bluuebunny/crossref_metadata_2025 huggingface dataset:
A case of repeated in-stent restenosis of coronary artery as a primary manifestation of seronegative antiphospholipid antibody syndrome
Authors: Fu Mingqiang , Chang Shufu , Ma Jianying , Ge Junbo
Published: January 2024

Background

Antiphospholipid antibody syndrome (APS) is a multisystemic autoimmune disorder which affects many organs or systems; however, coronary artery is relatively less frequently involved.

Case presentation

A 65-year-old female with effort chest pain was hospitalized for unstable angina in Janurary, 2015. Coronary angiography revealed sub-total occlusion of proximal left anterior descending (LAD) coronary artery, where a drug-eluting stent was successfully deployed. The patient experienced multiple in-stent stenosis at LAD coronary artery and coronary artery bypass graft (CABG) surgery was advised. Subsequently, severe stenosis of left circumflex (LCX) coronary artery emerged, and the patient suffered persistent in-stent restenosis. Eventually, the patient was diagnosed with seronegative antiphospholipid antibody syndrome and salvaged by immunosuppressants.

Conclusions

Repeated in-stent restenosis could be a primary manifestation of seronegative antiphospholipid antibody syndrome, and suppression of autoimmune activity and inflammation other than purely coronary revascularization might be a better option.
A large post-stenting intramural hematoma in the left anterior descending artery caused by a small intimal calcium spur; should we respect the calcium shape?
Authors: Samir Ahmad
Published: January 2024

Coronary heavy calcification (HC) poses a sturdy challenge to percutaneous coronary intervention (PCI). Scores considering calcification length, thickness, or circumferential extent, are widely accepted to dictate upfront calcium modification to improve PCI outcomes. Although often marginalized, calcification shape (morphology) may require consideration during procedure planning in selected cases. This case demonstrates how a focal but spur-shaped calcification led to a massive proximal left anterior descending (LAD) dissecting intramural hematoma.
Healthcare providers’ perspectives on implementing a brief physical activity and diet intervention within a primary care smoking cessation program: a qualitative study
Authors: Minian Nadia , Mehra Kamna , Lingam Mathangee , Dragonetti Rosa , Veldhuizen Scott , Zawertailo Laurie , deRuiter Wayne K. , Melamed Osnat C. , Moineddin Rahim , Thorpe Kevin E. , Taylor Valerie H. , Hahn Margaret , Selby Peter
Published: January 2024

Background

Post-smoking-cessation weight gain can be a major barrier to quitting smoking; however, adding behavior change interventions for physical activity (PA) and diet may adversely affect smoking cessation outcomes. The “Picking up the PACE (Promoting and Accelerating Change through Empowerment)” study assessed change in PA, fruit/vegetable consumption, and smoking cessation by providing a clinical decision support system for healthcare providers to utilize at the intake appointment, and found no significant change in PA, fruits/vegetable consumption, or smoking cessation. The objective of this qualitative study was to explore the factors affecting the implementation of the intervention and contextualize the quantitative results.

Methods

Twenty-five semi-structured interviews were conducted with healthcare providers, using questions based on the National Implementation Research Network’s Hexagon Tool. The data were analyzed using the framework’s standard analysis approach.

Results

Most healthcare providers reported a need to address PA and fruit/vegetable consumption in patients trying to quit smoking, and several acknowledged that the intervention was a good fit since exercise and diet could improve smoking cessation outcomes. However, many healthcare providers mentioned the need to explain the fit to the patients. Social determinants of health (e.g., low income, food insecurity) were brought up as barriers to the implementation of the intervention by a majority of healthcare providers. Most healthcare providers recognized training as a facilitator to the implementation, but time was mentioned as a barrier by many of healthcare providers. Majority of healthcare providers mentioned allied health professionals (e.g., dieticians, physiotherapists) supported the implementation of the PACE intervention. However, most healthcare providers reported a need for individualized approach and adaptation of the intervention based on the patients’ needs when implementing the intervention. The COVID-19 pandemic was found to impact the implementation of the PACE intervention based on the Hexagon Tool indicators.

Conclusion

There appears to be a need to utilize a flexible approach when addressing PA and fruit/vegetable consumption within a smoking cessation program, based on the context of clinic, the patients’ it is serving, and their life circumstances. Healthcare providers need support and external resources to implement this particular intervention.

Name of the registry

Clinicaltrials.gov.

Trial registration number

NCT04223336.

Date of registration

7 January 2020 Retrospectively registered.

URL of trial registry record

https://classic.clinicaltrials.gov/ct2/show/NCT04223336.
Barriers to using eHealth/mHealth platforms and perceived beneficial eHealth/mHealth platform features among informal carers of persons living with dementia: a qualitative study
Authors: Samari Ellaisha , Yuan Qi , Zhang YunJue , Jeyagurunathan Anitha , Subramaniam Mythily
Published: January 2024

Background

New technologies have brought about a new age of technology-enabled aids that can equip informal carers with the relevant resources for better care. These include but are not limited to facilitating access to healthcare providers, knowledge of caring for persons living with dementia, and sources of support for carers’ well-being. This qualitative study explores barriers to using eHealth/mHealth platforms and perceived beneficial eHealth/mHealth platform features among informal carers of persons living with dementia.

Methods

An exploratory qualitative study design was employed. Semi-structured interviews were conducted among 29 informal carers of persons living with dementia in Singapore recruited via convenience and snowball sampling. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data.

