bluuebunny/crossref_metadata_2025 huggingface dataset:
The engagement of tertiary students with an online mental health intervention during the coronavirus disease 2019 pandemic: A feasibility study
Authors: Pascoe Michaela C , Dash Sarah , Klepac Pogrmilovic Bojana , Patten Rhiannon K , Parker Alexandra G
Published: August 2022

Background

We discuss the feasibility of a brief, online mental health promotion programme for tertiary students and establish recommendations for future programmes.

Methods

The programme ‘Student Elevenses’ was delivered at a tertiary education institution. ‘Student Elevenses’ aimed to promote student wellbeing during the coronavirus disease 2019 crisis, comprised of 10–15-min daily online micro-interventions targeting six lifestyle areas for wellbeing, and was delivered via video conference. Upon programme completion, all students were invited to complete barriers to engagement survey, irrespective of whether they had attended or heard of the programme. Descriptive statistics were calculated for demographics, as well as feasibility and acceptability outcomes including recruitment rates, attendance rates and reported barriers to attendance. Open-ended questions were coded for themes.

Results

Less than 1% of those who consented to participate actually attended the programme, with attendance ranging from 2 to 17 participants. Participants were predominantly female (68%), domestic students (81%) and had a mean age of 29.5 years. The barriers students reported included fixed time, online format, a belief programme would not be helpful, preference for existing supports and perceived impacts of coronavirus disease 2019. Students recommended embedding support within policies/teaching, offering a range of supports and involving students in design.

Conclusion

Barriers to mental health promotion via telehealth should be considered to promote accessibility and acceptability for tertiary students. Future programmes should consider reaching students through mandatory activities (e.g. lectures, tutorials) and should include student consultation and co-design to support the development of programmes that meet student needs and preferences.
Improving Family Medicine Residents’ Confidence to Assess and Manage Psychiatric Crises in an Outpatient Clinic
Authors: Paulson Deirdre , Hidaka Brandon
Published: August 2022

Background and Objectives:

Primary care physicians (PCPS) are increasingly responsible for managing mental health, which can involve assessment and management of a psychiatric crisis. Psychiatric crises can include acute suicidal or homicidal ideation and capacity-impairing psychosis. Evidence suggests PCPs do not consistently assess or manage psychiatric crises and it is unclear how to train PCPs to address these potentially lethal scenarios. The main objective was to increase PCP resident confidence in assessing and managing a range of psychiatric crises.

Methods:

In a family medicine residency program that trains PCPs, we developed a three, 1-h didactic series and point-of-care reference documents. The curriculum focused on screening, outpatient management, inpatient criteria, logistics of voluntary and involuntary admission, and legal considerations. Resident confidence was measured by questionnaire before and 3 months after curriculum completion.

Results:

Prior to training, residents did not feel confident in assessing and managing psychiatric crises, except a slight majority (62%) in screening for suicidal and homicidal ideation. Resident confidence significantly increased for every aspect of assessing and managing psychiatric crises after the training (all P-values < .05), with the largest improvements for further assessing hallucinations, delusions, and suicidal and homicidal ideation.

Conclusions:

As PCPs increasingly manage mental illness, they will encounter a range of psychiatric crises in clinic. This study demonstrates that a brief training intervention and point-of-care resources can significantly increase PCP confidence to assess and manage these urgent, dangerous scenarios.
A feasibility and acceptability study of using an intra-oral camera and an asynchronous tele-mentoring protocol to detect and identify oral lesions
Authors: Northridge Mary E , Weiserbs Kera F , Sabounchi Shabnam Seyedzadeh , Torroni Andrea , Mohadjeri-Franck Nathalie S , Gargano Steven , George Eliot , Littlejohn Tina C , Troxel Andrea B , Wu Yinxiang , Testa Paul A , Wismer Jennifer , Zaremba Kiah , Tylawsky Peter , Bina Babak
Published: August 2022

Background:

To examine the feasibility and acceptability of integrating a tele-mentoring component into the identification of oral lesions at the dental clinics of a Federally Qualified Health Center network.

Design and Methods:

General Practice Residency faculty and residents completed research ethics courses and trained dentists to use intra-oral cameras at chairside to photograph oral lesions of patients at routine dental visits. These images were then uploaded into the patient electronic health records (EHRs) with attendant descriptions and an oral surgeon was notified, who reviewed the charts, placed his observations in the EHR, and communicated his findings via secure e-mail to the involved residents, who in turn contacted their patients regarding follow-up actions. Feasibility was assessed via checklists completed by provider participants and semi-structured interviews. Acceptability was assessed via brief exit interviews completed by patient participants.

Results:

All 12 of the dentist participants reported that they had successfully provided the tele-mentoring intervention, and that the process (from EHR data entry to interaction with the oral surgeon over findings to patient referral) was clear and straightforward. Of 39 patient participants, most strongly agreed or agreed that the use of an intra-oral camera by their dentists helped them to better understand oral cancer screening (94.9%) and that dentists answered their questions about oral cancer and were able to provide them with resources (94.8%).

