bluuebunny/crossref_metadata_2025 huggingface dataset:
Low preoperative psoas muscle mass index is a risk factor for distal cholangiocarcinoma recurrence after pancreatoduodenectomy: a retrospective analysis
Authors: Umezawa Saori , Kobayashi Shinjiro , Otsubo Takehito
Published: June 2022

Background

This study aimed to investigate whether preoperative muscle mass is associated with the recurrence of distal cholangiocarcinoma after pancreatoduodenectomy (PD).

Methods

We retrospectively examined 88 patients who had undergone PD for distal cholangiocarcinoma. The preoperative psoas muscle mass index (PMI) was measured using computed tomography as an index of muscle mass. We performed multivariate analysis of factors influencing early recurrence and developed a prognostic survival model using independent risk factors for recurrence.

Results

The cut-off PMI values for recurrence within 1 year of surgery, determined from the receiver operating characteristic curve, were 5.90 cm2/m2 in males and 3.98 cm2/m2 in females. Multivariate analysis of effects associated with early recurrence within 1 year indicated that low PMI (odds ratio [OR] 9.322; 95% confidence interval [CI] 2.832 − 30.678; p = 0.0002) and lymph node metastasis (OR 5.474; 95% CI 1.620 − 18.497; p = 0.0062) were independent risk factors, and the median recurrence-free survival (RFS) of the low and high PMI groups were 21.6 and 81.0 months, respectively (p = 0.0214). The median RFS for zero, one, and two risk factors of low PMI and lymph node metastasis were as follows: zero variables, median not reached; one variable, 15.3 months; two variables: 6 months.

Conclusions

Low preoperative PMI may be a risk factor for distal cholangiocarcinoma recurrence after PD.

Trial registration

The Institutional Review Board of St. Marianna University School of Medicine approved this study prior to commencement of data collection and analysis on October 9, 2020 (IRB no. 5006) and waived the informed consent requirement.
Socio-cultural implications for women’s menstrual health in the Pacific Island Countries and Territories (PICTs): a scoping review
Authors: Maulingin-Gumbaketi Elizabeth , Larkins Sarah , Whittaker Maxine , Rembeck Gun , Gunnarsson Ronny , Redman-MacLaren Michelle
Published: June 2022

Background

Globally, experiences of menarche and subsequent menstruation are embedded in social and cultural beliefs, norms and practices. Menarche is an important developmental milestone in sexual and reproductive health (SRH) for females. Menarche is intertwined with socio-cultural norms, beliefs and practices, which can impact on women’s ability to manage menstruation with dignity. This paper reviews the social and cultural factors that affect women’s ability to effectively manage their menstrual health and hygiene (MHH) in Pacific Island Countries and Territories (PICTs).

Methods

A scoping review was conducted following PRISMA scoping review guidelines and inclusion/exclusion criteria. An online search was conducted for peer-reviewed publications in Medline/OVID; Medline/PubMED; PsycINFO; CINAHL; Scopus and JSTOR, and Google Scholar. A search for grey literature was conducted in Google Scholar and websites of international and local organizations. Experts in the field also contributed additional references. Extracted data were summarised in an Excel spreadsheet. Searches were conducted between May and June, 2019, and then repeated in July, 2020.

Results

A total of 11 studies were included; 10 qualitative and one mixed methods study. Studies were conducted in Melanesian (n = 9), Polynesian (n = 1) and Micronesian (n = 1) PICTs. All 11 studies reported elements of societal and personal factors; ten studies reported evidence relating to interpersonal factors; nine studies reported elements relating to environmental factors; and two studies presented evidence linked to biological factors. Managing menstrual health with dignity is challenging for many women and girls because menstruation is associated with menstrual taboos and shame.

Conclusion

This review found that the MHH experiences of women in PICTs are affected by social and cultural beliefs, norms and practices. Beliefs, norms and practices about menarche need to be incorporated in SRH planning, programs and education in order to be relevant to diverse village and urban settings.
Depression secondary to vision loss in old age and an effective rapid screening tool for undiagnosed cases
Authors: Clancy Noah , Aslam Tariq , Cackett Peter
Published: June 2022

Background

Zenebe et al. recently stated that despite depression being a common mental health problem in the elderly population, it is underdiagnosed in over half of the cases (Zenebe et al. in Ann Gen Psychiatry, 2021). They described an extensive list of risk factors associated with geriatric depression. However, we noted that they did not include ophthalmic conditions in this list which have previously been identified as an important risk factor for depression in the elderly.

Main body

To determine the extent of undiagnosed anxiety and depression in our elderly population with vision loss, we screened a cohort of our patients, over 60 years with vision loss secondary to macular disease for both conditions.

Our cohort included 104 patients with mean best corrected visual acuity 0.58 LogMAR (Snellen equivalent 6/24). In this group, we identified 29.8% (31/104) and 28.8% (30/104) of patients with at least one depression or anxiety-related symptom, respectively, in the past 2 weeks. We identified 7.7% (8/104) and 3.8% (4/104) who had significant symptoms of depression and anxiety, respectively, that warranted further follow-up. Only two of these patients had previously been diagnosed with anxiety or depression with the majority having no previous history of either condition.

