bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic principles and unmet needs in the treatment of cough in pediatric patients: review and expert survey
Authors: Vogelberg Christian , Cuevas Schacht Francisco , Watling Christopher P. , Upstone Laura , Seifert Georg
Published: January 2023

Background

There are evidence gaps in the management of pediatric cough, particularly for acute pediatric cough. This study had two aims: to identify therapeutic principles and unmet needs in the treatment of cough in pediatric patients (internationally), and to consider the evidence required to address these unmet needs.

Methods

A MEDLINE/PubMed database search was performed to identify articles describing therapeutic principles in the treatment of pediatric cough. An online survey of international pediatric cough experts was conducted, with questions on the definitions, diagnosis, treatment, and unmet needs in pediatric cough management.

Results

Cough guidelines have differing definitions of pediatric patients (≤12–18 years), acute pediatric cough (< 2–3 weeks), and chronic pediatric cough (> 4–8 weeks). Similarly, among 18 experts surveyed, definitions varied for pediatric patients (≤10–21 years), acute pediatric cough (< 3–5 days to < 6 weeks), and chronic pediatric cough (> 2–8 weeks). Guidelines generally do not recommend over-the-counter or prescription cough medicines in acute pediatric cough, due to lack of evidence. In the expert survey, participants had differing opinions on which medicines were most suitable for treating acute pediatric cough, and noted that effective treatments are lacking for cough-related pain and sleep disruption. Overall, guidelines and experts agreed that chronic pediatric cough requires diagnostic investigations to identify the underlying cough-causing disease and thereby to guide treatment. There are unmet needs for new effective and safe treatments for acute pediatric cough, and for randomized controlled trials of existing treatments. Safety is a particular concern in this vulnerable patient population. There is also a need for better understanding of the causes, phenotypes, and prevalence of pediatric cough, and how this relates to its diagnosis and treatment.

Conclusions

Whereas pediatric cough guidelines largely align with regard to the diagnosis and treatment of chronic cough, there is limited evidence-based guidance for the management of acute cough. There is a need for harmonization of pediatric cough management, and the development of standard guidelines suitable for all regions and patient circumstances.
Risk factors and clinical outcomes of extubation failure in very early preterm infants: a single-center cohort study
Authors: Park Su Jeong , Bae Mi Hye , Jeong Mun Hui , Jeong Seong Hee , Lee NaRae , Byun Shin Yun , Park Kyung Hee
Published: January 2023

Background

Early extubation success (ES) in preterm infants may reduce various mechanical ventilation-associated complications; however, extubation failure (EF) can cause adverse short- and long-term outcomes. Therefore, the present study aimed to identify differences in risk factors and clinical outcomes between ES and EF in very early preterm infants.

Methods

This retrospective study was conducted between January 2017 and December 2021. Premature infants born at 32 weeks’ gestational age in whom extubation had failed at least once were assigned to the EF group. Successfully extubated patients with a similar gestational age and birth weight as those in the EF group were assigned to the ES group. EF was defined as the need for re-intubation within 120 h of extubation. Various variables were compared between groups.

Results

The EF rate in this study was 18.6% (24/129), and approximately 80% of patients with EF required re-intubation within 90.17 h. In the ES group, there was less use of inotropes within 7 days of life (12 [63.2%] vs. 22 [91.7%], p = 0.022), a lower respiratory severity score (RSS) at 1 and 4 weeks (1.72 vs. 2.5, p = 0.026; 1.73 vs. 2.92, p = 0.010), and a faster time to reach full feeding (18.7 vs. 29.7, p = 0.020). There was a higher severity of bronchopulmonary dysplasia BPD (3 [15.8%] vs. 14 [58.3%], p = 0.018), longer duration of oxygen supply (66.5 vs. 92.9, p = 0.042), and higher corrected age at discharge (39.6 vs. 42.5, p = 0.043) in the EF group. The cutoff value, sensitivity, and specificity of the respiratory severity score (RSS) at 1 week were 1.98, 0.71, and 0.42, respectively, and the cutoff value, sensitivity, and specificity of RSS at 4 weeks were 2.22, 0.67, and 0.47, respectively.

Conclusions

EF caused adverse short-term outcomes such as a higher BPD severity and longer hospital stay. Therefore, extubation in very early preterm infants should be carefully evaluated. Using inotropes, feeding, and RSS at 1 week of age can help predict extubation success.
Effectiveness of outpatient and community treatments for people with a diagnosis of ‘personality disorder’: systematic review and meta-analysis
Authors: Katakis Panos , Schlief Merle , Barnett Phoebe , Rains Luke Sheridan , Rowe Sarah , Pilling Steve , Johnson Sonia
Published: January 2023

Background

Quality of care and access to effective interventions have been widely criticised as limited for people diagnosed with ‘personality disorder’ or who have comparable needs (described in some recent papers as “Complex Emotional Needs” (CEN). It is important to identify effective interventions and the optimal context and mode of delivery for people with CEN. We aimed to investigate the effectiveness of psychosocial interventions delivered in community and outpatient settings in treating symptoms associated with ‘personality disorder’, and the moderating effects of treatment-related variables.

