bluuebunny/crossref_metadata_2025 huggingface dataset:
Coronavirus disease 2019 infection among working-aged people with multiple sclerosis and the impact of disease-modifying therapies
Authors: Murley Chantelle , Pettersson Emma , Hillert Jan , Machado Alejandra , Friberg Emilie
Published: April 2024

Background

The risk of coronavirus disease 2019 among people with multiple sclerosis with different disease-modifying therapies is not well established.

Objective

To investigate the occurrence of coronavirus disease 2019 and the remaining symptoms among people with multiple sclerosis and the associations with different disease-modifying therapies.

Methods

Individuals aged 20–50 listed in the Swedish Multiple Sclerosis Registry were invited to participate in a survey in 2021. Information on reported coronavirus disease 2019 infection and remaining symptoms were linked to individual-level register data. The risks by disease-modifying therapy of having coronavirus disease 2019 or having remaining symptoms were estimated with logistic regression.

Results

Of the 4393 participants, 1030 (23.4%) self-reported coronavirus disease 2019 (749 confirmed and 281 suspected). The observed odds for coronavirus disease 2019 did not differ by disease-modifying therapy ( p-values <0.05). The majority reporting coronavirus disease 2019 had fully recovered (68.5%), 4.2% were currently/recently sick, and 27.0% had symptoms remaining after 2 months. The most frequently reported remaining symptoms involved one's sense of smell or taste (37.0%), fatigue (20.0%), and breathing (12.0%). No statistically significant associations were observed between having remaining symptoms and the disease-modifying therapy.

Conclusion

Despite the initial concerns of differing infection risks by MS treatments, we observed no differences in coronavirus disease 2019 occurrence or remaining symptoms among those who had coronavirus disease 2019. Nonetheless, exercising caution in interpreting our findings, it remains implicit that people with multiple sclerosis are particularly susceptible to infection and that lingering symptoms may persist beyond the initial infection.
In Their Own Words: How Adolescents Use Social Media and How It Affects Them
Authors: van der Wal Amber , Valkenburg Patti M. , van Driel Irene I.
Published: April 2024

The aim of this qualitative study was to uncover homogeneity (commonalities between adolescents), heterogeneity (differences between adolescents), and duality (differences within adolescents) in the relationship between adolescents’ social media use and well-being. To do so, 8 focus groups with 55 adolescents aged 14–17 were conducted. Anchored in the differential susceptibility to media effects model, we examined adolescents’ (1) individual motives and (2) moods leading to social media use, (3) the nature of this use, (4) their affective responses, and (5) perceived longer-term effects. Through deductive thematic analysis, we noted large homogeneity in motives for social media use but heterogeneity in moods leading to social media use. In addition, our findings revealed heterogeneity and duality in the affective responses and the perceived long-term effects of social media use. This duality, where the same individual is affected in both positive and negative ways by social media use, appeared in various forms: concurrently, when adolescents experience conflicting feelings simultaneously, such as feeling both envy and inspiration; alternately, when adolescents shift between experiences, such as feelings of connection and isolation; and sequentially, for example, where initial enjoyment gradually turns into boredom. Furthermore, duality appeared across different cognitive and affective aspects of well-being. Directions for future research are provided on how to examine the role and meaning of various forms of homogeneity, heterogeneity, and duality in the relationship between adolescents’ social media use and well-being.
Restoring trust in employers: Diagnosing & treating the perception that an organization has “multiple personalities”
Authors: Williams Michele , Mulvey Paul W. , Mayer Roger C.
Published: April 2024

Maintaining employee trust is essential for the success of an organization. Employees who trust their employers perform better and are more likely to stay in their jobs. We have identified a phenomenon that we call organizational dissociative identity disorder that tends to erode employee trust. The phenomenon is somewhat analogous to the psychiatric diagnosis of dissociative identity disorder, in which a person appears to have multiple personalities. In the case of organizations, it is the perception of employees that dealing with their organization is like dealing with a person who has multiple personalities. Employees tend to experience this perception when they receive directives that seem inconsistent with one another or with previous directives, leading the employees to doubt the ability, the benevolence, the integrity, and often the fairness of their employer. This perception is most likely to occur after a period of organizational change. We propose ways to identify this situation and ameliorate its effects through carefully crafted communications of various types involving stakeholders at all levels of the organization.
Perispinal Etanercept to improve STroke Outcomes (PESTO): Protocol for a multicenter, international, randomized placebo-controlled trial
Authors: Thijs Vincent , Cloud Geoffrey C , Gilchrist Nigel , Parsons Brooke , Tilvawala Forum , Ho Jan , Ruthnam Lara , Stanislaus Vimal , Sprigg Nikola , Walker Marion , Bath Philip M , Churilov Leonid , Bernhardt Julie
Published: April 2024

Rationale:

A large proportion of stroke survivors will have long-lasting, debilitating neurological impairments, yet few efficacious medical treatment options are available. Etanercept inhibits binding of tumor necrosis factor to its receptor and is used in the treatment of inflammatory conditions. Perispinal subcutaneous injection followed by a supine, head down position may bypass the blood brain barrier. In observational studies and one small randomized controlled trial the majority of patients showed improvement in multiple post stroke impairments.