Patients from our cohort who screened for depression or anxiety often cited frustration completing tasks and loss of independence secondary to declining vision. They also complained that the vision loss resulted in a lack of confidence which in turn resulted in social isolation and loneliness. Most of the patients welcomed referral to their GP for follow-up for input regarding their mental health and they also stated an interest in attending hospital optometry low vision services and counselling support.

Conclusions

With increasing time pressures on healthcare services and the rising use of virtual clinics especially during the COVID-19 pandemic, it is still essential to screen efficiently for depression in those elderly patients who are at significant risk. There is a considerable burden of major depressive disease in the geriatric population, and we would recommend that physicians (Geriatricians, GPs, Ophthalmologists etc.) screen elderly patients with vision loss for depression using the rapid screening tool which we suggest.
The Stark law, from inception to COVID-19 blanket waivers: a review
Authors: Shenoy Amrita , Shenoy Gopinath N. , Shenoy Gayatri G.
Published: June 2022

The concept of physicians referring patients to their own healthcare entities is considered a “self-referral”. A discerning factor of a self-referral is when the physician has a financial interest in the entity of patient referral. Prospects of healthcare overutilization and costs, thereby, rise. Self-referral laws, therefore, are important to regulate overutilization and contain costs. In the 1980s, Congressman Fortney Stark initiated an act that was one of the precursors to one such self-referral law, known as the Stark Law. The Stark Law, in its initial phase, known as Stark I, addressed self-referrals selectively from laboratory services. Stark I, thereafter, in a series of subsequent amendments and enactments, burgeoned to include multiple services, referred as Designated Health Services (DHS), for self-referrals. The expanded law, inclusive of those DHS, is now known as Stark II. The passage of the 2010 Affordable Care Act as well as the prevailing 2019 Coronavirus Disease (COVID-19) pandemic further modified the Stark Law. Given the legislative history of the said law, the present review curates the legal initiatives of this law from its nascent formative stages to the present form. The purpose of the above curation is to present a bird’s eye view of its evolution and present analysts of any future research segments. This review, furthermore, describes the waivers of this law specific to COVID-19, or COVID-19 blanket waivers, which are instruments to assuage any barriers and further placate any hurdles arising from this law prevalent in this pandemic.
circPDE5A regulates prostate cancer metastasis via controlling WTAP-dependent N6-methyladenisine methylation of EIF3C mRNA
Authors: Ding Lifeng , Wang Ruyue , Zheng Qiming , Shen Danyang , Wang Huan , Lu Zeyi , Luo Wenqin , Xie Haiyun , Ren Liangliang , Jiang Minxiao , Yu Chenhao , Zhou Zhenwei , Lin Yudong , Lu Haohua , Xue Dingwei , Su Wenjing , Xia Liqun , Neuhaus Jochen , Cheng Sheng , Li Gonghui
Published: June 2022

Background

Circular RNA (circRNA) is a novel class noncoding RNA (ncRNA) that plays a critical role in various cancers, including prostate cancer (PCa). However, the clinical significance, biological function, and molecular mechanisms of circRNAs in prostate cancer remain to be elucidated.

Methods

A circRNA array was performed to identified the differentially expressed circRNAs. circPDE5A was identified as a novel circRNA which downregulated in clinical samples. Functionally, the in vitro and in vivo assays were applied to explore the role of circPDE5A in PCa metastasis. Mechanistically, the interaction between circPDE5A and WTAP was verified using RNA pulldown followed by mass spectrometry, RNA Immunoprecipitation (RIP) assays. m6A methylated RNA immunoprecipitation sequencing (MeRIP-seq) was then used to identified the downstream target of circPDE5A. Chromatin immunoprecipitation assay (ChIP) and dual-luciferase reporter assay were used to identified transcriptional factor which regulated circPDE5A expression.

Results

circPDE5A was identified downregulated in PCa tissues compared to adjacent normal tissue and was negatively correlated with gleason score of PCa patients. circPDE5A inhibits PCa cells migration and invasion both in vitro and in vivo. circPDE5A blocks the WTAP-dependent N6-methyladenisine (m6A) methylation of eukaryotic translation initiation factor 3c (EIF3C) mRNA by forming the circPDE5A-WTAP complex, and finally disrupts the translation of EIF3C. Moreover, the circPDE5A-dependent decrease in EIF3C expression inactivates the MAPK pathway and then restrains PCa progression.

Conclusions

Our findings demonstrate that FOXO4-mediated upregulation of circPDE5A controls PCa metastasis via the circPDE5A-WTAP-EIF3C-MAPK signaling pathway and could serve as a potential therapeutic targer for PCa.
Correction of hallux abducto valgus by scarf osteotomy. A ten‐year retrospective multicentre review of patient reported outcomes shows high satisfaction rates with podiatric surgery
Authors: Clee Sharon , Flanagan George , Pavier Julian , Reilly Ian
Published: June 2022

Background

Corrective surgery for hallux abducto valgus is one of the most performed elective procedures in foot and ankle practice. Numerous methods of surgical correction have been reported within the literature, with varying clinical and patient reported outcomes. This study reviews the patient experience and outcomes in five podiatric surgery centres using the scarf diaphyseal osteotomy.

