bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehensive Analysis of the Significance of Ferroptosis-Related Genes in the Prognosis and Immunotherapy of Oral Squamous Cell Carcinoma
Authors: Yin Junhao , Fu Jiayao , Zhao Yijie , Xu Jiabao , Chen Changyu , Zheng Lingyan , Wang Baoli
Published: August 2022

Oral squamous cell carcinoma (OSCC) is a life-threatening disease, associated with poor prognosis and the absence of specific biomarkers. Studies have shown that the ferroptosis-related genes (FRGs) can be used as tumor prognostic markers. However, FRGs’ prognostic value in OSCC needs further exploration. In our study, gene expression profile and clinical data of OSCC patients were collected from a public domain. We performed univariate and multivariate Cox regression analyses to construct a multigene signature. The Kaplan-Meier and receiver operating characteristic (ROC) methods were used to test the effectiveness of the signature, followed by the expression analysis of human leukocyte antigen (HLA) and immune checkpoints. The Cox regression analysis identified 4 hubs from 103 FRGs expressed in OSCC that were associated with overall survival (OS). A risk model based on the 4 FRGs was established to classify patients into high-risk and low-risk groups. Compared with the low-risk group, the survival time of the high-risk group was significantly reduced. According to the multivariate Cox regression analysis, the risk score acted as an independent predictor for OS. The accuracy of the 4 FRGs risk predictive model was confirmed by ROC curve analysis. Moreover, the low-risk group had the characteristics of higher expression of HLA and immune checkpoints, a lower tumor purity, and a higher immune infiltration, indicating a more sensitive response to immunotherapy. The novel FRGs-OSCC risk score system can be used to predict the prognosis of OSCC patients and their response to immunotherapy.
Choral Flourishing: Parent and child perspectives on the benefits of participation in an excellent youth choir
Authors: Barrett Margaret S , Zhukov Katie
Published: August 2022

Over the last decade research has reported a range of positive life and learning outcomes for adult and child choristers through first-person accounts derived through surveys and interviews. Little is known regarding parent and child perspectives on choral learning, particularly regarding the impacts of participating in excellent choirs on musical development, personal benefits, and contributing factors. This study interviewed six parents and their children regarding their perceptions of the impact of singing in a renowned Australian choir on the child’s musical development and personal growth. The PERMA model was utilized to analyze individual interviews. Findings show that Positive Emotions included enjoyment and humor; Engagement consisted of early exposure to singing, motivation, practising, and future plans for involvement in music; Relationships comprised strong friendships, belonging, and acceptance; Meaning encompassed valuing professional opportunities and cultural experiences; and Accomplishment incorporated musical, performance, and personal skills. Implications for choral educators include the need to balance striving for high singing standards with recognition of children’s needs and age limitations.
Room of her own: Remaking empty nest and creating herspaces in practices of Polish mothers whose children left home
Authors: Gajewska Magdalena , Herzberg-Kurasz Magdalena , Żadkowska Magdalena , Kostecka Marianna , Dowgiałło Bogna
Published: August 2022

The tension between the traditional scenario, in which women fulfil themselves mainly as mothers, as well as the emancipatory approach to women’s roles reverberates more and more in Polish society. This conflict between various social expectations has a significant impact on women’s experience of picking up the role of a mother, as well as the intensification of identity ambivalence accompanying their departure from said role. This paper describes the stage in mothers’ lives when adult children move out of their family homes. As part of the [blinded for the review] project, the authors have analysed the stories told by 40 Polish women, whose adult children had moved out of the house, leaving behind a void. The moment of entering a new stage of motherhood and womanhood has been told in the context of a private place – their homes. To further highlight the experience of this moment by the women who participated in the study, the authors have conducted an analysis of their stories within the framework of Victor Turner’s liminality theory. In the case of the women, who participated in the study, the experience of liminality does not lead to a new status that would be socially recognisable. Only nine of them – according to the analysis carried out by the authors – experienced, among other things due to owning or changing their own space, the phase of aggregation, which is typical of becoming a woman in a new role – a mother of an adult child who left home. In contrast, their approach towards space and the practices of everyday life became a pointer showing them the way out of the role of mothers and let them change their status, which the sociologists lack a name for, as the authors argue.
Machine learning classification of multiple sclerosis in children using optical coherence tomography
Authors: Ciftci Kavaklioglu Beyza , Erdman Lauren , Goldenberg Anna , Kavaklioglu Can , Alexander Cara , Oppermann Hannah M , Patel Amish , Hossain Soaad , Berenbaum Tara , Yau Olivia , Yea Carmen , Ly Mina , Costello Fiona , Mah Jean K , Reginald Arun , Banwell Brenda , Longoni Giulia , Ann Yeh E
Published: August 2022

Background:

In children, multiple sclerosis (MS) is the ultimate diagnosis in only 1/5 to 1/3 of cases after a first episode of central nervous system (CNS) demyelination. As the visual pathway is frequently affected in MS and other CNS demyelinating disorders (DDs), structural retinal imaging such as optical coherence tomography (OCT) can be used to differentiate MS.

Objective:

This study aimed to investigate the utility of machine learning (ML) based on OCT features to identify distinct structural retinal features in children with DDs.

