bluuebunny/crossref_metadata_2025 huggingface dataset:
Meaning(s) of transition(s) from military to civilian life at the intersection with mental health: implications for clinical settings
Authors: Misca Gabriela , Augustus Jo , Russell Jade , Walker Janet
Published: May 2023

The experiences of military personnel moving into civilian life can be varied for the individual, families and communities. This paper aims to shed light on the various meanings of the multiple and “nested” transitions of military personnel to civilian life in the context of attending a mental health service in the UK. This was achieved through secondary analysis of semi-structured interviews with veterans who were engaging with a mental health service in the UK and a further interview with the mental health service lead. A thematic analysis was employed based on a descriptive phenomenological approach. Results indicate that an appropriate support infrastructure needs to be put in place for veterans prior to, during and after the transition to civilian life. The support appropriateness includes themes specific to connectedness to others, support service accessibility, mental health professionals' military culture awareness and mental health stigma. Although the findings suggest that community services need an awareness of veterans' specific needs, many of the themes are similar to those of the general population. Therefore, the need for an integrated healthcare system is essential in the transition of military service personnel to civilian life. Drawing on international evidence as well as the current findings, implications for policy and practice are highlighted throughout.
Comparison of the probability of four anticonvulsant mood stabilizers to facilitate polycystic ovary syndrome in women with epilepsies or bipolar disorder—A systematic review and meta-analysis
Authors: Guo Jing , Liu Yan , Kong Lingling , Sun Yaoyao , Lu Zhe , Lu Tianlan , Qu Haiying , Yue Weihua
Published: May 2023

Background

Patients treated with anticonvulsant mood stabilizers have a higher incidence of polycystic ovary syndrome (PCOS). However, there is no comparison between different anticonvulsant mood stabilizers. The purpose of this study was to systematically evaluate the prevalence of PCOS in women taking anticonvulsant mood stabilizers and compare the probability of PCOS caused by different anticonvulsant mood stabilizers.

Methods

Five databases, namely PubMed, Embase, Web of Science, Cochrane Library, and Clinical Trials, were searched for literature on anticonvulsant mood stabilizers and PCOS published up to October 28, 2022. This meta-analysis was performed using Revman 5.4, Stata 14.0, and R4.1.0, and effect size pooling was performed in fixed- or random-effects models based on the results of I2 and Q-test, and the surface under the cumulative ranking curve (SUCRA) was used for analysis to assess the cumulative probability of drug-induced PCOS. Publication bias was assessed by funnel plot Egger's test and meta regression.

Results

Twenty studies with a total of 1,524 patients were included in a single-arm analysis, which showed a combined effect size (95% CI) of 0.21 (0.15–0.28) for PCOS in patients taking anticonvulsant mood stabilizers. Nine controlled studies, including 500 patients taking medication and 457 healthy controls, were included in a meta-analysis, which showed OR = 3.23 and 95% CI = 2.19–4.76 for PCOS in women taking anticonvulsant mood stabilizers. Sixteen studies with a total of 1416 patients were included in a network meta-analysis involving four drugs, valproate (VPA), carbamazepine (CBZ), oxcarbazepine (OXC), and lamotrigine (LTG), and the results of the network meta-analysis showed that VPA (OR = 6.86, 95% CI = 2.92–24.07), CBZ (OR = 3.28, 95% CI = 0.99–12.64), OXC (OR = 4.30, 95% CI = 0.40–49.49), and LTG (OR = 1.99, 95% CI = 0.16–10.30), with cumulative probabilities ranked as VPA (90.1%), OXC (63.9%), CBZ (50.1%), and LTG (44.0%).

Conclusion

The incidence of PCOS was higher in female patients treated with anticonvulsant mood stabilizers than in the healthy population, with VPA having the highest likelihood of causing PCOS. The most recommended medication when considering PCOS factors is LTG.

Systematic review registration

identifier: CRD42022380927
The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence
Authors: Hutsebaut Joost , Clarke Sharon L. , Chanen Andrew M.
Published: May 2023

Although national guidelines explicitly state that personality disorder can be diagnosed and treated in young people aged 12 to 18 years (adolescents), most clinicians remain hesitant. This creates a gap between science and practice, which we argue is largely motivated by moral reasons and, therefore, is best challenged by ethical arguments. We provide seven arguments in support of the notion that it is ethically right to diagnose and treat personality disorder when it occurs in adolescents. Central to these arguments is the scientific evidence that features of personality disorder are among the best predictors of a complex cluster of psychopathology leading to impairments in many areas of current and future mental, social and vocational functioning. We argue that intervention during adolescence and young adulthood is not only humane, but also critical for efforts to avert the longstanding psychosocial and health problems that seem refractory to treatment in adults with personality disorder. Moreover, we argue that regular services are often inadequately equipped to meet the needs of young people with personality disorder and that the common ‘stepped-care’ approach should be replaced by a ‘staged-care’ approach. Finally, we argue that early detection and intervention might have anti-stigmatizing effects, similar to other areas of healthcare in which stigmatizing labels have changed meaning when the conditions to which they refer have become more amenable to treatment.
How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis
Authors: Schwarz Julian , Wolff Jan , Heinze Martin , von Peter Sebastian , Habicht Juri Luis
Published: May 2023

Background

Intensive forms of outreach mental health care (IOC) such as crisis resolution or home treatment teams are increasingly implemented as alternatives to inpatient admission, providing recovery-oriented treatment at home at comparable costs and outcomes. However, one issue with IOC is the lack of continuity regarding staff members who provide home visits, complicating relationship building and meaningful therapeutic exchange. The aim of this study is to validate existing primarily qualitative findings using performance data and to explore a possible correlation between the number of staff involved within IOC treatment and the service users’ length of stay (LOS).

