bluuebunny/crossref_metadata_2025 huggingface dataset:
A Longitudinal Study of the Impact of a Suicide Bereavement Service on People Bereaved by Suicide
Authors: Visser Victoria , Tretheway Rebecca
Published: July 2023

Whilst the body of research on the impacts of suicide bereavement interventions continues to grow, there is little understanding of the impact over time. This study measured changes in suicidality, levels of loneliness and grief reactions over time between those receiving support from a community-based suicide bereavement service (StandBy) compared with those that did not receive this support. Data were collected through an online survey with participation at baseline being varying times post loss, and three-months post-baseline (StandBy n = 174, Comparison n = 322). Statistical analysis included linear mixed-effects modelling for repeated measures. Results were consistent with earlier studies showing the positive impact of StandBy on participants’ grief responses, loneliness and suicidality, specifically within the first 12 months after their loss. However, these outcomes were not retained over time, with the exception of suicidality. Further longitudinal studies consisting of more than two time-points and a greater period between time-points is warranted.
Critical psychology & education: Opportunities outside silos
Authors: Corcoran Tim , Vassallo Stephen
Published: July 2023

Many psychologists working in schools acknowledge how their work contributes to the reproduction and mitigation of societal injustices. While professionals engaged in education systems and classrooms may hope to achieve the latter, disciplinary conventions can compete with best intentions. In response, psychologists working in schools have recently been encouraged to realize anti-oppressive schooling by practicing what is referred to as critical school psychology. Although potentially new for school psychology, critical work bridging education and psychology has been available for some time in North America and internationally. To encourage the use of psychology in support of justice and in resistance to oppression, we review some of this work and invite those interested to consider psychosocial justice as an ethical orientation to enmeshed theory∼practice. The purposeful engagement of critically informed work from outside traditional divisional silos will not eradicate every problem facing schools today, but such action will, at the least, provide concerned practitioners options for collaborative knowledge-making and more preferred ways of working.
A necessary but painful journey: Experiences of unification in a probation service region
Authors: Millings Matthew , Burke Lol , Annison Harry , Carr Nicola , Robinson Gwen , Surridge Eleanor
Published: July 2023

In this article, we present some initial findings from the first year of a longitudinal study of the experiences of unification by staff in one Probation Service region. Their reaction to unification is explored as well as their hopes and fears regarding the newly unified service. Despite working in what was often presented as an unsettled and fractured environment marked by on-going staff shortages – whilst at the same time having to respond to the impact of the COVID-19 pandemic – amongst most participants there remained a high level of loyalty to the probation profession (or the idea of probation). However, while many expressed optimism regarding the longer-term prospects for the unified organisation, this was also overlaid with concerns about how unification would play out in the short to medium term. Their enduring sense of commitment and loyalty to their role was also being tested by what some saw as overbearing pressure to manage risk, coupled with the fear of being exposed if people whom they supervised committed a Serious Further Offence.
Exercise therapy including the cervical extensor muscles in individuals with neck pain: A systematic review
Authors: Colman David , Demoulin Christophe , Vanderthommen Marc , Saive Olivier , Durieux Nancy , Cagnie Barbara , Kaux Jean-François , Grosdent Stéphanie
Published: July 2023

Objective

To review the use (dosage parameters and combination with other therapeutic interventions) of cervical extensor muscle exercises and their effect on pain, disability (primary outcomes), range of motion, endurance and strength (secondary outcomes) in people with neck pain.

Data sources

An extensive literature search was conducted through MEDLINE (Ovid), Scopus (Elsevier) and Physiotherapy Evidence Database (PEDro) up to May 2023. The reference lists of all included studies and relevant reviews were screened for additional studies.

Review methods

Randomised controlled trials reporting the use of cervical extensor muscle exercises (alone or combined) applied to adults with idiopathic or traumatic neck pain were included. Study selection, data extraction and critical appraisal (PEDro assessment scale) were performed by two blinded reviewers. Data extraction included dosage parameters, other modalities combined with these exercises and outcomes.

Results

Thirty-five randomised controlled trails (eight of which were complementary analyses) with 2409 participants fulfilled the inclusion criteria. Twenty-six were of moderate to high quality. In most studies, cervical extensor muscle exercises were combined with various other therapeutic modalities and applied at different dosages. Only two studies (one high and one low quality) specifically assessed their effectiveness. The high-quality study showed significant improvements in neck pain and disability, pressure point threshold and neck mobility after both low load and high load training for 6 weeks.

Conclusion

The results suggest cervical extensor muscle exercises may reduce neck pain and disability; however firm conclusions cannot be drawn because of the few studies that addressed this question and the heterogeneity of the dosage parameters.
The Impact of Forced and Reinforced Channel Migration Strategies on Churn: Evidence from a Quasi-Natural Experiment
Authors: Dikareva-Brugman Anastasia , Guyt Jonne Y. , Konuș Umut
Published: July 2023