Methods:

This study included 512 eyes from 187 ( neyes = 374) children with demyelinating diseases and 69 ( neyes = 138) controls. Input features of the analysis comprised of 24 auto-segmented OCT features.

Results:

Random Forest classifier with recursive feature elimination yielded the highest predictive values and identified DDs with 75% and MS with 80% accuracy, while multiclass distinction between MS and monophasic DD was performed with 64% accuracy. A set of eight retinal features were identified as the most important features in this classification.

Conclusion:

This study demonstrates that ML based on OCT features can be used to support a diagnosis of MS in children.
Energy absorption of foam-filled corrugated core sandwich panels under quasi-static loading
Authors: Taghipoor Hossein , Sefidi Mahdi
Published: August 2022

The present paper tries to introduce the effect of foam-filled on a type of trapezoidal corrugated core and their structures derived from the related previous studies. The main purpose of this work is to present a novel geometry of trapezoidal cores, and their configurations are inspired by the earlier works. These absorbers have been proposed to raise the specific energy absorption (SEA) while declining the initial peak crushing force. Therefore, five corrugated core sandwich panels have been tested under quasi-static axial compressive load experimentally and then simulated by ABAQUS software. The accuracy of the numerical simulations is validated by comparing the numerical results with the corresponding experimental data. Besides, some other simulations have been carried out to investigate the effect of foam density, core type, and thickness in more detail. The comparison results show that the SEA rate of bi-core sandwich panels which has not been filled by foam is better than the single trapezoidal core sandwich panels, and this rate is roughly around 70%. The best performance is relevant to the pure foam core without any trapezoidal core structure and the next item is the single foam-filled corrugated core and the lowest performance among them is related to the bi-core corrugated core foam-filled.
Diagnostic and prognostic nomograms for newly diagnosed intrahepatic cholangiocarcinoma with brain metastasis: A population-based analysis
Authors: Liu Zhili , Yi Jianying , Yang Jie , Zhang Xingxin , Wang Lu , Liu Shuye
Published: August 2022

Brain metastasis (BM) is one of the rare metastatic sites of intrahepatic cholangiocarcinoma (ICC). ICC with BM can seriously affect the quality of life of patients and lead to a poor prognosis. The aim of this study was to establish two nomograms to estimate the risk of BM in ICC patients and the prognosis of ICC patients with BM. Data on 19,166 individuals diagnosed with ICC were retrospectively collected from the Surveillance, Epidemiology, and End Results (SEER) database. Independent risk factors and prognostic factors were identified by the logistic and the Cox regression, respectively. Next, two nomograms were developed, and their discrimination was estimated by concordance index ( C-index) and calibration plots, while the clinical benefits of the prognostic nomogram were evaluated using the receiver operating characteristic (ROC) curves, the decision curve analysis (DCA), and the Kaplan–Meier analyses. The independent risk factors for BM were T stage, N stage, surgery, alpha-fetoprotein (AFP) level, and tumor size. T stage, surgery, radiotherapy, and bone metastasis were prognostic factors for overall survival (OS). For the prognostic nomogram, the C-index was 0.759 (95% confidence interval (CI) = 0.745–0.773) and 0.764 (95% CI = 0.747–0.781) in the training and the validation cohort, respectively. The calibration curves revealed a robust agreement between predictions and actual observations probability. The area under curves (AUCs) for the 3-, 6-, and 9-month OS were 0.721, 0.727, and 0.790 in the training cohort and 0.702, 0.777, and 0.853 in the validation cohort, respectively. The DCA curves yielded remarkable positive net benefits over a wide range of threshold probabilities. The Kaplan–Meier analysis illustrated that the nomogram could significantly distinguish the population with different survival risks. We successfully established the two nomograms for predicting the incidence of BM and the prognosis of ICC patients with BM, which may assist clinicians in choosing more effective treatment strategies.
Clinical Interpretation of Jinn Possession and Cultural Formulation of Mental Illness
Authors: Isgandarova Nazila
Published: August 2022

This article addresses common interpretations of jinn possession among health care professionals. The author addresses the following questions: How do mental health providers interpret jinn possession? How do they view traditional healing practices, such as prophetic medicine, and folk medicine, to explain the phenomenon of jinn possession? The aim of this paper is to contribute to theoretical knowledge of existing research in this area and explore the possibility of improvement of the clinical practice with clients who claim to be possessed by jinn.
Cardiovascular risk associated with allopurinol or benzbromarone treatment in patients with gout
Authors: Eun Yeonghee , Han Heewon , Kim Kyunga , Kang Seonyoung , Lee Seulkee , Kim Hyungjin , Lee Jaejoon , Koh Eun-Mi , Cha Hoon-Suk
Published: August 2022

Background:

In previous studies, cardiovascular (CV) risk was increased in patients with gout. The effects of uric acid–lowering therapy on CV risk in gout patients have been investigated in numerous studies; however, allopurinol and benzbromarone have rarely been compared.

Objectives:

To compare CV risk based on allopurinol and benzbromarone treatment in Korean gout patients.

Design:

A nationwide population-based retrospective cohort study.

