bluuebunny/crossref_metadata_2025 huggingface dataset:
From high school to postsecondary education, training, and employment: Predicting outcomes for young adults with autism spectrum disorder
Authors: Yamamoto Scott H. , Alverson Charlotte Y.
Published: April 2022

Background and Aims

The fastest growing group of students with disabilities are those with Autism Spectrum Disorder (ASD). States annually report on post-high school outcomes (PSO) of exited students. This study sought to fill two gaps in the literature related to PSO for exited high-school students with ASD and the use of state data and predictive modeling.

Methods

Data from two states were analyzed using two predictive analytics (PA) methods: multilevel logistic regression and machine learning. The receiver operating characteristic curve (ROC) analysis was used to assess predictive performance.

Results

Data analyses produced two results. One, the strongest predictor of PSO for exited students with ASD was graduating from high school. Two, machine learning performed better than multilevel logistic regression in predicting PSO engagement across the two states.

Conclusion

This study contributed two new and important findings to the literature: (a) PA models should be applied to state PSO data because they produce useful information, and (b) PA models are accurate and reliable over time.

Implications

These findings can be used to support state and local educators to make decisions about policies, programs, and practices for exited high school students with ASD, to help them successfully transition to adult life.
Recovery and Return to Activity 1 Year After Ankle Fracture Managed With Open Reduction and Internal Fixation: A Prospective Longitudinal Cohort Study
Authors: Ramadi Ailar , Beaupre Lauren A. , Heinrichs Luke , Pedersen M. Elizabeth
Published: April 2022

Background:

Ankle fractures are common and frequently managed with open reduction and internal fixation (ORIF). Although these fractures can occur at any age, they are most common in younger individuals with high-energy trauma or older adults with lower-energy trauma. Our investigation focused on those aged 65 years or younger. Our primary objective was to describe recovery over the first postfracture year in (1) functional dorsiflexion using the weightbearing lunge test (WBLT), (2) patient-reported functional outcomes using the Olerud Molander Ankle Score (OMAS), (3) return to prefracture activity levels, and (4) return to work. Secondarily, we examined patient and clinical factors (including the WBLT and OMAS) associated with return to prefracture activities, including sports.

Methods:

Using a prospective inception cohort of 142 patients between 18 and 65 years old who underwent ORIF after ankle fracture and attended follow-up visits, we collected information from participants and their medical charts. We assessed functional dorsiflexion (using side-to-side difference in WBLT), patient-reported functional outcome (OMAS), and self-reported return to prefracture activity levels and work at 6 weeks, 6 months and 1 year postoperatively.

Results:

The WBLT, OMAS, and return to prefracture activity and work improved significantly over time ( P < .001). However, at 1 year postoperation, the mean side-to-side difference in the WBLT was 3.22±2.68 cm, 69 (72%) reported ankle stiffness, and only 49 (52%) had returned to prefracture activity levels. Of those who were working, 97% had returned to work by 1 year postoperation. Only the OMAS ( P < .001) and side-to-side difference in WBLT ( P = .011) were significantly associated with return to prefracture activity levels.

Conclusion:

Although participants improved significantly over the first postoperative year in all outcomes, many reported limitations in functional dorsiflexion and return to prefracture activities. Those with higher OMAS scores and smaller side-to-side difference in WBLT were more likely to return to prefracture activity levels by 1 year postoperatively. Level of Evidence: Level II, prognostic study.
Geographic Patterns in Psoriasis: An Observational Study of CorEvitas Psoriasis Registry
Authors: Enos Clinton W. , O’Connell Katie A. , Harrison Ryan W. , McLean Robert R. , Dube Blessing , Van Voorhees Abby S.
Published: April 2022

Background: How psoriasis disease characteristics, management, and outcomes each vary across the US is not fully understood. Objective: Assess regional disease characteristics for patients enrolled in CorEvitas Psoriasis Registry, report biologic initiations by class over the period, and evaluate regional outcome data for initiations with 6-month follow-up. Methods: Participants included new biologic initiations in CorEvitas Psoriasis Registry from 2014-2019 categorized into 7 different geographic regions: Northeast, East North Central, Mountain/West North Central, South Atlantic, East South Central, West South Central, and Pacific. Baseline demographics and disease characteristics are described by region. For participants with 6-month follow-up data, we report treatment patterns and treatment outcomes. Results: 7520 biologic initiations from 6320 patients were available. Over time, biologic initiations in most US regions within the Registry resulted in a pattern where IL-17 inhibitors were used most frequently, followed by IL-12/23 and IL-23 inhibitors, and lastly by TNF inhibitors. Baseline disease severity varied among regions with the East South Central reporting the largest proportion (25.1%) of very severe disease by body surface area. Frequencies of metabolic comorbid diseases varied between regions (obesity, diabetes, hyperlipidemia, each P < .001; hypertension P < .019), with the East South Central reporting the largest proportions. Rates of achieving PASI75 and IGA 0/1 varied at 6-months (P = .008 and P = .001, respectively), with the East South Central reporting the lowest frequencies. At 6-months 28.2% of biologic initiations in the East South Central were discontinued, of which 22% had switched to another therapy. Conclusion: Providers should be aware of regional trends in disease characteristics to improve overall care of psoriasis patients.
Globalisation and Social Work Curricula: What Are Our Students Telling Us?
Authors: Ramanathan Chathapuram , Colvin Marianna L. , Luna Naelys , Herzog Joseph
Published: April 2022