Aim:

Perispinal Etanercept to improve STroke Outcomes (PESTO) investigates whether perispinal subcutaneous injection of etanercept improves quality of life and is safe in patients with chronic, disabling, effects of stroke.

Methods and design:

PESTO is a multicenter, international, randomized placebo-controlled trial. Adult participants with a history of stroke between 1 and 15 years before enrollment and a current modified Rankin scale between 2 and 5 who are otherwise eligible for etanercept are randomized 1:1 to single dose injection of etanercept or placebo.

Study outcomes:

The primary efficacy outcome is quality of life as measured using the Short Form 36 Health Inventory at day 28 after first injection. Safety outcomes include serious adverse events.

Sample size target:

A total of 168 participants assuming an improvement of the SF-36 in 11% of participants in the control arm and in 30% of participants in the intervention arm, 80% power and 5% alpha.

Discussion:

PESTO aims to provide level 1 evidence on the safety and efficacy of perispinal etanercept in patients with long-term disabling effects of stroke.
Fuzzy based modeling and optimization of EDMed response of Zircaloy-2
Authors: Kumar Jitendra , Soota Tarun , Sunil BD Y , Gupta Nakul , Rajput Sunil Kumar , Sachan Prachi , Saxena Kuldeep K , Jule Leta Tesfaye
Published: April 2024

In this work, fuzzy model was developed that predicts response parameters and surface properties of an electrical discharge machined Zircaloy-2. Taguchi L18 mixed design was used to perform the experiments using different process parameters (polarity, pulse-on-time, pulse-off-time, tool electrode material, and peak current). Material removal rate (MRR) and tool wear rate (TWR) were chosen as machining response parameters, whereas number of particles (NoP) and the percentage particle area (PPA) for surface properties of EDMed surface. Digital image processing tool was used to evaluate the surface properties. Fuzzy-Sugeno (FS)-model was developed to predict MRR, TWR, NoP, and PPA. Model accuracy was found to be 94% for MRR and TWR, and 92% for NoP and PPA. Maximum MRR 1.53 × 10−3 mm3/min found when machining was performed using graphite tool with negative polarity. Fuzzy Sugeno-GRA method was successfully implemented to predict optimal response corresponding to high value of GRG.
The Equity Impact of Universal Home Visits to Pregnant Women and Their Spouses in Bauchi State, Nigeria: Secondary Analysis From a Cluster Randomised Controlled Trial
Authors: Cockcroft Anne , Belaid Loubna , Omer Khalid , Ansari Umaira , Aziz Amar , Gidado Yagana , Mudi Hadiza , Mohammed Rilwanu , Sale Rakiya , Andersson Neil
Published: April 2024

Background

Socio-economically disadvantaged women have poor maternal health outcomes. Maternal health interventions often fail to reach those who need them most and may exacerbate inequalities. In Bauchi State, Nigeria, a recent cluster randomised controlled trial (CRCT) showed an impressive impact on maternal health outcomes of universal home visits to pregnant women and their spouses. The home visitors shared evidence about local risk factors actionable by households themselves and the program included specific efforts to ensure all households in the intervention areas received visits.

Purpose

To examine equity of the intervention implementation and its pro-equity impact.

Research design and study sample

The overall study was a CRCT in a stepped wedge design, examining outcomes among 15,912 pregnant women.

Analysis

We examined coverage of the home visits (three or more visits) and their impact on maternal health outcomes according to equity factors at community, household, and individual levels.

Results

Disadvantaged pregnant women (living in rural communities, from the poorest households, and without education) were as likely as those less disadvantaged to receive three or more visits. Improvements in maternal knowledge of danger signs and spousal communication, and reductions in heavy work, pregnancy complications, and post-natal sepsis were significantly greater among disadvantaged women according to the same equity factors.

Conclusions

The universal home visits had equitable coverage, reaching all pregnant women, including those who do not access facility-based services, and had an important pro-equity impact on maternal health.
Evaluating the impact of an online autism training on changing employers’ autism knowledge and commitment to inclusion in the workplace
Authors: Ashworth Maria , Heasman Brett , Crane Laura , Remington Anna
Published: April 2024

Employers’ knowledge about autism can be a key barrier to autistic people obtaining employment. The current study evaluated the efficacy of an online autism training program, Understanding Autism in the Workplace, in changing employers’ autism knowledge and commitment to inclusion in the workplace. Employers ( N = 129) from 22 organizations in the UK completed the training with an autistic (n = 45) or non-autistic (n = 84) trainer and completed surveys measuring (1) autism knowledge and (2) commitment to inclusion in the workplace (CIW), before and after the training. Results showed that at a group level, autism knowledge and CIW improved from before training to after training for all participants, for both the autistic and non-autistic trainer. This latter result may be attributable to the training being co-designed by autistic people. At an individual level, however, only a minority of participants (both with an autistic and non-autistic trainer) showed a significant increase in autism knowledge (10.1%) and CIW (5.8%), suggesting autism training was more effective for some participants than others. Autism training should not be the sole initiative to address barriers to employment for autistic people but should be part of a broader package of support for employers.
A spectral assessment for instant preliminary evaluation of structures after seismic events
Authors: Rabiepour Mohammad , Chase James Geoffrey , Zhou Cong
Published: April 2024