Results

The participants in this study identified several barriers to using eHealth/mHealth platforms, including personal preference, apprehension, poor user experience and lack of skills. On the other hand, knowledge of dementia, caring for persons living with dementia and self-care, a list of resources, social support, location monitoring and alert systems, and the ability to manage appointments and transactions were valuable features for eHealth/mHealth platforms.

Conclusions

Despite the underutilisation of eHealth/mHealth platforms, carers expressed a keen interest in using them if they are functional and capable of reducing their care burden. The findings from this study can contribute to developing content and features for eHealth/mHealth interventions aimed at lightening carers’ burden in their day-to-day caring routine.
Prevalence of misconception about HIV/AIDS transmission and associated factors among reproductive age women in Ethiopia: a nationwide study
Authors: Yimer Ali , Kebede Kassaw Abdul-Aziz , Surur Sebwedin , Mussa Endris
Published: January 2024

Background

Misconceptions and myths are still the bottlenecks for the prevention of HIV/AIDS transmission in developing countries. This study aimed to assess the prevalence and associated factors of misconception about HIV transmission among reproductive age groups using the most recently available Ethiopian Demographic and Health Surveydata.

Methods

A cross-sectional study design was done using the Ethiopian Demographic and Health Survey 2016 data set. The data analysis was conducted using  Statistical Package for Social Sciences version 25. Multivariable logistic regression analysis was done to identify associated factors of misconception about HIV/AIDS transmission. A p-value of < 0.05 and an adjusted odds ratio with a 95% confidence interval were considered to confirm a statistically significant association.

Results

From the sample of 11,425 reproductive-age women, the prevalence of misconception about HIV/AIDS transmission among reproductive-age women in Ethiopia was 27.47%. Women residing in rural area [AOR:1.24; 95% CI: 1.03–1.75] compared to urban resident participants, attended primary education [AOR:0.58;95%CI: 0.49–0.68], attended secondary education [AOR:0.36;95%CI:0.29–0.46], attended higher education [AOR:0.24;95%CI: 0.18–0.32] compared to those participants without education, had history of HIV test [AOR:0.77; 95%CI: 0.67–0.88] compared to their counterpart, respondents living in Amhara region [AOR:0.44:95% CI:0.35–0.54], Benishangul [AOR: 0.34; 95% CI: 0.25–0.46], SNNPR [AOR:0.50; 95% CI: 0.38–0.67], Gambela [AOR:0.57; 95% CI: 0.42–0.79], Harari [AOR:0.62; 95% CI: 0.46–0.82], Addis Ababa [AOR:0.63; 95% CI: 0.49–0.81] compared to those living in Tigray and having richest wealth status[AOR:0.57;95% CI: 1.457–4.078] compared to those whose wealth index was poorest were significantly associated with the misconception about HIV transmission.

Conclusion

Over all the prevalence of misconception about HIV/AIDS transmission among reproductive-age women in Ethiopia was high. Residence, educational level, wealth index, region, and respondents who ever tested for HIV were significantly associated with the misconception about HIV/AIDS transmission. This high misconception could affect HIV/AIDS transmission and its prevention strategies unless timely and appropriate intervention should be taken. Strengthening strategies aimed at maximizing HIV/AIDS testing, scaling up educational status, and emphasizing regional-wide interventions might have a substantial contribution.
Identification of associated risk factors for serological distribution of hepatitis B virus via machine learning models
Authors: Yao Ning , Liu Yang , Xu Jiawei , Wang Qing , Zhou Quanhua , Wang Yue , Yi Dong , Wu Yazhou
Published: January 2024

Background

The provincial-level sero-survey was launched to learn the updated seroprevalence of hepatitis B virus (HBV) infection in the general population aged 1–69 years in Chongqing and to assess the risk factors for HBV infection to effectively screen persons with chronic hepatitis B (CHB).

Methods

A total of 1828 individuals aged 1–69 years were investigated, and hepatitis B surface antigen (HBsAg), antibody to HBsAg (HBsAb), and antibody to B core antigen (HBcAb) were detected. Logistic regression and three machine learning (ML) algorithms, including random forest (RF), support vector machine (SVM), and stochastic gradient boosting (SGB), were developed for analysis.

Results

The HBsAg prevalence of the total population was 3.83%, and among persons aged 1–14 years and 15–69 years, it was 0.24% and 4.89%, respectively. A large figure of 95.18% (770/809) of adults was unaware of their occult HBV infection. Age, region, and immunization history were found to be statistically associated with HBcAb prevalence with a logistic regression model. The prediction accuracies were 0.717, 0.727, and 0.725 for the proposed RF, SVM, and SGB models, respectively.