Conclusions:

Findings support further implementation research into adapting tele-mentoring using intra-oral cameras for training dental residents to detect and identify oral lesions and educating patients about oral cancer across settings.
Intraocular lens power calculation in eyes with previous corneal refractive surgery
Authors: Anders Philipp , Anders Lisa-Marie , Barbara Adel , Szentmary Nora , Langenbucher Achim , Gatzioufas Zisis
Published: August 2022

Intraocular lens (IOL) power calculation after corneal refractive surgery (CRS) becomes an expanding challenge for ophthalmologists as more and more cataract surgeries after CRS are required. These patients typically also have high expectations as to visual performance. Conventional IOL power calculation schemes frequently provide inaccurate results in these cases. This review aims to summarize and recommend currently available IOL power calculation methods for eyes with the most common CRS methods: radial keratotomy (RK), photorefractive keratectomy (PRK), laser in situ keratomileusis (LASIK), and small incision lenticule extraction (SMILE). To this end, biometry measuring methods and IOL formulas will be explained and combinations of both are proposed. In synopsis, it is evident that the latest generation of vergence formulas exhibit favorable IOL power prediction accuracy in post-CRS eyes, even though the predictive precision of methods in eyes without CRS is not attained. Ray tracing computation, intraoperative aberrometry, and machine learning–based formulas hold potential to further improve refractive outcomes in post-CRS eyes.
Current and Emerging Trends in Diabetes Care and Education: 2021 National Practice and Workforce Survey
Authors: Kavookjian Jan , Bzowyckyj Andrew S. , DiNardo Monica M. , Kocurek Barbara , Kolb Leslie E. , Noe Dawn , Ryan Donna , Saunders Magon May , See Michael , Uelmen Sacha
Published: August 2022

Purpose:

The purpose of the National Practice Survey is to understand current trends related to the diabetes care and education specialist’s integration into the full care team beyond formal diabetes self-management education and support services.

Methods:

The 2021 National Practice Survey (NPS2021) contained 61 questions for all respondents with an additional 56 questions pertaining to specific diabetes care and education segments. An anonymous survey was administered online to respondents who are diabetes care and education specialists or a part of the diabetes care team. Email lists were obtained from the Association of Diabetes Care & Education Specialists (ADCES) and the Certification Board for Diabetes Care and Education (CBDCE). Approximately 39,258 emails were sent, and 3357 were undeliverable, with 3797 surveys completed between February 9 to April 6, 2021, resulting in an 11% response rate. The response rate may have been affected by the COVID-19 public health emergency.

Results:

Diabetes care and education specialists represent an interprofessional specialty of nurses, dietitians, physicians, pharmacists, health educators, and others. Many respondents reported holding either certification as a Certified Diabetes Care and Education Specialist (CDCES) or being Board Certified in Advanced Diabetes Management (BC-ADM). In addition, there appears to be a slight increase in those trained as a Lifestyle Coach to provide the National Diabetes Prevention Program (CDC Recognized National DPP) compared to NPS2017. Most respondents reported being Caucasian/White (84%), followed by Hispanic or Latinx (7%) and African American/Black and Asian/Asian American (at 4% each), like in previous surveys. Respondents reported diverse care delivery models, including traditional and nontraditional services, and expanded models of care such as population health/risk stratification models, the Chronic Care Model, Accountable Care Organizations, managed care, and others.

Conclusion:

The NPS2021 describes DCES workforce opportunities and challenges. Identifying and addressing those that impact the specialty’s sustainability, diversity, and growth will guide strategies for the future workforce and their practice settings. Opportunities identified include embracing diabetes community care coordinators for person-centered delivery of care and education services and supporting frontline health care team members to increase competence and expertise in the prevention of type 2 diabetes, diabetes care, and education/support for related chronic diseases. In addition, as health care evolves, it creates opportunities for the DCESs to demonstrate a broader, key role as part of the diabetes care team.
Humeral Head Osteochondral Allograft Reconstruction for Chronic Locked Posterior Glenohumeral Dislocation With Large Reverse Hill–Sachs Defect
Authors: Johnson Emma E. , Campbell Michael , Cohen Steven B.
Published: August 2022

Background:

Locked posterior glenohumeral dislocations are a rare but often missed injury when it occurs. In these dislocations, patients may have a reverse Hill–Sachs lesion, which are associated with high rates of recurrent posterior glenohumeral instability. Open reduction with allograft reconstruction to reconstruct the defect can be used to treat chronic locked posterior glenohumeral dislocations.

Indications:

Osteochondral allograft reconstruction is indicated when patients have a large defect affecting less than 50% of the articular surface and if the humeral head has been dislocated for less than 6 months.

Technique Description:

With the patient in beach chair position, exposure is obtained through deltopectoral approach. An open reduction is performed, and the defect is debrided down to healthy bleeding bone. The defect is templated, and the allograft is harvested and prepared. The allograft is securely fixed using cannulated cancellous screws. The patient undergoes a postoperative rehabilitation protocol.

Results:

There have been several case series following allograft reconstruction for locked posterior dislocations that have demonstrated good results. Riff et al found favorable results in his series of 20 patients with isolated humeral head lesions, with significant improvement in patient-outcome measures. There are several potential complications though. A systematic review by Saltzman et al found allograft resorption to occur in 36% and glenohumeral arthritic changes to occur in 35% with frozen allografts. These rates appear to be improved with fresh allografts.