Methods

Routine data from an IOC team in a catchment area in Eastern Germany were analyzed. Basic parameters of service delivery were calculated and an in-depth descriptive analysis regarding staff continuity was performed. Further, an exploratory single case analysis was conducted, presenting the exact sequence of all treatment contacts for one case with low and one with high staff continuity.

Results

We analyzed 10.598 face-to-face treatment contacts based on 178 IOC users. The mean LOS was 30.99 days. About 75% of all home visits were conducted by two or more staff members simultaneously. Service users saw an average of 10.24 different staff per treatment episode. On 11% of the care days, only unknown staff, and on 34% of the care days at least one unknown staff member conducted the home visit. 83% of the contacts were performed by the same three staff members and 51% were made by one and the same staff member. A significant positive correlation (p = 0.0007) was found between the number of different practitioners seen by a service user in the first seven days of care and the LOS.

Conclusion

Our results suggest that a high number of different staff in the early period of IOC episodes correlates with an extended LOS. Future research must clarify the exact mechanisms of this correlation. Furthermore, it should be investigated how the multiple professions within IOC teams influence the LOS and the quality of treatment and what quality indicators may be suitable to ensure treatment processes.
Treatment strategy for insomnia disorder: Japanese expert consensus
Authors: Takaesu Yoshikazu , Sakurai Hitoshi , Aoki Yumi , Takeshima Masahiro , Ie Kenya , Matsui Kentaro , Utsumi Tomohiro , Shimura Akiyoshi , Okajima Isa , Kotorii Nozomu , Yamashita Hidehisa , Suzuki Masahiro , Kuriyama Kenichi , Shimizu Eiji , Mishima Kazuo , Watanabe Koichiro , Inada Ken
Published: May 2023

Purpose

There is a lack of evidence regarding answers for clinical questions about treating insomnia disorder. This study aimed to answer the following clinical questions: (1) how to use each hypnotic and non-pharmacological treatment differently depending on clinical situations and (2) how to reduce or stop benzodiazepine hypnotics using alternative pharmacological and non-pharmacological treatments.

Methods

Experts were asked to evaluate treatment choices based on 10 clinical questions about insomnia disorder using a nine-point Likert scale (1 = “disagree” to 9 = “agree”). The responses of 196 experts were collected, and the answers were categorized into first-, second-, and third-line recommendations.

Results

The primary pharmacological treatment, lemborexant (7.3 ± 2.0), was categorized as a first-line recommendation for sleep initiation insomnia, and lemborexant (7.3 ± 1.8) and suvorexant (6.8 ± 1.8) were categorized as the first-line recommendations for sleep maintenance insomnia. Regarding non-pharmacological treatments for primary treatment, sleep hygiene education was categorized as the first-line recommendation for both sleep initiation (8.4 ± 1.1) and maintenance insomnia (8.1 ± 1.5), while multicomponent cognitive behavioral therapy for insomnia was categorized as the second-line treatment for both sleep initiation (5.6 ± 2.3) and maintenance insomnia (5.7 ± 2.4). When reducing or discontinuing benzodiazepine hypnotics by switching to other medications, lemborexant (7.5 ± 1.8) and suvorexant (6.9 ± 1.9) were categorized as first-line recommendations.

Conclusion

Expert consensus indicates that orexin receptor antagonists and sleep hygiene education are recommended as first-line treatments in most clinical situations to treat insomnia disorder.
Case report: Suicide and inhibitions of thinking—An integrative view from traditional psychoanalytic and mentalizing perspectives
Authors: Seng Choi Chong
Published: May 2023

Suicide has been the subject of exploration in psychoanalysis. From Freud's internalized aggression and self-objectification in melancholic depression to contributions from object relation and self-psychology theorists, several of these central clinical concepts seem to share the commonality that one encounters an inhibition of thinking in a suicidal state of mind. Their freedom of thought is inhibited unswervingly despite the notion that we are born to think. Most psychopathologies, including suicide, relate to how we are often stuck with our thoughts. Thinking beyond this sense comes with significant emotional resistance. This case report follows through an attempt to integrate the hypothesized inhibitions on one's capability to think, involving one's own core conflicts and dysfunctional mental processing from the traditional psychoanalytic and mentalizing perspectives. The author hopes that further conceptualizations and research will empirically investigate these assumptions, potentially improving suicide risk assessment and prevention and enhancing psychotherapeutic outcomes.
Sustainable nutrition and the case of vegetable oils to match present and future dietary needs
Authors: Mannucci Pier Mannuccio , Jolliet Olivier , Meijaard Erik , Slavin Joanne , Rasetti Mario , Aleta Alberto , Moreno Yamir , Agostoni Carlo
Published: May 2023