Methods:

We used South Korea database of the Health Insurance Review and Assessment (HIRA) service to identify gout patients ⩾18 years of age who newly started allopurinol or benzbromarone between 2009 and 2015. The primary outcome of the study was the occurrence of a composite CV endpoint, which included coronary revascularization, hospitalization due to myocardial infarction, ischemic stroke, and transient ischemic attack. Cox proportional hazard regression analysis and Kaplan–Meier curves were used for analysis.

Results:

The study included 257,097 allopurinol initiators and 7868 benzbromarone initiators. Compared with allopurinol initiators, the adjusted hazard ratio (aHR) of the composite CV endpoint of benzbromarone initiators was 1.01 [95% confidence interval (CI): 0.83−1.21], which was not significantly different. The results did not change even when 1:3 propensity score matching was performed for baseline characteristics. In subgroup analysis of high-risk patients with CV disease, significant difference was not observed between allopurinol and benzbromarone initiators.

Conclusion:

In this study, significant difference was not found in CV risk between allopurinol and benzbromarone initiators. In the high-CV-risk group, the incidence of CV events did not differ between allopurinol and benzbromarone initiators.
E-Scooters and Craniofacial Trauma: A Systematic Review
Authors: Goh Elizabeth Z. , Beech Nicholas , Johnson Nigel R.
Published: August 2022

Study Design

Systematic review.

Objective

Standing electric scooters (e-scooters) provide a cheap and environmentally friendly transport alternative, but also elicit substantial concern regarding their volume of associated injuries especially in the craniofacial region. This review aims to explore the demographics, risk factors, types of injury and surgical management of craniofacial trauma associated with e-scooters.

Methods

PubMed and Scopus databases were systematically searched. Inclusion criteria were clinical studies investigating craniofacial trauma associated with e-scooters. Exclusion criteria were duplicates; non-English publications; non-full-text publications; studies with insufficient data.

Results

Of the 73 articles identified, 10 eligible articles representing 539 patients were included. The mean age was 31.5 years. Most cases were male (63.7%). Common risk factors were alcohol/drug intoxication, absence of distal extremity injuries and lack of helmet use. The most common mechanism of injury was mechanical falls (72.4%). The most common facial fracture pattern was middle third fractures (58.3%). Surgical management was required for 43.3% of fractures. Other types of injuries reported were traumatic brain injuries (17.6%), soft tissue injuries (58.3%), dental injuries (32.9%) and ophthalmological injuries (20.6%).

Conclusions

The findings of this review suggest common presentations for craniofacial trauma associated with e-scooters. Robust longitudinal evaluations with standardised descriptions of types of injuries are required. Gaps in knowledge relate to surgical management, post-operative complications and associated risk factors.
Assessing eHealth literacy among internet users in Lebanon: A cross-sectional study
Authors: Bardus Marco , Keriabian Arda , Elbejjani Martine , Al-Hajj Samar
Published: August 2022

Objective

Assessing the level of eHealth literacy in a population is essential to designing appropriate public health interventions. This study aimed to assess eHealth literacy among adult internet users in Lebanon, recruited through social media and printed materials. The study examined the relationship between internet use, perceived eHealth literacy, and sociodemographic characteristics.

Methods

A cross-sectional study based on a web-based questionnaire was conducted between January and May 2020. The survey assessed internet use and eHealth literacy using the homonymous scale (eHEALS) in English and Arabic. Cronbach's alpha and factor analyses were used to evaluate eHEALS’ psychometric properties. A generalized linear model was used to identify factors predicting the eHEALS.

Results

A total of 2715 respondents were recruited mostly through Facebook (78%) and printed materials (17%). Most respondents completed the survey in English (82%), were aged 30 ± 11 years, female (60%), Lebanese (84%), unmarried (62%), employed (54%), and with a graduate-level education (53%). Those who completed the eHEALS questionnaire ( n = 2336) had a moderate eHealth literacy ( M = 28.7, SD = 5.5). eHEALS was significantly higher among older females with a high education level, recruited from Facebook, Instagram, or ResearchGate, and perceived the Internet as a useful and important source of information.

Conclusions

Future internet-delivered public health campaigns in Lebanon should account for moderate-to-low levels of eHealth literacy and find ways to engage older males with low education levels representing neglected segments (e.g. Syrians). To be more inclusive, campaigns should reach neglected population segments through non-digital, community-based outreach activities.
Educating rehabilitation professionals on clinical skills for postural care services: A scoping review
Authors: McGuire Faye E , Hutson Jennifer , Oldenburg Hannah
Published: August 2022

Background: This scoping review aims to identify evidence-based practices for educating rehabilitation professionals who provide assistive technology interventions, specifically night-time postural care, to children with cerebral palsy.

Methods: A review of both peer-reviewed and grey literature published between 2000 and 2021 was undertaken in June 2021. The articles were analyzed using a process outlined by Arksey and O’Malley in 2005: scanning abstracts, completing initial and critical reviews, collating and summarizing data into themes.

Results: The search resulted in 15 articles, predominantly from the United Kingdom and the United States: 10 primary research, two reviews, two conceptual/theoretical, and one gray-literature source. Four themes emerged (1) Successful service delivery required competence, (2) Benefits of incorporating practice, collaboration, and feedback, (3) Effective online education through multifactorial approaches, (4) Considering different learning requirements among team members.