Firms increasingly face decisions about eliminating or downsizing channels that are costly or less efficient. Firms can employ several channel migration strategies to steer customers toward alternative channels. In this study, the authors focus on three different channel migration strategies: (1) forced migration, eliminating the phone channel; (2) reinforced migration, making the phone channel less visible; and (3) voluntary migration, giving consumers complete freedom to choose a channel. The authors investigate customers’ responses to these migration strategies in a contractual setting with a large-scale European insurance services provider. The results reveal that while reinforced channel migration does not lead to higher churn rates relative to voluntary migration, forced channel migration increases the average churn by 11.27 percentage points in absolute terms, representing a relative increase of 47%. The results suggest that reducing the visibility of a channel may provide benefits (fewer expenses) without affecting churn, whereas eliminating the channel provides more cost benefits (no channel expenses) while increasing churn. To help managers understand which approach (reinforced migration vs. forced migration) is preferable for a firm, the authors provide calculations showing that reinforced channel migration delivers higher customer lifetime value.
Practising citizenship through online media: An interpretive case study of Chinese New Zealanders’ civic engagement online
Authors: Du Yu
Published: July 2023

Civic engagement is vital for a functioning democracy. Digital media broadens avenues of civic engagement, allowing people to practise various forms of citizenship. This article explores Chinese New Zealanders’ civic engagement on various digital media platforms. The findings result from an interpretive analysis of 38 Chinese New Zealanders’ in-depth interviews. I found that interviewees practised engaged and flexible citizenship through digital media activities. These two forms of citizenship enable Chinese New Zealanders to negotiate multilayered identities and disclose internal diversity. They also used social media to develop essential skills to address everyday concerns. The research enriches the knowledge of the Chinese diaspora's online media practices and deepens the understanding of digital media's democratic potential.
Transcaval Coil Embolization of Type 2 Endoleak After Endovascular Aortic Repair: An Institutional Review
Authors: Cheadle Gerald A. , Dwivedi Amit J. , Wayne Erik J. , Cheadle William G. , Sigdel Abindra
Published: July 2023

Objectives

Endovascular aortic repair may be complicated by type 2 endoleaks. Intervention is generally recommended when the native sac continues to grow more than 5 mm. Transcaval coil embolization (TCE) of the native aneurysm sac is an emerging technique for repair of type 2 endoleaks. The objective of this study is to report an institutional review of our experience with this technique.

Methods

11 patients underwent TCE during the study period. Data were gathered on demographics, size increase of native aneurysm sac, operative details, and outcomes. Technical success was defined as resolution of the endoleak during completion sac angiogram at end of the procedure. Clinical success was defined as no growth in the aneurysm sac at interval follow-up.

Results

Coils were the embolant of choice in all cases. Technical success was achieved in all cases except 1 resulting in a 91% technical success rate. Median follow-up was 25 months (range, 3-33). Of the ten patients that had technically successful embolization, 8 patients had repeat computed tomography (CT) scans which showed no further expansion of the native sac resulting in a 80% clinical success rate. No complications were noted immediately post-op or at interval follow-up.

Conclusions

This institutional retrospective review demonstrates that TCE is an effective and safe option for type 2 endoleaks after endovascular aortic repair (EVAR) in selected patients with favorable anatomy. Longer term follow-up, more patients, and comparison studies are needed to further define durability and efficacy.
Sesquiterpenoids From the Leaves of Datura metel L.
Authors: Liu Yan , Zhuang Leixin , Tan Jinyan , Zhou Yuanyuan , Jiang Peng , Fan Ruifeng , Kuang Haixue , Yang Bingyou
Published: July 2023

In the course of chemical investigations of Datura metel L., a new sesquiterpenoid, dmetelin J (1) was isolated from the leaves, along with the 4 known compounds apocynol A (2), blumenol B (3), megastigmane (4), and ( + )-dehydrovomifoliol (5). Structure elucidation was performed by spectroscopic techniques, including 1- and 2-dimensional NMR spectroscopy and HRESIMS. Compounds 2, 3, and 5 were isolated from the Solanaceae for the first time. All isolated compounds were subjected to anti-inflammatory activity evaluation.
Strengthening Writing Ability Among Students Learning Chinese as a Second Language Through Creative Thinking Spiral Teaching Strategy
Authors: Wen Ju-May , Do Hai-Dung , Liu Eric Zhi-Feng , Lin Chun-Hung , Huang Shihping Kevin
Published: July 2023

This study investigated the effect of educational board games and the creative thinking spiral teaching strategy (CTSTS) on the learning outcomes of beginner-level Chinese language learners. Two dimensions were measured: learning outcome and writing ability. A total of 82 learners from one university in Taiwan participated in this study. Participants were non-randomly selected using convenience sampling. The participants were divided into the control group (40 participants) and experimental group (42 participants). In the control group, the teacher used the board game “Conveyance GO” as a teaching tool; in the experimental group, both Conveyance GO and CTSTS were used to teach the Chinese language. The results indicate no significant difference in learning outcomes between the groups. However, the experimental group exhibited a significantly larger improvement in writing abilities than did the control group, especially in terms of cohesion, coherence, and grammatical accuracy.
Genetic dissection of maize (Zea mays L.) chlorophyll content using multi-locus genome-wide association studies
Authors: Xiong Xuehang , Li Jianxin , Su Pingping , Duan Haiyang , Sun Li , Xu Shuhao , Sun Yan , Zhao Haidong , Chen Xiaoyang , Ding Dong , Zhang Xuehai , Tang Jihua
Published: July 2023

Background

The chlorophyll content (CC) is a key factor affecting maize photosynthetic efficiency and the final yield. However, its genetic basis remains unclear. The development of statistical methods has enabled researchers to design and apply various GWAS models, including MLM, MLMM, SUPER, FarmCPU, BLINK and 3VmrMLM. Comparative analysis of their results can lead to more effective mining of key genes.