Sustainable nutrition represents a formidable challenge for providing people with healthy, nutritious and affordable food, while reducing waste and impacts on the environment. Acknowledging the complexity and multi-dimensional nature of the food system, this article addresses the main issues related to sustainability in nutrition, existing scientific data and advances in research and related methodologies. Vegetable oils are epitomized as a case study in order to figure out the challenges inherent to sustainable nutrition. Vegetable oils crucially provide people with an affordable source of energy and are essential ingredients of a healthy diet, but entail varying social and environmental costs and benefits. Accordingly, the productive and socioeconomic context encompassing vegetable oils requires interdisciplinary research based on appropriate analyses of big data in populations undergoing emerging behavioral and environmental pressures. Since oils represent a major and growing source of energy at a global level, their role in sustainable nutrition should be considered beyond pure nutritional facts, at the light of soil preservation, local resources and human needs in terms of health, employment and socio-economic development.
Utility and usability evaluation of an information diary tool to measure health information access and exposure among patients with high cardiovascular risk
Authors: Lim Hooi Min , Ng Chirk Jenn , Abdullah Adina , Dalmazzo Jason , Lim Woei Xian , Lee Kah Hang , Dunn Adam G.
Published: May 2023

Background

Online health misinformation about statins potentially affects health decision-making on statin use and adherence. We developed an information diary platform (IDP) to measure topic-specific health information exposure where participants record what information they encounter. We evaluated the utility and usability of the smartphone diary from the participants' perspective.

Methods

We used a mixed-method design to evaluate how participants used the smartphone diary tool and their perspectives on usability. Participants were high cardiovascular-risk patients recruited from a primary care clinic and used the tool for a week. We measured usability with the System Usability Scale (SUS) questionnaire and interviewed participants to explore utility and usability issues.

Results

The information diary was available in three languages and tested with 24 participants. The mean SUS score was 69.8 ± 12.9. Five themes related to utility were: IDP functions as a health information diary; supporting discussion of health information with doctors; wanting a feedback function about credible information; increasing awareness of the need to appraise information; and wanting to compare levels of trust with other participants or experts. Four themes related to usability were: ease of learning and use; confusion about selecting the category of information source; capturing offline information by uploading photos; and recording their level of trust.

Conclusion

We found that the smartphone diary can be used as a research instrument to record relevant examples of information exposure. It potentially modifies how people seek and appraise topic-specific health information.
How digital health technologies promote healthy life in the Post-COVID-19 Era: evidences from national survey on Chinese adolescents and youngsters
Authors: Li Xiaojing , Zhang Min
Published: May 2023

The rapid development of intelligent technologies coupled with the stay-at-home trends in the Post-COVID-19 Era has significantly changed youth's health behavior as well as reshaped their lifestyles. Digital health technologies (DHTs) have been more and more used for health management among youngsters. However, little was known about the use of DHTs among youths and its consequences on their health, especially in developing countries like China. Inspired by behavior intervention technology (BIT) model, this study examined the underlying mechanisms of use and social interactions of DHTs on Chinese adolescents' and youngsters' healthy lifestyles and mental health, using a representatively national survey among high school and freshman students in China (N = 2,297). It found that use of DHTs had a significantly positive effect on Chinese youths' healthy lifestyles and mental health, with behavioral regulation as a mediator. However, social interactions of DHTs were negatively associated with their mental health. The findings contribute to a better guidance on health promotion, as well as the enhanced design of DHTs' products.
Continuity of care among diabetic patients in Accra, Ghana
Authors: Awumee Veronica , Dery Samuel Kennedy Kangtabe
Published: May 2023

Introduction

Diabetes mellitus is a fast-rising non-contagious disease of global importance that remains a leading cause of indisposition and death. Evidence shows that effective management of diabetes has a close link with continuity of care which is known to be the integral pillar of quality care. This study, therefore, sought to determine the extent of continuity of care between diabetic patients and their care providers as well as factors associated with relational continuity of care.

Methodology

This cross-sectional, facility-based study was conducted among diabetics in Accra, Ghana. We sampled 401 diabetic patients from three diabetic clinics in the region using a stratified and systematic random sampling technique. Data were collected using a structured questionnaire containing information on socio-demographic characteristics, the four dimensions of continuity of care, and patients' satisfaction. A 5-point Likert scale was used to measure patient's perception of relational, flexible, and team continuity, while most frequent provider continuity was used to measure longitudinal continuity of care. Scores were added for each person and divided by the highest possible score for each domain to estimate the continuity of care index. Data were collected and exported to Stata 15 for analysis.

