bluuebunny/crossref_metadata_2025 huggingface dataset:
Caregiver’s burden at the end of life of their loved one: insights from a longitudinal qualitative study among working family caregivers
Authors: Bijnsdorp Femmy M. , Onwuteaka-Philipsen Bregje D. , Boot Cécile R. L. , van der Beek Allard J. , Pasman H. Roeline W.
Published: August 2022

Background

Growing numbers of people with advanced illnesses who wish to die at home, a concurrent decline in the accessibility of professional home care, and policies aiming at prolonging work participation are increasing the reliance on family caregivers. This study aimed to describe trajectories in burden of working family caregivers who care for patients with a life-threatening illness, and identify factors in work and care that are related to changes in burden over time.

Methods

Semi-structured interviews were held in one to four rounds between July 2018 and November 2020 with 17 working family caregivers of patients with a life-threatening illness living at home. Transcripts were analysed as a single unit to create timelines per participant. Next, individual burden trajectories were created and grouped based on the course of burden over time. Factors related to changes in burden were analysed, as well as similarities and differences between the groups.

Results

It was common for family caregivers who combine work and end-of-life care to experience a burden. Two trajectories of caregiver burden were identified; caregivers with a persistent level of burden and caregivers with an increasing burden over time. Family caregivers with a persistent level of burden seemed to be at risk for burnout throughout the illness trajectory, but were often able to cope with the situation by making arrangements in care or work. Caregivers with an increasing burden were unable to make sufficient adjustments, which often resulted in burnout symptoms and sick leave. In both groups, burden was mostly related to aspects of the care situation. The emotional burden, a decreasing burden after death and a different view o﻿n the trajectory in hindsight proved to be important overarching themes.

Conclusions

Providing care to a loved one nearing the end of life is often emotionally burdensome and intensive. To facilitate the combination of paid work and family care, and reduce the risk of burnout, more support is needed from employers and healthcare professionals during the illness trajectory and after death. Bereaved family caregivers also warrant more attention from their supervisors and occupational physicians in order to facilitate their return to work.
Antimicrobial Evaluation of Sequentially extracted Leaf of Vernonia auriculifera Hiern (Rejicho)
Authors: Wado Teshale Etiso , Suleman Sultan , Mohammed Tesfaye
Published: August 2022

Background

Though there are reports aboutV. auriculiferaantimicrobial activity, there is not enough information about its activity on some bacterial and fungal species. Besides, there was no quantitative evaluation done for phytochemicals previously. Therefore, the main purpose of this research work is to evaluate the antimicrobial activity and quantitative evaluation of the phenol and flavonoid contents ofV. auriculifera.

Objectives

The objective of this study was to conduct the antimicrobial and quantitative evaluation of a sequentially extracted leaf ofVernonia auriculifera Hiern.

Methods

The leaves of the plant were cleaned with tap water and air-dried. The grounded leaf product was subsequently extracted by hexane, chloroform, and methanol in maceration flasks. Then the total phenol and total flavonoid content in each extract were determined. Standard strains of bacterial and fungal species were used to assess the antibacterial, and antifungal susceptibility test and to determine the minimum inhibitory concentration of crude extract.

Result

Extraction yield for hexane, chloroform, and methanol was 0.6 ± 0.05%, 1.7 ± 0.02%, and 3.3 ± 0.01% respectively. The total phenolic content of methanol extract was 72.998 ± 0.002 mg GAE /g. The total flavonoid content of hexane and chloroform extracts were 2.59 ± 0.004 mg QE/g and 9.6 ± 0.02 mg QE/g respectively. The antimicrobial activity test showed the chloroform extract was the most active against all test microorganisms.

Conclusion

This study has shown the activity ofV. auriculiferaagainst selected microorganisms of study. The chloroform extract was the most active as compared to the hexane and methanol extracts.
Harpagoside attenuates local bone Erosion and systemic osteoporosis in collagen-induced arthritis in mice
Authors: Kim Ju-Young , Cheon Yoon-Hee , Ahn Sung-Jun , Kwak Sung Chul , Chung Chong Hyuk , Lee Chang Hoon , Lee Myeung Su
Published: August 2022

Background

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that causes local bone erosion and systemic osteoporosis. Harpagoside (HAR), an iridoid glycoside, has various pharmacological effects on pain, arthritis, and inflammation. Our previous study suggests that HAR is more deeply involved in the mechanism of bone loss caused by inflammatory stimuli than hormonal changes. Here, we identified the local and systemic bone loss inhibitory effects of HAR on RA and its intracellular mechanisms using a type 2 collagen-induced arthritis (CIA) mouse model.

Methods

The anti-osteoporosis and anti-arthritic effects of HAR were evaluated on bone marrow macrophage in vitro and CIA in mice in vivo by obtaining clinical scores, measuring hind paw thickness and inflammatory cytokine levels, micro-CT and histopathological assessments, and cell-based assay.

Results

HAR markedly reduced the clinical score and incidence rate of CIA in both the prevention and therapy groups. Histological analysis demonstrated that HAR locally ameliorated the destruction of bone and cartilage and the formation of pannus. In this process, HAR decreased the expression of inflammatory cytokines, such as tumor necrosis factor-α, interleukin (IL)-6, and IL-1β in the serum of CIA mice. Additionally, HAR downregulated the expression of receptor activator of nuclear factor-κB ligand and upregulated that of osteoprotegerin. HAR suppressed systemic bone loss by inhibiting osteoclast differentiation and osteoclast marker gene expression in a CIA mouse model.

