GCS) will be recruited. Amantadine will be administered intravenously for five days at a dosage of 100 mg bid. The primary endpoint is an improvement of at least 3 points on the GCS. If participants present as non-responders (increase < 3 points or decrease on the GCS) within the first 48 h, the dosage will be doubled from day three to five. Secondary objectives aim to demonstrate that amantadine improves vigilance via alternative scales. Furthermore, the incidence of adverse events will be investigated and electroencephalography (EEG) will be recorded at baseline and end of treatment.

Discussion

The results of our study will help to systematically assess the clinical utility of amantadine for treatment of persisting coma in non-traumatic brain injury. We expect that, in the face of only moderate treatment risk, a relevant number of patients will benefit from amantadine medication by improved vigilance (GCS increase of at least 3 points) finally leading to a better rehabilitation potential and improved functional neurological outcome. Further, the EEG data will allow evaluation of brain network states in relation to vigilance and potentially outcome prediction in this study cohort.

Trial Registration

NCT05479032.
Rural-urban differentials in child body mass index over time
Authors: Wake Senahara Korsa , Zewotir Temesgen , Mekebo Gizachew Gobebo , Fissuh Yemane Hailu
Published: August 2023

Background

The body mass index is a simple index based on weight and height that can be used to screen children and adults for potential weight problems. The objective of this study was to investigate urban-rural variations in child BMI and its distribution from 2006 to 2016 in four low and middle-income countries.

Methods

This study used data from the Young Lives prospective cohort study conducted in Ethiopia, India, Peru, and Vietnam to assess the BMI change for children aged 5 to 15 between 2006 and 2016. We adopted a mixed-effect model to analyze the data.

Results

The study revealed substantial changes and rises in BMI in Vietnam, Peru, India, and Ethiopia between 2006 and 2016. Peru had the highest BMI changes in both urban-rural areas. A low BMI was observed in Ethiopia and India. Urban-rural differences had a significant role in determining BMI variation. In urban Ethiopia, the mean BMI increased from 14.56 kg/m2 to 17.52 kg/m2, and in rural areas, it increased from 14.57 kg/m2 to 16.67 kg/m2. Similarly, in urban Vietnam, the BMI increased from 16 kg/m2 to 20.3 kg/m2, and in rural areas, it increased from 14.69 kg/m2 to 18.93 kg/m2.

Conclusions

The findings showed an increase in BMI changes in Ethiopia, India, Peru, and Vietnam from 2006 to 2016. Urban-rural differences have a significant contribution to determining BMI variation.
Exercise intervention and improvement of negative emotions in children: a meta-analysis
Authors: Li Jiayu , Jiang Xiaoping , Huang Zan , Shao Tianyi
Published: August 2023

Background

Anxiety, depression, and stress are the most common mental health problems in childhood. Exercise interventions in childhood help to promote mental health.

Objective

To investigate the relationship between exercise interventions and improvement of negative emotions such as anxiety, depression, and stress in children (5–12 years).

Methods

Articles were searched in five electronic databases from their inception to January 2023. The meta-analysis was performed using Stata 16.0.

Results

Twenty-three intervention studies included 6830 children. 1) The exercise intervention group was significantly better than the control group in improving negative emotions (Standard Mean Difference SMD=-0.25, 95% Confidence Intervals CI: -0.34 to -0.15, P < 0.01). Exercise intervention improved different kinds of negative emotions: anxiety (SMD=-0.19, 95% CI: -0.33 to -0.06, P < 0.01), depression (SMD=-0.22, 95% CI: -0.43 to -0.01, P < 0.01), and stress (SMD=-0.33, 95% CI: -0.53 to -0.14, P < 0.01); it was most effective at relieving problematic stress. Exercise interventions lasting 20–45 min were most effective in improving children’s negative emotions (SMD=-0.38, 95% CI: -0.56 to -0.20, P < 0.01). An exercise intervention period of 10 weeks was more effective in improving children’s negative mood (SMD=-0.26, 95% CI: -0.34 to -0.17, P = 0.274).