Method

Patient reported outcome measures (PROMs) were captured using the Patient Satisfaction Questionnaire 10 (PSQ‐10), part of the PASCOM‐10 podiatric surgery audit tool. PROMs were collated across five hospital sites over a 10‐year period.

Results

Of 1351 patients reported during the period, 1189 had complete retrospective data. The most common patient aim of surgery was ‘no/less pain’ reported in 70% of patients. 96.8% of patients reported their original foot complaint as ‘better’ or ‘much better’ after surgery. 92.8% of patients reported their expectations had been met with 96.6% reporting they would have surgery again under the same conditions. 98.5% of patients noted that the risks, complications, and expectations had been discussed prior to surgery. The most common complication was metatarsal fracture (4.6%).

Conclusion

The scarf osteotomy (with or without an Akin phalangeal osteotomy) consistently showed high patient satisfaction with low complication rates using PSQ‐10 and this information can be used as part of the pre‐operative consenting process. Patient expectations for surgery were often achieved, which may be attributed to the pre‐operative work up of the patient. Further investigation into this correlation is suggested.

Level of clinical evidence

IV (retrospective review).
Efficacy and safety of Jian-Pi Huo-Xue granule for non-alcoholic fatty liver disease: study protocol for a randomized, double-blind, placebo-controlled trial
Authors: Sun Yuanlong , Chen Gaofeng , Chen Si , Wang Yanjie , Hu Yiyang , Zhao Yu
Published: June 2022

Background

Non-alcoholic fatty liver disease (NAFLD) has become the most prevalent form of chronic liver disease, with a global prevalence of 25% worldwide, but a consensus treatment is still lacking. Previous studies have shown that Jian-Pi Huo-Xue granules (JPHX) can reduce hepatic steatosis in ultrasound images, but lacked quantitative observation in imagined liver fat content. This study aimed to refine the efficacy and safety assessment of JPHX for NAFLD with magnetic resonance imaging-proton density fat fraction (MRI-PDFF) as the primary outcome.

Methods

This is a randomized, double-blind, placebo-controlled clinical trial. The trial will enrol 84 NAFLD participants who will be equally randomized to receive either JPHX or a placebo for 24 weeks. Follow-up will be performed 12 weeks after the intervention. The primary outcome will be the change from baseline to week 24 in MRI-PDFF. Secondary outcomes will be the body weight, body mass index (BMI), waist circumference, waist-to-hip ratio (WHR), serum liver function, blood lipids and glucose-related indicators, quality of life measurement health survey, and traditional Chinese medicine (TCM) syndrome scale. Outcomes will be monitored at baseline, 12 weeks and 24 weeks after enrolment. Adverse events occurring in this trial will be managed and recorded promptly.

Discussion

We designed a clinical trial for the treatment of NAFLD using JPHX, a TCM formulation that has been shown to have a positive effect on hepatic steatosis in a previous self-controlled trial. This trial will use a more recognized and quantitative imaging approach to demonstrate the efficacy of JPHX in the treatment of NAFLD and observe its safety to provide clinical evidence for its translational applications.

Trial registration

Chinese Clinical Trial Registry ChiCTR2100046132. Registered on 4 May 2021.
Experiment in semi-natural conditions did not confirm the influence of malaria infection on bird attractiveness to mosquitoes
Authors: Cozzarolo Camille-Sophie , Pigeault Romain , Isaïa Julie , Wassef Jérôme , Baur Molly , Glaizot Olivier , Christe Philippe
Published: June 2022

Background

Changes in host phenotype following parasite infection are often considered as host manipulation when they seem advantageous for the parasite. However, putative cases of host manipulation by parasites are rarely tested in field-realistic conditions. Infection-induced phenotypic change cannot be conclusively considered as host manipulation if no evidence shows that this trait is adaptive for the parasite in the wild. Plasmodium sp., the parasites causing malaria in vertebrates, are hypothesized to “manipulate” their host by making their odour more attractive to mosquitoes, their vector and final host. While this is fairly well supported by studies on mice and humans, studies focusing on avian malaria give contradictory results.

Methods

In the present study, genotyped birds at different stages (uninfected, acute and chronic) of Plasmodium relictum infection were exposed, in a large outdoor aviary, to their natural vector, the mosquito Culex pipiens.

Results

After genotyping the blood meals of more than 650 mosquitoes, we found that mosquitoes did not bite infected birds more than they bit them before infection, nor more than they bit uninfected hosts.

Conclusions

Our study highlights the importance of testing ecological behaviours under natural conditions and suggests that different processes might be at play in mammals and birds regarding potential manipulation of attractiveness by malaria parasites.