Methods

We systematically searched MEDLINE, EMBASE, PsycINFO, CINAHL, HMIC, ASSIA for articles published in English, from inception to November 23, 2020. We included randomized controlled trials examining interventions provided in community or outpatient settings for CEN. The primary outcome was ‘personality disorder’ symptoms, while secondary outcomes included anxiety symptoms, depressive symptoms, and global psychiatric symptoms. Random-effects meta-analysis was conducted for each outcome, and meta-regression analysis was performed to assess the moderating effects of treatment characteristics. The quality of the studies and the degree of publication bias was assessed.

Results

We included 54 trials (n = 3716 participants) in the meta-analysis. We found a large effect size (g = 0.78, 95% CI: 0.56 to 1.01, p < 0.0001) favoring interventions for ‘borderline personality disorder’ (BPD) symptoms over Treatment as Usual or Waitlist (TAU/WL), and the efficacy was maintained at follow-up (g = 1.01, 95% CI: 0.37 to 1.65, p = 0.002). Interventions effectively reduced anxiety symptoms (g = 0.58, 95% CI: 0.21 to 0.95, p = 0.002), depressive symptoms (g = 0.57, 95% CI: 0.32 to 0.83, p < 0.0001), and global psychiatric symptoms (g = 0.50, 95% CI: 0.35 to 0.66, p < 0.0001) compared to TAU/WL. The intervention types were equally effective in treating all symptom categories assessed. Treatment duration and treatment intensity did not moderate the effectiveness of the interventions for any outcome.

Conclusions

People with a ‘personality disorder’ diagnosis benefited from psychological and psychosocial interventions delivered in community or outpatient settings, with all therapeutic approaches showing similar effectiveness. Mental health services should provide people with CEN with specialised treatments in accordance with the availability and the patients’ preferences.
Effects of ambient temperature on mortality among elderly residents of Chengdu city in Southwest China, 2016–2020: a distributed-lag non-linear time series analysis
Authors: Xia Yizhang , Shi Chunli , Li Yang , Jiang Xianyan , Ruan Shijuan , Gao Xufang , Chen Yu , Huang Wei , Li Mingjiang , Xue Rong , Wen Xianying , Peng Xiaojuan , Chen Jianyu , Zhang Li
Published: January 2023

Background

With complex changes in the global climate, it is critical to understand how ambient temperature affects health, especially in China. We aimed to assess the effects of temperature on daily mortality, including total non-accidental, cardiovascular disease (CVD), respiratory disease, cerebrovascular disease, and ischemic heart disease (IHD) mortality between 2016 and 2020 in Chengdu, China.

Methods

We obtained daily temperature and mortality data for the period 2016–2020. A Poisson regression model combined with a distributed-lag nonlinear model was used to examine the association between temperature and daily mortality. We investigated the effects of individual characteristics by sex, age, education level, and marital status.

Results

We found significant non-linear effects of temperature on total non-accidental, CVD, respiratory, cerebrovascular, and IHD mortality. Heat effects were immediate and lasted for 0–3 days, whereas cold effects persisted for 7–10 days. The relative risks associated with extreme high temperatures (99th percentile of temperature, 28 °C) over lags of 0–3 days were 1.22 (95% confidence interval [CI]: 1.17, 1.28) for total non-accidental mortality, 1.40 (95% CI: 1.30, 1.50) for CVD morality, 1.34 (95% CI: 1.24, 1.46) for respiratory morality, 1.33 (95% CI: 1.20, 1.47) for cerebrovascular mortality, and 1.38 (95% CI: 1.20, 1.58) for IHD mortality. The relative risks associated with extreme cold temperature (1st percentile of temperature, 3.0 °C) over lags of 0–14 days were 1.32 (95% CI: 1.19, 1.46) for total mortality, 1.45 (95% CI: 1.24, 1.68) for CVD morality, 1.28 (95% CI: 1.09, 1.50) for respiratory morality, 1.36 (95% CI: 1.09, 1.70) for cerebrovascular mortality, and 1.26 (95% CI: 0.95, 1.68) for IHD morality. We found that hot and cold affects were greater in those over 85 years of age, and that women, individuals with low education levels, and those who were widowed, divorced, or never married, were more vulnerable.

Conclusions

This study showed that exposure to hot and cold temperatures in Chengdu was associated with increased mortality, with people over 85 years old, women, those with low education levels, and unmarried individuals being more affected by hot and cold temperatures.
Barriers and facilitators to state public health agency climate and health action: a qualitative assessment
Authors: Hartwell Cat , Lovell Sam , Hess Jeremy J. , Dolan Kathleen , Vickery Jamie , Errett Nicole A.
Published: January 2023

Background

As the health implications of climate change become more apparent, agencies and institutions across the United States are developing recommendations for state and territorial health agencies (S/THAs) to implement evidence-informed climate and health adaptation strategies. The CDC established the Building Resilience Against Climate Effects (BRACE) framework in 2010 to encourage local and state public health engagement in climate change adaptation. However, even after a decade of the BRACE initiative, the elements that affect the adoption and implementation of climate and health programming by S/THAs are not well understood.