Conclusions

Taken together, these findings show the beneficial effect of HAR on local symptoms and systemic bone erosion triggered by inflammatory arthritis.
Causes of futile care from the perspective of intensive care unit nurses (I.C.U): qualitative content analysis
Authors: Rakhshan Mahnaz , Joolaee Soodabeh , Mousazadeh Noushin , Hakimi Hamideh , Bagherian Samaneh
Published: August 2022

Background

Medical care that has therapeutic effects without significant benefits for the patient is called futile care. Intensive Care Units are the most important units in which nurses provide futile care. This study aimed to explain the causes of futile care from the perspective of nurses working in Intensive Care Units are.

Method

The study was conducted using a qualitative approach. Qualitative content analysis was used to analyze the data. Study participants were 17 nurses who were working in the Intensive Care Units are of hospitals in the north of Iran. They were recruited through a purposeful sampling method. Data was gathered using in-depth, semi-structured interviews from March to June 2021. Recruitment was continued until data saturation was reached.

Results

Two main themes, four categories, and thirteen subcategories emerged from the data analysis. The main themes were principlism and caring swamp. The categories were moral foundation, professionalism, compulsory care, and patient’s characteristics.

Conclusion

In general, futile care has challenged nursing staff with complex conflicts. By identifying some of these conflicts, nurses will be able to control such situations and plan for better management strategies. Also, using the findings of this study, nursing managers can adopt supportive strategies to reduce the amount of futile care and thus solve the specific problems of nurses in intensive care units such as burnout, moral stress, and intention to leave.
HDL functionality in type 1 diabetes: enhancement of cholesterol efflux capacity in relationship with decreased HDL carbamylation after improvement of glycemic control
Authors: Denimal Damien , Monier Serge , Simoneau Isabelle , Duvillard Laurence , Vergès Bruno , Bouillet Benjamin
Published: August 2022

Background

Reduced cholesterol efflux capacity (CEC) of HDLs is likely to increase cardiovascular risk in type 1 diabetes (T1D). We aimed to assess whether improvement of glycemic control in T1D patients is associated with changes in CEC in relation with changes in carbamylation of HDLs.

Methods

In this open-label trial, 27 uncontrolled T1D patients were given a three-month standard medical intervention to improve glycemic control. HDL fraction was isolated from plasma, and CEC was measured on THP-1 macrophages. Carbamylation of HDLs was evaluated by an immunoassay. Control HDLs from healthy subjects were carbamylated in vitro with potassium cyanate.

Results

HbA1c decreased from 11.4% [10.2–12.9] (median [1st–3rd quartiles]) at baseline to 8.1% [6.6–9.0] after the three-month intervention (P < 0.00001). The CEC of HDLs increased after intervention in 19 (70%) patients (P = 0.038). At the same time, the carbamylation of HDLs decreased in 22 (82%) patients after intervention (P = 0.014). The increase in CEC significantly correlated with the decrease in carbamylated HDLs (r = −0.411, P = 0.034), even after adjustment for the change in HbA1c (β = −0.527, P = 0.003). In vitro carbamylation of control HDLs decreased CEC by 13% (P = 0.041) and 23% (P = 0.021) using 1 and 10 mmol/L of potassium cyanate, respectively.

Conclusions

The improvement of CEC in relation to a decrease in the carbamylation of HDLs may likely contribute to the beneficial cardiovascular effect of glycemic control in T1D patients.

Trial registration: NCT02816099 ClinicalTrials.gov.
Tear proteomics analysis of patient suffered from delayed mustard gas keratopathy
Authors: Parvin Shahram , Shahriary Alireza , Aghamollaei Hossein , Gh B. Fatemeh Nobakht M. , Bagheri Hasan , Ghanei Mostafa , Daryabari Seyed-Hashem , Jadidi Khosrow , Arabfard Masoud
Published: August 2022

Understanding the molecular and cellular mechanisms involved in the pathogenesis of ocular injured induced by mustard gas can help better identify complications and discover appropriate therapies. This study aimed to analyze the proteomics of tears of chemical warfare victims with mustard gas ocular injuries and compare it with healthy individuals. In this case-control research, 10 mustard gas victims with long-term ocular difficulties (Chronic) were included in the patient group, while 10 healthy persons who were age and sex matched to the patients were included in the control group. Schirmer strips were used to collect the tears of the participants. Proteomics experiments were performed using the high-efficiency TMT10X method to evaluate the tear protein profile, and statistical bioinformatics methods were used to identify the differently expressed proteins. 24 proteins had different expressions between the two groups. Among these 24 proteins, 8 proteins had increased expression in veterans’ tears, while the remaining 16 proteins had decreased expression. Reactome pathways were used to look at proteins with various expressions, and 13 proteins were found to be engaged in the immune system, 9 of which were effective in the innate immune system, and 5 proteins were effective in the complement cascade. Ocular mustard gas exposure may cause a compromised immune system on the eye’s surface, exposing the cornea to external and endogenous infections, and eventually causing corneal opacity and reduced vision.
Sociodemographic and behavioural factors of adherence to the no-screen guideline for toddlers among parents from the French nationwide Elfe birth cohort
Authors: Poncet Lorraine , Saïd Mélèa , Gassama Malamine , Dufourg Marie-Noëlle , Müller-Riemenschneider Falk , Lioret Sandrine , Dargent-Molina Patricia , Charles Marie-Aline , Bernard Jonathan Y.
Published: August 2022

Background

Excessive screen time in infancy and childhood has been associated with consequences on children’s development and health. International guidelines call for no screen time before age 2 years, whereas in France, the most prominent guidelines recommend no screen before age 3 years. However, data are lacking on parental adherence to the no-screen guideline for toddlers and factors of adherence in France. Using data from the French nationwide Elfe birth cohort, we estimated adherence to the no-screen guideline at age 2 years and examined related factors, including sociodemographic characteristics, parental leisure activities and screen time.

