bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum lipid reference values recommended during a twin pregnancy and evaluating its association with perinatal outcomes
Authors: Huang Jiaqi , Meng Xinlu , LI Jiaxin , Gong Xiaoli , Wu Tianchen , Shi Huifeng , Li Xiaona , Wang Xueju , Yang Jing , Zhao Yangyu , Wei Yuan
Published: January 2024

Background

Maternal lipid metabolism fluctuations have been shown to increase the risk of adverse pregnancy outcomes. However, there is no consensus over what constitutes normal maternal lipid values during twin pregnancy. Therefore, the aim of this study was to establish a serum lipid reference range for a twin pregnancy.

Methods

A retrospective survey was conducted, from 2011 to 2021, at the Peking University Third Hospital. A total of 881 twin pregnancies, with lipid data from early and middle pregnancies, were included. After excluding those with adverse pregnancy outcomes, we performed a descriptive analysis of total cholesterol (TC), triglycerides (TG), high-density lipid cholesterol (HDL-C), and low-density lipid cholesterol (LDL-C) levels, using the mean and standard deviation to determine appropriate percentiles. We later determined the lipid reference range in early and middle pregnancy based on the initial results. We evaluated Inappropriate lipid levels associations with pregnancy outcomes, including gestational diabetes, pregnancy-induced hypertension, small for gestational age.

Results

(1) Serum levels of TC, TG, LDL-C, and HDL-C increased significantly from early to late pregnancy, where the greatest increase was observed in TG. (2) Based on the results, we recommend that TC, TG, and LDL-C serum reference values during early and middle pregnancy should be less than the 95th percentile. On the other hand, HDL-C should be greater than the 5th percentile. During early pregnancy, the values recommended are TC < 5.31 mmol/L, TG < 2.25 mmol/L, HDL > 1.02 mmol/L and LDL < 3.27 mmol/L, and those during middle pregnancy are TC < 8.74 mmol/L, TG < 4.89 mmol/L, HDL > 1.25 mmol/L and LDL < 5.49 mmol/L, while the values during late pregnancy are TC < 9.11 mmol/L, TG < 6.70 mmol/L, HDL > 1.10 mmol/L and LDL < 5.81 mmol/L. Higher levels of blood lipids were associated with GDM, PE, SGA.

Conclusions

We suggested a reference ranges for blood lipids during the twin pregnancy in a Chinese population. The reference ranges recommended by this study can be used to identify women with twin pregnancies using unfavorable lipid values. Higher levels of blood lipids were associated with adverse pregnancy outcomes.
Safe motherhood in crisis; threats, opportunities, and needs: a qualitative study
Authors: Moghassemi Sedigheh , Adib Moghaddam Elham , Arab Sahar
Published: January 2024

Background

The coronavirus disease (COVID)-19 pandemic has affected many aspects of life, including pregnancy, childbirth, and safe motherhood so that pregnancy and childbirth take place in completely novel and unusual conditions for people. Therefore, we aimed to determine the opportunities, threats, and needs of pregnant women during a crisis.

Methods

The present qualitative study was conducted among women who had a history of pregnancy and childbirth during the COVID-19 pandemic period in 2022. The data were collected by conducting face-to-face, semi-structured and in-depth interviews with 20 purposefully selected participants. Interviews continued until data saturation was attained. Data were analyzed through conventional qualitative content analysis based on the Graneheim and Lundman approach.

Results

The data were categorized under three main themes: 1(“Opportunities for safe motherhood in crisis“(2 Sub‑themes), 2) “Threats to safe motherhood in crisis“(2 Sub‑themes), and 3) “Needs for safe motherhood in crisis” (3 Sub‑themes).

Conclusions

Crisis is not always a threat. By developing an awareness of the opportunities, threats, and needs that safe motherhood faced during the COVID-19 crisis, policy makers can identify the existing gaps affecting the health of mothers and take the necessary measures to improve their conditions, experiences, and health in further crises.
A new step-wise surgical technique of knapsack-like uterine compression sutures for intractable postpartum hemorrhage in cesarean section
Authors: Han Lei , Zhang Baolin , Xu Huishu , Yin Hongmei , Pang Yiwei , Zhang Xianghui , Zhai Qingliang , Liu Xiaofeng , Wang Yanlin , Zhang Caiying , Xu Yingjiang , Liu Yanni , Chen Xuemei
Published: January 2024

Background

Intractable postpartum hemorrhage (PPH) during cesarean section has been a significant concern for obstetricians. We aimed to explore the effectiveness and safety of a new type of uterine compression suture, the step-wise surgical technique of knapsack-like sutures for treating intractable PPH caused by uterine atony and placenta factors in cesarean section.

Methods

The step-wise surgical technique of knapsack-like sutures was established on the basis of the artful combination of vertical strap-like sutures and an annular suture-ligation technique. This novel surgical technique was applied to 34 patients diagnosed with PPH during cesarean section due to severe uterine atony and placental factors in our department. The hemostatic effects, clinical outcomes and follow-up visit results were all reviewed and analyzed.

Results

This new uterine compression suture successfully stopped bleeding in 33 patients, and the effective rate was 97.06%. Only 1 patient failed and was changed to use bilateral uterine arterial embolization and internal iliac artery embolization. The follow-up visits indicated that 33 patients restored menstruation except for 1 who was diagnosed with amenorrhea. The gynecological ultrasound tests of all the patients suggested good uterine involutions, and they had no obvious complaints such as hypogastralgia.