This article introduces a simple, efficient spectral-based approach for rapid preliminary seismic assessment of earthquake-affected structures. Performance is validated using data from three highly earthquake-affected structures in New Zealand, where visual inspection with subjective outcomes missed damage, resulting in inaccurate and delayed decisions with significant social and economic losses. The three structures considered include (1) the instrumented Bank of New Zealand (BNZ) building; (2) the un-instrumented Queensgate Mall (QM) Complex; and (3) the un-instrumented Canterbury Television (CTV) building. This study uses these cases to highlight the importance of structural health monitoring (SHM) instrumentation and reliable quantified post-earthquake assessment methods in earthquake-prone areas, where each damaging earthquake and subsequent further-damaging aftershocks demand continuous monitoring to continuously assess damage and life safety risk. The simple, low-cost spectral analyses in this study clearly show the existence of damage and deterioration not fully discovered with standard visual inspection methods. This outcome highlights the importance of sensor networks and SHM instrumentation so quantitative, post-event analysis can rapidly augment and target further, more subjective visual inspection results.
Nail growth arrest under low body temperature during hibernation
Authors: Ishimoto Taiga , Kosumi Hideyuki , Natsuga Ken , Yamaguchi Yoshifumi
Published: April 2024

Growth and differentiation are reduced or stopped during hibernation, an energy conserving strategy in harsh seasons by lowered metabolism and body temperature. However, few studies evaluated this in a same individual using a non-invasive method. In this study, we applied a non-invasive tracking method of the nail growth throughout the hibernation period in the same hibernating animals, the Syrian hamster (Mesocricetus auratus). We found that nail growth was markedly suppressed during the hibernation period but rapidly recovered by the exit from the hibernation period. Our data suggest that nail growth was arrested during deep torpor, a hypometabolic and hypothermic state, but recovered during periodic arousal, a euthermic phase. Consistent with this, nail stem cells located in the nail matrix did not exit the cell cycle in the deep torpor. Thus, hibernation stops nail growth in a body temperature-dependent manner.
Basophil activation in insect venom allergy: comparison of an established test using liquid reagents with a test using 5-color tubes with dried antibody reagents
Authors: Waldherr Sebastian , Hils Miriam , Köberle Martin , Brockow Knut , Darsow Ulf , Blank Simon , Biedermann Tilo , Eberlein Bernadette
Published: April 2024

Background

Flow cytometry-based basophil activation tests (BAT) have been performed with various modifications, differing in the use of distinct identification and activation markers. Established tests use liquid reagents while a new development involves the use of tubes with dried antibody reagents. The aim of this pilot study was to compare these two techniques in patients with insect venom allergy.

Methods

Seventeen patients with an insect venom allergy were included in the study. The established “BAT 1” utilizes conventional antibody solutions of anti-CCR3 for basophil identification and anti-CD63 to assess basophil activation, whereas “BAT 2” uses dried anti-CD45, anti-CD3, anti-CRTH2, anti-203c and anti-CD63 for identification and activation measurement of basophils. Negative and positive controls as well as incubations with honey bee venom and yellow jacket venom at three concentrations were performed.

Results

Seven patients had to be excluded due to low basophil counts, high values in negative controls or negative positive controls. For the remaining 10 patients the overall mean (± SD) difference in activated basophils between the two tests was 0.2 (± 12.2) %P. In a Bland-Altman plot, the limit of agreement (LoA) ranged from 24.0 to -23.7. In the qualitative evaluation (value below/above cut-off) Cohen’s kappa was 0.77 indicating substantial agreement. BAT 2 took longer to perform than BAT 1 and was more expensive.

Conclusion

The BAT 2 technique represents an interesting innovation, however, it was found to be less suitable compared to an established BAT for the routine diagnosis of insect venom allergies.
Seasonal meropenem resistance in Acinetobacter baumannii and influence of temperature-driven adaptation
Authors: Liu Xiaoxuan , Qin Pu , Wen Hainan , Wang Weigang , Zhao Jianhong
Published: April 2024

Background

Recognition of seasonal trends in bacterial infection and drug resistance rates may enhance diagnosis, direct therapeutic strategies, and inform preventive measures. Limited data exist on the seasonal variability of Acinetobacter baumannii. We investigated the seasonality of A. baumannii, the correlation between temperature and meropenem resistance, and the impact of temperature on this bacterium.

Results

Meropenem resistance rates increased with lower temperatures, peaking in winter/colder months. Nonresistant strain detection exhibited temperature-dependent seasonality, rising in summer/warmer months and declining in winter/colder months. In contrast, resistant strains showed no seasonality. Variations in meropenem-resistant and nonresistant bacterial resilience to temperature changes were observed. Nonresistant strains displayed growth advantages at temperatures ≥ 25 °C, whereas meropenem-resistant A. baumannii with β-lactamase OXA-23 exhibited greater resistance to low-temperature (4 °C) stress. Furthermore, at 4 °C, A. baumannii upregulated carbapenem resistance-related genes (adeJ, oxa-51, and oxa-23) and increased meropenem stress tolerance.