Results

The results show that team continuity was the highest (0.9), followed by relational and flexibility continuity of care (0.8), and longitudinal continuity of care was the least (0.5). Majority of patients experienced high team (97.3%), relational (68.1%), and flexible (65.3%) continuity of care. Most patients (98.3%) were satisfied with the diabetes care they received from healthcare providers. Female subjects had higher odds of experiencing relational continuity of care as compared to male subjects. Furthermore, participants with higher educational levels were five times more likely to experience relational continuity of care than those with lower educational background.

Conclusion

The study demonstrated that the majority of diabetics had team continuity of care being the highest experienced among the four domains, followed by flexible and longitudinal being the least experienced. Notably, team and flexible continuity of care had a positive association with relational continuity of care. Higher educational level and being female were associated with relational continuity of care. There is therefore the need for policy action on the adoption of multidisciplinary team-based care.
Direct medical costs of ischemic heart disease in urban Southern China: a 5-year retrospective analysis of an all-payer health claims database in Guangzhou City
Authors: Xie Peixuan , Li Xuezhu , Guo Feifan , Zhang Donglan , Zhang Hui
Published: May 2023

Introduction

This study aimed to estimate the direct medical costs and out-of-pocket (OOP) expenses associated with inpatient and outpatient care for IHD, based on types of health insurance. Additionally, we sought to identify time trends and factors associated with these costs using an all-payer health claims database among urban patients with IHD in Guangzhou City, Southern China.

Methods

Data were collected from the Urban Employee-based Basic Medical Insurance (UEBMI) and the Urban Resident-based Basic Medical Insurance (URBMI) administrative claims databases in Guangzhou City from 2008 to 2012. Direct medical costs were estimated in the entire sample and by types of insurance separately. Extended Estimating Equations models were employed to identify the potential factors associated with the direct medical costs including inpatient and outpatient care and OOP expenses.

Results

The total sample included 58,357 patients with IHD. The average direct medical costs per patient were Chinese Yuan (CNY) 27,136.4 [US dollar (USD) 4,298.8] in 2012. The treatment and surgery fees were the largest contributor to direct medical costs (52.0%). The average direct medical costs of IHD patients insured by UEBMI were significantly higher than those insured by the URBMI [CNY 27,749.0 (USD 4,395.9) vs. CNY 21,057.7(USD 3,335.9), P < 0.05]. The direct medical costs and OOP expenses for all patients increased from 2008 to 2009, and then decreased during the period of 2009–2012. The time trends of direct medical costs between the UEBMI and URBMI patients were different during the period of 2008-2012. The regression analysis indicated that the UEBMI enrollees had higher direct medical costs (P < 0.001) but had lower OOP expenses (P < 0.001) than the URBMI enrollees. Male patients, patients having percutaneous coronary intervention operation and intensive care unit admission, patients treated in secondary hospitals and tertiary hospitals, patients with the LOS of 15–30 days, 30 days and longer had significantly higher direct medical costs and OOP expenses (all P < 0.001).

Conclusions

The direct medical costs and OOP expenses for patients with IHD in China were found to be high and varied between two medical insurance schemes. The type of insurance was significantly associated with direct medical costs and OOP expenses of IHD.
C-1 Substituted isoquinolines potentiate the antimycobacterial activity of rifampicin and ethambutol
Authors: Martin Liam T. , Lamming Eleanor D. , Maitra Arundhati , Mortazavi Parisa N. , Roddan Rebecca , Ward John M. , Bhakta Sanjib , Hailes Helen C.
Published: May 2023

Introduction

The emergence of extensively drug-resistant strains ofMycobacterium tuberculosisthreatens decades of progress in the treatment of a disease which remains one of the leading infectious causes of death worldwide. The development of novel antimycobacterial compounds is therefore essential to reinforce the existing antitubercular drug discovery pipeline. There is also interest in new compounds which can synergize with existing antitubercular drugs and can be deployed as part of a combination therapy. This strategy could serve to delay the emergence of resistance to first-line anti-tuberculosis drugs and increase their efficacy against resistant strains of tuberculosis. Previous research has established that several C-1 substituted tetrahydroisoquinolines have antimycobacterial activity. Here we sought to expand our understanding of their antimycobacterial structure activity relationships and their potential to act as adjunct therapies alongside existing antitubercular drugs.

Methods

Three chemical series were synthesised and assayed for their antimycobacterial potency, mammalian cell toxicity, inhibition of whole-cell efflux and synergism with isoniazid, rifampicin, and ethambutol.

Results

Several compounds were found to inhibit the growth of mycobacteria. Potent inhibitors of whole-cell efflux were also identified, as well as compounds which exhibited synergism with rifampicin and ethambutol.