Conclusion

Exercise interventions may improve negative emotions such as anxiety, depression, and stress in children. These findings may have clinical implications for children with negative affect. However, these studies showed a large heterogeneity, and the results should be interpreted with caution. Future studies should report the variability of exercise interventions by gender, age group, and type, intensity, and place of exercise.
Can lifestyle factors explain racial and ethnic inequalities in all-cause mortality among US adults?
Authors: Puka Klajdi , Kilian Carolin , Zhu Yachen , Mulia Nina , Buckley Charlotte , Lasserre Aurélie M. , Rehm Jürgen , Probst Charlotte
Published: August 2023

Background

Racial and ethnic inequalities in all-cause mortality exist, and individual-level lifestyle factors have been proposed to contribute to these inequalities. In this study, we evaluate the extent to which the association between race and ethnicity and all-cause mortality can be explained by differences in the exposure and vulnerability to harmful effects of different lifestyle factors.

Methods

The 1997–2014 cross-sectional, annual US National Health Interview Survey (NHIS) linked to the 2015 National Death Index was used. NHIS reported on race and ethnicity (non-Hispanic White, non-Hispanic Black, and Hispanic/Latinx), lifestyle factors (alcohol use, smoking, body mass index, physical activity), and covariates (sex, age, education, marital status, survey year). Causal mediation using an additive hazard and marginal structural approach was used.

Results

465,073 adults (18–85 years) were followed 8.9 years (SD: 5.3); 49,804 deaths were observed. Relative to White adults, Black adults experienced 21.7 (men; 95%CI: 19.9, 23.5) and 11.5 (women; 95%CI: 10.1, 12.9) additional deaths per 10,000 person-years whereas Hispanic/Latinx women experienced 9.3 (95%CI: 8.1, 10.5) fewer deaths per 10,000 person-years; no statistically significant differences were identified between White and Hispanic/Latinx men. Notably, these differences in mortality were partially explained by both differential exposure and differential vulnerability to the lifestyle factors among Black women, while different effects of individual lifestyle factors canceled each other out among Black men and Hispanic/Latinx women.

Conclusions

Lifestyle factors provide some explanation for racial and ethnic inequalities in all-cause mortality. Greater attention to structural, life course, healthcare, and other factors is needed to understand determinants of inequalities in mortality and to advance health equity.
Does refining an intervention based on participant feedback increase acceptability? An experimental approach
Authors: Keyworth Chris , Quinlivan Leah , Leather Jessica Z. , O’Connor Rory C. , Armitage Christopher J.
Published: August 2023

Background

Participant feedback is an important consideration for increasing intervention acceptability, yet whether incorporating such feedback actually improves acceptability is rarely tested.

Purpose

The present study describes a theory-based approach to assessing whether refining an intervention based on participant feedback increases acceptability.

Methods

Three hundred and ninety-three UK adults who had previously self-harmed were exposed to the same intervention at baseline and, six months later, were randomly allocated to receive either: (a) the same version of the intervention (control group), or (b) a version of the intervention that had been refined following participant feedback (experimental group). The main outcome measure was acceptability ratings for each of the seven domains specified in the Theoretical Framework of Acceptability (TFA).

Results

Mixed ANOVAs, with control versus experimental group as the between-participants factor and time (baseline versus follow-up) as the within participants factor showed no significant changes in acceptability.

Conclusions

The null effects reported here imply that participants found both the original and modified versions of the intervention equally acceptable, and that our process of refining an intervention based on participant feedback did not impact on acceptability. Nevertheless, we have operationalised a robust approach for examining whether participant feedback impacts on the acceptability of an intervention. Further research is required to understand better how participant feedback should be incorporated into the development of healthcare interventions.
Irritable bowel syndrome (IBS) among Lebanese adults: unidentified IBS and associated factors
Authors: Yazbeck Gabriella , Malaeb Diana , Shaaban Hamid , Sarray El Dine Abir , Hallit Souheil , Hallit Rabih
Published: August 2023

Background

Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders, but the condition is still underdiagnosed. The high of rate of unidentified IBS by patients can be related to different factors. The aim of this study is to assess the rate of unidentified IBS among Lebanese adults and investigate the role of socio-demographic factors, anxiety, depression, insomnia and eating attitudes on IBS diagnosis.