Discussion/Conclusion:

In conclusion, osteochondral allograft is an effective surgical treatment for large Hill–Sachs defects in chronic locked posterior dislocations.
Hypoxia and low temperature upregulate transferrin to induce hypercoagulability at high altitude
Authors: Li Meiquan , Tang Xiaopeng , Liao Zhiyi , Shen Chuanbin , Cheng Ruomei , Fang Mingqian , Wang Gan , Li Ya , Tang Shuzhen , Xie Li , Zhang Zhiye , Kamau Peter Muiruri , Mwangi James , Lu Qiumin , Li Yaxiong , Wang Yuming , MacKeigan Daniel Thomas , Cerenzia Eric G. , Ni Heyu , Lai Ren
Published: August 2022

Studies have shown significantly increased thromboembolic events at high altitude. We recently reported that transferrin could potentiate blood coagulation, but the underlying mechanism for high altitude–related thromboembolism is still poorly understood. Here, we examined the activity and concentration of plasma coagulation factors and transferrin in plasma collected from long-term human residents and short-stay mice exposed to varying altitudes. We found that the activities of thrombin and factor XIIa (FXIIa) along with the concentrations of transferrin were significantly increased in the plasma of humans and mice at high altitudes. Furthermore, both hypoxia (6% O2) and low temperature (0°C), 2 critical high-altitude factors, enhanced hypoxia-inducible factor 1α (HIF-1α) levels to promote the expression of the transferrin gene, whose enhancer region contains HIF-1α binding site, and consequently, to induce hypercoagulability by potentiating thrombin and FXIIa. Importantly, thromboembolic disorders and pathological insults in mouse models induced by both hypoxia and low temperature were ameliorated by transferrin interferences, including transferrin antibody treatment, transferrin downregulation, and the administration of our designed peptides that inhibit the potentiation of transferrin on thrombin and FXIIa. Thus, low temperature and hypoxia upregulated transferrin expression–promoted hypercoagulability. Our data suggest that targeting the transferrin-coagulation pathway is a novel and potentially powerful strategy against thromboembolic events caused by harmful environmental factors under high-altitude conditions.
Conformation of von Willebrand factor in shear flow revealed with stroboscopic single-molecule imaging
Authors: Bergal Hans T. , Jiang Yan , Yang Darren , Springer Timothy A. , Wong Wesley P.
Published: August 2022

von Willebrand factor (VWF) is a multimeric blood protein that acts as a mechanical probe, responding to changes in flow to initiate platelet plug formation. Previously, our laboratory tests had shown that using single-molecule imaging that shear stress can extend surface-tethered VWF, but paradoxically, we found that the required shear stress was higher than reported for free-in-flow VWF, an observation inconsistent with basic physical principles. To resolve this inconsistency critical to VWF’s molecular mechanism, we measured free-VWF extension in shear flow using pulsed laser stroboscopic imaging of single molecules. Here, laser pulses of different durations are used to capture multiple images of the same molecule within each frame, enabling accurate length measurements in the presence of motion blur. At high shear stresses, we observed a mean shift in VWF extension of <200 nm, much shorter than the multiple-micron extensions previously reported with no evidence for the predicted sharp globule-stretch conformational transition. Modeling VWF with a Brownian dynamics simulation, our results were consistent with VWF behaving as an uncollapsed polymer rather than the theorized compact ball. The muted response of free VWF to high shear rates implies that the tension experienced by free VWF in physiological shear flow is lower than indicated by previous reports and that tethering to platelets or the vessel wall is required to mechanically activate VWF adhesive function for primary hemostasis.
Boltzmann- and Non-Boltzmann-Based Thermometers in the First, Second and Third Biological Windows for the SrF2:Yb3+, Ho3+ Nanocrystals Under 980, 940 and 915 nm Excitations
Authors: Wang Linxuan , Li Liang , Yuan Maohui , Yang Zining , Han Kai , Wang Hongyan , Xu Xiaojun
Published: August 2022

Spectrally determination of temperature based on the lanthanide-doped nanocrystals (NCs) is a vital strategy to noninvasively measure the temperature in practical applications. Here, we synthesized a series of SrF2:Yb3+/Ho3+ NCs and simultaneously observed the efficient visible upconversion luminescence (UCL) and near-infrared (NIR) downconversion luminescence (DCL) under 980, 940 and 915 nm excitations. Subsequently, these NCs were further utilized for thermometers based on the Boltzmann (thermally coupled levels, TCLs) and non-Boltzmann (non-thermally coupled levels, NTCLs) of Ho3+ ions in the first (~ 650 nm), second (~ 1012 nm) and third (~ 2020 nm) biological windows (BW-I, BW-II and BW-III) under tri-wavelength excitations. The thermometric parameters including the relative sensitivity ($$S_{{\text{r}}}$$

S
r

) and temperature uncertainty ($$\delta T$$

δ
T

) are quantitatively determined on the I648/I541 (BW-I), I1186/I1012 (BW-II), and I1950/I2020 (BW-III) transitions of Ho3+ ions in the temperature range of 303–573 K. Comparative experimental results demonstrated that the thermometer has superior performances.
Primary root response to combined drought and heat stress is regulated via salicylic acid metabolism in maize
Authors: Yang Xiaoyi , Zhu Xinjie , Wei Jie , Li Wentao , Wang Houmiao , Xu Yang , Yang Zefeng , Xu Chenwu , Li Pengcheng
Published: August 2022