Conclusions

Structure-activity relationships were identified for antimycobacterial potency, improved selectivity, whole cell efflux inhibition and synergism. Potent whole-cell efflux inhibitors and synergistic compounds were identified, suggesting potential development as adjuncts to existing anti-tuberculosis chemotherapy.
Extended-spectrum beta-lactamases in poultry in Africa: a systematic review
Authors: Ayinla Akeemat O. , Mateus Ana L. P.
Published: May 2023

Extended-spectrum beta-lactamase (ESBL)-producing bacteria present a unique problem because of their ability to cause infections that are difficult to treat in animals and humans. The presence of ESBL-Escherichia coli (E. coli) in poultry raises a major public health concern due to the risk of zoonotic transfer via the food chain and direct contact with birds and the environment. This review aimed to determine the frequency of ESBL-producing E. coli and associated ESBL genes in poultry in Africa. Three databases (PubMed, ScienceDirect, and Web of Science) and predetermined websites were searched to identify scientific and grey literature. Studies (1582) were screened at title, abstract, and full-text levels. This review was registered with PROSPERO (CRD42021259872). Thirty-three studies were deemed eligible for this review. Phenotypic ESBL expression was confirmed in 22 studies (66.7%) with a wide range of colonization noted in sampled poultry (1 – 100%). The blaCTX-Mgene was the most commonly isolated with the variants blaCTX-M-1and blaCTX-M-15being the most predominant in North and West Africa respectively. ESBL-producing E. coli isolates are frequently detected in poultry in farms and slaughterhouses across Africa thereby posing a potential health risk to humans. The paucity of data however does not allow for inferences to be made about the true extent of ESBLs in poultry in Africa.
Risk factors of osteoporosis in elderly inpatients: A cross-sectional single-centre study
Authors: Li Han , Sun Tianbao , Han Dongmei , Gong Weiwei , Mao Weiwei , Gan Xianze , Shu Dan , Zhou Qian , Xu Lei , Hou Liufang , Zhou Mingcheng , Cai Mingwei , Lai Xueli
Published: May 2023

Objective: This study aimed to identify factors significantly associated with the occurrence of osteoporosis in elderly and very elderly patients.

Methods: Elderly hospitalized patients who were older than 60 years old, from the Rehabilitation Hospital from December 2019 to December 2020 were selected. Barthel index (BI), nutritional assessment, the causes of bone mineral density (BMD) reductions in elderly and elderly patients were analysed.

Results: A total of 94 patients (83.56 ± 8.37 years old) were enrolled. With increasing age, the BMD of the lumbar spine, femoral neck, and femoral shaft of elderly patients significantly decreased, and the incidence of osteoporosis (OP) significantly increased. The BMD of the lumbar spine was negatively correlated with female and positively correlated with serum 25-hydroxyvitamin D levels, the difference between actual body weight and ideal body weight, and blood uric acid levels; The BMD of the femoral neck was negatively correlated with age and female, and positively correlated with height and geriatric nutrition risk index score. The BMD of the femoral shaft was negatively correlated with female and positively correlated with BI.

Conclusion: With increasing age, the BMD of the lumbar spine and the femoral shaft significantly decreased, and the incidence of OP significantly increased in elderly and very elderly patients. Aric acid may protect bone health in elderly patients. Early attention to the nutritional status, exercise capacity, 25-hydroxyvitamin D level, and blood uric acid level in the elderly population can help identify high-risk elderly patients with OP.
Turning to friends in preference to parents for support in early adolescence: does this contribute to the gender difference in depressive symptoms?
Authors: Wright Nicky , Sharp Helen , Gay Jessica , Pickles Andrew , Hill Jonathan
Published: May 2023

Introduction

Based on established evidence of gender differences in friendship patterns, and the vulnerability associated with early reliance on friends, we hypothesized that in 13-year-olds, a preference for turning to friends rather than parents for emotional support contributes to the gender difference in depressive symptoms.

Methods

Using a cross-sectional design, 671 adolescents (53.7% girls; mean age 13.11 ± 0.52 years) in a UK birth cohort [Wirral Child Health and Development Study (WCHADS)] reported turning to their parents and to their friends when distressed [Network of Relationships Inventory (NRI)] and depressed [Short Mood and Feelings Questionnaire (SMFQ)]. Preferentially turning to friends was assessed as turning to friends minus turning to parents for support. Analyses used path analysis using the gsem command in Stata.

Results

Girls had higher depressive symptoms than boys (p < .001). Consistent with the hypotheses, girls had higher scores than boys for preferentially turning to friends (p < .001). Preferentially turning to friends was associated with higher depressive symptoms (p < .001), and this mediated the gender difference in depressive symptoms (p < .001). The association between preferentially turning to friends and depressive symptoms was stronger for girls than for boys (p = .004).

Conclusions

In young adolescents, preferentially turning to friends over parents when distressed is common, and the association between preferentially turning and depressive symptoms is markedly higher in girls than in boys. This reflects either a gender difference in social vulnerability to depression or a greater impact of depression on the reliance on friends instead of parents in girls. While clarifying the directions of influence requires prospective study, these findings provide the first evidence that the assessment of depression in young adolescents should consider the degree of reliance on friends and parents.
Feasibility, effectiveness and safety of self-management in pulmonary rehabilitation: a study protocol using a hybrid type 1 effectiveness-implementation design
Authors: Ricke Ellen , Dijkstra Arie , Bakker Eric W.
Published: May 2023

Background

As population ageing accelerates worldwide, chronic diseases will place an increasing burden on society and healthcare systems. Self-management interventions may become a key strategy for addressing chronic disease burden and healthcare costs, also in pulmonary rehabilitation (PR). One of the challenges here is long-term adherence. Understanding the level of adherence to PR may help inform clinical decision-making to focus more on self-management and less on clinical supervision. For this reason, a prediction model (PATCH) was developed. The presented protocol concerns a study that aims 1. to evaluate the safety and effectiveness of self-management within pulmonary rehabilitation (PR) on health outcomes in patients with chronic obstructive pulmonary disease (COPD), 2. to evaluate the predictive validity of the PATCH tool, and 3. to evaluate feasibility and acceptability of self-management and the PATCH tool by patients and physiotherapists.

