bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic ultrasound versus injection of local anesthetic in the treatment of women with chronic pelvic pain secondary to abdominal myofascial syndrome: a randomized clinical trial
Authors: Baltazar Maria Carolina Dalla Vecchia , Russo Jéssica Aparecida de Oliveira , De Lucca Victória , Mitidieri Andréia Moreira de Souza , da Silva Ana Paula Moreira , Gurian Maria Beatriz Ferreira , Poli-Neto Omero Benedicto , Rosa-e-Silva Júlio César
Published: August 2022

Background

Chronic pelvic pain (CPP) is defined as recurrent or continuous pain in the lower abdomen or pelvis, either non-menstrual or noncyclical, lasting for at least 6 months. There is strong evidence that up to 85% of patients with CPP have serious dysfunctions of the musculoskeletal system, including abdominal myofascial pain syndrome (AMPS). AMPS is characterized by intense and deep abdominal pain, originating from hyperirritable trigger points, usually located within a musculoskeletal band or its lining fascia. In the literature, there are few studies that address AMPS.

Objectives

To evaluate and compare the efficacy of therapeutic ultrasound (TUS) and injection of local anesthetic (IA) to improve pain in women with abdominal myofascial syndrome secondary to CPP.

Study design

Randomized controlled clinical trial.

Setting

Tertiary University Hospital.

Materials and methods

A randomized clinical trial was conducted, patients were allocated to two types of treatment: group TUS (n = 18), and group IA (n = 20). The instruments used for evaluation and reassessment were the Visual Analog Scale, Numerical Categorical Scale, McGill Pain Questionnaire, and SF-36 quality of life assessment questionnaire. They were evaluated before starting treatment, 1 week after the end of treatment, and at 1, 3, and 6 months.

Results

TUS and IA were effective in reducing clinical pain and improving quality of life through the variables analyzed among study participants. There was no significant difference between groups.

Limitations: absence of blinding; exclusion of women with comorbidities and other causes of CPP, the absence of a placebo group, the difference between the number of sessions used for each technique, and the COVID-19.

Conclusion

Treatment with TUS and IA were effective in reducing clinical pain and improving quality of life in women with AMPS secondary to CPP.

Trail registration

We declare that this clinical trial has been registered under the number [(ReBEC) no. RBR-39czsv] on 07/18/2018 in the Brazilian Registry of Clinical Trials.
Does access to no-cost contraception change method selection among individuals who report difficulty paying for health-related care?
Authors: Gero Alexandra , Simmons Rebecca G. , Sanders Jessica N. , Turok David K.
Published: August 2022

Background

Out-of-pocket costs continue to be a barrier to accessing necessary healthcare services, including contraception. We explored how eliminating out-of-pocket cost affects contraceptive method choice among people reporting difficulty paying for healthcare in the previous year, and whether method satisfaction differed by method choice.

Methods

We used data from the HER Salt Lake Contraceptive Initiative. This prospective cohort study provided participants with no-cost contraception (April 2016–March 2017) following a control period that provided no reduction in cost for the contraceptive implant, a reduced price for the hormonal IUD, and a sliding scale that decreased to no-cost for the copper IUD (September 2015–March 2016). We restricted the study population to those who reported difficulty paying for healthcare in the past 12 months. For our primary outcome assessing changes in method selection between intervention and control periods, we ran simultaneous multivariable logistic regression models for each method, applying test corrections for multiple comparisons. Among participants who continued their method for 1 year, we explored differences in method satisfaction using multivariable logistic regression.

Results

Of the 1,029 participants reporting difficulty paying for healthcare and controlling for other factors, participants more frequently selected the implant (aOR 6.0, 95% CI 2.7, 13.2) and the hormonal IUD (aOR 3.2, 95% CI 1.7, 5.9) during the intervention than control period. Comparing the same periods, participants less frequently chose the injection (aOR 0.5, 95% CI 0.3, 0.8) and the pill (aOR 0.4, 95% CI 0.3, 0.6). We did not observe a difference in uptake of the copper IUD (aOR 2.0, 95% CI 1.0, 4.1).Contraceptive satisfaction scores differed minimally by contraceptive method used among contraceptive continuers (n = 534). Those who selected LNG IUDs were less likely to report low satisfaction with their method (aOR 0.5, 95% CI 0.3, 0.97).

Conclusion

With costs removed, participants who reported difficulty paying for healthcare were more likely to select hormonal IUDs and implants and less likely to select the injectable or contraceptive pills. Among continuers, there were few differences in method satisfaction.

ClinicalTrials.gov Identifier NCT02734199
Rural-urban correlates of modern contraceptives utilization among adolescents in Zambia: a national cross-sectional survey
Authors: Sserwanja Quraish , Musaba Milton W. , Mutisya Linet M. , Mukunya David
Published: August 2022

Background

Modern contraceptive use among adolescents is low despite the adverse effects of adolescent pregnancies. Understanding correlates of modern contraceptive use in different settings is key to the design of effective context-specific interventions. We aimed to determine factors associated with modern contraceptives use among adolescents in rural and urban settings of Zambia.

Methods

We analyzed secondary data from 2018 Zambia demographic and health survey (ZDHS) focusing on adolescent girls aged 15–19 years. We used multivariable logistic regression in SPSS version 25 to examine rural-urban variations in factors associated with modern contraceptive utilization.