The primary root is the first organ to perceive the stress signals for abiotic stress. In this study, maize plants subjected to drought, heat and combined stresses displayed a significantly reduced primary root length. Metabolic and transcriptional analyses detected 72 and 5,469 differentially expressed metabolites and genes in response to stress conditions, respectively. The functional annotation of differentially expressed metabolites and genes indicated that primary root development was mediated by pathways involving phenylalanine metabolism, hormone metabolism and signaling under stress conditions. Furthermore, we found that the concentration of salicylic acid and two precursors, shikimic acid and phenylalanine, showed rapid negative accumulation after all three stresses. The expression levels of some key genes involved in salicylic acid metabolism and signal transduction were differentially expressed under stress conditions. This study extends our understanding of the mechanism of primary root responses to abiotic stress tolerance in maize.
The Mann-Kendall-Sneyers test to identify the change points of COVID-19 time series in the United States
Authors: Chen Xiang , Wang Hui , Lyu Weixuan , Xu Ran
Published: August 2022

Background

One critical variable in the time series analysis is the change point, which is the point where an abrupt change occurs in chronologically ordered observations. Existing parametric models for change point detection, such as the linear regression model and the Bayesian model, require that observations are normally distributed and that the trend line cannot have extreme variability. To overcome the limitations of the parametric model, we apply a nonparametric method, the Mann-Kendall-Sneyers (MKS) test, to change point detection for the state-level COVID-19 case time series data of the United States in the early outbreak of the pandemic.

Methods

The MKS test is implemented for change point detection. The forward sequence and the backward sequence are calculated based on the new weekly cases between March 22, 2020 and January 31, 2021 for each of the 50 states. Points of intersection between the two sequences falling within the 95% confidence intervals are identified as the change points. The results are compared with two other change point detection methods, the pruned exact linear time (PELT) method and the regression-based method. Also, an open-access tool by Microsoft Excel is developed to facilitate the model implementation.

Results

By applying the MKS test to COVID-19 cases in the United States, we have identified that 30 states (60.0%) have at least one change point within the 95% confidence intervals. Of these states, 26 states have one change point, 4 states (i.e., LA, OH, VA, and WA) have two change points, and one state (GA) has three change points. Additionally, most downward changes appear in the Northeastern states (e.g., CT, MA, NJ, NY) at the first development stage (March 23 through May 31, 2020); most upward changes appear in the Western states (e.g., AZ, CA, CO, NM, WA, WY) and the Midwestern states (e.g., IL, IN, MI, MN, OH, WI) at the third development stage (November 19, 2020 through January 31, 2021).

Conclusions

This study is among the first to explore the potential of the MKS test applied for change point detection of COVID-19 cases. The MKS test is characterized by several advantages, including high computational efficiency, easy implementation, the ability to identify the change of direction, and no assumption for data distribution. However, due to its conservative nature in change point detection and moderate agreement with other methods, we recommend using the MKS test primarily for initial pattern identification and data pruning, especially in large data. With modification, the method can be further applied to other health data, such as injuries, disabilities, and mortalities.
The work-life balance of general practitioners as a predictor of burnout and motivation to stay in the profession
Authors: Bodendieck Erik , Jung Franziska U. , Conrad Ines , Riedel-Heller Steffi G. , Hussenoeder Felix S.
Published: August 2022

Background

Work-life balance (WLB) is associated with a variety of health-related outcomes in the general population. Since General Practitioners (GPs) play a fundamental role in the health system, we wanted to analyze the associations between their WLB and burnout scores as well as motivation to stay in the profession.

Methods

In September 2019, physicians from various specialties answered a comprehensive questionnaire. We analyzed a subsample of 188 GPs that were working full time, 61.7% were female.

Results

Multivariate analysis showed a beneficial association between WLB and all three dimensions of burnout (Emotional Exhaustion, Cynicism, and Professional Efficacy) as well as the motivation to stay in the profession.

Conclusions

Improving GPs WLB could be a way to reduce physician burnout, strengthen the healthcare system, and attract a new generation of talented physicians.
Comparison of time consumption and success rate between CT angiography- and CT perfusion- based imaging assessment strategy for the patients with acute ischemic stroke
Authors: Chu Yue , Ma Gao , Xu Xiao-Quan , Lu Shan-Shan , Shi Hai-Bin , Liu Sheng , Liu Qiang-Hui , Wu Fei-Yun
Published: August 2022

Background

Our study aimed to compare the time consumption and success rate between CTA- and CTP- based assessment strategy, and to clarify the risk factors associated with the CTP scan failure.

Methods

Clinical and radiological data of 437 consecutive AIS patients who underwent multiphase CTA or CTP for pre-treatment evaluation were retrospectively enrolled (CTA group, n = 302; CTP group, n = 135). Time consumption and success rate of CTA- and CTP- based assessment strategy were compared using Mann–Whitney U test and Chi-Squared Test. Univariate analysis and receiver operating curve analysis were used to clarify the risk factors, and their performance in predicting the CTP scan failure.

Results

Time consumption of CTP scan and reconstruction was significantly longer than that of CTA [775 s vs 263.5 s, P < 0.001]. CTP scan showed significantly higher failure rate than CTA (11% vs 1%, P < 0.001). Severe motion was the most common cause of CTP failure (n = 12, 80%). Baseline National Institute of Health Stroke Scale (NIHSS) score in CTP failure group was significantly higher than that in CTP success group [17 vs 13, P = 0.007]. Baseline NIHSS score of 11 was the optimal threshold value to predict CTP failure with an area under the curve of 0.715, a sensitivity of 86.7%, and a specificity of 45.0%.