Methods

A cross-sectional study was conducted among Lebanese adults older than 18 years between June 2022 and December 2022, using a self-reporting questionnaire distributed via social media.

Results

A total of 425 participants was enrolled in the study with around 184 (46.8%) having a possible unidentified IBS. Higher psychological distress (aOR = 1.07) and insomnia severity (aOR = 1.08) were significantly associated with higher odds of having possible unidentified IBS whereas a higher household crowding index (aOR = 0.67) was significantly associated with lower odds of having possible IBS. The correlation of eating attitudes with cigarette smoking (aOR = 1.33; p = .025; 95% CI 1.04; 1.70) and insomnia severity with cigarette smoking (aOR = .89; p = .023; 95% CI .80; .98) were significantly associated with the presence of possible IBS. In nonsmokers, higher psychological distress (aOR = 1.07) and insomnia severity (aOR = 1.10) were significantly associated with higher odds of having possible IBS. In smokers, higher BMI (aOR = .78) was significantly associated with lower odds of having possible IBS, whereas higher eating attitudes scores (more inappropriate eating) (aOR = 1.40) were significantly associated with higher odds of having possible IBS.

Conclusion

The study highlighted the implication of raising awareness about IBS among the Lebanese population to promote early diagnosis and minimize the rate of unidentified IBS by patients. Initiation of appropriate treatment plans, tailored symptomatic management approach, and diet programs should be highly encouraged.
How safe are intra-articular corticosteroid injections to the hip?
Authors: Streck Laura Elisa , Braun Sebastian , Spilo Kimi , Boettner Cosima Sue , Brenneis Marco , Boettner Friedrich
Published: August 2023

Background

Intra-articular corticosteroid injections (ICSI) are an effective symptomatic treatment for osteoarthritis of the hip. However, the safety of ICSI has been questioned and a relatively high risk for septic arthritis, rapidly progressive osteoarthritis (RPIO) and periprosthetic joint infections (PJI) in patients undergoing subsequent total hip arthroplasty (THA) have been suggested.

Methods

This is a retrospective evaluation of 682 hips that underwent ICSI with 40 mg of Triamcinolone for primary osteoarthritis of the hip. All ICSI were performed using sterile techniques, the number of ICSI in each hip and the cumulative corticosteroid dosage were assessed. Pre- and post-injection radiographs were compared to identify cases with RPIO. Native joint septic arthritis, surgical site infections and PJI were identified by chart review.

Results

4 hips (0.6%) developed RPIO 2–4 months following ICSI. The cumulative Triamcinolone dose was not associated with the development of RPIO (p = 0.281). 1 case was diagnosed with septic arthritis and treated with staged THA, there were no signs of infection at a 5 years follow-up. 483 hips (75.7%) underwent THA, including 199 hips with THA less than 3 months following ICSI and 181 hips with > 1 ICSI prior to THA. There were 3 superficial surgical site infections/wound dehiscence and no PJI.

Conclusion

The rate of RPIO was 0.6%. The current findings suggest that if ICSI is performed under sterile conditions, the risk for septic arthritis or PJI following THA, even in patients with multiple ICSI or ICSI within 3 months prior to surgery, is minimal.
Students’ perception of e-learning during the Covid-19 pandemic: a survey study of Iranian nutrition science students
Authors: Eslamian Ghazaleh , Khoshnoodifar Mehrnoosh , Malek Shirin
Published: August 2023

Background

COVID–19 pandemic caused university closures, which created learning challenges for students worldwide. Switching to online educational systems had significant impact on students’ performances. The current study aims to investigate the perception of university students from the Nutrition Science department regarding e-learning in Iran.