Methods

In 2011, 18,329 newborns and their parents were enrolled in 349 randomly selected maternity units across mainland France. At age 2 years, screen exposure of 13,117 toddlers was reported by parents in phone interviews. Data on sociodemographic characteristics, parental leisure activities and screen time were collected from both parents. Three patterns of parental leisure activities were derived by principal component analysis: literate (e.g.,reading), screen-based, and physical/artistic activities. Multivariable logistic regression models were used to examine the associations of sociodemographic characteristics, parental leisure activities and parental screen time with adherence to the no-screen guideline for toddlers.

Results

Overall, 1809/13,117 (13.5%) families adhered to the no-screen guideline for toddlers. Adherence was reduced with maternal age < 40 years, low parental education, single-parent household and parental migration status. After adjusting for sociodemographic characteristics, adherence to the guideline was positively associated with a parental literate activity pattern (mothers: odds ratio [95% confidence interval]: 1.15 [1.08, 1.22]); fathers: 1.15 [1.07, 1.23]) and negatively with a screen-based activity pattern (mothers: 0.73 [0.69, 0.77]; fathers: 0.81 [0.76, 0.87]). With each additional hour of parental screen time, mothers and fathers were less likely to adhere to the guideline (mothers: adjusted odds ratio 0.80 [0.77, 0.83]; fathers: 0.88 [0.85, 0.91]).

Conclusions

Adherence to the no-screen guideline for toddlers in France was low. Parental leisure activities and parental screen time are major factors of adherence to the no-screen guideline and could be considered in targeted public health interventions.
Comprehensive characterization of clonality of driver genes revealing their clinical relevance in colorectal cancer
Authors: Shi Jian , Wang Li , Yin Xiangzhe , Wang Lixia , Bo Lin , Liu Kailai , Feng Ke , Lin Shihua , Xu Yanjun , Ning Shangwei , Zhao Hongying
Published: August 2022

Background

Genomic studies of colorectal cancer have revealed the complex genomic heterogeneity of the tumor. The acquisition and selection of genomic alterations may be critical to understanding the initiation and progression of this disease.

Methods

In this study, we have systematically characterized the clonal architecture of 97 driver genes in 536 colorectal cancer patients from TCGA.

Results

A high proportion of clonal mutations in 93 driver genes were observed. 40 genes showed significant associations between their clonality and multiple clinicopathologic factors. Kaplan–Meier analysis suggested that the mutation clonality of ANK1, CASP8, SMAD2, and ARID1A had a significant impact on the CRC patients' outcomes. Multivariable analysis revealed that subclonal ANK1 mutations, clonal CASP8 mutations, and clonal SMAD2 mutations independently predicted for shorter overall survival after adjusting for clinicopathological factors. The poor outcome of the subclonal ANK1 mutation may be caused by upregulation of IL4I1, IDO1, IFNG and MAPK12 which showed potential roles in tumor immune evasion through accumulation of immunosuppressive cells such as regulatory T cells and myeloid derived suppressor cells.

Conclusion

These results suggested that the clonality of driver genes could act as prognostic markers and potential therapeutic targets in human colorectal cancer.
Advances in nuclear medicine-based molecular imaging in head and neck squamous cell carcinoma
Authors: Li Danni , Li Xuran , Zhao Jun , Tan Fei
Published: August 2022

Head and neck squamous cell carcinomas (HNSCCs) are often aggressive, making advanced disease very difficult to treat using contemporary modalities, such as surgery, radiation therapy, and chemotherapy. However, targeted therapy, e.g., cetuximab, an epidermal growth factor receptor inhibitor, has demonstrated survival benefit in HNSCC patients with locoregional failure or distant metastasis. Molecular imaging aims at various biomarkers used in targeted therapy, and nuclear medicine-based molecular imaging is a real-time and non-invasive modality with the potential to identify tumor in an earlier and more treatable stage, before anatomic-based imaging reveals diseases. The objective of this comprehensive review is to summarize recent advances in nuclear medicine-based molecular imaging for HNSCC focusing on several commonly radiolabeled biomarkers. The preclinical and clinical applications of these candidate imaging strategies are divided into three categories: those targeting tumor cells, tumor microenvironment, and tumor angiogenesis. This review endeavors to expand the knowledge of molecular biology of HNSCC and help realizing diagnostic potential of molecular imaging in clinical nuclear medicine.
Germline genetic biomarkers to stratify patients for personalized radiation treatment
Authors: Deichaite Ida , Hopper Austin , Krockenberger Lena , Sears Timothy J. , Sutton Leisa , Ray Xenia , Sharabi Andrew , Navon Ami , Sanghvi Parag , Carter Hannah , Moiseenko Vitali
Published: August 2022

Background

Precision medicine incorporating genetic profiling is becoming a standard of care in medical oncology. However, in the field of radiation oncology there is limited use of genetic profiling and the impact of germline genetic biomarkers on radiosensitivity, radioresistance, or patient outcomes after radiation therapy is poorly understood. In HNSCC, the toxicity associated with treatment can cause delays or early cessation which has been associated with worse outcomes. Identifying potential biomarkers which can help predict toxicity, as well as response to treatment, is of significant interest.