Conclusions

CTP- based strategy showed longer time consumption and higher failure rate than CTA- based strategy. High baseline NIHSS score was significantly associated with CTP scan failure in AIS patients.
Determinants of stress coping behaviors in patients with Multiple Sclerosis (MS-DSCB): development and psychometrics of a PRECEDE model-based questionnaire
Authors: Hosseini Zahra , Homayuni Atefeh , Ghanbarnejad Amin
Published: August 2022

Objective

Stress management delays the onset or exacerbation of symptoms of multiple sclerosis. The present study aimed to develop and psychometrically evaluate a questionnaire to measure the determinants of stress coping behaviors in patients with multiple sclerosis.

Methods

This was a methodological study that was conducted in two stages: qualitative and quantitative phases. Participants in this study were patients with multiple sclerosis who referred to the MS Association and Charity Foundations for Special Diseases in Isfahan in 2021. Preliminary item pool was developed by qualitative part of the study. The validity of the questionnaire was determined with item impact, content validity ratio (CVR), content validity index (CVI), face validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).

Results

In the first stage, an item pool containing 97 items were generated and after removing duplicate items and merging some of them, a questionnaire containing 51 items was developed.

Ten items were removed based on the results of face validity and content validity. The EFA revealed 11 factors containing 41 items that explained 64% of the total variance of test. In CFA, 9 other items were deleted, and the questionnaire was reduced to 32 phrases in general. The results of the CFA determined the 9-factor structure of the questionnaire including awareness, attitude, self-efficacy, access to resources, skills of using resources, social support, important others, behavioral consequences and social comparison. The Cronbach's alpha coefficient of the questionnaire was 0.726.

Conclusion

The results showed that the designed questionnaire is a valid and reliable tool for assessing the determinants of stress coping behaviors in patients with multiple sclerosis. Identifying these factors and designing interventions based on them, in order to control or reduce stress in these patients, can help to improve the quality of life in these patients.
Determinants of consistent condom use among Filipino women: Results from the 2017 Philippine National Demographic and Health Survey
Authors: Pepito Veincent Christian F. , Amit Arianna Maever L. , Tang Clinton S. , Molen Ryan Gabriel C. , Co Luis Miguel B. , Aliazas Neil Andrew Kiamco , De Los Reyes Sarah J. , Tanchanco Lourdes Bernadette S.
Published: August 2022

Background

Consistent condom use in women, defined as the self-reported usage of male condom in every sexual encounter of the respondent with her most recent partner in the last 12 months, had been perennially low in the Philippines. This is despite consistent condom use being a tested and proven public health intervention to prevent unwanted pregnancy and sexually transmitted infections. Considering the high fertility rate, teenage pregnancy rate, and the rapidly increasing incidence of HIV in the country, we identified the determinants of consistent condom use in the Philippines.

Methods

We used data from the individual recode of the 2017 Philippine National Demographic and Health Survey. We used logistic regression for survey data to identify factors associated with consistent condom use.

Results

Out of 25,074 respondents, only 261 (1.13%) have used condoms consistently with their most recent partner. Reach of information and education campaigns on contraceptive use via different media ranged from 62% via television to 7% via short messaging service. After adjusting for confounders, those who were able to ask their partners to use condoms during sexual intercourse have 6.18 times (adjusted odds ratio (aOR): 6.18; 95% Confidence Interval (95% CI): 2.02. 18.94) greater odds of consistent condom use than those who were unable to ask their partners to use condoms during sexual intercourse. Meanwhile, HIV knowledge (aOR: 1.16; 95% CI: 0.98, 1.38) and hearing about contraception in television (aOR: 1.54; 95% CI: 1.00, 2.38) have weaker associations with consistent condom use.

Conclusions

The low percentage of those who use condoms consistently, together with the low reach of information and education campaigns, highlight the need to implement multi-faceted and context-specific interventions to promote sexual agency and/or consistent condom use to address the burden of unwanted pregnancies and HIV in the Philippines.
Changes in health behaviours in adults at-risk of chronic disease: primary outcomes from the My health for life program
Authors: Seib Charrlotte , Moriarty Stephanie , McDonald Nicole , Anderson Debra , Parkinson Joy
Published: August 2022

Background

Chronic disease is the leading cause of premature death globally, and many of these deaths are preventable by modifying some key behavioural and metabolic risk factors. This study examines changes in health behaviours among men and women at risk of diabetes or cardiovascular disease (CVD) who participated in a 6-month lifestyle intervention called the My health for life program.

Methods

The My health for life program is a Queensland Government-funded multi-component program designed to reduce chronic disease risk factors amongst at-risk adults in Queensland, Australia. The intervention comprises six sessions over a 6-month period, delivered by a trained facilitator or telephone health coach. The analysis presented in this paper stems from 9,372 participants who participated in the program between July 2017 and December 2019. Primary outcomes included fruit and vegetable intake, consumption of sugar-sweetened drinks and take-away, alcohol consumption, tobacco smoking, and physical activity. Variables were summed to form a single Healthy Lifestyle Index (HLI) ranging from 0 to 13, with higher scores denoting healthier behaviours. Longitudinal associations between lifestyle indices, program characteristics and socio-demographic characteristics were assessed using Gaussian Generalized Estimating Equations (GEE) models with an identity link and robust standard errors.