Conclusions

The logistic regression integrated with ML models could helpfully screen the risk factors for HBV infection and identify high-risk populations with CHB.
Characteristics, outcome, duration of hospitalization, and cycle threshold of patients with COVID-19 referred to four hospitals in Babol City: a multicenter retrospective observational study on the fourth, fifth, and sixth waves
Authors: Sadeghi Farzin , Halaji Mehrdad , Shirafkan Hoda , Pournajaf Abazar , Ghorbani Hossein , Babazadeh Sara , Ezami Nafiseh , Fallhpour Kobra , Fakhraie Fatemeh , Gorjinejad Shahrbano , Amoli Saghar Saber , Amiri Fatemeh Hejazi , Baghershiroodi Mahnaz , Ahmadnia Zahra , Salehi Maryam , Tourani Mehdi , Jafarzadeh Jalal , Tabari Farzane Shanehbandpour , Ahmadian Seyed Raheleh , Mohammadi Abandansari Rouzbeh , Jafarian Farzaneh , Rouhi Samaneh , Zabihollahi Arezoo , Mostafanezhad Sarina , Saeedi Fatemeh , Ebrahimian Arefeh , Deldar Zeinab , Zavareh Mahmoud Sadeghi Haddad , Bayani Masoumeh , Broun Mana Bazi , Shirzad Moein , Sabbaghi Siamak , Mohammadi Mohsen , Rahmani Rabeae , Yahyapour Yousef
Published: January 2024

Background

The aim of the present study was to compare the epidemiological patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infections, hospitalizations, deaths, and duration of hospitalization during the fourth, fifth and sixth epidemic waves of coronavirus disease 2019 (COVID-19) in Iran.

Methods

A multicenter retrospective observational study was conducted on hospitalized patients in four hospitals in the Babol district of northern Iran. The study periods were during the fourth, fifth, and sixth waves of the epidemic in Iran, (March 2021 to March 2022). A total of 13,312 patients with suspected COVID-19 were included. Patient demographics, medical history, length of hospital stay, and clinical outcomes were obtained from the hospital information system. Data on the cycle threshold (Ct) and SARS-CoV2 variant were collected for SARS-CoV2-positive cases.

Results

The highest number of hospitalized patients was reported during the fifth (Delta) wave (5231; 39.3%), while the lowest number of hospitalized patients was reported during the sixth (Omicron) wave (2143; 16.1%). In total, 6459 (48.5%) out of 13,312 hospitalized patients with suspected COVID-19 had a positive rRT-PCR result. The fifth (Delta) wave had the highest number of SARS-CoV2 rRT-PCR-positive hospitalized patients (3573, 55.3%), while the sixth (Omicron) wave had the lowest number (835, 12.9%). Moreover, 238 (3.7%) patients with laboratory-confirmed COVID-19 died. The hospital mortality rate was 6.8% in the fourth (Alpha) wave, which reduced to 2.7 and 3.5% in the fifth (Delta) and sixth (Omicron) waves, respectively (p < 0.001).

Conclusions

This is the most comprehensive study evaluating the epidemiologic characteristics of laboratory-confirmed SARS-CoV2 cases in Iran during the Alpha, Delta, and Omicron waves. The highest number of SARS-CoV2-positive hospitalized patients was in the fifth wave of COVID-19 (dominance of the Delta variant), while the sixth wave (dominance of the Omicron variant) had the lowest number. Comorbidities were similar, and cardiovascular disease, diabetes, kidney disease, and hypertension were the main risk factors in all waves.
COVID-19 vaccine hesitancy: assessing the prevalence, predictors, and effectiveness of a community pharmacy based counseling intervention
Authors: Kiptoo Joshua , Isiiko John , Yadesa Tadele Mekuriya , Rhodah Tumugumye , Alele Paul E. , Mulogo Edgar Mugema
Published: January 2024

Background

Coronavirus disease (COVID-19) vaccine hesitancy is a global challenge. In low- and middle-income countries (LMICs), the problem has persisted despite vaccine availability and decreasing infections. In Uganda, there is still limited information on the extent and predictors of vaccine hesitancy. This study sought to assess the prevalence and predictors of COVID-19 vaccine hesitancy, and the effectiveness of an intervention that involved community pharmacy counseling in combating COVID-19 vaccine hesitancy.

Methods

A total of 394 participants were enrolled in a 4-week prospective cohort interventional study. The study was conducted across eight community pharmacies in Mbarara City, between 9:00 AM and 5:00 PM daily. The study personnel ascertained the vaccination status of all clients seeking community pharmacy services. All unvaccinated clients were consecutively assessed for eligibility, and eligible clients were systematically enrolled after receiving the community pharmacy services for which they requested. The study intervention involved structured participant counseling (within the pharmacy premise), follow-up short message service (weekly), and telephone calls (bi-weekly). Only participants who did not accept to receive the COVID-19 vaccine despite counseling were followed up for four weeks, or until they accepted to receive a COVID-19 vaccine. The effectiveness of the community pharmacy counseling intervention was determined as an increase in COVID-19 vaccine acceptance, and desirable attitudinal change towards COVID-19 disease, vaccination exercise, and vaccines. Descriptive analysis was used to summarize data, and multivariate analysis was used to determine the predictors of COVID-19 vaccine hesitancy. A p-value < 0.05 was considered statistically significant.

Results

Out of 394 participants, 221 (56%) were hesitant to receive a COVID-19 vaccine. Participants expressed several reasons (mean 2±1) for COVID-19 vaccine hesitancy, mostly concerning vaccine safety (N=160, 47.3%). The overall COVID-19 vaccine acceptance rate increased by 25.4 percent points (43.9 – 69.3 percent points) after the study intervention. Age, religion, level of education, distance from the nearest public health facility, having a friend/family diagnosed with COVID-19, and personal suspicion of contracting COVID-19 were significant predictors of COVID-19 vaccine hesitancy.