The aim of this study was to understand perceptions among social work students regarding international/global practice, policy in the social work curriculum and international field internship experiences in their degree programmes. A survey of Bachelor of Social Work and Master of Social Work students was conducted in two social work programmes in the Southeastern United States ( n = 218). The analysis showed that the students expressed consistent recognition that global content matters, yet there was an observed discrepancy between recognition of the relevance of global content and its expected impact on students’ own future direct practice. They also perceived limited opportunities to engage in international learning experiences during their academic programmes. Results are discussed with implications for further research, social work education and curriculum development.
Operational response: Policing persons with mental illness in Australia
Authors: Miles-Johnson Toby , Morgan Matthew
Published: April 2022

Across the globe, policing persons with mental illness (PWMI) in crisis involves significant police work. Police must respond effectively to individuals whose behaviour and language are often erratic, and who may be intoxicated or experiencing psychosis. In Australia, police are often criticised for inappropriately handling mental health crises in the community and for differentially policing PWMI in crisis. To better understand Australian police response to PWMI in crisis, this study conducted interviews with 25 operational police officers working in one of the largest Australian state police organisations. The findings indicate that police response to PWMI in crisis is underpinned by trial-and-error practices, because officers are insufficiently trained to manage PWMI in crisis, and police are resistant to accept tasks considered ‘welfare work’. Officers are also relieved when response to PWMI in crisis includes mental health practitioners. We argue that whilst the availability of interagency schemes in Australia is generally restricted to metropolitan areas, effective policing response to PWMI in crisis should include a collaborative response between police and mental health practitioners.
Recombinant von Willebrand factor prophylaxis in patients with severe von Willebrand disease: phase 3 study results
Authors: Leebeek Frank W. G. , Peyvandi Flora , Escobar Miguel , Tiede Andreas , Castaman Giancarlo , Wang Michael , Wynn Tung , Baptista Jovanna , Wang Yi , Zhang Jingmei , Mellgård Björn , Özen Gülden
Published: April 2022

International guidelines conditionally recommend long-term prophylaxis in patients with von Willebrand disease (VWD) and severe and frequent bleeding. As recombinant von Willebrand factor (rVWF; vonicog alfa) may reduce the frequency of treated spontaneous bleeding events (BEs), we investigated the efficacy and safety of rVWF prophylaxis in adults with severe VWD. Patients with BEs requiring VWF therapy in the past year (on-demand VWF therapy [prior on-demand group] or plasma-derived VWF prophylaxis [pdVWF; switch group]) were enrolled in a prospective, open-label, nonrandomized, phase 3 study. The planned duration of rVWF prophylaxis was 12 months; starting rVWF dose was 50 ± 10 VWF: ristocetin cofactor (VWF:RCo) IU/kg twice weekly (prior on-demand group) or based on prior pdVWF weekly dose/dosing frequency (switch group). The primary endpoint was annualized bleeding rate (ABR) of treated spontaneous BEs (sABR) during rVWF prophylaxis. Over the 12-month study period, treated sABR decreased by 91.5% on-study vs historical sABR in 13 patients in the prior on-demand group, and by 45.0% in 10 patients in the switch group (model-based analysis ratio, 0.085; 95% confidence interval [CI], 0.021-0.346 and 0.550; 95% CI, 0.086-3.523, respectively). No treated spontaneous BEs were recorded in 84.6% (11/13) and 70.0% (7/10) of patients, respectively. The safety profile of rVWF was consistent with the previously established profile, with no new adverse drug reactions identified. Findings suggest that rVWF prophylaxis can reduce treated spontaneous BEs in patients previously receiving on-demand VWF therapy and maintains at least the same level of hemostatic control in patients who switch from prophylaxis with pdVWF to rVWF, with a favorable safety profile. This trial was registered at www.clinicaltrials.gov (#NCT02973087) and www.clinicaltrialsregister.eu (#EudraCT 2016-001478-14).
Application of unsupervised deep learning algorithms for identification of specific clusters of chronic cough patients from EMR data
Authors: Shao Wei , Luo Xiao , Zhang Zuoyi , Han Zhi , Chandrasekaran Vasu , Turzhitsky Vladimir , Bali Vishal , Roberts Anna R. , Metzger Megan , Baker Jarod , La Rosa Carmen , Weaver Jessica , Dexter Paul , Huang Kun
Published: April 2022

Background

Chronic cough affects approximately 10% of adults. The lack of ICD codes for chronic cough makes it challenging to apply supervised learning methods to predict the characteristics of chronic cough patients, thereby requiring the identification of chronic cough patients by other mechanisms. We developed a deep clustering algorithm with auto-encoder embedding (DCAE) to identify clusters of chronic cough patients based on data from a large cohort of 264,146 patients from the Electronic Medical Records (EMR) system. We constructed features using the diagnosis within the EMR, then built a clustering-oriented loss function directly on embedded features of the deep autoencoder to jointly perform feature refinement and cluster assignment. Lastly, we performed statistical analysis on the identified clusters to characterize the chronic cough patients compared to the non-chronic cough patients.