Conclusions

This step-wise surgical technique of knapsack-like uterine compression sutures can compress the uterus completely. It is a technique that can conserve the uterus and fertility function without special equipment in caesarean section for PPH, with the characteristics of being safe, simple and stable (3 S) with rapid surgery, reliable hemostasis and resident doctor to operation (3R).
Ultrasonographic evaluation of the gallbladder motor function in the diagnosis and prognosis of intrahepatic cholestasis of pregnancy
Authors: Tai Minghui , Chen Long , He Yajuan , Wang Fei , Tian Zhen
Published: January 2024

Background

Intrahepatic cholestasis of pregnancy (ICP) is characterized by skin pruritus, elevated liver enzymes, and increased serum total bile acids. Several previous studies have revealed that the fasting and ejection volumes of the gallbladder in cholestasis of pregnancy are greater than those in normal pregnancy. The goal of this study was to explore the gallbladder volume and evaluate the diagnostic and prognostic value of ultrasound in ICP.

Methods

We prospectively recruited a cohort of 60 ICP patients at the First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, China from January 2020 to December 2021 and compared their data with those from healthy pregnant women (n = 60). The gallbladder volume was evaluated by real-time ultrasound examination after overnight fasting and at 30, 60, 120, and 180 min after a liquid test meal of 200 mL, and the ejection fraction was calculated. Continuous data between two groups were compared by Student’s t test. Differences were considered significant for p < 0.05. The diagnostic and prognostic value of the volume and ejection function of the gallbladder was analyzed by the receiver operating characteristic (ROC) curve.

Results

The ICP group had significantly higher gallbladder basal volume (43.49 ± 1.34 cm3 vs. 26.66 ± 0.83 cm3, p < 0.01) and higher ejection fraction compared with the healthy group. The ejection fraction higher than 54.55% at 120 min might predict ICP diagnosis with 96.67% sensitivity and 88.33% specificity, and an AUC of 0.9739 (95% CI 0.9521–0.9956), while the gallbladder volume higher than 12.52 cm3 at 60 min might predict ICP severity with 59.18% sensitivity and 72.73% specificity, and an AUC of 0.7319 (95% CI 0.5787–0.8852).

Conclusion

Our results indicate abnormal volume and ejection function of the gallbladder in patients with ICP. The ejection fraction at 120 min can assist in the diagnosis if ICP exists, and the gallbladder volume at 60 min may assess the degree of severity of ICP.
Prognostic value and immunological role of PD-L1 gene in pan-cancer
Authors: Wang Yongfeng , Jiang Hong , Fu Liangyin , Guan Ling , Yang Jiaxin , Ren Jingyao , Liu Fangyu , Li Xiangyang , Ma Xuhui , Li Yonghong , Cai Hui
Published: January 2024

Objective

PD-L1, a target of immune checkpoint blockade, has been proven to take the role of an oncogene in most human tumors. However, the role of PD-L1 in human pan-cancers has not yet been fully investigated.

Materials and methods

Pan-cancer analysis was conducted to analyze expression, genetic alterations, prognosis analysis, and immunological characteristics of PD-L1. Estimating the correlation between PD-L1 expression and survival involved using pooled odds ratios and hazard ratios with 95% CI. The Kaplan–Meier (K-M) technique, COX analysis, and receiver operating characteristic (ROC) curves were applied to the survival analysis. Additionally, we investigated the relationships between PD-L1 and microsatellite instability (MSI), tumor mutational burden (TMB), DNA methyltransferases (DNMTs), the associated genes of mismatch repair (MMR), and immune checkpoint biomarkers using Spearman's correlation analysis. Also, immunohistochemical analysis and qRT-PCR were employed in evaluating PD-L1’s protein and mRNA expression in pan-caner.

Results

PD-L1 showed abnormal mRNA and protein expression in a variety of cancers and predicted prognosis in cancer patients. Furthermore, across a variety of cancer types, the aberrant PD-L1 expression was connected to the MSI, MMR, TMB, drug sensitivity, and tumor immune microenvironment (TIME). Moreover, PD-L1 was significantly correlated with infiltrating levels of immune cells (T cell CD8 + , neutrophil, and so on).

Conclusion

Our study provides a better theoretical basis and guidance for the clinical treatment of PD-L1.
A hsa_circ_001726 axis regulated by E2F6 contributes to metastasis of hepatocellular carcinoma
Authors: Ai Jiaoyu , Zhang Wanlin , Deng Wensheng , Yan Likun , Zhang Lidong , Huang Zongjing , Wu Ziyi , Ai Junhua , Jiang Hai
Published: January 2024

Background

CircRNAs participate in the development of hepatocellular carcinoma (HCC). This work aims to explore the key tumor promoting circRNA as a gene therapy target.

Methods

The differentially expressed gene circRNAs in HCC tumor tissues was identified by mining GSE121714 dataset. EdU staining, wound healing, transwell invasion assay, TUNEL staining and western blotting examined proliferation, migration, invasion, apoptosis and epithelial mesenchymal transition (EMT). Xenograft mouse model and orthotopic transplantation tumor mouse model were constructed to verify the role of hsa_circ_001726 in growth and metastasis of HCC. The relationship among CCT2, E2F6, hsa_circ_001726, miR-671-5p and PRMT9 was identified by RNA-fluorescence in situ hybridization, luciferase reporter assay and RNA Immunoprecipitation.