Results

Overall, 12.0% (360/3000, 95% CI: 10.9–13.2) of adolescents in Zambia were using modern contraceptives. Use of modern contraceptives was higher in rural areas at 13.7% (230/1677, 95% CI: 12.1–15.3) compared to 9.8% (130/1323, 95% CI: 8.3–11.6) in urban areas. In the rural areas, having a child (aOR = 13.99; 95% CI 8.60–22.77), being married (aOR = 2.13; 95% CI 1.42–3.18), being older at 19 years (aOR = 3.90; 95% CI 1.52–10.03), having been visited by a field health worker (aOR = 1.62; 95% CI 1.01–2.64), having been exposed to family planning messages on mass media (aOR = 2.87; 95% CI 1.01–8.18) and belonging to the richest wealth quintile (aOR = 2.27; 95% CI 1.43–3.62) were associated with higher odds of contraceptive utilization. Furthermore, adolescents in the Northern (aOR = 0.29; 95% CI 0.11–0.80) and Luapula (aOR = 0.35; 95% CI 0.15–0.81) provinces were associated with less odds of utilizing contraceptives compared to those in Western province. In the urban areas, older age at 19 years (aOR = 4.80; 95% CI 1.55–14.84) and having a child (aOR = 18.52; 95% CI 9.50–36.14) were the only factors significantly associated with modern contraceptive utilization.

Conclusion

Age and having a child were associated with modern contraceptive use in both rural and urban areas. In rural areas (province, marital status, being visited by field health workers, family planning messages exposure and wealth index) were the only associated factors. This indicates that interventions aiming to increase contraceptive utilization should be context specific.
Baseline assessment of staff perception of critical value practices in government hospitals in Kuwait
Authors: ALFadhalah Talal , Al Mudaf Buthaina , Al Tawalah Haya , Al Fouzan Wadha A. , Al Salem Gheed , Alghanim Hanaa A. , Ibrahim Samaa Zenhom , Elamir Hossam , Al Kharji Hamad
Published: August 2022

Background

Notification of laboratory-determined critical values is key for effective clinical decision making and is thus a consequential step in a patient’s health care and safety. This study presents an overview of staff reporting policies and procedures concerning critical values in Kuwaiti governmental hospitals.

Methods

A cross-sectional descriptive study design was adopted. Study subjects were affiliated with laboratories from five government hospitals (four general and one sub-specialty hospital). All laboratory staff in every hospital were included. The Statistical Package for the Social Sciences (version 23) was used to analyse the collected data at a significance level of ≤ 0.05. Quantitative data analysis included univariate descriptive (means, medians, standard deviations, frequencies, percentages) and bivariate (chi-squared, ANOVA and Kruskal–Wallis tests) analyses. These analyses provided associations between participating hospitals and staff perceptions towards the policies and procedures surrounding critical values.

Results

559 questionnaires were returned, a total response of 30.5% after those of 79 phlebotomists were excluded (eligible sample size n = 1833). The notification of critical values differs between participated laboratories in delivering protocol and time duration. Linked protocols between laboratories did not exist regarding policies and guidelines for applying the same procedures for critical value notification. There are differences in critical value limits among the participating laboratories.

Conclusion

This study is the first to survey laboratory staff perceptions of critical value practices in Kuwaiti government hospitals. Enhancing critical value reporting and policy is crucial for improving patient safety and to develop high-quality health services. The findings of this study can help policy makers implement future intervention studies to enhance laboratory practices in the area of critical values and improve patient safety and the quality of government hospital systems.
TRIM18 is a critical regulator of viral myocarditis and organ inflammation
Authors: Fang Mingli , Zhang Ao , Du Yong , Lu Wenting , Wang Junying , Minze Laurie J. , Cox Timothy C. , Li Xian Chang , Xing Junji , Zhang Zhiqiang
Published: July 2022

Background

Infections by viruses including severe acute respiratory syndrome coronavirus 2 could cause organ inflammations such as myocarditis, pneumonia and encephalitis. Innate immunity to viral nucleic acids mediates antiviral immunity as well as inflammatory organ injury. However, the innate immune mechanisms that control viral induced organ inflammations are unclear.

Methods

To understand the role of the E3 ligase TRIM18 in controlling viral myocarditis and organ inflammation, wild-type and Trim18 knockout mice were infected with coxsackievirus B3 for inducing viral myocarditis, influenza A virus PR8 strain and human adenovirus for inducing viral pneumonia, and herpes simplex virus type I for inducing herpes simplex encephalitis. Mice survivals were monitored, and heart, lung and brain were harvested for histology and immunohistochemistry analysis. Real-time PCR, co-immunoprecipitation, immunoblot, enzyme-linked immunosorbent assay, luciferase assay, flow cytometry, over-expression and knockdown techniques were used to understand the molecular mechanisms of TRIM18 in regulating type I interferon (IFN) production after virus infection in this study.

Results

We find that knockdown or deletion of TRIM18 in human or mouse macrophages enhances production of type I IFN in response to double strand (ds) RNA and dsDNA or RNA and DNA virus infection. Importantly, deletion of TRIM18 protects mice from viral myocarditis, viral pneumonia, and herpes simplex encephalitis due to enhanced type I IFN production in vivo. Mechanistically, we show that TRIM18 recruits protein phosphatase 1A (PPM1A) to dephosphorylate TANK binding kinase 1 (TBK1), which inactivates TBK1 to block TBK1 from interacting with its upstream adaptors, mitochondrial antiviral signaling (MAVS) and stimulator of interferon genes (STING), thereby dampening antiviral signaling during viral infections. Moreover, TRIM18 stabilizes PPM1A by inducing K63-linked ubiquitination of PPM1A.

