bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of venous and pooled capillary hemoglobin levels for the detection of anemia among adolescent girls
Authors: Jenkins Mica , Amoaful Esi Foriwa , Abdulai Mutala , Quartey Veronica , Situma Ruth , Ofosu-Apea Porbilla , Aballo Jevaise , Demuyakor Maku E. , Gosdin Lucas , Mapango Carine , Jefferds Maria Elena D. , Addo O. Yaw
Published: June 2024

Introduction

Blood source is a known preanalytical factor affecting hemoglobin (Hb) concentrations, and there is evidence that capillary and venous blood may yield disparate Hb levels and anemia prevalence. However, data from adolescents are scarce.

Objective

To compare Hb and anemia prevalence measured by venous and individual pooled capillary blood among a sample of girls aged 10–19 years from 232 schools in four regions of Ghana in 2022.

Methods

Among girls who had venous blood draws, a random subsample was selected for capillary blood. Hb was measured using HemoCue® Hb-301. We used Lin’s concordance correlation coefficient (CCC) to quantify the strength of the bivariate relationship between venous and capillary Hb and a paired t-test for difference in means. We used McNemar’s test for discordance in anemia cases by blood source and weighted Kappa to quantify agreement by anemia severity. A multivariate generalized estimating equation was used to quantify adjusted population anemia prevalence and assess the association between blood source and predicted anemia risk.

Results

We found strong concordance between Hb measures (CCC = 0.86). The difference between mean venous Hb (12.8 g/dL, ± 1.1) and capillary Hb (12.9 g/dL, ± 1.2) was not significant (p = 0.26). Crude anemia prevalence by venous and capillary blood was 20.6% and 19.5%, respectively. Adjusted population anemia prevalence was 23.5% for venous blood and 22.5% for capillary (p = 0.45). Blood source was not associated with predicted anemia risk (risk ratio: 0.99, 95% CI: 0.96, 1.02). Discordance in anemia cases by blood source was not significant (McNemar p = 0.46). Weighted Kappa demonstrated moderate agreement by severity (ĸ = 0.67). Among those with anemia by either blood source (n = 111), 59% were identified by both sources.

Conclusion

In Ghanaian adolescent girls, there was no difference in mean Hb, anemia prevalence, or predicted anemia risk by blood source. However, only 59% of girls with anemia by either blood source were identified as having anemia by both sources. These findings suggest that pooled capillary blood may be useful for estimating Hb and anemia at the population level, but that caution is needed when interpreting individual-level data.
Associations of ω-3, ω-6 polyunsaturated fatty acids intake and ω-6: ω-3 ratio with systemic immune and inflammatory biomarkers: NHANES 1999-2020
Authors: Li Yifan , Tang Hao , Yang Xiaotong , Ma Lili , Zhou Hangqi , Zhang Guangjiang , Chen Xin , Ma Lijun , Gao Jing , Ji Wei
Published: June 2024

Background

In recent years, diseases caused by abnormal immune-inflammatory responses have become increasingly severe. Dietary intervention involving omega-3 polyunsaturated fatty acids (ω-3 PUFAs) has emerged as a potential treatment. However, research investigating the relationship between ω-3, ω-6 PUFAs, and ω-6 to ω-3 ratio with inflammatory biomarkers remains controversial.

Methods

To investigate the correlation between the intake of ω-3 and ω-6 PUFAs and the ratio of ω-6: ω-3 with biomarkers of inflammation, the National Health and Nutrition Examination Survey (NHANES) data (1999 to 2020) was utilized. The systemic immune-inflammation index (SII), platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and white blood cell (WBC) were selected as study subjects. Dietary data for ω-3 and ω-6 PUFAs were collected via two 24-h dietary recall interviews. SII index and other indicators were obtained from the blood routine data. The multiple linear regression and restricted cubic spline models were utilized to evaluate the association of ω-3, ω-6 PUFAs intake, and ω-6: ω-3 ratio to SII and secondary measures.

Results

This study involved a total of 43,155 American adults. ω-3 and ω-6 PUFAs exhibited negative correlations with SII, PLR, NLR, and WBC. The correlation between ω-6: ω-3 ratio and SII, PLR, NLR, and WBC was not significant. Furthermore, the dose–response relationship showed that the relationship between the intake of ω-3 and ω-6 PUFAs and SII was an “L” pattern.

Conclusion

Intake of dietary ω-3 and ω-6 PUFAs reduces the levels of several inflammatory biomarkers in the body and exerts immunomodulatory effects.
Analysis of factors associated with positive surgical margins and the five-year survival rate after prostate cancer resection and predictive modeling
Authors: Li Kai , Zhang Yantao , Tian Sinan , Su Qingguo , Mei Yanhui , Shi Wei , Cao Jingyuan , Song Lijuan
Published: June 2024

Background

This study analyzed the risk factors associated with positive surgical margins (PSM) and five-year survival after prostate cancer resection to construct a positive margin prediction model.

Methods

We retrospectively analyzed the clinical data of 148 patients treated with prostatectomy. The patients were divided into PSM group and Negative surgical margins (NSM) group. Several parameters were compared between the groups. All patients were followed up for 60 months. The risk factors for PSM and five-year survival were evaluated by univariate analysis, followed by multifactorial dichotomous logistic regression analysis. Finally, ROC curves were plotted for the risk factors to establish a predictive model for PSM after prostate cancer resection.