Methods

Patients with HNSCC who received RT and underwent next generation sequencing of somatic tumor samples, transcriptome RNA-seq with matched normal tissue samples were included. Patients were then grouped by propensity towards increased late vs. early toxicity (Group A) and those without (Group B), assessed by CTCAE v5.0. The groups were then analyzed for association of specific germline variants with toxicity and clinical outcomes.

Results

In this study we analyzed 37 patients for correlation between germline variants and toxicity. We observed that TSC2, HLA-A, TET2, GEN1, NCOR2 and other germline variants were significantly associated with long term toxicities. 34 HNSCC patients treated with curative intent were evaluated for clinical outcomes. Group A had significantly improved overall survival as well as improved rates of locoregional recurrence and metastatic disease. Specific variants associated with improved clinical outcomes included TSC2, FANCD2, and PPP1R15A, while the HLA-A and GEN1 variants were not correlated with survival or recurrence. A group of five HLA-DMA/HLA-DMB variants was only found in Group B and was associated with a higher risk of locoregional recurrence.

Conclusions

This study indicates that germline genetic biomarkers may have utility in predicting toxicity and outcomes after radiation therapy and deserve further investigation in precision radiation medicine approaches.
Fecal microbiota transplantation versus glucocorticoids for the induction of remission in mild to moderate ulcerative colitis
Authors: Huang Chunlan , Huang Zehua , Ding Ling , Fu Yang , Fan Junjie , Mei Qixiang , Lou Lihong , Wang Jingjing , Yin Nuoming , Lu Yingying , Guo Sanwei , Zeng Yue
Published: August 2022

Objective

To compare efficacy and safety of fecal microbiota transplantation (FMT) with glucocorticoid as induction therapy in ulcerative colitis (UC).

Methods

The patients with active mild to moderate UC were recruited into the single-center, prospective cohort study. The patients were treated with either FMT (FMT group) or glucocorticoids (GCs group). Patients received FMT administration for 3 days. The primary outcome was clinical and endoscopic remission at week 12. Inflammatory parameters were assessed by routine blood tests. Safety was assessed by adverse events recorded. The serum levels of TNF-α, IFN-γ, IL-1β, IL-4, IL-5, IL-6, IL-10 IL-8, IL-12p70, IL-13, IL-17A and IL-23 following FMT were measured by Luminex multiplex assay.

Results

Of the 122 patients, 62 patients were treated with FMT and 60 with glucocorticoids. 34 patients in FMT group (54.8%) and 29 in GCs group (48.3%) reached the primary outcome (p = 0.30). The incidence of adverse events in GCs group (35/60, 58.3%) was significantly higher than that in FMT group (14/62, 22.6%) and two serious adverse events were observed following GCs. Patients in FMT group were stratified into responders (RE) and non-responders (NR) groups. The level of TNF-α and IL-6 decreased significantly in RE group, while IL-10 decreased significantly in NR group.

Conclusion

FMT therapy was as effective as glucocorticoids to induce remission in active mild to moderate UC, accompanied by fewer adverse events. The modification of serum TNF-α, IL-6 and IL-10 might be related to the efficacy of FMT in UC.

Trial registration This study was registered with ClinicalTrials.gov (NCT02435160). Registered on 6 April, 2015. https://clinicaltrials.gov/ct2/results?cond=&term=NCT02435160&cntry=&state=&city=&dist=
Identification of LARS as an essential gene for osteosarcoma proliferation through large-Scale CRISPR-Cas9 screening database and experimental verification
Authors: Chen Wenhao , Lin Yuxiang , Jiang Meichen , Wang Qingshui , Shu Qiang
Published: August 2022

Background

Osteosarcoma is one of the most malignant tumors, and it occurs mostly in children and adolescents. Currently, surgery and chemotherapy are the main treatments. The recurrence rate is high and the prognosis is often poor. Finding an effective target gene therapy for osteosarcoma may effectively improve its prognosis.

Method

In this study, genes essential for the survival of osteosarcoma cells were identified by genome-wide screening of CRISPR-Cas9 based on the DepMap database. The expression of these essential genes in osteosarcoma patients’ tissues and normal tissues was identified in the GSE19276 database. Functional pathway enrichment analysis, protein interaction network construction, and LASSO were performed to construct a prognostic risk model based on these essential genes. CCK8 assay was used to detect the effect of essential gene-LARS (Leucyl-TRNA Synthetase 1) on the proliferation of osteosarcoma.

Results

In this study, 785 genes critical for osteosarcoma cell proliferation were identified from the DepMap. Among these 785 essential genes, 59 DEGs were identified in osteosarcoma tissues. In the functional enrichment analysis, these 59 essential genes were mainly enriched in cell cycle-related signaling pathways. Furthermore, we established a risk score module, including LARS and DNAJC17, screened from these 59 genes, and this module could divide osteosarcoma patients into the low-risk and high-risk groups. In addition, knockdown of LARS expression inhibited the proliferative ability of osteosarcoma cells. A significant correlation was found between LARS expression and Monocytic lineage, T cells, and Fibroblasts.