Conclusions

Our results indicate that TRIM18 serves as a negative regulator of viral myocarditis, lung inflammation and brain damage by downregulating innate immune activation induced by both RNA and DNA viruses. Our data reveal that TRIM18 is a critical regulator of innate immunity in viral induced diseases, thereby identifying a potential therapeutic target for treatment.
β-Elemene alleviates cisplatin resistance in oral squamous cell carcinoma cell via inhibiting JAK2/STAT3 pathway in vitro and in vivo
Authors: Wang Haiye , Ma Yingyi
Published: July 2022

Objective

To investigate the effect of β-Elemene (β-Ele) on the cisplatin sensitivity of OSCC cells and its mechanism in vitro and in vivo.

Methods

The human OSCC cell lines Tca-8113 and the cisplatin-resistant cell line Tca-8113-CDDP were cultured with β-Ele or/and cisplatin. The cytotoxicity of cisplatin or β-Ele, cell viability, cell cycles and apoptosis were detected. And the expression of JAK2/STAT3 related protein were detected. The xenograft tumor model of OSCC was established in nude mice and treated with cisplatin and/or β-Ele. The volume and weight of the transplanted tumor was measured, and the expression of p-JAK2 and p-STAT3 and cell apoptosis in the xenograft tumor tissues were detected.

Results

The combination of β-Ele and cisplatin significantly suppressed the cell proliferation, induced cell cycle arrest, promoted the apoptosis of Tca-8113-CDDP cells, and suppressed the activation of JAK2/STAT3 signaling pathway. The rescue experiments suggested that β-Ele enhanced cisplatin sensitivity via down-regulating JAK2/STAT3 signaling pathway. In vivo, β-Ele and cisplatin synergistically suppressed the tumor growth and induced apoptosis, and down-regulated the expression of p-JAK2 and p-STAT3.

Conclusions

β-Ele inhibits the cell viability and enhances the cisplatin sensitivity of OSCC by blocking the activation of JAK/STAT3 signaling pathway in vitro and in vivo, and the combination of β-Ele and cisplatin maybe a novel treatment for OSCC.
Dancing in local space: rolling hoop orbital amplification combined with local cascade nanozyme catalytic system to achieve ultra-sensitive detection of exosomal miRNA
Authors: Gao Xin , Wu Haiping , Li Yujian , Zhang Lu , Song Mingxuan , Fu Xuhuai , Chen Rui , Ding Shijia , Zeng Jiawei , Li Jia , Liu Ping
Published: August 2022

The exosomal miRNA (exo-miRNA) derived from tumor cells contains rich biological information that can effectively aid in the early diagnosis of disease. However, the extremely low abundance imposes stringent requirements for accurate detection techniques. In this study, a novel, protease-free DNA amplification strategy, known as “Rolling Hoop Orbital Amplification” (RHOA), was initially developed based on the design concept of local reaction and inspired by the childhood game of rolling iron ring. Benefiting from the local space constructed by the DNA orbital, the circular DNA enzyme rolls directionally and interacts efficiently with the amplification element, making it nearly 3-fold more productive than conventional free-diffusion amplification. Similarly, the localized cascade nanozyme catalytic system formed by bridging DNA probes also exhibits outperformed than free ones. Therefore, a localized energized high-performance electrochemiluminescence (ECL) biosensor was constructed by bridging cascading nanozymes on the electrode surface through DNA probes generated by RHOA, with an impressive limit of detection (LOD) of 1.5 aM for the detection of exosomal miRNA15a-5p and a stable linearity over a wide concentration range from 10− 2 to 108 fM. Thus, this work is a focused attempt at the localized reaction, which is expected to provide a reliable method for accurately detecting of exo-miRNAs.

Graphical Abstract
Development of shortened HIV-related stigma scales for young people living with HIV and young people affected by HIV in India
Authors: Marbaniang Ivan , Borse Rohidas , Sangle Shashikala , Kinikar Aarti , Chavan Amol , Nimkar Smita , Suryavanshi Nishi , Mave Vidya
Published: July 2022

Background

HIV-related stigma is associated with poor quality of life and poor healthcare-seeking behaviours in young people living with HIV (YPLHIV) and young people affected by HIV (YPAHIV). India has an estimated 120,000 YPLHIV and 4 million YPAHIV, but efforts to measure HIV-related stigma in them are sparse, impeded by the lack of measuring instruments. Here, we describe the development of the Pune HIV-Stigma Scale (PHSS) and modified-PHSS to measure HIV-related stigma among YPLHIV and YPAHIV, respectively, in India.

Methods

We used data from a mental health study for YPLHIV and YPAHIV aged 15–25 years, conducted at Byramjee Jeejeebhoy Government Medical College & Sassoon General Hospitals, Pune, India, between August 2018 and June 2021. Findings from multiple confirmatory factor analyses and cognitive interviews guided the development of the 12-item PHSS. The modified-PHSS was developed by confirming the structure of the PHSS for YPAHIV. Convergent validity with Center for Epidemiological Studies Depression (CES-D) and UCLA Loneliness scales was assessed using Spearman’s correlation coefficients.

Results

Model fit indices were good for both the PHSS (χ2 = 65.0, df = 48, p value: 0.052; root mean square error of approximation (RMSEA): 0.054; comparative fit index (CLI): 0.980; Tucker–Lewis index (TLI): 0.972; and standardized root mean square residual (SRMR): 0.067), and the modified-PHSS (χ2 = 56.9, df = 48, p value: 0.176; RMSEA: 0.045; CLI: 0.983; TFI: 0.976, and SRMR: 0.078). Spearman’s correlation coefficients indicated low to moderate convergent validity (ρ: 0.03–0.52) across different subscales of the PHSS and modified-PHSS. Cronbach’s alpha for the PHSS was 0.82 and for the modified-PHSS 0.81.

