bluuebunny/crossref_metadata_2025 huggingface dataset:
Exposure to systemic antibiotics in outpatient care and the risk of multiple sclerosis
Authors: Sipilä Jussi OT , Viitala Matias , Hänninen Arno , Soilu-Hänninen Merja
Published: July 2023

Background:

Infections, early life exposures and the microbiome have been associated with the aetiology of multiple sclerosis (MS). Data on any possible roles of antibiotics is scarce and conflicting.

Objective:

The objective of this study was to investigate associations between outpatient systemic antibiotic exposure and the risk of MS in a nationwide case-control setting.

Methods:

Patients with MS were identified from the nation MS registry and their exposure to antibiotics was compared with that of persons without MS, provided by the national census authority. Antibiotic exposure was investigated using the national prescription database and analyzed by Anatomical Therapeutic Chemical (ATC) category.

Results:

Among the 1830 patients with MS and 12765 control persons, there were no associations between exposure to antibiotics in childhood (5–9 years) or adolescence (10–19 years) and the subsequent risk of MS. There was also no association between antibiotic exposure 1–6 years before disease onset and the risk of MS, save for exposure to fluoroquinolones in women (odds ratio: 1.28; 95% confidence interval: 1.03, 1.60; p = 0.028) which is probably associated with the increased infection burden in the MS prodrome.

Conclusion:

Use of systemic prescription antibiotics was not associated with subsequent MS risk.
Predicting Rectal Cancer Response to Total Neoadjuvant Treatment Using an Artificial Intelligence Model Based on Magnetic Resonance Imaging and Clinical Data
Authors: Ouyang Ganlu , Chen Zhebin , Dou Meng , Luo Xu , Wen Han , Deng Xiangbing , Meng Wenjian , Yu Yongyang , Wu Bing , Jiang Dan , Wang Ziqiang , Yao Yu , Wang Xin
Published: July 2023

Purpose

To develop a model for predicting response to total neoadjuvant treatment (TNT) for patients with locally advanced rectal cancer (LARC) based on baseline magnetic resonance imaging (MRI) and clinical data using artificial intelligence methods.

Methods

Baseline MRI and clinical data were curated from patients with LARC and analyzed using logistic regression (LR) and deep learning (DL) methods to predict TNT response retrospectively. We defined two groups of response to TNT as pathological complete response (pCR) versus non-pCR (Group 1), and high sensitivity [tumor regression grade (TRG) 0 and TRG 1] versus moderate sensitivity (TRG 2 or patients with TRG 3 and a reduction in tumor volume of at least 20% compared to baseline) versus low sensitivity (TRG 3 and a reduction in tumor volume <20% compared to baseline) (Group 2). We extracted and selected clinical and radiomic features on baseline T2WI. Then we built LR models and DL models. Receiver operating characteristic (ROC) curves analysis was performed to assess predictive performance of models.

Results

Eighty-nine patients were assigned to the training cohort, and 29 patients were assigned to the testing cohort. The area under receiver operating characteristics curve (AUC) of LR models, which were predictive of high sensitivity and pCR, were 0.853 and 0.866, respectively. Whereas the AUCs of DL models were 0.829 and 0.838, respectively. After 10 rounds of cross validation, the accuracy of the models in Group 1 is higher than in Group 2.

Conclusion

There was no significant difference between LR model and DL model. Artificial Intelligence-based radiomics biomarkers may have potential clinical implications for adaptive and personalized therapy.
Xiaoliu Pingyi Recipe Inhibits Lung Pre-Metastatic Niche Formation and Prevents Myeloid-Derived Suppressor Cells Recruitment
Authors: Li Honglin , Yang Feiran , Zhang Lei , Zhao Ruohan , Li Xiurong , Li Huijie
Published: July 2023

Background:

Metastasis, a leading cause of cancer-related deaths, involves complex mechanisms. The premetastatic niche (PMN) is a crucial contributor to this process. Myeloid-derived suppressor cells (MDSCs) play an important role in PMN formation and promote tumor progression and metastasis. The Xiaoliu Pingyi recipe (XLPYR), a traditional Chinese medicine, is effective in preventing postoperative recurrence and metastasis in cancer patients.

Objective:

This study investigated the effects of XLPYR on MDSCs recruitment and on the expression of PMN markers and elucidated the mechanisms involved in the prevention of tumor metastasis.

Methods:

C57BL/6 mice were subcutaneously injected with Lewis cells and treated with cisplatin and XLPYR. Tumors were resected after 14 days after the establishment of a model of lung metastasis, and tumor volume and weight were measured. Lung metastases were observed 21 days after resection. MDSCs in the lung, spleen, and peripheral blood were detected by flow cytometry. Western blotting, qRT-PCR and ELISA were used to detect the expression of S100A8, S100A9, MMP9, LOX, and IL-6/STAT3 in premetastatic lung tissue.

Results:

XLPYR treatment inhibited tumor growth and prevented lung metastasis. Compared to mice without subcutaneous tumor cell transplantation, the model group had an increased proportion of MDSCs, higher expression of S100A8, S100A9, MMP9, and LOX in the premetastatic lung. XLPYR treatment reduced the proportion of MDSCs, S100A8, S100A9, MMP9, and LOX expression, and downregulated the IL-6/STAT3 pathway.

