bluuebunny/crossref_metadata_2025 huggingface dataset:
Nursing Research in Arab Countries: Current Status, Trends, Challenges, and Opportunities
Authors: Wehbe-Alamah Hiba , Doumit Myrna A. A. , Bernstein Joshua , Aboul-Enein Basil H.
Published: April 2024

Introduction

Twenty-two Arab countries comprise the League of Arab States. While united in Arab identity, diversities among these countries exist at many levels. Conducting and publishing research in the Arabic speaking countries is an essential pillar for improving the status of the nursing profession.

Purpose

The purpose of this study is to assess the current status, trends, challenges, and opportunities of nursing research in Arab countries.

Methodology

An integrative review was conducted using (1) Index Medicus for the Eastern Mediterranean Regional Office Database Journals Directory (IMEMR), (2) the Iraqi Academic Scientific Journals Database (IASJD), (3) Ulrichsweb (UW), (4) The Geneva Foundation for Medical Education and Research/Middle Eastern Journals (GFMER), (5) the Nursing Journal Directory (NJD), (6) the Directory of Open Access Journals (DOAJ), and (7) Google Scholar. Journals and articles that met inclusion criteria were accessed, retrieved, reviewed, and subjected to content analysis by three authors, two of which were fluent in English, French, and Arabic languages. A third author fluent in all three languages confirmed the findings.

Results

Nursing research in Arabic-speaking countries has evolved over the past decades but is still lacking compared to global nursing research. Moreover, it was found to be largely situated within academic institutions and linked to tenure and promotion requirements.

Conclusion

Nursing journals in Arabic-speaking countries do not adequately represent that overall region and are limited in access.
Demystifying the Chinese local state: Planning and contesting urban growth at Hexi New Town, Nanjing
Authors: Wang Lili
Published: April 2024

Taking note of the limitations of previously dominant political economy perspectives on China’s urban transformation, and inspired by recent works calling for “beyond-growth” and “micro-level” studies of the Chinese state, as well as ethnographic approaches to the state, this paper aims to explore the often-untold everyday politics of decision-making processes in China’s state-led urban development. Using an urban design project at Hexi New Town in Nanjing, China, as an empirical lens, the article makes three main contributions. Firstly, it reveals how the Chinese local state is constitutive of and lived through intense negotiations and contestations over urban visions, subjectivities, and rules of practices in everyday life. Secondly, building upon existing ethnographic approaches to the state, which focus primarily on state-society dynamics, this paper develops a framework to re-conceptualize the power topology within the Chinese local state as a field of relational modalities (ruling power relations (re)enacted in everyday practices) and relational embeddedness (situated positionalities and subjectivities of state actors). Thirdly, it further shows how the power modalities (the interplay of political-economy power vs technical-power, territorial power vs trans-territorial power) of the Chinese local state are constantly reworked, sometimes re-enacted, sometimes challenged, through both formal and tacit rules in the state’s everyday life. As such, the article provides a new set of entry points to open the black-box of the Chinese local state and to explore the relational nature and an ethnographic perspective of the local state and urban politics in China and beyond.
Modification of Humeral Component Results in Increased Impingement Free Range of Motion in a Reverse Shoulder Arthroplasty Model
Authors: Schroeder Dalton Dale , Borsgard Alexander , Rossman Timothy Lee , Stewart Cory Michael
Published: April 2024

Introduction

Shoulder arthroplasties have been demonstrated to provide reliable pain relief as well as functional benefits. The advent of the reverse shoulder arthroplasty allowed for expanded indications for shoulder replacement. Several studies comparing the outcomes of anatomic and reverse total shoulder arthroplasties have demonstrated decreased range of motion in the reverse arthroplasty cohort, especially in internal rotation. The authors hypothesized that slight modifications to the humeral component of a reverse shoulder arthroplasty could result in increased impingement free range of motion without significant sacrifices to stability.

Methods

A reverse shoulder arthroplasty model was fashioned to mimic a setting of anterior mechanical impingement after replacement. Sequential resections were taken from the anterior aspect of the polyethylene up to a resection of 10 mm. A solid modeling software was utilized to compare the experimental group to the control group with regard to impingement free motion. Finite element analysis was subsequently utilized to assess stability of the construct in comparison to the nonmodified polyethylene.

Results

Impingement free internal rotation increased minimally at 3 mm of resection but considerably at each further increase in resection. A resection of 10 mm resulted roughly 30% improvement in impingement free internal rotation. Instability in this model increased with modifications beyond 7 mm.

Conclusion

Slight alterations to the geometry of the humeral tray and polyethene components can result in improvements in impingement-free internal rotation without substantial increased instability in this model. Further work is needed to determine in vivo implications of modifications to the humeral tray and polyethylene.
The Concept of Treatment for Surgical Infection in the Hindfoot
Authors: Alizade Chingiz , Aliyev Huseyn , Alizada Farhad
Published: April 2024

Background:

Chronic osteomyelitis of the calcaneus (OC) and open infected calcaneal fractures, especially when complicated by infected soft tissue defects, present significant surgical challenges. Accepted recommendations for the surgical treatment of this pathology are yet to be established.