Conclusions: There’s beginning evidence that rehabilitation professionals’ competence with night-time postural care might be achieved via active, interactive, multi-factorial online training.
Stasis and Sorting of Americans’ Abortion Opinions: Political Polarization Added to Religious and Other Differences
Authors: Hout Michael , Perrett Stuart , Cowan Sarah K.
Published: August 2022

Americans disagree on legal abortion now about as much as they did in the 1970s, but their attitudes now sort much more according to political identity. Differences of opinion by religion, gender, race, and work that were key to understanding abortion attitudes in the 1970s persisted through 2021. The General Social Survey shows that first conservatives increased their opposition to legal abortion rights; their mean score dropped 1.1 points (on a 6-point scale) from 3.8 to 2.7 from 1974 to 2004. As conservatives’ opinions leveled off, liberals increased their support of abortion rights from 4.7 in 2004 to 5.3 or 5.4 in 2021 (because of Covid-19, survey mode changed, creating uncertainty about the sources of change). Women were significantly more divided by political ideology than men were throughout the time series, but gendered political differences did not displace or reduce religious, educational, racial, or work-life differences.
The practical, ethical and legal reasons why patients should not be transferred between NHS trusts for phage therapy
Authors: Jones Joshua D , Ferguson Pamela R , Suleman Mehrunisha
Published: August 2022

Bacteriophages (phages) are naturally occurring viruses of bacteria that have a long history of use as antimicrobials, known as phage therapy. The antibiotic resistance crisis has driven renewed interest in phage therapy, which has been used on an unlicensed compassionate basis in various Western contexts. The option to use unlicensed medicines exists to allow clinicians to respond to genuine clinical needs arising in their own patients. However, in the UK some clinicians may, in the absence of suitable patients of their own, seek to transfer patients from other NHS trusts into their own Trust. This article sets out why patient transfer is not necessary and the practical, ethical and legal reasons why patients should not be transferred between NHS Trusts for phage therapy. Phage preparations should always be transported to the patient and the patient treated in the Trust in which they would have received care in the absence of phage. We enclose suggested best practice guidelines for adoption across the UK that will protect patient safety and safeguard clinicians and Trusts from potential litigation.
Air pollution, metabolites and respiratory health across the life-course
Authors: Gruzieva Olena , Jeong Ayoung , He Shizhen , Yu Zhebin , de Bont Jeroen , Pinho Maria G.M. , Eze Ikenna C. , Kress Sara , Wheelock Craig E. , Peters Annette , Vlaanderen Jelle , de Hoogh Kees , Scalbert Augustin , Chadeau-Hyam Marc , Vermeulen Roel C.H. , Gehring Ulrike , Probst-Hensch Nicole , Melén Erik
Published: August 2022

Previous studies have explored the relationships of air pollution and metabolic profiles with lung function. However, the metabolites linking air pollution and lung function and the associated mechanisms have not been reviewed from a life-course perspective. Here, we provide a narrative review summarising recent evidence on the associations of metabolic profiles with air pollution exposure and lung function in children and adults. Twenty-six studies identified through a systematic PubMed search were included with 10 studies analysing air pollution-related metabolic profiles and 16 studies analysing lung function-related metabolic profiles. A wide range of metabolites were associated with short- and long-term exposure, partly overlapping with those linked to lung function in the general population and with respiratory diseases such as asthma and COPD. The existing studies show that metabolomics offers the potential to identify biomarkers linked to both environmental exposures and respiratory outcomes, but many studies suffer from small sample sizes, cross-sectional designs, a preponderance on adult lung function, heterogeneity in exposure assessment, lack of confounding control and omics integration. The ongoing EXposome Powered tools for healthy living in urbAN Settings (EXPANSE) project aims to address some of these shortcomings by combining biospecimens from large European cohorts and harmonised air pollution exposure and exposome data.
Bioavailability and speciation of Cadmium in contaminated paddy soil as alleviated by biochar from co-pyrolysis of peanut shells and maize straw
Authors: Xu Weijie , Xiao Linlin , Hou Shuzhen , Rukh Gul , Xu Meizhen , Pan Yatian , Xu Jingweng , Lan Wangkaining , Ruan Zhongqiang , Zhong Bing , Liu Dan
Published: August 2022

Background

Biochar is an important material for remediation of Cd in contaminated paddy soils. However, different biochars have variable effects on bioavailability of Cd while single biochar cannot properly amend immobilized Cd. Co-production of biochar from peanut shells and maize straw at different mass mixing ratios (1:0, 1:1, 1:2, 1:3). The characteristics, properties and effects of co-pyrolysis biochars on amendments of Cd polluted paddy soil was evaluated.

Results

Our research revealed that yield, ash, elemental contents and specific surface area of co-pyrolysis biochars have variable amendment effects compared with single biochar. The co-pyrolysis biochars have produced rich oxygen-containing functional groups and crystal structure, especially 1P3M (co-pyrolysis biochar produced from peanut shell and maize straw in mass ratios of 1:3). The addition of biochar has significantly enhanced pH and EC value, however, content of available Cd during incubation was significantly reduced compared with control treatment. The efficiency of biochars have reduced available Cd in order of 1P3M > M > 1P1M > 1P2M > 2P1M > 3P1M > P after incubation. The 1P3M was most effective in reducing CaCl2-extractable Cd concentration up to 43.97%. The BCR sequential extraction method has produced lowest exchangeable fraction Cd content and highest residual fraction Cd content in 1P3M among all biochar amended treatments.