Conclusion

We developed the first scales to measure HIV-related stigma among YPLHIV and YPAHIV in India. These concise scales can facilitate measurement of HIV-related stigma more frequently in research studies. We recommend that they be tested in different Indian languages.
IGF2BP1-regulated expression of ERRα is involved in metabolic reprogramming of chemotherapy resistant osteosarcoma cells
Authors: He Qing , Hao Peng , He Gang , Mai Hantao , Liu Wenzhou , Zhang Weiqiong , Zhang Kelin , Zhong Guifang , Guo Ruilian , Yu Changzhi , Li Yang , Wong Chipiu , Chen Qian , Chen Yantao
Published: August 2022

Doxorubicin (Dox) is the standard treatment approach for osteosarcoma (OS), while acquired drug resistance seriously attenuates its treatment efficiency. The present study aimed to investigate the potential roles of metabolic reprogramming and the related regulatory mechanism in Dox-resistant OS cells. The results showed that the ATP levels, lactate generation, glucose consumption and oxygen consumption rate were significantly increased in Dox-resistant OS cells compared with parental cells. Furthermore, the results revealed that the increased expression of estrogen-related receptor alpha (ERRα) was involved in metabolic reprogramming in chemotherapy resistant OS cells, since targeted inhibition of ERRα restored the shifting of metabolic profiles. Mechanistic analysis indicated that the mRNA stability, rather than ERRα transcription was markedly increased in chemoresistant OS cells. Therefore, it was hypothesized that the 3ʹ-untranslated region of ERRα mRNA was methylated by N6-methyladenine, which could further recruit insulin-like growth factor 2 mRNA binding protein 1 (IGF2BP1) to suppress mRNA decay and increase mRNA stability. IGF2BP1 knockdown downregulated ERRα and reversed the metabolic alteration of resistant OS cells. Additionally, the oncogenic effect of the IGF2BP1/ERRα axis on Dox-resistant OS cells was verified by in vitro and in vivo experiments. Clinical analysis also revealed that the expression levels of IGF2BP1 and ERRα were associated with the clinical progression of OS. Collectively, the current study suggested that the IGF2BP1/ERRα axis could regulate metabolic reprogramming to contribute to the chemoresistance of OS cells.
What is polypharmacy in people living with HIV/AIDS? A systematic review
Authors: Danjuma Mohammed Ibn-Mas’ud , Khan Safah , Wahbeh Farah , Naseralallah Lina Mohammad , Jumbo Unwam E. , Elzouki Abdelnaser
Published: August 2022

Polypharmacy in people living with HIV/AIDS (PLWHA) is a rising morbidity that exacts hefty economic burden on health budgets in addition to other adverse clinical outcomes. Despite recent advances, uncertainty remains around its exact definition in PLWHA. In this systematic review and Meta-analysis, we explored relevant databases (PUBMED, EMBASE, CROI) for studies evaluating polypharmacy in PLWHA from January 2000 to August 2021 to ascertain the exact numerical threshold that defines this morbidity. Two independent reviewers extracted and reviewed relevant variables for analyses. The review included a total of 31 studies involving n = 53,347 participants with a mean age of 49.5 (SD ± 17.0) years. There was a total of 36 definitions, with 93.5% defining polypharmacy as the concomitant use of 5 or more medications. We found significant variation in the numerical definition of polypharmacy, with studies reporting it as “minor” (N = 3); “major” (N = 29); “severe” (N = 2); “excessive” (N = 1); and “higher” (N = 1). Most studies did not incorporate a duration (84%) in their definition and excluded ART medications (67.7%). A plurality of studies in PLWHA have established that polypharmacy in this cohort of patients is the intake of ≥ 5 medications (including both ART and non-ART). To standardize the approach to addressing this rising morbidity, we recommend incorporation of this definition into national and international PLWHA treatment guidelines.
Identification of stage-related and severity-related biomarkers and exploration of immune landscape for Dengue by comprehensive analyses
Authors: Xiong Nan , Sun Qiangming
Published: August 2022

Background

At present, there are still no specific therapeutic drugs and appropriate vaccines for Dengue. Therefore, it is important to explore distinct clinical diagnostic indicators.

Methods

In this study, we combined differentially expressed genes (DEGs) analysis, weighted co-expression network analysis (WGCNA) and Receiver Operator Characteristic Curve (ROC) to screen a stable and robust biomarker with diagnosis value for Dengue patients. CIBERSORT was used to evaluate immune landscape of Dengue patients. Gene Ontology (GO) enrichment, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and Gene set enrichment analysis (GSEA) were applied to explore potential functions of hub genes.

Results

CD38 and Plasma cells have excellent Area Under the Curve (AUC) in distinguishing clinical stages for Dengue patients, and activated memory CD4+ T cells and Monocytes have good AUC for this function. ZNF595 has acceptable AUC in discriminating dengue hemorrhagic fever (DHF) from dengue fever (DF) in whole acute stages. Analyzing any serotype, we can obtain consistent results. Negative inhibition of viral replication based on GO, KEGG and GSEA analysis results, up-regulated autophagy genes and the impairing immune system are potential reasons resulting in DHF.

