bluuebunny/crossref_metadata_2025 huggingface dataset:
Effective web-based clinical practice guidelines resources: recommendations from a mixed methods usability study
Authors: Wang Wei , Choi Dorothy , Yu Catherine H.
Published: January 2023

Background

Clinical practice guidelines (CPG) are an important knowledge translation resource to help clinicians stay up to date about relevant clinical knowledge. Effective communication of guidelines, including format, facilitates its implementation. Despite the digitalization of healthcare, there is little literature to guide CPG website creation for effective dissemination and implementation. Our aim was to assess the effectiveness of the content and format of the Diabetes Canada CPG website, and use our results to inform recommendations for other CPG websites.

Methods

Fourteen clinicians (family physicians, nurses, pharmacists, and dieticians) in diabetes care across Canada participated in this mixed-methods study (questionnaires, usability testing and interviews). Participants “thought-aloud” while completing eight usability tasks on the CPG website. Outcomes included task success rate, completion time, click per tasks, resource used, paths, search attempts and success rate, and error types. Participants were then interviewed.

Results

The Diabetes Canada CPG website was found to be usable. Participants had a high task success rate of 79% for all tasks and used 144 (standard deviation (SD) = 152) seconds and 4.6 (SD = 3.9) clicks per task. Interactive tools were most frequently used compared to full guidelines and static tools. Misinterpretation accounted for 48% of usability errors. Participants overall found the website intuitive, with effective content and design elements.

Conclusion

Different versions of CPG information (e.g. interactive tools, quick reference guide, static tools) can help answer clinical questions more quickly. Effective web design should be assessed during CPG website creation for effective guideline dissemination and implementation.
The relationship between self-reported physical frailty and sensor-based physical activity measures in older adults – a multicentric cross-sectional study
Authors: Schmidle Stephanie , Gulde Philipp , Koster Raphael , Soaz Cristina , Hermsdörfer Joachim
Published: January 2023

Background

The decline in everyday life physical activity reflects and contributes to the frailty syndrome. While especially self-reported frailty assessments have the advantage of reaching large groups at low costs, little is known about the relationship between the self-report and objective measured daily physical activity behavior.
The main objective was to evaluate whether and to what extent a self-reported assessment of frailty is associated with daily physical activity patterns.

Methods

Daily activity data were obtained from 88 elderly participants (mean 80.6 ± 9.1 years) over up to 21 days. Acceleration data were collected via smartwatch. According to the results of a self-report frailty questionnaire, participants were retrospectively split up into three groups, F (frail, n = 43), P (pre-frail, n = 33), and R (robust, n = 12). Gait- and activity-related measures were derived from the built-in step detector and acceleration sensor and comprised, i.a., standard deviation of 5-s-mean amplitude deviation (MADstd), median MAD (MADmedian), and the 95th percentile of cadence (STEP95). Parameters were fed into a PCA and component scores were used to derive behavioral clusters.

Results

The PCA suggested two components, one describing gait and one upper limb activity. Mainly gait related parameters showed meaningful associations with the self-reported frailty score (STEP95: R2 = 0.25), while measures of upper limb activity had lower coefficients (MADmedian: R2 = 0.07). Cluster analysis revealed two clusters with low and relatively high activity in both dimensions (cluster 2 and 3). Interestingly, a third cluster (cluster 1) was characterized by high activity and low extent of ambulation. Comparisons between the clusters showed significant differences between activity, gait, age, sex, number of chronic diseases, health status, and walking aid. Particularly, cluster 1 contained a higher number of female participants, whose self-reports tended towards a low health status, the frequent use of a walking aid, and a higher score related to frailty questions.

Conclusions

The results demonstrate that subjective frailty assessments may be a simple first screening approach. However, especially older women using walking aids may classify themselves as frail despite still being active. Therefore, the results of self-reports may be particularly biased in older women.
Yolk sac tumor and dysgerminoma in the left gonad following gonadoblastoma in the right gonad in a 46,XY DSD with a novel SRY missense mutation: a case report
Authors: Xie Chengxiu , Cai Jian , Li Nan , Hua Ping , Yang Zexuan , Yu Xia , Tang Dongmei , Hu Yu , Liu Qingsong
Published: January 2023

Background

Approximately 10–15% of 46,XY disorders of sex development (DSDs) have an SRY mutation residing in the high mobility group (HMG) domain. Here, we present a case of 46,XY DSD caused by a novel missense mutation in the HMG region of SRY rapidly progressing to germ cell tumors (GCTs).

Case presentation

An adolescent female (15 years old) exhibiting primary amenorrhea was later diagnosed as a 46,XY female with bilateral gonadal dysplasia on the basis of peripheral lymphocyte karyotype 46,XY and a novel missense mutation in SRY (c.281 T > G, p.L94R). The novel missense mutation (c.281 T > G, p.L94R) and its adjacent region were conserved. Protein structure analysis showed that the mutant site was located in the middle of the HMG domain, and the mutant protein had a diminished ability to bind to DNA. Imaging examination revealed an adolescent female with a naive uterus. Laparoscopy and initial pathological examination revealed left gonadal dysplasia and right gonadal dysplasia with gonadoblastoma (GB). Right gonadectomy by laparoscopy was performed upon consent from the patient’s parents. Less than 1 year postoperatively, the left gonadal gland deteriorated as observed by the findings of a mass in the left adnexal region by pelvic MRI and serum AFP > 1000 ng/ml by serological tests, and then total hysterectomy and adnexal and left gonadectomy by laparoscopy were performed. The GCT stage was classified as stage Ic according to FIGO. At this time, pathologic examination showed that the left gonad had progressed to yolk sac tumor and dysgerminoma. The patient underwent chemotherapy post-operatively but developed type III myelosuppression and tumor recurrence several months later.