Conclusions

It is concluded that 1P3M has a much greater potential to decreased the bioavailability of Cd in contaminated paddy soil. And 1P3M was highly effective for transporting Cd from soluble form to less toxic stable forms in polluted paddy soils.

Graphical Abstract
Genetic diversity of DGAT1 gene linked to milk production in cattle populations of Ethiopia
Authors: Samuel Behailu , Mengistie Dejenie , Assefa Ermias , Kang Mingue , Park Chankyu , Dadi Hailu , Dinka Hunduma
Published: August 2022

Background

Diacylglycerol acyl-CoA acyltransferase 1 (DGAT1) has become a promising candidate gene for milk production traits because of its important role as a key enzyme in catalyzing the final step of triglyceride synthesis. Thus use of bovine DGAT1 gene as milk production markers in cattle is well established. However, there is no report on polymorphism of the DGAT1 gene in Ethiopian cattle breeds. The present study is the first comprehensive report on diversity, evolution, neutrality evaluation and genetic differentiation of DGAT1 gene in Ethiopian cattle population. The aim of this study was to characterize the genetic variability of exon 8 region of DGAT1 gene in Ethiopian cattle breeds.

Results

Analysis of the level of genetic variability at the population and sequence levels with genetic distance in the breeds considered revealed that studied breeds had 11, 0.615 and 0.010 haplotypes, haplotype diversity and nucleotide diversity respectively. Boran-Holstein showed low minor allele frequency and heterozygosity, while Horro showed low nucleotide and haplotype diversities. The studied cattle DGAT1 genes were under purifying selection. The neutrality test statistics in most populations were negative and statistically non-significant (p > 0.10) and consistent with a populations in genetic equilibrium or in expansion. Analysis for heterozygosity, polymorphic information content and inbreeding coefficient revealed sufficient genetic variation in DGAT1 gene. The pairwise FST values indicated significant differentiation among all the breeds (FST = 0.13; p ≤ 0.05), besides the rooting from the evolutionary or domestication history of the cattle inferred from the phylogenetic tree based on the neighbourhood joining method. There was four separated cluster among the studied cattle breeds, and they shared a common node from the constructed tree.

Conclusion

The cattle populations studied were polymorphic for DGAT1 locus. The DGAT1 gene locus is extremely crucial and may provide baseline information for in-depth understanding, exploitation of milk gene variation and could be used as a marker in selection programmes to enhance the production potential and to accelerate the rate of genetic gain in Ethiopian cattle populations exposed to different agro ecology condition.
Antihypertensive medicine use differs between Ghana and Nigeria
Authors: Hollingworth Samantha A. , Ankrah Daniel , Uzochukwu Benjamin S. C. , Okeke Chinyere C. , Ruiz Francis , Thacher Emily
Published: August 2022

Background

Non-communicable diseases are a growing burden in many African countries; cardiovascular disease is the main disease. Antihypertensive medicines (AHM) are a common treatment option but we know little about community use in most low- and medium-income countries (LMIC). We aimed to describe the use of antihypertensive medicines (AHM) in Ghana and Nigeria using a novel data source.

Methods

We used data from mPharma—a health and pharmaceutical company which distributes pharmaceuticals to hospital and retail pharmacies. We extracted data using the anatomical therapeutic chemical (ATC) classification codes and calculated use in defined daily doses and explored patterns by class, medicines, dose, and originator or generic product.

Results

AHM use differed between Ghana and Nigeria. The most used classes in Ghana were angiotensin receptor blockers (ARB) followed by calcium channel blockers (CCB) and angiotensin-converting-enzyme inhibitors (ACEi). The five most used products were 16 mg candesartan, 30 mg nifedipine, 10 mg lisinopril, 5 mg amlodipine and 50 mg losartan. In Nigeria ARB, CCB and diuretics were widely used; the top five products were 50 mg losartan, 10 mg lisinopril, 30 mg nifedipine, 40 mg furosemide, and 5 mg amlodipine. More originator products were used in Ghana than Nigeria.

Conclusion

The differences between Ghana and Nigeria may result from a combination of medical, contextual and policy evidence and reflect factors related to clinical guidance (e.g. standard treatment guidelines), accessibility to prescribers and the role of community pharmacies, and structure of the health system and universal health coverage including funding for medicines. We show the feasibility of using novel data sources to gain insights on medicines use in the community.
Better maternity care pathways in pregnancies after stillbirth or neonatal death: a feasibility study
Authors: Mills Tracey A. , Roberts Stephen A. , Camacho Elizabeth , Heazell Alexander E. P. , Massey Rachael N. , Melvin Cathie , Newport Rachel , Smith Debbie M. , Storey Claire O. , Taylor Wendy , Lavender Tina
Published: August 2022

Background

Around 1 in 150 babies are stillborn or die in the first month of life in the UK. Most women conceive again, and subsequent pregnancies are often characterised by feelings of stress and anxiety, persisting beyond the birth. Psychological distress increases the risk of poor pregnancy outcomes and longer-term parenting difficulties. Appropriate emotional support in subsequent pregnancies is key to ensure the wellbeing of women and families. Substantial variability in existing care has been reported, including fragmentation and poor communication. A new care package improving midwifery continuity and access to emotional support during subsequent pregnancy could improve outcomes. However, no study has assessed the feasibility of a full-scale trial to test effectiveness in improving outcomes and cost-effectiveness for the National Health Service (NHS).