Results

Eleven differentially expressed circRNAs were found in HCC tumors. Among them, hsa_circ_001726 was highly expressed in HCC tumors and cells, which was transcribed from CCT2. As a transcription factor of CCT2, E2F6 knockdown inactivated CCT2 promoter and reduced hsa_circ_001726 expression. Moreover, hsa_circ_001726 elevated PRMT9 expression by sponging miR-671-5p, and then activated Notch signaling pathway. Additionally, hsa_circ_001726 deficiency repressed malignant phenotypes of HCC cells, including proliferation, migration, invasion, EMT and apoptosis. In vivo, hsa_circ_001726 deficiency reduced tumor growth and lung metastasis of HCC in xenograft mouse models and orthotopic transplantation tumor mouse models.

Conclusion

Hsa_circ_001726 functioned as an oncogene in HCC, which was derived from CCT2 and regulated by E2F6. Hsa_circ_001726 elevated PRMT9 expression by sponging miR-671-5p, and then activated Notch signaling pathway, thereby accelerating malignant phenotypes of HCC. Therefore, targeting hsa_circ_001726 may be a new avenue for HCC treatment.
Imaging diagnosis and differential diagnosis of extraskeletal osteosarcoma
Authors: Wang Xiao-chun , Zhang Ling , Lin Jiong-bin , Huang Xiao-yao , Liang Jing-hong , Zhong Jian-ping , Peng Ji-dong , Zhong Jun-yuan
Published: January 2024

Objective

The aim of this study was to investigate the clinical, imaging and pathological features of extraskeletal osteosarcoma (EOS) and to improve the understanding of this disease and other similar lesions.

Methods

The data for 11 patients with pathologically confirmed extraosseous osteosarcoma, including tumour site and size and imaging and clinical manifestations, were analysed retrospectively.

Results

Six patients were male (60%), and 5 were female (40%); patient age ranged from 23 to 76 years (average age 47.1 years). Among the 11 patients, 7 had clear calcifications or ossification with different morphologies, and 2 patients showed a massive mature bone tumour. MRI showed a mixed-signal mass with slightly longer T1 and T2 signals in the tumour parenchyma. Enhanced CT and MRI scans showed enhancement in the parenchyma. Ten patients had different degrees of necrosis and cystic degeneration in the mass, 2 of whom were complicated with haemorrhage, and MRI showed “fluid‒fluid level” signs. Of the 11 patients, five patients survived after surgery, and no obvious recurrence or metastasis was found on imaging examination. One patient died of lung metastasis after surgery, and 2 patients with open biopsy died of disease progression. One patient died of respiratory failure 2 months after operation. 2 patients had positive surgical margins, and 1 had lung metastasis 6 months after operation and died 19 months after operation. Another patient had recurrence 2 months after surgery.

Conclusion

The diagnosis of EOS requires a combination of clinical, imaging and histological examinations. Cystic degeneration and necrosis; mineralization is common, especially thick and lumpy mineralization. Extended resection is still the first choice for localized lesions. For patients with positive surgical margins or metastases, adjuvant chemoradiotherapy is needed.
CLEC19A overexpression inhibits tumor cell proliferation/migration and promotes apoptosis concomitant suppression of PI3K/AKT/NF-κB signaling pathway in glioblastoma multiforme
Authors: Mohajerani Fatemeh , Tehrankhah Zahra Moazezi , Rahmani Saeid , Afsordeh Nastaran , Shafiee Sajad , Pourgholami Mohammad Hossein , Soltani Bahram M. , Sadeghizadeh Majid
Published: January 2024

Background

GBM is the most frequent malignant primary brain tumor in humans. The CLEC19A is a member of the C-type lectin family, which has a high expression in brain tissue. Herein, we sought to carry out an in-depth analysis to pinpoint the role of CLEC19A expression in GBM.

Methods

To determine the localization of CLEC19A, this protein was detected using Western blot, Immunocytochemistry/Immunofluorescence, and confocal microscopy imaging. CLEC19A expression in glioma cells and tissues was evaluated by qRT-PCR. Cell viability, proliferation, migration, and apoptosis were examined through MTT assay, CFSE assay, colony formation, wound healing assay, transwell test, and flow cytometry respectively after CLEC19A overexpression. The effect of CLEC19A overexpression on the PI3K/AKT/NF-κB signaling pathway was investigated using Western blot. An in vivo experiment substantiated the in vitro results using the glioblastoma rat models.

Results

Our in-silico analysis using TCGA data and measuring CLEC19A expression level by qRT-PCR determined significantly lower expression of CLEC19A in human glioma tissues compared to healthy brain tissues. By employment of ICC/IF, confocal microscopy imaging, and Western blot we could show that CLEC19A is plausibly a secreted protein. Results obtained from several in vitro readouts showed that CLEC19A overexpression in U87 and C6 glioma cell lines is associated with the inhibition of cell proliferation, viability, and migration. Further, qRT-PCR and Western blot analysis showed CLEC19A overexpression could reduce the expression levels of PI3K, VEGFα, MMP2, and NF-κB and increase PTEN, TIMP3, RECK, and PDCD4 expression levels in glioma cell lines. Furthermore, flow cytometry results revealed that CLEC19A overexpression was associated with significant cell cycle arrest and promotion of apoptosis in glioma cell lines. Interestingly, using a glioma rat model we could substantiate that CLEC19A overexpression suppresses glioma tumor growth.