Conclusion

COVID-19 vaccine hesitancy is a big challenge in Uganda. A mix of sociodemographic and COVID-19 vaccine perceptions are the key predictors of COVID-19 vaccine hesitancy. Although COVID-19 vaccines were not available at the time of the study, this study found that structured counseling interventions can improve COVID-19 vaccine acceptance rates. Larger prospective studies should evaluate the effectiveness of similar interventions in community pharmacies and other healthcare settings.
Police-reported family violence victimisation or perpetration and mental health-related emergency department presentations: an Australian data-linkage study
Authors: Papalia Nina , Simmons Melanie , Trood Michael , McEwan Troy , Spivak Benjamin
Published: January 2024

Background

Family violence is a leading social determinant of mental ill-health but its link to mental health-related emergency department presentations is poorly understood. Existing research has largely used retrospective designs with a focus on victimisation, typically among women. We examined whether police-reported family violence victimisation and perpetration were prospectively associated with mental health emergency department presentations in women and men. We also identified family violence risk and vulnerability characteristics associated with such presentations.

Methods

Demographics, prior police involvement, and individual and relationship vulnerabilities were provided by Victoria Police for 1520 affected family members (i.e., primary victims) and 1470 respondents (i.e., persons alleged to have perpetrated family violence) from family violence reports in 2016–17. Emergency mental health presentations 22–30 months post-family-violence report were determined through linkage with the Victorian Emergency Minimum Dataset and compared to statewide presentations.

Results

Emergency mental health presentations during follow-up were identified in 14.3% of the family violence sample, with 1.9% presenting for self-harm. Mental health presentation rates per 1,000 people were markedly higher among affected family members and respondents of both sexes and all ages than in the general population, except for male affected family members aged 45 + . Adjusting for age and sex, the mental health presentation rate was 6 and 11 times higher among affected family members and respondents, respectively, than in the general population. Individual vulnerabilities were more closely related to risk of emergency mental health presentations than relationship characteristics.

Conclusions

Police-recorded family violence is associated with increased mental health-related emergency department presentations over the short-to-medium term. Strengthened cross-sector collaboration is needed to identify, address, and refer individuals with overlapping family violence and mental health needs and to improve victims’ and perpetrators’ access to community mental health and related services. This should help prevent individuals from reaching a crisis point in their mental health.
Association of phase angle with sarcopenia and muscle function in patients with COPD: a case-control study
Authors: Valisoltani Neda , Mohammadi Hamed , Aliannejad Rasoul , Naeini Fatemeh , Harsini Asma Rajabi , Sadeghi Erfan , Mirzaee Pouya , Imani Hossein
Published: January 2024

Background and aims

The predictive value of phase angle for sarcopenia diagnosis has been discussed for years. The present investigation was conducted to determine the association between phase angle and sarcopenia in patients with COPD.

Methods

In this case-control study, 222 smoker men were divided into healthy and COPD groups. COPD was diagnosed by a pulmonologist through spirometry. Anthropometric indices, phase angle, muscle function, sarcopenia, and dietary intake were assessed.

Results

A significant inverse association was observed between phase angle and sarcopenia after adjustment for age and energy intake (OR: 0.31, 95% CI 0.18–0.52) and after adjustment for BMI (OR: 0.31, 95% CI 0.18–0.52). A significant decrease was detected in anthropometric indices and indicators of sarcopenia and muscle function in COPD cases compared to the healthy controls.

Conclusions

Although further studies are suggested, phase angle might be considered an indicator of sarcopenia and muscle function in COPD patients.
Systematic review of the significance of neutrophil to lymphocyte ratio in anastomotic leak after gastrointestinal surgeries
Authors: Haghi Sarvin Es , Khanzadeh Monireh , Sarejloo Shirin , Mirakhori Fariba , Hernandez Jairo , Dioso Emma , Goutnik Michael , Lucke-Wold Brandon , Ghaedi Arshin , Khanzadeh Shokoufeh
Published: January 2024

Introduction

The inflammatory response is thought to be a critical initiator of epigenetic alterations. The neutrophil to lymphocyte ratio (NLR), a biomarker of inflammation, is computed by dividing the number of neutrophils by the number of lymphocytes. The primary goal of this systematic review and meta-analysis was to evaluate the pre-operative NLR of gastrointestinal surgery patients who had an anastomotic leak (AL) in comparison to those who did not AL.

Methods

We performed a comprehensive search for relevant papers published before May 4, 2022, using PubMed, Scopus, and Web of Science. Standardized mean difference (SMD) with a 95% confidence interval (CI) was pooled in meta-analysis to yield a summary estimate. We utilized the random-effects model to create pooled effects since we discovered a substantial heterogeneity level. For evaluating quality, the Newcastle-Ottawa scale (NOS) was implemented.

Results

The research comprised 12 studies with a total of 2940 individuals who had GI operations, 353 of whom went on to develop AL. We discovered that patients who had GI surgeries and acquired AL had significantly higher NLR levels than those who did not (random-effects model: SMD = 0.75, 95% CI = 0.11–1.38, p = 0.02). Patients with AL showed significantly higher NLR levels than control group in retrospective studies (SMD = 0.93, 95% CI = 0.20–1.66, p=0.01) but not in prospective studies (SMD = − 0.11, 95% CI = − 0.65–0.43, p = 0.69), according to the subgroup analysis based on research design. Subgroup analysis based on ethnicity yielded that white patients with AL exhibited significantly higher NLR values than the control group (SMD = 1.35, 95% CI = 0.01–2.68, p = 0.04) but this result was not applied to East Asian patients (SMD = 0.14, 95% CI = -0.13–0.41, p = 0.29).