Methods

A prospective, mixed-methods pre-and post-cohort study, in two Northwest England Maternity Units. Thirty-eight women, (≤ 20 weeks’ gestation, with a previous stillbirth, or neonatal death) were offered the study intervention (allocation of a named midwife care coordinator and access to group and online support). Sixteen women receiving usual care were recruited in the 6 months preceding implementation of the intervention. Outcome data were collected at 2 antenatal and 1 postnatal visit(s). Qualitative interviews captured experiences of care and research processes with women (n = 20), partners (n = 5), and midwives (n = 8).

Results

Overall recruitment was 90% of target, and 77% of women completed the study. A diverse sample reflected the local population, but non-English speaking was a barrier to participation. Study processes and data collection methods were acceptable. Those who received increased midwifery continuity valued the relationship with the care coordinator and perceived positive impacts on pregnancy experiences. However, the anticipated increase in antenatal continuity for direct midwife contacts was not observed for the intervention group. Take-up of in-person support groups was also limited.

Conclusions

Women and partners welcomed the opportunity to participate in research. Continuity of midwifery care was supported as a beneficial strategy to improve care and support in pregnancy after the death of a baby by both parents and professionals. Important barriers to implementation included changes in leadership, service pressures and competing priorities.

Trial registration

ISRCTN17447733 first registration 13/02/2018.
A fatal neonatal case of fungemia due to Exophiala dermatitidis—case report and literature review
Authors: Mpakosi Alexandra , Siopi Maria , Demetriou Maria , Falaina Vasiliki , Theodoraki Martha , Meletiadis Joseph
Published: August 2022

Background

Systemic infections caused by the black yeast-like fungus Exophiala dermatitidis are rare, but are associated with high mortality especially in immunocompromised patients. We report the first case of E. dermatitidis fungemia in a premature extremely low birth weight (ELBW) neonate who succumbed despite antifungal therapy with liposomal amphotericin (AMB) and fluconazole. A systematic review of all fungemia cases due to E. dermatitidis was also conducted aiming for a better understanding of the risk factors, treatment strategies and outcomes.

Case presentation

A male, ELBW premature neonate, soon after his birth, developed bradycardia, apnoea and ultimately necrotizing enterocolitis with intestinal perforation requiring surgical intervention. Meanwhile, he had also multiple risk factors for developing bloodstream infection, such as intubation, mechanical ventilation, central venous catheter (CVC), parenteral nutrition, empirical and prolonged antibiotic use. His blood cultures were positive, firstly for Acinetobacter junii and then for Klebsiella pneumoniae together with E. dermatitidis while on fluconazole prophylaxis and antibiotic empiric therapy. Despite the treatment with broad spectrum antibiotics, liposomal AMB and fluconazole, the newborn succumbed. A literature review identified another 12 E. dermatitidis bloodstream infections, mainly in patients with hematologic malignancies and solid organ transplant recipients (61%), with overall mortality 38% despite CVC removal and antifungal therapy.

Conclusions

Due to the rarity of E. dermatitidis infections, little is known about the characteristics of this yeast, the identification methods and the optimal therapy. Identification by common biochemical tests was problematic requiring molecular identification. Resolution of neonatal fungemia is difficult despite proper antifungal therapy especially in cases with multiple and severe risk factors like the present one. Therapeutic intervention may include CVC removal and treatment for at least 3 weeks with an azole (itraconazole or fluconazole after susceptibility testing) or AMB monotherapy but not echinocandins or AMB plus azole combination therapy.
HIV among people who inject drugs in India: a systematic review
Authors: Pachuau Lucy Ngaihbanglovi , Tannous Caterina , Dhami Mansi Vijaybhai , Agho Kingsley Emwinyore
Published: August 2022

Background

Little is known about the epidemiology of HIV infection among HIV positive people who inject drugs (PWID) in India. Injecting drug use has emerged as an important route of HIV transmission in India. The objective of this study was to conduct a systematic review on the risk behaviours associated with HIV infection among HIV positive PWID and assess the data reported.

Methods

A systematic search of six electronic databases, Scopus, PubMed, PsycINFO, CINAHL, Embase and Ovid Medline was conducted. These databases were searched for published studies on injecting risk behaviours, sexual risk behaviours and socio-demographic factors associated with HIV infection among HIV positive PWID in India.

Results

A total of 15 studies were included in the review of which 3 studies evaluated HIV/HCV coinfection among HIV positive PWID. Older age, low educational level and employment status were significantly associated with HIV infection. Sharing of syringe and needle, frequency of injection, early initiation of injecting practice, inconsistent condom use and having multiple sexual partners were all commonly associated with HIV infection among HIV positive PWID.