Methods

Using an implementation science framework, this study sought to further understand and define the barriers and facilitators that determine the breadth and success of climate change and health activities undertaken by state health agencies (SHAs). We conducted focus groups with representatives from SHAs with and without climate and health programs, and analyzed data using the framework method for qualitative research.

Results

This study identified funding, state and agency-level prioritization, staff capability and capacity, and political will and polarization as factors that influence the readiness for implementation and implementation climate for climate and health activities.

Conclusions

As the impacts of climate change intensify, S/THAs will need to expand resources and capacity, and seek advocacy and assistance from external organizations in order to support the level of engagement required to strengthen climate resilience. Findings from this study have implications for public health policy and highlight potential pathways to expand support for climate and health activities in S/THAs in the U.S.
Gender difference in the associations between health literacy and problematic mobile phone use in Chinese middle school students
Authors: Li Dan-Lin , Wang Sizhe , Zhang Daoxu , Yang Rong , Hu Jie , Xue Yanni , Huang Xuexue , Wan Yuhui , Pan Chen-Wei , Fang Jun , Zhang Shichen
Published: January 2023

Background

Problematic mobile phone use (PMPU) is becoming increasingly popular and has serious harmful effects on physical and mental health among adolescents. Inadequate health literacy (HL) is related to some risky behaviors and mental health problems in adolescents. Nevertheless, few studies have explored the relationship between HL and PMPU and the gender difference in the relationship among Chinese adolescents. The aim of this study was to examine the associations between HL and PMPU and explore gender difference in the associations.

Methods

A total of 22,628 junior and senior high school students (10,990 males and 11,638 females) in 6 regions of China participated in this study. HL and PMPU were measured by self-report validated questionnaires. Chi-square tests and logistic regression analysis were conducted in the study.

Results

Logistic regression analysis showed that students with inadequate HL are likely to have PMPU (OR = 2.013, 95% CI: 1.840–2.202), and different degrees of association can be seen in six dimensions. Besides, in both males and females, students with inadequate HL had a higher risk of PMPU (ORmale = 1.607, 95% CI: 1.428–1.807; ORfemale = 2.602, 95% CI: 2.261–2.994). Regarding the gender difference, the results showed that males had more PMPU than females, and the difference was more significant for students with adequate HL than those with inadequate HL (ORinadequate = 1.085, 95% CI: 1.016–1.159; ORadequate = 1.770, 95% CI: 1.490–2.101). Similarly, there were associations in the six dimensions.

Conclusions

HL decreases PMPU, and males have a higher risk of PMPU than females. These findings suggest a reasonable strategy to reduce PMPU by improving the HL level of adolescents.
Bioinformatic modelling of SARS-CoV-2 pandemic with a focus on country-specific dynamics
Authors: Liu Jakub , Suchocki Tomasz , Szyda Joanna
Published: January 2023

Background

One of the seminal events since 2019 has been the outbreak of the SARS-CoV-2 pandemic. Countries have adopted various policies to deal with it, but they also differ in their socio-geographical characteristics and public health care facilities. Our study aimed to investigate differences between epidemiological parameters across countries.

Method

The analysed data represents SARS-CoV-2 repository provided by the Johns Hopkins University. Separately for each country, we estimated recovery and mortality rates using the SIRD model applied to the first 30, 60, 150, and 300 days of the pandemic. Moreover, a mixture of normal distributions was fitted to the number of confirmed cases and deaths during the first 300 days. The estimates of peaks’ means and variances were used to identify countries with outlying parameters.

Results

For 300 days Belgium, Cyprus, France, the Netherlands, Serbia, and the UK were classified as outliers by all three outlier detection methods. Yemen was classified as an outlier for each of the four considered timeframes, due to high mortality rates. During the first 300 days of the pandemic, the majority of countries underwent three peaks in the number of confirmed cases, except Australia and Kazakhstan with two peaks.

Conclusions

Considering recovery and mortality rates we observed heterogeneity between countries. Liechtenstein was the “positive” outlier with low mortality rates and high recovery rates, at the opposite, Yemen represented a “negative” outlier with high mortality for all four considered periods and low recovery for 30 and 60 days.
Biomechanical study of femoral neck system for young patients with nonanatomically reduced femoral neck fractures: a finite element
Authors: Fan Zhirong , Chen Ping , Yu Xiubing , Li Xing , Su Haitao , Chen Haiyun , Yang Bing , Qi Ji , Wang Haizhou
Published: January 2023

Background

A consensus regarding the optimal approach for treating femoral neck fractures is lacking. We aimed to investigate the biomechanical outcomes of Femoral Neck System (FNS) internal fixation components in the treatment of nonanatomically reduced femoral neck fractures.

Method

We constructed two types of femoral neck fractures of the Pauwels classification with angles of 30° and 50°, and three models of anatomic reduction, positive buttress reduction and negative buttress reduction were constructed. Subgroups of 1 to 4 mm were divided according to the distance of displacement in the positive buttress reduction and negative buttress reduction models. The von Mises stress and displacements of the femur and FNS internal fixation components were measured for each fracture group under 2100-N axial loads.