Conclusions

To our knowledge, this is the first report providing in-silico, molecular, cellular, and in vivo evidences on the role of CLEC19A as a putative tumor suppressor gene in GBM. These results enhance our understanding of the role of CLEC19A in glioma and warrant further exploration of CLEC19A as a potential therapeutic target for GBM.
Cyclin B2 impairs the p53 signaling in nasopharyngeal carcinoma
Authors: Liu Qinsong , Yuan Yong , Shang Xiaofen , Xin Lu
Published: January 2024

Background

Cyclin B2 (CCNB2), a member of the cyclin family, is an oncogene in multiple cancers, including nasopharyngeal carcinoma (NPC). However, the epigenetics mechanism for CCNB2 overexpression in NPC remains unclear. This study dissects the regulatory role of CCNB2 in NPC and the molecular mechanism.

Methods

Differentially methylated genes (DMG) and differentially expressed genes (DEG) were screened out in GSE52068 and GSE13597 databases, respectively, and candidate targets were identified by the Venn diagram. GO annotation and pathway enrichment analyses were performed on selected DMG and DEG, and a PPI network was constructed to pinpoint hub genes. PCR and qMSP were conducted to detect the expression and methylation of CCNB2 in cells. The siRNA targeting CCNB2 was transfected into NPC cells, and the migration, proliferation, cell cycle, epithelial-mesenchymal transition (EMT), tumorigenesis, and metastasis were examined. The upstream factor responsible for CCNB2 overexpression in NPC was explored. The p53 activity in NPC cells was assessed using western blot analysis.

Results

CCNB2 showed hypomethylation and overexpression in NPC. CCNB2 silencing inhibited cell migration, proliferation, cell cycle entry, and EMT. JMJD6 was overexpressed in NPC and upregulated CCNB2 through demethylation. JMJD6 reversed the effects of CCNB2 downregulation, resulting in elevated cellular activity in vitro and tumorigenic and metastatic activities in vivo. CCNB2 blocked the p53 pathway, while the p53 pathway inhibitor reversed the effect of CCNB2 silencing to increase the activity of NPC cells.

Conclusions

JMJD6 enhanced CCNB2 transcription by demethylating CCNB2, thereby repressing the p53 pathway and promoting NPC progression.
Magnetic resonance imaging-guided intracranial resection of glioblastoma tumors in patient-derived orthotopic xenografts leads to clinically relevant tumor recurrence
Authors: Oudin Anais , Moreno-Sanchez Pilar M. , Baus Virginie , Niclou Simone P. , Golebiewska Anna
Published: January 2024

Background

Preclinical in vivo cancer models are essential tools for investigating tumor progression and response to treatment prior to clinical trials. Although treatment modalities are regularly assessed in mice upon tumor growth in vivo, surgical resection remains challenging, particularly in the orthotopic site. Here, we report a successful surgical resection of glioblastoma (GBM) in patient-derived orthotopic xenografts (PDOXs).

Methods

We derived a cohort of 46 GBM PDOX models that faithfully recapitulate human disease in mice. We assessed the detection and quantification of intracranial tumors using magnetic resonance imaging (MRI).To evaluate feasibility of surgical resection in PDOXs, we selected two models representing histopathological features of GBM tumors, including diffuse growth into the mouse brain. Surgical resection in the mouse brains was performed based on MRI-guided coordinates. Survival study followed by MRI and immunohistochemistry-based evaluation of recurrent tumors allowed for assessment of clinically relevant parameters.

Results

We demonstrate the utility of MRI for the noninvasive assessment of in vivo tumor growth, preoperative programming of resection coordinates and follow-up of tumor recurrence. We report tumor detection by MRI in 90% of GBM PDOX models (36/40), of which 55% (22/40) can be reliably quantified during tumor growth. We show that a surgical resection protocol in mice carrying diffuse primary GBM tumors in the brain leads to clinically relevant outcomes. Similar to neurosurgery in patients, we achieved a near total to complete extent of tumor resection, and mice with resected tumors presented significantly increased survival. The remaining unresected GBM cells that invaded the normal mouse brain prior to surgery regrew tumors with similar histopathological features and tumor microenvironments to the primary tumors.

Conclusions

Our data positions GBM PDOXs developed in mouse brains as a valuable preclinical model for conducting therapeutic studies that involve surgical tumor resection. The high detectability of tumors by MRI across a substantial number of PDOX models in mice will allow for scalability of our approach toward specific tumor types for efficacy studies in precision medicine-oriented approaches. Additionally, these models hold promise for the development of enhanced image-guided surgery protocols.
Neutrophil to lymphocyte ratio as an assessment tool to differentiate between uterine sarcoma and myoma: a systematic review and meta-analysis
Authors: Tabatabaei Fatemeh , Babadi Saghar , Nourigheimasi Shima , Ghaedi Arshin , Khanzadeh Monireh , Bazrgar Aida , Gargari Morad Kohandel , Khanzadeh Shokoufeh
Published: January 2024

Background

This systematic review and meta-analysis aimed to determine the potential value of neutrophil to lymphocyte ratio (NLR) as an assessment tool in the clinical distinction between uterine sarcoma and uterine leiomyoma.