Conclusions

CD38, Plasma cells, activated memory CD4+ T cells and Monocytes can be used to distinguish clinical stages for dengue patients, and ZNF595 can be used to discriminate DHF from DF, regardless of serotypes.

Graphical abstract
Application of the sliding window method and Mask-RCNN method to nuclear recognition in oral cytology
Authors: Mitate Eiji , Inoue Kirin , Sato Retsushi , Shimomoto Youichi , Ohba Seigo , Ogata Kinuko , Sakai Tomoya , Ohno Jun , Yamamoto Ikuo , Asahina Izumi
Published: August 2022

Background

We aimed to develop an artificial intelligence (AI)-assisted oral cytology method, similar to cervical cytology. We focused on the detection of cell nuclei because the ratio of cell nuclei to cytoplasm increases with increasing cell malignancy. As an initial step in the development of AI-assisted cytology, we investigated two methods for the automatic detection of cell nuclei in blue-stained cells in cytopreparation images.

Methods

We evaluated the usefulness of the sliding window method (SWM) and mask region-based convolutional neural network (Mask-RCNN) in identifying the cell nuclei in oral cytopreparation images. Thirty cases of liquid-based oral cytology were analyzed. First, we performed the SWM by dividing each image into 96 × 96 pixels. Overall, 591 images with or without blue-stained cell nuclei were prepared as the training data and 197 as the test data (total: 1,576 images). Next, we performed the Mask-RCNN by preparing 130 images of Class II and III lesions and creating mask images showing cell regions based on these images.

Results

Using the SWM method, the highest detection rate for blue-stained cells in the evaluation group was 0.9314. For Mask-RCNN, 37 cell nuclei were identified, and 1 cell nucleus was identified as a non-nucleus after 40 epochs (error rate:0.027).

Conclusions

Mask-RCNN is more accurate than SWM in identifying the cell nuclei. If the blue-stained cell nuclei can be correctly identified automatically, the entire cell morphology can be grasped faster, and the diagnostic performance of cytology can be improved.
Efficacy of cognitive remediation on activities of daily living in individuals with mild cognitive impairment or early-stage dementia: a systematic review and meta-analysis
Authors: Tulliani Nikki , Bissett Michelle , Fahey Paul , Bye Rosalind , Liu Karen P. Y.
Published: August 2022

Introduction

Instrumental activities of daily living are essential for ageing well and independent living. Little is known about the effectiveness of cognitive remediation on instrumental activities of daily living performance for individuals with mild cognitive impairment or early-stage dementia. The objective of this study was to evaluate the immediate and long-term carryover effects of cognitive remediation on improving or maintaining instrumental activities of daily living performance in older adults with mild cognitive impairment and early-stage dementia.

Methods

Randomized controlled trials published from 2009 to 2022 were identified in OvidSP versions of MEDLINE and Embase, EBSCO versions of CINAHL and PsycINFO, and the Cochrane Central Register of Controlled Trials. A narrative synthesis of the findings was reported on the outcomes of the included studies. Relevant data was extracted and analysed using R software’s ‘metafor’ package with a random effect model with 95% CI.

Results

Thirteen studies, totalling 1414 participants, were identified in the narrative analysis. The results of meta-analysis, inclusive of 11 studies, showed that cognitive remediation elicited a significant improvement in the instrumental activities of daily living performance (SMD: 0.17, 95% CI 0.03–0.31). There was insufficient evidence of any lasting effect.

Discussion

Cognitive remediation is effective in improving instrumental activities of daily living performance immediately post-intervention in older adults with mild cognitive impairment and early-stage dementia. It appears that individualized interventions with a short duration, such as 10 hours, might be beneficial.

Systematic review registration

PROSPERO CRD42016042364
Developing and evaluating a pollination systems knowledge assessment in a multidisciplinary course
Authors: Jimenez P. Citlally , Golick Doug , Couch Brian A. , Dauer Jenny M.
Published: August 2022

Background

Although pollinators play an integral role in human well-being, their continued global decline reflects the need to provide and evaluate general pollinator knowledge to promote their conservation. Enhancing learners’ understanding of the complexity inherent in pollination systems within the science classroom may help them make more informed decisions regarding pollinator conservation actions. By measuring conceptual understanding of pollination systems, science educators can identify learners’ knowledge needs and inform their teaching in science classrooms. Based on previously developed theoretical frameworks describing pollination systems knowledge, we created and evaluated a new instrument to assess pollination systems and conservation actions knowledge. The Pollination Systems Knowledge Assessment (PSKA) is a multiple-true–false instrument containing 18 question stems and 70 accompanying T–F items encompassing three organizational components of pollination knowledge regarding (1) plant structures, (2) pollinator structures and behaviors, and (3) pollination systems function and pollinator conservation.

Results

We refined the PSKA based on expert discussions, think-aloud interviews, and pilot testing before and after presenting a wild pollinator conservation unit within a postsecondary science literacy course. The PSKA elucidated learners’ misconceptions and revealed discriminating items from the three organizational components of pollination systems knowledge.

Conclusions

The PSKA may aid educators in exploring learners’ conceptual understanding, identifying areas of misconceptions, and refining educational programming aimed at improving learners’ pollination systems knowledge.
Effect of short-term educational intervention on complementary feeding index among infants in rural Bangladesh: a randomized control trial
Authors: Rahman Aminur , Bhuiyan Mohammad Badrul , Das Sumon Kumar
Published: August 2022

Background

Timely, adequate and appropriate Complementary Feeding (CF) is essential for the growth and cognitive development of infants, but until today, evidence-based information is scarce in terms of impact evaluation of CF index (CFI). The study aimed to examine the effect of the short-term intervention of promoting CF practices on the nutritional status of infants in rural Bangladesh.