Results

The heritability of CC was 0.86. Six statistical models (MLM, BLINK, MLMM, FarmCPU, SUPER, and 3VmrMLM) and 1.25 million SNPs were used for the GWAS. A total of 140 quantitative trait nucleotides (QTNs) were detected, with 3VmrMLM and MLM detecting the most (118) and fewest (3) QTNs, respectively. The QTNs were associated with 481 genes and explained 0.29-10.28% of the phenotypic variation. Additionally, 10 co-located QTNs were detected by at least two different models or methods, three co-located QTNs were identified in at least two different environments, and six co-located QTNs were detected by different models or methods in different environments. Moreover, 69 candidate genes within or near these stable QTNs were screened based on the B73 (RefGen_v2) genome.GRMZM2G110408(ZmCCS3) was identified by multiple models and in multiple environments. The functional characterization of this gene indicated the encoded protein likely contributes to chlorophyll biosynthesis. In addition, the CC differed significantly between the haplotypes of the significant QTN in this gene, and CC was higher for haplotype 1.

Conclusion

This study’s results broaden our understanding of the genetic basis of CC, mining key genes related to CC and may be relevant for the ideotype-based breeding of new maize varieties with high photosynthetic efficiency.
Decreased frequency of Th22 cells and IL-22 cytokine in kidney transplant patients with active cytomegalovirus infection
Authors: Hassanzadeh Yashgin , Yaghobi Ramin , Pakzad Parviz , Geramizadeh Bita
Published: July 2023

Background

The immunity of CD4+ T cell subsets against human cytomegalovirus (HCMV) is considerable due to their essential role in controlling the infection in transplant individuals. Previously explained CD4+ subsets such as T helper (Th) 1 have been proven to have a protective role against HCMV infection, while the role of the recently identified Th22 subset has not been described yet. Here, the frequency changes of Th22 cells and the IL-22 cytokine production were investigated in kidney transplant recipients with and without HCMV infection.

Methods

Twenty kidney transplant patients and ten healthy controls were enrolled in this study. Patients were categorized into HCMV + and HCMV- groups based on the HCMV DNA real-time PCR results. After isolating CD4+ T cells from PBMCs, the phenotype (CCR6+CCR4+CCR10+) and cytokine profile (IFN-γ−IL-17−IL-22+) of Th22 cells were analyzed by flow cytometry. The gene expression of Aryl Hydrocarbon Receptor (AHR) transcription factor was analyzed by real-time PCR.

Results

The phenotype frequency of these cells was lower in recipients with infection than in those without infection and healthy controls (1.88 ± 0.51 vs. 4.31 ± 1.05; P = 0.03 and 4.22 ± 0.72; P = 0.01, respectively). A lower Th22 cytokine profile was observed in patients with infection than in the two other groups (0.18 ± 0.03 vs. 0.20 ± 0.03; P = 0.96 and 0.33 ± 0.05; P = 0.04, respectively). AHR expression was also lower in patients with active infection.

Conclusions

Overall, this study for the first time suggests that the reduced levels of Th22 subset and IL-22 cytokine in patients with active HCMV infection might indicate the protective role of these cells against HCMV.
Perceptions of the roles, impact, challenges and needs of community drug distributors in the control and elimination of neglected tropical diseases in difficult-to-access communities in Ghana
Authors: Forson Akua Obeng , Awuah Raphael Baffour , Mohammed Abdul Rahim , Owusu-Asenso Christopher Mfum , Atakora Sefa Bonsu , Akosah-Brempong Gabriel , Abdulai Anisa , Sraku Isaac Kwame , Dhikrullahi Shittu B. , Attah Simon K. , Afrane Yaw Asare
Published: July 2023

Introduction

The success of mass drug administration (MDA) campaigns to control and eliminate neglected tropical diseases (NTDs) in Ghana depends, to a large extent, on the essential role community drug distributors (CDDs) play. This study aimed to investigate community’s perceptions of CDDs’ roles, impact of CDDs’ work, challenges faced by CDDs, and views on resources required to enhance CDDs’ work to sustain MDA campaigns.

Methods

A cross-sectional qualitative study employing the use of focus group discussions (FGDs) with community members and CDDs in selected NTD endemic communities together with individual interviews with district health officers (DHOs) was conducted. We interviewed 104 people aged 18 and over, purposively selected, through eight individual interviews, and 16 focus group discussions.

Results

Participants in the community FGDs noted that health education and the distribution of drugs were the main roles of CDDs. Participants also perceived that the work of CDDs had prevented the onset of NTDs, treated symptoms of NTDs, and generally reduced the incidence of infections. In the interviews with CDDs and DHOs, lack of cooperation/non-compliance by community members, demands by community members, lack of working resources and low financial motivation were mentioned as the main challenges to the work of CDDs. Moreover, the provision of logistics and financial motivation for CDDs were identified as factors that will enhance their work.

Conclusions

Incorporating more attractive schemes will incentivise CDDs to improve output. Addressing the challenges highlighted is an important step for the work of CDDS to be effective in controlling NTDs in difficult-to-access communities in Ghana.
Diagnostic performance of metagenomic next-generation sequencing for Pneumocystis jirovecii pneumonia
Authors: Li Xuefang , Li Zhijun , Ye Jian , Ye Wu
Published: July 2023

Objective

Pneumocystis jirovecii pneumonia (PJP) can be a life-threatening opportunistic infection. We aimed to evaluate the diagnostic accuracy of metagenomic next-generation sequencing (mNGS) for PJP.