Graphical Abstract
Combined exome and transcriptome sequencing of non-muscle-invasive bladder cancer: associations between genomic changes, expression subtypes, and clinical outcomes
Authors: Goel Anshita , Ward Douglas G. , Noyvert Boris , Yu Minghao , Gordon Naheema S. , Abbotts Ben , Colbourne John K. , Kissane Stephen , James Nicholas D. , Zeegers Maurice P. , Cheng Kar Keung , Cazier Jean-Baptiste , Whalley Celina M. , Beggs Andrew D. , Palles Claire , Arnold Roland , Bryan Richard T.
Published: June 2022

Background

Three-quarters of bladder cancer patients present with early-stage disease (non-muscle-invasive bladder cancer, NMIBC, UICC TNM stages Ta, T1 and Tis); however, most next-generation sequencing studies to date have concentrated on later-stage disease (muscle-invasive BC, stages T2+). We used exome and transcriptome sequencing to comprehensively characterise NMIBCs of all grades and stages to identify prognostic genes and pathways that could facilitate treatment decisions. Tumour grading is based upon microscopy and cellular appearances (grade 1 BCs are less aggressive, and grade 3 BCs are most aggressive), and we chose to also focus on the most clinically complex NMIBC subgroup, those patients with grade 3 pathological stage T1 (G3 pT1) disease.

Methods

Whole-exome and RNA sequencing were performed in total on 96 primary NMIBCs including 22 G1 pTa, 14 G3 pTa and 53 G3 pT1s, with both exome and RNA sequencing data generated from 75 of these individual samples. Associations between genomic alterations, expression profiles and progression-free survival (PFS) were investigated.

Results

NMIBCs clustered into 3 expression subtypes with different somatic alteration characteristics. Amplifications of ARNT and ERBB2 were significant indicators of worse PFS across all NMIBCs. High APOBEC mutagenesis and high tumour mutation burden were both potential indicators of better PFS in G3pT1 NMIBCs. The expression of individual genes was not prognostic in BCG-treated G3pT1 NMIBCs; however, downregulated interferon-alpha and gamma response pathways were significantly associated with worse PFS (adjusted p-value < 0.005).

Conclusions

Multi-omic data may facilitate better prognostication and selection of therapeutic interventions in patients with G3pT1 NMIBC. These findings demonstrate the potential for improving the management of high-risk NMIBC patients and warrant further prospective validation.
Can MRI knee joint measurements predict the population at risk of ACL injury?
Authors: Hamdan Mohammad , Haddad Bassem , Alshrouf Mohammad Ali , Azzam Muayad I. , Isleem Ula , Hamasha Reem , Albtoush Omar M. , Alhusban Muna Tayel , Mubarak Nidaa , Alryalat Saif Aldeen
Published: June 2022

Background

Anterior cruciate ligament (ACL) injuries have been increasing significantly over time. The relationship between the ACL injury and the knee joint structures is poorly understood. The purpose of this study is to examine whether the measurements of different structures in the knee joint are linked with ACL injury in affected patients.

Methods

This retrospective case–control study included patients who suffered from ACL tears and underwent magnetic resonance imaging (MRI). A control group of patients with no knee pathologies on MRI was included. Fourteen knee variables, including lateral meniscus (LM) posterior horn height, length, depth, and volume; medial meniscus (MM) posterior horn height, length, depth, and volume; lateral and medial (MFC) femoral condyle sphere diameter; lateral and medial tibial plateau length; and patella tendon horizontal and vertical diameter, were collected. A multivariate logistic regression including LM posterior horn depth, MM posterior horn length, MM volume, MFC sphere diameter, and patella tendon horizontal diameter and receiver operating characteristic curve, was used to compare the two groups.

Results

A total of 85 patients were included in our study; 54 suffered from ACL injuries and 31 as a control group with normal knee MRI. Logistic regression revealed that increased LM posterior horn depth (OR = 1.27; 95% CI = 1.03–1.56; p = 0.028), decreased MM posterior horn length (OR = 0.71; 95% CI = 0.55–0.93; p = 0.013), and MFC sphere diameter (OR = 1.20; 95% CI = 1.01–1.43; p = 0.035) were independent risk factors for ACL rupture. The MFC sphere diameter yielded the highest area under the curve: 0.747 (95% CI, 0.632–0.862). No difference was found in the other measurements between the two groups.

Conclusions

Concerning the difference in anatomical variations, the lateral meniscus posterior horn depth and medial femoral condyle sphere diameter were higher, while medial meniscus posterior horn length was lower in patients with an ACL injury. These structural knee measurements could have a possible increase in the likelihood of sustaining an ACL injury and can be used by clinicians to predict ACL injury.
Genome-wide linkage search for cancer susceptibility loci in a cohort of non BRCA1/2 families in Sri Lanka
Authors: Wijesiriwardhana Prabhavi , Musolf Anthony M. , Bailey-Wilson Joan E. , Wetthasinghe T. Kalum , Dissanayake Vajira H. W.
Published: June 2022

Objective

Although linkage studies have been utilized for the identification of variants associated with cancer in the world, little is known about their role in non BRCA1/2 individuals in the Sri Lankans. Hence we performed linkage analysis to identify susceptibility loci related to the inherited risk of cancer in a cohort of Sri Lankans affected with hereditary breast cancer. The Illumina global screening array having 654,027 single nucleotide polymorphism markers was performed in four families, in which at least three individuals within third degree relatives were affected by breast cancer. Two-point parametric linkage analysis was conducted assuming disease allele frequency of 1%. Penetrance was set at 90% for carriers with a 10% phenocopy rate.