Conclusion

In conclusion, LARS was identified as an essential gene for survival in osteosarcoma based on the DepMap database. Knockdown of LARS expression significantly inhibited the proliferation of osteosarcoma cells, suggesting that it is involved in the formation and development of osteosarcoma. The results are useful as a foundation for further studies to elucidate a potential osteosarcoma diagnostic index and therapeutic targets.
Pain levels and patient comfort after lower limb arthroplasty comparing i.v. patient-controlled analgesia, continuous peripheral nerve block and neuraxial analgesia: a retrospective cohort analysis of clinical routine data
Authors: Yurutkina Alina , Klaschik Sven , Kowark Pascal , Gass Annette , Link Carolina , Randau Thomas Martin , Jiménez-Cruz Jorge , Coburn Mark , Hilbert Tobias
Published: August 2022

Background

Insufficient pain control after lower limb arthroplasty results in delayed recovery and increased risk for pain chronicization. The ideal kind of analgesia is still discussed controversially. We conducted a retrospective analysis of single-center routine data from a German university hospital, including patients receiving either total hip (THA) or knee arthroplasty (TKA).

Methods

All patients received general anesthesia. Patients undergoing THA received either continuous epidural ropivacaine infusion (0.133%, Epi) or patient-controlled analgesia (PCA) with the Wurzburg Pain Drip (tramadol, metamizole and droperidol, WPD) or with piritramide (Pir). After TKA, patients received either continuous femoral nerve block (ropivacaine 0.2%, PNB) or Pir.

Results

The analyzed cohort comprised 769 cases. Use of WPD after THA (n = 333) resulted in significantly reduced Numeric Rating Scale (NRS) values at rest, compared to Epi (n = 48) and Pir (n = 72) (.75 [IQR 1.14] vs. 1.17 [1.5], p = .02 vs. 1.47 [1.33], p < .0001) as well as maximum NRS scores (2.4 [1.7] vs. 3.29 [1.94], p < .001 vs. 3.32 [1.76], p < .0001). Positive feedback during follow-up visits was significantly increased in patients with a WPD PCA (p < .0001), while negative feedback (senso-motoric weakness/technical problems/nausea/dizziness/constipation) was particularly increased in Epi patients and lowest in those with WPD (p < .0001). After TKA, Pir (n = 131) resulted in significantly reduced NRS values at rest, compared to PNB (n = 185) (1.4 [1.4] vs. 1.6 [1.68], p = .02). Positive feedback was increased in patients with a Pir PCA in comparison with PNB (p = .04), while negative feedback was increased in PNB patients (p = .04). Overall, WPD presented with the lowest rate of any complications (8.7%), followed by Pir (20.2%), PNB (27.6%) and Epi (31.3%) (p < .001).

Conclusions

In the assessed population, the use of a WPD PCA after THA offered better pain control and patient comfort in comparison with continuous epidural or piritramide-based analgesia. After TKA, the use of a Pir PCA provided superior analgesia and a lower complication rate compared to continuous PNB.
Improving screening methods for psychosis in an adolescent help-seeking population using the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR) versus the Prodromal Questionnaire -16 items version (PQ-16)
Authors: de Jong Yvonne , Boon Albert E. , Gouw Daniek , van der Gaag Mark , Mulder Cornelis L.
Published: August 2022

Background

Screening methods for detecting Ultra High Risk status (UHR) or psychosis should be improved, especially in adolescent samples. We therefore tested whether the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR) add value to the Prodromal Questionnaire-16 items version (PQ-16) for detecting UHR status or psychosis.

Methods

We included help-seeking adolescents who had completed the PQ-16, YSR, CBCL, and a Comprehensive Assessment of an At Risk Mental States (CAARMS) interview, and used independent samples t-tests and binary logistic regression analyses to determine the scales contributing to the prediction of UHR status or of having reached the psychosis threshold (PT). Cutoff scores were determined using ROC analyses.

Results

Our sample comprised 270 help-seeking adolescents (mean age 14.67; SD 1.56, range 12–17); 67.8% were girls and 66.3% were of Dutch origin. The Thought Problems syndrome scales of both the YSR and the CBCL best predicted UHR or PT, and had screening values comparable to the PQ-16. Other syndrome scales did not improve screening values. Although combining measures reduced the number of false negatives, it also increased the number of adolescents to be interviewed. The best choice was to combine the YSR Thought Problems scale and the PQ-16 as a first-step screener.

Conclusions

Combining measures improves the detection of UHR or PT in help-seeking adolescents. The Thought Problems subscales of the YSR and CBCL can both be used as a first-step screener in the detection of UHR and/or psychosis.

Trial registration Permission was asked according to the rules of the Ethics Committee at Leiden. This study is registered as NL.44180.058.13
Validation of the International Trauma Questionnaire—Child and Adolescent Version (ITQ-CA) in a Chinese mental health service seeking adolescent sample
Authors: Ho G. W. K. , Liu H. , Karatzias T. , Hyland P. , Cloitre M. , Lueger-Schuster B. , Brewin C. R. , Guo C. , Wang X. , Shevlin M.
Published: August 2022

Background

The International Trauma Questionnaire—Child and Adolescent version (ITQ-CA) is a self-report measure that assesses posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) based on the diagnostic formulation of the 11th version of the International Classification of Diseases (ICD-11). This study aimed to provide a Chinese translation and psychometric evaluation of the ITQ-CA using a sample of mental-health service seeking adolescents in Mainland China.