Conclusion

Our research suggests a potential association between preoperative NLR and postoperative AL. However, it is essential to acknowledge the variability in the findings, with significantly higher NLR levels observed in retrospective studies and among white patients, but not consistently replicated in prospective studies and among East Asian patients. Further investigations with larger and more diverse cohorts are warranted to validate these findings and explore potential factors contributing to the observed discrepancies.
Heteronormative biases and distinctive experiences with prostate cancer among men who have sex with men: a qualitative focus group study
Authors: Panken Evan , Frydenlund Noah , Mistry Neil , Prabhu Rahul , Wong Jeffrey , Kundu Shilajit , Victorson David , Amarasekera Channa
Published: January 2024

Background

Men who have sex with men (MSM) face many challenges and biases in healthcare. Within urology there is a need to better understand how prostate cancer impacts MSM given the unique ways in which side effects that accompany treatment may affect this population. The goal of this study is to explore the experience of MSM with prostate cancer to advance the existing literature in this area and inform implementation and delivery of clinical practice and policy guidelines.

Methods

Four focus groups were conducted with a semi-structured interview guide. Using a phenomenological qualitative approach consistent with grounded theory [1] and naturalistic inquiry principles we sought to better understand the direct experiences of MSM with prostate cancer. Audio transcriptions were thematically analyzed to identify themes that impact MSM throughout their prostate cancer journey. An iterative, team-wide classification process was used to identify, organize, and group common codes into higher-order categories and themes.

Results

Patient’s choice of provider and their interactions with the healthcare system were strongly impacted by their sexual identities. Participants commented on navigating the heteronormative healthcare environment and the impact of assumptions they encountered. MSM experienced the sexual side effects of prostate cancer treatment in unique ways. Issues with erectile dysfunction and ejaculatory dysfunction had significant impacts on patient’s sexual experience, with some describing being forced to explore new modes of sexual expression. Anejaculation was a theme that was distressing for many participants. The emotional impact of a prostate cancer diagnosis was significant in the men interviewed. Common themes included loss of identity and fear for future relationships.

Conclusions

MSM have unique concerns after prostate cancer treatment that differ from men who don’t identify as MSM. It is critical that providers familiarize themselves with the concerns of this patient population regarding prostate cancer treatment. An important step toward reducing heteronormative bias in prostate cancer care is to better understand the goals, identity, and sexual practices of MSM and to provide informed anticipatory guidance.
Self-reported oral health-related quality of life and caries experiences of 5-year-old children in Mandalay, Myanmar
Authors: Min Saw Nay , Duangthip Duangporn , Gao Sherry Shiqian , Detsomboonrat Palinee
Published: January 2024

Background

This study aimed to examine the impact of dental caries and other potential socio-demographic factors on the oral health-related quality of life (OHRQoL) of preschool children from Myanmar. This was done using the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) as reported by both the children and their parents.

Methods

A structured questionnaire was conducted to collect demographic information about the children and their caregivers, as well as socioeconomic data. The OHRQoL was assessed by interviewing the children and their parents using the Myanmar versions of SOHO-5c and SOHO-5p, respectively. Caries experience was assessed by two calibrated examiners and recorded using the dmft index. The Poisson regression model was adopted to investigate the association between OHRQoL and dental caries including socioeconomic factors.

Results

A total of 454 pairs participated in the study. Among them, 64% of children and 70% of parents reported a negative impact on OHRQoL (with SOHO-5c and SOHO-5p scores exceeding 0). The mean score (SD) of the child self-report and parental version of the SOHO-5 was 1.86 (2.27) and 2.65 (3.13), respectively. Difficulties in eating and sleeping were the most commonly reported by both children and parents. The overall prevalence of dental caries was 87% (mean dmft score:5.59, SD:4.65). The final multivariate-adjusted model revealed that children with higher caries experiences were more likely to have lower OHRQoL for both child self-report (RR 4.38, 95% CI 3.16–6.14, p < 0.001) and parental report (RR 6.07, 95% CI 4.38–8.41, p < 0.001), respectively. A lower family income had a negative impact on the children’s OHRQoL in child self-report (RR 1.59, 95% CI 1.26–2.04, p < 0.001) and parental report (RR 1.46, 95% CI 1.19–1.78, p < 0.001).

Conclusion

Two-thirds of the study children and their parents perceived the negative impact on children’s OHRQoL. Higher caries experience and lower family income were associated with poorer OHRQoL of 5-year-old Myanmar children.
Long-term results of regenerative treatment of intrabony defects: a cohort study with 5-year follow-up
Authors: Lee Jae-Hong , Jeong Seong-Nyum
Published: January 2024

Background

The aim of this retrospective cohort study was to evaluate the long-term clinical and radiographic outcomes and survival of teeth in periodontal regenerative treatment of intrabony defects using combined enamel matrix protein derivative (EMD) and deproteinized porcine bone mineral (DPBM) compared to EMD alone.

Methods

A total of 333 intrabony defects in 176 patients (mean age: 54.7 ± 8.9 years) were followed-up for 58.6 ± 11.2 (range, 25–78) months after periodontal regenerative treatment. Changes in clinical (pocket probing depth and clinical attachment level) and radiographic (defect depth and defect width) parameters were analyzed using serial periapical radiographs. Kaplan–Meier and multivariate Cox proportional-hazards regression analyses for tooth loss were also performed.