Conclusions

XLPYR may prevent MDSCs recruitment and reduce the expression of S100A8, MMP9, LOX, and IL6/STAT3 in premetastatic lung tissue, thus reducing lung metastases.
‘I Would Have Never Told You that’ – Using Rich Pictures as a Qualitative Tool to Uncover Tacit Perspectives on Leadership
Authors: Kado Sinead Katherine , Clarke Simon , Carr Sandra
Published: July 2023

Interviews and focus groups are the mainstay of qualitative research, but may not capture fully the perspectives of participants when investigating complex social phenomena. Increasingly visual elicitation techniques, including Rich Pictures, are being utilised to further explore tacit perspectives. Two key questions around Rich Pictures were considered: ‘What are the affordances and constraints of using Rich Pictures to uncover tacit perspectives?’ and ‘Moving forward, how can we most effectively use Rich Pictures in future research?’ This case study answers these questions by reflecting on our experiences while conducting research into the complex social phenomena of leadership in health professions education. Through our reflections on using Rich Pictures, the research participants’ experience, and in-depth literature exploration of Rich Pictures, the affordances and constraints of this data collection tool are examined. Furthermore, the considerations needed when using Rich Pictures are expounded before providing a set of guiding recommendations for those considering using Rich Pictures in their qualitative research.
Association between adverse childhood experiences and later-life allostatic load in UK Biobank female participants
Authors: Jakubowski Debbie , Peterson Caryn E , Sun Jiehuan , Hoskins Kent , Rauscher Garth H , Argos Maria
Published: July 2023

Background:

Adverse childhood experiences during key developmental periods have been shown to impact long-term health outcomes. Adverse childhood experiences may include psychological, physical, or sexual abuse; neglect; or socioeconomic factors. Adverse childhood experiences are linked with an increase in poor health behavior such as smoking and alcohol consumption, and may also influence epigenetic changes, inflammatory response, metabolic changes, and allostatic load.

Objective:

We sought to explore associations between adverse childhood experiences and allostatic load in adult female participants in the UK Biobank.

Design:

The UK Biobank is a multisite cohort study established to capture lifestyle, environment, exposure, health history, and genotype data on individuals in the United Kingdom.

Methods:

Adverse childhood experiences were assessed from the Childhood Trauma Screener, which measures abuse and neglect across five items. Biological measures at enrollment were used to construct allostatic load, including measures of metabolic, inflammatory, and cardiovascular function. Females with a cancer diagnosis prior to enrollment were removed as it may influence allostatic load. Poisson regression models were used to assess the association between adverse childhood experiences and allostatic load, accounting for a priori confounders.

Results:

A total of 33,466 females with complete data were analyzed, with a median age at enrollment of 54 (range = 40–70) years. Among the study sample, the mean allostatic load ranged from 1.85 in those who reported no adverse childhood experiences to 2.45 in those with all adverse childhood experiences reported. In multivariable analysis, there was a 4% increase in average allostatic load among females for every additional adverse childhood experience reported (incidence rate ratio = 1.04, 95% confidence interval = 1.03–1.05). Similar results were observed when assessing individual adverse childhood experience components.

Conclusion:

This analysis supports a growing body of evidence suggesting that increased exposure to early life abuse or neglect is associated with increased allostatic load in females.
Time-out for well-being: A mixed methods evaluation of attitudes and likelihood to engage in different types of online emotional well-being programmes in the perinatal period
Authors: Davis Jacqueline A , Finlay-Jones Amy L , Bear Natasha , Prescott Susan L , Silva Desiree T , Ohan Jeneva L
Published: July 2023

Background:

Positive maternal mental health during the perinatal period contributes to general well-being and positive emotional bonds with the child, encouraging an optimal developmental trajectory. Online interventions to enhance maternal well-being and develop coping skills, such as meditation-based interventions, can be a low-cost way to improve mother and child outcomes. However, this depends on end-user engagement. To date, there is limited evidence about women’s willingness to engage and preferences for online programmes.

Objectives:

This study explored pregnant women’s attitudes towards and likelihood to undertake minimal online well-being training programmes (mindfulness, self-compassion, or general relaxation), engagement barriers and enablers, and programme structure preferences.

Design:

A mixed methods triangulation design was undertaken using a validating quantitative model. Quantile regressions were applied to the quantitative data. Content analysis was undertaken for the qualitative data.

Methods:

Consenting pregnant women ( n = 151) were randomized equally to read about three online programme types. Participants were sent an information leaflet, tested by a consumer panel prior to distribution.

Results:

Participants generally held positive attitudes about all three types of interventions, with no statistically significant differences in preferences between programme types. Participants appreciated the importance of mental health and were receptive to fostering skills to support their emotional well-being and stress management. The most frequent perceived barriers were lack of time, tiredness, and forgetfulness. Programme structure preferences indicated one to two modules per week, less than 15 min in duration, and over 4 weeks. Programme functionality, such as regular reminders and easy accessibility, is important to end users.

Conclusion:

Our findings reinforce the importance of determining participant preferences in designing and communicating engaging interventions for perinatal women. This research contributes to the understanding of population-based interventions that can be provided as simple, scalable, cost-effective, and home-based activities in pregnancy for the benefit of individuals, their families, and society more broadly.
Feasibility and acceptability testing of CommSense: A novel communication technology to enhance health equity in clinician–patient interactions
Authors: LeBaron Virginia , Flickinger Tabor , Ling David , Lee Hansung , Edwards James , Tewari Anant , Wang Zhiyuan , Barnes Laura E
Published: July 2023

Background

Quality patient–clinician communication is paramount to achieving safe and compassionate healthcare, but evaluating communication performance during real clinical encounters is challenging. Technology offers novel opportunities to provide clinicians with actionable feedback to enhance their communication skills.