Results

Thirty-one variants exhibited genome-wide suggestive HLODs. The top overall HLOD score was at rs1856277, an intronic variant in MYO16 on chromosome 13. The two most informative families also suggested several candidate linked loci in genes, including ERAP1, RPRM, WWOX, CDH1, EXOC1, HUS1B, STIM1 and TUSC1. This study provides the first step in identifying germline variants that may be involved in risk of cancer in cancer-aggregated non-BRCA1/2 families from the understudied Sri Lankan population. Several candidate linked regions showed suggestive evidence of linkage to cancer risk.
Alternative use of phage display: phage M13 can remain viable in the intestines of poultry without causing damage
Authors: Santos Fabiana de Almeida Araújo , Valadares Junior Edson Campos , Goulart Luiz Ricardo , Nunes Pedro Lucas Figueiredo , Mendonça Eliane Pereira , Girão Lúcio Vilela Carneiro , da Hora Aline Santana , Ferreira Thatiana Bragine , Bastos Luciana Machado , Medeiros-Ronchi Alessandra Aparecida , Fonseca Belchiolina Beatriz
Published: June 2022

Phage display (PD) is a tool for developing new molecules to control pathogens. Peptides selected by PD are commonly synthesised and tested, but the use of phage M13 displaying the selected peptides as a direct biding in the intestinal tract has not yet been tested. This study evaluated whether phage M13 can remain viable in the chicken gastrointestinal tract and whether it causes injury or humoral immune response. We inoculated phage M13 or E. coli ER2738 (ECR) infected with M13 into birds at different ages. We found the virus in faeces at 5 or 13 days after inoculation, just when it infected the ECR. The presence of phage M13 or ECR did not result in gut injuries and had no impacts on weight gain and bird health. Furthermore, the levels of IgY were similar in all treatments, which indicates that the virus can be used in chicken until 42 days without being recognised by the immune system. This work provides a scientific basis for the use of PD as a tool in numerous applications to control different pathogens.
The effectiveness of smoking cessation interventions for socio-economically disadvantaged women: a systematic review and meta-analysis
Authors: O’Connell Nicola , Burke Emma , Dobbie Fiona , Dougall Nadine , Mockler David , Darker Catherine , Vance Joanne , Bernstein Steven , Gilbert Hazel , Bauld Linda , Hayes Catherine B.
Published: June 2022

Introduction

This systematic review and meta-analysis assessed the effectiveness of smoking cessation interventions among women smokers in low socio-economic status (SES) groups or women living in disadvantaged areas who are historically underserved by smoking cessation services.

Methods

A systematic literature search was conducted using MEDLINE (OVID), EMBASE, Cochrane, CINAHL, PsychINFO and Web of Science databases. Eligibility criteria included randomised controlled trials of any smoking cessation intervention among women in low SES groups or living in socio-economically disadvantaged areas. A random effects meta-analysis assessed effectiveness of interventions on smoking cessation. Risk of bias was assessed with the Cochrane Risk of Bias tool. The GRADE approach established certainty of evidence.

Results

A total of 396 studies were screened for eligibility and 11 (6153 female participants) were included. Seven studies targeted women-only. 5/11 tested a form of face-to-face support. A pooled effect size was estimated in 10/11 studies. At end of treatment, two-thirds more low SES women who received a smoking cessation intervention were more likely to stop smoking than women in control groups (risk ratio (RR) 1.68, 95% CI 1.36–2.08, I2= 34%). The effect was reduced but remained significant when longest available follow-up periods were pooled (RR 1.23, 95% CI 1.04–1.48, I2 = 0%). There was moderate-to-high risk of bias in most studies. Certainty of evidence was low.

Conclusions

Behavioural and behavioural + pharmacotherapy interventions for smoking cessation targeting women in low SES groups or women living in areas of disadvantage were effective in the short term. However, longer follow-up periods indicated reduced effectiveness. Future studies to explore ways to prevent smoking relapse in this population are needed.

Systematic review registration

PROSPERO: CRD42019130160
Changes in glycaemic control of oral anti-diabetic medications assessed by continuous glucose monitors among patients with type 2 diabetes: a protocol of network meta-analysis
Authors: Zheng Mingyue , Khoja Adeel , Patel Anamica , Luo Yunting , He Qian , Zhao Xuan , Yang Shenqiao , Hu Peng , Lin Wei
Published: June 2022

Background

Continuous glucose monitors (CGMs) can measure interstitial fluid glucose levels to provide comprehensive real-time glucose profile among people with type 2 diabetes. These can accurately detect glucose levels, hyperglycaemia and hypoglycaemia events compared with conventional self-monitoring. Increased application of CGMs provides a valuable opportunity to evaluate glucose control on oral anti-diabetic medications. This review will compare the efficacy and safety of oral anti-diabetic medications among patients with type 2 diabetes, evaluated by CGM.