Results

The experimental results show that the DCAE model generated three chronic cough clusters and one non-chronic cough patient cluster. We found various diagnoses, medications, and lab tests highly associated with chronic cough patients by comparing the chronic cough cluster with the non-chronic cough cluster. Comparison of chronic cough clusters demonstrated that certain combinations of medications and diagnoses characterize some chronic cough clusters.

Conclusions

To the best of our knowledge, this study is the first to test the potential of unsupervised deep learning methods for chronic cough investigation, which also shows a great advantage over existing algorithms for patient data clustering.
CoMI: consensus mutual information for tissue-specific gene signatures
Authors: Huang Sing-Han , Lo Yu-Shu , Luo Yong-Chun , Chuang Yi-Hsuan , Lee Jung-Yu , Yang Jinn-Moon
Published: April 2022

Background

The gene signatures have been considered as a promising early diagnosis and prognostic analysis to identify disease subtypes and to determine subsequent treatments. Tissue-specific gene signatures of a specific disease are an emergency requirement for precision medicine to improve the accuracy and reduce the side effects. Currently, many approaches have been proposed for identifying gene signatures for diagnosis and prognostic. However, they often lack of tissue-specific gene signatures.

Results

Here, we propose a new method, consensus mutual information (CoMI) for analyzing omics data and discovering gene signatures. CoMI can identify differentially expressed genes in multiple cancer omics data for reflecting both cancer-related and tissue-specific signatures, such as Cell growth and death in multiple cancers, Xenobiotics biodegradation and metabolism in LIHC, and Nervous system in GBM. Our method identified 50-gene signatures effectively distinguishing the GBM patients into high- and low-risk groups (log-rank p = 0.006) for diagnosis and prognosis.

Conclusions

Our results demonstrate that CoMI can identify significant and consistent gene signatures with tissue-specific properties and can predict clinical outcomes for interested diseases. We believe that CoMI is useful for analyzing omics data and discovering gene signatures of diseases.
Cross-species transcriptomes reveal species-specific and shared molecular adaptations for plants development on iron-rich rocky outcrops soils
Authors: Dias Mariana Costa , Caldeira Cecílio , Gastauer Markus , Ramos Silvio , Oliveira Guilherme
Published: April 2022

Background

Canga is the Brazilian term for the savanna-like vegetation harboring several endemic species on iron-rich rocky outcrops, usually considered for mining activities. Parkia platycephala Benth. and Stryphnodendron pulcherrimum (Willd.) Hochr. naturally occur in the cangas of Serra dos Carajás (eastern Amazonia, Brazil) and the surrounding forest, indicating high phenotypic plasticity. The morphological and physiological mechanisms of the plants’ establishment in the canga environment are well studied, but the molecular adaptative responses are still unknown. To understand these adaptative responses, we aimed to identify molecular mechanisms that allow the establishment of these plants in the canga environment.

Results

Plants were grown in canga and forest substrates collected in the Carajás Mineral Province. RNA was extracted from pooled leaf tissue, and RNA-seq paired-end reads were assembled into representative transcriptomes for P. platycephala and S. pulcherrimum containing 31,728 and 31,311 primary transcripts, respectively. We identified both species-specific and core molecular responses in plants grown in the canga substrate using differential expression analyses. In the species-specific analysis, we identified 1,112 and 838 differentially expressed genes for P. platycephala and S. pulcherrimum, respectively. Enrichment analyses showed that unique biological processes and metabolic pathways were affected for each species. Comparative differential expression analysis was based on shared single-copy orthologs. The overall pattern of ortholog expression was species-specific. Even so, we identified almost 300 altered genes between plants in canga and forest substrates with conserved responses in the two species. The genes were functionally associated with the response to light stimulus and the circadian rhythm pathway.

Conclusions

Plants possess species-specific adaptative responses to cope with the substrates. Our results also suggest that plants adapted to both canga and forest environments can adjust the circadian rhythm in a substrate-dependent manner. The circadian clock gene modulation might be a central mechanism regulating the plants’ development in the canga substrate in the studied legume species. The mechanism may be shared as a common mechanism to abiotic stress compensation in other native species.
Amplicon-based sequencing and co-occurence network analysis reveals notable differences of microbial community structure in healthy and dandruff scalps
Authors: Wang Li , Yu Tao , Zhu Yaxin , Luo Yingfeng , Dong Fan , Lin Xuemei , Zhao Wenzhong , He Zilong , Hu Songnian , Dong Zhiyang
Published: April 2022

Background

Dandruff is a chronic, recurring, and common scalp problem that is caused by several etiopathogeneses with complex mechanisms. Management of this condition is typically achieved via antifungal therapies. However, the precise roles played by microbiota in the development of the condition have not been elucidated. Despite their omnipresence on human scalp little is known about the co-occurrence/co-exclusion network of cutaneous microbiota.

Results

We characterized the scalp and hair surface bacterial and fungal communities of 95 dandruff-afflicted and healthy individuals residing in China. The degree distributions of co-occurrence/co-exclusion network in fungi-bacteria and bacteria-bacteria were higher in the healthy group (P < 0.0001), whereas the betweenness values are higher in the dandruff group (P < 0.01). Meanwhile, the co-occurrence/co-exclusion network among fungi-fungi and fungi-bacteria showed that compared to the healthy group, the dandruff group had more positive links (P < 0.0001). In addition, we observed that Malassezia slooffiae, Malassezia japonica and Malassezia furfur, were more abundant in the dandruff group than in the healthy group. These microbiota were co-exclusion by either multiple bacterial genera or Malassezia sp. in healthy group. The lactic acid bacteria on the scalp and hair surface, especially the genera Lactobacillus and Lactococcus, exhibit a negative correlation with multiple bacterial genera on the scalp and hair surface. Lactobacillus plantarum and Pediococcus lactis isolated on the healthy human scalp can inhibit the growth of Staphylococcus epidermidis in vitro.