Methods

An educational-intervention study followed a randomized controlled trial (RCT) design (NCT03024710). Mothers and family members in the intervention arm received intensive counselling on CF through community health workers (CHWs), whereas existing healthcare services were received in the comparison arm. The study was carried out in the rural Matlab sub-district of Bangladesh between April 2011 and March 2013. In the specified study areas among 360 mother-infant pairs systematically assigned into intervention group and comparison group. Short-term educational intervention on CF was provided for the intervention group and existing services were un-intervened for the comparison group. The outcome of interventions was evaluated after the implementation period using Generalized equation estimation model.

Results

At baseline, the study participants were not different except mean height (p = 0.04), weight-for-age Z score (WAZ) (p = 0.03) and religion (p = 0.04) in between two groups. The mean CFI was significantly higher at intervention area than the comparison and higher category of CFI (score 10 or more) was significantly higher at intervention area than comparison. After adjustment, one-unit CFI increased height-for-age z score by 0.07 units and decreased WAZ by 0.13 units in the intervention group but not significantly changed observed at comparison group.

Conclusion

Guided short-term nutritional intervention and developed CFI indicated a significantly better score in intervention area than comparison groups and would be a well adaptable tool for future studies.

Trial registration

The trial was registered (NCT03024710) at clinical trial registration website. Date of registration: 1/19/2017.

Name of the registry:Clinical Trial.gov.

Date of registration:19/1/2017 (retrospective registered).

URL of trial:https://clinicaltrials.gov/ct2/show/NCT03024710
Protocol of trans-Tasman feasibility randomised controlled trial of the Younger Women’s Wellness After Breast Cancer (YWWACP) lifestyle intervention
Authors: Sharples K. , Vear N. K. , Porter-Steele J. , Anderson D. J. , Moeke-Maxwell T. H. , Laing B. B. , Young L. , Bailey T. G. , Benge S. , Huang Y. , Crowley E. , Day R. , Cartwright R. , Findlay M. , Porter D. , Kuper M. , Campbell I. , McCarthy A. L.
Published: August 2022

Background

Younger women (defined as those < 50 years who are likely pre-menopausal at time of diagnosis) with breast cancer often experience persistent treatment-related side effects that adversely affect their physical and psychological wellbeing. The Women’s Wellness After Cancer Program (WWACP) was adapted and piloted in Australia to address these outcomes in younger women. The aims of this feasibility study are to determine (1) the potential to translate the Younger WWACP (YWWACP) intervention to a broader population base in Aotearoa/New Zealand and Australia, and (2) the potential for success of a larger, international, phase ΙΙΙ, randomised controlled trial.

Methods

This bi-national, randomised, single-blinded controlled trial involves two main study sites in Aotearoa/New Zealand (Kōwhai study) and Australia (EMERALD study). Young women aged 18 to 50 years who completed intensive treatment (surgery, chemotherapy, and/or radiotherapy) for breast cancer in the previous 24 months are eligible. The potential to translate the YWWACP to women in these two populations will be assessed according to several feasibility outcomes. These include examining intervention accessibility, acceptability and uptake; intervention sustainability and adherence; the prevalence components of the intervention in the control group; intervention efficacy; participants’ perception of measurement burden; the effectiveness of planned recruitment strategies; and trial methods and procedures. The studies collectively aim to enrol 60 participants in the intervention group and 60 participants in the control group (total = 120 participants).

Discussion

Ethical approval has been received from the Southern Health and Disability Ethics Committee (Kōwhai ref: 19/STH/215), and UnitingCare Human Research Ethics Committee (EMERALD ref: 202103). This study will provide important data on the feasibility of the refined YWWACP in the trans-Tasman context. This study will account for and harmonise cross-country differences to ensure the success of a proposed international grant application for a phase ΙΙΙ randomised controlled trial of this program to improve outcomes in younger women living with breast cancer.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR): Kōwhai ACTRN12620000260921, registered on 27 February 2020. EMERALD ACTRN12621000447853, registered on 19 April 2021.
Co-designing a cancer care intervention: reflections of participants and a doctoral researcher on roles and contributions
Authors: Tanay Mary Anne Lagmay , Armes Jo , Oakley Catherine , Sage Lesley , Tanner Deb , Roca Jose , Bryson Liz , Greenall Barbara , Urwin Lauren , Wyatt Toni , Robert Glenn
Published: August 2022

Background

Patient and Public Involvement is most usually framed in the context of designing, conducting and/or disseminating research. Participatory methods such as Experience-Based Co-Design (EBCD) further allow service users to directly engage in developing, testing and implementing interventions and services alongside healthcare staff. This paper aims to explore how participants in an EBCD project came—over time—to perceive their role and involvement in co-designing a cancer care intervention.

Methods

The findings are based on our reflections, a research diary, email correspondence and fieldnotes from co-design events. Co-design participants who attended most of the ten co-design events took part through written reflections or audio-recorded video calls. Ten reflective pieces were collected from clinicians (n = 4), PPI group members/patient participants (n = 4), a doctoral researcher (n = 1) and a visual illustrator (n = 1). Inductive data analysis of participant reflections was carried out using reflexive thematic analysis. Meeting fieldnotes, email correspondence and the researcher’s diary were deductively analysed using the initial themes generated from this inductive analysis.