Results

(1) Serum PSA, percentage of positive puncture stitches, clinical stage, surgical approach, Gleason score on puncture biopsy, and perineural invasion were significantly associated with the risk of PSM (P < 0.05). Serum PSA, perineural invasion, Gleason score on puncture biopsy, and percentage of positive puncture stitches were independent risk factors for PSM. (2) Total prostate-specific antigen (tPSA) by puncture, nutritional status, lymph node metastasis, bone metastasis, and seminal vesicle invasion may be risk factors for five-year survival. Lymph node metastasis and nutritional status were the main risk factors for the five-year survival of patients with prostate cancer. (3) After plotting the ROC curve, the area under the curve (AUC) [AUC: 0.776, 95%, confidence interval (CI): 0.725 to 0.854] was found to be a valid predictor of PSM; the AUC [AUC: 0.664, 95%, confidence interval (CI): 0.576 to 0.753] was also a valid predictor of five-year survival (P < 0.05). (4) The scoring system had a standard error of 0.02 and a cut-off value of 6. It predicted PSM after prostate cancer resection with moderate efficacy.

Conclusions

Serum PSA, perineural invasion, puncture biopsy Gleason score, and percentage of positive puncture stitches were independent risk factors for positive surgical margins (PSM). Also, lymph node metastasis and nutritional status were the main risk factors for the five-year survival of patients with prostate cancer. Overall, the prediction efficacy of this scoring system concerning the risk of PSM after prostate cancer resection was moderate.
Improved survival of locoregional-advanced larynx and hypopharynx cancer patients treated according to the DeLOS-II protocol
Authors: Wichmann Gunnar , Wald Theresa , Pirlich Markus , Stoehr Matthaeus , Zebralla Veit , Kuhnt Thomas , Nicolay Nils Henrik , Hambsch Peter , Krücken Irene , Hoffmann Karl-Titus , Lordick Florian , Kluge Regine , Wiegand Susanne , Dietz Andreas
Published: June 2024

Introduction

Larynx organ preservation (LOP) in locoregional-advanced laryngeal and hypopharyngeal squamous cell carcinoma (LA-LHSCC) being only R0-resectable (clear margins > 5 mm) by total laryngectomy (TL) is desirable. Based on tumor-specific survival (TSS) and overall survival (OS) data from the RTOG 91-11 trial and meta-analyses of randomized clinical trials (RCTs), cisplatin-based concurrent radiochemotherapy (CRT) is discussed being superior to cisplatin-based induction chemotherapy followed by radiotherapy (IC+RT) and TL followed by postoperative RT (TL+PORT) or radiochemotherapy (TL+PORCT). Outside of RCTs, T4 LHSCC treated with TL+PORCT demonstrated improved OS and TSS compared to CRT alone; comparisons with docetaxel plus cisplatin (TP)-based IC+RT are unpublished. Head-to-head comparisons in RCTs of these four alternatives are missing.

Materials and methods

We utilized monocentric registry data to compare the outcome in the LOP trial DeLOS-II (NCT00508664) and propensity score (PS)–matched LHSCC patients. DeLOS-II utilized endoscopic tumor staging after one cycle of TP-based IC for selecting TL+R(C)T for non-responders versus IC+RT for responders. Main risk factors for survival (localization hypopharynx, T4, N+, tobacco smoking >30 pack years, alcohol consumption >60 g/day, age, sex) were used to calculate the individual PS for each DeLOS-II patient and 330 LHSCC patients suitable for DeLOS-II according to eligibility criteria in Leipzig by CRT (78), TL+PORT (148), and TL+PORCT (104). We performed PS matching with caliper width 0.2.

Results

The 52 DeLOS-II patients (whole intent-to-treat cohort) and three PS-matched cohorts (52 LHSCC patients each) had equal distribution regarding risk factors including Charlson comorbidity score (CS; all p > 0.05) but differed in outcome. During 12,498.6 months of follow-up, 162 deaths (36/41/43/42 in DeLOS-II/TL+PORCT/TL+PORT/CRT, p = 0.356) occurred; DeLOS-II patients had superior OS and TSS. Compared to DeLOS-II, the HR (95% CI) observed in TL+PORCT, TL+PORT, and CRT for OS and TSS were 1.49 (0.92–2.43), 1.49 (1.15–3.18), and 1.81 (1.11–2.96) for OS; and 2.07 (0.944–4.58), 3.02 (1.32–6.89), and 3.40 (1.58–7.31) for TSS.

Conclusion

In addition potential LOP, LA-LHSCC suitable for LOP according the DeLOS-II protocol may achieve improved survival.
Construction of a novel nomogram for predicting overall survival in patients with Siewert type II AEG based on LODDS: a study based on the seer database and external validation
Authors: Yu Xiaohan , Bai Chenglin , Yu Yang , Guo Xianzhan , Wang Kang , Yang Huimin , Luan Xiaodan
Published: June 2024

Background

In recent years, the incidence of adenocarcinoma of the esophagogastric junction (AEG) has been rapidly increasing globally. Despite advances in the diagnosis and treatment of AEG, the overall prognosis for AEG patients remains concerning. Therefore, analyzing prognostic factors for AEG patients of Siewert type II and constructing a prognostic model for AEG patients is important.