Conclusions

We showed that microbial networks on scalp and hair surface with dandruff were less integrated than their healthy counterparts, with lower node degree and more positive and stronger links which were deemed to be unstable and may be more susceptible to environmental fluctuations. Lactobacillus bacteria have extensive interactions with other bacteria or fungi in the scalp and hair surface micro-ecological network and can be used as targets for improving scalp health.
Normalization strategy for selection of reference genes for RT-qPCR analysis in left ventricles of failing human hearts
Authors: Červenák Zdenko , Červenák Filip , Adamičková Adriana , Šalingová Barbara , Gažová Andrea , Kyselovič Ján
Published: April 2022

Background

Quantitative RT-PCR is a valuable tool for assessing the gene expression in different human tissues, particularly due to its exceptional sensitivity, accuracy and reliability. However, the choice of adequate control for normalization is a crucial step, greatly affecting the results of all subsequent analyses. So far, only a few studies were focused on the selection of optimal reference genes in left ventricles of failing human hearts, leading to several disparities in experimental results focused on differential gene expression in this area. Therefore, the main objective of this study was to identify a set of suitable reference genes in normal and failing left ventricle tissues, which could increase the reliability of RT-qPCR-based studies in the future.

Methods

We analyzed the expression of 15 commonly used housekeeping genes (ACTB, B2M, GAPDH, GUSB, HMBS, HPRT1, IPO8, PGK1, POLR2A, PPIA, RPLP0, TBP, TFRC, UBC and YWHAZ) in left ventricles of normal and failed hearts with two-step approach. In the first step, we excluded genes which are variantly expressed using ANOVA-based statistical method. Afterwards, the remaining genes were analyzed using geNorm, NormFinder and BestKeeper algorithms, together with delta Cq method. Finally, the geometric mean of gene rankings across all methods was calculated.

Results

Our analysis identified IPO8 and POLR2A as the most stably expressed genes, whereas ACTB and B2M were found to be expressed variantly, suggesting a potential role of these genes in the pathophysiological processes in failing human hearts.

Discussion/conclusion

Using our two-step approach, we identified and validated two reference genes expressed invariantly in left ventricles of both healthy and failing human hearts, as well as provided a guideline for the selection of reference genes in studies comparing gene expression in these types of tissues.
Accuracy of the Euro CTO(CASTLE) score obtained on coronary computed tomography angiography for Predicting 30-minute wire crossing in chronic total occlusions
Authors: Yu Yan-tan , Sha Zhi-yi , Chang Shu-min , Zhai Du-tian , Zhang Xiao-jiao , Hou Ai-jie , Feng Wen-jie , Li Dao-wei , Wang Yong , Luan Bo
Published: April 2022

Background

To investigate the feasibility and accuracy of the Euro CTO (CASTLE)CTAscore obtained on coronary computed tomography angiography (CCTA) for predicting the success of percutaneous coronary intervention (PCI) and the 30-min wire crossing in chronic total occlusions (CTO).

Method

One hundred and fifty patients (154 CTO cases; median age, 61 (interquartile range [IQR], 54–68) years; 75.3% male) received CCTA at the People's Hospital of Liaoning Provincce within 1 month before the procedure. The Euro CTO (CASTLE) score obtained on CCTA(CASTLECTA) was calculated and compared with the Euro CTO (CASTLE) score obtained based on coronary angiography (CASTLECAG) for the predictive value of 30-min wire crossing and CTO procedural success.

Results

In our study, the CTO-PCI success rate was 89.0%, with guidewires of 65 cases (42.2%) crossing within 30 min. There were no significant differences in the median CASTLECTAand CASTLECAGscores in the procedure success group (3 [IQR, 2–4] vs 3 (IQR, 2–3]; p = 0.126). However, the median CASTLECTAscore was significantly higher than the median CASTLECAGscore in the procedure failure group (4 [IQR, 3–5.5] vs 4 [IQR, 2.5–5.5]; p = 0.021). There was no significant difference between the median CASTLECTAscore and the median CASTLECAGscore in the 30-min wire crossing failure group (3 [IQR, 3–4] vs 3 [IQR, 2–4]; p = 0.254). However, the median CASTLECTAscore was significantly higher than the median CASTLECAGscore in the 30-min wire crossing group (3 [IQR, 2–3] vs 2 [IQR, 2–3]; p < 0.001). The CASTLECTAscore described higher levels of calcification than the CASTLECAGscore (48.1% vs 33.8%; p = 0.015). There was no significant difference between the CASTLECTAscore (area under the curve [AUC], 0.643; 95% confidence interval [CI], 0.561–0.718) and the CASTLECAGscore (AUC, 0.685; 95% CI, 0.606–0.758) for predicting procedural success (p = 0.488). The CASTLECTAscore (AUC, 0.744; 95% CI, 0.667–0.811) was significantly better than the CASTLECAGscore (AUC, 0.681; 95% CI, 0.601–0.754; p = 0.046) for predicting 30-min wire crossing with the best cut-off value being CASTLECTA ≤ 3. The sensitivity, specificity, positive predictive value, and negative predictive value were 90.8%, 55.2%, 54.6%, and 87.0%, respectively.