Methods

We comprehensively searched Web of Science, Scopus, and PubMed for relevant papers published before March 19, 2023. The standardized mean difference (SMD) was provided, along with a 95% confidence interval (CI). The random-effects model was employed to derive pooled effects due to the high levels of heterogeneity. The Newcastle-Ottawa scale was used for the quality assessment. Our study was registered in PROSPERO (CRD42023478331).

Results

Overall, seven articles were included in the analysis. A random-effect model revealed that patients with uterine sarcoma had higher NLR levels compared to those with uterine myoma (SMD = 0.60, 95% CI = 0.22–0.98; p = 0.002). In the subgroup analysis according to sample size, we found that patients with uterine sarcoma had elevated levels of NLR compared to those with uterine myoma in either large studies (SMD = 0.58, 95% CI = 0.04–1.13; P < 0.001) or small studies (SMD = 0.64, 95% CI = 0.33–0.96; P = 0.32). In the sensitivity analysis, we found that the final result was not significantly changed when single studies were removed, suggesting that the finding of this meta-analysis was stable. The pooled sensitivity of NLR was 0.68 (95% CI = 0.61–0.73), and the pooled specificity was 0.64 (95% CI = 0.59–0.69).

Conclusion

NLR might be utilized as an assessment tool in clinics to help clinicians differentiate between patients with uterine sarcoma and those with myoma.
A cluster randomized controlled trial comparing the effectiveness of two school-based interventions for autistic youth with anxiety
Authors: Pickard Katherine , Maddox Brenna , Boles Richard , Reaven Judy
Published: January 2024

Background

Recent systematic reviews have indicated that cognitive behavioral therapy (CBT) is effective in reducing anxiety symptoms for autistic and non-autistic children. However, the vast majority of CBT research for autistic youth has been implemented within university settings and primarily by mental health providers. Schools hold great promise to equitably manage the mental health symptoms of autistic youth. Although preliminary research evaluating CBT within schools has been promising, CBT has not yet been compared to another readily available school mental health program. The goal of this protocol paper is to describe a multi-site study comparing two school-based interventions, Facing Your Fears-School Based (FYF-SB) and Zones of Regulation (ZOR) via a cluster randomized controlled type 1 hybrid effectiveness-implementation trial to determine which of the two interventions will best support autistic youth with anxiety in schools.

Methods

Up to 100 elementary and middle schools will be randomized into FYF-SB or ZOR. Once schools are randomized, a minimum of two interdisciplinary school providers at each school will be trained to deliver either FYF-SB or ZOR over the course of 12 weeks to groups of 2–5 autistic students ages 8–14 years. Over the course of two years, a total of 200 autistic students will receive either ZOR or FYF-SB. The primary outcome of this trial is child anxiety, as rated by masked evaluators and via caregiver- and student-report, which will be measured at baseline, post-treatment, and 6-month follow-up. Semi-structured interviews will also be conducted with a purposive sample of students, caregivers, and school providers to understand the acceptability, appropriateness, and feasibility of either ZOR or FYF-SB. Stakeholder engagement is a central component of this project via two stakeholder advisory boards that will directly inform and oversee the project.

Discussion

Results of this study will provide evidence about the relative impact of two school-based mental health interventions on outcomes reported as meaningful by caregivers and school providers. The additional focus on evaluating factors that support the implementation of FYF-SB and ZOR will allow future studies to test targeted implementation strategies that support mental health programming uptake and implementation within public schools.

Trial registration

This trial is registered with clinicaltrials.gov (NCT05863520).
Correlation analysis and gender differences of cognitive function based on mini-mental state examination (MMSE) and suicidal tendency in patients with schizophrenia
Authors: Zhu Quanfeng , Zhang Xiang-Yang
Published: January 2024

Background

The aim of this study was to investigate the correlation and gender differences between cognition and suicidal tendency in patients with schizophrenia.

Methods

A total of 554 patients with schizophrenia were recruited. The Mini-Mental State Examination (MMSE), Positive and Negative Syndrome Scale (PANSS), Interpersonal Reactivity Index (IRI), Toronto Alexithymia Scale (TAS), and Insomnia Severity Index (ISI) were used to assess clinical symptoms.

Results

In male patients, MMSE score and the incidence of suicidal tendency were correlated (P = 0.04, OR = 1.06, 95%CI: 1.00–1.12). Among patients with cognitive dysfunction, IRI score (P = 0.01, OR = 1.04, 95%CI: 1.01–1.06), and types of antipsychotic drugs (P < 0.01, OR = 3.97, 95%CI: 1.76–8.97) in male patients were associated risk factors for suicidal ideation. Among patients without cognitive dysfunction, PANSS positive subscale score (P = 0.03, OR = 1.06, 95%CI: 1.01–1.11), and PANSS general psychopathology score (P = 0.02, OR = 1.05, 95%CI: 1.01–1.08) were associated risk factors for suicidal ideation in male patients and PANSS positive subscale score (P < 0.01, OR = 1.15, 95%CI: 1.05–1.26) were associated risk factors for suicidal ideation in female patients.