Methods

Data of primary Siewert type II AEG patients from the SEER database from 2004 to 2015 were obtained and randomly divided into training and internal validation cohort. Additionally, data of primary Siewert type II AEG patients from the China Medical University Dandong Central Hospital from 2012 to 2018 were collected for external validation. Each variable in the training set underwent univariate Cox analysis, and variables with statistical significance (p < 0.05) were added to the LASSO equation for feature selection. Multivariate Cox analysis was then conducted to determine the independent predictive factors. A nomogram for predicting overall survival (OS) was developed, and its performance was evaluated using ROC curves, calibration curves, and decision curves. NRI and IDI were calculated to assess the improvement of the new prediction model relative to TNM staging. Patients were stratified into high-risk and low-risk groups based on the risk scores from the nomogram.

Results

Age, Differentiation grade, T stage, M stage, and LODDS (Log Odds of Positive Lymph Nodes)were independent prognostic factors for OS. The AUC values of the ROC curves for the nomogram in the training set, internal validation set, and external validation set were all greater than 0.7 and higher than those of TNM staging alone. Calibration curves indicated consistency between the predicted and actual outcomes. Decision curve analysis showed moderate net benefit. The NRI and IDI values of the nomogram were greater than 0 in the training, internal validation, and external validation sets. Risk stratification based on the nomogram’s risk score demonstrated significant differences in survival rates between the high-risk and low-risk groups.

Conclusion

We developed and validated a nomogram for predicting overall survival (OS) in patients with Siewert type II AEG, which assists clinicians in accurately predicting mortality risk and recommending personalized treatment strategies.
Honghua Xiaoyao tablet combined with estradiol improves ovarian function in D-galactose-induced aging mice by reducing apoptosis and affecting the release of reproductive hormones: an in vivo study
Authors: Su Chan , Zhang Ruihong , Zhang Xiujuan , Feng Xiaoning , Wu Qiong , Gao Yiwei , Hao Jing , Mu Yu-lan
Published: June 2024

Context: It is very necessary to delay ovarian aging and prevent age-related health problems. The active ingredient in Honghua Xiaoyao tablet (HHXYT) has the effects of anti-oxidation, anti-inflammation, immune regulation and so on.

Objective: To explore the effect and mechanism of Honghua Xiaoyao tablet on aging model mice.

Materials and methods: The aging model was established by intraperitoneal injection of D-galactose in model mice. The mice in the HHXYT-L,M,H group were given 0.3 g/kg, 0.6 g/kg and 1.2 g/kg Honghua Xiaoyao tablet suspension respectively, and the HHXYT-M + E2 group was given 0.6 g/kg HHXYT +0.13 mg/kg estradiol valerate for 30 days. In this study, ELISA, HE, Western blot, IH and TUNEL were used.

Results: HHXYT + E2 can improve the gonadal index, estrous cycle of aging mice. In HHXYT-M + E2 group, the level of FSH and LH decreased, while E2 and AMH increased significantly. The number of growing follicles in HHXYT-M + E2 group increased, which was better than that of HHXYT alone. Western blot results showed that HHXYT-M + E2 group decreased the expression of Bax, cleaved-Parp, cleaved-Casp-3 and CytC molecules and increased the expression of Bcl-2 in ovarian tissue. FSHR expression decreased in model group and increased in HHXYT group. TUNEL staining showed that the number of apoptotic cells in HHXYT group was reduced, and the HHXYT-M + E2 group was the most significantly.

Discussion and conclusion: HHXYT can improve the level of sex hormones and increase the number of growing follicles in aging mice. HHXYT-M + E2 group has the best effect, and its mechanism may be related to reducing ovarian granulosa cell apoptosis.
A real-world data analysis of tirzepatide in the FDA adverse event reporting system (FAERS) database
Authors: Liu Liyuan
Published: June 2024

Background

Tirzepatide, a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist, is indicated for chronic weight management in adults with obesity or overweight as an adjunct to a reduced-calorie diet and increased physical activity. However, the safety profile of Tirzepatide-associated adverse events requires comprehensive evaluation.

Methods

The AE reports from the first quarter of 2022 to the third quarter of 2023 were selected by exploring the FDA Adverse Event Reporting System (FAERS) database. The new and unexpected potenial AE signals were detected using the disproportionality analysis, including reporting odds ratio(ROR), the proportional reporting ratio (PRR) the Bayesian confidence propagation neural network (BCPNN) and the empirical Bayes geometric mean(EBGM). Then the MedDRA was used to systematically classify the results.

Results

A total of 1,904,481 case reports were obtained from 2022Q2 to 2023Q3. Forty-sixth tirzepatide-induced ADRs at the preferred terms (PTs) level are associated with 8 system organ class In addition, this study uncovered multiple anticipated ADRs, such as gastrooesophageal reflux disease, dyspepsia, and vomiting, in line with the drug labels. Moreover, unexpected and significant ADRs at PTs level, such as incorrect dose administered, injection site haemorrhage, and increased appetite, were discovered and linked to Injury, poisoning, and procedural complications, General disorders and administration site conditions, and Metabolism and nutrition disorders at the System Organ Class level.

Conclusion

This study offered new perspectives on the monitoring, surveillance, and management of adverse drug reactions related to tirzepatide. The outcomes of severe adverse events and their respective detection signals, along with unexpected significant adverse event signals, are important to consider in efforts to enhance clinical medication safety when using tirzepatide.
Cost-effectiveness analysis of Anaprazole versus Ilaprazole for the treatment of duodenal ulcers in China
Authors: Ni Huitong , Shi Jiaqi , Hu Ming , Zhou Naitong , Yang Shu
Published: June 2024

Objective

Anaprazole, an innovative drug, has shown promise in initial clinical trials for patients with duodenal ulcers (DU) in China. This study aimed to evaluate the potential effects, safety, and cost-effectiveness of Anaprazole compared to Ilaprazole in the treatment of DU and the budgetary impact on the healthcare system.