Results

Compared to periodontal surgery with EMD alone with a mean follow-up of 5 years, combined EMD and DPBM showed significantly better gain in clinical attachment level (EMD and DPBM: 2.8 ± 2.3 mm vs. EMD alone: 2.2 ± 2.2 mm) and reduction in probing pocket depth (EMD and DPBM: 2.8 ± 1.8 mm vs. EMD alone: 2.3 ± 1.8 mm), defect depth (EMD and DPBM: 2.5 ± 2.4 mm vs. EMD alone: 2.0 ± 2.4 mm) and defect width (EMD and DPBM: 0.6 ± 1.0 mm vs. EMD alone: 0.2 ± 1.3 mm). The overall survival rates of the teeth were 91.48% and 95.20% in the patient- and tooth-based analyses, respectively, showing no statistically significant difference.

Conclusions

Within the limitations of the current study, combined EMD and DPBM offered additional clinical and radiographic benefits over a mean of 5 years compared to EMD alone. However, tooth loss did not differ significantly between the two groups.

Clinical relevance

Compared to EMD alone, combined EMD and DPBM for intrabony defects has additional clinical advantages; however, patient- and tooth-related risk factors must be considered when performing periodontal regenerative surgery.
A postpartum functional assessment tool for women based on the international classification of functioning, disability and health
Authors: Zhao Ying , Yuan Meng , Wu Jie , Wang Zhao , Jia Fan , Ma Lili , Yang Yang , Zhou Jingjie , Zhang Ming
Published: January 2024

Background

Postpartum dysfunctions and complications can occur in women. However, functional assessment should be conducted to make treatment plans before any intervention is implemented. In this context, the International Classification of Functioning, Disability and Health (ICF) may be a useful tool for women postpartum to document functional data and set rehabilitation goals. The purpose of this study was to determine the corresponding domains that should be considered in the evaluation of women’s postpartum functioning based on the International Classification of Functioning, Disability and Health (ICF) model using the Delphi method.

Methods

Fifteen domestic experts were invited to conduct two rounds of expert consensus survey on the ICF-based postpartum functional assessment category pool obtained through literature retrieval, clinical investigation, and reference to relevant literature. The sample was medical staff with professional knowledge of women’s health. The opinions of experts were summarized, and the positive coefficient, authority coefficient and coordination degree of experts were calculated.

Results

A total of 15 domestic experts participated in this expert consensus. Through two rounds of a questionnaire survey, 69 items were finally selected to form the ICF-based postpartum functional assessment tool for women. The items included 32 items of body function, 12 items of body structure, 17 items of activity and participation, and 8 items of environmental factors. In addition, we identified 8 items of personal factors. The expert positive coefficients of the two rounds of expert consensus were both 100%, the authority coefficient was 0.789, and the coefficient of variation was between 0.09 to 0.31.

Conclusion

A postpartum functional assessment tool for women based on the ICF model was constructed based on the Delphi method, which can provide more comprehensive health management and life intervention for postpartum women.

Trial registration

The Registration number of the Chinese Clinical Trial Registry is ChiCTR2200066163, 25/11/2022.
Prediction of postoperative infectious complications in elderly patients with colorectal cancer: a study based on improved machine learning
Authors: Tian Yuan , Li Rui , Wang Guanlong , Xu Kai , Li Hongxia , He Lei
Published: January 2024

Background

Infectious complications after colorectal cancer (CRC) surgery increase perioperative mortality and are significantly associated with poor prognosis. We aimed to develop a model for predicting infectious complications after colorectal cancer surgery in elderly patients based on improved machine learning (ML) using inflammatory and nutritional indicators.

Methods

The data of 512 elderly patients with colorectal cancer in the Third Affiliated Hospital of Anhui Medical University from March 2018 to April 2022 were retrospectively collected and randomly divided into a training set and validation set. The optimal cutoff values of NLR (3.80), PLR (238.50), PNI (48.48), LCR (0.52), and LMR (2.46) were determined by receiver operating characteristic (ROC) curve; Six conventional machine learning models were constructed using patient data in the training set: Linear Regression, Random Forest, Support Vector Machine (SVM), BP Neural Network (BP), Light Gradient Boosting Machine (LGBM), Extreme Gradient Boosting (XGBoost) and an improved moderately greedy XGBoost (MGA-XGBoost) model. The performance of the seven models was evaluated by area under the receiver operator characteristic curve, accuracy (ACC), precision, recall, and F1-score of the validation set.

Results

Five hundred twelve cases were included in this study; 125 cases (24%) had postoperative infectious complications. Postoperative infectious complications were notably associated with 10 items features: American Society of Anesthesiologists scores (ASA), operation time, diabetes, presence of stomy, tumor location, NLR, PLR, PNI, LCR, and LMR. MGA-XGBoost reached the highest AUC (0.862) on the validation set, which was the best model for predicting postoperative infectious complications in elderly patients with colorectal cancer. Among the importance of the internal characteristics of the model, LCR accounted for the highest proportion. Conclusions: This study demonstrates for the first time that the MGA-XGBoost model with 10 risk factors might predict postoperative infectious complications in elderly CRC patients.
Navigation programs to support community-dwelling individuals with life-limiting illness: determinants of implementation
Authors: Scruton Sarah , Warner Grace , Kendell Cynthia , Pfaff Kathryn , Stajduhar Kelli , Patrick Linda , Dujela Carren , Fauteux Faith , Urquhart Robin
Published: January 2024

Background

As the Canadian population ages and the prevalence of chronic illnesses increases, delivering high-quality care to individuals with advanced life limiting illnesses becomes more challenging. Community-based navigation programs are a promising approach to address these challenges, but little is known about how these programs are successfully implemented to meet the needs of this population. This study sought to identify the key determinants that contribute to the successful implementation of these programs within Canada.