Methods:

Drawing from our experience and the consensus among experts, we have developed a concept for selecting optimal, well-known surgical approaches based on the specific pathologic presentation. This concept distinguishes 4 main forms of hindfoot infection: infected wounds, open infected fractures, OC, and their mixed forms. Patients with conditions that could confound the treatment outcomes, such as diabetes mellitus and neurotrophic diseases, were excluded from this analysis. We present a retrospective analysis of the treatment outcomes for 44 patients (4 women and 40 men) treated between 2009 and 2022 using some refined surgical techniques. Treatment success was evaluated based on the absence of disease recurrence within a 2-year follow-up, the avoidance of below-knee amputations, and the restoration of weightbearing function.

Results:

The treatment results were considered through the prism of our proposed concept and according to the Cierny-Mader classification. There were 4 instances of disease recurrence, necessitating 6 additional surgeries, 2 of which (4.5% of the patient cohort) resulted in amputations. In the remaining cases, we were able to restore weightbearing function and eliminate the infection through reconstructive surgeries, employing skin grafts when necessary.

Conclusion:

Surgical infections of the hindfoot area remain a significant challenge. The strategic concept we propose for surgical decision making, tailored to the specific pathology, represents a potential advancement in addressing this challenge. This framework could provide valuable guidance for orthopaedic surgeons in their clinical decision-making process.

Level of Evidence:

Level IV, case series.
Outcomes of Percutaneous Zadek Osteotomy for Insertional Achilles Tendinopathy with Two-Year Minimum Follow-Up: A Retrospective Study
Authors: Hall SarahRose , Schipper Oliver , Kaplan Jonathan , Johnson Anne Holly , Gonzalez Tyler , Vulcano Ettore
Published: April 2024

Introduction/Purpose:

Insertional Achilles tendinopathy (IAT) is a common source of posterior heel pain treated by orthopaedic foot and ankle surgeons. Traditional surgical treatment consists of an open Achilles tendon debridement with re-attachment as well as excision of the posterosuperior calcaneal prominence with or without a gastrocnemius recession. However, frequent complications include wound healing issue, scar pain, weakness and sural nerve injury. Accordingly, the percutaneous ZO is gaining popularity in the field as an alternative to an open midline splitting approach. Limited literature exists describing outcomes of the percutaneous ZO using a larger sample size. The purpose of this study was to analyze patient reported outcomes and complications after percutaneous ZO with a minimum two-year follow-up period.

Methods:

One hundred and eight cases treated with percutaneous ZO were retrospectively reviewed across October 2017-July 2021 and outcomes data was available for 104 cases with a minimum two-year follow-up. Patient sex, age, and pertinent comorbidities were recorded. Postoperative complications and patient satisfaction following intervention were evaluated. Foot Function Index score (FFI) was utilized to measure patients’ pain and functional outcomes. Visual Analyzing Scale score (VAS) was also utilized to evaluate pain. These measurements were taken at preoperative and final follow-up. Statistical comparisons were performed using two-tailed, paired t-test with p< 0.05.

Results:

Mean follow-up time was 41.2±13.1 months (range 24-65 months). The mean FFI score improved from 56.1±5.9 (range 47-88) preoperatively to 11.0±5.1 (range 7-59) postoperatively (p < 0.001). Average VAS score improved in patients receiving percutaneous ZO from 7.6±1.3 (range 5-10) to 0.4±0.9 (range 0-7) postoperatively (p < 0.001). The overall complication rate was 3.8% (N =4). Of 104 cases, 98.1% of patients were satisfied with their procedure (102/104).

Conclusion:

The percutaneous ZO is a safe and highly effective intervention for treatment of IAT. At a minimum of two-years follow-up, this intervention is associated with minimal complications, improved functional outcomes, reduced pain, and high patient satisfaction. Table 1 Functional and subjective pain preoperative and postoperative scores as evaluated by functional foot index (FFI) and visual analogue scale (VAS), respectively
Long-Term Follow-up of Patients With Cytomegalovirus Retinitis Treated With a Ganciclovir Implant
Authors: Caranfa Jonathan T. , Duker Jay S.
Published: April 2024

Purpose: To assess the long-term safety and clinical outcomes of a ganciclovir intravitreal implant in patients with cytomegalovirus (CMV) retinitis. Methods: A retrospective study was performed of patients with CMV retinitis treated with a ganciclovir intravitreal implant. Results: The study included 13 patients (16 eyes) previously treated with a ganciclovir intravitreal implant. The mean time since the last implant placement was 21.3 years and the mean total duration of follow-up, 22.7 years. Visual acuity (VA) ranged from 20/25 to light perception, with 56% of eyes maintaining a VA of 20/60 or better at the most recent follow-up examination. Common ocular complications included epiretinal membrane (38%), macular fibrosis/scarring (25%), retinal detachment (RD) (25%), implant dislocation (25%), and immune reactivation uveitis (19%). Intraocular surgery was required in 10 eyes (63%), with the most frequent being cataract extraction (31%), pars plana vitrectomy (PPV) for implant removal (19%), and PPV for RD (13%). Conclusions: Results show the long-term safety of the ganciclovir intravitreal implant despite its residual inactive inert shell. Complication rates are consistent with those expected from infectious sequelae.
Capturing the Social Life of a Person by Integrating Experience-Sampling Methodology and Personal-Social-Network Assessments
Authors: Stadel Marie , Bringmann Laura F. , Stulp Gert , Elmer Timon , Verdonck Stijn , Mestdagh Merijn , van Duijn Marijtje A. J.
Published: April 2024