Conclusion

The CASTLECTAscores obtained from noninvasive CCTA perform better for the prediction of the 30-min wire crossing than the CASTLECAGscore.
Influence of data disclosures on physician decisions about off-label uses: findings from a qualitative study
Authors: Chansky Melanie C. , Price Simani M. , Aikin Kathryn J. , O’Donoghue Amie C.
Published: April 2022

Background

Prescribing approved products for unapproved uses (off-label use) is not uncommon among physicians in certain medical specialties. Available evidence about an off-label use – both supportive and unsupportive – can influence prescribers’ decisions about a drug’s appropriateness for a particular case. The objectives of this study were: (1) to examine physician perceptions about off-label uses generally, including their awareness of unsupportive data; and (2) to explore the influence of disclosure information about unsupportive data on off-label prescribing decisions.

Methods

Semi-structured interviews were conducted between December 2019 and January 2020 with oncologists (n = 35) and primary care physicians (n = 35). Interviews explored general prescribing practices, understanding of and information sources for learning about off-label use of prescription drugs, awareness of unsupportive data related to off-label uses, and preferences and reactions to disclosure statements about the existence of unsupportive data related to an off-label use.

Results

Most participants reported prescribing drugs for off-label uses (with half reporting regular off-label prescribing). However, among those who prescribe off-label, approximately two-thirds had never seen unsupportive data about off-label uses. Physicians preferred a disclosure statement that provided a summary of the unsupportive data about the off-label use; this statement also led most physicians to say they were unlikely or less likely to prescribe the drug for that use.

Conclusions

This study suggests that physicians’ decision-making about prescribing for off-label uses of approved drugs may be influenced by awareness of unsupportive data. Our interviews also suggest that providing more information about unsupportive study findings may result in a reduction in reported prescribing likelihood.
There and back again: the shape of telemedicine in U.S. nursing homes following COVID-19
Authors: Ford James H , Jolles Sally A , Heller Dee , Langenstroer Madeline , Crnich Christopher
Published: April 2022

Introduction

Telemedicine use in nursing homes (NHs) expanded during the COVID-19 pandemic. The objectives of this study were to characterize plans to continue telemedicine among newly adopting NHs and identify factors limiting its use after COVID-19.

Methods

Key informants from 9 Wisconsin NHs that adopted telemedicine during COVID-19 were recruited. Semi-structured interviews and surveys were employed to identify participant perceptions about the value of telemedicine, implementation challenges encountered, and plans and barriers to sustaining its delivery after COVID-19. Directed content analysis and a deductive thematic approach using the Systems Engineering Initiative for Patient Safety (SEIPS) model was used during analyses. Quantitative and qualitative data were integrated to identify participant views on the value of telemedicine and the tools and work system enhancements needed to make telemedicine easier and more effective.

Results

All participating NHs indicated a preference to continue telemedicine after COVID-19. Urgent assessments of resident change-in-condition and cognitively based sub-specialty consultations were identified as the encounter types most amenable to telemedicine. Reductions in resident off-site encounters and minimization of resident therapy interruptions were identified as major benefits of telemedicine. Twelve work system enhancements needed to better sustain telemedicine were identified, including improvements to: 1) equipment/IT infrastructure; 2) scheduling; 3) information exchange; and 4) telemedicine facilitators.

Discussion

NHs that adopted telemedicine during COVID-19 wish to continue its use. However, interventions that enhance the integration of telemedicine into NH and off-site clinic work systems require changes to existing regulations and reimbursement models to sustain its utilization after COVID-19.
The role of depression and physical activity in the association of between sleep quality, and duration with and health-related quality of life among the elderly: a UK Biobank cross-sectional study
Authors: Hu Wei , Chu Jiadong , Chen Xuanli , Liu Siyuan , Sun Na , Han Qiang , Li Tongxing , Feng Zhaolong , He Qida , Shen Yueping
Published: April 2022

Background

Although studies have shown that sleep quality (duration) is associated with health-related quality of life (HRQoL), most of these studies have been small-sized and targeted at young and middle-aged adults. In addition, few studies have explored the path mechanism of sleep disorders leading to impaired HRQoL.

Objectives

This study aimed to determine the association between sleep quality and duration and HRQoL among the elderly in the United Kingdom, assess whether depression mediated the association, and explore the role of physical activity (PA) in the path association.

Methods

Data were extracted from the baseline survey of the UK Biobank, a large prospective cohort study enrolling more than 500,000 participants, of which 52,551 older adults (aged ≥60 years) were included in the study. HRQoL was assessed using the European Quality of Life-5 Dimensions. Tobit and multivariate logistic regression models were used to determine the association between sleep quality and duration and HRQoL. The mediating and moderated mediation models were estimated using the PROCESS macro and MEDCURVE macro.