Methods

This pilot study evaluated the acceptability and feasibility of CommSense, a novel natural language processing (NLP) application designed to record and extract key metrics of communication performance and provide real-time feedback to clinicians. Metrics of communication performance were established from a review of the literature and technical feasibility verified. CommSense was deployed on a wearable (smartwatch), and participants were recruited from an academic medical center to test the technology. Participants completed a survey about their experience; results were exported to SPSS (v.28.0) for descriptive analysis.

Results

Forty ( n = 40) healthcare participants (nursing students, medical students, nurses, and physicians) pilot tested CommSense. Over 90% of participants “strongly agreed” or “agreed” that CommSense could improve compassionate communication ( n = 38, 95%) and help healthcare organizations deliver high-quality care ( n = 39, 97.5%). Most participants ( n = 37, 92.5%) “strongly agreed” or “agreed” they would be willing to use CommSense in the future; 100% ( n = 40) “strongly agreed” or “agreed” they were interested in seeing information analyzed by CommSense about their communication performance. Metrics of most interest were medical jargon, interruptions, and speech dominance.

Conclusion

Participants perceived significant benefits of CommSense to track and improve communication skills. Future work will deploy CommSense in the clinical setting with a more diverse group of participants, validate data fidelity, and explore optimal ways to share data analyzed by CommSense with end-users.
Topoiof Nonprofit Proposal Writing
Authors: DeJeu Emily Barrow
Published: July 2023

Studies of the grant proposal tend to conflate academic research grant proposals with other kinds of nonprofit grant proposal genres, even though research and nonprofit grant proposals have different audiences and goals. To address this gap, this study draws on the Aristotelian concept of topoi (or typical arguments) and uses corpus analysis, interview, and coding methods to answer the question, what topoi distinguish the academic research and nonprofit grant proposal genres? Findings suggest key differences in the topoi that research and nonprofit proposals use to advocate for problems and outcomes, set goals, and establish credibility.
Tectonics of the Western Internal Jura fold-and-thrust belt: 2D kinematic forward modelling
Authors: Marro Adeline , Hauvette Louis , Borderie Sandra , Mosar Jon
Published: July 2023

The balancing technique, called 2D kinematic forward modelling, is a powerful tool to understand the kinematic evolution of fold-and-thrust belts. This study presents a new 2D kinematic forward model for the westernmost Internal Jura fold-and-thrust belt (FTB), situated immediately adjacent to the Geneva Basin. The technique used not only provides a new valid balanced cross-section but also offers new insights regarding the kinematic evolution of the Western Internal Jura FTB. Our model proposes a pure thin-skinned style dominated by forward stepping deformation accompanied by minor back-stepping thrust sequences. A first deformation step is attributed to the thrusting of the Crêt de la Neige Anticline, followed by the Crêt Chalam Thrust and its imbrications. This is followed by thrusting along the Tacon and the Bienne thrusts. Imbricate fault-bend folding explains the steep southern limb of the Crêt de la Neige and the Bellecombe anticlines. 2D kinematic forward modelling yields a total amount of shortening by 23.6 km for the Western Internal Jura FTB. In addition to the primary décollement located at the base of the Keuper Group evaporites, three other décollements are found within the marly layers of the Aalenian “faciès de transition” units, the Oxfordian “Couches d’Effingen-Geissberg” members and the Berriasian Goldberg formation. The multiple thrust horizon approach is supported by new precise seismic interpretations. Our model provides a valid alternative to previous models that either propose local thickening of the Triassic evaporites or inversion of normal faults in the basement. This fully explains the elevated position of the Mesozoic cover in the Jura FTB.
Interferon-γ regulates immunosuppression in septic mice by promoting the Warburg effect through the PI3K/AKT/mTOR pathway
Authors: Fu Xu-zhe , Wang Yu
Published: July 2023

Background

The main cause of high mortality from sepsis is that immunosuppression leads to life-threatening organ dysfunction, and reversing immunosuppression is key to sepsis treatment. Interferon γ (IFNγ) is a potential therapy for immunosuppression of sepsis, promoting glycolysis to restore metabolic defects in monocytes, but the mechanism of treatment is unclear.

Methods

To explore the immunotherapeutic mechanism of IFNγ, this study linked the Warburg effect (aerobic glycolysis) to immunotherapy for sepsis and used cecal ligation perforation (CLP) and lipopolysaccharide (LPS) to stimulate dendritic cells (DC) to establish in vivo and in vitro sepsis models, Warburg effect inhibitors (2-DG) and PI3K pathway inhibitors (LY294002) were used to explore the mechanism by which IFNγ regulates immunosuppression in mice with sepsis through the Warburg effect.

