bluuebunny/crossref_metadata_2025 huggingface dataset:
Healthcare providers’ and policymakers’ experiences and perspectives on barriers and facilitators to chronic disease self-management for people living with hypertension and diabetes in Cameroon
Authors: Mogueo Amélie , Defo Barthelemy Kuate , Mbanya Jean Claude
Published: November 2022

Background

Hypertension and diabetes are chronic noncommunicable diseases ranked among the leading causes of morbidity and mortality in resource-limited settings. Interventions based on patient empowerment (PE) have been shown to be effective in the management of these diseases by improving a variety of important health outcomes. This study aims to examine from the healthcare providers’ and policymakers’ experiences and perspectives, the facilitators and barriers in the management of hypertension and diabetes for patient empowerment to achieve better health outcomes in the context of the healthcare system in Cameroon.

Methods

We carried out a qualitative study involving three levels of embedded analysis in a public primary healthcare delivery system in Cameroon, through 22 semi-structural interviews with healthcare providers and policymakers and 36 observations of physicians’ consultations. We combined thematic and lexicometric analyses to identify robust patterns of differences and similarities in the experiences and perspectives of healthcare providers and policymakers about direct and indirect factors associated with patients’ self-management of disease.

Results

We identified 89 barriers and 42 facilitators at the central, organizational, and individual levels; they were preponderant at the organizational level. Factors identified by healthcare providers mainly related to self-management of the disease at the organizational and individual levels, whereas policymakers reported factors chiefly at the central and organizational levels. Healthcare providers involved in the decision-making process for the delivery of healthcare tended to have a sense of ownership and responsibility over what they were doing to help patients develop self-management abilities to control their disease.

Conclusion

While interventions focused on improving patient-level factors are essential to PE, there is a need for interventions paying more attention to organizational and political barriers to PE than so far. Interventions targeting simultaneously these multilevel factors may be more effective than single-level interventions.
Lifelong versus not lifelong death wishes in older adults without severe illness: a cross-sectional survey
Authors: Elzinga Elke , Zomers Margot , van der Burg Kiki , van Veen Sisco , Schweren Lizanne , van Thiel Ghislaine , van Wijngaarden Els
Published: November 2022

Background

Some older adults with a persistent death wish without being severely ill report having had a death wish their whole lives (lifelong persistent death wish; L-PDW). Differentiating them from older adults without severe illness who developed a death wish later in life (persistent death wish, not lifelong; NL-PDW) can be relevant for the provision of adequate help and support. This study aims to gain insight into the characteristics, experiences, and needs of older adults with a L-PDW versus older adults with a NL-PDW and into the nature of their death wishes.

Methods

In the Netherlands, in April 2019, a cross-sectional survey study was conducted among a large representative sample of 32,477 citizens aged 55 years and older. Respondents with a L-PDW (N = 50) were compared with respondents with a NL-PDW (N = 217) using descriptive statistics, Kruskal–Wallis tests, and Fisher’s exact tests.

Results

Respondents with a L-PDW were relatively younger and less often had (step)children. They less often looked back on a good and satisfying life with many good memories and more often reported trauma. Older adults with a NL-PDW more often reported loss and bereavement. Overall, the groups showed a lot of similarities. Both groups reported a death wish diverse in nature, numerous health problems, and a variety of needs for help and support.

Conclusions

Some of the differences we found between the groups might be particularly relevant for the provision of adequate help and support to older adults with a L-PDW (i.e., their past and trauma) and to older adults with a NL-PDW (i.e., their loss and bereavement). The heterogeneity of both groups and the diverse nature of their death wish indicate that careful assessment of the death wish, its background, and underlying needs is required to provide personalized help and support to older adults with a death wish.
Results of a Web-based survey of 2105 Greek migraine patients in 2020: demographics, clinical characteristics, burden and the effects of the COVID-19 pandemic on the course of migraine
Authors: Dermitzakis Emmanouil V. , Kouroudi Aikaterini , Argyriou Andreas A. , Spingos Konstantinos C. , Bilias Konstantinos , Vikelis Michail
Published: November 2022

The Greek Society of Migraine and Headache Patients (GSMHP), maintaining a strong commitment to research and information, conducted its second web-based online survey named "Migraine in Greece—2020", following its first one conducted in 2018. The 2020 study included 2,105 migraine patients who were called to answer 151 questions. The purposes of the current research were to record the demographic and clinical characteristics of migraine patients in Greece, including the severity and effects of migraine on respondents' quality of life, as well as to survey the effects of the coronavirus pandemic on the course of migraine. Our population, internet-based study provides data that will hopefully contribute to better comprehend the clinical phenotype and course of migraine during the COVID-19 pandemic.
The interaction between antenatal care and abnormal temperature during delivery and its relationship with postpartum care: a prospective study of 1,538 women in semi-rural Uganda
Authors: Rahim Nicholas E. , Ngonzi Joseph , Boatin Adeline A. , Bassett Ingrid V. , Siedner Mark J. , Mugyenyi Godfrey R. , Bebell Lisa M.
Published: November 2022

Background

Postnatal care (PNC) is an important tool for reducing maternal and neonatal morbidity and mortality. However, what predicts receipt and maintenance in PNC, particularly events during pregnancy and the peripartum period, is not well understood. We hypothesized that fever or hypothermia during delivery would engender greater health consciousness among those attending antenatal care, leading to greater PNC engagement after hospital discharge and our objective was to evaluate this relationship.