Conclusions

The patient initially presented with right gonadoblastoma but chose only right gonadectomy by laparoscopy to preserve the female sex characteristics, which resulted in rapid deterioration of the left gonad and poor treatment outcomes. This case demonstrates the importance of early genetic diagnosis and treatment of 46,XY female DSD.
Risk factors of childhood cancer in Armenia: a case-control study
Authors: Avagyan Manushak , Demirchyan Anahit , Abrahamyan Lusine
Published: January 2023

Introduction

Childhood cancer (CC) is a leading cause of death among children aged 0–19 years worldwide. Each year, 400,000 new cases of CC are diagnosed globally. Given the between-country differences in CC incidence rates, types and trends, this study aimed to identify possible risk factors for CC in Armenia.

Methods

We used a case-control study design and enrolled participants from the only specialized pediatric hematology and oncology center in Armenia. Cases included patients ≤ 14 years old diagnosed and treated with a malignant disease between 2017 and 2020 in the centre. Controls included patients diagnosed and treated in the center during the same period for a non-malignant disease. We conducted telephone interviews with mothers of cases and controls. Independent risk factors of cancer were identified using multivariable logistic regression analysis.

Results

Overall, 234 participants (117 cases, 117 controls) were included in the study. Based on the fitted model, maternal usage of folic acid during pregnancy was protective against CC, almost twice decreasing its odds (OR = 0.54; 95% CI: 0.31–0.94). On the contrary, experiencing horrifying/terrifying event(s) during pregnancy (OR = 2.19; 95% CI: 1.18–4.07) and having induced abortions before getting pregnant with the given child (OR = 2.94; 95% CI: 1.45–5.96) were associated with higher odds for a child to develop cancer.

Conclusion

Despite the limited sample size of the study, significant modifiable risk factors for CC in Armenia were identified, all of which were linked to the period of pregnancy. The data from this study adds to the limited information available from etiological CC research throughout the world, and it will increase understanding of CC risk factors in settings with small populations and low resources. Although these findings may be helpful for future research, they should be taken with caution unless validated from further larger-scale studies.
The barriers and facilitators to the reporting and recording of self-harm in young people aged 18 and under: a systematic review
Authors: Waller Gillian , Newbury-Birch Dorothy , Simpson Diane , Armstrong Emma , James Becky , Chapman Lucy , Ahmed Farhin , Ferguson Jennifer
Published: January 2023

Background and aims

This systematic review sought to identify, explain and interpret the prominent or recurring themes relating to the barriers and facilitators of reporting and recording of self-harm in young people across different settings, such as the healthcare setting, schools and the criminal justice setting.

Methods

A search strategy was developed to ensure all relevant literature around the reporting and recording of self-harm in young people was obtained. Literature searches were conducted in six databases and a grey literature search of policy documents and relevant material was also conducted. Due to the range of available literature, both quantitative and qualitative methodologies were considered for inclusion.

Results

Following the completion of the literature searches and sifting, nineteen papers were eligible for inclusion.

Facilitators to reporting self-harm across the different settings were found to be recognising self-harm behaviours, using passive screening, training and experience, positive communication, and safe, private information sharing. Barriers to reporting self-harm included confidentiality concerns, negative perceptions of young people, communication difficulties, stigma, staff lacking knowledge around self-harm, and a lack of time, money and resources.

Facilitators to recording self-harm across the different settings included being open to discussing what is recorded, services working together and co-ordinated help. Barriers to recording self-harm were mainly around stigma, the information being recorded and the ability of staff being able to do so, and their length of professional experience.

Conclusion

Following the review of the current evidence, it was apparent that there was still progress to be made to improve the reporting and recording of self-harm in young people, across the different settings. Future work should concentrate on better understanding the facilitators, whilst aiming to ameliorate the barriers.
Parents’ drinking, childhood hangover? Parental alcohol use, subjective health complaints and perceived stress among Swedish adolescents aged 10–18 years
Authors: Wahlström Joakim , Magnusson Charlotta , Låftman Sara Brolin , Svensson Johan
Published: January 2023

Background

Alcohol abuse is not only harmful to the consumer but may also negatively impact individuals in the drinker’s social environment. Alcohol’s harm to others is vital to consider when calculating the true societal cost of alcohol use. Children of parents who have alcohol use disorder tend to have an elevated risk of negative outcomes regarding, e.g., health, education, and social relationships. Research on the general youth population has established a link between parental drinking and offspring alcohol use. However, there is a lack of knowledge regarding other outcomes, such as health. The current study aimed to investigate the associations between parental drinking and children’s psychological and somatic complaints, and perceived stress.