Results

Five main themes were identified: (1) changing perception of roles during the co-design process, (2) defining a ‘co-designer’, (3) engagement and ownership, (4) role of the research facilitator in maintaining momentum, and (5) perceived benefits of involvement.

Conclusion

Our findings show the changing perceptions of roles and contributions among participants over time. Patients typically described their role as co-designers in terms simply of sharing their experiences. In contrast, clinicians perceived themselves as co-designers because they were working with patients who were actively involved in decision-making. Levels of engagement were affected by several factors such as time and facilitation, but most participants came to view themselves as co-owners of the intervention. Overall, participants perceived their involvement as a positive experience with clinicians also reporting wider positive impacts on their clinical practice.
Intravitreal aflibercept for the treatment of patients with diabetic macular edema in routine clinical practice in Latin America: the AQUILA study
Authors: Rodríguez Francisco J. , Wu Lihteh , Bordon Arnaldo F. , Charles Martin , Lee JinKyung , Machewitz Tobias , Mueller Margarete , Gay Gabriela del Carmen , Fromow-Guerra Jans ,   the AQUILA Investigators, Reinhart Marcelo , Caride Gastón Gómez , Negri Herminio , Galván Gerónimo , Irungaray Juan , Irós Mariano , Vidosevich Matko , Rivero Noe , Zompa Tamara , Francos Juan Pablo , Salgado Paula , Caceres Barrios Gerardo , Regnasco Octavio , Rodríguez Francisco J. , Piñeros Hildegard , Arias Juan , Buendia Javier , Navarro Naranjo Gustavo Adolfo , Endo Beatriz , Hernandez Myrian , Wu Lihteh , Evans Tinoco Teodoro , Garcia Gerardo , Padilla Andres , Gómez Cespedes Adriana , Dalma Jose , Cano Rene , Fromow-Guerra Jans , Saldaña Natalia , Jimenez Juan Manuel , García Franco Renata del Carmen , Solis Vivanco Adriana , Hernandez Vazquez Angeles Yael
Published: August 2022

Background

AQUILA (NCT03470103) was a prospective, observational, 12-month cohort study to understand treatment patterns and to evaluate the clinical effectiveness and safety of intravitreal aflibercept (IVT-AFL) in patients from Latin America with diabetic macular edema (DME).

Methods

Treatment-naïve and previously treated (switching to IVT-AFL) patients (aged ≥ 18 years) were enrolled from March 2018, with a primary completion date of September 2020, from Argentina, Colombia, Costa Rica and Mexico. Patients received IVT-AFL in a routine clinical practice setting.

Results

Of 258 patients in the full analysis set, 181 were treatment-naïve and 77 had received previous treatment. The mean ± standard deviation number of IVT-AFL injections by Month 12 was 3.7 ± 1.8 (treatment-naïve) and 4.0 ± 2.2 (previously treated). The median duration from diagnosis to IVT-AFL treatment was 1.8 months (treatment-naïve) and 16.0 months (previously treated). Mean best-corrected visual acuity (Early Treatment Diabetic Retinopathy Study letters) improved from baseline to Month 12 by + 8.1 ± 17.7 (treatment-naïve; baseline: 54.5 ± 19.4) and + 4.6 ± 15.4 letters (previously treated; baseline: 52.9 ± 18.6).

Conclusion

AQUILA is the first study to assess the use of IVT-AFL in routine clinical practice in Latin America. Despite few patients being treated with the label-recommended regimen of 5 initial monthly doses or receiving ≥ 8 injections in 12 months, functional and anatomic visual outcomes improved during 12 months of treatment with IVT-AFL. Patients receiving the label-recommended number of injections had numerically greater improvements in visual acuity outcomes. Patients with DME treated regularly and more frequently with IVT-AFL therefore have the potential to achieve outcomes consistent with those observed in interventional studies.

Trial registration Clinicaltrials.gov, NCT03470103. Registered February 5, 2018, https://clinicaltrials.gov/ct2/show/NCT03470103
Long-term peripheral retinal vascular behavior in retinopathy of prematurity patients treated with ranibizumab intravitreal injection as monotherapy using fluorescein angiography
Authors: Al Rasheed Raghad , Adhi Mohammad Idrees , Alowedi Sarah Abdullah , Albdah Bayan , Aldebasi Tariq , Hazzazi Mohammad A.
Published: August 2022

Background

Few challenges are faced with the introduction of anti-VEGF agents as a modality of treatment for retinopathy of prematurity. The clinical behavior and time course of regression post injection differ compared to post laser ablation. This study aims to evaluate the long-term peripheral retinal vascularization outcome of Ranibizumab intravitreal injections monotherapy in the treatment of retinopathy of prematurity.

Method

Hospital-based quasi-experimental study. Include ROP patients who received intravitreal ranibizumab (IVR), as primary treatment for type 1 ROP. Patients were examined under general anaesthesia to ensure documentation of all junctions of vascular and avascular zones. Images were taken by RetCam III, Phoenix ICON and fluorescein angiography was performed to describe vascular behaviors.

Results

The mean gestational age was 24.67 weeks and the mean postmenstrual age at the time of intravitreal ranibizumab treatment was 36.3 weeks. Fluorescein angiography was performed at 155–288 weeks; most eyes showed two disk diameters of avascular peripheral retina. Only eyes with original aggressive ROP who required a second injection (six eyes) showed extensive peripheral avascular retina reaching zone I (13.64%). Neovascularization was evident in five eyes (11.36%), all with an original aggressive ROP and received multiple injections.