Methods

Women were prospectively enrolled immediately postpartum at Mbarara Regional Referral Hospital (MRRH). We collected postpartum vital signs and surveyed women by telephone about PNC receipt, fever, and infection at two and six weeks postpartum. Our outcome of interest was receipt of PNC post-discharge, defined as whether a participant visited a health facility and/or was hospitalized in the postpartum period. Our explanatory variables were whether a participant was ever febrile (> 38.0˚C) or hypothermic (< 36.0˚C) during delivery stay and whether a participant attended at least 4 antenatal care (ANC) visits. We used logistic regressions to estimate the association between ANC and fever/hypothermia with PNC, including an interaction term between ANC and fever/hypothermia to determine whether there was a modifying relationship between variables on PNC. Regression models were adjusted for age, marital status, parity, HIV serostatus, Mbarara residency, and whether the participant was referred to MRRH,

Results

Of the 1,541 women, 86 (5.6%) reported visiting a health facility and/or hospitalization and 186 (12.0%) had an abnormal temperature recorded during delivery stay. Of those who reported at least one visit, 59/86 (68.6%) delivered by cesarean, 37/86 (43.0%) reported post-discharge fever, and 44/86 (51.2%) reported post-discharge infection. Neither ANC attendance, abnormal temperature after delivery, nor their interaction term, were significantly associated with post-discharge PNC. The included covariates were not significantly associated with the outcome.

Conclusions

While the overall proportion of women reporting post-discharge PNC was low, those who reported visiting a health facility and/or hospitalization had high proportions of post-discharge fever, post-discharge infection, and cesarean delivery, which suggests that these visits may have been related to problem-focused care. No significant associations between ANC and PNC were observed in this cohort. Further research assessing ANC quality and PNC visit focus is needed to ensure ANC and PNC are optimized to reduce morbidity and mortality.
Trends in hospitalization and in-hospital mortality rates among patients with lung cancer in Spain between 2010 and 2020
Authors: Galindo-Utrero Abraham , San-Román-Montero Jesús María , Gil-Prieto Ruth , Gil-de-Miguel Ángel
Published: November 2022

Background

Lung cancer is the third most frequent tumor and the main cause of death by tumor in Spain. Although the incidence and mortality are still significantly higher in men than in women, the disparity between the sexes is decreasing. The objective of this study was to analyze the evolution of lung cancer hospitalization and in-hospital mortality rates in Spain from 2010 to 2020.

Methods

The reports of the Minimum Basic Data Set (MBDS) at hospital discharge were used to retrospectively analyze the data of all patients with a primary diagnosis of lung cancer, according to the International Classification of Diseases (ICD-9-CM and ICD-10-CM).

Results

Between 2010 and 2020, there were 315,263 hospitalizations and 70,490 deaths from lung cancer in Spain, the majority (~ 80%) in men. Overall, the rates of hospitalization and in-hospital mortality from lung cancer showed a downward trend throughout the period, although the number of new diagnoses and the absolute number of deaths in women increased. Due to the aging of the population, the degree of comorbidity in patients with lung cancer, although it remains relatively low, is also on the rise.

Conclusion

Lung cancer represents a substantial clinical and economic burden for patients and for the National Health System, so it is necessary to promote primary prevention campaigns, as well as to develop more effective population screening measures to detect cancers early and increase the patient survival.
Adaptation of Essential Care for Every Baby educational program to improve infant outcomes in the context of Zika
Authors: McNelis Kera , Prasanphanich Nina , Martin-Herz Susanne P. , Carter Terrell , Merchant Hannah Foehringer , Patterson Janna , Hager Salwan , Chitashvili Tamar , Jarvis Shivon Belle , Kamath-Rayne Beena D.
Published: November 2022

Background

The outbreak and ongoing transmission of Zika virus provided an opportunity to strengthen essential newborn care and early childhood development systems through collaboration with the US Agency for International Development Applying Science to Strengthen and Improve Systems (USAID ASSIST). The objective was to create a system of sustainable training dissemination which improves newborn care-related quality indicators in the context of Zika.

Methods

From 2018–19, USAID ASSIST supported a series of technical assistance visits by the American Academy of Pediatrics (AAP) in four Caribbean countries to strengthen the clinical capacity in care of children potentially affected by Zika through dissemination of Essential Care for Every Baby (ECEB), teaching QI methodology, coaching visits, and development of clinical care guidelines. ECEB was adapted to emphasize physical exam findings related to Zika. The first series of workshops were facilitated by AAP technical advisors and the second series were facilitated by the newly trained local champions. Quality of care was monitored with performance indicators at 134 health facilities.

Results

A repeated measures (pre-post) ANOVA was conducted, revealing significant pre-post knowledge gains [F(1) = 197.9, p < 0.001] on knowledge check scores. Certain performance indicators related to ECEB practices demonstrated significant changes and midline shift on the run chart in four countries.