Methods

The ITQ-CA was translated and back-translated from English to simplified Chinese and finalized with consensus from an expert panel. Adolescents ages 12–17 were recruited via convenience sampling from an outpatient psychiatric clinic in Mainland China. Participants completed the ITQ-CA; measures of four criterion variables (depression, anxiety, stress, adverse childhood experiences); and the PTSD Checklist for DSM-5 (PCL-5). Construct validity, concurrent validity, and comparison of PTSD caseness between ICD-11 and DSM-5 measures were assessed.

Results

The final sample consisted of 111 Chinese adolescents (78% female; mean age of 15.23), all diagnosed with a major depressive disorder. Confirmatory factor analysis indicated the two-factor second-order model provided optimal fit. All criterion variables were positively and significant correlated with the six ITQ-CA symptom cluster summed scores. In the present sample, 69 participants (62.16%) met symptom criteria for ICD-PTSD or CPTSD using the ITQ-CA, and 73 participants (65.77%) met caseness for DSM-5 PTSD using the PCL-5. Rates of PTSD symptom cluster endorsement and caseness deriving from both diagnostic systems were comparable.

Conclusions

The Chinese ITQ-CA has acceptable psychometric properties and confers additional benefits in identifying complex presentations of trauma-related responses in younger people seeking mental health services.
Risk of tick-borne pathogen spillover into urban yards in New York City
Authors: Gregory Nichar , Fernandez Maria P. , Diuk-Wasser Maria
Published: August 2022

Background

The incidence of tick-borne disease has increased dramatically in recent decades, with urban areas increasingly recognized as high-risk environments for exposure to infected ticks. Green spaces may play a key role in facilitating the invasion of ticks, hosts and pathogens into residential areas, particularly where they connect residential yards with larger natural areas (e.g. parks). However, the factors mediating tick distribution across heterogeneous urban landscapes remain poorly characterized.

Methods

Using generalized linear models in a multimodel inference framework, we determined the residential yard- and local landscape-level features associated with the presence of three tick species of current and growing public health importance in residential yards across Staten Island, a borough of New York City, in the state of New York, USA.

Results

The amount and configuration of canopy cover immediately surrounding residential yards was found to strongly predict the presence of Ixodes scapularis and Amblyomma americanum, but not that of Haemaphysalis longicornis. Within yards, we found a protective effect of fencing against I. scapularis and A. americanum, but not against H. longicornis. For all species, the presence of log and brush piles strongly increased the odds of finding ticks in yards.

Conclusions

The results highlight a considerable risk of tick exposure in residential yards in Staten Island and identify both yard- and landscape-level features associated with their distribution. In particular, the significance of log and brush piles for all three species supports recommendations for yard management as a means of reducing contact with ticks.

Graphical Abstract
Retrospective analysis of the diagnostic accuracy of lung ultrasound for pulmonary embolism in patients with and without pleuritic chest pain
Authors: Nazerian Peiman , Gigli Chiara , Reissig Angelika , Pivetta Emanuele , Vanni Simone , Fraccalini Thomas , Ferraris Giordana , Ricciardolo Alessandra , Grifoni Stefano , Volpicelli Giovanni ,   WINFOCUS and US SIMEU study group, Nazerian Peiman
Published: August 2022

Background

Lung ultrasound (LUS) has a role in the diagnosis of pulmonary embolism (PE) mainly based on the visualization of pulmonary infarctions. However, examining the whole chest to detect small peripheral infarctions by LUS may be challenging. Pleuritic pain, a frequent presenting symptom in patients with PE, is usually localized in a restricted chest area identified by the patient itself. Our hypothesis is that sensitivity of LUS for PE in patients with pleuritic chest pain may be higher due to the possibility of focusing the examination in the painful area. We combined data from three prospective studies on LUS in patients suspected of PE and extracted data regarding patients with and without pleuritic pain at presentation to compare the performances of LUS.

Results

Out of 872 patients suspected of PE, 217 (24.9%) presented with pleuritic pain and 279 patients (32%) were diagnosed with PE. Pooled sensitivity of LUS for PE in patients with and without pleuritic chest pain was 81.5% (95% CI 70–90.1%) and 49.5% (95% CI 42.7–56.4%) (p < 0.001), respectively. Specificity of LUS was similar in the two groups, respectively 95.4% (95% CI 90.7–98.1%) and 94.8% (95% CI 92.3–97.7%) (p = 0.86). In patients with pleuritic pain, a diagnostic strategy combining Wells score with LUS performed better both in terms of sensitivity (93%, 95% CI 80.9–98.5% vs 90.7%, 95% CI 77.9–97.4%) and negative predictive value (96.2%, 95% CI 89.6–98.7% vs 93.3%, 95% CI 84.4–97.3%). Efficiency of Wells score + LUS outperformed the conventional strategy based on Wells score + d-dimer (56.7%, 95% CI 48.5–65% vs 42.5%, 95% CI 34.3–51.2%, p = 0.02).