Methods

The design of the study is cross-sectional. Data were collected through online surveys from Iranian students from the Nutrition Sciences Department. Stratified random sampling was used to randomly select 955 participants. A self-administered validated questionnaire was used for data collection. Descriptive statistics, Analysis of Variance (ANOVA) and Chi-Square tests were used for analysis of the data.

Results

Results revealed that 67.2% of students didn’t have any former experience of e-learning. About 38.3% had moderate levels of Information Technology (IT) skills. Our results revealed that based on students’ responses, being able to stay at home was one of the most common benefits of e-learning (39.1%). However, the most common challenge that students faced was related to technical problems (39.6%). When compared to e-learning, most students preferred face-to face type of learning. Students believed that this method no only increased their knowledge but also their skills and social competence as compared to e-learning. Only 28% of students rated e-learning as enjoyable. Furthermore, acceptance of online based education was statistically associated with students’ degree level.

Conclusion

In conclusion, students reported both advantages and disadvantages of e-learning but still reported that face-to-face learning is considered the most effective form of learning.
Influence of Basic Health Care Provision Fund in improving primary Health Care in Kano state, a descriptive cross-sectional study
Authors: Ibrahim Zainab Auwalu , Konlan Kennedy Diema , Moonsoo Yoon , Kwetishe Paul , Ryu Jongsoo , Ro Da Sol , Kim So Yoon
Published: August 2023

Background

The Basic Health Care Provision Fund (BHCPF) is a direct financial investment that funds Primary Healthcare (PHC) to improve the quality of services. This study assessed the influence of the BHCPF in improving PHC services.

Methods

A descriptive cross-sectional study was conducted among PHC workers in 100 facilities randomly selected from the 484 designated PHCs for implementing the BHCPF project in Kano state. Using multiple sampling methods, 200 healthcare workers in PHC facilities were selected and assisted by trained data collectors to respond to the questionnaires. Chi-square analysis was used to show associated factors, while binary regression analysis was used to determine the relationship between factors influencing the BHCPF implementation in PHC.

Result

The findings showed healthcare workers had higher awareness (61.7%) and good utilization (57.1%) of BHCPF. Challenges of the BHCPF implementation were insufficiently skilled health professionals (85%), lack of data management capacity (52.6%), low community participation and awareness (52.0%), delay in releasing funds (60.7%), poor infrastructure (87.8%), and weak financial management and accountability system (58.2%). Healthcare professionals having a diploma were four times more likely to have the National Health Management Information System (NHMIS) in their facilities (AOR = 4.955, 95% CI = 1.120–21.036; P-value 0.035) than those without. Primary healthcare facilities were two times more likely to have the NHMIS (AOR = 2.549, 95% CI = 1.167–5.566: P-value 0. 019) than health post.

Conclusion

The factors that influenced PHC facilities to promote the implementation of BHCPF included: periodic evaluation of the facilities, availability of functional storage facilities, and improving the standard of care in PHC facilities. There is a need for retraining healthcare workers and creating more community awareness of the BHCPF.
Healthcare leaders’ and elected politicians’ approach to support-systems and requirements for complying with quality and safety regulation in nursing homes – a case study
Authors: Magerøy Malin Rosell , Braut Geir Sverre , Macrae Carl , Wiig Siri
Published: August 2023

Background

Healthcare leaders play an important and complex role in managing and handling the dual responsibility of both Health, Safety and Environment (HSE) for workers and quality and patient safety (QPS). There is a need for better understanding of how healthcare leaders and decision makers organize and create support structures to handle these combined responsibilities in practice. The aim of this study was to explore how healthcare leaders and elected politicians organize, control, and follow up the work of HSE and QPS in a Norwegian nursing home context. Moreover, we explore how they interpret, negotiate, and manage the dual responsibility and possible tensions between employee health and safety, and patient safety and quality of service delivery.

Methods

The study was conducted in 2022 as a case study exploring the experience of healthcare leaders and elected politicians in five municipalities responsible for providing nursing homes services in Norway. Elected politicians (18) and healthcare leaders (11) participated in focus group interviews (5) and individual interviews (11). Data were analyzed using inductive thematic analysis.