Results

When the Pauwels angle was 30°, the positive 1-mm and 2-mm models had lower FNS stress than the negative buttress model. The positive 3- and 4-mm models showed FNS stress similar to that of the negative buttress model. But the four positive buttress models had similar stresses on the femur as the negative buttress model. When the Pauwels angle was 50°, the four positive buttress models had higher FNS stress than the negative buttress model. Three positive buttress models (2 mm, 3 and 4 mm) resulted in lower stress of the femur than the negative buttress model, though the 1-mm model did not. When the Pauwels angle was 30°, the positive buttress model had a lower displacement of the FNS than the negative buttress model and a similar displacement of the femur with the negative buttress model. When the Pauwels angle was 50°, the positive buttress model had a higher displacement of the FNS and femur than the negative buttress model. Our study also showed that the von Mises stress and displacement of the internal fixation and the femur increased as the fracture angle increased.

Conclusion

From the perspective
of biomechanics, when the Pauwels angle was 30°, positive buttress was more
stable to negative buttress. However, when the Pauwels angle was 50°, this advantage weakens.
In our opinion, the clinical efficacy of FNS internal fixation with positive
buttress may be related to the fracture angle, neck-shaft angle and alignment
in the lateral view. This result needs verification in further clinical
studies.
The association between vertical laminar fracture and recurrent kyphosis after implant removal of Thoracolumbar burst fracture: a retrospective study
Authors: Li Hualin , Chen Qi , Hu Jiasen , Yu Jiapei , Xiang Jianwei , Li Kaiyu , Weng Junjie , Tian Naifeng
Published: January 2023

Background

Surgeons often encounter recurrent kyphosis of Cobb angle following thoracolumbar burst fracture surgery. Some factors affecting postoperative correction loss have been studied in previous studies, but few have examined the relationship between laminar fractures and postoperative loss of correction.

Methods

The clinical data of 86 patients with thoracolumbar burst fracture who met the inclusion criteria and were admitted to our Department of Spine Surgery between 2013 and 2020 was retrospectively analyzed. To examine the association between laminar fracturs and postoperative correction loss, demographic and radiographic characteristics of the two groups were analyzed.

Results

The presence or absence of laminar fractures was statistically different between the two groups (P < 0.05). Binary logistic regression analysis showed that laminar fractures and preoperative Cobb were statistically significant in the two groups. There were statistically significant differences in the degree of injury of laminar fractures in the coronal plane between the two groups (P < 0.05).

Conclusion

This study investigated that the presence or absence of laminar fractures and preoperative Cobb contribute to loss of correction after thoracolumbar burst fracture surgery. There was a statistically significant difference between full-length and partial-length laminar fractures on the loss of postoperative correction of thoracolumbar burst fractures with laminar fractures.
“Functional outcomes and MRI-based tendon healing after (antero-) superior rotator cuff repair among patients under 50 years: retrospective analysis of traumatic versus non-traumatic rotator cuff tears”
Authors: Themessl Alexander , Wagner Timon , Rupp Marco-Christopher , Degenhardt Hannes , Woertler Klaus , Hatter Kate A. , Imhoff Andreas B. , Siebenlist Sebastian , Pogorzelski Jonas
Published: January 2023

Background

Rotator cuff tears among patients under 50 years either result from an adequate trauma or are considered non-traumatic due to work-related or athletic overuse. The impact of these different mechanisms on postoperative functional outcomes and tendon healing has not yet been fully understood. Therefore, it was the purpose of this study to investigate the influence of etiology of (antero-)superior rotator cuff tears on postoperative outcomes and the healing rates after arthroscopic rotator cuff repair in a young patient population.

Methods

Patients under 50 years who underwent arthroscopic rotator cuff repair between 2006–2017 for an anterosuperior rotator cuff tear with a minimum follow up of 24 months were included in this study. Revision surgeries or reconstructive concomitant procedures other than long head of the biceps tenodesis were excluded. Patients were divided into two groups according to the etiology of their rotator cuff tear (traumatic vs. non-traumatic). Demographic and outcome scores including the American Shoulder and Elbow Surgeons (ASES) score, the Constant Score (CS), bilateral strength measurements and postoperative tendon integrity evaluated on magnetic resonance imaging (MRI) were assessed and compared between both groups.

Results

The mean follow up for this study was 55.6 months (24 – 158). Twenty-one patients (50.0%) had a traumatic RCT and 21 patients (50.0%) had a non-traumatic tear. Outcome scores did not differ significantly between groups. Strength measurements of the supraspinatus revealed significantly decreased force of the affected side as opposed to the contralateral side (p = 0.001), regardless of etiology. Retear rates were similar in both groups (37.5% and 33.3%, p = n.s.). Cuff integrity at follow-up was not predictive of superior scores or strength.

Conclusion

Surgical treatment of traumatic and non-traumatic RCT yields good clinical results in patients under the age of 50. The etiology of the rotator cuff tear did not significantly affect postoperative outcomes or healing rates. About one third of the patients suffered from a retear postoperatively, however retears were not predictive of inferior outcomes at midterm follow-up.

Study design

Level III.