Results

IFNγ markedly inhibited the reduction in cytokine secretion from lipopolysaccharide (LPS)-stimulated splenocytes. IFNγ-treated mice had significantly increased the percentages of positive costimulatory receptor CD86 on Dendritic cells expressing and expression of splenic HLA-DR. IFNγ markedly reduced DC-cell apoptosis by upregulating the expression of Bcl-2 and downregulating the expression of Bax. CLP-induced formation of regulatory T cells in the spleen was abolished in IFNγ -treated mice. IFNγ treatment reduced the expression of autophagosomes in DC cells. IFNγ significant reduce the expression of Warburg effector-related proteins PDH, LDH, Glut1, and Glut4, and promote glucose consumption, lactic acid, and intracellular ATP production. After the use of 2-DG to suppress the Warburg effect, the therapeutic effect of IFNγ was suppressed, demonstrating that IFNγ reverses immunosuppression by promoting the Warburg effect. Moreover, IFNγ increased the expression of phosphoinositide 3-kinases (PI3K), protein kinase B (Akt), rapamycin target protein (mTOR), hypoxia-inducible factor-1 (HIF-1α), pyruvate dehydrogenase kinase (PDK1) protein, the use of 2-DG and LY294002 can inhibit the expression of the above proteins, LY294002 also inhibits the therapeutic effect of IFNγ.

Conclusions

It was finally proved that IFNγ promoted the Warburg effect through the PI3K/Akt/mTOR pathway to reverse the immunosuppression caused by sepsis. This study elucidates the potential mechanism of the immunotherapeutic effect of IFNγ in sepsis, providing a new target for the treatment of sepsis.
A study on the genus Candolleomyces (Agaricales: Psathyrellaceae) from Punjab, Pakistan
Authors: Haqnawaz Muhammad , Niazi Abdul Rehman , Khalid Abdul Nasir
Published: July 2023

Many basidiomata of the genus Candolleomyces were found on sandy and loamy soil from the Indus Riverbed, Kot Addu District. A phylogenetic study was conducted to examine the occurrence of Candolleomyces sindhudeltae sp. nov. using a combination of ITS and LSU regions. Our morphological, anatomical, and phylogenetic studies indicated the novelty of Candolleomyces sindhudeltae sp. nov. The distinguishing features of C. sindhudeltae are convex to campanulate and areolate pileus with scalloped to cracked cap margins, branched, and pale reddish lamellae, greenish-brown ellipsoid to ovoid basidiospores, polymorphic cheilo, and caulocystidia. The novel taxa formed independent phylogenetic relationships within the genus Candolleomyces. The addition of our new species to the genus Candolleomyces makes us confident that the genus was separated from Psathyrella accurately.
Global, regional, and national burden of heart failure associated with atrial fibrillation
Authors: Kularatna Sanjeewa , Jadambaa Amarzaya , Hewage Sumudu , Brain David , McPhail Steven , Parsonage William
Published: July 2023

Background

Heart failure is a leading cause of mortality and morbidity worldwide, and Atrial fibrillation (AF) is among many modifiable risk factors for heart failure. No estimates are available on the magnitude of the burden of heart failure associated with AF, and this study estimated the global, regional, and national burdens associated with AF.

Methods

We used the comparative risk assessment method to estimate the disease burden in terms of prevalence and years lived with disability (YLD). The population-attributable fraction for heart failure and AF was calculated from prevalence estimates of AF and the recalculated relative risks of heart failure associated with AF from a systematic review summarising the longitudinal association between AF and outcomes. The burden of heart failure was retrieved from the Global Burden of Disease database.

Results

Globally, 2.6% (95% uncertainty interval 1.3 to 4.7%) of the burden of heart failure is associated with AF. This was 1.5 (95% UI 0.6 to 3.2) million people in 2019, a 49.8% increase from 1990. The highest prevalence was from South-East Asia, East Asia and Oceania. The highest YLD was estimated for Central Europe, Eastern Europe and Central Asia. High-income countries showed a sharp decline in the age standardised prevalence and YLD rates from 1990 to 2019.

Conclusion

The burden of heart failure associated with AF has increased substantially over the past two decades despite the advances in AF management. However, falling prevalence and YLD rates of heart failure associated with AF in high-income countries over time indicate that reducing this burden is possible.
Technologies for frailty, comorbidity, and multimorbidity in older adults: a systematic review of research designs
Authors: Gallucci Alessia , Trimarchi Pietro D. , Tuena Cosimo , Cavedoni Silvia , Pedroli Elisa , Greco Francesca Romana , Greco Antonio , Abbate Carlo , Lattanzio Fabrizia , Stramba-Badiale Marco , Giunco Fabrizio
Published: July 2023

Background

Frailty, neurodegeneration and geriatric syndromes cause a significant impact at the clinical, social, and economic level, mainly in the context of the aging world. Recently, Information and Communication Technologies (ICTs), virtual reality tools, and machine learning models have been increasingly applied to the care of older patients to improve diagnosis, prognosis, and interventions. However, so far, the methodological limitations of studies in this field have prevented to generalize data to real-word. This review systematically overviews the research designs used by studies applying technologies for the assessment and treatment of aging-related syndromes in older people.

Methods

Following the PRISMA guidelines, records from PubMed, EMBASE, and Web of Science were systematically screened to select original articles in which interventional or observational designs were used to study technologies’ applications in samples of frail, comorbid, or multimorbid patients.

Results

Thirty-four articles met the inclusion criteria. Most of the studies used diagnostic accuracy designs to test assessment procedures or retrospective cohort designs to build predictive models. A minority were randomized or non-randomized interventional studies. Quality evaluation revealed a high risk of bias for observational studies, while a low risk of bias for interventional studies.