Results

Improvements in HLI scores were noted between baseline (Md = 8.8; IQR = 7.0, 10.0) and 26-weeks (Md = 10.0; IQR = 9.0, 11.0) which corresponded with increases in fruit and vegetable consumption and decreases in takeaway frequency (p < .001 for all) but not risky alcohol intake. Modelling showed higher average HLI among those aged 45 or older (β = 1.00, 95% CI = 0.90, 1.10, p < .001) with vocational educational qualifications (certificate/diploma: β = 0.32, 95% CI = 0.14, 0.50, p < .001; bachelor/post-graduate degree β = 0.79, 95% CI = 0.61, 0.98, p < .001) while being male, Aboriginal or Torres Strait Islander background, or not currently working conferred lower average HLI scores (p < .001 for all).

Conclusions

While participants showed improvements in dietary indicators, changes in alcohol consumption and physical activity were less amenable to the program. Additional research is needed to help understand the multi-level barriers and facilitators of behaviour change in this context to further tailor the intervention for priority groups.
Translation, cultural adaptation, and validation of the Integrated Palliative Outcome Scale-renal (IPOS-r) to Czech
Authors: Křemenová Zuzana , Vlčková Karolína
Published: August 2022

Background

Patients with advanced kidney disease suffer from burdensome symptoms, which should be assessed by valid and reliable patient-reported outcome measures.

This study aimed to provide a translation, cultural adaptation, and validation of the Czech version of the IPOS-r.

Methods

The IPOS-r was translated to Czech and culturally adapted using cognitive interviews. During the validation phase, patients and staff in dialysis centres and outpatient renal clinics completed the IPOS-r. Internal consistency was tested with Cronbach’s alpha, its reliability via intraclass correlation coefficient for total IPOS-r score, and weighted Kappa (for test-retest and interrater reliability of individual items). Convergent validity was tested with Spearman correlation to Kidney Disease Quality of Life Survey-Short Form 1.2 (KDQOL-SF 1.2). We assessed sensitivity to change using a distribution-based approach.

Results

Two sets of translators independently performed forward and backward translations of the IPOS-r. Ten patients and ten health care professionals participated in cognitive pre-testing. The sample size for validation included 88 patients (mean age 66 ± SD13.8; 58% men) who were treated with haemodialysis (70.5%), home haemodialysis (5.5%), peritoneal dialysis (3%), and conservative management (21%). Cronbach’s alpha was 0.72, and the intraclass correlation was 0.84 for test-retest reliability and 0.73 for interrater reliability. The IPOS-r correlated with KDQOL-SF 1.2 had a rho between 0.4–0.8 for most of the IPOS-r items, showing good convergent validity. The IPOS-r measure is feasible and takes 9 minutes to complete. Patients who reported a change in health status after 1 month demonstrated a total IPOS-r score change of eight points in both positive and negative directions.

Conclusions

The process of translation and cultural adaptation of the IPOS-r was successful, and the Czech IPOS-r measure is a valid and reliable tool. The Czech IPOS-r can be used to assess symptoms in patients with advanced chronic kidney disease.

Trial registration

GAUK [82121].
Direct medical costs of young-onset colorectal cancer: a worldwide systematic review
Authors: Garg Ria , Cheng Vicki , Ellis Ursula , Verma Vanay , McTaggart-Cowan Helen , Peacock Stuart , Loree Jonathan M. , Sadatsafavi Mohsen , De Vera Mary A.
Published: August 2022

Background

Given the rising incidence of young-onset colorectal cancer (yCRC) among individuals younger than 50 years old, understanding the economic burden of yCRC is required to inform the delivery of healthcare services. Therefore, we conducted a systematic review of studies assessing the direct medical costs of yCRC, and where relevant average-age onset CRC (aCRC).

Methods

We searched MEDLINE, EMBASE, and Web of Science from inception to May 2022 for original, peer-reviewed studies, that reported direct medical costs (e.g., chemotherapy, radiotherapy, outpatient visits, inpatient care, prescription medications) for yCRC and aCRC. We used a modified version of the Consolidated Health Economic Evaluation Reporting Standards checklist to appraise the studies. Costs were inflation-adjusted to 2020 US dollars.

Results

We included 14 studies from 10 countries, including the USA, England, France, Korea, Vietnam, China, Italy, Australia, Canada and Japan. Five studies focused on prevalent disease and reported annualized per-capita cost of prevalent yCRC, ranging from $2,263 to $16,801 and $1,412 to $14,997 among yCRC and aCRC cases, respectively. Nine studies estimated the cost of incident disease. Synthesis of per-capita costs incurred 12 months following colorectal cancer diagnosis ranged from $23,368 to $89,945 for yCRC and $19,929 to $67,195 for aCRC. Five studies used multivariable approaches to compare costs associated with yCRC and aCRC, four showed no differences and one suggested greater costs with yCRC.