Conclusions

There were significant gender differences in the correlation between cognitive functioning and suicidal ideation in patients with schizophrenia. Cognitive function may play an important mediating role in other factors on suicide.
Psychosocial Factors Associated with dizziness and chronic dizziness: a nationwide cross-sectional study
Authors: Jang Yuna , Hur Hyun Jung , Park Bumhee , Park Hye Youn
Published: January 2024

Background

Dizziness is a common symptom in adults, and chronic dizziness, such as persistent postural-perceptual dizziness, is also frequently reported and affects the quality of life of patients. This study aimed to identify psychosocial factors related to dizziness and chronic dizziness in a large-scale nationwide cohort.

Methods

This population-based cross-sectional study used the database of the Eighth Korea National Health and Nutrition Examination Survey in 2020. Data from 4,147 adults over 40 years old were analyzed, and 1,102 adults who experienced dizziness were included in the dizziness cohort. Demographic data, medical conditions, comorbidities, functional status variables, nutritional variables and psychological variables were collected. The pattern of depressive symptoms according to the severity of dizziness was analyzed by network analysis.

Results

The prevalence rate of dizziness was 24.6% in the general population, and chronic dizziness (≥ 3 months) developed in 210 of 1,102 (17.1%) individuals who experienced dizziness. Multiple logistic regression analysis revealed that female sex, stress, and depression were associated with dizziness. Chronic dizziness was related to tympanic abnormalities, diabetes, short sleep duration, and higher levels of stress and depression. Psychomotor retardation/agitation was a central symptom of depression in patients with chronic dizziness.

Conclusions

This study found sex differences in factors associated with dizziness and identified psychosocial factors linked to chronic dizziness. Focusing on somatic factors rather than depressive symptoms may benefit patients with chronic dizziness.
Effectiveness of a socioecological model-guided, smart device-based, self-management-oriented lifestyle intervention in community residents: protocol for a cluster-randomized controlled trial
Authors: Yang Shujuan , Yu Bin , Liao Kai , Qiao Xu , Fan Yunzhe , Li Ming , Hu Yuekong , Chen Jiayan , Ye Tingting , Cai Changwei , Ma Chunlan , Pang Tong , Huang Zixing , Jia Peng , Reinhardt Jan D. , Dou Qingyu
Published: January 2024

Background

Healthy lifestyles are crucial for preventing chronic diseases. Nonetheless, approximately 90% of Chinese community residents regularly engage in at least one unhealthy lifestyle. Mobile smart devices-based health interventions (mHealth) that incorporate theoretical frameworks regarding behavioral change in interaction with the environment may provide an appealing and cost-effective approach for promoting sustainable adaptations of healthier lifestyles. We designed a randomized controlled trial (RCT) to evaluate the effectiveness of a socioecological model-guided, smart device-based, and self-management-oriented lifestyles (3SLIFE) intervention, to promote healthy lifestyles among Chinese community residents.

Methods

This two-arm, parallel, cluster-RCT with a 6-month intervention and 6-month follow-up period foresees to randomize a total of 20 communities/villages from 4 townships in a 1:1 ratio to either intervention or control. Within these communities, a total of at least 256 community residents will be enrolled. The experimental group will receive a multi-level intervention based on the socioecological model supplemented with a multi-dimensional empowerment approach. The control group will receive information only. The primary outcome is the reduction of modifiable unhealthy lifestyles at six months, including smoking, excess alcohol consumption, physical inactivity, unbalanced diet, and overweight/obesity. A reduction by one unhealthy behavior measured with the Healthy Lifestyle Index Score (HLIS) will be considered favorable. Secondary outcomes include reduction of specific unhealthy lifestyles at 3 months, 9 months, and 12 months, and mental health outcomes such as depression measured with PHQ-9, social outcomes such as social support measured with the modified Multidimensional Scale of Perceived Social Support, clinical outcomes such as obesity, and biomedical outcomes such as the development of gut microbiota. Data will be analyzed with mixed effects generalized linear models with family and link function determined by outcome distribution and accounting for clustering of participants in communities.

Discussion

This study will provide evidence concerning the effect of a mHealth intervention that incorporates a behavioral change theoretical framework on cultivating and maintaining healthy lifestyles in community residents. The study will provide insights into research on and application of similar mHealth intervention strategies to promote healthy lifestyles in community populations and settings.

Trial registration number

ChiCTR2300070575. Date of registration: April 17, 2023. https://www.chictr.org.cn/index.aspx.
Knowledge, attitude, and practice of diabetes in patients with and without sight-threatening diabetic retinopathy from two secondary eye care centres in India
Authors: Pardhan Shahina , Raman Rajiv , Biswas Anupama , Jaisankar Durgasri , Ahluwalia Sanjiv , Sapkota Raju
Published: January 2024

Background/Aims

Good knowledge, Attitude, and Practice (KAP) of diabetes influence its control and complications. We examined the KAP of diabetes in patients with sight-threatening diabetic retinopathy (STDR) and non-sight-threatening diabetic retinopathy (NSTDR) attending two different referral hospitals in India.

Methods

400 consecutive patients (mean age = 58.5 years ± 10.3) with diabetic retinopathy attending retina referral clinics in Chennai (private) and Darjeeling (public) were recruited. A validated questionnaire on diabetic KAP was administered in English or the local language. Data were analysed using an established scalar-scoring method in which a score of 1 was assigned to the correct answer/healthy lifestyle and 0 to an incorrect answer/unhealthy lifestyle/practice. Clinical data included fasting blood sugar, blood pressure, retinopathy, and visual acuity. Retinopathy was graded as STDR/NSTDR from retinal images using Early Treatment of Diabetic Retinopathy Study criteria.