Conclusions

The majority of the reviewed articles use an observational design mainly to study diagnostic procedures and suffer from a high risk of bias. The scarce presence of methodologically robust interventional studies may suggest that the field is in its infancy. Methodological considerations will be presented on how to standardize procedures and research quality in this field.
Antimicrobial stewardship programs in seven Latin American countries: facing the challenges
Authors: Pallares Christian José , Porras Jessica , De La Cadena Elsa , García-Betancur Juan Carlos , Restrepo-Arbeláez Natalia , Viveros Sara María Cobo , Cornistein Wanda , Castañeda-Méndez Paulo , Cuellar Luis , Boldim-Ferreira Diogo , Chaverri-Murillo Jorge , Labarca Jaime A. , Villegas María Virginia
Published: July 2023

Background

Studies have shown that more than 50% of the antibiotics used in hospitals are unnecessary or inappropriate and, that antimicrobial resistance may cost up to 20 billion USD in excess medical costs each year. On the other hand, Antimicrobial Stewardship Programs (ASP) significantly reduce inappropriate antimicrobial use, emergence of antimicrobial resistance, healthcare associated infections, and costs in hospital settings.

Objective

To evaluate the development of ASP and antibiotic savings in 7 Latin American hospitals using standardized quantitative indicators in all the participating health care institutions.

Methods

An interventional study was conducted, where pre- and post- evaluations were performed using a standardized score tool adapted from the Joint Commission International accreditation standards and, the Colombian Institute of Technical Standards and Certification. We evaluated ASP from 7 Latin American hospitals between 2019 and 2020. A pre-intervention evaluation was done in each hospital to quantify the degree of development of the ASP (ASP Development score). Based on these results, tailored on-site training was implemented in each hospital, followed by a post-intervention evaluation to quantify improvement of ASP-development indicators. In addition, monetary savings in antimicrobials derived from the ASP intervention were estimated.

Results

In the pre-intervention evaluation, the average ASP development score for the 7 institutions was 65.8% (40-94.3%). The items with the lowest development score were those related to monitoring and communicating the ASP progress and success. For the post-intervention evaluation, 2 institutions couldn’t participate due to the pressure imposed by the COVID-19 pandemic. For the remaining 5/7 hospitals, the average ASP development score was 82.3% with an increase of 12.0% when compared to the pre-intervention measurement of the same institutions (average pre-intervention score 70.3% (48.2%-94.3%) The items with a significant increase were key performance indicators, AMS education and training of the prescribers. Three of the seven (3/7) hospitals reported antibiotic monetary savings associated to the ASP intervention.

Conclusions

The use of the tool described shown to be useful to evaluate specific areas of ASP-development that were lacking and tailor interventions for the participating hospitals, consequently, it helped improve ASP-development in the institutions that underwent pre- intervention and post-intervention analysis. In addition, the strategies showed monetary savings on antimicrobial costs when measured.
A pilot, randomized, placebo-controlled study of mindfulness meditation in treating insomnia in multiple sclerosis
Authors: Guarnaccia Joseph B. , Njike Valentine Y. , Dutton Anne , Ayettey Rockiy G. , Treu Judith A. , Comerford Beth P. , Sinha Rajita
Published: July 2023

Objective

Mindfulness is an established approach to reduce distress and stress reactivity by improving awareness and tolerability of thoughts and emotions. This study compares mindfulness training to sleep hygiene in persons with multiple sclerosis (PWMS) who report chronic insomnia, examining sleep efficiency (SE), self-reported sleep quality and quality of life.

Methods

Fifty-three PWMS were randomized (1:1) in a single-blinded, parallel group design to ten, two-hour weekly sessions of Mindfulness Based Stress Intervention for Insomnia (MBSI-I) over a span of ten weeks or a single, one hour sleep hygiene (SH) session over one day. The primary outcome measure was SE, measured by the Fitbit™ Charge 2 wrist device, at 10 and 16 weeks from the start of study interventions. Self-report outcomes included the Pittsburg Sleep Quality Rating Scale (PSQI), Insomnia Severity Index (ISI) and the Multiple Sclerosis Quality of Life Inventory (MSQLI). Nineteen participants in the MBSI-I group and 24 in the SH group completed the primary study. Subsequently, ten participants in the original SH group participated in the 10-week MSBI-I course and their data was added to the MBSI-I cohort (eMSBI-I).

Results

While neither SE nor the PSQI showed significant differences between MBSI-I, eMBSI-I and SH groups, ISI improved in both the MSBI-I and eMBSI-I vs SH at 10 weeks (p = 0.0014 and p = 0.0275) but not 16 weeks. However, pre and post assessments within the MBSI-I and eMBSI-I cohorts did show significant improvement in the PSQI and ISI at 10 and 16 weeks, while SH was significant in the ISI only at 16 weeks. Several quality of life measurements, including fatigue, mental health and cognitive function favored the mindfulness cohorts.

Conclusion

This pilot study demonstrates beneficial effects of MBSR on insomnia, sleep quality and quality of life in PWMS.

Trial registration

NCT03949296. 14 May 2019.
Screening of placenta accreta spectrum disorder using maternal serum biomarkers and clinical indicators: a case–control study
Authors: Zhou Jiayi , Yang Si , Xu Xingneng , Xu Xiuting , Wang Xuwei , Ye Anqi , Chen Yanhong , He Fang , Yu Bolan
Published: July 2023

Background

Placenta accreta spectrum (PAS) disorder is a major cause of postpartum hemorrhage-associated maternal and fetal death, and novel methods for PAS screening are urgently needed for clinical application.