Methods

A comprehensive electronic literature search of Web of Knowledge, PubMed, Cochrane Library, CNKI and Wanfang data was performed. Bivariate analysis was conducted to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), the area under the summary receiver operator characteristic (SROC) curve and the Q-point value (Q*).

Results

The literature search resulted in 9 studies with a total of 1343 patients, including 418 cases diagnosed with PJP and 925 controls. The pooled sensitivity of mNGS for diagnosis of PJP was 0.974 [95% confidence interval (CI), 0.953–0.987]. The pooled specificity was 0.943 (95% CI, 0.926–0.957), the DOR was 431.58 (95% CI, 186.77-997.27), the area under the SROC curve was 0.987, and the Q* was 0.951. The I2 test indicated no heterogeneity between studies. The Deek funnel test suggested no potential publication bias. Subgroup analyses showed that the area under the SROC curve of mNGS for diagnosis of PJP in immunocompromised and non-HIV patients was 0.9852 and 0.979, respectively.

Conclusions

Current evidence indicates that mNGS exhibits excellent accuracy for the diagnosis of PJP. The mNGS is a promising tool for assessment of PJP in both immunocompromised and non-HIV patients.
Treatment of Urticaria caused by severe cryptosporidiosis in a 17-month-old child – a case report
Authors: Azami Mehdi , Amini Rarani Saeid , Kiani Fatemeh
Published: July 2023

Background

Cryptosporidium is an intracellular protozoan that causes gastrointestinal symptoms in humans and animals. In immunocompromised patients and children under 5 years of age, the infection is severe and can be life-threatening due to severe diarrhea.

Case presentation

We report a case of urticaria associated with Cryptosporidium in a 17-month-old female Iranian child. The patient had moderate diarrhea (> 3 loose, watery stools but not more than 10 diarrhea stools in a day), weight loss, and acute urticarial (rash clears completely within 6 weeks). Since the child’s father worked in livestock farming, the parasite may have been transferred from the cow or calve to the house and the child. Several Cryptosporidium oocysts were detected in the modified acid-fast staining of the child’s stool sample. The patient was successfully treated with nitazoxanide (100 mg twice daily) and became negative for parasites three days after treatment and one week after discharge from the hospital. The child was observed to produce < 3 loose stools in the previous 24 h after 1-week post-treatment and after 6 months of follow-up.

Conclusion

A number of parasites are associated with urticaria, but to our knowledge, there is no information on Cryptosporidium-induced urticaria. Therefore, our result may be evidence for the role of this parasite in the development of urticaria if other causes such as food allergies, autoimmune diseases and etc. don’t role in urticaria.
Achievement of appropriate cesarean rates using Robson’s 10-Group classification system in Brazilian private practice
Authors: Campos Andrea Silveira de Queiroz , Rattner Daphne , Diniz Carmen Simone Grilo
Published: July 2023

Background

Increasing cesarean section (CS) rates are a global concern because they are related to higher maternal and neonatal complication rates and do not provide positive childbirth experiences. In 2019, Brazil ranked second globally, given its overall CS rate of 57%. According to the World Health Organization (WHO), populational CS rates of 10–15% are associated with decreased maternal, neonatal, and infant mortality rates. This study aimed to investigate whether multidisciplinary care following evidence-based protocols associated with a high motivation of both women and professionals for a vaginal birth leads to less overuse of CS in a Brazilian private practice (PP).

Methods

This cross-sectional study evaluated CS rates by Robson group for women who sought vaginal birth in a private practice in Brazil comparing with Swedish data. Collaborative care of midwives and obstetricians who adopted evidence-based guidelines was offered. CS rates, overall and by Robson group, contribution of each Robson group to the overall CS rate, clinical and nonclinical interventions, vaginal birth, pre-labor CS, and intrapartum CS proportions were estimated. The expected CS rate was calculated using the World Health Organization C-model tool. The analysis used Microsoft Excel and R Studio (version 1.2.1335. 2009–2019).

Results

The PP overall CS rate was 15.1% (95%CI, 13.4–17.1%) versus the 19.8% (95%CI, 14.8–24.7%) rate expected by the WHO C-model tool. The population included 43.7% women in Robson Group 1 (nulliparous, single, cephalic, at term, spontaneous labor), 11.4% in Group 2 (nulliparous, single, cephalic, at term, induced labor or CS before labor), and 14.9% in Group 5 (multiparous women with previous CS), the greatest contributors to higher CS rates (75.4% of them). The Swedish overall CS rate was 17.9% (95%CI, 17.6–18.1%) in a population of 27% women in Robson Group 1, 10.7% in Group 2, and 9.2% in Group 5.

Conclusions

Multidisciplinary care following evidence-based protocols, associated with high motivation of both women and professionals for vaginal birth, may lead to a significant and safe reduction of CS rates even in contexts such as Brazil, with high medicalization of obstetric care and excess CS.
Metabolic syndrome score as an indicator in a predictive nomogram for lymph node metastasis in endometrial cancer
Authors: Feng Xuan , Li Xing Chen , Yang Xiao , Cheng Yuan , Dong Yang Yang , Wang Jing Yuan , Zhou Jing Yi , Wang Jian Liu
Published: July 2023

Background

Lymph node metastasis (LNM) is an important factor affecting endometrial cancer (EC) prognosis. Current controversy exists as to how to accurately assess the risk of lymphatic metastasis. Metabolic syndrome has been considered a risk factor for endometrial cancer, yet its effect on LNM remains elusive. We developed a nomogram integrating metabolic syndrome indicators with other crucial variables to predict lymph node metastasis in endometrial cancer.