Methods

Two multicentre, randomized controlled trials were used as data sources. The efficacy and safety of Anaprazole and Ilaprazole were compared using an anchored matching-adjusted indirect comparison (MAIC). A cost-utility analysis (CUA) was performed using a Markov model. A budget impact analysis (BIA) was conducted to evaluate the impact on the expenditure of the Chinese healthcare system. Deterministic and probabilistic sensitivity analyses were undertaken to test the uncertainty.

Results

The study findings indicated that Anaprazole and Ilaprazole have similar efficacy and safety in treating DU (OR = 1.05; 95% CI, 0.94–1.01; p = 0.35; OR = 0.63; 95% CI, 0.39–1.08; p = 0.12). The ICUR was 2,995.41¥/QALY, which is below the WTP threshold. The CUA results showed that Anaprazole is a cost-effective intervention with a probability of 85% at a given threshold. The results demonstrated strong robustness in the sensitivity analysis. Anaprazole imposed a low burden on the Chinese healthcare budget in the BIA.

Conclusion

Compared with Ilaprazole, Anaprazole has similar efficacy, safety, and high cost-effectiveness, while also impacting the total expenditure of the healthcare system.

Clinical Trial Registration:

ClinicalTrials.gov, identifier NCT04215653 and NCT02847455
Computational study of transcatheter aortic valve replacement based on patient-specific models—rapid surgical planning for self-expanding valves
Authors: Meng Zhuangyuan , Zhang Haishan , Cai Yunhan , Gao Yuan , Liang Changbin , Wang Jun , Chen Xin , Guo Liang , Wang ShengZhang
Published: June 2024

Transcatheter aortic valve replacement (TAVR) is a minimally invasive interventional solution for treating aortic stenosis. The complex post-TAVR complications are associated with the type of valve implanted and the position of the implantation. The study aimed to establish a rapid numerical research method for TAVR to assess the performance differences of self-expanding valves released at various positions. It also aimed to calculate the risks of postoperative paravalvular leak and atrioventricular conduction block, comparing these risks to clinical outcomes to verify the method’s effectiveness and accuracy. Based on medical images, six cases were established, including the aortic wall, native valve and calcification; one with a bicuspid aortic valve and five with tricuspid aortic valves. The parameters for the stent materials used by the patients were customized. High strain in the contact area between the stent and the valve annulus may lead to atrioventricular conduction block. Postoperatively, the self-expanding valve maintained a circular cross-section, reducing the risk of paravalvular leak and demonstrating favorable hemodynamic characteristics, consistent with clinical observations. The outcomes of the six simulations showed no significant difference in valve frame morphology or paravalvular leak risk compared to clinical results, thereby validating the numerical simulation process proposed for quickly selecting valve models and optimal release positions, aiding in TAVR preoperative planning based on patients’geometric characteristics.
Does late water deficit induce root growth or senescence in wheat?
Authors: Shazadi Kanwal , Christopher John T. , Chenu Karine
Published: June 2024

In crops like wheat, terminal drought is one of the principal stress factors limiting productivity in rain-fed systems. However, little is known about root development after heading, when water uptake can be critical to wheat crops. The impact of water-stress on root growth was investigated in two wheat cultivars, Scout and Mace, under well-watered and post-anthesis water stress in three experiments. Plants were grown outside in 1.5-m long pots at a density similar to local recommended farming practice. Differences in root development were observed between genotypes, especially for water stress conditions under which Scout developed and maintained a larger root system than Mace. While under well-watered conditions both genotypes had shallow roots that appeared to senesce after heading, a moderate water stress stimulated shallow-root growth in Scout but accelerated senescence in Mace. For deep roots, post-heading biomass growth was observed for both genotypes in well-watered conditions, while under moderate water stress, only Scout maintained net growth as Mace deep roots senesced. Water stress of severe intensity affected both genotypes similarly, with root senescence at all depths. Senescence was also observed above ground. Under well-watered conditions, Scout retained leaf greenness (i.e. stay-green phenotype) for slightly longer than Mace. The difference between genotypes accentuated under moderate water stress, with rapid post-anthesis leaf senescence in Mace while Scout leaf greenness was affected little if at all by the stress. As an overall result, grain biomass per plant (‘yield’) was similar in the two genotypes under well-watered conditions, but more affected by a moderate stress in Mace than Scout. The findings from this study will assist improvement in modelling root systems of crop models, development of relevant phenotyping methods and selection of cultivars with better adaptation to drought.
Ecosystem engineers can regulate resource allocation strategies in associated plant species
Authors: Yang Pengfei , Niu Mengqiu , Fu Quansheng , Qian Lishen , Huang Meihong , Li Zhimin , Sun Hang , Chen Jianguo
Published: June 2024