Methods

The purpose of this study was to develop new methods for PAS screening using serum biomarkers and clinical indicators. A total of 95 PAS cases and 137 controls were enrolled in a case–control study as cohort one, and 44 PAS cases and 35 controls in a prospective nested case–control study were enrolled as cohort two. All subjects were pregnant women of Chinese Han population. Biomarkers for PAS from maternal blood samples were screened based on high-throughput immunoassay and were further validated in three phases of cohort one. Screening models for PAS were generated using maternal serum biomarkers and clinical indicators, and were validated in two cohorts. The expression levels of biomarkers were analyzed using histopathological and immunohistochemical (IHC) techniques, and gene expression was examined by QPCR in the human placenta. Binary logistic regression models were built, and the area under the curve (AUC), sensitivity, specificity, and Youden index were calculated. Statistical analyses and model building were performed in SPSS and graphs were generated in GraphPad Prism. The independent-sample t test was used to compare numerical data between two groups. For nonparametric variables, a Mann–Whitney U test or a X2 test was used.

Results

The results demonstrated that the serum levels of matrix metalloproteinase-1 (MMP-1), epidermal growth factor (EGF), and vascular endothelial growth factor-A (VEGF-A) were consistently higher, while the level of tissue-type plasminogen activator (tPA) was significantly lower in PAS patients compared with normal term controls and patients with pre-eclampsia (PE) and placenta previa (PP). IHC and QPCR analysis confirmed that the expression of the identified biomarkers significantly changed during the third trimester in human placenta. The generated screening model combining serum biomarkers and clinical indicators detected 87% of PAS cases with AUC of 0.94.

Conclusions

Serum biomarkers can be used for PAS screening with low expense and high clinical performance; therefore, it may help to develop a practicable method for clinical prenatal PAS screening.
Associations between detectable circulating tumor DNA and tumor glucose uptake measured by 18F-FDG PET/CT in early-stage non-small cell lung cancer
Authors: Ottestad Anine Larsen , Johansen Håkon , Halvorsen Tarje Onsøien , Dai Hong Yan , Wahl Sissel Gyrid Freim , Emdal Elisabeth Fritzke , Grønberg Bjørn Henning
Published: July 2023

Background

The low level of circulating tumor DNA (ctDNA) in the blood is a well-known challenge for the application of liquid biopsies in early-stage non-small cell lung cancer (NSCLC) management. Studies of metastatic NSCLC indicate that ctDNA levels are associated with tumor metabolic activity as measured by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT). This study investigated this association in NSCLC patients considered for potentially curative treatment and explored whether the two methods provide independent prognostic information.

Method

Patients with stage I-III NSCLC who had routinely undergone an 18F-FDG PET/CT scan and exploratory ctDNA analyses were included. Tumor glucose uptake was measured by maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) from the 18F-FDG PET/CT scans. ctDNA detectability and quantity, using variant allele frequency, were estimated by tumor-informed ctDNA analyses.

Results

In total, 63 patients (median age 70 years, 60% women, and 90% adenocarcinoma) were included. The tumor glucose uptake (SUVmax, MTV, and TLG) was significantly higher in patients with detectable ctDNA (n = 19, p < 0.001). The ctDNA quantity correlated with MTV (Spearman’s ρ = 0.53, p = 0.021) and TLG (Spearman’s ρ = 0.56, p = 0.013) but not with SUVmax (Spearman’s ρ = 0.034, p = 0.15). ctDNA detection was associated with shorter OS independent of MTV (HR: 2.70, 95% CI: 1.07–6.82, p = 0.035) and TLG (HR: 2.63, 95% CI: 1.06–6.51, p = 0.036). Patients with high tumor glucose uptake and detectable ctDNA had shorter overall survival and progression-free survival than those without detectable ctDNA, though these associations were not statistically significant (p > 0.05).

Conclusion

There was a positive correlation between plasma ctDNA quantity and MTV and TLG in early-stage NSCLC patients. Despite the correlation, the results indicated that ctDNA detection was a negative prognostic factor independent of MTV and TLG.
Active involvement of people with lived experience of suicide in suicide research: a Delphi consensus study
Authors: Krysinska Karolina , Ozols Ingrid , Ross Anna , Andriessen Karl , Banfield Michelle , McGrath Martina , Edwards Bronwen , Hawgood Jacinta , Kõlves Kairi , Ross Victoria , Pirkis Jane
Published: July 2023

Background

The importance and value of involvement of people with lived experience of suicide has been recognized in suicide research and prevention. Nonetheless, clear guidance on research collaboration and co-production is lacking. This study aimed to address this gap by developing a set of guidelines on active involvement of people with lived experience of suicide in suicide studies., i.e., conducting research with or by people with lived experience, rather than to, about or for them.

Methods

The Delphi method was used to determine statements on best practice for the active involvement of people with lived experience of suicide in suicide research. Statements were compiled through a systematic search of the scientific and grey literature, and reviewing qualitative data from a recent related study conducted by the authors. Two expert panels: people with lived experience of suicide (n = 44) and suicide researchers (n = 29) rated statements over three rounds of an online survey. Statements endorsed by at least 80% of panellists of each panel were included in the guidelines.

Results

Panellists endorsed 96 out of 126 statements in 17 sections covering the full research cycle from deciding on the research question and securing funding, to conducting research and disseminating and implementing outcomes. Overall, there was a substantial level of agreement between the two panels regarding support from research institutions, collaboration and co-production, communication and shared decision making, conducting research, self-care, acknowledgment, and dissemination and implementation. However, panels also disagreed on specific statements regarding representativeness and diversity, managing expectations, time and budgeting, training, and self-disclosure.