Methods

A qualitative study was undertaken to understand the implementation of eleven innovative, community-based navigation programs that aim to address the needs of individuals with life-limiting illnesses as they approach the end of life. The Consolidated Framework for Implementation Research (CFIR) guided the study design. Key informants (n = 23) within these programs took part in semi-structured interviews where they were asked to discuss how these programs are implemented. Data were analyzed using techniques employed in qualitative description.

Results

We identified key determinants of successful implementation within each CFIR domain. In the outer setting domain, participants emphasized the importance of filling gaps in care to meet client needs, developing strong relationships with clients and community-based organizations, and navigating relationships with healthcare providers. At the inner setting level, leadership support, staff compatibility, and available resources were identified as important factors. In terms of intervention characteristics, the ability to adapt was cited as a facilitator, whereas costs were identified as a barrier. For the characteristics of individuals, participants described the importance of having staff whose values align with the program, and who have the experience and skills necessary to work with complex clients. Finally, having strong champions and evaluation processes were highlighted as important process-oriented determinants of successful implementation.

Conclusion

This study provides valuable insights into the determinants of successful implementation of community-based navigation programs in Canada. Understanding these determinants can guide the future development and integration of navigation programs to successfully meet the needs of those with life-limiting illnesses.
Comparative analysis of the immune responses of CcIgZ3 in mucosal tissues and the co-expression of CcIgZ3 and PCNA in the gills of common carp (Cyprinus carpio L.) in response to TNP-LPS
Authors: Zhang Jiaqi , Ren Haoyue , Zhu Qiannan , Kong Xiangrui , Zhang Feng , Wang Chang , Wang Yimeng , Yang Guiwen , Zhang Fumiao
Published: January 2024

Fish live in an aquatic environment rich in various microorganisms and pathogens. Fish mucosal-associated lymphoid tissue (MALT) plays a very important role in immune defence. This study was conducted to characterize the immune response mediated by CcIgZ3 in common carp (Cyprinus carpio.) and investigate the proliferating CcIgZ3+ B lymphocytes in gill. We determined the expression of CcIgZ3 in many different tissues of common carp following stimulation by intraperitoneal injection of TNP-LPS (2,4,6-Trinitrophenyl hapten conjugated to lipopolysaccharide) or TNP-KLH (2,4,6-Trinitrophenyl hapten conjugated to Keyhole Limpet Hemocyanin). Compared with TNP-KLH, TNP-LPS can induce greater CcIgZ3 expression in the head kidney, gill and hindgut, especially in the gill. The results indicate that the gill is one of the main sites involved in the immune response mediated by CcIgZ3. To examine the distribution of CcIgZ3+ B lymphocytes, immunohistochemistry (IHC) experiments were performed using a polyclonal antibody against CcIgZ3. The results indicated that CcIgZ3 was detected in the head kidney, hindgut and gill. To further examine whether CcIgZ3+ B lymphocytes proliferate in the gills, proliferating CcIgZ3+ B cells were analysed by immunofluorescence staining using an anti-CcIgZ3 polyclonal antibody and an anti-PCNA monoclonal antibody. CcIgZ3 and PCNA (Proliferating Cell Nuclear Antigen) double-labelled cells in the gills were located within the epithelial cells of the gill filaments of common carp stimulated with TNP-LPS at 3 dps and 7 dps, and relatively more proliferating CcIgZ3+ B cells appeared in the gills of common carp at 7 dps. These data imply that CcIgZ3+ B cells in the gills might be produced by local proliferation following TNP-LPS stimulation. In summary, compared with those in TNP-KLH, CcIgZ3 preferentially affects the gills of common carp following challenge with TNP-LPS. CcIgZ3+ B cells proliferate in the gills to quickly produce the CcIgZ3 antibody. In addition, CcIgZ3+ B cells can be activated to induce a strong immune response very early locally in the gill and produce the antibody CcIgZ3, which helps exert an immune-protective effect. These results suggest that an effective vaccine can be designed to promote production of the mucosal antibody CcIgZ3.
Evaluation of changes in serum biochemical parameters in zarudny’s spur-thighed tortoises (Testudo graeca zarudnyi) influenced by gender and season
Authors: Khaki Zohreh , Rostami Amir , Esfandiary Farshad
Published: January 2024

Background

The Zarudny’s spur-thighed tortoise or Iranian tortoise (Testudo graeca zarudnyi) has just been reported from Iran so far. Therefore, the purpose of this study was to determine the effects of season and gender on serum biochemical parameters of this valuable species in Iran.