Methods

This study is based on patients diagnosed with EC in Peking University People’s Hospital between January 2004 and December 2020. A total of 1076 patients diagnosed with EC and who underwent staging surgery were divided into training and validation cohorts according to the ratio of 2:1. Univariate and multivariate logistic regression analyses were used to determine the significant predictive factors.

Results

The prediction nomogram included MSR, positive peritoneal cytology, lymph vascular space invasion, endometrioid histological type, tumor size >  = 2 cm, myometrial invasion >  = 50%, cervical stromal invasion, and tumor grade. In the training group, the area under the curve (AUC) of the nomogram and Mayo criteria were 0.85 (95% CI: 0.81–0.90) and 0.77 (95% CI: 0.77–0.83), respectively (P < 0.01). In the validation group (N = 359), the AUC was 0.87 (95% CI: 0.82–0.93) and 0.80 (95% CI: 0.74–0.87) for the nomogram and the Mayo criteria, respectively (P = 0.01). Calibration plots revealed the satisfactory performance of the nomogram. Decision curve analysis showed a positive net benefit of this nomogram, which indicated clinical value.

Conclusion

This model may promote risk stratification and individualized treatment, thus improving the prognosis.
The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer after curative surgery
Authors: Li Qi , An Tailai , Wu Jianbin , Lu Weiqi , Wang Yan , Li Jia , Yang Lina , Chen Yiqi , Lin Lizhu , Yang Zhenjiang
Published: July 2023

Background

The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer has not been exhaustively investigated. Thus, the present study was performed to evaluate the effect of sarcopenia on the outcome of patients with left-sided colon and rectal cancer.

Methods

Patients with pathologically diagnosed stage I, II and III left-sided colon or rectal cancer who had undergone curative surgery between January 2008 and December 2014 were retrospectively reviewed. The psoas muscle index (PMI) identified by 3D-image analysis of computed tomographic images was the criterion used to diagnose sarcopenia. The cut-off value recommended by Hamaguchi (PMI value < 6.36 cm2/m2 for men and < 3.92 cm2/m2 for women) was adopted to confirm the diagnosis of sarcopenia. According to the PMI, each patient was divided into the sarcopenia group (SG) or the nonsarcopenia group (NSG). Then, the SG was compared with the NSG in terms of postoperative outcomes.

Results

Among the 939 patients included, 574 (61.1%) were confirmed to have preoperative sarcopenia. Initially, it was demonstrated that the SG was not significantly different from the NSG in terms of most baseline characteristics except for a lower body mass index (BMI) (P < 0.001), a larger tumour size (P < 0.001) and more weight loss (more than 3 kg in the last three months) (P = 0.033). The SG had a longer hospital stay after surgery (P = 0.040), more intraoperative blood transfusions (P = 0.035), and higher incidence of anastomotic fistula (P = 0.027), surgical site infection (SSI) (P = 0.037) and hypoalbuminemia (P = 0.022), 30-day mortality (P = 0.042) and 90-day mortality (P = 0.041). The SG had significantly worse overall survival (OS) (P = 0.016) and recurrence-free survival (RFS) (P = 0.036) than the NSG. Subsequently, Cox regression analysis revealed that preoperative sarcopenia was an independent predictive factor for worse OS (P = 0.0211, HR = 1.367, 95% CI: 1.049–1.782) and RFS (P = 0.045, HR = 1.299, 95% CI: 1.006–1.677).

Conclusion

Preoperative sarcopenia adversely affects the outcome of patients with left-sided colon and rectal cancer, and preoperative nutrition supplementation may help us improve their long-term and short-term outcomes.
Comprehensive management for complex complications after periumbilical fat implantation into the upper eyelid
Authors: Jiang Xuewei , Chen Wei , Chen Nan , Wang Yu , Lin Jiayan , Tian Xufeng , Wu Hailong , Zhang Qun
Published: July 2023

Background

Recently, periumbilical fat (PF) mass, an autologous material with a high survival rate, has been transplanted to treat sunken or dissatisfactory double eyelids. However, the intricate complications of PF grafts and associated reconstructive strategies are infrequently discussed.

Methods

During 3 years, 20 patients (33 eyes) with eyelid malformations caused by PF grafts into the orbital septum or on the surface of the levator aponeurosis underwent corrective blepharoplasty. We recorded patients’ subjective feelings and identified deformities from crease abnormalities, bloated appearance, and problems with the eyelid’s height. Then, we categorize them into three types based on their complexity: type I, swollen appearance; type II, obvious adhesion; type III, severe comprehensive damage. The relevant management included removing fat implants, releasing the adhesion, and rebuilding the physical structure according to the anatomic damage mechanism. The improvement effect was assessed with a satisfaction survey from patients and doctors at 6 months of follow-up.

Results

The swollen appearance was observed in 26 eyes (78.8%), an unsmooth double-eyelid line was in 23 eyes (69.7%), and the incidence of adhesion was in 22 eyes (66.7%). Following a comprehensive evaluation, 15 eyes (45.5%) and 13 (39.4%) were classified as type I and type II respectively. After the 6-month follow-up, 22 eyes (66.7%) showed exceptional aesthetic results, whereas only 2 eyes as type III had a poor outcome.