Methods

Data were derived from a nationally representative sample, obtained from the 2010 Swedish Level-of-Living survey (LNU). Parents and adolescents (ages 10–18) living in the same households were interviewed independently. The final study sample included 909 adolescents from 629 households. The three outcomes, psychological and somatic complaints and perceived stress, were derived from adolescents’ self-reports. Parents’ self-reports of alcohol use, both frequency and quantity, were used to categorise adolescents as having abstaining, low-consuming, moderate-drinking, or heavy-drinking parents. Control variables included adolescents’ gender, age, family structure, and household socioeconomic status. Linear and binary logistic regression analyses were performed.

Results

Parental heavy drinking was more common among adolescents living in more socioeconomically advantaged households and among adolescents living with two custodial parents or in reconstituted families. Adolescents with heavy-drinking parents reported higher levels of psychological and somatic complaints and had an increased likelihood of reporting stress, compared with those having moderate-drinking parents. These associations remained statistically significant when adjusting for all control variables.

Conclusion

The current study’s results show that parental alcohol consumption is associated with poorer offspring adolescent health. Public health policies that aim to reduce parental drinking or provide support to these adolescents may be beneficial. Further studies investigating the health-related outcomes among young people living with heavy-drinking parents in the general population are needed to gain more knowledge about these individuals and to implement adequate public health measures.
Construction and validation of a risk prediction model for delayed discharge in elderly patients with hip fracture
Authors: Cao Hong , Yu Jian , Chang YaRu , Li Yue , Zhou Bingqian
Published: January 2023

Background

Because of their poor physical state, elderly hip fracture patients commonly require prolonged hospitalization, resulting in a drop in bed circulation rate and an increased financial burden. There are currently few predictive models for delayed hospital discharge for hip fractures. This research aimed to develop the optimal model for delayed hospital discharge for hip fractures in order to support clinical decision-making.

Methods

This case-control research consisted of 1259 patients who were continuously hospitalized in the orthopedic unit of an acute hospital in Tianjin due to a fragility hip fracture between January and December 2021. Delayed discharge was defined as a hospital stay of more than 11 days. The prediction model was constructed through the use of a Cox proportional hazards regression model. Furthermore, the constructed prediction model was transformed into a nomogram. The model’s performance was assessed using the area under the receiver operating characteristic curve (AUC), calibration curves and decision curve analysis (DCA). the STROBE checklist was used as the reporting guideline.

Results

The risk prediction model developed contained the Charlson Comorbidity Index (CCI), preoperative waiting time, anemia, hypoalbuminemia, and lower limbs arteriosclerosis. The AUC for the risk of delayed discharge was in the training set was 0.820 (95% CI,0.79 ~ 0.85) and 0.817 in the testing sets. The calibration revealed that the forecasted cumulative risk and observed probability of delayed discharge were quite similar. Using the risk prediction model, a higher net benefit was observed than when considered all patients were at high risk, demonstrating good clinical usefulness.

Conclusion

Our prediction models could support policymakers in developing strategies for the optimal management of hip fracture patients, with a particular emphasis on individuals at high risk of prolonged LOS.
Acellular dermal matrix for one-stage treatment of lower extremity full-thickness skin defect: a case series
Authors: Li Gongchi , Shen Qian , Zhou Pan , Liu Hanlin , Chen Jianghai
Published: January 2023

Background

Self-repair of lower limb wounds has always been one of the research hotspots. Flaps and skin graft are the preferred treatment for lower extremity wound reconstruction. However, these treatments have many disadvantages, such as secondary damage, poor healing quality. In recent years, the use of acellular dermal matrix has emerged as an alternative treatment option for extremity ulcers.

Methods

This study aimed to explore whether acellular dermal matrix can be used as a single treatment to promote wound healing. 7 patients with lower extremities cutaneous deficiency exposing bone or tendon, were covered by Pelnac, which was an acellular dermal matrix product approved by China Food and Drug Administration. All the wound was treated by Pelnac without flaps and skin graft. The external dressing was changed every 10 days.

Results

After a maximum of 20 weeks, all the wounds were completely healed. During the 12 months follow-up period none of the patients developed skin wear on the treatment area. All patients maintained their postoperative ambulatory ability. All patients were satisfied with the appearance and feeling after wound healing.

Conclusion

These findings may mean acellular dermal matrix is a novel method offering opportunity for treatment of lower extremities cutaneous deficiency exposing bone or tendon. It also has the potential to close wounds of all uninfected, non-ischemic, full-thickness cutaneous deficiency.
Retreatment of XP-endo Shaper and R-Endo files in curved root canals
Authors: Hassan Hayam Y. , Hadhoud Fahd M. , Mandorah Ayman
Published: January 2023

Objectives

To compare the retreatment efficiency of XP-endo Shaper and R-Endo files in curved root canals using ImageJ software.