Results

The Tobit model showed that the elderly with short or long sleep duration (β = − 0.062, 95% confidence interval [CI] = − 0.071 to − 0.053; β = − 0.072, 95% CI = − 0.086 to − 0.058) had worse HRQoL after adjusting potential covariates. In the logistic regression models, we found an inverted U-shaped association between sleep duration and HRQoL. Moreover, a significant positive association was observed between sleep quality and HRQoL (all P < 0.05). The results also revealed that depression mediated the association between sleep disorders and HRQoL (sleep quality: β = 0.008, 95% CI = 0.007–0.010; sleep duration: θ = 0.001 [mean], 95% CI = 0.001–0.002). Furthermore, PA moderated all paths among sleep quality and duration, depression, and HRQoL, and greater effects were observed in the elderly with lower PA levels.

Conclusions

The findings show that poor sleep quality and duration were independently associated with worse HRQoL among the elderly in the United Kingdom. Furthermore, PA buffers the mediating effect of depression and adverse effects of sleep disorders on HRQoL. It is essential to properly increase PA and provide early intervention for depression in the elderly with sleep disorders to improve their HRQoL.
Increased rate of enteric bacteria as cause of periprosthetic joint infections in patients with liver cirrhosis
Authors: Koepf Uta S. , Scheidt Sebastian , Hischebeth Gunnar T. R. , Strassburg Christian P. , Wirtz Dieter C. , Randau Thomas M. , Lutz Philipp
Published: April 2022

Introduction

Periprosthetic joint infections (PJI) are a major complication in joint-arthroplasty. Rifampicin is often used as an additional agent to treat PJI, because it penetrates bacterial biofilms. However, rifaximin, belonging to the same antibiotic class as rifampicin, is frequently used to prevent episodes of hepatic encephalopathy in patients with cirrhosis and may induce resistance to rifampicin. The aim of this study was to examine the microbial pattern of periprosthetic joint infections in cirrhotic patients and to test the hypothesis that intake of rifaximin increases the rate of resistance to rifampicin in periprosthetic joint infections.

Methods

A cohort of cirrhotic patients and PJI (n = 25) was analysed on the characteristics of bacterial isolates from sonication and tissue analysis. In a second step a subgroup analysis on the development of rifampicin resistant bacterial specimens, depending on the intake of rifaximin (8 rifaximin intake patients vs. 13 non rifaximin intake patients) was performed.

Results

Intestinal bacteria were found in 50% of the specimens, which was significantly more frequent than in a control cohort. By comparison of the single bacterial isolates, rifampicin resistance was detected in 69.2% (9/13) of the rifaximin-intake samples. In contrast, the non-rifaximin-intake isolates only were resistant to rifampicin in 22.2% (4/18) of the cases (p = 0.01). The odds ratio for developing a rifampicin-resistance through rifaximin intake was calculated as OR = 13.5.

Conclusion

Periprosthetic joint infections have a high incidence of being caused by enteric bacteria in cirrhotic patients. Due to this change in microbial pattern and the innate resistance to rifampicin of most of gram-negative bacteria, the therapy with rifampicin should be carefully considered. The association between the use of rifaximin and developed resistance to rifampicin has a major impact on the treatment of PJI.
Relationship between gestational body mass index change and the risk of gestational diabetes mellitus: a community-based retrospective study of 41,845 pregnant women
Authors: Zhang Shuang , Liu Huikun , Li Nan , Dong Wei , Li Weiqin , Wang Leishen , Zhang Yu , Yang Yingzi , Leng Junhong
Published: April 2022

Background

Gestational diabetes mellitus (GDM) is associated with adverse health consequences for women and their offspring. It is associated with maternal body mass index (BMI) and may be associated with gestational weight gain (GWG). But due to the heterogeneity of diagnosis and treatment and the potential effect of GDM treatment on GWG, the association between the two has not been thoroughly clarified. Compared to body weight, BMI has the advantage that it considers height during the whole course of pregnancy. Understanding BMI changes during pregnancy may provide new evidence for the prevention of GDM.

Methods

This study investigated the BMI change of pregnant women based on a retrospective study covering all communities in Tianjin, China. According to the results of GDM screening at 24–28 weeks of gestation, pregnancies were divided into the GDM group and the non-GDM group. We compared gestational BMI change and GWG in the two groups from early pregnancy to GDM screening. GWG was evaluated according to the IOM guidelines. Logistic regression was applied to determine the significance of variables with GDM.

Results

A total of 41,845 pregnant women were included in the final analysis (GDM group, n = 4257 vs. non-GDM group, n = 37,588). BMI gain has no significant differences between the GDM and non-GDM groups at any early pregnancy BMI categories (each of 2 kg/m2), as well as weight gain (P > 0.05). Early pregnancy BMI was a risk factor for GDM (OR 1.131, 95% CI 1.122–1.139). And BMI gain was associated with a decreased risk of GDM in unadjusted univariate analysis (OR 0.895, 95% CI 0.869–0.922). After adjusting on early pregnancy BMI and other confounding factors, the effect of BMI gain was no longer significant (AOR 1.029, 95% CI 0.999–1.061), as well as weight gain (AOR 1.006, 95% CI 0.995–1.018) and GWG categories (insufficient: AOR 1.016, 95% CI 0.911–1.133; excessive: AOR 1.044, 95% CI 0.957–1.138).