Conclusions

The deformities emerging from periumbilical fat into the upper eyelid are associated with the shape of the fat and the adhesion in tissues. Graft removal, adhesion release, and restoration of the natural anatomic structure can have positive outcomes.
Influencing factors of low vision 2 years after vitrectomy for proliferative diabetic retinopathy: an observational study
Authors: Wang Shengxia , Liu Yongjun , Du Yunhong , Bao Huijing , Zhu Junli , Liu Xin
Published: July 2023

Background

Proliferative diabetic retinopathy (PDR) can seriously affect the vision and quality of life of patients. The present study aimed to evaluate the clinical effect of vitrectomy for PDR by observing visual recovery and postoperative complications and to explore the factors influencing low vision.

Methods

This was a case series observational study. Consecutive eyes of patients with PDR who underwent 23G vitrectomy in our hospital within one year (2019.11-2020.11) were collected and followed up for more than 2 years. Patients’ visual acuity, surgical complications and management were collected before the operation and during the follow-up. Decimal visual acuity was recorded and converted to the logarithm of the minimal angle of resolution (logMAR) for statistical analysis. Excel was used to establish a database, and SPSS 22.0 statistical software was used for data analysis.

Results

A total of 127 patients and 174 eyes were included in the study. The mean age was 57.8 years. The best corrected visual acuity (BCVA) was < 0.3 in 89.7% of eyes before surgery and ≥ 0.3 in 48.3% of eyes after surgery. Among 174 eyes, visual acuity improved in 83.3%. There was no change in 8.6% of eyes, while 8.1% of eyes had decreased visual acuity after surgery. The average logMAR visual acuity was 1.5 ± 0.7 before surgery and 0.7 ± 0.6 after surgery, indicating significant improvement (p < 0.05). Logistic regression analysis showed that intraoperative silicone oil filling and postoperative complication were significant risk factors for postoperative low vision, while preoperative pseudophakic lens and postoperative intra vitreal injection of anti-VEGF were protective factors for vision recovery (p < 0.05). The incidence of postoperative complications was 15.5%, top three of which were vitreous haemorrhage, neovascular glaucoma and traction retinal detachment.

Conclusion

Vitrectomy is safe and effective in the treatment of PDR with few complication. Postoperative intra vitreal injection of anti-VEGF is a protective factor for vision recovery.

Trial registration

The trial registration number is ChiCRT2100051628, and the date of registration was September 28, 2021.
Depression, anxiety, and burnout among psychiatrists during the COVID-19 pandemic: a cross-sectional study in Beijing, China
Authors: Dong Ping , Lin Xiao , Wu Fei , Lou Sijia , Li Na , Hu Sifan , Shi Le , He Jia , Ma Yundong , Bao Yanping , Lu Lin , Sun Wei , Sun Hongqiang
Published: July 2023

Background

With the rise of reported mental disorders and behavioral issues after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, psychiatrists and mental health care are urgently needed more than ever before. The psychiatric career carries a high emotional burden and stressful demands, which bring issues on psychiatrists’ mental health and well-being into question. To investigate the prevalence and risk factors of depression, anxiety, and work burnout among psychiatrists in Beijing during the COVID-19 pandemic.

Methods

This cross-sectional survey was conducted from January 6 to January 30, 2022, two years after COVID-19 was declared a global pandemic. Recruitment was performed using a convenience sample approach by sending online questionnaires to psychiatrists in Beijing. The symptoms of depression, anxiety, and burnout were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Maslach Burnout Inventory-General Survey (MBI-GS). The perceived stress and social support were measured by the Chinese Perceived Stress Scale (CPSS) and Social Support Rating Scale (SSRS), respectively.

Results

The data of 564 psychiatrists (median [interquartile range] age, 37 [30–43] years old) of all 1532 in Beijing were included in the statistical analysis. The prevalence of symptoms of depression, anxiety and burnout were 33.2% (95% CI, 29.3-37.1%, PHQ-9 ≥ 5), 25.4% (95% CI, 21.8-29.0%, GAD-7 ≥ 5) and 40.6% (95% CI, 36.5-44.7%, MBI-GS ≥ 3 in each of the three subdimensions), respectively. The psychiatrist with a higher score on perceived stress was more likely to suffer from depressive symptoms (adjusted odds ratios [ORs]: 4.431 [95%CI, 2.907–6.752]); the anxiety symptoms (adjusted ORs: 8.280 [95%CI, 5.255–13.049]), and the burnout conditions (adjusted ORs: 9.102 [95%CI, 5.795–14.298]). Receiving high social support was an independent protective factor against symptoms of depression (adjusted ORs: 0.176 [95%CI, [0.080–0.386]), anxiety (adjusted ORs: 0.265 [95%CI, 0.111–0.630]) and burnout (adjusted ORs: 0.319 [95%CI, 0.148–0.686]).

Conclusions

Our data suggest a considerable proportion of psychiatrists also suffer from depression, anxiety, and burnout. Perceived stress and social support influence depression, anxiety, and burnout. For public health, we must work together to reduce the pressure and increase social support to mitigate mental health risks in psychiatrists.
Hand hygiene practices during meal preparation—a ranking among ten European countries
Authors: Mihalache Octavian Augustin , Teixeira Paula , Langsrud Solveig , Nicolau Anca Ioana
Published: July 2023

Background

The aim of this paper was to map consumers’ food hygiene practices from 10 European countries and evaluate which demographic groups are more likely to be exposed to foodborne pathogens and establish a ranking of adherence to food hygiene practices in 10 European countries.