Conclusion

ECEB can be adapted to incorporate important local practices, causes of neonatal morbidity and mortality, and differing healthcare system structures, which, as one part of a larger technical assistance package, leads to improved performance of health systems.
Factors associated with insomnia and suicidal thoughts among outpatients, healthcare workers, and the general population in Taiwan during COVID-19 pandemic: a cross-sectional study
Authors: Lin Yi-Hsuan , Chen Jung-Sheng , Huang Po-Ching , Lu Mei-Yun , Strong Carol , Lin Chung-Ying , Griffiths Mark D. , Ko Nai-Ying
Published: November 2022

Background

Insomnia and suicidal thoughts are two of the negative impacts that have been caused by the COVID-19 pandemic. Identifying the factors that contribute to these psychological problems may help develop strategies to sustain the mental health of the public. The present study examined the psychosocial impacts caused by the COVID-19 pandemic among different populations in Taiwan, and investigated the relationships between these psychosocial variables, insomnia, and suicidal thoughts.

Methods

Between September 2020 and May 2021, online questionnaires including psychometrically validated scales were distributed to a convenience sample of outpatients (n = 205), healthcare workers (HCWs) (n = 500), and individuals in the general population (n = 1200) in Taiwan to collect data regarding their insomnia severity, suicidal thoughts, fear of COVID-19, trust of information, and resilience. Multivariate logistic regression methods were used to identify variables associated with suicidal thoughts and insomnia.

Results

Greater fear of COVID-19 was significantly associated with suicidal thoughts: odds ratios (ORs) with 95% confidence interval (CI) = 1.155 (1.002–1.330) for outpatients; 1.127 (1.035–1.228) for HCWs; and 1.100 (1.130–1.222) for those in the general population. Higher resilience was significantly associated with lower insomnia: OR (95% CI) = 0.819 (0.725–0.926) for outpatients; 0.803 (0.728–0.887), for HCWs; 0.829 (0.785–0.875), and for those in the general population. In addition, there was a statistically significant association between insomnia diagnosis and greater fear of COVID-19 among HCWs (OR [95% CI] = 1.102 [1.062–1.144]) and those in the general population (OR [95% CI] = 1.079 [1.053–1.106]). Among outpatients, there was a statistically significant association between suicidal thoughts and lower trust of information (OR [95% CI] = 0.794 [0.646–0.976]), while among those in the general population there was a statistically significant association between suicidal thoughts and higher insomnia severity (OR [95% CI] = 1.175 [1.13–1.222]). A statistically significant association was also found between insomnia diagnosis and higher suicidal thoughts among those in the general population (OR [95% CI] = 3.455 [2.338–5.106]).

Conclusions

Trust of information, fear, and resilience were important factors for suppressing suicidal thoughts and insomnia among the three study populations. Health policies that monitor psychological status and build resiliency of the public are recommended to help develop tailored strategies for different populations affected by the COVID-19 pandemic.
Social capital and willingness to participate in COVID-19 vaccine trials: an Italian case-control study
Authors: Terraneo Marco , Quaglia Valeria , Nuvolati Giampaolo , Bani Marco , Russo Selena , Strepparava Maria Grazia , Capici Serena , Cavaliere Rebecca , Cazzaniga Marina Elena
Published: November 2022

Background

What leads healthy people to enter in a volunteer register for clinical trials? This study aimed to investigate the relationship between the decision to volunteer in clinical trials for a COVID-19 vaccine and social capital, in a sample of healthy volunteers in Italy. Since social capital is characterized by trust, reciprocity, and social and political participation, we claim that it is key in leading individuals to actively take action to protect public health, and to take a risk for the (potential) benefit not only of themselves but for the entire community.

Methods

This study was conducted through the administration of a questionnaire to healthy volunteers registered for a phase 1 clinical trial for a COVID-19 vaccine in the Unit Research Centre of ASST-Monza, in September 2020. The primary purpose of a phase 1 study is to evaluate the safety of a new drug candidate before it proceeds to further clinical studies. To approximate a case–control study, we randomly matched the 318 respondents to healthy volunteers (cases) with 318 people randomly selected by Round 9 of the European Social Survey (controls), using three variables, which we considered to be associated with the decision to volunteer: gender, age, and education level. To execute this matching procedure, we used the “ccmatch” module in STATA.

Results

The findings highlight the positive impact of social capital in the choice of healthy individuals to volunteer in COVID-19 vaccine clinical trials. Controlling for possible confounding factors, some exemplary results show that people with a high level of general trust have a greater likelihood of volunteering compared to people with low trust (OR = 2.75, CI = 1.58–4.77); we also found that it is more probable that volunteers are people who have actively taken action to improve things compared with people who have not (for individuals who did three or more actions: OR = 7.54, CI = 4.10–13.86). People who reported voting (OR = 3.91, CI = 1.70–8.99) and participating in social activities more than other people of their age (OR = 2.89, CI = 1.82–4.60) showed a higher probability to volunteer.

Conclusions

Together with the adoption of urgent health measures in response to COVID-19, government policymakers should also promote social capital initiatives to encourage individuals to actively engage in actions aimed at protecting collective health. Our findings make an empirical contribution to the research on vaccines and its intersection with social behaviour, and they provide useful insights for policymakers to manage current and future disease outbreaks and to enhance the enrolment in vaccine trials.
BMI and pelvimetry help to predict the duration of laparoscopic resection for low and middle rectal cancer
Authors: Teng Wenhao , Liu Jingfu , Chen Meimei , Zang Weidong , Wu Aiwen
Published: November 2022

Background

In rectal cancer surgery, recent studies have found associations between clinical factors, especially pelvic parameters, and surgical difficulty; however, their findings are inconsistent because the studies use different criteria. This study aimed to evaluate common clinical factors that influence the operative time for the laparoscopic anterior resection of low and middle rectal cancer.