Methods

Forty extracted mandibular first molars with curved mesial canals (25°–35°) were chosen. Access cavities, preparation and obturation of root canals were performed. Roots were randomly distributed into two groups corresponding to the retreatment files used. Group 1 retreated with XP-endo Shaper file, and group 2 retreated with R-Endo files. Each root was sectioned and photographed. ImageJ software was used to estimate the percentage of residual filling material that existed on the three root canal segments. Mann–Whitney U and the Kruskal–Wallis tests were used to compare the percentages of residual filling material between the teeth segments (P < .05).

Results

The R-Endo group showed a significantly higher median percentage of residual filling material than the XP-endo Shaper group. In both groups, the coronal segments had the highest median of the residual filling material, followed by the middle and apical segments.

Conclusion

XP-endo Shaper is significantly more effective than R-Endo in removing root canal filling materials in the coronal, middle, and apical segments.
Comparative evaluation of caries prevalence among group of Egyptian adolescents using DMFS and ICDASII methods: a cross-sectional study
Authors: Zaazou Mohamed. H. , Zaki Dalia Y. , Abdelnabi Ali , Hamdy Tamer M. , Saleh Reham S. , Hassan Shahinaz N. , Zaki Zeinab M. , Moharam Lamiaa M.
Published: January 2023

Background

Limited data is available regarding the prevalence of dental caries as a chronic disease among adolescents using different caries assessment indices. The aim of this study was to compare and describe the prevalence of dental caries among group of Egyptian students using two caries assessment indices; DMFS and ICDAS II.

Methods

This descriptive, cross-sectional epidemiological study included 2760 public secondary school students with age range from 15 to 18 years with permanent dentition and good general health. Presence of; retained teeth, congenital or developmental anomalies in the permanent dentition, orthodontic treatments, systematic conditions, smoking and general health problems were considered the exclusion criteria in this study. Participants were selected randomly from 8 public secondary schools in the Great Cairo, Egypt. The examination was achieved by 6 trained and previously calibrated examiners using sets of diagnostic mirrors, compressed air, a WHO probe and cotton rolls. DMFS index and ICDAS II system were used as caries detection methods. In DMFS index; the number of decayed (D), missing (M) and filled (F) surfaces was recorded, while in the ICDAS II index, the assessment of both cavitated and non-cavitated carious, missed and filled teeth with restorations /sealants was recorded. The examiners performed the oral examination using both scoring systems in an alternating manner. The collected data were explored for normality using Kolmogorov–Smirnov and Shapiro–Wilk tests. Chi square test was used to analyze the frequencies.

Results

There was a statistical significant difference between the DMFS and ICDAS II methods results regarding the recorded number of caries affected teeth and cavitated teeth surfaces. The prevalence of dental caries among the investigated secondary school students was (69.56%) and (78.29%) for DMFS and ICDAS II, respectively.

Conclusions

The prevalence of dental caries among Egyptian adolescent is high. ICDAS scoring system revealed higher caries prevalence values than DMFS method. ICDAS method is the best choice for the preventive goals, while DMFS is sufficient for clinical purposes.
Public stigma and treatment preferences for alcohol use disorders
Authors: Finn Sara Wallhed , Mejldal Anna , Nielsen Anette Søgaard
Published: January 2023

Background

Alcohol use disorders (AUD) are among the most highly stigmatized medical conditions. Only a minority of individuals with AUD seek treatment, and stigma is one of the most prominent barriers to treatment-seeking. However, there is a lack of knowledge about the associations between stigma and preferences for help-seeking, and the associations between stigma and preferences for treatment seeking.

Aim

to investigate the associations between stigma and preferences for where to seek help and treatment for AUD. As sub-analyses, associations between stigma, level of alcohol use and preferences for help-seeking and treatment preferences will be analyzed.

Method

Cross-sectional design, including n = 3037 participants aged 30 – 65 years, living in Denmark. Data: In 2020, an online questionnaire was administered by a market research company. The questionnaire covered demographics, preferences for help-seeking and treatment for AUD, stigma measured with the Difference, Disdain & Blame Scales for Public Stigma, and alcohol use measured with the Alcohol Use Disorder Test (AUDIT). Analyses: restricted cubic spline models were applied to model outcomes. Odds ratios were calculated.

Results

A lower level of stigma was associated with a higher probability of preferring formal and informal help-seeking for AUD. Both high and low levels of stigma were associated with a higher probability of preferring to consult general practitioners. Stigma was not associated with other preferences for treatment-seeking, nor trying to change oneself or a passive strategy. The sub-analyses, grouped by level of alcohol use, showed similar results.

Conclusion

Stigma is associated with lower preferences for formal and informal help-seeking, however not type of treatment preferred. Future studies should address stigma in relation to other factors of the treatment-seeking process.
Contraceptive stockouts in Western Kenya: a mixed-methods mystery client study
Authors: Tumlinson Katherine , Britton Laura E. , Goland Emilia , Chung Stephanie , Bullington Brooke W. , Williams Caitlin R. , Wambua Debborah Muthoki , Onyango Dickens Otieno , Senderowicz Leigh
Published: January 2023

Background

The prevalence of modern contraception use is higher in Kenya than in most countries in Sub-Saharan Africa. The uptake has however slowed down in recent years, which, among other factors, has been attributed to challenges in the supply chain and increasing stockouts of family planning commodities. Research on the frequency of contraceptive stockouts and its consequences for women in Kenya is still limited and mainly based on facility audits.