Methods

The research design consisted of a cross-national quantitative consumer survey regarding food safety and hygiene practices during meal preparation (SafeConsume project) and was conducted in ten European countries (France, Denmark, Germany, Greece, Hungary, Norway, Portugal, Romania, Spain and UK). The survey questions were based on recommended hand hygiene practices and on observed practices from a field study performed in 90 European households from six of the countries covered by the survey (France, Hungary, Norway, Portugal, Romania, and UK).

SPSS Statistics 26 (IBM Software Group, Chicago, IL) was used for the descriptive and regression analyses of the data. Regression analyses were used to check the relation between demographic characteristics, country of origin and self-reported hand hygiene practices.

Results

According to the regression models, families with elderly members aged over 65 showed a higher tendency to follow proper hand washing practices compared to families without elderly members. Meanwhile, families with children under the age of 6 reported being up to twice as likely to wash their hands at critical moments compared to families without children.

Overall, taking into consideration the likelihood of washing hands after touching raw chicken and the percentages scores for proper hand cleaning methods and key moments for hand washing, the rank of the countries regarding proper hand hygiene practices was the following: Denmark, Greece, Norway, Romania, Hungary, Germany, UK, Portugal, France, and Spain.

Conclusions

Information and education should point both at the key moments as suggested by the Royal Society for Public Health (RSPH) and the International Scientific Forum on Home Hygiene (IFH) and safe practices.

Public health burden generated by improper hand washing may be significantly reduced if education is targeted on consumers’ behaviour and practices.
Consumer health risk assessment of Arsenic and Mercury in hen eggs through Monte Carlo simulations
Authors: Abedi Abdol-samad , Hoseini Hedayat , Mohammadi-Nasrabadi Fatemeh , Rostami Negar , Esfarjani Fatemeh
Published: July 2023

Background

This study was conducted to assess the concentration of heavy metals (arsenic and mercury) and estimate the probability that consumption of hen egg products collected in Iran has carcinogenic or non-carcinogenic consequences.

Methods

A total of eighty-four hen eggs from 21 major brands were randomly selected from among thirty local supermarkets in two seasons (winter (January) and summer (August) 2022). Arsenic (As) and Mercury (Hg) was determined by using ICP-MS. The human health risk assessment refers to the formulation of the USEPA standard focused on Estimated Daily Intake (EDI), International Lifetime Cancer Risk (ILCR), Target Hazard Quotient (THQ), and Monte Carlo simulation (MCS) as a probabilistic method. Data analysis was carried out using the statistical software SPSS. Differences in mean concentrations of As and Hg in two seasons were tested by paired t-test.

Results

Over two seasons, the average As and Hg concentrations in hen eggs were 0.79 and 0.18 µg.kg−1, respectively. Seasonal difference in As concentration (p = 0.451) was not significant, whereas that of Hg concentration (p < 0.001) was significant. The calculated value of EDI was 0.29 µg As/day and 0.06 µg Hg/day. The EWI in the maximum scenario of as level in hen eggs was estimated to be 8.71 µg As and 1.89 µg Hg/month for Iranian adults. THQ's mean for As and Hg in adults was determined to be 0.00385 and 0.00066, respectively. In addition, ILCRs by MCS for As were 4.35E-4.

Conclusion

In total, the result indicates that there was not a significant risk of developing cancer; the calculation of THQ was still below the accepted level of 1, indicating that there was no risk while, according to most regulatory programs (ILCR > 10− 4) shows a threshold carcinogenic risk of arsenic through consuming in hen eggs. Therefore, policymakers need to be aware that it is prohibited to establish chicken farms in heavily polluted urban areas. It is essential to regularly conduct examinations to measure the presence of heavy metals in both ground waters used for agriculture and the feed provided to chickens. Additionally, it is advisable to focus on raising public awareness about the importance of maintaining a healthy diet.
Association between the built environment and moderate to vigorous leisure-time physical activity among suzhou adolescents: a cross-sectional study
Authors: Lv Hewu , Wang Rui
Published: July 2023

Introduction

Cardiovascular disease and obesity are both significantly influenced by physical inactivity. A rapidly expanding corpus of research contends that features of the built environment might encourage adolescents to lead active lives. There are still issues with the present evidence for determining which aspects of the built environment give adolescents the opportunity to engage in leisure-time physical activity (LTPA). This study looked at the relationship between the characteristics of the built environment and moderate-to-vigorous leisure-time physical activity (Leisure-time MVPA) of adolescents.

Methods

2628 adolescents between the ages of 11 and 18 were chosen as study participants from 19 Suzhou urban communities. They must have resided in the neighborhood for longer than six months and be permanent residents there. The International Physical Activities Questionnaire (n = 2628) and the Neighborhood Environment Walkability Scale for Chinese Children (NEWS-CC) were used to collect the data. LTPA are connected to different modes: Walking, leisure-time MPA, and leisure-time VPA. Univariate analysis and multinomial logistic regression were used to screen for potential associations between the built environment and the leisure-time MVPA in adolescents.

Results

Univariate analysis of the general demographic and built environment showed statistically significant differences in gender, residential density, accessibility, pedestrian safety, aesthetic and security (P < 0.05). Step by walking reference category, security (P < 0.05, OR = 1.131) were associated with adolescents' leisure-time MPA, aesthetics (P < 0.05, OR = 1.187) were associated with adolescents' leisure-time VPA, they both have a significant positive correlation.