The daily social life of a person can be captured with different methodologies. Two methods that are especially promising are personal-social-network (PSN) data collection and experience-sampling methodology (ESM). Whereas PSN data collections ask participants to provide information on their social relationships and broader social environment, ESM studies collect intensive longitudinal data on social interactions in daily life using multiple short surveys per day. In combination, the two methods enable detailed insights into someone’s social life, including information on interactions with specific interaction partners from the personal network. Despite many potential uses of such data integration, there are few studies to date using the two methods in conjunction. This is likely due to their complexity and lack of software that allows capturing the full social life of someone while keeping the burden for participants and researchers sufficiently low. In this article, we report on the development of methodology and software for an ESM/PSN integration within the established ESM tool m-Path. We describe results of a first study using the developed tool that illustrate the feasibility of the proposed method combination and show that participants consider the assessments insightful. We further outline study-design choices and ethical considerations when combining the two methodologies. We hope to encourage applications of the presented methods in research and practice across different fields.
Examining student and faculty attitudes in developing a social justice studies minor
Authors: Messerschmitt-Coen Shelby , Bradfield Shelley-Jean , McMahon Elizabeth , Mena Paulina , Oberhauser Gannon
Published: April 2024

Social justice in education is becoming a more prominent and necessary area of study in higher education. Facets of social justice align directly with values of liberal arts education, and students who are exposed to social justice pedagogy develop the knowledge and skills necessary to meet critical learning outcomes associated with the liberal arts. Given such demands to incorporate social justice pedagogy and practice into curriculum, the purpose of this study was to understand student and faculty attitudes and values regarding social justice education in order to guide the creation of this academic program at our college, as well as other institutions, particularly liberal arts colleges and/or predominately white institutions, that are interested in creating or enhancing their social justice education programs. Themes from focus groups with students and faculty revealed needs, desires, and concerns from the campus community regarding social justice education. Additionally, we created a social justice studies program for our institution using a strategic review of existing curriculum, resulting in a new academic minor built on existing courses that required no new faculty lines and little additional work on behalf of the faculty. Insights from this process are shared.
STK16 promoted colorectal cancer progress in a c-MYC signaling-dependent manner
Authors: Peng Li , Guangshi Liu , Wusman Lai Bijiang· , Tao Li
Published: April 2024

Background

Colorectal cancer standed as a global health challenge, ranking third in cancer incidence and second in cancer-related deaths worldwide. A deeper understanding of the intricate mechanisms driving colorectal cancer development was pressing need. STK16 had garnered attention in recent researches, while its involvement in cancer had been minimally explored. c-MYC had emerged as a key player in cancer biology. Due to its complex structure, multifunctionality, and intricate interactions, directly inhibiting the activity of c-MYC proves to be challenging. Hence, current research was directing efforts towards modulating c-MYC expression levels.

Methods

Immunoblot, Immunohistochemistry and immunoprecipitation assays were conducted to assess the indicated protein expression levels. RT-PCR was performed to detect the corresponding mRNA expression levels. The proliferation, migration, invasion, and colony formation abilities of the specified cancer cells were investigated using CCK8 assays, Brdu assays, transwell assays, and colony formation assays, respectively. Cellular and animal experiments were performed to investigate the correlation between STK16 signaling and c-MYC signaling.

Results

STK16 plays a positive regulatory role in the progression of colorectal cancer. Delving into the molecular mechanisms, we unveiled that STK16 phosphorylated c-MYC at serine 452, a pivotal event hindering the ubiquitin-proteasome pathway degradation of c-MYC. Importantly, colorectal cancer proliferation mediated by STK16 was found to be dependent on the phosphorylation of c-MYC at S452. Furthermore, the researchers demonstrated that STK16 knockout or pharmacological inhibition significantly curtailed colorectal cancer proliferation and c-MYC expression in in vivo animal models.

Conclusion

We discovered that STK16 phosphorylates c-MYC at serine 452, hindering its degradation via the ubiquitin-proteasome pathway. STK16 inhibition, either genetically or pharmacologically, effectively curtails cancer growth and c-MYC expression in vivo. These findings highlight STK16 as a potential therapeutic target for colorectal cancer.
Predictive value of the systemic immune-inflammation index on one-year mortality in geriatric hip fractures
Authors: Çelen Zekeriya Ersin
Published: April 2024

Background

Geriatric hip fractures are associated with a high incidence of mortality. This study examines the predictive value of the systemic immune-inflammation index (SII) on one-year mortality in elderly hip fracture patients.