Methods

This study employs a set of methods that includes mystery clients, focus group discussions, key informant interviews, and journey mapping workshops. Using this multi-method approach, we aim to quantify the frequency of method denial resulting from contraceptive stockout and describe the impact of stockouts on the lived experiences of women seeking contraception in Western Kenya.

Results

Contraceptives were found to be out of stock in 19% of visits made to health facilities by mystery clients, with all contraceptive methods stocked out in 9% of visits. Women experienced stockouts as a sizeable barrier to accessing their preferred method of contraception and a reason for taking up non-preferred methods, which has dire consequences for heath, autonomy, and the ability to prevent unintended pregnancy. Reasons for contraceptive stockouts are many and complex, and often linked to challenges in the supply chain – including inefficient planning, procurement, and distribution of family planning commodities.

Conclusions

Contraceptive stockouts are frequent and negatively impact patients, providers, and communities. Based on the findings of this study, the authors identify areas where funding and sustained action have the potential to ameliorate the frequency and severity of contraceptive stockouts, including more regular deliveries, in-person data collection, and use of data for forecasting, and point to areas where further research is needed.
Aedes aegypti exhibits a distinctive mode of late ovarian development
Authors: Zhang Heng , Goh Feng Guang , Ng Lee Ching , Chen Chun Hong , Cai Yu
Published: January 2023

Background

Insects live in almost every habitat on earth. To adapt to their diverse environments, insects have developed a myriad of different strategies for reproduction reflected in diverse anatomical and behavioral features that the reproductive systems of females exhibit. Yet, ovarian development remains largely uncharacterized in most species exceptDrosophila melanogaster(D. melanogaster), a high Diptera model. In this study, we investigated the detailed developmental process of the ovary inAedes aegypti(Ae. aegypti), a major vector of various disease-causing pathogens that inhabits tropical and subtropical regions.

Results

Compared withDrosophila melanogaster, a model of higher Diptera, the processes of pole cell formation and gonad establishment during embryonic stage are highly conserved inAe. aegypti. However,Ae. aegyptiutilizes a distinct strategy to form functional ovaries during larval/pupal development. First, during larval stage,Ae. aegyptiprimordial germ cells (PGCs) undergo a cyst-like proliferation with synchronized divisions and incomplete cytokinesis, leading to the formation of one tightly packed “PGC mass” containing several interconnected cysts, different fromD. melanogasterPGCs that divide individually. This cyst-like proliferation is regulated by the target of rapamycin (TOR) pathway upon nutritional status. Second, ecdysone-triggered ovariole formation during metamorphosis exhibits distinct events, including “PGC mass” breakdown, terminal filament cell degeneration, and pre-ovariole migration. These unique developmental features might explain the structural and behavioral differences betweenAedesandDrosophilaovaries. Importantly, both cyst-like proliferation and distinct ovariole formation are also observed inCulex quinquefasciatusandAnopheles sinensis, suggesting a conserved mode of ovarian development among mosquito species. In comparison withDrosophila, the ovarian development inAedesand other mosquitoes might represent a primitive mode in the lower Diptera.

Conclusions

Our study reveals a new mode of ovarian development in mosquitoes, providing insights into a better understanding of the reproductive system and evolutionary relationship among insects.
Starch intake, amylase gene copy number variation, plasma proteins, and risk of cardiovascular disease and mortality
Authors: Li Huiping , Borné Yan , Wang Yaogang , Sonestedt Emily
Published: January 2023

Background

Salivary amylase, encoded by theAMY1gene, initiate the digestion of starch. Whether starch intake orAMY1copy number is related to disease risk is currently rather unknown. The aim was to investigate the association between starch intake andAMY1copy number and risk of cardiovascular disease (CVD) and mortality and whether there is an interaction. In addition, we aim to identify CVD-related plasma proteins associated with starch intake andAMY1copy number.

Methods

This prospective cohort study used data from 21,268 participants from the Malmö Diet and Cancer Study. Dietary data were collected through a modified diet history method and incident CVD and mortality were ascertained through registers.AMY1gene copy number was determined by droplet digital polymerase chain reaction, a risk score of 10 genetic variants inAMY1was measured, and a total of 88 selected CVD-related proteins were measured. Cox proportional hazards regression was used to analyze the associations of starch intake andAMY1copy number with disease risk. Linear regression was used to identify plasma proteins associated with starch intake andAMY1copy number.

Results

Over a median of 23 years’ follow-up, 4443 individuals developed CVD event and 8125 died. After adjusting for potential confounders, a U-shape association between starch intake and risk of CVD (P-nonlinearity = 0.001) and all-cause mortality (P-nonlinearity = 0.03) was observed. No significant association was found betweenAMY1copy number and risk of CVD and mortality, and there were no interactions between starch intake andAMY1copy number (Pinteraction > 0.23). Among the 88 plasma proteins, adrenomedullin, interleukin-1 receptor antagonist protein, fatty acid-binding protein, leptin, and C-C motif chemokine 20 were associated with starch intake after adjusting for multiple testing.