Conclusions

Meropenem resistance rates in A. baumannii display seasonality and are negatively correlated with local temperature, with rates peaking in winter, possibly linked to the differential adaptation of resistant and nonresistant isolates to temperature fluctuations. Furthermore, due to significant resistance rate variations between quarters, compiling monthly or quarterly reports might enhance comprehension of antibiotic resistance trends. Consequently, this could assist in formulating strategies to control and prevent resistance within healthcare facilities.
Lidocaine effects on neutrophil extracellular trapping and angiogenesis biomarkers in postoperative breast cancer patients with different anesthesia methods: a prospective, randomized trial
Authors: Zhang Wenjuan , Liu Jiao , Li Xiaohui , Bai Zhixia , Sun Yan , Chen Xuexin
Published: April 2024

Background

Anesthesia techniques and drug selection may influence tumor recurrence and metastasis. Neutrophil extracellular trapping (NETosis), an immunological process, has been linked to an increased susceptibility to metastasis in individuals with tumors. Furthermore, recurrence may be associated with vascular endothelial growth factor A (VEGF-A), a mediator of angiogenesis. This study investigates the impact of lidocaine (combined with sevoflurane or propofol anesthesia ) during breast cancer surgery inhibits the expression of biomarkers associated with metastasis and recurrence (specifically H3Cit, NE, MPO, MMP-9 and VEGF-A).

Methods

We randomly assigned 120 women undergoing primary or invasive breast tumor resection to receive one of four anesthetics: sevoflurane (S), sevoflurane plus i.v. lidocaine (SL), propofol (P), and propofol plus i.v. lidocaine (PL). Blood samples were collected before induction and 3 h after the operation. Biomarkers associated with NETosis (citrullinated histone H3 [H3Cit], myeloperoxidase [MPO], and neutrophil elastase [NE]) and angiogenesis were quantified using enzyme-linked immunosorbent assays.

Results

Patient and breast tumor characteristics, along with perioperative management, did not differ between study groups. In intra-group comparisons, S and P groups demonstrated a statistically significant increase in post-operative MPO (S group: 10.39[6.89–17.22] vs. 14.31[8.55–20.87] ng ml-1, P = 0.032; P group: 9.45[6.73–17.37] vs. 14.34[9.87–19.75] ng ml-1, P = 0.035)and NE(S group: 182.70[85.66-285.85] vs. 226.20[91.85-391.65] ng ml-1, P = 0.045; P group: 154.22[97.31–325.30] vs. 308.66[132.36-483.57] ng ml-1, P = 0.037) concentrations compared to pre-operative measurements, whereas SL and PL groups did not display a similar increase. H3Cit, MMP-9, and VEGF-A concentrations were not significantly influenced by the anesthesia techniques and drugs.

Conclusions

Regardless of the specific technique employed for general anesthesia, there was no increase in the postoperative serum concentrations of MPO and NE after perioperative lidocaine infusion compared to preoperative serum concentrations. This supports the hypothesis that intravenous lidocaine during cancer surgery aimed at achieving a cure may potentially decrease the likelihood of recurrence. Further interpretation and discussion of clinical implications are warranted, emphasizing the significance of these findings in the context of cancer surgery and recurrence prevention.

Clinical trial registration

ChiCTR2300068563.
The relationship between serum manganese concentration with all-cause and cause-specific mortality: a retrospective and population-based cross-sectional study
Authors: Ou Jianyun , Sun Yunfei , Tong Jie , Tang Weihong , Ma Genshan
Published: April 2024

Background

The study aimed to explore the association between manganese concentration and all-cause, cardiovascular disease (CVD)-related, and cancer-related mortality in the general population of the United States.

Methods

We integrated the data from the National Health and Nutrition Examination Survey from 2011 to 2018. A total of 9,207 subjects were selected based on the inclusion and exclusion criteria. The relationship between manganese concentration and all-cause, CVD-related, and cancer-related mortality was analyzed by constructing a Cox proportional hazard regression model and a restricted cubic spline (RCS) plot. Additionally, subgroup analyses stratified by age, sex, race/ethnicity, hypertension, diabetes mellitus (DM), chronic heart disease, chronic heart failure, angina pectoris, heart attack, stroke, and BMI were further performed.

Results

In the full adjusted model, compared with the lowest quartile, the adjusted hazard ratios with 95% confidence intervals (CIs) for all-cause, CVD-related, and cancer-related mortality across manganese quartiles were (1.11 (0.87,1.41), 0.96 (0.74, 1.23), and 1.23 (0.96, 1.59); P-value for trend =0.041), (0.86 (0.54, 1.37), 0.87 (0.55, 1.40), and 1.07 (0.67, 1.72); P-value for trend =0.906), and (1.45 (0.92, 2.29), 1.14 (0.70, 1.88), and 1.26 (0.75, 2.11); P-value for trend =0.526), respectively. The RCS curve shown a U-shaped association between manganese concentration and all-cause mortality and CVD-related mortality (P-value for nonlinear <0.05). However, there was an increase and then a decrease in the link between manganese concentration and cancer-related mortality (P-value for nonlinear <0.05). Manganese exposure was positively correlated with sex (correlation coefficient, r =0.19, P-value <0.001) and negatively correlated with age (correlation coefficient, r =-0.11, P-value <0.001) and serum creatinine (correlation coefficient, r =-0.12, P-value <0.001), respectively.