Methods and analysis

This is a protocol of a hybrid type 1 effectiveness-implementation design, performed in primary physiotherapy practices in The Netherlands. The aim is to include 108 patients with COPD who have already followed PR for at least six weeks (maintenance stage of PR). According to the Dutch KNGF Guideline COPD, physiotherapists should reduce the number of supervised treatments after the maintenance phase and support self-management. In practice, this does not (always) happen. This protocol is based on implementing guideline advice: clinical supervision will be halved but patients are stimulated to engage in self-management by exercising unsupervised, leading to no change in the total planned exercise frequency. During the supervised sessions physiotherapists will assess and stimulate self-management. At baseline, and after 3, 6, 9 and 12 months, health outcomes (including adherence) will be evaluated as the primary outcome of this study. At each measurement, the physiotherapist will decide on the basis of individual scores whether the patient needs more clinical supervision or not. Secondary outcomes are the discriminatory power of the PATCH tool (can patients be correctly classified as adherent or non-adherent), and feasibility and acceptability of self-management and the PATCH tool by patients and physiotherapists. Questionnaires and semi-structured interviews will be used for assessment of the outcomes.

Trial registration number: METc 2023/074.
Contributions of digital social research to develop Telemedicine in Calabria (Southern Italy): identification of inequalities in post-COVID-19
Authors: Taddei Luciana , Mendicino Francesco , Grande Teresa , Mulé Antonella , Micozzi Roberto , Parini Ercole Giap
Published: May 2023

The paper discusses the role that sociology and digital social research methods could play in developing E-health and Telemedicine, specifically after the COVID-19 pandemic, and the possibility of dealing with new pandemics. In this article, we will reflect on an interdisciplinary research pilot project carried out by a team of sociologists, medical doctors, and software engineers at The University of Calabria (Italy), to give a proof of concept of the importance to develop Telemedicine through the contribution of digital social research. We apply a web and app survey to administrate a structured questionnaire to a self-selected sample of the University Community. Digital social research has highlighted socioeconomic and cultural gaps that affect the perception of Telemedicine in the University Community. In particular, gender, age, educational, and professional levels influence medical choices and behaviors during Covid-19. There is often an unconscious involvement in Telemedicine (people use it but don't know it is Telemedicine), and an optimistic perception grows with age, education, professional, and income levels; equally important are the comprehension of digital texts and the effective use of Telemedicine. Limited penetration of technological advances must be addressed primarily by overcoming sociocultural and economic barriers and developing knowledge and understanding of digital environments. The key findings of this study could help direct public and educational policies to reduce existing gaps and promote Telemedicine in Calabria.
Patterns of investment in agricultural research and innovation for the Global South, with a focus on sustainable agricultural intensification
Authors: Prasad P. V. Vara , Bhatnagar Nirat , Bhandari Vineet , Jacob George , Narayan Kaushal , Echeverría Ruben , Beintema Nienke , Farah Cox Paul , Compton Julia
Published: May 2023

This study is the first attempt to determine global investment patterns for research and innovation in agriculture systems for the Global South, and specifically for innovation funding targeted at sustainable agricultural intensification. We analyzed and modeled patterns of funding from governments in the Global South, development partners, private companies, and private equity and venture capital funds, using primary and secondary sources of data spanning 2010 to 2019. We ascertain the key providers and recipients of innovation funding and how it is shared out between different topics and value chains. Results showed that about $60 billion of funding (ranging from $50 to $70 billion) goes toward agricultural innovation for the Global South each year, with 60–70% of it coming from these countries' own governments (and the government of China accounting for as much as all others combined). This $60 billion investment represents just 4.5% of Global South agricultural output. Furthermore, <7% of the total funding was found to have detectable environmental intentions, and less than 5% had both social and environmental intentions. Adopting a standard for transparent reporting and measurement could potentially lead to swift changes in funding patterns toward sustainability goals.
Comparative study of halo-vest reduction and skull traction reduction in the treatment of cervical fracture dislocation in patients with ankylosing spondylitis
Authors: Wang Liang , Wang Haibin , Wang Can , Zhang Bangke , Yang Haisong , Lu Xuhua
Published: May 2023

Background

This study aimed to investigate the safety and efficacy of the halo-vest in the treatment of cervical fracture in patients with ankylosing spondylitis (AS) and kyphosis.

Methods

From May 2017 to May 2021, 36 patients with cervical fractures with AS and thoracic kyphosis were included in this study. The patients with cervical spine fractures with AS underwent preoperative reduction by halo-vest or skull tractions. Instrumentation internal fixation and fusion surgery were then performed. The level of cervical fractures, the operative duration, blood loss, and treatment outcomes were investigated preoperatively and postoperatively.