Conclusions

In a population of patients suspected of PE, LUS showed better sensitivity for the diagnosis of PE when applied to the subgroup with pleuritic chest pain. In these patients, a diagnostic strategy based on Wells score and LUS performed better to exclude PE than the conventional strategy combining Wells score and d-dimer.
A spontaneous reduction in tumor size of a thymic carcinoma: a case report
Authors: Kuroki Shoei , Ayabe Takanori , Tanaka Hiroyuki , Nakada Hiroshi , Maeda Ryo
Published: August 2022

Background

Spontaneous regression of thymic carcinoma is extremely rare. We report a case of a resected thymic carcinoma with preoperative spontaneous regression in a 67-year-old woman.

Case presentation

The patient presented with low-grade fever and anterior chest pain. Chest computed tomography (CT) showed a 55 × 43 mm exophytic heterogeneously enhancing mass showing some areas of necrosis. Chest CT done one day preoperatively revealed that the tumor had rapidly shrunk for one month. Surgical resection was performed to obtain a definitive diagnosis and achieve complete resection, yielding a postoperative diagnosis of thymic carcinoma. The patient survived without signs of recurrence for 12 months postoperatively.

Conclusions

Mediastinal tumors with necrosis demonstrating spontaneous regression should include thymic carcinomas in the differential diagnosis.
Regression of choroidal metastasis from breast carcinoma with palbociclib
Authors: Parakh Shweta , Das Shrutanjoy , Maheshwari Shrey , Gupta Vinita , Luthra Gaurav , Luthra Saurabh
Published: August 2022

Background

Uveal metastasis is reported to be the most common intraocular malignancy. The most common site of origin of ocular metastases in females is the breast. In some cases, uveal metastatic lesions respond to systemic chemotherapy. We report a case of a patient who developed choroidal metastasis, while on endocrine therapy with selective estrogen receptor modulator (SERM), tamoxifen, for estrogen receptor (ER) positive, progesterone receptor (PR) positive and (human epidermal growth factor receptor 2) HER2 negative primary breast carcinoma, which then regressed following systemic chemotherapy with palbociclib.

Case description

An 83-year-old female, with a history of modified radical mastectomy, chemotherapy and radiation therapy for infiltrating duct carcinoma of the breast, presented with a choroidal metastatic lesion in the left eye along with liver and lung metastases, 3 years after the primary carcinoma was treated. At the time of presentation, she was on tamoxifen. The choroidal tumor showed regression after the introduction of palbociclib, a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor.

Conclusion

This report highlights the use of palbociclib, in the palliative treatment of choroidal metastasis from primary breast cancer. The use of chemotherapy for choroidal metastasis can help avoid external beam radiation therapy and its concurrent side effects. Although there are a few reports involving the use of palbociclib for metastatic breast carcinoma, all of those have been in conjunction with and/or following non-response to other treatment modalities. Ours is the first report wherein palbociclib has been used as the first-line palliative chemotherapy and helped in regression of choroidal metastasis.
Partnership dynamics and the fertility gap between Sweden and Spain
Authors: Nishikido Momoko , Cui Qi , Esteve Albert
Published: August 2022

Below-replacement fertility has persisted across European countries for a few decades, though, with variation. Delays in age at first union and first birth have been key factors in the declining fertility levels within these societies. While the vast majority of births occurs within a stable partnership, the link between partnership formation and childbearing is rarely taken into account. In this paper, we examine the role of partnership formation in explaining the gap between Sweden and Spain regarding transitions to first birth. We utilize data from the 2018 Spanish Fertility Survey and the 2012/2013 Swedish Generations and Gender Survey to explore transition probabilities to first birth and implement Kitagawa decomposition and standardization techniques. Results show that having a partner is a strong predictor of becoming a first-time parent in the next 3 years, mainly within the ages 25 to 35. On average, Swedish first-birth transition probabilities for women are only 12% higher than probabilities of Spanish counterparts within this age range, suggesting that the proportion of partnerships formed plays a crucial role in explaining the fertility gap. Decomposition results confirm that before age 30, 74% of the difference in first-order births among women are due to the difference in partnership composition. We further find that earlier union formation in Spain could potentially reduce childlessness levels. Overall, our study highlights the importance of examining the role of partnership dynamics in fertility studies.
Priorities for rheumatic and musculoskeletal disease research in Ireland
Authors: Dorris Emma R. , Grealis Stacey , Kegl Karmen , Kennedy Norelee , Larkin Louise , Lynch Brian , Moran Ailis , O’Brien Justine , Skeffington Stephanie , Slater Kayleigh , Ward Rebecca , Willett Allison
Published: August 2022

Background

Research priority setting is a useful approach to decide which unanswered questions are most worth trying to solve through research. The aim is to reduce bias in the research agenda. Traditionally, research was decided by funders, policymakers, and academics with limited influence from other stakeholders like people living with health conditions, caregivers, or the community. This can lead to research gaps that fail to address these important stakeholder needs. The objective of this study is to identify the top research priorities for Rheumatic and Musculoskeletal Disease (RMD) research in Ireland.

Methods

The process framework included a design workshop, two online surveys and a review of the literature.

Participants

545 people completed the first survey to identify RMD research topics relevant to Ireland, of which 72% identified as a person living with RMD. 460 people completed the second survey to prioritise these research topics.

Results

The first survey had 2185 research topics submitted. These were analysed and grouped into 38 topic areas which were ranked in the second survey. The top three research priorities for RMD research in Ireland focused on preventing RMD progression, RMD diagnosis and its impact, and pain management.