Conclusions

Our findings suggest that elevated serum manganese concentrations are associated with all-cause and CVD-related mortality in the U.S. population and that maintenance of serum manganese between 8.67-9.23 µg/L may promote public health.
Diagnostic value of LGE and T1 mapping in multiple myeloma patients’heart
Authors: Cui Qian , Yu Jing , Ge Xihong , Gao Guangfeng , Liu Yang , He Qiang , Shen Wen
Published: April 2024

Background

Unidentified heart failure occurs in patients with multiple myeloma when their heart was involved. CMR with late gadolinium enhancement (LGE) and T1 mapping can identify myocardial amyloid infiltrations.

Purpose

To explore the role of CMR with late gadolinium enhancement (LGE) and T1 mapping for detection of multiple myeloma patients’heart.

Material and methods

A total of 16 MM patients with above underwent CMR (3.0-T) with T1 mapping (pre-contrast and post-contrast) and LGE imaging. In addition, 26 patients with non-obstructive hypertrophic cardiomyopathy and 26 healthy volunteers were compared to age- and sex-matched healthy controls without a history of cardiac disease, diabetes mellitus, or normal in CMR. All statistical analyses were performed using the statistical software GraphPad Prism. The measurement data were represented by median (X) and single sample T test was adopted. Enumeration data were represented by examples and Chi-tested was adopted. All tests were two-sided, and P values < 0.05 were considered statistically significant.

Results

In MM group, LVEF was lower than healthy controls and higher than that of non-obstructive hypertrophic cardiomyopathy group, but without statistically significant difference (%: 49.1 ± 17.5 vs. 55.6 ± 10.3, 40.4 ± 15.6, all P > 0.05). Pre-contrast T1 values of MM group were obviously higher than those of healthy controls and non-obstructive hypertrophic cardiomyopathy group (ms:1462.0 ± 71.3vs. 1269.3 ± 42.3, 1324.0 ± 45.1, all P < 0.05). 16 cases (100%) in MM group all had LGE.

Conclusion

LGE joint T1 mapping wider clinical use techniques and follow-up the patients’disease severity.
Stability analysis and numerical evaluations of a COVID-19 model with vaccination
Authors: Izadi Mohammad , Waezizadeh Tayebeh
Published: April 2024

A novel (nonlinear) mathematical model for the transmission of Coronavirus 19 (COVID-19) with eight compartments and considering the impact of vaccination is examined in this manuscript. The qualitative behavior of the system such as the boundedness of solutions, the basic reproduction number, and the stability of the equilibrium points is investigated in detail. Some domestic real data collected from the Kerman University of Medical Science (KUMC) is used to estimate the parameters of the proposed model. We predict the dynamical behavior of the system through numerical simulations based on a combined spectral matrix collocation methodology. In this respect, we first linearize the nonlinear system of equations by the method of quasilinearization (QLM). Hence, the shifted version of Chebyshev polynomials of the second kind (SCPSK) is utilized along with the domain-splitting strategy to acquire the solutions of the system over a long time interval. The uniform convergence and upper bound estimation of the SCPSK bases are proved in a rigorous manner. Moreover, the technique of residual error functions is used to testify the accuracy of the QLM-SCPSK method. The presented numerical results justify the robustness and good accuracy of the QLM-SCPSK technique. The achieved numerical orders of convergence indicate that the QLM-SCSK algorithm has exponential rate of convergence. Using the linearization technique in one hand and the domain-splitting strategy on the other hand, enable us to predict the behaviour of similar disease problems with high accuracy and maximum efficiency on an arbitrary domain of interest.
Ascertaining the Francophone population in Ontario: validating the language variable in health data
Authors: Batista Ricardo , Hsu Amy T. , Bouchard Louise , Reaume Michael , Rhodes Emily , Sucha Ewa , Guerin Eva , Prud’homme Denis , Manuel Douglas G. , Tanuseputro Peter
Published: April 2024

Background

Language barriers can impact health care and outcomes. Valid and reliable language data is central to studying health inequalities in linguistic minorities. In Canada, language variables are available in administrative health databases; however, the validity of these variables has not been studied. This study assessed concordance between language variables from administrative health databases and language variables from the Canadian Community Health Survey (CCHS) to identify Francophones in Ontario.

Methods

An Ontario combined sample of CCHS cycles from 2000 to 2012 (from participants who consented to link their data) was individually linked to three administrative databases (home care, long-term care [LTC], and mental health admissions). In total, 27,111 respondents had at least one encounter in one of the three databases. Language spoken at home (LOSH) and first official language spoken (FOLS) from CCHS were used as reference standards to assess their concordance with the language variables in administrative health databases, using the Cohen kappa, sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV).