Conclusions

Ranibizumab treated babies with incomplete retinal vascularization require close and long-term follow-up visits to assess post injection vascular behavior. Peripheral retinal avascular zone of more than two-disc diameters was present in most of the patients evidenced by fluorescein angiography. Babies with initial diagnosis of aggressive ROP are more likely to have persistent peripheral neovascularization.
Awareness of obstetric fistula and its associated factors among women of reproductive age in sub-Saharan Africa
Authors: Budu Eugene , Ahinkorah Bright Opoku , Okyere Joshua , Seidu Abdul-Aziz , Aboagye Richard Gyan , Yaya Sanni
Published: August 2022

Background

Awareness about obstetric fistula and its concomitant factors is central to efforts to eliminate obstetric fistula in sub-Saharan Africa. We, therefore, assessed the magnitude of obstetric fistula awareness and its associated factors among women of reproductive age in sub-Saharan Africa.

Methods

Data for the study were extracted from the most recent Demographic and Health Surveys of 14 countries in sub-Saharan Africa. We included 185,388 women aged 15–49 years in this study. Percentages were used to summarise the prevalence of obstetric fistula awareness across the 14 countries studied. We adopted a multivariable multilevel binary logistic regression to examine the factors associated with obstetric fistula awareness in sub-Saharan Africa. We presented the results of the regression analysis using adjusted odds ratios with their 95% confidence intervals. Statistical significance was set at p < 0.05.

Results

The average prevalence of obstetric fistula awareness was 37.9%, ranging from 12.8% in Gambia to 63.9% in Uganda. Awareness of obstetric fistula was low among never married and cohabiting women compared to married women. Compared with women with parity 4 or more, those with no birth had the lowest odds of obstetric fistula awareness. The study also showed that obstetric fistula awareness was lower among women who were working, those who are not exposed to mass media, those in the poorest wealth category, those who have never had sex, and those in communities with low literacy level. The study however found that the odds of obstetric fistula awareness increased with age and education, and was higher in urban areas compared to rural areas. Women, who had ever terminated a pregnancy were more likely to be aware of obstetric fistula compared to those who had never terminated a pregnancy.

Conclusion

The study demonstrated a low awareness of obstetric fistula among women in sub-Saharan Africa. Educative and sensitisation interventions should incorporate the factors identified in the present study during its implementation. To raise women’s awareness of obstetric fistula, there is the need for sub-Saharan African countries to consciously raise community literacy rate, increase access to mass media platforms and invest intensively in formal education for women.
Sexual and reproductive health knowledge and practices among youth with and without mental illness in Uganda: a comparative study
Authors: Tumwakire Emily , Ashaba Scholastic , Mubangizi Vincent , Gavamukulya Yahaya
Published: August 2022

Background

Sexual and reproductive health challenges among youth in low-income countries have persistently remained a public health challenge. In addition to these challenges, approximately 25% of youth experience a mental health illness, a situation anticipated to steeply increase especially in sub-Saharan Africa. However, there is still a scarcity of knowledge on the sexual and reproductive health of youth with mental illness in comparison to youth without mental illness in low-income countries. In this paper, the objective was to compare the sexual and reproductive health knowledge and practices among youth with mental illness and without mental illness at Mbarara Regional Referral Hospital (MRRH), South Western Uganda.

Methods

Using a cross-sectional comparative study design, 104 youth with mental illness and 101 youth without mental illness were recruited as they sought medical health care services at MRRH. Structured interviews were conducted and they covered sexual and reproductive health knowledge and sexual practices.

Results

205 youth were interviewed and of these 53 males and 51 females had mental illness while 49 males and 52 females did not have a mental illness. More youth without mental illness (61.7%) had more knowledge of sexual and reproductive health compared to youth with mental illness (38.3%) with a prevalence odds ratio of 0.29 (CI 0.16–0.52) and p value of 0.001. All youth were knowledgeable about contraceptive methods. Youth with MI engaged more in risky sexual practices though the difference wasn’t statistically significant.

Conclusions

Youth generally have low sexual and reproductive health knowledge and this was found to be significantly lower in youth with mental illness compared to those without mental illness and they generally tend to engage in risky sexual behavior. It is recommended to incorporate SRH services among the mainstream general youth health care and mental health care services is critical to reducing sexual and reproductive health challenges among youth.
Evaluation of the soldier's physical fitness test results (strength endurance) ın relation to genotype: longitudinal study
Authors: Yıldırım Damla Selin , Erdoğan Murat , Dalip Metin , Bulğay Celal , Cerit Mesut
Published: July 2022

Background

The aim of this study is to determine the effect of ACE gene polymorphism on the parameters studied (push-up & sit-up) in a long-term study, which has been carried out for many years and to find out whether the differences in ACE gene's metabolism due to the influence of parameters such as outside impacts and lifestyle (active or sedentary life) have a role in the development of strength endurance or not.

Main text

59 male army officers made up the research team. A follow-up study of strength endurance (push-up and sit-up) test was conducted in the gym. The exam took two minutes to complete, and each application was tested separately. In both 2004 and 2019, persons with genotype ID had the best mean sit-up and push-up outcomes, followed by participants with genotype DD, and finally participants with genotype II (P 0.05). Compared to the original rates in 2004, all genotype groups showed a significant reduction in push-up and sit-up scores in the test.

Conclusion

The findings of this study may reveal if strength and lifestyle choices affect the metabolic implications of the genetic polymorphism in the body. Particular varieties actuated by genes, on either hand, don’t result in significant improvements without any changes in individuals’ practices or ways of living, as per the conclusions.