Methods

The following databases will be searched: Cochrane Library, PubMed, EMBASE, CINAHL, PsycINFO, Scopus and grey literature (ClinicalTrials.gov, PsycEXTRA, ProQuest Dissertations, Google Scholar and Theses Global) for the identification of studies. The review will include and summarise evidence from randomised clinical trials that use CGMs for blood glucose management in adults (aged ≥ 18 years), published in English between January 2000 and May 2021 without any restrictions of countries. Reference list of all selected articles will independently be screened to identify additional studies left out in the initial search. Primary outcomes will be HbA1c (≤ 7.0%), time spent with hypoglycaemia (< 70 mg/dl) or hyperglycaemia (≥ 180 mg/dl). Secondary outcomes will be change in weight, blood pressure and related comorbidities (cardiovascular mortality, heart failure events, myocardial infarction and stroke). Study selection, data extraction and quality assessment will be conducted independently by at least two reviewers. A third reviewer will determine and resolve discrepancies. At least two independent reviewers will cross-check data synthesis. The quality of evidence of the review will be assessed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Tool.

Discussion

The review is anticipated to provide up to date evidence for further studies and clinic practices regarding glycaemic control, hypoglycaemia, and hyperglycaemia issues. The results will be published in a peer-reviewed journal.

Trial registration

PROSPERO CRD42020188399.
Inappropriate use of antibiotics and its predictors in pediatric patients admitted at the Central Hospital of Nampula, Mozambique
Authors: Xavier Sancho Pedro , Victor Audêncio , Cumaquela Graciano , Vasco Melsequisete Daniel , Rodrigues Osiyallê Akanni Silva
Published: June 2022

Background

Antibiotics are synthetic or natural substances used to treat bacterial infectious diseases. When used incorrectly, they can be a factor in the development of antimicrobial resistance, increased treatment time, costs, and mortality. The present study aimed to assess the pattern of inappropriate use of antibiotics and their predictors in pediatric patients admitted to the Central Hospital in Nampula, Mozambique.

Methods

A cross-sectional, retrospective study with a quantitative approach was conducted between January and July 2019. The population consisted of children ages 0–10 years hospitalized in the pediatric ward I. Binary logistic regression was used to determine risk factors for the inappropriate use of antibiotics with 95% confidence interval.

Results

The prevalence of antibiotic use among pediatric patients was 97.5%. Of the 464 antibiotics prescribed, 39.9% were for patients suffering from gastroenteritis, 21.8% and 9.1% for those affected with pneumonia and malaria, respectively. Most antibiotics were for parenteral use (95.9%, 445/464). Many (36.5%) of the prescriptions had errors, primarily in the duration of treatment (74.0%) or dosage (24.4%). Binary logistic regression analysis revealed that patients prescribed ≥ 3 antibiotics (OR = 2.83, 95% CI 1.245–6.462, p-value = 0.013) or hospitalized for a short time (OR = 1.88, 95% CI 1.133–2.3140, p-value = 0.015) were more likely to experience inappropriate use of antibiotics.

Conclusion

The study showed both a high prevalence of antibiotic use and a high error rate in prescriptions, especially among patients prescribed ≥ 3 antibiotics or hospitalized for a short time. These results are concerning, since inappropriate and excessive use of antibiotics is a major factor in the development of antibiotic-resistant microorganisms. Therefore, policies to reduce the inappropriate and excessive use of antibiotics are necessary.
Psychometric properties of Farsi version of the resilience scale (CD-RISC) and its role in predicting aggression among Iranian athletic adolescent girls
Authors: Nooripour Roghieh , Hoseinian Simin , Vakili Yaghoob , Ghanbari Nikzad , Matacotta Joshua J. , Mozaffari Nazir , Ilanloo Hossein , Lavie Carl
Published: June 2022

The sport presents an opportunity for young people to experience the joys of success and cope with setbacks to develop resilient behaviors. However, there is a lack of clarity about how sport can cultivate resilience, particularly among adolescent girls. This study investigated the psychometric properties of Farsi version of the Resilience Scale (CD-RISC) and its role in predicting aggression in Iranian athletic adolescent girls. The method of the present study was cross-sectional. The population of this study was Iranian athletic adolescent girls, and 475 Iranian athletic adolescent girls were selected through the convenience sampling method. The participants completed the Resilience Scale (CD-RISC), Quality of Mindfulness, General Self-efficacy (GSE), Alexithymia, and Aggression Scale. The CD-RISC’s psychometric properties were analyzed using confirmatory factor analysis, while reliability was tested using Cronbach’s alpha. Discriminant validity was measured by examining the relationship with alexithymia, and convergent validity was assessed with the quality of mindfulness and GSE. In addition, multiple regression analysis was conducted on the prediction of aggression by the CD-RISC subscales. The five-factor structure provided a good fit for the data. CD-RISC had significant negative associations with alexithymia, and there was a significant positive correlation between CD-RISC and Quality of Mindfulness, GSE. The results indicate that CD-RISC significantly predicts aggression in athletic adolescent girls. The CD-RISC has good validity for athletic adolescent girls in Iran and can be used in psychological evaluations in the Iranian context. CD-RISC significantly predicts aggression among athletic adolescent girls.
Comparative analysis of deep learning based Afaan Oromo hate speech detection
Authors: Ganfure Gaddisa Olani
Published: June 2022