Results

A total of 25 cases were included in the halo-vest group and 11 cases were included in the skull tractions group. The intraoperative blood loss and the surgery duration were significantly less in the halo-vest group than in the skull traction group. A comparison of American Spinal Injury Association scores at admission and final follow-up showed that the neurological function of patients improved in both groups. All patients had reached solid bony fusion during the follow-up.

Conclusion

This study presented a unique approach to use halo-vest treatment fixation of unstable cervical fracture in patients with AS. The patient should also have early surgical stabilization with a halo-vest to correct spinal deformity and avoid worsening of neurological status.
Treatment of proximal patellar tendon rupture with custom-made anchor-like plate and suture: cases report and literature review
Authors: Qi Hongfei , Li Zhong , Ma Teng , Ren Cheng , Xu Yibo , Huang Qiang , Zhang Kun , Li Ming
Published: May 2023

We reported 2 cases of patellar tendon rupture at the lower pole of the patella. For patellar tendon rupture, simple suture fixation has been proved to be inadequate in strength. Our center uses custom-made anchor-like plate and suture to treat proximal patellar fracture. The fixation strength is reliable, no additional bone tunnel is required, and the fixation of the lower patellar fracture can be achieved at the same time. After the operation, the patient starts functional exercise of the knee joint at an early stage, The function of the knee joint of the patient recovered well after 1 year, without other complications.
Experimental Methodology to Characterize the Noise Paths in a Horizontal-Axis Washing Machine
Authors: Albero Cristian , Sánchez-Tabuenca Beatriz
Published: May 2023

In this paper, an experimental methodology to characterize the noise paths in a washing machine with a horizontal axis was developed. The noise paths considered in this research were the noise that escapes through holes, the non-resonant path through the panels, and the noise radiated by the panels of the cabinet. The characterization method was based on several sound intensity measurements on the outside panels of the washing machine. In addition to these measurements, characterization of the radiation factor was performed by applying a method that relates intensity and vibration measurements while the structure of the washing machine is excited using a shaker. Applying the methodology to a washing machine, the main transmission path of the noise along the frequency domain where this home appliance has its highest values was identified. This methodology can provide the manufacturer with a guide to improve the acoustic performance of washing machines by applying noise control solutions in the noise path depending on the frequency domain.
The Strategic Use of an Immunomodulatory Feed Additive in Supplements for Grazing Young Nellore Bulls Transported after Weaning: Performance, Physiological, and Stress Parameters
Authors: Batista Luis Henrique Curcino , Oliveira Ivanna Morais , Prados Laura Franco , Araújo Laylles Costa , Ferreira Igor Machado , Abreu Mateus José Inácio de , Almeida Saulo Teixeira Rodrigues de , Borges César Aparecido de Araújo , Siqueira Gustavo Rezende , Resende Flávio Dutra de
Published: May 2023

The objective of this study was to evaluate four different feeding strategies using an immunomodulatory feed additive for newly weaned Nellore cattle, before and after road transport, on their physiological parameters and performances during the growing phase of pastures. In total, eighty-four young Nellore bulls (initial BW = 174 ± 11 kg; 7 ± 1 months of age) were blocked by their initial body weights 42 days before road transport (d −42) and randomly assigned to one of the four supplementation strategies. The treatments were: (1) Control (CON): no immunomodulatory feed additive (NUTRA) supplementation; (2) NUTRA pre: the inclusion of NUTRA only in the pre-transport period (d −42 to d 0); (3) NUTRA post: the inclusion of NUTRA for 42 days, only in the post-transport period (d 0 to d 42); and (4) NUTRA growth: the inclusion of NUTRA during the whole experimental period (d −42 to d 210). On d 0, the calves were transported on dirty roads in a commercial livestock trailer for 200 km (8 h). There was no effect of the treatments on the animal performance or the physiological parameters in their plasma. However, there were effects on the day of the blood sampling for all the parameters. The highest concentration of cortisol was observed on d 3 post-transport (129 ng/mL) and this decreased over time (22.4 ng/mL; d 210). On the other hand, their glucose peaked at unloading, with lower concentrations on d 7 and d 14. Their total protein concentrations increased from d 0 to d 7. The immunomodulatory feed additive supplementation at 10 g/100 kg BW/day did not modulate the physiological responses in their plasma and did not influence the performance of the Nellore bulls during the growing phase of their pastures.
Polyclonal Antibodies Derived from Transchromosomic Bovines Vaccinated with the Recombinant F1-V Vaccine Increase Bacterial Opsonization In Vitro and Protect Mice from Pneumonic Plague
Authors: Biryukov Sergei S. , Wu Hua , Dankmeyer Jennifer L. , Rill Nathaniel O. , Klimko Christopher P. , Egland Kristi A. , Shoe Jennifer L. , Hunter Melissa , Fetterer David P. , Qiu Ju , Davies Michael L. , Bausch Christoph L. , Sullivan Eddie J. , Luke Thomas , Cote Christopher K.
Published: May 2023