Results

Usable data from 383 participants (95.8%) were analysed. Of these, 83 (21.7%) had STDR, and 300 (78.3%) had NSTDR. The NSTDR group reported a significantly lower total KAP score (mean rank = 183.4) compared to the STDR group (mean rank = 233.1), z = -3.0, p < 0.001. A significantly greater percentage in the NSTDR group reported to being unaware that diabetes could affect eyes, did not know about possible treatment for DR, and checked their blood sugar less frequently than once a month.

Conclusion

Patients who had not developed STDR had poorer KAP about diabetes and diabetes-related eye diseases. This is an important issue to address as the risk of their progressing to STDR is high unless appropriate steps to improve their knowledge/awareness and lifestyle practice are introduced early.
Experiences with family planning and abortion services during the Covid-19 pandemic: a qualitative study in Bangladesh, Iran and Netherlands
Authors: Asadisarvestani Khadijeh , Hulsbergen Myrrith
Published: January 2024

Objective

Access to family planning services is a human right that plays an essential role in society's health, particularly women’s health. The COVID-19 pandemic has affected all aspects of human life including access to family planning services. Accordingly, the main goal of this study was to explore the experiences of women and service providers from the main challenges and obstacles of access to family planning services and abortion services in Bangladesh, Iran, and the Netherlands during the COVID-19 pandemic.

Methods

In this qualitative study, the data were collected through online, telephone, or in-person semi-structured interviews with key informants. Participants selected by purposive sampling method. The participants included women aged 15 to 49 (n = 63) and service providers (n = 54) in the 3 abovementioned countries. These individuals were included from October 2020 until December 2020. Conventional thematic analysis was employed to analyze the collected data.

Results

The main extracted themes were challenges (reduction of referral; disruption of access to services; insufficient knowledge; worries among staff; rising prices; and unavailability of some contraceptives), measures (time extension and visit scheduling; telephone, online, and door to door services; and support of the media) and recommendations (health facility improvements; free, online, and closer services; and ongoing trainings and awareness campaigns).

Conclusion

The COVID-19 pandemic has affected family planning and reproductive health services in different ways and has uncovered existing inequalities in access to these services. However, in Iran, the reported challenges were also rooted in new population policies that have further limited access to family planning and abortion services.
The impact of isolation on comorbidity of PTSD symptoms and depression: evidence from PTRP-5-6 in China
Authors: Yan Wenjie , Shang Zhilei , Wu Lili , Lv Hongli , Jia Yanpu , Zhan Jingye , Wang Jing , Ouyang Hui , Liu Weizhi , Chen Wenfang
Published: January 2024

Background

The Omicron pandemic struck Shanghai, China, resulting in impairments of both physical and psychological health on those patients who were confirmed and transferred to the Fangcang shelters. The way of isolation led to high risk of posttraumatic stress symptoms (PTSS) and depressive symptoms among the patients in Fangcang shelters. We aim to estimate the prevalence and comorbidity of PTSS and depressive symptoms in patients from China’s Fangcang shelters during the epidemic.

Methods

Demographic information questionnaire, the posttraumatic stress disorder checklist for DSM-5 (PCL-5), and Patient Health Questionnaire (PHQ-9) were used in the study. The data were collected online via mobile phones during 10th April to 20th April, 2022, as part of our Psychological Trauma Recover Project-5-6 (PTRP-5-6), a longitudinal study focusing on individuals who have experienced trauma.

Results

A total of 336 subjects were included in the analysis. The results revealed (1) the prevalence of depressive symptoms, and PTSS were 30.1% (cut-off = 10) and 6% (cut-off = 33); (2) Multiple logistic regression showed that female (OR = 3.04, p < 0.05), suffering from dyspnea (OR = 5.83, p < 0.05) or gastrointestinal symptoms (OR = 6.38, p < 0.05) were risk factors for PTSS; higher education level (OR = 3.27, p < 0.05) and suffering from dizziness or headache (OR = 2.46, p < 0.05) were risk factors for depressive symptoms; (3)Respectively, 85% of the patients who reported PTSS also experienced depressive symptoms, 16.8% of the patients who reported depressive symptoms presented PTSS.

Conclusion

In the context of COVID-19, the comorbidity rate of PTSS and depressive symptoms among patients in Fangcang shelters increased with the severity of depressive symptoms.
A qualitative synthesis of practice-based learning from case studies on COVID community champion programmes in England, UK
Authors: South Jane , Woodall James , Stansfield Jude , Mapplethorpe Tom , Passey Andrew , Bagnall Anne-Marie
Published: January 2024

Background

Community-based volunteering supports outbreak management by extending reach into at-risk communities. This paper examines the application of a ‘community champions’ model in England, UK, during the COVID-19 pandemic. Evidence pre-pandemic shows that community champion interventions tap into social networks to strengthen connections with disadvantaged communities. During the pandemic, the UK government set up a COVID community champions funding award scheme for local authorities to develop local programmes that addressed emerging inequalities. The study aim was to identify transferable learning on community engagement in the pandemic by undertaking a secondary qualitative synthesis of practice-based case studies of local COVID community champion programmes.