Conclusion

Our study identified significant injecting and sexual risk behaviours among HIV positive PWID in India. There is an increasing HIV transmission among PWID in different states, more so in the northeastern states and in metropolitan cities in India. More studies need to be conducted in other regions of the country to understand the true burden of the disease. The lack of sufficient data among HIV positive female PWID does not preclude the possibility of a hidden epidemic among female PWID. The need of the hour is for the prevention of further transmission by this high-risk group through the provision of comprehensive programs, surveillance and robust continuation of harm reduction services.
The positive impact of a care–physical activity initiative for people with a low socioeconomic status on health, quality of life and societal participation: a mixed-methods study
Authors: Mulderij Lisanne Sofie , Verkooijen Kirsten T. , Groenewoud Stef , Koelen Maria A. , Wagemakers Annemarie
Published: August 2022

Background

Overweight and obesity rates are increasing worldwide, particularly among people with a low socioeconomic status (SES). Care–physical activity (care–PA) initiatives may improve participants’ lifestyles and thereby lower overweight and obesity rates. A two-year care–PA initiative specifically developed for citizens with a low SES, X-Fittt 2.0, was offered free of charge to participants, and included 12 weeks of intensive guidance and sports sessions, and 21 months of aftercare. Here, we study the impact of X-Fittt 2.0 on health, quality of life (QoL) and societal participation using a mixed-methods design.

Methods

Questionnaires and body measurements were taken from 208 participants at the start of X-Fittt 2.0 (t0) and after 12 weeks (t1), one year (t2) and two to three years (t3). We also held 17 group discussions (t1, n = 71) and 68 semi-structured interviews (t2 and t3). Continuous variables were analysed using a linear mixed-model analysis (corrected for gender, age at t0, height, education level and employment status at the different time points), while we used descriptive statistics for the categorical variables. Qualitative data were analysed using a thematic analysis.

Results

Body weight was significantly lower at all three post-initiative time points compared with the baseline, with a maximum of 3.8 kg difference at t2. Body Mass Index, waist circumference, blood pressure and self-perceived health only significantly improved during the first 12 weeks. A positive trend regarding paid work was observed, while social visits decreased. The latter might be explained by the COVID-19 pandemic, as lockdowns limited social life. Furthermore, participants reported increased PA (including sports) and a few stopped smoking or drinking alcohol. Participants mentioned feeling healthier, fitter and more energetic. Additionally, participants’ self-esteem and stress levels improved, stimulating them to become more socially active. However, the participants also mentioned barriers to being physically active, such as a lack of money or time, or physical or mental health problems.

Conclusions

X-Fittt 2.0 improved the health, QoL and societal participation of the participants. Future initiatives should take into account the aforementioned barriers, and consider a longer intervention period for more sustainable results. More complete data are needed to confirm the findings.
Gender difference in prevalence of hypertension among Indians across various age-groups: a report from multiple nationally representative samples
Authors: Mohanty Parimala , Patnaik Lipilekha , Nayak Gayatri , Dutta Ambarish
Published: August 2022

Background

Prevalence of hypertension increases with age, but there is a general perception in India that women are less affected at every stage of life, although empiric evidence hardly exists regarding gender difference in hypertension in Indians of different ages. Therefore, we aimed to examine the gender difference in hypertension among Indians across various age-groups; and the contribution of variation in body mass index (BMI) to this difference.

Methods

Data were analysed after combining National Family Health Survey 4 (n = 294,584 aged 35–49 years) and Study of Ageing and Health wave 2 (n = 7118 aged 50 + years) datasets (NFHS-SAGE). Longitudinal Ageing Study of India (LASI) dataset (n = 65,900 aged > 45years) was analysed to replicate the results. Hypertension was defined if systolic and diastolic blood pressure was > 89 and/or > 139 respectively and/or if there was a history of anti-hypertensive medication. Descriptive summaries were tabulated and plotted to examine the gender difference in hypertension in various age-groups (35–39,40–44, 45–49, 50–54, 55–59, 60–64, 65–69, ≥ 70). Odds Ratios (ORs) from logistic regression models estimated the age gradient of hypertension and their male-female difference, adjusted for Body Mass Index (BMI).

Results

Males had a higher prevalence of hypertension up to 50 years; after that, females had higher rates. The estimates of age gradient, expressed as ORs, were 1.02 (1.02, 1.02) in males versus 1.05(1.05, 1.06) in females (p < 0.001) in NFHS-SAGE and 1.01(1.01, 1.02) in males versus 1.04(1.03, 1.04)in females (p < 0.001) in LASI;these differences marginally changed after adjustment with BMI.

Conclusion

This is perhaps the first study to comprehensively demonstrate that cardio-metabolic risk in Indian females surpasses males after 50 years of age, “busting the myth” that Indian females are always at much lower risk than males; and this evidence should inform the Indian healthcare system to prioritise older women for screening and treatment of hypertension.
Imaging-detected bone stress injuries at the Tokyo 2020 summer Olympics: epidemiology, injury onset, and competition withdrawal rate
Authors: Adachi Takuya , Katagiri Hiroki , An Jae-Sung , Engebretsen Lars , Tateishi Ukihide , Saida Yukihisa , Koga Hideyuki , Yagishita Kazuyoshi , Onishi Kentaro , Forster Bruce B.
Published: August 2022

Background

Prevention and early detection of injuries are essential in optimising sport participation and performance. The aim of this study is to investigate the epidemiology, athlete injury history, and competition withdrawal rate of imaging-detected bone stress injuries during the Tokyo 2020 Olympic Games.