Conclusion

Security was positively associated with adolescents' leisure-time MPA, aesthetics was positively associated with adolescents' leisure-time VPA. This suggests that built environment may associated with leisure-time MVPA of Suzhou adolescents.
Etiology and clinical characteristics of a non-cystic fibrosis bronchiectasis cohort in a middle eastern population
Authors: Shafiq Irfan , Wahla Ali Saeed , Uzbeck Mateen Haider , Zoumot Zaid , Abuzakouk Mohamed , Elkhalifa Shuayb , Bodi Govinda , Almazrouei Khalaf Mohamed , Bodi Kashyap , Isse Said
Published: July 2023

Background

Bronchiectasis is a widely prevalent airway disease characterized by airway dilatation and recurrent infections, that can lead to respiratory failure in severe cases. The etiology of bronchiectasis varies geographically, but there is a lack of published data examining its etiology specifically within the Middle Eastern population.

Methods

We conducted a retrospective analysis of our bronchiectasis patient registry, extracting clinical and demographic characteristics from electronic medical records. Quantitative variables were presented as the median and interquartile range (IQR), while categorical variables were expressed as numbers and percentages. Statistical comparisons for continuous characteristics were performed using the t-test, and significance was determined by a p-value less than 0.05.

Results

In total we analysed 260 records (63% female, 37% male), with median age of 58 years (interquartile range (IQR) 38–71), Body Mass Index (BMI) 25.8(IQR 22–30), forced expiratory volume in the first second (FEV1) %predicted 65 (IQR 43–79) and FEV1/forced vital capacity (FVC) 0.76 (0.67–0.86). Sixty-five cases (25%) were post-infectious in aetiology (excluding post-TB – n:27 10.4%). Forty-eight (18.5%) patients were labelled idiopathic, while Primary Ciliary Dyskinesia (PCD) accounted for 23 (8.8%) cases. Pseudomonas aeruginosa was the most common colonizing organism (32.7%), followed by Haemophilus influenzae (9.2%) and Methicillin-Sensitive Staphylococcus aureus(6.9%). At the time of review, 11 patients had died (median age, FEV %predicted, and bronchiectasis severity index (BSI) 59 years, 38% and 15.5 respectively), all due to respiratory failure, and as expected, all were classed severe on BSI. The BSI score was available for 109 patients, of which 31(28%) were classed mild, 29(27%) were moderate, and 49 (45%) were classed severe. The median BSI score was 8 (IQR 4–11). On dividing the patients according to obstructive vs. restrictive spirometry, we found that patients with FEV1/FVC < 0.70 had significantly higher BSI (10.1 vs. 6.9, p-value < 0.001) and that 8 out of the 11 deceased patients had FEV1/FVC < 70%.

Conclusions

In our study, post-infectious, idiopathic, and PCD were identified as the most common etiologies of bronchiectasis. Additionally, patients with obstructive spirometry appeared to have a worse prognosis compared to those with restrictive spirometry.
The perceptions of healthcare practitioners on obesity management in Peninsular Malaysia: a cross-sectional survey
Authors: Yunus Nor Akma , Russell Grant , Muhamad Rosediani , Soh Sze-Ee , Sturgiss Elizabeth
Published: July 2023

Background

Practitioners’ perceptions of patients with obesity and obesity management shape their engagement in obesity care delivery. This study aims to describe practitioners’ perceptions, experiences and needs in managing patients with obesity, determine the extent of weight stigma among health practitioners, and identify the factors associated with negative judgment towards patients with obesity.

Methods

A cross-sectional online survey was conducted from May to August 2022 with health practitioners commonly involved in obesity management in Peninsular Malaysia, including doctors in primary care, internal medicine and bariatric surgery, and allied health practitioners. The survey explored practitioners’ perceptions, barriers and needs in managing obesity, and evaluated weight stigma using the Universal Measures of Bias – Fat (UMB Fat) questionnaire. Multiple linear regression analysis was used to identify demographic and clinical-related factors associated with higher negative judgment towards patients with obesity.

Results

A total of 209 participants completed the survey (completion rate of 55.4%). The majority (n = 196, 94.3%) agreed that obesity is a chronic disease, perceived a responsibility to provide care (n = 176, 84.2%) and were motivated to help patients to lose weight (n = 160, 76.6%). However, only 22% (n = 46) thought their patients were motivated to lose weight. The most frequently reported barriers to obesity discussions were short consultation time, patients’ lack of motivation, and having other, more important, concerns to discuss. Practitioners needed support with access to multi-disciplinary care, advanced obesity training, financing, comprehensive obesity management guidelines and access to obesity medications. The mean (SD) of the UMB Fat summary score was 2.99 (0.87), with the mean (SD) domain scores ranging between 2.21 and 4.36 (1.06 to 1.45). No demographic and clinical-related factors were significantly associated with negative judgment from the multiple linear regression analyses.

Conclusion

Practitioners in this study considered obesity a chronic disease. While they had the motivation and capacity to engage in obesity management, physical and social opportunities were the reasons for not discussing obesity with their patients. Practitioners needed more support to enhance their capability and opportunity to engage with obesity management. Weight stigma in healthcare settings in Malaysia should be addressed, given the possibility of hindering weight discussions with patients.