Results

Language variables from home care and LTC databases had the highest agreement with LOSH (kappa = 0.76 [95%CI, 0.735–0.793] and 0.75 [95%CI, 0.70–0.80], respectively) and FOLS (kappa = 0.66 for both). Sensitivity was higher with LOSH as the reference standard (75.5% [95%CI, 71.6–79.0] and 74.2% [95%CI, 67.3–80.1] for home care and LTC, respectively). With FOLS as the reference standard, the language variables in both data sources had modest sensitivity (53.1% [95%CI, 49.8–56.4] and 54.1% [95%CI, 48.3–59.7] in home care and LTC, respectively) but very high specificity (99.8% [95%CI, 99.7–99.9] and 99.6% [95%CI, 99.4–99.8]) and predictive values. The language variable from mental health admissions had poor agreement with all language variables in the CCHS.

Conclusions

Language variables in home care and LTC health databases were most consistent with the language often spoken at home. Studies using language variables from administrative data can use the sensitivity and specificity reported from this study to gauge the level of mis-ascertainment error and the resulting bias.
Strategies that facilitate the delivery of exceptionally good patient care in general practice: a qualitative study with patients and primary care professionals
Authors: O’Malley Roisin , O’Connor Paul , Lydon Sinéad
Published: April 2024

Background

In recent years, proactive strengths-based approaches to improving quality of care have been advocated. The positive deviance approach seeks to identify and learn from those who perform exceptionally well. Central to this approach is the identification of the specific strategies, behaviours, tools and contextual strategies used by those positive deviants to perform exceptionally well. This study aimed to: identify and collate the specific strategies, behaviours, processes and tools used to support the delivery of exceptionally good care in general practice; and to abstract the identified strategies into an existing framework pertaining to excellence in general practice; the Identifying and Disseminating the Exceptional to Achieve Learning (IDEAL) framework.

Methods

This study comprised a secondary analysis of data collected during semi-structured interviews with 33 purposively sampled patients, general practitioners, practice nurses, and practice managers. Discussions explored the key factors and strategies that support the delivery of exceptional care across five levels of the primary care system; the patient, provider, team, practice, and external environment. For analysis, a summative content analysis approach was undertaken whereby data were inductively analysed and summated to identify the key strategies used to achieve the delivery of exceptionally good general practice care, which were subsequently abstracted as a new level of the IDEAL framework.

Results

In total, 222 individual factors contributing to exceptional care delivery were collated and abstracted into the framework. These included specific behaviours (e.g., patients providing useful feedback and personal history to the provider), structures (e.g., using technology effectively to support care delivery (e.g., electronic referrals & prescriptions)), processes (e.g., being proactive in managing patient flow and investigating consistently delayed wait times), and contextual factors (e.g., valuing and respecting contributions of every team member).

Conclusion

The addition of concrete and contextual strategies to the IDEAL framework has enhanced its practicality and usefulness for supporting improvement in general practices. Now, a multi-level systems approach is needed to embed these strategies and create an environment where excellence is supported. The refined framework should be developed into a learning tool to support teams in general practice to measure, reflect and improve care within their practice.
Prevalence and associated factors of anemia among postpartum mothers in public health facilities in Ethiopia, 2024: a systematic review and meta-analysis
Authors: Lakew Gebeyehu , Yirsaw Amlaku Nigusie , Berhie Alemshet Yirga , Belayneh Asnake Gashaw , Bogale Solomon Ketema , Getachew Eyob , Andarge Getnet Alemu , Seid Kedir , Bogale Eyob Ketema
Published: April 2024

Background

Postpartum anemia, characterized by hematocrit or hemoglobin levels below the defined cutoff point (< 11gm/dl or hematocrit < 33%), is a prevalent global issue. It serves as an indirect contributor to maternal mortality and morbidity. Mothers in the postpartum period experience diminished quality of life, impaired cognitive function, emotional instability, and an increased risk of postpartum depression due to anemia. Additionally, infants of affected mothers may face challenges such as insufficient breast milk supply and a lack of proper care. Examining the combined prevalence and factors associated with postpartum anemia is crucial for addressing maternal health risks and complications during the postnatal phase attributed to anemia.

Objective

The study aimed to synthesize the existing literature on the prevalence and associated factors of postpartum anemia in public health facilities of Ethiopia, in 2024.

Methods

The study was conducted by searching through the Google Scholar, PubMed, and Cochrane Library search engines. The search utilized keywords and MeSH terms such as anemia, low hemoglobin, postpartum, postnatal women, and Ethiopia. The collected data underwent analysis and comparison with the WHO criteria to determine if it met the threshold for declaring a public health concern. Heterogeneity was evaluated through the Cochran Q test and I2 statistics. Prevalence and odds ratio estimations were performed using a random-effects model with a 95% confidence interval.

Result

Four studies were included in this systematic review and meta-analysis. The overall pooled prevalence of anemia among postpartum women in Ethiopia was 69% (95% CI: 60- 77%).Lack of formal education(OR = 3.5;CI:2.639,4.408),Low Pre-delivery hemoglobin (OR = 4.2;CI: 1.768–6.668), Postpartum women < 4 ANC visit (OR = 2.72; 95% CI:2.14,3.3 ),history of post partum hemorrhage (OR = 2.49; CI: 1.075–3.978),history of Forceps/vacuum delivery(OR = 3.96; CI:2.986–4.947), Poor iron and folic acid adherence (OR = 2.8;95% CI:2.311,3.297), C/S (OR = 4.04; 95% CI: 3.426,4.671),lower dietary diversity (OR = 4.295% CI:1.768,6.668) were significantly associated postpartum anemia.