Conclusion

Our synthesis of direct medical costs of yCRC across multiple jurisdictions provide relevant information for healthcare decisions, including on-going considerations for expanding CRC screening strategies to younger adults.
Paternal hypoxia exposure primes offspring for increased hypoxia resistance
Authors: Ragsdale Alexandria , Ortega-Recalde Oscar , Dutoit Ludovic , Besson Anne A. , Chia Jolyn H. Z. , King Tania , Nakagawa Shinichi , Hickey Anthony , Gemmell Neil J. , Hore Timothy , Johnson Sheri L.
Published: August 2022

Background

In a time of rapid environmental change, understanding how the challenges experienced by one generation can influence the fitness of future generations is critically needed. Using tolerance assays and transcriptomic and methylome approaches, we use zebrafish as a model to investigate cross-generational acclimation to hypoxia.

Results

We show that short-term paternal exposure to hypoxia endows offspring with greater tolerance to acute hypoxia. We detected two hemoglobin genes that are significantly upregulated by more than 6-fold in the offspring of hypoxia exposed males. Moreover, the offspring which maintained equilibrium the longest showed greatest upregulation in hemoglobin expression. We did not detect differential methylation at any of the differentially expressed genes, suggesting that other epigenetic mechanisms are responsible for alterations in gene expression.

Conclusions

Overall, our findings suggest that an epigenetic memory of past hypoxia exposure is maintained and that this environmentally induced information is transferred to subsequent generations, pre-acclimating progeny to cope with hypoxic conditions.
Frailty in individuals with depression, bipolar disorder and anxiety disorders: longitudinal analyses of all-cause mortality
Authors: Mutz Julian , Choudhury Umamah , Zhao Jinlong , Dregan Alexandru
Published: August 2022

Background

Frailty is a medical syndrome that is strongly associated with mortality risk and an emerging global health burden. Mental disorders are associated with reduced life expectancy and elevated levels of frailty. In this study, we examined the mortality risk associated with frailty in individuals with a lifetime history of mental disorders compared to individuals without a history of mental disorders.

Methods

The UK Biobank study recruited > 500,000 adults, aged 37–73, between 2006 and 2010. We derived the two most common albeit distinctive measures of frailty, the frailty phenotype and the frailty index. Individuals with lifetime depression, bipolar disorder or anxiety disorders were identified from multiple data sources. The primary outcome was all-cause mortality. We have also examined differences in frailty, separately by sex and age.

Results

Analyses included up to 297,380 middle-aged and older adults with a median follow-up of 12.19 (interquartile range = 1.31) years, yielding 3,516,706 person-years of follow-up. We observed higher levels of frailty in individuals with mental disorders for both frailty measures. Standardised mean differences in the frailty index ranged from 0.66 (95% confidence interval [CI] 0.65–0.67) in individuals with anxiety disorders to 0.94 (95% CI 0.90–0.97) in individuals with bipolar disorder, compared to people without mental disorders. For key comparisons, individuals with a mental disorder had greater all-cause mortality hazards than the comparison group without mental disorders. The highest hazard ratio (3.65, 95% CI 2.40–5.54) was observed among individuals with bipolar disorder and frailty, relative to non-frail individuals without mental disorders.

Conclusions

Our findings highlight elevated levels of frailty across three common mental disorders. Frailty and mental disorders represent potentially modifiable targets for prevention and treatment to improve population health and life expectancy, especially where both conditions coexist.
Genotyping and pathogenicity of fowl adenovirus isolated from broiler chickens in Egypt
Authors: Safwat Marwa M. , Sayed Al Shimaa R. , Ali Elsayed Marwa F. , Ibrahim Awad Abd El Hafez
Published: August 2022

Background

Over the past 10 years, inclusion body hepatitis outbreaks, essentially from commercial broiler flocks, have been detected in different geographic regions highlighting the wide distribution of FAdVs around the world resulting in serious economic losses due to increased mortalities as well as poor performance within poultry farms in Assiut province, Egypt. Thus, this study was achieved to detect fowl adenovirus in broiler chicken flocks in Assiut province, Egypt and to recognize the pathogenicity of the isolated virus.

Results

The phylogeny of the L1 loop of the hexon gene exposed that the isolated virus clustered and belonged to the reference strains serotype D FAdV. The isolated virus is closely related to inclusion body hepatitis (IBH) strains causing extensive economic losses. The pathogenicity study of the virus showed typical macroscopic lesions with 6% mortality; furthermore, histopathological inspection exhibited severe hepatitis and degenerative changes after 5d from infection in the immune system. 

Conclusion

Results in this research support the primary pathogenicity and mortality caused by FADV serotype 2 (IBH) alone without immunosuppressive agents thus robust control measures should be implanted against FAdV to evade the serious economic losses in poultry farms.
Dietary total antioxidant capacity in relation to metabolic health status in overweight and obese adolescents
Authors: Mohammadi Sobhan , Lotfi Keyhan , Mirzaei Saeideh , Asadi Ali , Akhlaghi Masoumeh , Saneei Parvane
Published: August 2022

Background

Although several studies evaluated the relationship between individual dietary antioxidants and metabolic health conditions, data on the association between dietary total antioxidant capacity and metabolic health among children and adolescents is limited. This study investigated the relationship between dietary total antioxidant capacity and metabolic health status in Iranian overweight/obese adolescents.

Methods

This cross-sectional study was conducted on 203 overweight/obese adolescents. Dietary intakes were evaluated by a validated food frequency questionnaire. Ferric Reducing-Antioxidant Power (FRAP) was considered to indicate dietary total antioxidant capacity. Anthropometric parameters and blood pressure status were measured. Fasting blood samples were obtained to determine circulating insulin, glucose, and lipid profile. Two different methods (modified International Diabetes Federation (IDF) criteria and IDF criteria along with insulin resistance) were applied to classify participants as metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO).