Methods

Patients who underwent laparoscopic radical resection of low and middle rectal cancer from January 2018 to December 2020 were retrospectively analyzed and classified according to the operative time. Preoperative clinical and magnetic resonance imaging (MRI)-related parameters were collected. Logistic regression analysis was used to identify factors for predicting the operative time.

Results

In total, 214 patients with a mean age of 60.3 ± 8.9 years were divided into two groups: the long operative time group (n = 105) and the short operative time group (n = 109). Univariate analysis revealed that the male sex, a higher body mass index (BMI, ≥ 24.0 kg/m2), preoperative treatment, a smaller pelvic inlet (< 11.0 cm), a deeper pelvic depth (≥ 10.7 cm) and a shorter intertuberous distance (< 10.1 cm) were significantly correlated with a longer operative time (P < 0.05). However, only BMI (OR 1.893, 95% CI 1.064–3.367, P = 0.030) and pelvic inlet (OR 0.439, 95% CI 0.240–0.804, P = 0.008) were independent predictors of operative time. Moreover, the rate of anastomotic leakage was higher in the long operative time group (P < 0.05).

Conclusion

Laparoscopic rectal resection is expected to take longer to perform in patients with a higher BMI or smaller pelvic inlet.
An imConvNet-based deep learning model for Chinese medical named entity recognition
Authors: Zheng Yuchen , Han Zhenggong , Cai Yimin , Duan Xubo , Sun Jiangling , Yang Wei , Huang Haisong
Published: November 2022

Background

With the development of current medical technology, information management becomes perfect in the medical field. Medical big data analysis is based on a large amount of medical and health data stored in the electronic medical system, such as electronic medical records and medical reports. How to fully exploit the resources of information included in these medical data has always been the subject of research by many scholars. The basis for text mining is named entity recognition (NER), which has its particularities in the medical field, where issues such as inadequate text resources and a large number of professional domain terms continue to face significant challenges in medical NER.

Methods

We improved the convolutional neural network model (imConvNet) to obtain additional text features. Concurrently, we continue to use the classical Bert pre-training model and BiLSTM model for named entity recognition. We use imConvNet model to extract additional word vector features and improve named entity recognition accuracy. The proposed model, named BERT-imConvNet-BiLSTM-CRF, is composed of four layers: BERT embedding layer—getting word embedding vector; imConvNet layer—capturing the context feature of each character; BiLSTM (Bidirectional Long Short-Term Memory) layer—capturing the long-distance dependencies; CRF (Conditional Random Field) layer—labeling characters based on their features and transfer rules.

Results

The average F1 score on the public medical data set yidu-s4k reached 91.38% when combined with the classical model; when real electronic medical record text in impacted wisdom teeth is used as the experimental object, the model's F1 score is 93.89%. They all show better results than classical models.

Conclusions

The suggested novel model (imConvNet) significantly improves the recognition accuracy of Chinese medical named entities and applies to various medical corpora.
Diagnostic delay of myositis: an integrated systematic review
Authors: Namsrai Tergel , Parkinson Anne , Chalmers Anita , Lowe Christine , Cook Matthew , Phillips Christine , Desborough Jane
Published: November 2022

Background

Idiopathic inflammatory myopathies (IIM) are a heterogenous group of rare muscular autoimmune diseases characterised by skeletal muscle inflammation with possible diagnostic delay. Our aim was to review the existing evidence to identify overall diagnostic delay for IIM, factors associated with diagnostic delay, and people’s experiences of diagnostic delay.

Methods

Three databases and grey literature sources were searched. Diagnostic delay was defined as the period between the onset of symptoms and the year of first diagnosis of IIM. We pooled the mean delay using random effects inverse variance meta-analysis and performed subgroup analyses.

Results

328 titles were identified from which 27 studies were included. Overall mean diagnostic delay was 27.91 months (95% CI 15.03–40.79, I2 = 99%). Subgroup analyses revealed a difference in diagnostic delay between non-inclusion body myositis (IBM) and IBM types. There was no difference in diagnostic delay between studies in which myositis specific autoantibodies (MSA) were tested or not tested. In countries with gatekeeper health systems, where primary care clinicians authorize access to specialty care, people experienced longer periods of diagnostic delay than people with IIM in countries with non-gatekeeper systems. While studies discussed factors that may influence diagnostic delay, significant associations were not identified. No qualitative studies examining people’s experiences of diagnostic delay were identified.

Conclusion

Diagnostic delay of IIM has extensive impacts on the quality of life of people living with this disease. Understanding the experiences of people with IIM, from symptom onset to diagnosis, and factors that influence diagnostic delay is critical to inform clinical practice and training activities aimed at increasing awareness of this rare disease and expediting diagnosis.