Balancing the biomass requirements of different functions for the purpose of population reproduction and persistence can be challenging for alpine plants due to extreme environmental stresses from both above- and below-ground sources. The presence of ecosystem engineers in alpine ecosystems effectively alleviates microenvironmental stresses, hence promoting the survival and growth of other less stress-tolerant species. However, the influence of ecosystem engineers on plant resource allocation strategies remains highly unexplored. In this study, we compared resource allocation strategies, including biomass accumulation, reproductive effort (RE), root fraction (RF), as well as relationships between different functions, among four alpine plant species belonging to Gentianaceae across bare ground, tussock grass-, cushion-, and shrub-engineered microhabitats. Shrub-engineered microhabitats exerted the strongest effects on regulating plant resource allocation patterns, followed by tussock grass- and cushion-engineered microhabitats. Additionally, apart from microhabitats, population background and plant life history also significantly influenced resource allocation strategies. Generally, plants established within engineered microhabitats exhibited higher biomass accumulation, as well as increased flower, leaf and stem production. Furthermore, individuals within engineered microhabitats commonly displayed lower RF, indicating a greater allocation of resources to above-ground functions while reducing allocation to root development. RE of annual plants was significantly higher than that of perennial plants. However, individuals of annual plants within engineered microhabitats showed lower RE compared to their counterparts in bare ground habitats; whereas perennial species demonstrated similar RE between microhabitat types. Moreover, RE was generally independent of plant size in bare-ground habitats but exhibited size-dependency in certain populations for some species within specific engineered microhabitat types. However, size-dependency did exist for absolute reproductive and root biomass allocation in most of the cases examined here. No trade-offs were observed between flower mass and flower number, nor between leaf mass and leaf number. The capacity of ecosystem engineers to regulate resource allocation strategies in associated plants was confirmed. However, the resource allocation patterns resulted synergistically from the ecosystem engineering effects, population environmental backgrounds, and plant life history strategies. In general, such regulations can improve individual survival and reproductive potential, potentially promoting population persistence in challenging alpine environments.
Word frequency and cognitive effort in turns-at-talk: turn structure affects processing load in natural conversation
Authors: Rühlemann Christoph , Barthel Mathias
Published: June 2024

Frequency distributions are known to widely affect psycholinguistic processes. The effects of word frequency in turns-at-talk, the nucleus of social action in conversation, have, by contrast, been largely neglected. This study probes into this gap by applying corpus-linguistic methods on the conversational component of the British National Corpus (BNC) and the Freiburg Multimodal Interaction Corpus (FreMIC). The latter includes continuous pupil size measures of participants of the recorded conversations, allowing for a systematic investigation of patterns in the contained speech and language on the one hand and their relation to concurrent processing costs they may incur in speakers and recipients on the other hand. We test a first hypothesis in this vein, analyzing whether word frequency distributions within turns-at-talk are correlated with interlocutors' processing effort during the production and reception of these turns. Turns are found to generally show a regular distribution pattern of word frequency, with highly frequent words in turn-initial positions, mid-range frequency words in turn-medial positions, and low-frequency words in turn-final positions. Speakers' pupil size is found to tend to increase during the course of a turn at talk, reaching a climax toward the turn end. Notably, the observed decrease in word frequency within turns is inversely correlated with the observed increase in pupil size in speakers, but not in recipients, with steeper decreases in word frequency going along with steeper increases in pupil size in speakers. We discuss the implications of these findings for theories of speech processing, turn structure, and information packaging. Crucially, we propose that the intensification of processing effort in speakers during a turn at talk is owed to an informational climax, which entails a progression from high-frequency, low-information words through intermediate levels to low-frequency, high-information words. At least in English conversation, interlocutors seem to make use of this pattern as one way to achieve efficiency in conversational interaction, creating a regularly recurring distribution of processing load across speaking turns, which aids smooth turn transitions, content prediction, and effective information transfer.
Neurofeedback and meditation technology in outpatient offender treatment: a feasibility and usability pilot study
Authors: van der Schoot A. , Wilpert J. , van Horn J. E.
Published: June 2024

Introduction

Although Cognitive Behavioral Therapy (CBT) is the most often used intervention in forensic treatment, its effectivity is not consistently supported. Interventions incorporating knowledge from neuroscience could provide for more successful intervention methods.

Methods

The current pilot study set out to assess the feasibility and usability of the study protocol of a 4-week neuromeditation training in adult forensic outpatients with impulse control problems. The neuromeditation training, which prompts awareness and control over brain states of restlessness with EEG neurofeedback, was offered in addition to treatment as usual (predominantly CBT).

Results

Eight patients completed the neuromeditation training under guidance of their therapists. Despite some emerging obstacles, overall, the training was rated sufficiently usable and feasible by patients and their therapists.

Discussion

The provided suggestions for improvement can be used to implement the intervention in treatment and set up future trials to study the effectiveness of neuromeditation in offender treatment.
An examination of the mediating role of maladaptive emotion regulation strategies in the complex relationship between interpersonal needs and suicidal behavior
Authors: Abdollahpour Ranjbar Hamed , Bakhshesh-Boroujeni Michael , Farajpour-Niri Sepideh , Hekmati Issa , Habibi Asgarabad Mojtaba , Eskin Mehmet
Published: June 2024

Background

Studies have shown that psychological factors, notably interpersonal needs and emotion regulation, play a significant role in suicidal behavior. Interpersonal needs are significant contextual components that affect emotion regulation and contribute to a wide range of dysfunctional behaviors, such as suicidal behavior. It has been postulated that emotion regulation mediates the associations between proximal and distal risk factors of suicidal behavior.