Methods

A single-center retrospective study was conducted between February 2017 and October 2020. Three hundred and eleven surgically treated consecutive hip fracture patients were included in the study. Admission, postoperative first day, and postoperative fifth-day SII values were calculated. The receiver operating characteristic (ROC) curve was used to calculate the cut-off values, and patients were divided into high and low groups according to these cut-off values. After univariate Cox regression analysis, significant factors were included in the multivariate Cox proportional hazards model to adjust the effect of covariates and explore independent predictive factors associated with mortality. Further subgroup analysis was performed to evaluate the accuracy of the results for different clinical and biological characteristics.

Results

The mean age was 80.7 ± 8.0 years, and women made up the majority (67.8%) of the patients. The one-year mortality rate was 28.0%. After univariate and multivariate analyses, high postoperative fifth-day SII remained an independent predictor of one-year mortality (adjusted HR 2.16, 95% CI 1.38–3.38, p = 0.001). Older age, male gender, Charlson comorbidity index (CCI) ≥ 2, and hypoalbuminemia were found to be other independent predictors. The optimal cut-off value of the postoperative fifth-day SII was calculated at 1751.9 units (p < 0.001).

Conclusion

The postoperative fifth-day SII is a simple and useful inflammatory biomarker for predicting one-year mortality in patients with hip fracture.
The global patent landscape of emerging infectious disease monkeypox
Authors: Cai Yuanqi , Zhang Xiaoming , Zhang Kuixing , Liang Jingbo , Wang Pingping , Cong Jinyu , Xu Xin , li Mengyao , Liu Kunmeng , Wei Benzheng
Published: April 2024

Background

Monkeypox is an emerging infectious disease with confirmed cases and deaths in several parts of the world. In light of this crisis, this study aims to analyze the global knowledge pattern of monkeypox-related patents and explore current trends and future technical directions in the medical development of monkeypox to inform research and policy.

Methods

A comprehensive study of 1,791 monkeypox-related patents worldwide was conducted using the Derwent patent database by descriptive statistics, social network method and linear regression analysis.

Results

Since the 21st century, the number of monkeypox-related patents has increased rapidly, accompanied by increases in collaboration between commercial and academic patentees. Enterprises contributed the most in patent quantity, whereas the initial milestone patent was filed by academia. The core developments of technology related to the monkeypox include biological and chemical medicine. The innovations of vaccines and virus testing lack sufficient patent support in portfolios.

Conclusions

Monkeypox-related therapeutic innovation is geographically limited with strong international intellectual property right barriers though it has increased rapidly in recent years. The transparent licensing of patent knowledge is driven by the merger and acquisition model, and the venture capital, intellectual property and contract research organization model. Currently, the patent thicket phenomenon in the monkeypox field may slow the progress of efforts to combat monkeypox. Enterprises should pay more attention to the sharing of technical knowledge, make full use of drug repurposing strategies, and promote innovation of monkeypox-related technology in hotspots of antivirals (such as tecovirimat, cidofovir, brincidofovir), vaccines (JYNNEOS, ACAM2000), herbal medicine and gene therapy.
The associates of anxiety among lung cancer patients: Dehydroepiandrosterone (DHEA) as a potential biomarker
Authors: Wu Jia-Rong , Chen Vincent Chin -Hung , Fang Yu-Hung , Hsieh Ching-Chuan , Wu Shu-I
Published: April 2024

Objective

Anxiety is a prevalent comorbidity in lung cancer (LC) patients associated with a decline in quality of life. Dehydroepiandrosterone (DHEA), a neuroactive steroid, levels rise in response to stress. Prior research on the association between DHEA and anxiety has yielded contradictory results and no study has investigated this association in LC patients.

Methods

A total of 213 patients with LC were recruited from a general hospital. Data on demographic and cancer-related variables were collected. Using the Chinese version of the Hospital Anxiety and Depression Scale (HADS), the degree of anxiety was determined. Cortisol, DHEA, and Dehydroepiandrosterone sulfate (DHEA-S) levels in saliva were measured. Adjusting for confounding variables, a multivariate regression analysis was conducted.

Results

147 men and 66 women comprised our group with an average age of 63.75 years. After accounting for demographic and treatment-related factors, anxiety levels were significantly correlated with, post-traumatic stress symptoms (PTSSs) (β = 0.332, p < 0.001) and fatigue (β = 0.247, p = 0.02). Association between anxiety and three factors, including DHEA, PTSSs, and fatigue, was observed in patients with advanced cancer stages (III and IV) (DHEA β = 0.319, p = 0.004; PTSS β = 0.396, p = 0.001; fatigue β = 0.289, p = 0.027) and those undergoing chemotherapy (DHEA β = 0.346, p = 0.001; PTSS β = 0.407, p = 0.001; fatigue β = 0.326, p = 0.011).

Conclusions

The association between anxiety and DHEA remained positive in advanced cancer stages and chemotherapy patients. Further study is necessary to determine whether DHEA is a potential biomarker of anxiety in LC patients.
The prognostic role of pre-treatment neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in esophageal squamous cell carcinoma treated with concurrent chemoradiotherapy
Authors: Man Qirong , Li Peishun , Fan Jing , Yang Sen , Xing Chao , Bai Yunling , Hu Miaomiao , wang Baohu , Zhang Kaixian
Published: April 2024

Purpose

In this study, we retrospectively investigated the prognostic role of pre-treatment neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in esophageal squamous cell carcinoma patients (ESCC) treated with concurrent chemo-radiotherapy (CCRT).