Trial registration

Retrospectively registered.
Sexual violence and risk factors among night shift female college students in Hawassa city, South Ethiopia, 2020
Authors: Esayas Hawi Leul , Gemeda Hirut , Melese Teshome , Birgoda Gebremariam Temesgen , Terefe Bezabih , Abebe Samuel , Bekele Muluken , Wolde Fitsum , Birie Bamlaku
Published: January 2023

Background

Sexual violence is any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, against a person’s sexuality using coercion, by any person regardless of their relationship to the victim, in any setting. Several studies were undertaken on sexual violence among students in general. Nevertheless, there is paucity of information about sexual violence among night shift students in particular; even if they are more vulnerable to sexual violence due to the nature of the class time. The government has embraced legal and policy frameworks to discourse the problem of sexual violence in Ethiopia; nevertheless, the problem still is quite pervasive.

Objective

This study was aimed to assess the prevalence of sexual violence and risk factors among night shift female college students in Hawassa city.

Methods

Institution-based cross-sectional study design was employed. A structured questionnaire was used to collect the data from 345 study participants. Systematic random sampling technique was used to choice study participants. Epi data version 3.1statistical software and Statistical Package for Social Sciences version 22.0 were used to enter and analysis the data. Both bivariable and multivariable logistic regression analyses were performed to recognize risk factors. P values < 0.05 with 95% confidence level were used to state statistical significance.

Results

A total of 330 students were participated in the study making a response rate of 95.6% with a mean age of 24.9. The prevalence of last 12 month sexual violence was 202 (61.2%) 95% CI (55.8, 66.4) which includes rape, attempted rape and sexual harassment. The 12 month prevalence of each form of violence was 46 (13.9%) 95% CI (10.6, 17.9), 23 (6.9%) 95% CI (3.6, 10.9) and 163 (49.4%) 95% CI (46.2, 53.6) of rape, attempted rape and sexual harassment respectively. The independent predictors of sexual violence having a father with no formal education (AOR = 2.39, 95% CI 1.04, 5.33) presence of multiple sexual partners (AOR = 3.44, 95% CI 1.64, 7.2), having sexual partner (AOR = 1.89, 95% CI 1.03, 3.5), and consuming alcohol (3.55, 95% CI 1.84–6.85) by the victims.

Conclusion

This study shown that the prevalence of sexual violence is high among night shift female college students in Hawassa city. Having a father with no formal education, drinking alcohol, having multiple sexual partners and having sexual partner were more likely to have sexual violence within the last 12 month. Thus, students should prevent themselves from health risky behaviors and Hawassa educational bureau should be work on awareness creation concerning women empowerment with in marriage and Further broad and longitudinal studies are needed to determine the predictors of the problem among female students at Hawassa and Ethiopia as a whole.
Prevalence, predictors and pregnancy outcomes of unprescribed and herbal medicine use in Ibadan, Nigeria
Authors: Adeoye Ikeola , Etuk Victoria
Published: January 2023

Background

Unprescribed and herbal medicines use among pregnant women is a public health concern in low and middle-income countries because of the potential teratogenic effects, insufficient safety and weak drug regulatory systems. Unprescribed and herbal medicines are common among pregnant women in Nigeria, and only a few researchers have documented the prevalence and the risk factors. However, evidence on the associated pregnancy outcomes is still lacking. We assessed the prevalence, predictors and pregnancy outcomes of unprescribed and herbal medicines use among pregnant women in Ibadan, Nigeria.

Methods

This study was a component of the Ibadan Pregnancy Cohort Study, a prospective cohort study, among pregnant women in Ibadan, Nigeria, who were enrolled at ≤ 20 weeks gestation at their first antenatal visit and followed up till delivery. In all, 571 women participated in the maternal drug use assessment during the third trimester using a pretested interviewer-administered questionnaire. The primary outcomes were unprescribed and herbal medicines use and pregnancy outcomes, secondary outcomes, were abstracted from medical records. The predictors assessed included sociodemographic, obstetric, antenatal care utilization, and lifestyle characteristics. Bi-variate logistic and Poisson regression analyses were used to evaluate the predictors and relative risk for the pregnancy outcomes of unprescribed and herbal medicines at 5% significance.

Results

The prevalence of unprescribed and herbal medicine use was 31.9% and 21.7%, respectively. On bivariate analysis, the significant predictors of unprescribed medicine (which were protective) were tertiary education, increasing income, adequate antenatal care (≥ 4 visits), and at least two doses of sulfadoxine-pyrimethamine. However, high parity and having an antenatal admission increased the risk. However, after adjusting for confounders, the significant factors associated with unprescribed medicines were; tertiary education (AOR) = 0.23; 95% CI: (0.06 – 0.95); p-value: 0.043] and obtaining at least two doses of sulfadoxine-pyrimethamine [AOR = 0.33; 95% CI: (0.29 – 3.60); p-value: 0.048]. For herbal medicines, the predictors were similar to unprescribed drugs. However, after adjusting for confounders, none was significant for herbal medicines. Unprescribed and herbal medicines were not significantly associated with pregnancy outcomes.