Method

The sample consisted of 340 community-dwelling individuals (62.5% women; SD = 0.48) with an age range of 18 through 55 (M = 30.23; SD = 8.54) who completed the interpersonal needs questionnaire, the suicide behaviors questionnaire-revised, and the cognitive emotion regulation questionnaire. The Structural Equation Modeling (SEM) approach was utilized to evaluate a mediation model.

Results

The findings indicate that interpersonal needs (i.e., perceived burdensomeness r = .55, p <.01 and thwarted belongingness r = .25, p <.01) and putatively maladaptive cognitive emotion regulation strategies (i.e., self-blame; r = .38, p <.01, catastrophizing; r = .55, p <.01, rumination; r = .40, p <.01, and other blame; r = .44, p <.01) have strong associations with suicidal behavior, and these strategies have a mediating effect on the association between interpersonal needs and suicidal behavior.

Conclusions

Our findings show that contextual-interpersonal needs, which underpin suicidal behavior, are significantly influenced by maladaptive emotional processes. Thus, therapeutic outcomes might be enhanced by focusing on the content of the associated cognitions and trying to reduce maladaptive regulatory processes like rumination and catastrophization.
Determinants influencing health-promoting behaviors in individuals at high risks of stroke: a cross-sectional study
Authors: Chen Mengxia , Wang Mengdi , Qiao Mengting , Huang Xiaorong , Li Dongmei , Yu Longjuan , Gan Lifen , Chen Wenyao , Weng Yanqiu , Zhang Jingwen , Yu Bing , Liu Jianmin , Zhang Lingjuan
Published: June 2024

Background

Quit smoking, moderate drinking, exercise, and healthy eating habits are all known to decrease the risk of stroke. As a result, understanding the health behaviors of high risk groups for stroke is crucial. Health behavior is influenced by knowledge, social environment, and health beliefs. However, little research has been done on these relationships. For a better grasp of the relationships mentioned above, consider using the COM-B model (capability, opportunity, motivation, and behavior). The purpose of this study was to investigate the variables related to health behavior and to test the mediating effect of health beliefs.

Methods

The cross-sectional study was carried out at a physical examination center of a tertiary hospital in Shanghai, China. 986 high-risk populations of stroke have been tested using the Health Behavior Scale (HBS-SP), Stroke Knowledge Questionnaire (SKQ), Health Beliefs Questionnaire (HBS), and Multidimensional Scale of Perceived Social Support (MSPSS). The structural equation modeling was used in this study.

Results

The scores for MSPSS, SKQ, HBS, and HBS-SP were 60.64 ± 13.72, 26.60 ± 9.77, 157.71 ± 34.34, and 2.46 ± 0.41, respectively. The revised model fits well (approximate root mean square error = 0.042; comparative fit index = 0.946). The health behavior was obviously and positively correlated to social Support, stroke knowledge, and health beliefs. Moreover, health belief has a mediating effect on the relation of social support, stroke knowledge, and health behavior.

Conclusion

Chinese high risk groups for stroke have a mediate level of health behaviors. Factors associated with health behaviors are knowledge of stroke, health beliefs, and social support. The COM-B-based model can be used to explain the health behavior of individuals at risk of stroke and to guide the formulation of effective health management programs.
Digital health literacy among primary and secondary school teachers—a quantitative study
Authors: Rangnow Pia , Fischer Lisa , Hartmann Anja , Renninger Denise , Stauch Lisa , Okan Orkan , Dadaczynski Kevin
Published: June 2024

Introduction

Digital health literacy (DHL) is a key competency for individuals’ daily decisions toward their health behavior and wellbeing. While there is much focus on health literacy (HL) among the general population, teachers have been rarely addressed. Given the shortages in the teaching workforce in Europe and the impact of demanding working conditions on their health, it is important to address DHL in teachers. This paper examines the DHL of primary and secondary teachers and its associations with sociodemographic and school-related factors.

Methods

An online cross-sectional study was conducted with 1,600 German primary and secondary school teachers between October and December 2022. To assess DHL, the Digital Health Literacy Instrument (DHLI) including seven subscales was used. Statistical analyses were conducted on item and subscale level and an overall DHL score was calculated. Next to descriptive analyses, bivariate and regression analyses were conducted to explore potential associations with sociodemographic and school-related factors.

Results

The frequency of difficulty in using digital health information varied across DHL dimensions and was greatest for protecting privacy (70.9%) and evaluating reliability (40.0%). In multivariate analysis, females more often reported a sufficient ability of adding content (OR = 1.61, CI = 1.05–2.48), while males more often reported a sufficient ability to protect their privacy (OR = 0.45, CI = 0.27–0.75). Teachers with leadership positions more often reported a sufficient ability in adding content (OR = 1.78, CI = 1.07–2.98). Regarding the ability to determine the relevance of online health-related information, no associations with a predictor variable were found.

Discussion

The results suggest that it is important to examine the individual dimensions of DHL and their distinct associations with sociodemographic and school-level factors, rather than just to rely on the overall level of DHL. The differential patterns identified in this study suggest a greater intervention need for teachers from higher age groups, primary and secondary general schools, and those without leadership roles. However, based on the limited predictive power of the variables included, further individual and school-level factors and their potential association with DHL should be investigated in the future. The promotion of DHL should be integrated into both teacher education and in-service training.
From active duty to activism: how moral injury and combat trauma drive political activism and societal reintegration among Israeli veterans
Authors: Levy Adi , Gross Michael L.
Published: June 2024

Trigger warning

This article deals with combat experiences and their consequences and could be potentially disturbing.