Conclusions

The prioritised research topics indicate important areas of RMD research for Ireland. Research funded in response to these co-created research priorities will have increased relevance and impact.
Eco-friendly control method against invasive pest box tree moth, (Cydalima perspectalis (Walker) (Lepidoptera: Crambidae))
Authors: Tozlu Elif , Tozlu Göksel , Kotan Recep , Tekiner Nasibe , Dadaşoğlu Fatih , Göktürk Temel
Published: August 2022

Background

Buxus sempervirens(Boxwood) is a type of plant that has economic and cultural significance, danger of extinction due to various factors.Cydalima perspectalis(Walker, 1859) (Lepidoptera: Crambidae), an invasive species, has an important role as a boxwood pest. The inadequacy of the pheromone trap methods recommended to control the pest or the negative effects of chemical insecticides on the environment have led to seeking alternative approaches in this regard. In this study, it was conducted to determine whether entomopathogens can be applied in pest control, the insecticidal effects ofBacillus thuringiensissubsp. kenyae(FDP-8),Bacillus cereus(FD-63),Brevibacillus brevis(FD-1) andVibrio hollisae(FD-70) bacterial strains at the concentration of 1 × 108 CFU/ml andBeauveria bassiana(Bals.-Criv.) Vuill. (Cordycipitaceae) (ET 10) fungal isolate at the concentrations of 1 × 106, 1 × 107and 1 × 108conidia/ml were tested under controlled conditions.

Results

As compared the results of the bacterial strains and fungal tested, it was determined that the best results were obtained from in the fungal isolate at the concentration of 1 × 108conidia/ml. After 192 and 216 h. of observation, the 1 × 108 CFU/ml of bacterial strains:B. cereusFD-63,B. brevisFD-1 andV. hollisaeFD-70; also, 1 × 108conidia/ml concentration of ET 10 fungal isolate ofB. bassianacontrolC. perspectaliscaused mortality rate of 100% under laboratory conditions.

Conclusion

Future studies of these microorganisms against this pest in the field, may be an important alternative method to control this pest.
Comorbidities and outcomes among patients hospitalized with COVID-19 in Upper Egypt
Authors: Khedr Eman M. , Daef Enas , Mohamed-Hussein Aliae , Mostafa Ehab F. , Zein Mohamed , Hassany Sahar M. , Galal Hanan , Hassan Shimaa Abbas , Galal Islam , Zarzour Amro A. , Hassan Hebatallah M. , Amin Mariam Taher , Hashem Maiada K. , Osama Khaled , Gamea Ayman
Published: August 2022

Background

The coronavirus disease 19 (COVID-19) pandemic has spread rapidly around the globe with considerable morbidity and mortality. Coexistence of comorbidities with COVID-19 had consistently been reported as risk factors for unfavorable outcome. We aimed to evaluate the impact of comorbidities in COVID-19 patients on the outcome and determine predictors of prolonged hospital stay, requisite for intensive care unit (ICU) admission. Four hundred and thirty-nine adult patients who are admitted through (June and July 2020) in our University Hospitals were included in the study. All participants were diagnosed with COVID-19 according to Egyptian Ministry of Health guidance as definite case or probable case.

Results

Patients with comorbidities represented 61.7% of all cases. Constitutional symptoms especially myalgia and lower respiratory tract (LRT) symptoms such as dyspnea were significantly higher in patients with comorbidities (P < 0.05). Patients with comorbidities had significantly worse laboratory parameters. ICU admission was higher in patients with comorbidities (35.8%). Among different comorbidities 45.4% of cardiovascular diseases (CVD) cases were admitted in ICU followed by diabetes mellitus (DM) cases (40.8%). Also, patients with comorbidities needed invasive mechanical ventilation more than those without comorbidity (31 versus 10.7%, P < 0.001). Significant lower frequency of recovery was found in COVID-19 patients with comorbidities (59% versus 81%, P < 0.001) and death rate was significantly higher in cases with comorbidities (P < 0.001). The survival rates in cases with pre-existing CVD and neurological diseases were lower than those without disease (P < 0.002 and 0.001, respectively).

Conclusions

Association of cardiovascular comorbid conditions including hypertension or neurological diseases including old cerebrovascular strokes together with COVID-19 infections carries higher risks of mortality. However, other comorbidities such as diabetes mellitus, chronic pulmonary or kidney diseases may also contribute to increased COVID-19 severity.
Genetic investigations pathway for people with intellectual disability, autism and/or epilepsy
Authors: Clark Elaine , Koutsogianni Maria
Published: August 2022

Genomic medicine is an evolving medical specialty that uses genomic information about an individual as part of their clinical care (e.g. for diagnostic or therapeutic decision-making). It has rapidly grown since the completion of the Human Genome Project in 2003. In England, the National Health Service's Genomic Medicine Service is considered to be the first national healthcare system to offer whole-genome sequencing as part of routine clinical care. Already, genomic medicine is making an impact in the fields of oncology, pharmacology, rare and undiagnosed diseases, infectious disease and neurology. In this article, we present a useful tool kit for clinicians working with individuals with intellectual disability, autism spectrum disorder and epilepsy. This article provides evidence for the importance of genetic testing, conveys an understanding of the range of genetic tests available and their diagnostic yields and how these apply to intellectual disability, autism spectrum disorder and epilepsy. Our simple tool kit gives information on when to refer to a clinical geneticist and where to find resources for clinicians and parents on genetic testing.