Conclusions

Unprescribed and herbal medicines use were common among pregnant women in Ibadan, Nigeria, particularly among women with low economic status and those with poor utilization of antenatal care services. These significant predictors can be targeted for public health intervention. Specifically, health education that discourages the use of unprescribed and herbal medications to pregnant women during antenatal care.
Risk perception of sun exposure and knowledge of vitamin D among the healthcare providers in a high-risk country: a cross-sectional study
Authors: Siddiqee Mahbubul H. , Bhattacharjee Badhan , Hasan Mahbub , Shojon Mohammad , Hassan Mehedi , Rouf Rashawan Raziur , Siddiqi Umme Raihan , Rabbi Fazlay , Siddiqi Umme Ruman
Published: January 2023

Background

High levels of vitamin D deficiency are commonly reported even in regions with abundant sunshine. This necessitates a comprehensive understanding of the determinants that influence sun exposure practices. As the primary source of health-related knowledge for the general public, the attitude of the healthcare professionals towards sunlight and their awareness related to vitamin D deficiency can be critical in this regard.

Methods

A cross-sectional survey was conducted among 2,242 physicians, intern doctors, and senior medical students in Bangladesh from October 2019 to February 2020. A pre-tested structured questionnaire (containing twelve close-ended questions) was used. The perceptions of health risks due to sun exposure, and basic knowledge of the physiological and epidemiological aspects of vitamin D deficiency were tested.

Results

An overall negative attitude towards sunlight in the context of Bangladesh was highlighted – 68% participants thought regular sun exposure would be harmful or very harmful; 26% thought the level of UV radiation was very high; 44% recommended using sunscreen always; skin burns, heat stroke, and cancer were selected as potential consequences of regular sun exposure by 45%, 21%, and 30% respondents respectively. Overall knowledge regarding vitamin D deficiency appeared to be biased towards bone health; other symptoms and associated illnesses not having obvious link to Calcium-metabolism were identified much lesser frequently. Furthermore, ‘sunrise to 10 am’ was identified as the best time to get vitamin D by 69% participants; 60% believed < 30 min of weekly sun exposure would be sufficient for the Bangladeshi population; an only 33% identified that prevalence of vitamin D insufficiency in Bangladesh would be 50% or more. Taking vitamin D-rich food was suggested by more respondents over regular sun exposure (43% vs. 33%) as more effective remedial strategy to curb vitamin D deficiency in Bangladesh.

Conclusion

In addition to highlighting some crucial knowledge gaps, results from this study provides a comprehensive baseline dataset for knowledge and attitude regarding the public health aspects of vitamin D deficiency among the healthcare providers in Bangladesh, which would be generalizable to other countries with similar socio-demographic context, and will facilitate taking more effective policies worldwide.
Barriers and facilitators in the referral pathways to low vision services from the perspective of patients and professionals: a qualitative study
Authors: Stolwijk M. L. , van Nispen R. M. A. , van der Ham A. J. , Veenman E. , van Rens G. H. M. B.
Published: January 2023

Background

Underutilization of and lack of access to low vision services (LVS) has been reported internationally. The purpose of this study was to identify barriers and facilitators in LVS referral procedures and service delivery from both the perspective of people with visual impairment and professionals from different eye care providers in the Netherlands.

Methods

A qualitative study in the Netherlands was conducted. Barriers and facilitators were explored through semi structured interviews with older adults with macular degeneration, diabetic retinopathy and/or glaucoma (n = 14), and healthcare professionals including ophthalmologists and LVS professionals (n = 16). Framework analysis was used for analyzing the interviews with Atlas.ti software.

Results

According to both patients and professionals, facilitators in LVS access and utilization are having motivation, self-advocacy, high participation needs and social support, as well as being negatively impacted by the impairment. Both samples found having good communication skills and informing patients about LVS as a healthcare provider to facilitate access. A long patient-provider relationship and the Dutch healthcare system were also mentioned as facilitators. Professionals additionally found long disease duration and the presence of low vision optometric services in the ophthalmic practice to promote access.

Barriers that were reported by patients and professionals are lack of motivation, self-advocacy and acceptance of the impairment in patients. In addition, having low participation needs as a patient, lack of information provision by providers and time constraints in the ophthalmic practice were mentioned as barriers. Professionals also reported lack of social support, short disease duration of patients, a short patient-provider relationship and lack of coordination of care in the ophthalmic practice to hinder access.

Conclusions

Findings suggest that providers’ lack of information provision about LVS, especially to patients who are less assertive, hamper referral to LVS. Providers should have attention for patients’ LVS needs and actively inform them and their social network about LVS to facilitate access. Educating and training providers about how and when to address LVS may help to reduce barriers in the referral pathways. In addition, referral procedures may benefit from tools that make providers more aware of LVS.
Patients' attitudes towards switching to national volume-based procurement (NVBP) Drugs—a qualitative investigation in Wuhan, China
Authors: Tao Jinyi , Li Shihong , Xu Qiling , Gong Shiwei , Zeng Fang
Published: January 2023

Background

The implementation of the NVBP policy has generated considerable reductions in drug procurement prices and an increase in the market share of the NVBP drugs.This study aimed to investigate patients' attitudes towards switching to drugs of national volume-based procurement (NVBP) and identify their underlying influencing factors in Wuhan, China.

Methods

A total of 21 eligible patients from the Wuhan Union Hospital who were switched to NVBP drugs between January 2022 and May 2022 were included in our study. Semi-structured face-to-face interviews were conducted to collect interview information and the interview data was analyzed by the Colaizzi seven-step method.