Methods

We retrospectively analyzed the records of 338 patients with pathologically diagnosed esophageal squamous cell carcinoma that underwent concurrent chemo-radiotherapy from January 2013 to December 2017. Univariate and multivariate analyses were used to identify prognostic factors for progression free survival (PFS) and overall survival (OS).

Results

The result showed that the thresholds for NLR and PLR were 2.47 and 136.0 by receiver operating characteristic curve. High NLR and PLR were both associated with tumor length (P < 0.05). High NLR and PLR were significantly associated with poor PFS and OS. Multivariate analyses identified NLR, PLR and TNM stage were independent risk factors for PFS and OS.

Conclusions

We show that the pre-treatment NLR and PLR may serve as prognostic indicators for esophageal squamous cell carcinoma treated with concurrent chemo-radiotherapy.
Social media addiction: associations with attachment style, mental distress, and personality
Authors: Eichenberg Christiane , Schneider Raphaela , Rumpl Helena
Published: April 2024

Background

Social media bring not only benefits but also downsides, such as addictive behavior. While an ambivalent closed insecure attachment style has been prominently linked with internet and smartphone addiction, a similar analysis for social media addiction is still pending. This study aims to explore social media addiction, focusing on variations in attachment style, mental distress, and personality between students with and without problematic social media use. Additionally, it investigates whether a specific attachment style is connected to social media addiction.

Methods

Data were collected from 571 college students (mean age = 23.61,SD = 5.00, 65.5% female; response rate = 20.06%) via an online survey administered to all enrolled students of Sigmund Freud PrivatUniversity Vienna. The Bergen Social Media Addiction Scale (BSMAS) differentiated between students addicted and not addicted to social media. Attachment style was gauged using the Bielefeld Partnership Expectations Questionnaire (BFPE), mental distress by the Brief Symptom Inventory (BSI-18), and personality by the Big Five Inventory (BFI-10).

Results

Of the total sample, 22.7% of students were identified as addicted to social media. For personality, it was demonstrated that socially media addicted (SMA) students reported significantly higher values on the neuroticism dimension compared to not socially media addicted (NSMA) students. SMA also scored higher across all mental health dimensions—depressiveness, anxiety, and somatization. SMA more frequently exhibited an insecure attachment style than NSMA, specifically, an ambivalent closed attachment style. A two-step cluster analysis validated the initial findings, uncovering three clusters: (1) secure attachment, primarily linked with fewer occurrences of social media addiction and a lower incidence of mental health problems; (2) ambivalent closed attachment, generally associated with a higher rate of social media addiction and increased levels of mental health problems; and (3) ambivalent clingy attachment, manifesting a medium prevalence of social media addiction and a relatively equitable mental health profile.

Conclusions

The outcomes are aligned with previous research on internet and smartphone addiction, pointing out the relevance of an ambivalent closed attachment style in all three contexts. Therapeutic interventions for social media addiction should be developed and implemented considering these findings.
User satisfaction with child and adolescent mental health services: the association between user satisfaction and clinical outcomes
Authors: Børge Mathiassen , Yngvild Arnesen
Published: April 2024

Background

This study aimed to examine the association between user satisfaction and clinical outcomes with child and adolescent mental health services (CAMHS) from the perspective of young people and their parents. The evidence bases for CAMHS user satisfaction measures are limited, with few studies investigating the link between user satisfaction and clinical outcomes. In particular, the perspectives of young people are missing.

Methods

The parent and youth versions of the Experience of Service Questionnaire (ESQ), which evaluates the factors of general satisfaction (GS), satisfaction with care (SWC) and satisfaction with environment (SWE), were used to measure user satisfaction. The outcome measures were scores on the Strengths and Difficulties Questionnaire (SDQ), Children’s Global Assessment Scale (CGAS), and Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). Hierarchical regression analysis was conducted on data collected from 233 young people and 495 parents who utilized CAMHS services.

Results

GS and SWC predicted outcomes for both young people (ΔR2 = 0.08, p <.05) and parents (ΔR2 = 0.01, p <.05), indicating that user satisfaction had a significant impact on clinical outcomes for CAMHS users. In addition, GS and SWC significantly predicted young people-reported outcomes in the interaction model (ΔR2 = 0.10, p <.05), while no significant association was found with parent-reported outcomes (ΔR2 = 0.02, p =.09).

Conclusion

User satisfaction, particularly for young people, has a significant impact on clinical outcomes. The causal relationship between user satisfaction and mental health outcomes requires further study.
Measuring General Health Literacy in Chinese adults: validation of the HLS19-Q12 instrument
Authors: Liu Rongmei , Zhao Qiuping , Yu Mingyang , Chen Hui , Yang Xiaomo , Liu Shuaibin , Okan Orkan , Chen Xinghan , Xing Yuhan , Guo Shuaijun
Published: April 2024

Background

Health literacy measurement lays a solid foundation to identify associations with health outcomes and monitor population health literacy levels over time. In mainland China, most existing health literacy instruments are either knowledge-based or practice-based, making health literacy results incomparable between China and other countries. This study aimed to examine the reliability and validity of the 12-item Health Literacy Population Survey (HLS19-Q12) in a general population of Chinese adults.