Social media platforms like Facebook, YouTube, and Twitter are banking on developing machine learning models to help stop the spread of hateful speech on their platforms. The idea is that machine learning models that utilize natural language processing will detect hate speech faster and better than people can. Despite numerous progress has been made for resource reach language, only a few attempts have been made for Ethiopian Languages such as Afaan Oromo. This paper examines the viability of deep learning models for Afaan Oromo hate speech recognition. Toward this, the biggest dataset of hate speech was collected and annotated by the language experts. Variations of profound deep learning models such as CNN, LSTMs, BiLSTMs, LSTM, GRU, and CNN-LSTM are examined to evaluate their viability in identifying Afaan Oromo Hate speeches. The result uncovers that the model dependent on CNN and Bi-LSTM outperforms all the other investigated models with an average F1-score of 87%.
Preliminary study on hydrological angular momentum determined from CMIP6 historical simulations
Authors: Nastula Jolanta , Śliwińska Justyna , Kur Tomasz , Wińska Małgorzata , Partyka Aleksander
Published: June 2022

Polar motion (PM) is an essential parameter needed to transform coordinates between celestial and terrestrial reference frames, thus playing a crucial role in precise positioning and navigation. The role of hydrological signals in PM excitation is not yet fully understood, which is largely because of the lack of agreement between estimates of hydrological angular momentum (HAM) computed from different data sources. In this study, we used data obtained from the latest, sixth phase of the Coupled Model Intercomparison Project (CMIP6) to assess the impact of the continental hydrosphere on PM excitation. To do so, we exploited soil moisture and snow water variables obtained from historical simulations of CMIP6 to estimate climate-based HAM. The HAM series were computed, then we analysed their variability in terms of trends, seasonal and non-seasonal oscillations. An important part of this study is the validation of HAM estimates based on comparison with the hydrological signal in geodetically observed PM excitation (geodetic residuals, GAO). In addition, HAM series based on climate models were compared with those determined from global gravimetric data provided by the Gravity Recovery and Climate Experiment (GRACE) mission, and from the Land Surface Discharge Model (LSDM). This study also aimed to identify the most appropriate CMIP6 models for interpretation of PM variations. Overall, the correspondence between GAO and HAM received from CMIP6 was lower than the previously obtained consistency with GRACE results, and the level of agreement was dependent on the oscillation considered and the model used. However, it may be possible to identify several CMIP6 models from among the almost 100 available that provides a HAM series more compatible with GAO than HAM from GRACE or LSDM, especially in annual oscillations. The GISS-E2-1-G_historical_r10i1p1f1 model was found to provide the highest consistency with GAO for annual prograde amplitudes, GFDL-CM4_historical_r1i1p1f1 for annual retrograde amplitudes, BCC-ESM1_historical_r3i1p1f1 for the annual prograde phase, and MIROC-ES2L_historical_r2i1p1f2 for the annual retrograde phase. Because of their length, the CMIP6 data allow for analysis of the past and future changes in HAM from 1850 to 2100, which is of particular importance in the exploration of the impact of climate change on PM excitation.

Graphical Abstract
Urinary tract diversion with gastric conduit after total pelvic exenteration for Crohn’s disease-related anorectal cancer: a case report
Authors: Kimura Kei , Kanematsu Akihiro , Tomono Masato , Kataoka Kozo , Beppu Naohito , Uchino Motoi , Shinohara Hisashi , Ikeuchi Hiroki , Yamamoto Shingo , Ikeda Masataka
Published: June 2022

Background

In Japan, Crohn’s disease (CD)-related cancers occur most frequently in the anal canal. Many patients with advanced CD-related cancer require total pelvic exenteration (TPE) based on their medical history, and choosing the most effective method for urinary diversion is a major concern. We herein report the first case of CD-related cancer treatment with urinary diversion using a gastric conduit after TPE in Japan.

Case presentation

A 51-year-old man with a 25 year history of CD was referred to our institution after having been diagnosed with fistulae between the rectum and urethra. Sigmoidoscopy revealed stenosis of the anal canal, and histological examination of this lesion led to a diagnosis of mucinous adenocarcinoma. Magnetic resonance imaging showed that the tumor had invaded the prostate and left internal obturator muscle, and TPE with left internal obturator muscle resection was planned. Urinary diversion was performed with a gastric conduit. The gastric conduit was created by trimming a gastric tube to a 1.5 cm width via stapled resection of the greater curvature, and the branches of the right gastroepiploic artery were preserved as feeding vessels. The ureters were raised from the mesentery on the right side of the ligament of Treitz. Ureterogastric anastomosis was performed using the Wallace technique, and the entire anastomosis was then retroperitonealized. The anastomotic site had a bleeding tendency, but hemostasis was obtained by proton pump inhibitor administration and discontinuation of enoxaparin, which had been administered to prevent venous thrombosis. No other major complications occurred, and the patient’s quality of life was recovered 6 months after surgery.

Conclusion

Urinary diversion using a gastric conduit is a feasible treatment option for patients with CD-related anorectal cancer requiring TPE.
Contraceptive discontinuation among women of reproductive age in Papua New Guinea
Authors: Dadzie Louis Kobina , Seidu Abdul-Aziz , Ahinkorah Bright Opoku , Tetteh Justice Kanor , Salihu Tarif , Okyere Joshua , Yaya Sanni
Published: June 2022

Background

Papua New Guinea has one of the lowest contraceptive prevalence rates among women of reproductive age in the Western Pacific Region and this makes contraceptive discontinuation in this country a critical public health issue worth studying. This study sought to assess the factors associated with contraceptive discontinuation among women of reproductive age in Papua New Guinea.