Introduction

Moral injury (MI) is a severe form of combat trauma that shatters soldiers’ moral bearings as the result of killing in war. Among the myriad ways that moral injury affects veterans’ reintegration into civilian life, its impact on political and societal reintegration remains largely unstudied but crucial for personal, community, and national health.

Methods

13 in-depth interviews examine combat soldiers’ exposure to potentially morally injurious events (PMIEs) that include killing enemy combatants, harming civilians, and betrayal by commanders, the military system, and society. Interviewees also described their political activities (e.g., voting, fundraising, advocacy, protest) and social activism (e.g., volunteering, teaching, charitable work). Interviewees also completed the Moral Injury Symptom Scale.

Results

Two distinct narratives process PMIEs. In a humanitarian narrative, soldiers hold themselves or their in-group morally responsible for perpetrating, witnessing, or failing to prevent a morally transgressive act such as killing or injuring civilians or placing others at unnecessary risk. In contrast, a national security perspective blames an out-group for leaving soldiers with no choice but to act in ways that trigger moral distress. Associated with shame and guilt, the humanitarian perspective triggered amends-making and social activism after discharge. In contrast, a national security perspective associated with anger and frustration fostered protest and intense political activism.

Discussion

Despite its harmful health effects, moral trauma and injury can drive intense political and social activism, depending upon the narrative veterans adopt to interpret PMIEs. Aside from moral injury’s personal, familial, and social effects, moral injury drives veterans’ return to the political arena of civil society. As such, veterans play a central role in politics and dramatically affect post-war policy in democratic nations following conflict.
Decoding Fujian’s cervical HPV landscape: unmasking dominance of non-16/18 HR-HPV and tailoring prevention strategies at a large scale
Authors: Zhang Yulong , Li Haibo , You Qianru , Chen Yusha , Zhao Ziyan , Chen Jiancui , Su Yanzhao , Zheng Xiangqin , Yi Huan , Song Jianrong
Published: June 2024

Background

Persistent HR-HPV causes cervical cancer, exhibiting geographic variance. Europe/Americas have higher HPV16/18 rates, while Asia/Africa predominantly have non-16/18 HR-HPV. This study in Fujian, Asia, explores non-16/18 HR-HPV infections, assessing their epidemiology and cervical lesion association for targeted prevention.

Methods

A total of 101,621 women undergoing HPV screening at a hospital in Fujian Province from 2013 to 2019 were included. HPV genotyping was performed. A subset of 11,666 HPV-positive women with available histopathology results were analyzed to characterize HPV genotype distribution across cervical diagnoses.

Results

In 101,621 samples, 24.5% tested positive for HPV. Among these samples, 17.3% exhibited single infections, while 7.2% showed evidence of multiple infections. The predominant non-16/18 high-risk HPV types identified were HPV 52, 58, 53, 51, and 81. Single HPV infections accounted for 64.1% of all HPV-positive cases, with 71.4% of these being non-16/18 high-risk HPV infections. Age-related variations were observed in 11,666 HPV-positive patients with pathological results. Cancer patients were older. In the cancer group, HPV52 (21.8%) and HPV58 (18.6%) were the predominant types, followed by HPV33, HPV31, and HPV53. Compared to single HPV16/18 infection, non-16/18 HPV predominated in LSIL. Adjusted odds ratios (OR) for LSIL were elevated: multiple HPV16/18 (OR 2.18), multiple non-16/18 HR-HPV (OR 2.53), and multiple LR-HPV (OR 2.38). Notably, solitary HPV16/18 conferred higher odds for HSIL and cancer.

Conclusion

Our large-scale analysis in Fujian Province highlights HPV 52, 58, 53, 51, and 81 as predominant non-16/18 HR-HPV types. Multiple HPV poses increased LSIL risks, while solitary HPV16/18 elevates HSIL and cancer odds. These findings stress tailored cervical cancer prevention, highlighting specific HPV impacts on lesion severity and guiding region-specific strategies for optimal screening in Asia, emphasizing ongoing surveillance in the vaccination era.
Social transition, socioeconomic status and self-rated health in China: evidence from a national cross-sectional survey (CGSS)
Authors: Gao Yi , Zeng Jing , Liao Zangyi , Yang Jing
Published: June 2024

Background

Social transition is one of the multi-level mechanisms that influence health disparities. However, it has received less attention as one of the non-traditional social determinants of health. A few studies have examined China’s social transition and its impact on health inequality in self-rated health (SRH). Therefore, this study explores the impact of China’s market-oriented reforms—social transition and socioeconomic status (SES)—on residents’ SRH.

Methods

Using the cross-sectional data from the Chinese General Social Survey (CGSS) in 2017, we analyzed the effects of social transition and SES on the SRH of Chinese residents using the RIF (Recentered influence function) method. The RIF decomposition method investigated health differences among different populations and their determinants.

Results

Social transition and SES have significant positive effects on the SRH of Chinese residents. The correlation between SES and the SRH of Chinese residents is moderated by social transition, implying that social transition can weaken the correlation between SES and the SRH of Chinese residents. The impacts of SES and social transition on SRH vary across populations.

Conclusion

Promoting social transition and favoring disadvantaged groups with more resources are urgently needed to promote equitable health outcomes.
Nudge theory and gambling: a scoping review
Authors: Fortier Marie-Ève , Audette-Chapdelaine Sophie , Auger Anne-Marie , Brodeur Magaly
Published: June 2024

Background

Gambling disorder (GD) is a pressing public health concern with significant societal costs. The recently developed nudge theory, which is rooted in behavioral economics, aims to influence the decision-making behaviors of individuals by implementing changes in the environment.