Results

The analysis identified five main themes explaining how the healthcare leaders and elected politicians organize, control, and follow up the work of HSE and QPS:

1. Establish frameworks and room for maneuver in the work with HSE and QPS.

2. Create good routines and channels for communication and collaboration.

3. Build a culture for a health-promoting work environment and patient safety.

4. Create systems to handle the possible tensions in the dual responsibility between caring for employees and quality and safety in service delivery.

5. Define clear boundaries in responsibility between politics and administration.

Conclusions

The study showed that healthcare leaders and elected politicians who are responsible for ensuring sound systems for quality and safety for both patients and staff, do experience tensions in handling this dual responsibility. They acknowledge the need to create systems and awareness for the responsibility and argue that there is a need to better separate the roles and boundaries between elected politicians and the healthcare administration in the execution of HSE and QPS.
The association between triglyceride glucose index and arthritis: a population-based study
Authors: Yan Yuxin , Zhou Liyu , La Rui , Jiang Ming , Jiang Dinghua , Huang Lixin , Xu Wu , Wu Qian
Published: August 2023

Objectives

Insulin resistance is a well-established contributor to inflammation; however, the specific association between the triglyceride glucose (TyG) index, a biomarker reflecting insulin resistance, and arthritis remains unexplored. As a result, the main aim of this study was to examine the correlation between the TyG index and arthritis.

Methods

This observational study used data from the National Health and Nutrition Examination Survey (NHANES), which was conducted between 2007 and 2018. To investigate the relationship between the TyG index and arthritis, various statistical analyses were employed, including weighted multivariable logistic regression analysis, subgroup analysis, curve fit analysis, and threshold effect analysis.

Results

In total, 14,817 patients were enrolled in the trial, with 4,191 individuals (28.29%) diagnosed with arthritis. An increased risk of arthritis was found to be significantly correlated with higher TyG index values (odds ratio OR = 1.15, 95% confidence interval CI: 1.07–1.23), according to the results of multivariable logistic regression analysis after full adjustment. Subgroup analysis and interaction tests further indicated that the TyG index exhibited an additive effect when combined with other established risk factors, including age (OR = 1.29; 95% CI: 1.17–1.41), body mass index (BMI) (OR = 1.43; 95% CI: 1.24–1.69), and diabetes (OR = 1.20; 95% CI: 1.11–1.31). Additionally, curve fit analysis and threshold effect analysis demonstrated a nonlinear relationship with a breakpoint identified at 8.08 µmol/L.

Conclusion

The TyG index was positively correlated with arthritis in adults under 60 years of age in the United States who had normal weight and no diabetes. Further large-scale prospective studies are warranted for a comprehensive analysis of the role of the TyG index in arthritis.
GREM1 is a potential biomarker for the progression and prognosis of bladder cancer
Authors: Jiang Peng-cheng , Xu Li-zhe , Ning Jin-zhuo , Cheng Fan
Published: August 2023

Background

Gremlin-1 (GREM1) is a protein closely related to tumor growth, although its function in bladder cancer (BCa) is currently unknown. Our first objective was to study the GREM1 treatment potential in BCa.

Methods

BCa tissue samples were collected for the detection of GREM1 expression using Western blot analysis and Immunofluorescence staining. Association of GREM1 expression with clinicopathology and prognosis as detected by TCGA (The Cancer Genome Atlas) database. The functional investigation was tested by qRT-PCR, western blot analysis, CCK-8, cell apoptosis, wound healing, and transwell assays. The interaction between GREM1 and the downstream PI3K/AKT signaling pathway was assessed by Western blot analysis.

Results

GREM1 exhibited high expression in BCa tissues and was linked to poor prognosis. Stable knockdown of GREM1 significantly inhibited BCa cell (T24 and 5637) proliferation, apoptosis, migratory, invasive, as well as epithelial-mesenchymal transition (EMT) abilities. GREM1 promotes the progression in BCa via PI3K/AKT signaling pathway.