Conclusions

This study identified consensus recommendations on active involvement of people with lived experience of suicide in suicide research, including co-production. Support from research institutions and funders, and training on co-production for researchers and people with lived experience, are needed for successful implementation and uptake of the guidelines.
Development of the non-occupational post-exposure prophylaxis (NPEP) knowledge scale among Chinese men who have sex with men
Authors: Li Haochu , Wei Ran , Weinstein Traci L. , Kim Eunsook , Jacques-Tiura Angela J. , Ning Xiaofu , Ma Wei
Published: July 2023

Background

Nonoccupational post-exposure prophylaxis (NPEP) is a short course of medication taken to reduce the likelihood of acquiring human immunodeficiency virus (HIV) infection upon exposure. A review of the literature demonstrates an urgent need for an empirically validated instrument that measures detailed knowledge of NPEP among the key population of men who have sex with men (MSM).

Methods

Semi-structured interviews, focus groups, and a cross-sectional survey with a sample of 419 MSM was conducted in 2018 in China to develop and psychometrically evaluate the new instrument, the NPEP Knowledge Scale. Exploratory and confirmatory factor analyses, differential item functioning analyses, and structural equation modeling were conducted using Mplus 7.4.

Results

The NPEP Knowledge Scale demonstrated excellent reliability and validity. Cronbach’s alpha was 0.903. The range of item R2 were 0.527–0.969, p’s < 0.001. Model estimated inter-item correlations ranged between 0.534 and 0.968. In addition, HIV knowledge, NPEP use, and NPEP knowledge were all significantly correlated.

Conclusions

The NPEP Knowledge Scale is suitable for research, program evaluation, and clinical and community services that require using NPEP to minimize the ever-present risk of new HIV infections.
Alcohol consumption and risky sexual behaviors among fishers in Elmina in Ghana
Authors: Kyei-Arthur Frank , Kyei-Gyamfi Sylvester
Published: July 2023

Background

Alcohol consumption is part of human social behavior and constitutes a routine part of social life in many countries. Prior studies have found over-indulgence of fishers in alcohol in fishing communities. The study uses the Alcohol Myopia Theory (AMT) to analyze and explain the phenomena of fishers engaging in sex after alcohol consumption, and condom use with sexual partner(s) after alcohol consumption. The study investigated alcohol consumption, predictors of alcohol consumption, and the reasons for drinking alcohol among fishers. It also examined fishers’ engagement in sex after alcohol consumption, the use of condoms with sexual partners after drinking alcohol, and predictors of the use of condoms with sexual partners after drinking alcohol.

Methods

A cross-sectional convergent parallel mixed-method design was used to study 385 fishers in Elmina. Also, two focus group discussions were conducted among male and female fishers. Descriptive statistics were used to analyze the quantitative data, while the qualitative data was analyzed thematically.

Results

Generally, 59.2% of participants indulged in alcohol consumption. Most male participants (70.6%) indulged in alcohol consumption than female participants (48.5%). Also, 48.5% of participants indulged in binge alcohol consumption, while 38.1% indulged in moderate alcohol consumption. The predictors of alcohol consumption were sex, religion, and type of fishing occupation. Participants identified consuming alcohol to kill loneliness and boredom, to forget family and work-related issues, and to have fun as reasons why fishers consume alcohol. Sixty-four percent of participants have ever engaged in sexual intercourse after consuming alcohol in the past 12 months. However, 70% of participants did not use a condom the last time they had sex after drinking alcohol. Only ethnicity of participants predicted their use of a condom the last time they had sex after drinking alcohol. The primary reasons for the non-use of condoms were do not like using condoms (37.9%), forgetting to use a condom (33.0%), and had sex with a trusted regular partner (15.5%).

Conclusions

This study demonstrated that alcohol consumption was prevalent among fishers, especially among male fishers, which contributes to risky sexual behaviors among them as espoused by the AMT. It is recommended that fishers are targeted for alcohol use and risky sexual behavior programs and interventions since alcohol use is prevalent among them and most of them also engage in unprotected sexual intercourse after consuming alcohol.
Prescription drug monitoring programs use mandates and prescription stimulant and depressant quantities
Authors: Gunadi Christian , Shi Yuyan
Published: July 2023

Background

While the mandate to check patients’ prescription history in Prescription Drug Monitoring Program (PDMP) database before prescribing/dispensing controlled drugs has been shown to be an important tool to curb opioid abuse, less is known about whether the mandate can reduce the misuse of other commonly abused prescription drugs. We examined whether PDMP use mandates were associated with changes in prescription stimulant and depressant quantities.

Methods

Using data from Automated Reports and Consolidate Ordering System (ARCOS), we employed difference-in-differences design to estimate the association between PDMP use mandates and prescription stimulant and depressant quantities in 50 U.S. states and the District of Columbia from 2006 to 2020. Limited PDMP use mandate was specific only to opioids or benzodiazepines. Expansive PDMP use mandate was non-specific to opioid or benzodiazepine and required prescribers/dispensers to check PDMP when prescribing/dispensing targeted controlled substances in Schedule II-V. The main outcomes were population-adjusted prescription stimulant (amphetamine, methylphenidate, lisdexamfetamine) and depressant (amobarbital, butalbital, pentobarbital, secobarbital) quantities in grams.