Aim

This scoping review aims to synthesize the literature on nudge theory as it relates to gambling.

Methods

This scoping review accords with the Arksey and O’Malley framework, as refined by Levac et al. It includes only articles from peer-reviewed journals that focus, as main themes, on both nudge theory and gambling. The final study selection includes six articles.

Results

The scoping review process led to studies explaining how (1) nudges aim to prod people toward healthier gambling choices, fostering the adoption of more responsible gambling practices, and (2) some gambling features, called dark nudges (or sludges), exploit and harm the decision-making processes of people who gamble.

Conclusion

This scoping review highlights the fact that many stakeholders are involved in the field of gambling, and that better cooperation between them would promote safer and more responsible gambling practices. Future research is also needed to empirically test nudges to develop a better understanding of their impact on those who gamble.
Evaluating the impact of distance learning on gender-affirming healthcare competence: knowledge acquisition and satisfaction among healthcare professionals in Italy
Authors: Favazzi Ughetta Maria , Marconi Matteo , Carbone Pietro , Guerrera Debora , Ruocco Angela , Manoli Martina , Molinaro Francesca , Regini Federica Maria , Vittozzi Andrea , Mazzaccara Alfonso , Pierdominici Marina
Published: June 2024

Background

Transgender and gender diverse (TGD) individuals face significant healthcare barriers, with one of the most critical being the inadequate knowledge and skills of healthcare professionals (HCPs) in TGD health. To address this issue, we undertook a project to develop a distance learning course for all healthcare professions, encompassing a comprehensive range of topics related to TGD health issues.

Objectives

This study aimed to evaluate the impact of a course on gender-affirming healthcare competence, with a focus on knowledge acquisition and satisfaction levels. The hypothesis was that participating in the course would enhance the participants' knowledge on the covered topics.

Methods

A distance learning course, designed for all Continuing Medical Education professions, was conducted between March and September 2023. The course was structured according to the Problem-Based Learning methodology. We implemented a pre-test vs. post-test study design to evaluate the enhancement of knowledge, based on a set of Multiple Choice Questions (MCQs), and investigated users' satisfaction through the administration of a semi-structured questionnaire. We examined the pre- and post-course proportions of correct responses to questions, along with the mean score difference, categorized by learners' sex, age, and geographical area. Eventually, a Satisfaction Training Index was created.

Results

The maximum capacity was reached, with 29,998 out of 30,000 available spots filled. Of those enrolled, 18,282 HCPs successfully completed the training. Post-test results revealed an increase in correct answers across all MCQs, with overall mean score rising from 48.8 to 68.0 (p < 0.001). Stratified analysis indicated improvements across all participant categories. A higher average increase among female (19.87) compared to male enrollees (17.06) was detected (p < 0.001). Both “over 55” and “46–55” age groups showed the greatest score increases compared to “35–46” and “under 35” groups, despite no significant differences in pre-test scores. Course satisfaction was high, averaging 4.38 out of 5. Top-rated aspects included “learning new concepts” (4.49), “accessibility” (4.46), and “platform functionality” (4.46).

Conclusion

Our research hypothesis was confirmed by the significant increase in knowledge going from pre-test to post-test and by the high level of user satisfaction. The obtained results serve as a foundation for planning additional professional education in TGD health.
Relationship between quadriceps muscle architecture and lower limb strength and physical function in older adults community-dwelling individuals: a cross-sectional study
Authors: Cinarli Fahri Safa , Ulubaba Hilal Er , Ucar Ozan , Kilinc Deniz Can , Ciftci Rukiye , Karayigit Raci , Aldhahi Monira I , Al-Mhanna Sameer Badri , Gülü Mehmet
Published: June 2024

Background and objective

Factors related to muscle architecture may lead to functional limitations in activities of daily living in the older adults. This study aimed to investigate the relationship between quadriceps femoris (QF) architecture and physical function in older adults community-dwelling people.

Methods

The study included 25 community-dwelling older adults participants aged over 60 years (14 women and 11 men) who were not engaged in regular physical activity. The rectus femoris (RF) and vastus intermedius (VI) muscle thicknesses as well as the RF cross-sectional area (CSA) were assessed using 2D ultrasonography. The 30 Seconds Chair Stand test (30sCST) and Timed Up and Go Test (TUG) were used to assess lower body muscle power and functional mobility, respectively.

Results

The QF muscle architecture showed moderate and large correlations with the 30sCST (r range = 0.45–0.67, p < 0.05) and TUG (r range = 0.480–0.60, p < 0.05). RF thickness was a significant (p < 0.01) independent predictor of 30sCST (R2 = 0.45) and TUG (R2 = 0.36). VI thickness was a significant (p < 0.05) independent predictor of 30sCST (R2 = 0.20) and TUG (R2 = 0.231). RF CSA was a significant independent predictor of the 30sCST (R2 = 0.250, p < 0.05) and TUG (R2 = 0.27, p < 0.01). Multiple linear regression models explained 38% of the 30sCST variance and 30% of the TUG variance in the older adults group.

Conclusion

Quadriceps muscle group directly affects basic activities of daily living in the older adults. Ultrasound measurements, which are non-invasive tools, are extremely valuable for understanding the limitations of activities of daily living in the older adults.