Methods

A systematic staged approach for synthesis of practice-based case studies was used. In total, 16 COVID community champion case studies, which were written by practitioners involved in local programme implementation and published by the Local Government Association, were included. Case studies covered aims, programme development and delivery, examples of activities and a discussion of learning. Framework qualitative analysis methods were used to code and organise data prior to cross case analysis. The final stage produced an overarching thematic framework that best represented descriptive and interpretive themes.

Results

The results provide an overview of common features of COVID community champion programmes and emergent learning. All local programmes aimed to reduce health inequalities by involving at-risk communities in local prevention efforts, adapting the approach to local priorities. Two levels of community engagement were volunteer mobilisation and subsequent community-based outreach activities. Elements of capacity building, such as training and creation of networks, were common. The synthesis of practice-based learning found that stronger relationships with communities were regarded as a key mechanism to support more equitable prevention strategies. Other learning themes related to champion roles, community engagement strategies and programme implementation.

Conclusions

By focusing on how community champion approaches were applied by local authorities in England during the COVID-19 pandemic, this study contributes to knowledge on volunteer mobilisation as a mechanism to improve public health communication and outreach. Notwithstanding the limitations of experiential evidence, the synthesis of practice-based learning highlights potentially transferable community engagement strategies for health protection and health improvement.
Factors influencing psychological concerns about COVID-19 in South Korea: direct and indirect damage during the early stages of pandemic
Authors: Kim Min-sung , Cho Sung-il
Published: January 2024

Background

COVID-19 pandemic has led to psychological concerns, the distribution of which across populations may differ depending on whether pandemic-related damage is direct or indirect. This study aims to investigate concerns associated with direct and indirect damage according to population characteristics, and identify relatively vulnerable groups that are particularly affected by concerns.

Method

This cross-sectional study used data from the 2020 Korea Community Health Survey, which collected data based on a complex sampling design. A total of 208,106 responses from individuals aged ≥ 19 were collected via in-person interviews. The items related to COVID-19 concerns were measured by Likert scales ranging from 1 to 5 and categorized into two types: direct concerns, which pertained to infection or death, and indirect concerns, which pertained to criticism, vulnerability, and economic damage, through factor analysis. We compared the means and effect size of direct concerns, indirect concerns, and overall concerns using weighted mean, ANOVA, and multiple regression analysis.

Results

Exploratory and confirmatory factor analyses supported a two-factor structure for psychological concerns about COVID-19 (CFI = 0.99, TLI = 0.97, SRMR = 0.02, RMSEA = 0.06), which were divided into direct and indirect concerns. Mean scores were 3.62 for direct concerns and 4.07 for indirect concerns. Direct concerns were higher in females (B = .26); the elderly (B = .15); those diagnosed with hypertension or diabetes (B = .04; B = .06); those with few assistants during quarantine (B = .15); and those whose neighbors responded inappropriately to COVID-19 (B = .07). Indirect concerns were lower among the elderly (B = -.04), and higher among young; married (B = .25); pink- or blue-collar workers (B = .08; B = .06); and those who felt that the city responded inappropriately to COVID-19 (B = .02).

Conclusion

The prevalence of concerns regarding direct and indirect damage caused by the COVID-19 pandemic differed according to population characteristics. Some factors had a marked influence on direct and indirect concerns. Our findings could inform psychological interventions and policies for future pandemics. Customized interventions are needed to prevent negative psychological concerns and improve mental health.
Effectiveness of a multidisciplinary treatment with youth-initiated mentoring for youths with mental health needs from multi-problem families: a quasi-experimental study
Authors: Koper Natasha , Boin Yukiko , Creemers Hanneke E. , van Dam Levi , Stams Geert Jan J. M. , Branje Susan
Published: January 2024

Background

Children from multi-problem families have an increased risk for experiencing mental health problems. These families face problems in several domains that are often found to be chronic and intergenerational. Yet, the effects of mental health care for youths from multi-problem families are small at best, urging research on new treatment programs. The InConnection approach is an integrated care program to improve resilience of youths with mental health needs from multi-problem families by connecting professional expertise from multiple disciplines with the informal social network of the youth. Youths are asked to nominate a youth-initiated mentor (YIM) from the supportive adults in their network.

Methods

This quasi-experimental study compared the effectiveness of the InConnection approach to treatment as usual in a sample of 107 families (n = 66 intervention group, n = 41 control group) with n = 115 youths receiving treatment (cases). Youths (n = 102 reports, Mage = 15.59 years), parents (n = 85 reports) and case managers (n = 107 reports) responded to questionnaires four times over 15 months. Using these data, we measured youth resilience as the primary outcome, seven secondary outcomes, and three intermediate outcomes.

Results

Latent growth models showed only one significant change in outcomes over time across conditions, namely a decrease in case manager-reported child unsafety, and only two condition effects, which were both parent-reported. Parents in the InConnection group reported improvements over time in youth’s emotional and behavioral problems and their own positive parenting, whereas control parents reported no changes (ps ≤ 0.013).

Discussion

The treatment conditions were not effective in improving most of the youth and parental outcomes over time, except for child safety reported by the case manager. The InConnection approach only outperformed care as usual on two parent-reported outcomes. Future research should examine for whom and under what circumstances the InConnection approach works more convincingly.

Trial registration

Netherlands Trial Register NL7565. Retrospectively registered on 05/03/2019.