Results

According to IDF and IDF/HOMA definitions, a total of 79 (38.9%) and 67 (33.0%) adolescents were respectively defined as MUO. Considering IDF criteria, the highest tertile of FRAP was related to lower odds of being MUO in the maximally-adjusted model (OR: 0.40; 95%CI: 0.16–0.96), compared to the lowest tertile. However, based on the IDF/HOMA-IR criteria, no significant relation was found between FRAP and odds of MUO (OR: 0.49; 95%CI: 0.19–1.23) after considering all possible confounders.

Conclusions

Adolescents with higher intakes of dietary antioxidants have a lower possibility of being MUO based on IDF criteria. However, no substantial relation was found considering HOMA-IR/IDF definition. Further prospective cohort studies need to be done to confirm these findings.
Hypoxia-induced MIF induces dysregulation of lipid metabolism in Hep2 laryngocarcinoma through the IL-6/JAK-STAT pathway
Authors: Yang Minlan , Wu Sa , Cai Weisong , Ming Xiaoping , Zhou Yuhao , Chen Xiong
Published: August 2022

Purpose

Hypoxia is a common feature of laryngocarcinoma. Alterations in lipid metabolism are an important metabolic rewiring phenomenon for malignant cells to maintain their rapid proliferation in the hypoxic microenvironment, which makes most cancers, including laryngocarcinoma, difficult to cure. However, the mechanisms involved in lipid metabolism in laryngocarcinoma is still unclear. This study aimed to clarify the changes in lipid metabolism of laryngocarcinoma cells under hypoxic conditions and explore the related mechanisms.

Methods

Hep2 cells were incubated in a normoxic or hypoxic environment (5% CO2 and 1% O2) at 37 °C for 24 h. CCK-8 cell viability assay and colony formation assay were performed to detect cells proliferation. And lipid metabolic indices including TG and NEFA were determined by kits. The mechanism involved in the regulation of lipid metabolism was explored by RNA-seq and bioinformatic analysis. The MIF inhibitor ISO-1 and JAK inhibitor XL019 were used to verify the mechanism. Finally, a tumour xenograft model was applied to further verify these results in vivo.

Results

Hypoxia promoted cell proliferation and increased the levels of TG and NEFA in Hep2 cells. Three genes, MIF, ENO2, and LDHA, that were screened by the intersection of hypoxia gene sets and fatty gene sets and were verified by qPCR. The MIF levels were elevated when cells were exposed to hypoxia. Through GSEA and RNA-seq analysis, the JAK/STAT pathway was screened. Hypoxia increased MIF levels and activated the IL-6/JAK/STAT pathway. The MIF inhibitor ISO-1inhibited cell proliferation under hypoxia and reversed the change in TG levels and IL-6 levels. And ISO-1 reversed the expression pattern of the screened genes in the JAK/STAT pathway. Finally, a tumour xenograft model further verified these results in vivo.

Conclusion

Hypoxia induced reprogramming of lipid metabolism in laryngocarcinoma cells through the MIF/IL-6/JAK-STAT pathway. This study revealed one mechanism that allows laryngocarcinoma cells to adapt to the hypoxic tumour microenvironment. Therefore, a drug targeting the MIF/IL-6/JAK-STAT pathway might be a promising therapeutic option for the treatment of laryngocarcinoma.
MicroRNAs secreted by human preimplantation embryos and IVF outcome
Authors: Kamijo Shintaro , Hamatani Toshio , Sasaki Hiroyuki , Suzuki Hiroki , Abe Akane , Inoue Osamu , Iwai Maki , Ogawa Seiji , Odawara Kei , Tanaka Kanako , Mikashima Mutsumi , Suzuki Masami , Miyado Kenji , Matoba Ryo , Odawara Yasushi , Tanaka Mamoru
Published: August 2022

Objective

To generate an effective embryo prediction model and identify a non-invasive evaluation method by analyzing microRNAs (miRNAs) in embryo culture medium.

Design

Analysis of microRNA profiles from spent culture medium of blastocysts with good morphology that did or did not result in pregnancy.

Setting

Clinical and experimental research.

Patients

Sixty patients who underwent thawed embryo transfer of blastocysts after intracytoplasmic sperm injection.

Intervention(s)

None.

Main outcome measure(s)

The association of miRNA abundance levels secreted by blastocysts in culture medium and implantation success.

Results

Our RNA sequencing analysis found a total of 53 differentially expressed miRNAs in the culture media of pregnancy and non-pregnancy groups. Twenty-one miRNAs were analyzed for their potential to predict implantation success. Eight miRNAs (hsa-miR-191-5p, hsa-miR-320a, hsa-miR-92a-3p, hsa-miR-509-3p, hsa-miR-378a-3p, hsa-miR-28-3p, hsa-miR-512-5p, and hsa-miR-181a-5p) were further extracted from the results of a logistic regression analysis of qPCR Ct values. A prediction model for high-quality blastocysts was generated using the eight miRNAs, with an average accuracy of 0.82 by 5-fold cross validation.

Conclusion

We isolated blastocyst miRNAs that may predict implantation success and created a model to predict viable embryos. Increasing the number of investigated cases and further studying the effect of each miRNA on embryonic development is needed to refine the miRNA-based predictive model.