Conclusion

Postpartum women in Ethiopia continue to face a considerable public health challenge in the form of anemia. Consequently, there is a pressing need for the government to formulate comprehensive, multi-sectorial policies and strategies. These initiatives should be designed to address the substantial regional disparities influenced by interconnected factors, with the aim of reducing the prevalence of anemia among postpartum women in Ethiopia.
Factors associated with anaemia among pregnant women in Rwanda: an analysis of the Rwanda demographic and health survey of 2020
Authors: Nuwabaine Lilian , Kawuki Joseph , Kamoga Livingstone , Sserwanja Quraish , Gatasi Ghislaine , Donkor Elorm , Mutisya Linet M , Asiimwe John Baptist
Published: April 2024

Background

Anaemia in pregnancy is associated with several adverse outcomes for mothers and newborns, as well as their families. In this study, we assessed the prevalence of anaemia and the associated factors among pregnant women in Rwanda.

Methods

Secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS) was used. Multistage stratified sampling was used to select 435 pregnant women included in the study. Anaemia among pregnant women was defined as a haemoglobin value < 11 g/dL. Multivariable logistic regression was used to assess the associated factors with anaemia in pregnancy, using SPSS (version 26).

Results

Of the 435 pregnant women, 24.6% (95%CI: 21.1–29.3) were anaemic (1 in 4 pregnant women). Not working (AOR = 2.45; 95%CI: 1.14–5.26), being unmarried (AOR = 1.23; 95%CI: 1.24–3.57), low wealth index (AOR = 9.19; 95%CI: 1.64–51.56), having difficulty accessing a nearby health facility (AOR = 5.40; 95%CI: 2.21–13.23), and normal body mass index (AOR = 3.33; 95%CI: 1.46–7.59) were associated with higher odds of being anaemic. However, not taking iron supplements (AOR = 0.16; 95% CI: 0.04–0.67), having no exposure to television (AOR = 0.35; 95%CI: 0.14–0.91), being from the southern region (AOR = 0.14; 95% CI: 0.03–0.66), and low husband/partner’s education (AOR = 0.08; 95% CI: 0.01–0.59) were associated with lower odds of being anaemic.

Conclusions

The study findings indicate a high prevalence of anaemia in pregnancy, which was associated with several socio-demographics. There is a need for setting up mobile clinics and health facilities in hard-to-reach areas for easy accessibility to early anaemia screening services. Conducting mass screening for anaemia targeting pregnant women who are not working, the unmarried, and those with a low wealth index would also be beneficial. The intake of locally available iron rich foods and/ or bio-fortified foods is also recommended.
Diverse impacts of female chromosomal polymorphisms on assisted reproduction outcomes: a retrospective cohort study
Authors: Lu Yongjie , Tian Tian , Chen Lixue , Yan Liying , Chang Liang , Qiao Jie
Published: April 2024

Background

The effects of female chromosomal polymorphisms (FCPs) on various aspects of reproductive health have been investigated, yet the findings are frequently inconsistent. This study aims to clarify the role of FCPs on the outcomes of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).

Methods

This retrospective cohort study comprised 951 couples with FCPs and 10,788 couples with normal karyotypes who underwent IVF/ICSI treatment at Peking University Third Hospital between 2015 and 2021. The exposure was FCPs. The embryological outcomes and clinical outcomes were compared.

Results

The FCPs, as a whole, compromised the oocyte maturation rate (76.0% vs. 78.8%, P = 0.008), while they did not adversely affect other IVF/ICSI outcomes. Further detailed analyses showed that every type of FCPs contributed to the lower oocyte maturation rate, particularly the rare FCPs (69.0% vs. 78.8%, P = 0.008). The female qh + was associated with a higher normal fertilization rate (63.0% vs. 59.2%, adjusted P = 0.022), a higher clinical pregnancy rate (37.0% vs. 30.7%, adjusted P = 0.048), and a higher live birth rate (27.0% vs.19.0%, adjusted P = 0.003) in couples undergoing IVF. Conversely, in couples undergoing ICSI, female qh + was found to be related to a lower normal fertilization rate (58.8% vs. 63.8%, P = 0.032), a comparable clinical pregnancy rate (25.7% vs. 30.9%, P = 0.289), and a comparable live birth rate (19.8% vs. 19.2%, P = 0.880) compared to the control group. Additionally, an increased risk of preterm birth was observed in women undergoing IVF with multiple polymorphisms (62.5% vs. 16.9%, adjusted P <  0.001) and in women undergoing ICSI with pstk+ (36.4% vs. 15.4%, P = 0.036).