Trial registration: PROSPERO Registration number: CRD42022307236 URL of the PROSPERO registration: https://www.crd.york.ac.uk/PROSPEROFILES/307236_PROTOCOL_20220127.pdf
Heritability estimates of distichiasis in Staffordshire bull terriers using pedigrees and genome-wide SNP data
Authors: Joergensen Dina , Madsen Per , Ropstad Ernst-Otto , Lingaas Frode
Published: November 2022

Background

Distichiasis is the most frequently recorded eye disorder in the Norwegian Staffordshire bull terrier (SBT). The condition is often mild but can, in severe cases, lead to pain and blindness. The current study's main purpose was to estimate the heritability based on pedigree information as well as single nucleotide polymorphisms (SNPs) to evaluate whether it is realistic to reduce the frequency by systematic breeding. The majority of the dogs had only one examination as a young puppy. To evaluate whether this early screening gave a reliable representation of the disease burden in the population, we compared the diagnosis in puppies and adult dogs.

Results

Our material consisted of data from 4177 dogs with an overall prevalence of distichiasis of 8.38% (CI 7.56–9.26). The prevalence in puppies examined around eight weeks of age was significantly lower than in dogs examined after 52 weeks (2.87%, CI 2.29–3.54 versus 18.72%, CI 16.71–20.87). The heritability was estimated in dogs examined after 52 weeks. We used both pedigree (1391 dogs) and genotype (498 dogs) information for the estimates. The pedigree-based heritability was ~ 0.22 (on the underlying scale ~ 0.48), while the genomic-based heritability (on the underlying scale) was ~ 0.47, and ~ 0.37 when excluding close relatives with equal affection status.

Conclusions

Screening for distichiasis in puppies before eight weeks of age is not sufficient to give an accurate estimate of the prevalence, and an additional examination after one year is recommended. The heritability of distichiasis is medium to high, showing that it should be possible to reduce the prevalence by selective breeding.
Preparation of triangular silver nanoparticles and their biological effects in the treatment of ovarian cancer
Authors: Yin Man , Xu Xiangyu , Han Hui , Dai Jiahui , Sun Ronghe , Yang Linqing , Xie Junyu , Wang Yunfei
Published: November 2022

Background

In recent years, silver nanoparticles (AgNPs) have gradually been widely used, especially in the field of anticancer medicine. Ovarian cancer (OC) is the gynaecological malignancy with the highest mortality rate, and the current treatment is still based on surgery, chemotherapy and postoperative targeted therapy. Therefore, the development of safe and effective nanoparticles for targeted therapy of OC is very important. This study aimed to prepare a new type of triangular silver nanoparticles (tAgNPs) and evaluate the anticancer properties for OC in vitro and in vivo.

Methods

The tAgNPs were chemically synthesized and characterized using scanning electron microscopy (SEM), ultraviolet (UV) spectrophotometry and other techniques. By performing cell-based tests, such as cell counting kit-8 (CCK-8), plate colony formation, cell apoptosis, reactive oxygen species (ROS), and western blot (WB) assays, the inhibitory effects and related mechanisms of tAgNPs on OC cells were analysed.The anticancer effect of tAgNPs in vivo was verified by a SKOV3 tumor-bearing mouse model.

Results

Five types of tAgNPs with different colours were successfully synthesized, with a particle size of 25–50 nm and a good dispersion. The results of in vitro experiments showed that tAgNPs treatment reduced the viability and proliferation of SKOV3 cells, arrested the cell cycle in G0/G1 phase, inhibited the expression levels of proliferation-related factors and cyclins, and promoted cell apoptosis by producing ROS and increasing caspase-3 activity. Consistent with the results of in vitro experiments, in vivo animal experiments also showed that tAgNPs significantly inhibited the proliferation of ovarian cancer. More importantly, no obvious toxic and side effects were observed.

Conclusions

In this study, a novel triangular AgNPs was successfully prepared. tAgNPs are very stable, significantly inhibit the proliferation of OC cells and tumour growth in tumour-bearing mice, providing a promising nanotargeted therapy for OC.
Effectiveness of protocolized management for patients sustaining maxillofacial fracture with massive oronasal bleeding: a single-center experience
Authors: Wu Fang-Chi , Hung Kuo-Shu , Lin Yu-Wen , Sung Kang , Yang Tsung-Han , Wu Chun-Hsien , Wang Chih-Jung , Yen Yi-Ting
Published: November 2022

Background

Maxillofacial fractures can lead to massive oronasal bleeding; however, surgical hemostasis and packing procedures can be challenging owing to complex facial anatomy. Only a few studies investigated maxillofacial fractures with massive oronasal hemorrhage. However, thus far, no studies have reported a protocolized management approach for maxillofacial trauma from a single center. This study aimed to evaluate the effectiveness of protocolized management for maxillofacial fractures with oronasal bleeding.

Methods

Patients were identified from the National Cheng University Hospital trauma registry from 2010 to 2020. We included patients with a face Abbreviated Injury Scale (AIS) score of > 3 and active oronasal bleeding. Patients’ characteristics were compared between the angiography and non-angiography groups and between survivors and nonsurvivors.