Conclusions

In this large prospective study among Swedish adults, a U-shaped association between starch intake and risk of CVD and all-cause mortality was found. Several plasma proteins were identified which might provide information on potential pathways for such association.AMY1copy number was not associated with CVD risk or any of the plasma proteins, and there was no interaction between starch intake andAMY1copy number on disease risk.
Faecal haemoglobin concentrations are associated with all-cause mortality and cause of death in colorectal cancer screening
Authors: Kaalby Lasse , Deding Ulrik , Al-Najami Issam , Berg-Beckhoff Gabriele , Bjørsum-Meyer Thomas , Laurberg Tinne , Shaukat Aasma , Steele Robert J. C. , Koulaouzidis Anastasios , Rasmussen Morten , Kobaek-Larsen Morten , Baatrup Gunnar
Published: January 2023

Background

Colorectal cancer (CRC) screening reduces all-cause and CRC-related mortality. New research demonstrates that the faecal haemoglobin concentration (f-Hb) may indicate the presence of other serious diseases not related to CRC. We investigated the association between f-Hb, measured by a faecal immunochemical test (FIT), and both all-cause mortality and cause of death in a population-wide cohort of screening participants.

Methods

Between 2014 and 2018, 1,262,165 participants submitted a FIT for the Danish CRC screening programme. We followed these participants, using the Danish CRC Screening Database and several other national registers on health and population, until December 31, 2018. We stratified participants by f-Hb and compared them using a Cox proportional hazards regression on all-cause mortality and cause of death reported as adjusted hazard ratios (aHRs). We adjusted for several covariates, including comorbidity, socioeconomic factors, demography and prescription medication.

Results

We observed 21,847 deaths in the study period. Our multivariate analyses indicated an association relationship between increasing f-Hb and the risk of dying in the study period. This risk increased steadily from aHR 1.38 (95% CI: 1.32, 1.44) in those with a f-Hb of 7.1–11.9 μg Hb/g faeces to 2.20 (95% CI: 2.10, 2.30) in those with a f-Hb ≥60.0 μg Hb/g faeces, when compared to those with a f-Hb ≤7.0 μg Hb/g faeces. The pattern remained when excluding CRC from the analysis. Similar patterns were observed between incrementally increasing f-Hb and the risk of dying from respiratory disease, cardiovascular disease and cancers other than CRC. Furthermore, we observed an increased risk of dying from CRC with increasing f-Hb.

Conclusions

Our findings support the hypothesis that f-Hb may indicate an elevated risk of having chronic conditions if causes for the bleeding have not been identified. The mechanisms still need to be established, but f-Hb may be a potential biomarker for several non-CRC diseases.
Nasal TSLP and periostin in infants with severe bronchiolitis and risk of asthma at 4 years of age
Authors: Garcia-Garcia Maria Luz , Sastre Beatriz , Arroyas Maria , Beato Maite , Alonso Patricia , Rodrigo-Muñoz José Manuel , Del Pozo Victoria , Casas Inmaculada , Calvo Cristina
Published: January 2023

Background

Severe bronchiolitis is often associated with subsequent respiratory morbidity, mainly recurrent wheezing and asthma. However, the underlying immune mechanisms remain unclear. The main goal of this study was to investigate the association of nasal detection of periostin and thymic stromal lymphopoietin (TSLP) during severe bronchiolitis with the development of asthma at 4 years of age.

Methods

Observational, longitudinal, post-bronchiolitis, hospital-based, follow-up study. Children hospitalized for bronchiolitis between October/2013 and July/2017, currently aged 4 years, included in a previous study to investigate the nasal airway secretion of TSLP and periostin during bronchiolitis, were included. Parents were contacted by telephone, and were invited to a clinical interview based on a structured questionnaire to obtain information on the respiratory evolution. The ISAAC questionnaire for asthma symptoms for 6–7-year-old children, was also employed.

Results

A total of 248 children were included (median age 4.4 years). The mean age at admission for bronchiolitis was 3.1 (IQR: 1.5–6.5) months. Overall, 21% had ever been diagnosed with asthma and 37% had wheezed in the last 12 months. Measurable nasal TSLP was detected at admission in 27(11%) cases and periostin in 157(63%). The detection of nasal TSLP was associated with the subsequent prescription of maintenance asthma treatment (p = 0.04), montelukast (p = 0.01), and the combination montelukast/inhaled glucocorticosteroids (p = 0.03). Admissions for asthma tended to be more frequent in children with TSLP detection (p = 0.07). In the multivariate analysis, adjusting for potential confounders, the detection of TSLP remained independently associated with chronic asthma treatment prescription (aOR:2.724; CI 1.051–7.063, p:0.04) and with current asthma (aOR:3.41; CI 1.20–9.66, p:0.02).

Nasal detection of periostin was associated with lower frequency of ever use of short-acting beta2-agonists (SABA) (p = 0.04), lower prevalence of current asthma (p = 0.02), less prescription of maintenance asthma treatment in the past 12 months (p = 0.02, respectively). In the multivariate analysis, periostin was associated with lower risk of asthma at 4 years, independently of the atopic status (aOR:0.511 CI 95% 0.284–0.918, p:0.025).