Conclusions

BMI in early pregnancy was a risk factor for GDM, while BMI gain before GDM screening was not associated with the risk of GDM. Therefore, the optimal BMI in early pregnancy is the key to preventing GDM.
Evaluation of neural tube defects from 2014 to 2019 in Turkey
Authors: Çaylan Nilgün , Yalçin Sıddıka Songül , Tezel Başak , Aydin Şirin , Üner Oben , Kara Fatih
Published: April 2022

Objective

The aim of this study is to determine the frequency of neural tube defects (NTDs) and to examine the epidemiological characteristics of NTD related deaths in Turkey.

Methods

This nationwide descriptive study was included NTD related infant deaths, termination of pregnancy for fetal anomaly (ToPFA) and stillbirth cases registered in Death Notification System between 2014 and 2019, and patients diagnosed with NTD in the 2018 birth cohort.

Findings

In the 2018 birth cohort, there were 3475 cases of NTD at birth (27.5 per 10,000). The fatality rates for live-born babies with NTD in this cohort were 13.5% at first year, and 15.6% at the end of March, 2022. NTDs were associated with 11.7% of ToPFA cases, 2.5% of stillbirths and 2.8% of infant deaths in 2014–2019. NTD related stillbirth rate was 1.74 per 10,000 births, while NTD related ToPFA rate and infant mortality rate were 0.61 and 2.70 per 10,000 live births respectively. NTD-related stillbirth and infant mortality rate were highest in the Eastern region (3.64 per 10,000 births; 4.65 per 10,000 live births respectively), while ToPFA rate was highest in the North and West regions (1.17 and 0.79 per 10,000 live births respectively) (p < 0.05). Prematurity and low birth weight were the variables with the highest NTD related rates for stillbirths (11.26 and 16.80 per 10,000 birth), ToPFA (9.25 and 12.74) per 10,000 live birth), and infant deaths (13.91 and 20.11 per 10,000 live birth) (p < 0.05).

Conclusion

NTDs are common and have an important place among the mortality causes in Turkey. Primary prevention through mandatory folic acid fortification should be considered both to reduce the frequency of NTD and related mortality rates.
Matrix metalloproteinase 9 is associated with conjunctival microbiota culture positivity in Korean patients with chronic Stevens-Johnson syndrome
Authors: Moon Jayoon , Lee Yunjin , Yoon Chang Ho , Kim Mee Kum
Published: April 2022

Background

Stevens-Johnson syndrome (SJS) is an abnormal immune-response causing extensive exfoliation of the mucocutaneous tissue including conjunctiva. While several factors are associated with the alteration of conjunctival microbiota, the conjunctiva of SJS patients are found to harbor a different microbiota compared to healthy subjects. We investigated the conjunctival microbiota of Korean SJS patients, and identified factors associated with the conjunctival microbiota and its positive culture.

Methods

Medical records were retrospectively reviewed in 30 chronic SJS patients who had undergone conjunctival swab culture sampling. Demographic factors, chronic ocular surface complications score (COCS), tear break-up time (TBUT), tear secretion, tear matrix metalloproteinase 9 (MMP9), and results of conjunctival swab culture were assessed.

Results

Positive culture was seen in 58.1%. Gram positive bacteria was most commonly isolated, among which Coagulase-negative Staphylococci (45.5%) and Corynebacterium species (40.9%) were predominantly observed. Tear MMP9 positivity was observed significantly more in the positive culture group (100%) compared to the negative culture group (70%) (P = 0.041). Topical cyclosporine and corticosteroid were not associated with repetitive positive cultures. No significant differences in COCS, TBUT, and tear secretion were found between culture-positive and culture-negative groups.

Conclusion

Our study suggests that tear MMP9 positivity may be related with the presence of an abnormal ocular surface microbiota in chronic SJS patients.
Longitudinal association between the timing of adiposity peak and rebound and overweight at seven years of age
Authors: Lin Dan , Chen Di-di , Huang Jun , Li Yun , Wen Xiao-sa , Shi Hui-jing
Published: April 2022

Background

The timing of adiposity peak (AP) or adiposity rebound (AR) is a determinant of overweight or obesity in adolescence and adulthood. However, limited studies have reported the association in young school-age children. We aimed to evaluate this association and explore the role of health behaviours in it.

Methods

Routinely collected, sequential, anthropometric data from the 1st to 80th months of age were used to estimate AP and AR timings in 2330 children born in Shanghai between 2010 and 2013. Multivariate regression analyses were applied to identify the associations between the AP or AR timings and the risk of developing overweight or obesity in first-grade school children. The roles of health behaviours, including dietary patterns, physical activity level, sleep and snacking habits, and screen time, were also evaluated.

Results

Children with a late AP or an early AR were at higher risk of overweight but not obesity or central obesity in their first grade. A high physical activity level was associated with a lower risk of having overweight in children with a late AP, and limited screen time was associated with a decreased risk of having overweight or obesity in children with an early AR. The absence of a late-night snacking habit in children with a non-early AR indicated a decreased risk of having overweight. However, this association was not observed among children with an early AR.

Conclusion

The timings of AP and AR are tied to overweight in middle childhood. Prevention strategies are suggested to move forward to control late AP and early AR.
The characteristics and perioperative outcomes of children with orofacial clefts managed at an academic hospital in Johannesburg, South Africa
Authors: Sithole Prosperity A. , Motshabi-Chakane Palesa , Muteba Michel K.
Published: April 2022

Background

Orofacial clefts (OFCs) are the commonest congenital anomalies of the head and neck. Their aetiology is multifactorial, and prevalence has a geographical variation. This study sought to describe OFC cases that presented for surgery.