Results

Forty-nine patients were included. Among them, 34 (69%) underwent angiography, of whom 21 received arterial embolization. Forty-seven patients (96%) successfully achieved hemostasis by adhering to the treatment protocol at our institution. Compared with the non-angiography group, the angiography group had significantly more patients requiring oral intubation (97% vs. 53%, P < 0.001), Glasgow Coma Scale < 9 (GCS; 79% vs. 27%, P < 0.001), head AIS > 3 (65% vs. 13%, P = 0.001), higher Injury Severity Score (ISS; 43 [33–50] vs. 22 [18–27], P < 0.001), higher incidence of cardiopulmonary resuscitation (CPR; 41% vs. 0%, P = 0.002), higher mortality rate (35% vs. 7%, P = 0.043), and more units of packed red blood cells (PRBC) transfused within 24 h (12 [6–20] vs. 2 [0–4], P < 0.001). The nonsurvivor group had significantly more patients with hypotension (62% vs. 8%; P < 0.001), higher need for CPR (85% vs. 8%; P < 0.001), head AIS > 3 (92% vs. 33%; P < 0.001), skull base fracture (100% vs. 64%; P = 0.011), GCS score < 9 (100% vs. 50%; P = 0.003), higher ISS (50 [43–57] vs. 29 [19–48]; P < 0.001), and more units of PRBC transfused within 24 h (18 [13–22] vs. 6 [2–12]; P = 0.001) than the survivor group. More patients underwent angiography in the nonsurvivor group than in the survivor group (92% vs. 61%; P = 0.043). Among embolized vessels, the internal maxillary artery (65%) was the most common bleeding site. Hypoxic encephalopathy accounted for 92% of deaths.

Conclusions

Protocol-guided management effectively optimizes outcomes in patients with maxillofacial bleeding.
A novel NF1 mutation in a pediatric patient with renal artery aneurysm
Authors: Chillura Ilenia , Restivo Giulia Angela , Callari Simonetta , Cibella Sabrina , D’Alessandro Maria Michela , Corrado Ciro , Vallone Mario , Antona Vincenzo , Corsello Giovanni
Published: November 2022

Background

Neurofibromatosis type 1 (NF1) is a neurocutaneous syndrome, due to heterozygous pathogenic variants in NF1 gene. The main clinical manifestations are multiple café au lait spots, axillary and inguinal freckling, cutaneous and plexiform neurofibromas, optic glioma, Lisch nodules and osseous lesions, such as sphenoid and tibial dysplasia. Vasculopathy is another feature of NF1; it consists of stenosis, aneurysms, and arteriovenous malformations, frequently involving renal arteries.

Case presentation

We report on a 9-year-old girl with a novel mutation in NF1 gene and renal artery aneurysm, treated by coil embolization and complicated with hypertension.

Conclusion

Vasculopathy is a complication of NF1, affecting from 0.4 to 6.4% of patients with NF1. Among the vascular abnormalities, renal artery aneurysm is a rare manifestation, with only a few cases regarding adult patients and no pediatric reports described in current literature. The finding of a vascular abnormality in a specific site requires the evaluation of the entire vascular system because multiple vessels could be involved at the same time.
The Prospective Lynch Syndrome Database: background, design, main results and complete MySQL code
Authors: Møller Pål
Published: November 2022

A brief description of why and for which purposes the Prospective Lynch Syndrome Database was established, the principles and design, and the main classes of results are given. Data input is assumption-free input enabling validation of paradigms used to explain the results. The design is considering cancer/age as discrete events to occur or not in a time dimension in a closed room compliant with population genetic paradigms and last centuries developing paradigms of interpreting discrete events reflecting conditional and/or co-occurring stochastic probabilities. Which may be in contrast to the paradigm that any observed event has a cause. The results may indicate that some current paradigms on carcinogenesis should be reconsidered. The complete analytic code in MySQL© syntax together with a flowchart illustrating how the different pieces of codes interrelate are included as supplementary files, enabling third parties to use or modify the code to examine prospectively observed events in their own activities when referring to this report as the source.
Surface treatment of red painted and slipped wares in the middle Yangtze River valley of Late Neolithic China: multi-analytical case analysis
Authors: Li Tao , Li Guoyuan , Li Zongyang , Wu Tengfei , Tian Hui , Shan Siwei , Wang Lihua
Published: November 2022

Red slipped and painted wares (RSW and RPW) were manufactured to cook, serve, or store foods and liquids in the middle Yangtze River valley (MYRV) of China some 8500 and 7800 years ago, respectively. Their primary use narrowed down to serving and drinking in the Upper Qujialing (5300–4500 cal BP) and Shijiahe (4500–4200 cal BP) periods when initial states (bang guo) took shape and developed in the region. The increasing social complexity in MYRV correlated with the formation of community and neighborhood identity through rituals and socio-economic ties involving the widespread use of RSW and RPW. How the two wares were produced and used helps us understand the relationships among productive activities, identity, and social inequality in MYRV. This paper presents the first overview of RSW and RPW in the Neolithic MRYV. It introduces a multi-analytical study of the two wares—mostly dating to the Shijiahe period—unearthed from the site of Fenghuangzui in Xianyang City of Hubei Province, China. Optical microscopic examination revealed that the paint of RPW—50 μm thick on average—was applied using a brush while the slip of RSW is thinner and finer and possibly formed by self-slipping. Handheld X-ray fluorescence (hhXRF) and benchtop micro-XRF analyses ascribed the red paint or slip to iron and iron oxide. Raman and X-ray absorption fine structure analyses confirmed that iron was present in the paint or slip in the form of hematite with a poorly developed crystalline structure. Furthermore, thin-section petrography implied that different pastes were used to produce RPW and RSW, and hhXRF data indicated that the Upper Qujialing and Shijiahe pottery differ in the concentrations of five elements (Zr, Fe, Mn, Ti, and Ba), which might be helpful in future provenance studies of RSW and RPW. Our study discloses the complexity of the manufacture of RSW and RPW at Fenghuangzui. More details of RSW and RPW production and use from our ongoing project shall reveal the role of the two wares in the social dynamics of the Late Neolithic MYRV.