Methods

The data used for the analysis were obtained from the Papua New Guinea Demographic and Health Survey which was conducted in 2016–2018. The outcome variable for this study was contraceptive discontinuation among women of reproductive age. Crude odds ratios and adjusted odds ratios with 95% confidence intervals were estimated using binary logistic regression.

Results

About 33.26% of the women discontinued injectables, 19.15% discontinued pills and 3.77% discontinued other contraception methods. Women aged 20–24 [aOR = 2.12, CI = [= [1.04,4.31] through to those aged 30–34 [aOR = 1.98, CI = 1.03,3.79] had higher odds to discontinue contraceptive usage compared to those aged 45–49. Women with no information on choice of contraception [aOR = 2.85, CI = 2.31,3.51], those with two or more births in the last five years [aOR = 2.35, CI = 1.65,3.35] and those living in the Highland region [aOR = 1.71, CI = 1.28,2.29] were more likely to discontinue contraceptive usage compared with those with information on contraceptive choices, those with no births and those living in the Island region respectively. However, women in the rural areas [aOR = 0.78, CI = 0.61,0.99], women using LARC [aOR = 0.10, CI = 0.06,0.15], injectables [aOR = 0.43, CI = 0.30,0.63] and other modern contraception methods including condom [aOR = 0.22, CI = 0.15,0.34] were less likely to discontinue contraceptive usage.

Conclusion

A nationwide mass education on the benefits of contraception is recommended for the Papua New Guinea National Department of Health to tackle the key findings of this study which were high contraceptive discontinuation prevalence with lack of information on choice, disproportionately high contraceptive discontinuation rate in the Highland Region and the desire to give birth to more than two children as some factors associated with contraceptive discontinuation in Papua New Guinea.
A practical ‘How-To’ Guide to plain language summaries (PLS) of peer-reviewed scientific publications: results of a multi-stakeholder initiative utilizing co-creation methodology
Authors: Dormer Laura , Schindler Thomas , Williams Lauri Arnstein , Lobban Dawn , Khawaja Sheila , Hunn Amanda , Ubilla Daniela Luzuriaga , Sargeant Ify , Hamoir Anne-Marie
Published: June 2022

Background

Peer-reviewed scientific publications and congress abstracts are typically written by scientists for specialist audiences; however, patients and other non-specialists are understandably interested in the potential implications of research and what they may mean for them. Plain language summaries (PLS)—summaries of scientific articles in easy-to-read language—are emerging as a valuable addition to traditional scientific publications. Co-creation of PLS with the intended audience is key to ensuring a successful outcome, but practical guidance on how to achieve this has been lacking.

Methods

Building on the Patient Engagement (PE) Quality Guidance previously developed by Patient Focused Medicines Development (PFMD), a multi-stakeholder working group (WG) of individuals with patient engagement experience and/or expertise in PLS was established to develop further activity-specific guidance. PLS guidance was developed through a stepwise approach that included several rounds of co-creation, public consultation (two rounds), internal review and a final external review. The iterative development process incorporated input from a wide variety of stakeholders (patient representatives, industry members, publishers, researchers, medical communications agencies, and public officials involved in research bodies). Feedback from each step was consolidated by the WG and used for refining the draft guidance. The final draft was then validated through external consultation.

Results

The WG comprised 14 stakeholders with relevant experience in PE and/or PLS. The WG developed a set of 15 ethical principles for PLS development. These include the necessity for objective reporting and the absence of any promotional intent, the need for balanced presentation, the importance of audience focus, the need to apply health literacy principles, and the importance of using inclusive and respectful language. The first public consultation yielded 29 responses comprising 478 comments or edits in the shared draft guidance. The second public consultation was an online survey of 14 questions which had 32 respondents. The final ‘How-To’ Guide reflects feedback received and provides a rational, stepwise breakdown of the development of PLS.

Conclusions

The resulting ‘How-To’ Guide is a standalone, practical, ready-to-use tool to support multi-stakeholder co-creation of PLS.
Arthritis-associated osteoclastogenic macrophage, AtoM, as a key player in pathological bone erosion
Authors: Agemura Tomoya , Hasegawa Tetsuo , Yari Shinya , Kikuta Junichi , Ishii Masaru
Published: June 2022

Osteoclasts are myeloid lineage cells with a unique bone-destroying ability that maintains bone homeostasis together with bone formation by osteoblasts. An advanced intravital imaging system using a two-photon microscopy has enabled the observation and evaluation of osteoclast dynamics and behaviors in the bone marrow of living mice. Using this system, it has become clear that pathological osteoclasts under inflamed conditions differ from physiological osteoclasts under a steady-state. Recently, we identified novel osteoclast precursors in arthritis, called arthritis-associated osteoclastogenic macrophages (AtoMs), which differentiate into pathological osteoclasts and induce inflammatory bone destruction. In this review, we introduce the in vivo imaging of physiological and pathological osteoclasts and their differentiation mechanism.