Methods

A cross-sectional study was conducted to recruit primary carers of students from 11 schools in Zhengzhou, Henan Province, using convenience cluster sampling. Participants completed an online self-administered survey that collected information on key sociodemographics, health literacy (HLS19-Q12 and a comparison tool: Health Literacy Questionnaire (HLQ)), and health-related outcomes. Using the COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist as a guideline, we tested internal consistency, test-retest reliability, content validity, structural validity, concurrent predictive validity, and convergent validity of the HLS19-Q12.

Results

Overall, 14,184 participants completed the full survey. The HLS19-Q12 showed excellent internal consistency (Cronbach’s α = 0.93), moderate test-retest reliability (intra-class correlation coefficient = 0.54), satisfactory content validity (based on the 12-matrix health literacy model), and strong structural validity (comparative fit index = 0.94, Tucker and Lewis’s index of fit = 0.93, root mean square error of approximation = 0.095). Concurrent predictive validity results showed health literacy was associated with both health determinants and health-related outcomes. The HLS19-Q12 had weak to strong correlations (coefficients = 0.24 to 0.42) with the nine scales of the HLQ. Respondents had an average score of 81.6 (± 23.0) when using the HLS19-Q12, with 35.0% and 7.5% having problematic and inadequate levels of health literacy, respectively.

Conclusions

The HLS19-Q12 is a reliable and valid instrument to measure health literacy in our sample. Further validation is needed with a more nationally representative sample of Chinese adults. The HLS19-Q12 could be used as a comprehensive, skills-based, and easy-to-administer health literacy assessment tool integrated into population surveys and intervention evaluations.
Inflammation mediates the association between furan exposure and the prevalence and mortality of chronic obstructive pulmonary disease: National Health and Nutrition Examination Survey 2013–2018
Authors: Sun Di , Wang Yuanying , Wang Jingwei , Dilixiati Nafeisa , Ye Qiao
Published: April 2024

Background

Although extensive research has established associations between chronic obstructive pulmonary disease (COPD) and environmental pollutants, the connection between furan and COPD remains unclear. This study aimed to explore the association between furan and COPD while investigating potential mechanisms.

Methods

The study involved 7,482 adults from the National Health and Nutrition Examination Survey 2013–2018. Exposure to furan was assessed using blood furan levels. Participants were categorized into five groups based on quartiles of log10-transformed blood furan levels. Logistic regression and restricted cubic spline regression models were used to assess the association between furan exposure and COPD risk. Mediating analysis was performed to assess the contribution of inflammation to the effects of furan exposure on COPD prevalence. Cox regression was used to assess the association between furan exposure and the prognosis of COPD.

Results

Participants with COPD exhibited higher blood furan levels compared to those without COPD (P < 0.001). Log10-transformed blood furan levels were independently associated with an increased COPD risk after adjusting for all covariates (Q5 vs. Q1: OR = 4.47, 95% CI = 1.58–12.66, P = 0.006, P for trend = 0.001). Inflammatory cells such as monocytes, neutrophils, and basophils were identified as mediators in the relationship between furan exposure and COPD prevalence, with mediated proportions of 8.73%, 20.90%, and 10.94%, respectively (all P < 0.05). Moreover, multivariate Cox regression analysis revealed a positive correlation between log10-transformed blood furan levels and respiratory mortality in COPD patients (HR = 41.00, 95% CI = 3.70–460.00, P = 0.003).

Conclusions

Exposure to furan demonstrates a positive correlation with both the prevalence and respiratory mortality of COPD, with inflammation identified as a crucial mediator in this relationship.
Correlation of pre-existing comorbidities with disease severity in individuals infected with SARS-COV-2 virus
Authors: Marušić Jasmina , Hasković Edhem , Mujezinović Adnan , Đido Vedran
Published: April 2024

Shortly after the first publication on the new disease called Coronavirus Disease 2019 (Covid-19), studies on the causal consequences of this disease began to emerge, initially focusing only on transmission methods, and later on its consequences analyzed in terms of gender, age, and the presence of comorbidities. The aim of our research is to determine which comorbidities have the greatest negative impact on the worsening of the disease, namely which comorbidities indicate a predisposition to severe Covid-19, and to understand the gender and age representation of participants and comorbidities. The results of our study show that the dominant gender is male at 54.4% and the age of 65 and older. The most common comorbidities are arterial hypertension, diabetes mellitus, and cardiovascular diseases. The dominant group is recovered participants aged 65 and older, with comorbidities most frequently present in this group. The highest correlation between patients with different severity of the disease was found with cardiovascular diseases, while the coefficient is slightly lower for the relationship between patients with different disease severity and urinary system diseases and hypertension. According to the regression analysis results, we showed that urinary system diseases have the greatest negative impact on the worsening of Covid-19, with the tested coefficient b being statistically significant as it is 0.030 < 0.05. An increase in cardiovascular diseases affects the worsening of Covid-19, with the tested coefficient b being statistically significant as it is 0.030 < 0.05. When it comes to arterial hypertension, it has a small impact on the worsening of Covid-19, but its tested coefficient b is not statistically significant as it is 0.169 > 0.05. The same applies to diabetes mellitus, which also has a small impact on the worsening of Covid-19, but its tested coefficient b is not statistically significant as it is 0.336 > 0.05. Our study has shown that comorbidities such as urinary system diseases and cardiovascular diseases tend to have a negative impact on Covid-19, leading to a poor outcome resulting in death, while diabetes mellitus and hypertension have an impact but without statistical significance.
Exposure to pro-tobacco and anti-tobacco media messages and events and smoking behaviour among adolescents in Gambia
Authors: Addo Isaac Yeboah , Acquah Evelyn , Nyarko Samuel H. , Dickson Kwamena S. , Boateng Ebenezer N. K. , Ayebeng Castro
Published: April 2024