Results

Twenty-one semi-structured face-to-face interviews were conducted. The duration of each interview was 25–35 min and three themes related to patients' attitudes and their influencing factors were extracted, including (1) Patients' perception of the NVBP drugs; (2) Family and social influence to patients; (3) Medication habits of patients. This study found: 1) 71.4% patients (15/21) showed a positive attitude towards switching to NVBP medicines; 2)80.9% patients (17/21) have felt a significant reduction in their medication cost after the implementation of the NVBP policy; 3)Advices from healthcare professionals and health insurance reimbursement policies showed great impacts on patients' attitude towards switching to NVBP drugs; 4)Attitudes towards switching to NVBP drugs varied considerably among patients with different severities of disease.

Conclusion

The implementation of the NVBP policy has significantly reduced the cost of healthcare for patients and has been supported by71.4% (15 of 21) patients. However, some issues have been identified in the implementation of the policy in this study. Health professionals in general need to contribute more efforts to improve patients' preconceptions about the NVBP drugs and boost their confidence in the NVBP drugs.
An investigative study on the zoonotic potential of Helicobacter pylori
Authors: Shaaban Sabah I. , Talat Dalia , Khatab Shymaa A. , Nossair Mohamed A. , Ayoub Mousa A. , Ewida Rania M. , Diab Mohamed Said
Published: January 2023

Background

Helicobacter pylori is one of the most common bacterial infections and is widespread globally. It causes a variety of gastrointestinal disorders, though a great proportion of infections are asymptomatic. A total of 143 fresh stool samples were collected from apparently healthy farm and pet animals (43 cattle, 50 buffaloes, 50 sheep, 50 dogs, and 50 cats), in addition to 768 human stool samples. The samples were examined using stool antigen and rapid antibody tests, and further confirmation of glmM “human antigen-positive samples and animal milk samples” was conducted by polymerase chain reaction (PCR).

Results

The prevalence rates of H. pylori infection in animals were 22.2% and 16% in antibody and stool antigen tests, respectively. The detection rates were 28%, 24%, 12%, 10%, and 4.7% in cats, dogs, buffaloes, sheep, and cattle, respectively. On the other hand, the prevalence rate of H. pylori infection in human stool samples was 74.8%, and a statistically significant association was observed between prevalence and several factors, such as sex, age, and locality. PCR was performed to detect the glmM gene of H. pylori, and this gene was found in 21 of 27 human antigen-positive samples and 5 of 13 animal milk samples.

Conclusions

H. pylori was detected in both human and animal samples. Furthermore, glmM was found in milk and human samples. Our findings suggest that pet and farm animals could transmit H. pylori infection to humans.
Gene expression profiles in mesenchymal stromal cells from bone marrow, adipose tissue and lung tissue of COPD patients and controls
Authors: Kruk Dennis , Yeung Anna C. Y. , Faiz Alen , ten Hacken Nick H. T. , Timens Wim , van Kuppevelt Toin H. , Daamen Willeke , Hof Danique , Harmsen Martin C. , Rojas Mauricio , Heijink Irene H.
Published: January 2023

Background

Chronic obstructive pulmonary disease (COPD) is characterized by irreversible lung tissue damage. Novel regenerative strategies are urgently awaited. Cultured mesenchymal stem/stromal cells (MSCs) have shown promising results in experimental models of COPD, but differences between sources may impact on their potential use in therapeutic strategies in patients.

Aim

To assess the transcriptome of lung-derived MSCs (LMSCs), bone marrow-derived MSCs (BM-MSC) and adipose-derived MSCs (AD-MSCs) from COPD patients and non-COPD controls.

Methods

We studied differences in gene expression profiles between the MSC-subtypes, as well as between COPD and control using RNA sequencing (RNA-seq).

Results

We show that besides heterogeneity between donors, MSCs from different sources have strongly divergent gene signatures. The growth factors FGF10 and HGF were predominantly expressed in LMSCs. MSCs from all sources displayed altered expression profiles in COPD, with most pronounced significantly up- and downregulated genes in MSCs from adipose tissue. Pathway analysis revealed that the most differentially expressed genes in COPD-derived AD-MSCs are involved in extracellular matrix (ECM) binding and expression. In LMSCs, the gene that differed most strongly between COPD and control was CSGALNACT1, an ECM modulating gene.

Conclusion

Autologous MSCs from COPD patients display abnormalities with respect to their transcriptome, which were surprisingly most profound in MSCs from extrapulmonary sources. LMSCs may be optimally equipped for lung tissue repair because of the expression of specific growth factor genes.
Detection of early-stage lung cancer in sputum using automated flow cytometry and machine learning
Authors: Lemieux Madeleine E. , Reveles Xavier T. , Rebeles Jennifer , Bederka Lydia H. , Araujo Patricia R. , Sanchez Jamila R. , Grayson Marcia , Lai Shao-Chiang , DePalo Louis R. , Habib Sheila A. , Hill David G. , Lopez Kathleen , Patriquin Lara , Sussman Robert , Joyce Roby P. , Rebel Vivienne I.
Published: January 2023

Background

Low-dose spiral computed tomography (LDCT) may not lead to a clear treatment path when small to intermediate-sized lung nodules are identified. We have combined flow cytometry and machine learning to develop a sputum-based test (CyPath Lung) that can assist physicians in decision-making in such cases.