Results

There was no evidence that limited PDMP use mandate was associated with a reduction in the prescription stimulant and depressant quantities. However, expansive PDMP use mandate that was non-specific to opioid or benzodiazepine and required prescribers/dispensers to check PDMP when prescribing/dispensing targeted controlled substances in Schedule II-V was associated with 6.2% (95% CI: -10.06%, -2.08%) decline in prescription amphetamine quantity.

Conclusion

Expansive PDMP use mandate was associated with a decline in prescription amphetamine quantity. Limited PDMP use mandate did not appear to change prescription stimulant and depressant quantities.
Associations between exposure to sexual abuse, substance use, adverse health outcomes, and use of youth health services among Norwegian adolescents
Authors: Stea TH , Steigen AM , Dangmann CR , Granrud MD , Bonsaksen T
Published: July 2023

Background

A strong association between sexual abuse and adverse health outcomes has been reported among adolescents. The present study aimed to provide more information about adverse health outcomes associated with sexual abuse and substance use, and to examine the use of youth health services among Norwegian adolescents.

Methods

National representative cross-sectional study among 16–19-year-old Norwegian adolescents (n = 9784). Multivariable regression analyses, adjusted for socioeconomic status and age, were used to examine the association between exposure to sexual abuse, substance use and health risk factors, and the use of youth health services.

Results

Adolescents exposed to sexual abuse had higher odds of depressive symptoms (males: OR:3.8; 95% CI:2.5–5.8, females: 2.9;2.4–3.5), daily headache (males: 5.3;2.8–10.1, females:1.9; 1.5–2.4), high medication use (males: 3.2;1.7-6.0, females: 2.0;1.6–2.6), self-harm (males: 3.8;2.4-6.0, females:3.2; 2.6–3.9), suicidal thoughts (males: 3.3; 2.2-5.0, females:3.0; 2.5–3.6) and suicide attempts (males: 9.5;5.6–16.0, females:3.6;2.7–4.9). Furthermore, exposure to sexual abuse was associated with higher odds of using school health services (males: 3.9;2.6–5.9, females: 1.6;1.3–1.9) and health services for youth (males: 4.8;3.1–7.6, females: 2.1;1.7–2.5). In general, substance use was associated with increased odds of adverse health related outcomes and use of youth health services, but the strength of the relationships varied according to sex. Finally, results indicated a significant interaction between sexual abuse and smoking that was associated with increased odds of having suicidal thoughts for males (2.6;1.1–6.5) but a decreased odds of having suicidal thoughts and have conducted suicide attempts once or more for females (0.6;0.4-1.0 and 0.5;0.3–0.9, respectively).

Conclusions

The present study confirmed a strong relationship between exposure to sexual abuse and health risks, especially among males. Moreover, males exposed to sexual abuse were much more likely to use youth health services compared to sexually abused females. Substance use was also associated with adverse health outcomes and use of youth health services, and interactions between sexual abuse and smoking seemed to influence risk of suicidal thoughts and attempts differently according to sex. Results from this study increase knowledge about possible health related effects of sexual abuse which should be used to identify victims and provide targeted treatment by youth health services.
Incidence, risk factors, and prognosis of acute exacerbation of rheumatoid arthritis-associated interstitial lung disease: a systematic review and meta-analysis
Authors: Xie Maosheng , Zhu Chao , Ye Yujin
Published: July 2023

Introduction

Acute exacerbation (AE) is a devastating complication of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and leads to high mortality. This study aimed to investigate the incidence, risk factors, and prognosis of acute exacerbation of rheumatoid arthritis-associated interstitial lung disease (AE-RA-ILD).

Methods

PubMed, EMBASE, Web of Science, and Medline were searched through 8 February 2023. Two independent researchers selected eligible articles and extracted available data. The Newcastle Ottawa Scale was used to assess the methodological quality of studies used for meta-analysis. The incidence and prognosis of AE-RA-ILD were investigated. Weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) and pooled odds ratios (ORs) with 95% CIs were calculated to explore the risk factors of AE in RA-ILD.

Results

Twenty-one of 1,589 articles were eligible. A total of 385 patients with AE-RA-ILD, of whom 53.5% were male, were included. The frequency of AE in patients with RA-ILD ranged from 6.3 to 55.6%. The 1-year and 5-year AE incidences were 2.6–11.1% and 11–29.4%, respectively. The all-cause mortality rate of AE-RA-ILD was 12.6–27.9% at 30 days and 16.7–48.3% at 90 days. Age at RA diagnosis (WMD: 3.61, 95% CI: 0.22–7.01), male sex (OR: 1.60, 95% CI:1.16–2.21), smoking (OR: 1.50, 95% CI: 1.08–2.08), lower forced vital capacity predicted (FVC%; WMD: −8.63, 95% CI: −14.68 to − 2.58), and definite usual interstitial pneumonia (UIP) pattern (OR: 1.92, 95% CI: 1.15–3.22) were the risk factors of AE-RA-ILD. Moreover, the use of corticosteroids, methotrexate, and biological disease-modifying anti-rheumatic drugs, was not associated with AE-RA-ILD.

Conclusion

AE-RA-ILD was not rare and had a poor prognosis. Age at RA diagnosis, male sex, smoking, lower FVC%, and definite UIP pattern increased the risk of AE-RA-ILD. The use of medications, especially methotrexate and biological disease-modifying anti-rheumatic drugs, may not be related to AE-RA-ILD.

Registration

CRD42023396772.