Conclusions

Our research unravels the diverse impacts of various FCPs on IVF/ICSI outcomes, highlighting the detrimental effects of FCPs on oocyte maturation and the risk of preterm birth.
Non–small cell lung cancer and immune checkpoint inhibitor therapy: does non-alcoholic fatty liver disease have an effect?
Authors: Li Yi , Gong Bingxin , Guo Yusheng , Liu Weiwei , Chen Chao , Jiang Shanshan , Pan Feng , Song Jiyu , Yang Lian , Zhou Guofeng
Published: April 2024

Background

Immunotherapy based on the application of immune checkpoint inhibitors (ICIs) is one of the standard treatments for advanced non-small cell lung cancer (NSCLC). Non-alcoholic fatty liver Disease (NAFLD) has demonstrated predictive value for response to immunotherapy in non-lung cancer types. Our study investigated the effect of NAFLD on the efficacy of real-life use of ICIs for patients with stage III / IV NSCLC.

Methods

The clinical and imaging data of patients with stage III / IV NSCLC who were first admitted to Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from March 2020 to July 2022 were retrospectively collected to ensure that they underwent at least one CT scan before treatment. A total of 479 patients were divided into the NAFLD group (Liver/Spleen density ratio ≤ 1) and the non-NAFLD group (Liver/Spleen density ratio > 1) by measuring the baseline liver and spleen CT value. The overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and disease control rate (DCR) of the patients were obtained.

Results

A total of 118 patients with NAFLD and 361 patients without NAFLD were included in the study. Patients with NAFLD tended to have higher BMI and higher total bilirubin compared to patients without NAFLD. The median duration of follow-up in the study was 22 m (IQR, 17–29 m). Both of 2 groups had a higher DCR (94% vs. 92%, p = 0.199) and ORR (38.1% vs. 44.9%, p = 0.452) respectively. There was no difference in efficacy between the two groups. In univariate analysis, NAFLD had no significant effect on PFS (p = 0.785) and OS (p = 0.851). Surprisingly, the presence of hypertension was observed to be associated with a higher OS (HR 1.471 95%CI 1.018–2.127, p = 0.040). Besides, based on multivariate analysis, lactic dehydrogenase was associated with PFS (HR 1.001 95%CI 1.000,1.002, p = 0.037) and OS (HR 1.002, 95%CI 1.001–1.003, p < 0.001).

Conclusions

Among patients with NSCLC, NAFLD did not result in changes in survival or disease progression after immune checkpoint inhibitor therapy.
A therapeutic ERCP in an only 5.9 kg infant with obstruction jaundice using JF-260V duodenoscope
Authors: Zhang Tian , Shu Yijun , Weng Hao , Weng Mingzhe , Zhou Ying , Cai Wei , Wang Xuefeng
Published: April 2024

Background

Endoscopic retrograde cholangiopancreatography (ERCP) has found extensive use in pediatric patients; however, challenges persist in the application of therapeutic ERCP in infants.

Case presentation

This case report details the presentation of a 5.9-kilogram infant with obstructive jaundice and suspected hemolytic anemia who underwent ERCP to alleviate biliary obstruction. The infant was admitted due to clay-colored stools, jaundice, and liver injury. Ultrasound and magnetic resonance cholangiopancreatography (MRCP) revealed dilation of the common bile duct (CBD) accompanied by the presence of stones. ERCP was conducted using a JF-260V duodenoscope under general anesthesia. Successful stone extraction and biliary drainage were achieved.

Conclusions

In centers with considerable expertise in ERCP and pediatric anesthesia, the use of a conventional adult duodenoscope for therapeutic ERCP in infants can be considered safe and feasible, provided careful and stringent patient selection criteria are applied. In the future, clear guidelines and standardized protocols for the indications and procedures of pediatric ERCP should be established.
Thriving from work questionnaire: Spanish translation and validation
Authors: Peters Susan E. , Gundersen Daniel A. , Neidlinger Stephanie M. , Ritchie-Dunham Jim , Wagner Gregory R.
Published: April 2024

Background

Thriving from Work is a construct that has been highlighted as an important integrative positive worker well-being indicator that can be used in both research and practice. Recent public discourse emphasizes the important contributions that work should have on workers’ lives in positive and meaningful ways and the importance of valid and reliable instruments to measure worker well-being. The Thriving from Work Questionnaire measures how workers’ experiences of their work and conditions of work contributes in positive ways to their thriving both at and outside of work.

Methods

The purpose of this study was to translate the Thriving from Work Questionnaire from English to Spanish, and then validate the translated questionnaire in a sample of 8,795 finance workers in Peru and Mexico. We used item response theory models replicating methods that were used for the original validation studies. We conducted a differential item functioning analysis to evaluate any differences in the performance of models between Peru and Mexico. We evaluated criterion validity with organizational leadership, flourishing, vitality, community well-being, and worker’s home location socio-economic position.

Results

The current study demonstrates that the Spanish (Peru/Mexico) questionnaire was found to be a reliable and valid measure of workers’ thriving from work. One item was dropped from the long-form version of the original U.S. questionnaire. Both the long and short form versions of the questionnaire had similar psychometric properties. Empirical reliability was high. Criterion validity was established as hypothesized relationships between constructs was supported. There were no differences in the performance of the model between countries suggesting utility across Latin American countries.

Conclusions

The current study demonstrated that the Spanish (Peru and Mexico) version of the questionnaire is both a reliable and valid measure of worker well-being in Latin America. Specific recommendations are made for the adaptation of the questionnaire and directions of future research.