Background

Despite the widespread prevalence of adolescent smoking in Gambia, a West African country, there is limited research exploring the relationships between exposure to pro-tobacco and anti-tobacco media messages and events and smoking behaviour among young people. This study investigates the interplay of these exposures and smoking behaviour among 11-17-year-old adolescents in Gambia.

Methods

Secondary data analysis was conducted using the 2017 Gambia Global Youth and Tobacco Survey (GYTS), which included a total of 9,127 respondents. Descriptive and inferential analyses, including proportions, Pearson’s chi-squared tests, and multivariable logistic regression models, were employed to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI).

Results

The final model revealed significant associations between exposure to anti-tobacco media messages and events and smoking behaviour. Adolescents exposed to anti-tobacco media messages had a 29% increased odds of smoking (aOR 1.29,CI = 1.08,1.53) compared to those unexposed, while exposure to anti-tobacco media events showed a 31% increased odds (aOR 1.31,CI = 1.09,1.59) compared to those unexposed. Exposure to pro-tobacco messages, such as witnessing tobacco use on TV (aOR 1.41, CI = 1.17,1.69) and owning objects with tobacco brand logos (aOR 1.49,CI = 1.19,1.86), was associated with higher odds of smoking. Covariates, including sex, age, and exposure to smoking behaviour by significant others, also demonstrated associations with smoking behaviour. Notably, male respondents showed significantly higher odds of smoking (aOR = 4.01,CI = 3.28,4.89) compared to females. Respondents aged 15 years and older had increased odds of smoking (aOR = 1.47,CI = 1.22,1.76) compared to those below 15 years old. Those whose fathers smoke displayed higher odds of smoking (aOR = 1.35, CI = 1.04,1.76) compared to individuals with non-smoking parents. Additionally, those whose closest friends smoke showed remarkably higher odds of smoking (aOR = 2.87,CI = 2.37, 3.48) compared to those without such influence.

Conclusion

This study underscores the significant impact of exposure to both anti-tobacco and pro-tobacco media messages and events on smoking behaviour among adolescents in Gambia. However, pro-tobacco messages had a greater influence on smoking prevalence than anti-tobacco messages and events. Understanding these associations is crucial for devising effective public health interventions aimed at reducing tobacco use in this population.
Quantitative evaluation of meniscus injury using synthetic magnetic resonance imaging
Authors: Zhang Lingtao , Mai Wenfeng , Mo Xukai , Zhang Ruifen , Zhang Dong , Zhong Xing , Zhao Shuangquan , Shi Changzheng
Published: April 2024

Background

Magnetic resonance imaging (MRI) can diagnose meniscal lesions anatomically, while quantitative MRI can reflect the changes of meniscal histology and biochemical structure. Our study aims to explore the association between the measurement values obtained from synthetic magnetic resonance imaging (SyMRI) and Stoller grades. Additionally, we aim to assess the diagnostic accuracy of SyMRI in determining the extent of meniscus injury. This potential accuracy could contribute to minimizing unnecessary invasive examinations and providing guidance for clinical treatment.

Methods

Total of 60 (n=60) patients requiring knee arthroscopic surgery and 20 (n=20) healthy subjects were collected from July 2022 to November 2022. All subjects underwent conventional MRI and SyMRI. Manual measurements of the T1, T2 and proton density (PD) values were conducted for both normal menisci and the most severely affected position of injured menisci. These measurements corresponded to the Stoller grade of meniscus injuries observed in the conventional MRI. All patients and healthy subjects were divided into normal group, degeneration group and torn group according to the Stoller grade on conventional MRI. One-way analysis of variance (ANOVA) was employed to compare the T1, T2 and PD values of the meniscus among 3 groups. The accuracy of SyMRI in diagnosing meniscus injury was assessed by comparing the findings with arthroscopic observations. The diagnostic efficiency of meniscus degeneration and tear between conventional MRI and SyMRI were analyzed using McNemar test. Furthermore, a receiver operating characteristic curve (ROC curve) was constructed and the area under the curve (AUC) was utilized for evaluation.