Conclusions

Our results show a positive correlation between nasal TSLP detection in severe bronchiolitis and the presence of current asthma, prescription of asthma maintenance treatment and respiratory admissions up to the age of 4 years. By contrast, we found a protective association between nasal periostin detection and current asthma at 4 years, ever diagnosis of asthma, maintenance asthma treatment prescription, and respiratory admissions.
Action on the social determinants for advancing health equity in the time of COVID-19: perspectives of actors engaged in a WHO Special Initiative
Authors: Solar Orielle , Valentine Nicole , Castedo Antia , Brandt Gonzalo Soto , Sathyandran Jaitra , Ahmed Zahra , Cheh Paul , Callon Emma , Porritt Felicity , Espinosa Isabel , Fortune Kira , Kubota Shogo , Elliott Elizabeth , David April Joy , Bigdeli Maryam , Hachri Hafid , Bodenmann Patrick , Morisod Kevin , Biehl Molly , Nambiar Devaki , Williams Carmel , Allen Jessica , Goldblatt Peter , Placella Erika , Marmot Michael , Rasanathan Kumanan
Published: January 2023

Since the 2008 publication of the reports of the Commission on Social Determinants of Health and its nine knowledge networks, substantial research has been undertaken to document and describe health inequities. The COVID-19 pandemic has underscored the need for a deeper understanding of, and broader action on, the social determinants of health. Building on this unique and critical opportunity, the World Health Organization is steering a multi-country Initiative to reduce health inequities through an action-learning process in ‘Pathfinder’ countries. The Initiative aims to develop replicable and reliable models and practices that can be adopted by WHO offices and UN staff to address the social determinants of health to advance health equity. This paper provides an overview of the Initiative by describing its broad theory of change and work undertaken in three regions and six Pathfinder countries in its first year-and-a-half. Participants engaged in the Initiative describe results of early country dialogues and promising entry points for implementation that involve model, network and capacity building. The insights communicated through this note from the field will be of interest for others aiming to advance health equity through taking action on the social determinants of health, in particular as regards structural determinants.
Radiogenomic analysis of prediction HER2 status in breast cancer by linking ultrasound radiomic feature module with biological functions
Authors: Cui Hao , Sun Yue , Zhao Dantong , Zhang Xudong , Kong Hanqing , Hu Nana , Wang Panting , Zuo Xiaoxuan , Fan Wei , Yao Yuan , Fu Baiyang , Tian Jiawei , Wu Meixin , Gao Yue , Ning Shangwei , Zhang Lei
Published: January 2023

Background

Human epidermal growth factor receptor 2 (HER2) overexpressed associated with poor prognosis in breast cancer and HER2 has been defined as a therapeutic target for breast cancer treatment. We aimed to explore the molecular biological information in ultrasound radiomic features (URFs) of HER2-positive breast cancer using radiogenomic analysis. Moreover, a radiomics model was developed to predict the status of HER2 in breast cancer.

Methods

This retrospective study included 489 patients who were diagnosed with breast cancer. URFs were extracted from a radiomics analysis set using PyRadiomics. The correlations between differential URFs and HER2-related genes were calculated using Pearson correlation analysis. Functional enrichment of the identified URFs-correlated HER2 positive-specific genes was performed. Lastly, the radiomics model was developed based on the URF-module mined from auxiliary differential URFs to assess the HER2 status of breast cancer.

Results

Eight differential URFs (p < 0.05) were identified among the 86 URFs extracted by Pyradiomics. 25 genes that were found to be the most closely associated with URFs. Then, the relevant biological functions of each differential URF were obtained through functional enrichment analysis. Among them, Zone Entropy is related to immune cell activity, which regulate the generation of calcification in breast cancer. The radiomics model based on the Logistic classifier and URF-module showed good discriminative ability (AUC = 0.80, 95% CI).

Conclusion

We searched for the URFs of HER2-positive breast cancer, and explored the underlying genes and biological functions of these URFs. Furthermore, the radiomics model based on the Logistic classifier and URF-module relatively accurately predicted the HER2 status in breast cancer.
A novel mutation in the proteoglycan 4 gene causing CACP syndrome: two sisters report
Authors: Bağrul İlknur , Ceylaner Serdar , Yildiz Yasemin Tasci , Tuncez Serife , Aydin Elif Arslanoglu , Bağlan Esra , Ozdel Semanur , Bülbül Mehmet
Published: January 2023

Background

Camptodactyly-arthropathy-coxa vara-pericarditis (CACP) syndrome, caused by biallelic pathogenic mutations in the proteoglycan 4 (PRG4) gene, is characterized by early-onset camptodactyly, noninflammatory arthropathy, coxa vara deformity, and rarely, pericardial effusion. This syndrome can mimic juvenile idiopathic arthritis. CACP syndrome is caused by mutations in the proteoglycan 4 (PRG4) gene. To date, only 36 pathogenic mutations have been reported in this gene, but none have been reported from Azerbaijan.

Case presentation

Herein, we report two siblings presented with chronic polyarthritis, had a prior diagnosis of juvenile idiopathic arthritis, but was subsequently diagnosed as CACP syndrome with novel mutation in the PRG4 gene.