Methods

We collected and analysed imaging and clinical information in athletes with bone stress injuries diagnosed in the Olympic Village polyclinic during the Games. Two physicians independently and retrospectively reviewed all imaging examinations of bone stress injuries.

Results

A total of 11,315 individual athletes from 206 National Olympic Committees competed at the Games, during which 567 MRIs and 352 X-rays were performed at the Olympic Village polyclinic. Radiology examinations revealed four stress fractures and 38 stress reactions in 29 athletes (median age 24 years, range 18–35 years). Of these, 72% of athletes (n = 21) had symptoms before entering the Olympic Village. Bone stress injuries were most common in women (55%), the lower extremities (66%), and track and field athletes (45%). Six athletes (21%) did not start or did not finish their competitions.

Conclusions

This study revealed 42 imaging-detected bone stress injuries in the polyclinic of the Tokyo 2020 Olympic Village. The high proportion of athletes with symptoms before entering the village and the high proportion of competition withdrawals suggests the usefulness of an early MRI examination.
Skeletal and dentoalveolar effects of class II malocclusion treatment using bi-maxillary skeletal anchorage: a systematic review
Authors: Alhammadi Maged S. , Qasem Amal Abdulsalam A. , Yamani Aisha Mohammed S. , Duhduh Rawan Duhduh A. , Alshahrani Rahaf T. , Halboub Esam , Almashraqi Abeer A.
Published: August 2022

Background

The goal of this systematic review was to assess the available evidence regarding the skeletal and dentoalveolar effects of bi-maxillary skeletal anchorage devices (BMSADs) used in treating growing class II malocclusion patients.

Methods

A comprehensive search was conducted on PubMed, Scopus, Science Direct, Web of Science, Cochrane, and LILACS up to November 2021, which was augmented by a manual search. The studies included were clinical trials (RCTs) and/or follow-up observational studies (retrospective and prospective). The outcomes of interest were the skeletal, dentoalveolar, and occlusal treatment-induced changes obtained from pre- and post-cephalometric measurements. The risks of bias of the included studies were assessed using an assessment tool from previous publications.

Results

Out of 742 screened articles, only 4 were eligible and thus included in the qualitative synthesis. They showed a moderate overall risk of bias. The results are presented as mean changes in both the study and control groups. All studies reported retrusion of the maxillary base and advancement of the mandible (meaning reduced ANB angle). Three of the included studies reported an increase in the vertical jaw relation, which was contrary to what the fourth study reported. Three studies reported an increase in the maxillary incisors’ inclination or position, while one study reported their retroclination. Proclination of the mandibular incisors happened in two studies, whereas the other two studies reported retroclination. The overjet was reduced in all included studies.

Conclusion

Apart from the protrusive effects on the mandible, retrusive effects on the maxilla, and the consequent reduction of the overjet, BMSADs results in inconsistent skeletal and dentoalveolar effects. However, the current evidence is limited due to the variability in the biomechanics of the intermaxillary components, type of anchorage, and comparable groups in the included studies. Further RCTs with more standardized methodologies are highly encouraged.

Clinical relevance

BMSADs (using miniscrews or miniplates on both jaws) induces more skeletal than dentoalveolar effects. However, this must be practiced with caution, based on the benefit to risk (surgical insertion) ratio, and the limited evidence available in hand so far.

Registration The protocol for this systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO, No.: CRD42020199601).
The effects of the ethanol extract of Cordia myxa leaves on the cognitive function in mice
Authors: Kendir Gülsen , Bae Ho Jung , Kim Jihyun , Jeong Yongwoo , Bae Hyo Jeoung , Park Keontae , Yang Xingquan , Cho Young-jin , Kim Ji-Young , Jung Seo Yun , Köroğlu Ayşegül , Jang Dae Sik , Ryu Jong Hoon
Published: August 2022

Background

Cordia myxa L. (Boraginaceae) is widely distributed in tropical regions and it’s fruits, leaves and stem bark have been utilized in folk medicine for treating trypanosomiasis caused by Trypanosoma cruzi. A population-based study showed that T. cruzi infection is associated with cognitive impairments. Therefore, if C. myxa has ameliorating activities on cognitive function, it would be useful for both T. cruzi infection and cognitive impairments.

Methods

In this study, we evaluated the effects of an ethanol extract of leaves of C. myxa (ELCM) on memory impairments and sensorimotor gating deficits in mice. The phosphorylation level of protein was observed by the Western blot analysis.

Results

The administration of ELCM significantly attenuated scopolamine-induced cognitive dysfunction in mice, as measured by passive avoidance test and novel object recognition test. Additionally, in the acoustic startle response test, we observed that the administration of ELCM ameliorated MK-801-induced prepulse inhibition deficits. We found that these behavioral outcomes were related with increased levels of phosphorylation phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt) and glycogen synthase kinase 3 beta (GSK-3β) in the cortex and extracellular signal-regulated kinase (ERK) and cAMP response element-binding protein (CREB) in the hippocampus by western blot analysis.

Conclusions

These results suggest that ELCM would be a potential candidate for treating cognitive dysfunction and sensorimotor gating deficits observed in individuals with neurodegenerative diseases.