Results

This study was performed on 20 clinically healthy adult Zarudny’s spur-thighed tortoises. Blood samples were collected from the jugular vein and then serum biochemical parameters and body weight were measured in autumn and winter. The following biochemical parameters were measured: total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein, total protein, creatinine, urea, glucose, calcium, inorganic phosphorus, total bilirubin, uric acid, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and lactate dehydrogenase. Urea concentration increased significantly at emergence from hibernation. Also, in winter, total protein, phosphorous, creatinine, total bilirubin concentrations and alkaline phosphatase activity decreased significantly compared to autumn, but aspartate aminotransferase and lactate dehydrogenase activities were significantly higher than in autumn. There was no significant difference for the parameters mentioned above by gender, except for phosphorous. Phosphorous concentration in females was significantly higher than that of males in autumn. Cholesterol and low-density lipoprotein cholesterol levels in females were significantly higher than males in autumn and winter.

Conclusions

The present study is the first study that monitors the serum biochemical parameters of adult Zarudny’s spur-thighed tortoises based on season and gender. Seasonal reference intervals should be used for biochemical parameters in this valuable species. Also, sex-specific reference intervals for phosphate and cholesterol are necessary.
Towards pharmacogenomics-guided tuberculosis (TB) therapy: N-acetyltransferase-2 genotypes among TB-infected Kenyans of mixed ethnicity
Authors: Njagi Lilian N. , Mecha Jared O. , Mureithi Marianne W , Otieno Leon E. , Nduba Videlis
Published: January 2024

Background

Though persons of African descent have one of the widest genetic variability, genetic polymorphisms of drug-metabolising enzymes such as N-Acetyltransferase-2 (NAT2) are understudied. This study aimed to identify prevalent NAT2 single nucleotide polymorphisms (SNPs) and infer their potential effects on enzyme function among Kenyan volunteers with tuberculosis (TB) infection. Genotypic distribution at each SNP and non-random association of alleles were evaluated by testing for Hardy-Weinberg Equilibrium (HWE) and Linkage Disequilibrium (LD).

Methods

We isolated genomic DNA from cryopreserved Peripheral Blood Mononuclear Cells of 79 volunteers. We amplified the protein-coding region of the NAT2 gene by polymerase chain reaction (PCR) and sequenced PCR products using the Sanger sequencing method. Sequencing reads were mapped and aligned to the NAT2 reference using the Geneious software (Auckland, New Zealand). Statistical analyses were performed using RStudio version 4.3.2 (2023.09.1 + 494).

Results

The most frequent haplotype was the wild type NAT2*4 (37%). Five genetic variants: 282C > T (NAT2*13), 341 T > C (NAT2*5), 803A > G (NAT2*12), 590G > A (NAT2*6) and 481C > T (NAT2*11) were observed with allele frequencies of 29%, 18%, 6%, 6%, and 4% respectively. According to the bimodal distribution of acetylation activity, the predicted phenotype was 76% rapid (mainly consisting of the wildtype NAT2*4 and the NAT2*13A variant). A higher proportion of rapid acetylators were female, 72% vs 28% male (p = 0.022, odds ratio [OR] 3.48, 95% confidence interval [CI] 1.21 to 10.48). All variants were in HWE. NAT2 341 T > C was in strong complete LD with the 590G > A variant (D′ = 1.0, r2 = − 0.39) but not complete LD with the 282C > T variant (D′ = 0.94, r2 = − 0.54).

Conclusion

The rapid acetylation haplotypes predominated. Despite the LD observed, none of the SNPs could be termed tag SNP. This study adds to the genetic characterisation data of African populations at NAT2, which may be useful for developing relevant pharmacogenomic tools for TB therapy. To support optimised, pharmacogenomics-guided TB therapy, we recommend genotype-phenotype studies, including studies designed to explore gender-associated differences.
Nonlinear relationship between untraditional lipid parameters and the risk of prediabetes: a large retrospective study based on Chinese adults
Authors: Li Mingkang , Zhang Wenkang , Zhang Minhao , Li Linqing , Wang Dong , Yan Gaoliang , Qiao Yong , Tang Chengchun
Published: January 2024

Background

Abnormal lipid metabolism poses a risk for prediabetes. However, research on lipid parameters used to predict the risk of prediabetes is scarce, and the significance of traditional and untraditional lipid parameters remains unexplored in prediabetes. This study aimed to comprehensively evaluate the association between 12 lipid parameters and prediabetes and their diagnostic value.

Methods

This cross-sectional study included data from 100,309 Chinese adults with normal baseline blood glucose levels. New onset of prediabetes was the outcome of concern. Untraditional lipid parameters were derived from traditional lipid parameters. Multivariate logistic regression and smooth curve fitting were used to examine the nonlinear relationship between lipid parameters and prediabetes. A two-piecewise linear regression model was used to identify the critical points of lipid parameters influencing the risk of prediabetes. The areas under the receiver operating characteristic curve estimated the predictive value of the lipid parameters.

Results

A total of 12,352 participants (12.31%) were newly diagnosed with prediabetes. Following adjustments for confounding covariables, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol were negatively correlated with prediabetes risk. Conversely, total cholesterol, triglyceride (TG), lipoprotein combine index (LCI), atherogenic index of plasma (AIP), non-HDL-C, atherogenic coefficient, Castelli’s index-I, remnant cholesterol (RC), and RC/HDL-C ratio displayed positive correlations. In younger adults, females, individuals with a family history of diabetes, and non-obese individuals, LCI, TG, and AIP exhibited higher predictive values for the onset of prediabetes compared to other lipid profiles.

Conclusion

Nonlinear associations were observed between untraditional lipid parameters and the risk of prediabetes. The predictive value of untraditional lipid parameters for prediabetes surpassed that of traditional lipid parameters, with LCI emerging as the most effective predictor for prediabetes.