Graphic Abstract
A species-transport model for circulation in a leading-edge vortex
Authors: Giner-Morency Clara , Wong Jaime G.
Published: November 2022

In this study, we propose a model to predict circulation growth along the span of a rotating wing, in which circulation transport is represented as species transport. Fluid particles entering the vortex shear layer at the leading edge are initialized as vorticity-containing mass and are advected by the flow along the span. A circulation budget is presented, consisting of a generation and transport term, the latter derived from the vorticity transport equation, which leaves only two unknowns for the modeller to determine: the shear-layer thickness and the spanwise flow distribution. We find that the model is insensitive to the value chosen for the shear-layer thickness, as varying the thickness by an order of magnitude only changes the output by a few percent. Meanwhile, we use Bernoulli equation in a rotating coordinates system as a basic model for spanwise flow. To verify the accuracy of the model, the predicted circulation values are compared against experimental circulation values and show good agreement to measurements close to the axis of rotation, which corresponds to the spanwise locations at which the spanwise flow model best matches experimental data. It is suggested, therefore, that this model produces accurate results subject to an appropriate spanwise flow model.
The youngest are hit hardest: The influence of the COVID-19 pandemic on the hospitalization rate for children, adolescents, and young adults with anorexia nervosa in a large German representative sample
Authors: Herpertz-Dahlmann Beate , Dempfle Astrid , Eckardt Stefan
Published: November 2022

Background

The COVID-19 pandemic has severely impacted the mental health of children and adolescents. Young people at risk for anorexia nervosa (AN) have been especially shown to be affected. There are no studies that have investigated the respective proportions of hospitalized children, adolescents, and young adults separately as well as of both sexes during the COVID-19 crisis.

Methods

This study is based on the administrative data of the largest German statutory health insurance. All children (0–14 years) and adolescents (15–19 years) with a discharge diagnosis of typical and atypical AN according to the International Classification of Diseases (ICD)-10 were included. Admission rates per 10,000 person-years were calculated separately by sex and age group, based on admission numbers from the 9-month interval from January to September of 2019, 2020, and 2021 and the number of insured persons per sex and age group of each year.

Results

The entire sample comprised approximately 4.7 million children and adolescents. There was a highly significant increase of 40% (relative risk (RR): 1.4; [1.27, 1.55]; p < 0.0001) in admission rates in the female children’s and the adolescents’ group (RR:1.32; [1.24, 1.41]; p< 0.0001) between the pre-COVID-19 and peri-COVID-19 periods in 2019 and 2021, respectively. Among males, hospitalization rates significantly increased in the children (RR: 1.69; [1.09, 2.62]; p < 0.02).

Conclusions

Young people appear to be especially prone to develop AN during a crisis, such as with social isolation and school closures. Home-based or mobile pediatric services should be established to prevent this often chronic and disabling disorder in young patients.
Gene-Level Associations in Patients With and Without Pathogenic Germline Variants in CDKN2A and Pancreatic Cancer
Authors: Astiazaran-Symonds Esteban , Graham Cole , Kim Jung , Tucker Margaret A. , Ingvar Christian , Helgadottir Hildur , Pastorino Lorenza , van Doorn Remco , Sampson Joshua N. , Zhu Bin , Bruno William , Queirolo Paola , Fornarini Giuseppe , Sciallero Stefania , Carter Brian , Hicks Belynda , Hutchinson Amy , Jones Kristine , Stewart Douglas R. , Chanock Stephen J. , Freedman Neal D. , Landi Maria Teresa , Höiom Veronica , Puig Susana , Gruis Nelleke , Yang Xiaohong R. , Ghiorzo Paola , Goldstein Alisa M.
Published: November 2022

PURPOSE

Pancreatic ductal adenocarcinoma (PDAC) is a component of familial melanoma due to germline pathogenic variants (GPVs) in CDKN2A. However, it is unclear what role this gene or other genes play in its etiology.

MATERIALS AND METHODS

We analyzed 189 cancer predisposition genes using parametric rare-variant association (RVA) tests and nonparametric permutation tests to identify gene-level associations in PDAC for patients with ( CDKN2A +) and without ( CDKN2A–) GPV. Exome sequencing was performed on 84 patients with PDAC, 47 CDKN2A+ and 37 CDKN2A–. After variant filtering, various RVA tests and permutation tests were run separately by CDKN2A status. Genes with the strongest nominal associations were evaluated in patients with PDAC from The Cancer Genome Atlas and the UK Biobank (UKB). A secondary analysis including only GPV from UKB was also performed.