Objectives

The study aimed to describe the preoperative characteristics, concomitant congenital anomalies and perioperative outcomes of children presenting for cleft repair surgery over a 5-year period at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH).

Methods

A retrospective descriptive record review for children under the age of 14 years who presented for cleft repair surgery at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) during a 5-year period, from 1 January 2014 to 31 December 2018. Descriptive and comparative statistics were used to report the results.

Results

A total of 175 records were included in the study. The median (IQR) age was 11 (6—27) months, with a predominance of males 98 (56%). Most of the children had cleft lip and palate (CLP) 71(41%). The prevalence of concomitant congenital anomalies was 22%, emanating mostly from head and neck congenital anomalies. Nine syndromes were identified in 15 children with syndromic clefts. Twenty-nine percent of children were underweight for age. There were 25 anaesthetic related complications, commonly airway related. Six children with complex multiple congenital anomalies were admitted in the intensive care unit postoperatively. No mortalities were recorded.

Conclusion

Majority of children with orofacial clefts underwent cleft repair surgery without serious complications and intensive care unit admission. Only six children were diagnosed with significant anomalies needing intensive care management.
Associations between alexithymia, parental rearing styles, and frequency of drug use in male methamphetamine dependence patients
Authors: Huang Cui , Yuan Qiuyu , Shi Shengya , Ge Menglin , Sheng Xuanlian , Yang Meng , Zhang Ling , Wang Lei , Zhang Kai , Zhou Xiaoqin
Published: April 2022

Background

Alexithymia, which is characterized by difficulty identifying and describing feelings, is a stable personality trait and it has been associated with early life experiences. Methamphetamine dependence patients with high level of alexithymia may be particularly vulnerable to engaging in more frequent methamphetamine use. Therefore, we aimed to evaluate whether alexithymia was associated with frequency of methamphetamine use. Additionally, the current study sought to examine early-life factors associated with the development of alexithymia, i.e., parental rearing styles.

Method

Participants were 108 non-injecting methamphetamine dependent patients from a male compulsory detoxification center. The level of alexithymia was assessed by Toronto Alexithymia Scale-20(TAS-20). In addition, we applied Egna Minneu av. Bardndosnauppforstran (EMBU) to assess the parental rearing styles, including the dimensions of warmth, rejection, punishment/strictness, overinvolvement, overprotection, and favoring.

Results

The total score of TAS-20 was positively correlated with frequency of methamphetamine use (r = 0.26, p < 0.01). Specifically, except for externally oriented thinking, difficulty identifying feelings (r = 0.23, p < 0.05) and difficulty describing feelings (r = 0.25, p < 0.05) were positively correlated with frequency of methamphetamine use. Multiple linear regression showed that more maternal rejection (B = 0.59, p = 0.002), or less maternal warmth (B = -0.22, p = 0.004) was associated with higher levels of alexithymia. Ordinal logistic regression showed that for every 1 score increase in the total score of TAS-20, there was a 1.06 times risk of a one level increase in the level of methamphetamine use frequency (OR = 1.06, p = 0.01).

Conclusions

These results have major implications for understanding the role of alexithymia in craving and addiction, while providing a further and explicit entry point for addiction treatment. Moreover, more attention should be focused on parenting in relation to early experiences.
Associations of youth mental health, parental psychological distress, and family relationships during the COVID-19 outbreak in China
Authors: Bai Yashuang , Liu Xiaohan , Zhang Bo , Fu Mingqi , Huang Ning , Hu Qitu , Guo Jing
Published: April 2022

Background

The COVID-19 pandemic has brought significant changes in society and family life, which could be particularly difficult for parents. The present study examines the relationship between youth mental health and parental psychological distress after the first peak of the COVID-19 Outbreak in China. The parent-child and marital relationships were examined as moderators of the above relationship.

Methods

Parents and their children aged 10 to 18 years were recruited for this study. The parents completed the Depression Anxiety Stress Scales-21 (DASS-21), the Strengths and Difficulties Questionnaire (SDQ), and a subset of items from the questionnaire of the COVID-19 Supporting Parents, Adolescents, and Children in Epidemics (Co-SPACE) survey of parental mental health, child’s psychological symptoms, parent-child, and marital relationship. Several multiple linear regressions were used to analyze the data.

Results

The largest variance in parental mental health was explained by the child’s psychological symptoms (effect size beta = 0.27). Parent-child (effect size beta = -0.13) and marital relationship (effect size beta = -0.21) were negatively associated with parental mental health. The relationship between child’s psychological symptoms and parental mental health was moderated by marital relationship (effect size beta = -0.07). Both parent-child and marital relationships presented with a significant interaction with impact scores, while only parent-child relationships with burden scores.

Conclusions

Youth mental health problems were significantly associated with parental psychological symptoms during the early phase of the COVID-19 pandemic The parent-child and marital relationship moderated the association between youth psychological symptoms and parental mental health. Interventions for alleviating parenting stress and support services that improve family relationships may be particularly effective in reducing parental psychological distress associated with future COVID-19 or related crises.