Conclusion

Findings demonstrate that the progression-promoting effect of GREM1 in BCa, providing a novel biomarker for BCa-targeted therapy.
The multi-omics analyses of acsl1 reveal its translational significance as a tumor microenvironmental and prognostic biomarker in clear cell renal cell carcinoma
Authors: Yang Yang , Liang Jiayu , Zhao Junjie , Wang Xinyuan , Feng Dechao , Xu Hang , Shen Yu , Zhang Yaowen , Dai Jindong , Wang Zhipeng , Wei Qiang , Liu Zhenhua
Published: August 2023

Background

Clear cell renal cell carcinoma (ccRCC) is the dominant subtype of kidney cancer. Dysregulation of long-chain acyl-CoA synthetase 1 (ACSL1) is strongly implicated in undesirable results in varieties of cancers. Nevertheless, the dysregulation and associated multi-omics characteristics of ACSL1 in ccRCC remain elusive.

Methods

We probed the mRNA and protein profiles of ACSL1 in RCC using data from the Cancer Genome Atlas, Gene Expression Omnibus, the Human Protein Atlas (HPA), and Clinical Proteomic Tumor Analysis Consortium (CPTAC) and verified them in our patient cohort and RCC cell lines. Correlations between ACSL1 expression and clinicopathological features, epigenetic modification and immune microenvironment characteristics were analyzed to reveal the multi-omics profile associated with ACSL1.

Results

ACSL1 was down-regulated in ccRCC tissues compared to adjacent normal tissues. Lower expression of ACSL1 was linked to unfavorable pathological parameters and prognosis. The dysregulation of ACSL1 was greatly ascribed to CpG island-associated methylation modification. The ACSL1 high-expression subgroup had enriched fatty acid metabolism-related pathways and high expression of ferroptosis-related genes. In contrast, the ACSL1 low-expression subgroup exhibited higher immune and microenvironment scores, elevated expression of immune checkpoints PDCD1, CTLA4, LAG3, and TIGIT, and higher TIDE scores. Using data from the GDSC database, we corroborated that down-regulation of ACSL1 was associated with higher sensitivity towards Erlotinib, Pazopanib, and PI3K-Akt-mTOR-targeted therapeutic strategies.

Conclusion

Taken together, our findings point to ACSL1 as a biomarker for prognostic prediction of ccRCC, identifying the tumor microenvironment (TME) phenotype, and even contributing to treatment decision-making in ccRCC patients.
Improved weed segmentation in UAV imagery of sorghum fields with a combined deblurring segmentation model
Authors: Genze Nikita , Wirth Maximilian , Schreiner Christian , Ajekwe Raymond , Grieb Michael , Grimm Dominik G.
Published: August 2023

Background

Efficient and site-specific weed management is a critical step in many agricultural tasks. Image captures from drones and modern machine learning based computer vision methods can be used to assess weed infestation in agricultural fields more efficiently. However, the image quality of the captures can be affected by several factors, including motion blur. Image captures can be blurred because the drone moves during the image capturing process, e.g. due to wind pressure or camera settings. These influences complicate the annotation of training and test samples and can also lead to reduced predictive power in segmentation and classification tasks.

Results

In this study, we propose , a combined deblurring and segmentation model for weed and crop segmentation in motion blurred images. For this purpose, we first collected a new dataset of matching sharp and naturally blurred image pairs of real sorghum and weed plants from drone images of the same agricultural field. The data was used to train and evaluate the performance of on both sharp and blurred images of a hold-out test-set. We show that outperforms a standard segmentation model that does not include an integrated deblurring step, with a relative improvement of $$13.4 \%$$

13.4
%

in terms of the Sørensen-Dice coefficient.

Conclusion

Our combined deblurring and segmentation model is able to accurately segment weeds from sorghum and background, in both sharp as well as motion blurred drone captures. This has high practical implications, as lower error rates in weed and crop segmentation could lead to better weed control, e.g. when using robots for mechanical weed removal.