Conclusion

Our report expands the knowledge of PRG4 mutations, which will aid in CACP patient counseling.
Conspiracy beliefs and COVID-19 guideline adherence in adolescent psychiatric outpatients: the predictive role of adverse childhood experiences
Authors: Goreis Andreas , Pfeffer Bettina , Zesch Heidi Elisabeth , Klinger Diana , Reiner Tamara , Bock Mercedes M. , Ohmann Susanne , Sackl-Pammer Petra , Werneck-Rohrer Sonja , Eder Harald , Skala Katrin , Czernin Klara , Mairhofer Dunja , Rohringer Bernhard , Bedus Carolin , Lipp Ronja , Vesely Christine , Plener Paul L. , Kothgassner Oswald D.
Published: January 2023

Background

Conspiracy beliefs have become widespread throughout the COVID-19 pandemic. Previous studies have shown that endorsing conspiracy beliefs leads to lower protective guideline adherence (i.e., wearing face masks), posing a threat to public health measures. The current study expands this research across the lifespan, i.e., in a sample of adolescents with mental health problems. Here, we investigated the association between conspiracy beliefs and guideline adherence while also exploring the predictors of conspiracy beliefs.

Methods

N = 93 adolescent psychiatric outpatients (57% female, mean age: 15.8) were assessed using anonymous paper–pencil questionnaires. Endorsement of generic and COVID-19 conspiracy beliefs was assessed, in addition to items measuring adherence to protective guidelines and mental health (stress, depressive symptoms, emotional/behavioral problems, and adverse childhood experiences). Multiple regressions and supervised machine learning (conditional random forests) were used for analyses.

Results

Fourteen percent of our sample fully endorsed at least one COVID-19 conspiracy theory, while protective guidelines adherence was relatively high (M = 4.92, on a scale from 1 to 7). The endorsement of COVID-19 conspiracy beliefs—but not of generic conspiracy beliefs—was associated with lower guideline adherence (β = − 0.32, 95% CI − 0.53 to − 0.11, p < .001). Conditional random forests suggested that adverse childhood experiences and peer and conduct problems were relevant predictors of both conspiracy belief categories.

Conclusion

While a significant proportion of our sample of adolescents in psychiatric treatment endorsed conspiracy beliefs, the majority did not. Furthermore, and to some degree, contrary to public perception, we found that adolescents show relatively good adherence to public health measures—even while experiencing a high degree of mental distress. The predictive value of adverse childhood experiences and peer/conduct problems for conspiracy beliefs might be explained by compensatory mechanisms to ensure the safety, structure, and inclusion that conspiracies provide.
A model for predicting both breast cancer risk and non-breast cancer death among women > 55 years old
Authors: Schonberg Mara A. , Wolfson Emily A. , Eliassen A. Heather , Bertrand Kimberly A. , Shvetsov Yurii B. , Rosner Bernard A. , Palmer Julie R. , Ngo Long H.
Published: January 2023

Background

Guidelines recommend shared decision making (SDM) for mammography screening for women ≥ 75 and not screening women with < 10-year life expectancy. High-quality SDM requires consideration of women’s breast cancer (BC) risk, life expectancy, and values but is hard to implement because no models simultaneously estimate older women’s individualized BC risk and life expectancy.

Methods

Using competing risk regression and data from 83,330 women > 55 years who completed the 2004 Nurses’ Health Study (NHS) questionnaire, we developed (in 2/3 of the cohort, n = 55,533) a model to predict 10-year non-breast cancer (BC) death. We considered 60 mortality risk factors and used best-subsets regression, the Akaike information criterion, and c-index, to identify the best-fitting model. We examined model performance in the remaining 1/3 of the NHS cohort (n = 27,777) and among 17,380 Black Women’s Health Study (BWHS) participants, ≥ 55 years, who completed the 2009 questionnaire. We then included the identified mortality predictors in a previously developed competing risk BC prediction model and examined model performance for predicting BC risk.

Results

Mean age of NHS development cohort participants was 70.1 years (± 7.0); over 10 years, 3.1% developed BC, 0.3% died of BC, and 20.1% died of other causes; NHS validation cohort participants were similar. BWHS participants were younger (mean age 63.7 years [± 6.7]); over 10-years 3.1% developed BC, 0.4% died of BC, and 11.1% died of other causes. The final non-BC death prediction model included 21 variables (age; body mass index [BMI]; physical function [3 measures]; comorbidities [12]; alcohol; smoking; age at menopause; and mammography use). The final BC prediction model included age, BMI, alcohol and hormone use, family history, age at menopause, age at first birth/parity, and breast biopsy history. When risk factor regression coefficients were applied in the validation cohorts, the c-index for predicting 10-year non-BC death was 0.790 (0.784–0.796) in NHS and 0.768 (0.757–0.780) in BWHS; for predicting 5-year BC risk, the c-index was 0.612 (0.538–0.641) in NHS and 0.573 (0.536–0.611) in BWHS.

Conclusions

We developed and validated a novel competing-risk model that predicts 10-year non-BC death and 5-year BC risk. Model risk estimates may help inform SDM around mammography screening.