Methods

Single cell suspensions prepared from induced sputum samples collected over three consecutive days were labeled with a viability dye to exclude dead cells, antibodies to distinguish cell types, and a porphyrin to label cancer-associated cells. The labeled cell suspension was run on a flow cytometer and the data collected. An analysis pipeline combining automated flow cytometry data processing with machine learning was developed to distinguish cancer from non-cancer samples from 150 patients at high risk of whom 28 had lung cancer. Flow data and patient features were evaluated to identify predictors of lung cancer. Random training and test sets were chosen to evaluate predictive variables iteratively until a robust model was identified. The final model was tested on a second, independent group of 32 samples, including six samples from patients diagnosed with lung cancer.

Results

Automated analysis combined with machine learning resulted in a predictive model that achieved an area under the ROC curve (AUC) of 0.89 (95% CI 0.83–0.89). The sensitivity and specificity were 82% and 88%, respectively, and the negative and positive predictive values 96% and 61%, respectively. Importantly, the test was 92% sensitive and 87% specific in cases when nodules were < 20 mm (AUC of 0.94; 95% CI 0.89–0.99). Testing of the model on an independent second set of samples showed an AUC of 0.85 (95% CI 0.71–0.98) with an 83% sensitivity, 77% specificity, 95% negative predictive value and 45% positive predictive value. The model is robust to differences in sample processing and disease state.

Conclusion

CyPath Lung correctly classifies samples as cancer or non-cancer with high accuracy, including from participants at different disease stages and with nodules < 20 mm in diameter. This test is intended for use after lung cancer screening to improve early-stage lung cancer diagnosis.

Trial registration ClinicalTrials.gov ID: NCT03457415; March 7, 2018
Unmanned aerial vehicles for surveillance and control of vectors of malaria and other vector-borne diseases
Authors: Mechan Frank , Bartonicek Zikmund , Malone David , Lees Rosemary Susan
Published: January 2023

The use of Unmanned Aerial Vehicles (UAVs) has expanded rapidly in ecological conservation and agriculture, with a growing literature describing their potential applications in global health efforts including vector control. Vector-borne diseases carry severe public health and economic impacts to over half of the global population yet conventional approaches to the surveillance and treatment of vector habitats is typically laborious and slow. The high mobility of UAVs allows them to reach remote areas that might otherwise be inaccessible to ground-based teams. Given the rapidly expanding examples of these tools in vector control programmes, there is a need to establish the current knowledge base of applications for UAVs in this context and assess the strengths and challenges compared to conventional methodologies. This review aims to summarize the currently available knowledge on the capabilities of UAVs in both malaria control and in vector control more broadly in cases where the technology could be readily adapted to malaria vectors. This review will cover the current use of UAVs in vector habitat surveillance and deployment of control payloads, in comparison with their existing conventional approaches. Finally, this review will highlight the logistical and regulatory challenges in scaling up the use of UAVs in malaria control programmes and highlight potential future developments.

Graphical Abstract
Recognizing pathology of renal tumor from macroscopic cross-section image by deep learning
Authors: Lin Zefang , Yang Weihong , Zhang Wenqiang , Jiang Chao , Chu Jing , Yang Jing , Yuan Xiaoxu
Published: January 2023

Objectives

This study aims to develop and evaluate the deep learning-based classification model for recognizing the pathology of renal tumor from macroscopic cross-section image.

Methods

A total of 467 pathology-confirmed patients who received radical nephrectomy or partial nephrectomy were retrospectively enrolled. The experiment of distinguishing malignant and benign renal tumor are conducted followed by performing the multi-subtypes classification models for recognizing four subtypes of benign tumor and four subtypes of malignant tumors, respectively. The classification models used the same backbone networks which are based on the convolutional neural network (CNN), including EfficientNet-B4, ResNet-18, and VGG-16. The performance of the classification models was evaluated by area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy. Besides, we performed the quantitative comparison among these CNN models.

Results

For the model to differentiate the malignant tumor from the benign tumor, three CNN models all obtained relatively satisfactory performance and the highest AUC was achieved by the ResNet-18 model (AUC = 0.9226). There is not statistically significance between EfficientNet-B4 and ResNet-18 architectures and both of them are significantly statistically better than the VGG-16 model. The micro-averaged AUC, macro-averaged sensitivity, macro-averaged specificity, and micro-averaged accuracy for the VGG-16 model to distinguish the malignant tumor subtypes achieved 0.9398, 0.5774, 0.8660, and 0.7917, respectively. The performance of the EfficientNet-B4 is not better than that of VGG-16 in terms of micro-averaged AUC except for other metrics. For the models to recognize the benign tumor subtypes, the EfficientNet-B4 ranked the best performance, but had no significantly statistical difference with other two models with respect to micro-averaged AUC.

Conclusions

The classification results were relatively satisfactory, which showed the potential for clinical application when analyzing the renal tumor macroscopic cross-section images. Automatically distinguishing the malignant tumor from benign tumor and identifying the subtypes pathology of renal tumor could make the patient-management process more efficient.