Results

According to the measurements of SyMRI, there was no statistical difference of T1 value or PD value measured by SyMRI among the normal group, degeneration group and torn group, while the difference of T2 value was statistically significant among 3 groups (P=0.001). The arthroscopic findings showed that 11 patients were meniscal degeneration and 49 patients were meniscal tears. The arthroscopic findings were used as the gold standard, and the difference of T1 and PD values among the 3 groups was not statistically significant, while the difference of T2 values (32.81±2.51 of normal group, 44.85±3.98 of degeneration group and 54.42±3.82 of torn group) was statistically significant (P=0.001). When the threshold of T2 value was 51.67 (ms), the maximum Yoden index was 0.787 and the AUC value was 0.934.

Conclusions

The measurement values derived from SyMRI could reflect the Stoller grade, illustrating that SyMRI has good consistency with conventional MRI. Moreover, the notable consistency observed between SyMRI and arthroscopy suggests a potential role for SyMRI in guiding clinical diagnoses.
Body composition assessment by artificial intelligence can be a predictive tool for short-term postoperative complications in Hartmann’s reversals
Authors: Suthakaran Reshi , Cao Ke , Arafat Yasser , Yeung Josephine , Chan Steven , Master Mobin , Faragher Ian G. , Baird Paul N. , Yeung Justin M. C.
Published: April 2024

Background

Hartmann's reversal, a complex elective surgery, reverses and closes the colostomy in individuals who previously underwent a Hartmann's procedure due to colonic pathology like cancer or diverticulitis. It demands careful planning and patient optimisation to help reduce postoperative complications. Preoperative evaluation of body composition has been useful in identifying patients at high risk of short-term postoperative outcomes following colorectal cancer surgery. We sought to explore the use of our in-house derived Artificial Intelligence (AI) algorithm to measure body composition within patients undergoing Hartmann’s reversal procedure in the prediction of short-term postoperative complications.

Methods

A retrospective study of all patients who underwent Hartmann's reversal within a single tertiary referral centre (Western) in Melbourne, Australia and who had a preoperative Computerised Tomography (CT) scan performed. Body composition was measured using our previously validated AI algorithm for body segmentation developed by the Department of Surgery, Western Precinct, University of Melbourne. Sarcopenia in our study was defined as a skeletal muscle index (SMI), calculated as Skeletal Muscle Area (SMA) /height2 < 38.5 cm2/m2 in women and < 52.4 cm2/m2 in men.

Results

Between 2010 and 2020, 47 patients (mean age 63.1 ± 12.3 years; male, n = 28 (59.6%) underwent body composition analysis. Twenty-one patients (44.7%) were sarcopenic, and 12 (25.5%) had evidence of sarcopenic obesity. The most common postoperative complication was surgical site infection (SSI) (n = 8, 17%). Sarcopenia (n = 7, 87.5%, p = 0.02) and sarcopenic obesity (n = 5, 62.5%, p = 0.02) were significantly associated with SSIs. The risks of developing an SSI were 8.7 times greater when sarcopenia was present.

Conclusion

Sarcopenia and sarcopenic obesity were related to postoperative complications following Hartmann’s reversal. Body composition measured by a validated AI algorithm may be a beneficial tool for predicting short-term surgical outcomes for these patients.
Clinical outcomes of self-glazed zirconia veneers produced by 3D gel deposition: a retrospective study
Authors: Yu Feifei , Xiang Fangyue , Zhao Jing , Lin Nengjie , Sun Zhe , Zheng Yuanna
Published: April 2024

Background

Self-glazed zirconia (SZ) restorations are made by a novel additive three-dimensional gel deposition approach, which are suitable for a straightforward completely digital workflow. SZ has recently been used as minimally invasive veneer, but its clinical outcomes have not been clarified yet. This study aimed to evaluate the preliminary clinical outcomes of SZ veneers compared with the widely used lithium disilicate glass–ceramic veneers made by either pressing (PG) or milling (MG) process.

Methods

Fifty-six patients treated with SZ, PG, and MG veneers by 2 specialists between June 2018 and October 2022 were identified. Patients were recalled for follow-up at least 1 year after restoration. Clinical outcomes were assessed by 2 independent evaluators according to the modified United States Public Health Service (USPHS) criteria. Overall patient satisfaction was assessed using visual analogue scale (VAS), and analyzed by one-way ANOVA. Chi-square test was applied to compare the difference in the success and survival rates among the 3 groups.

Results

A total of 51 patients restored with 45 SZ, 40 PG, and 41 MG veneers completed the study, with a patient dropout rate of 8.9%. Mean and standard deviation of follow-up period was 35.0 ± 14.7 months. All restorations performed well at baseline, except for 2 SZ veneers with mismatched color (rated Bravo). During follow-up, marginal discrepancy (rated Bravo) was found in 4 MG veneers and 1 PG veneer, and partially fractured (rated Charlie) was found in another 2 PG veneers. The survival rate of SZ, PG, and MG veneers was 100%, 95%, and 100%, with a success rate of 95.56%, 92.50%, and 90.24%, respectively, none of which were significantly different (p = 0.099 and 0.628, respectively). The mean VAS score of SZ, PG, and MG was 95.00 ± 1.57, 93.93 ± 2.40, and 94.89 ± 2.00 respectively, without significant difference (p > 0.05).

Conclusion

SZ veneers exhibited comparable preliminary clinical outcomes to PG and MG veneers, which could be considered as a feasible option for minimally invasive restorative treatment.