RESULTS

In RVA tests, ERCC4 and RET showed the most compelling evidence as plausible PDAC candidate genes for CDKN2A+ patients. In contrast, the findings in CDKN2A– patients provided evidence for HMBS, EPCAM, and MRE11 as potential new candidate genes and confirmed ATM, BRCA2, and PALB2 as PDAC genes, consistent with findings in The Cancer Genome Atlas and the UKB. As expected, CDKN2A– patients were more likely to harbor GPVs from the 189 genes investigated. When including only GPVs from UKB, significant associations with PDAC were seen for ATM, BRCA2, and CDKN2A.

CONCLUSION

These results suggest that variants in other genes likely play a role in PDAC in all patients and that PDAC in CDKN2A+ patients has a distinct etiology from PDAC in CDKN2A– patients.
Queer Ecology in Loïe Fuller’s Modernist Dance and Magnus Hirschfeld’sDie Transvestiten
Authors: Linge Ina
Published: November 2022

Dance orients the performer’s body toward both environment and pleasure, yet the intersection of environmental and sexual attunement in dance practice remains an underexplored area of research. This article considers how environmental and sexual readings of dance practice can be brought together by proposing a queer ecological approach to modernist dance. Drawing on research in dance studies, feminist and queer science studies, and sexology studies, the article examines the work of Loïe Fuller, an early pioneer of modernist dance, to show how Fuller’s work engages with themes of both sex and nature and consequently introduces environmentally attuned thinking to early twentieth century sexual knowledge production. By examining the parallels and divergences between Magnus Hirschfeld’s early twentieth-century sexological writing about “transvestitism” and Loïe Fuller’s modernist dance, via the copycat dancer Henry Cyril Paget, this article shows that both dance and sexology rethought the relationship between sex and nature by grappling, to different extents, with a queer vision of nature, where nature loses its explanatory force and moral authority. This reveals the importance of nature and the nonhuman in the production of modern concepts of sex, gender, and sexuality and the important role that dance can play in illuminating the intersection of sex and nature.
Predictive factors for hypothyroidy after hemithyroidectomy
Authors: Chaabouni Mohamed Amine , Sellami Moncef , Jameleddine Esma , Kharrat Rania , Thabet Wadii , Mnejja Malek , Hammami Boutheina , Ayadi Sirine , Achour Imen , Charfeddine Ilhem
Published: November 2022

Background: Hemithyroidectomy is one of the most common procedures performed. It is used to treat patients with benign unilateral nodules. Hemithyroidectomy results in fewer risks of hypothyroidism and the need for thyroid hormone replacement therapy. The present study was designed to identify potential clinicopathologic risk factors associated with the onset of biochemical hypothyroidism.

Methods: We conducted a retrospective review of all patients who underwent hemithyroidectomy between 2004 and 2019. Hypothyroidism was defined as a serum thyrotropin level greater than 5 mIU/L. The patients were analyzed for age, sex, preoperative and postoperative thyroid stimulating hormone (TSH), state, side, and volume of the remaining lobe, and histologic diagnosis.

Results: Hypothyroidism was diagnosed in 30.8% of 214 patients. This complication appeared in the first year in 83.3% of the cases. A preoperative TSH level greater than 1.32 mIU/l, a remaining volume of the lobe less than 3 ml, and the presence of thyroiditis were associated with a significant increase in the risk of developing hypothyroidism (p<0.01). There were no significant differences in age, sex, state, and side of the remaining lobe. The mean thyroxine dose was 57 ± 26 micrograms.

Conclusions: The risk of hypothyroidism after hemithyroidectomy should be assessed prior to surgery. Close monitoring is recommended in patients at high risk of developing this complication. However, all patients who undergo hemithyroidectomy should be monitored at least for the first year.
Comparison of mobile health education messages verses face-to-face consultation for weight reduction among overweight female adolescents in Thailand
Authors: Wongtongtair Supim , Iamsupasit Sompoch , Somrongthong Ratana , Kumar Ramesh , Yamarat Khemika
Published: November 2022

Background: Obesity is considered a significant public health problem in Thailand. This study was conducted to compare the impact of mobile health education messages verses face-to-face consultation on weight reduction among overweight female university students.

Methods: This Quasi-experimental study comprised three groups: a control group, a group receiving mobile health education, and a group receiving face-to-face consultation. Each group contained 26 participants taking part over a period of 12 weeks, with a 12-week follow-up thereafter. The data analysis used two-way repeated measures ANOVA with least significant difference testing. The study was ethically approved at Chulalongkorn University, Thailand.

Results: The results revealed that the intervention found significant results in weight reduction among the respondents (p < 0.05). In addition, both intervention groups significantly improved their health belief, social support, and health behavior scores in comparison to the control group (p < 0.001). The results show that the average scores for social support for eating and exercise at baseline were significantly lower than at post-intervention or follow-up (p < 0.001). In addition, the results of both aspects of social support showed that the average social support score at post-intervention was significantly higher than at follow-up. Furthermore, the health behavior score measured post-intervention was higher than at follow-up. There was a statistically significant difference in average metabolism during physical activity (p < 0.001) but no statistical difference in average eating behavior score.

Conclusion: The study found that the use of mobile health education to deliver health programs facilitates communication between the healthcare provider and individual, and can empower adolescent females in their pursuit of weight loss by improving their attitudes and knowledge, leading to better health behavior.

Keywords

Electronic health education, Facebook, health education, health belief model, social support, obesity, Thailand, health behaviors