Plague is an ancient disease that continues to be of concern to both the public health and biodefense research communities. Pneumonic plague is caused by hematogenous spread of Yersinia pestis bacteria from a ruptured bubo to the lungs or by directly inhaling aerosolized bacteria. The fatality rate associated with pneumonic plague is significant unless effective antibiotic therapy is initiated soon after an early and accurate diagnosis is made. As with all bacterial pathogens, drug resistance is a primary concern when developing strategies to combat these Yersinia pestis infections in the future. While there has been significant progress in vaccine development, no FDA-approved vaccine strategy exists; thus, other medical countermeasures are needed. Antibody treatment has been shown to be effective in animal models of plague. We produced fully human polyclonal antibodies in transchromosomic bovines vaccinated with the recombinant F1-V plague vaccine. The resulting human antibodies opsonized Y. pestis bacteria in the presence of RAW264.7 cells and afforded significant protection to BALB/c mice after exposure to aerosolized Y. pestis. These data demonstrate the utility of this technology to produce large quantities of non-immunogenic anti-plague human antibodies to prevent or possibly treat pneumonic plague in human.
ESKAPEE Pathogen Biofilm Control on Surfaces with Probiotic Lactobacillaceae and Bacillus species
Authors: Neidhöfer Claudio , Rathore Kamni , Parčina Marijo , Sieber Martin A.
Published: May 2023

Combatting the rapidly growing threat of antimicrobial resistance and reducing prevalence and transmission of ESKAPEE pathogens in healthcare settings requires innovative strategies, one of which is displacing these pathogens using beneficial microorganisms. Our review comprehensively examines the evidence of probiotic bacteria displacing ESKAPEE pathogens, with a focus on inanimate surfaces. A systematic search was conducted using the PubMed and Web of Science databases on 21 December 2021, and 143 studies were identified examining the effects of Lactobacillaceae and Bacillus spp. cells and products on the growth, colonization, and survival of ESKAPEE pathogens. While the diversity of study methods limits evidence analysis, results presented by narrative synthesis demonstrate that several species have the potential as cells or their products or supernatants to displace nosocomial infection-causing organisms in a variety of in vitro and in vivo settings. Our review aims to aid the development of new promising approaches to control pathogen biofilms in medical settings by informing researchers and policymakers about the potential of probiotics to combat nosocomial infections. More targeted studies are needed to assess safety and efficacy of different probiotic formulations, followed by large-scale studies to assess utility in infection control and medical practice.
Sarcopenic Obesity: Involvement of Oxidative Stress and Beneficial Role of Antioxidant Flavonoids
Authors: Jung Un Ju
Published: May 2023

Sarcopenic obesity, which refers to concurrent sarcopenia and obesity, is characterized by decreased muscle mass, strength, and performance along with abnormally excessive fat mass. Sarcopenic obesity has received considerable attention as a major health threat in older people. However, it has recently become a health problem in the general population. Sarcopenic obesity is a major risk factor for metabolic syndrome and other complications such as osteoarthritis, osteoporosis, liver disease, lung disease, renal disease, mental disease and functional disability. The pathogenesis of sarcopenic obesity is multifactorial and complicated, and it is caused by insulin resistance, inflammation, hormonal changes, decreased physical activity, poor diet and aging. Oxidative stress is a core mechanism underlying sarcopenic obesity. Some evidence indicates a protective role of antioxidant flavonoids in sarcopenic obesity, although the precise mechanisms remain unclear. This review summarizes the general characteristics and pathophysiology of sarcopenic obesity and focuses on the role of oxidative stress in sarcopenic obesity. The potential benefits of flavonoids in sarcopenic obesity have also been discussed.
Integral Valorization of Grape Pomace for Antioxidant Pickering Emulsions
Authors: Diaz-Ramirez Julen , Basasoro Senda , González Kizkitza , Eceiza Arantxa , Retegi Aloña , Gabilondo Nagore
Published: May 2023

Full harnessing of grape pomace (GP) agricultural waste for the preparation of antioxidant Pickering emulsions is presented herein. Bacterial cellulose (BC) and polyphenolic extract (GPPE) were both prepared from GP. Rod-like BC nanocrystals up to 1.5 µm in length and 5–30 nm in width were obtained through enzymatic hydrolysis (EH). The GPPE obtained through ultrasound-assisted hydroalcoholic solvent extraction presented excellent antioxidant properties assessed using DPPH, ABTS and TPC assays. The BCNC-GPPE complex formation improved the colloidal stability of BCNC aqueous dispersions by decreasing the Z potential value up to −35 mV and prolonged the antioxidant half-life of GPPE up to 2.5 times. The antioxidant activity of the complex was demonstrated by the decrease in conjugate diene (CD) formation in olive oil-in-water emulsions, whereas the measured emulsification ratio (ER) and droplet mean size of hexadecane-in-water emulsions confirmed the physical stability improvement in all cases. The synergistic effect between nanocellulose and GPPE resulted in promising novel emulsions with prolonged physical and oxidative stability.