bluuebunny/crossref_metadata_2025 huggingface dataset:
Different clinical phenotypes of AQP4-IgG positive NMOSD in two first degree relatives
Authors: Ssemmanda Salvatore , Musubire Abdu Kisekka
Published: September 2023

Background

Neuromyelitis optica spectrum disorder (NMOSD) are autoimmune inflammatory disorders of the CNS in which patients have severe relapses of optic neuritis and myelitis. Aquaporin-4 antibody (AQP4-IgG) positive NMOSD has not been reported in members of the same family in Sub Saharan Africa. We report the uncommon scenario in which both a Ugandan HIV positive woman and her HIV negative daughter were diagnosed with AQP4-IgG positive NMOSD. We discuss pathogenic mechanisms that may underlie familial presentation of AQP4-IgG positive NMOSD.

Case Presentation

Case 1, a 54-year-old female teacher with a 20-year history of HIV infection and virally suppressed on Tenofovir, Lamivudine and Dolutegravir HAART regimen, presented with 8 months of progressive quadriparesis and urinary incontinence with a T6 sensory level. She had gadolinium enhancing longitudinally extensive transverse myelitis on MRI and was AQP4-IgG positive on serum studies. She received IV Methylprednisone 1 g daily for 3 days as a pulse and was continued on tapering doses of oral Prednisone with maintenance doses of Azathioprine. She showed slow improvements in limb motor function. Her daughter, case 2, is a 35-year-old HIV negative nutritionist, independently ambulant, with no known comorbidities or precedent autoimmune disease. She presented 1 year before her mother’s AQP4-IgG positive NMOSD diagnosis with 7 months history of bilateral visual loss of rapid onset, with gadolinium-enhancing optic nerves on Brain and orbit MRI, in keeping with bilateral optic neuritis. She was AQP4-IgG positive on serum studies. She stabilized on tapered doses of oral Prednisone and continues daily oral Azathioprine with moderate improvement in her vision and no further relapses as yet.

Conclusions

We add to existing literature and hypothesize that NMOSD appears to show a complex genetic background. To our knowledge, this is the first report in Sub-Saharan Africa, of familial AQP4-IgG positive NMOSD presenting with clinical heterogeneity between first degree relatives. A better understanding of the pathogenic mechanisms involved, including genome wide studies for particular risk loci for familial NMOSD, will be pivotal for future preventative and therapeutic strategies.
Screening for postpartum depression and risk of suicidality with obstetrical patients: a cross-sectional survey
Authors: Boisvert Carlie , Talarico Robert , Gandhi Jasmine , Kaluzienski Mark , Dingwall-Harvey Alysha LJ , White Ruth Rennicks , Sampsel Kari , Wen Shi Wu , Walker Mark , Muldoon Katherine A. , El-Chaâr Darine
Published: September 2023

Background

Pregnancy is a vulnerable time where the physical and social stress of the COVID-19 pandemic affects psychological health, including postpartum depression (PPD). This study is designed to estimate the prevalence and correlates of PPD and risk of suicidality among individuals who gave birth during the COVID-19 pandemic.

Methods

We surveyed individuals who gave birth at The Ottawa Hospital and were ≥ 20 days postpartum, between March 17 and June 16, 2020. A PPD screen consisted of a score ≥ 13 using the Edinburgh Postnatal Depression Scale. A score of 1, 2, or 3 on item 10 (“The thought of harming myself has occurred to me”) indicates risk of suicidality. If a participant scores greater than ≥ 13 or ≥ 1 on item 10 they were flagged for PPD, the Principal Investigator (DEC) was notified within 24 h of survey completion for a chart review and to assure follow-up. Modified Poisson multivariable regression models were used to identify factors associated with PPD and risk of suicidality using adjusted risk ratios (aRR) and 95% confidence intervals (CI).

Results

Of the 216 respondents, 64 (30%) screened positive for PPD and 17 (8%) screened positive for risk of suicidality. The maternal median age of the total sample was 33 years (IQR: 30–36) and the infant median age at the time of the survey was 76 days (IQR: 66–90). Most participants reported some form of positive coping strategies during the pandemic (97%) (e.g. connecting with friends and family, exercising, getting professional help) and 139 (64%) reported negative coping patterns (e.g. over/under eating, sleep problems). In total, 47 (22%) had pre-pregnancy anxiety and/or depression. Negative coping (aRR:2.90, 95% CI: 1.56–5.37) and pre-existing anxiety/depression (aRR:2.03, 95% CI:1.32–3.11) were associated with PPD. Pre-existing anxiety/depression (aRR:3.16, 95% CI:1.28–7.81) was associated with risk of suicidality.

Conclusions

Almost a third of participants in this study screened positive for PPD and 8% for risk of suicidality. Mental health screening and techniques to foster positive coping skills/strategies are important areas to optimize postpartum mental health.
Pregnancy is associated with reduced progression of symptomatic adenomyosis: a retrospective pilot study
Authors: Hiratsuka Daiki , Omura Erika , Ishizawa Chihiro , Iida Rei , Fukui Yamato , Hiraoka Takehiro , Akaeda Shun , Matsuo Mitsunori , Harada Miyuki , Wada-Hiraike Osamu , Osuga Yutaka , Hirota Yasushi
Published: September 2023

Background

Adenomyosis is a common gynecological disease in women of reproductive age and causes various symptoms such as dysmenorrhea and heavy menstrual bleeding. However, the influence of pregnancy on the progression of adenomyosis remains unclear. The insight into whether the size of adenomyosis is increased, decreased, or unchanged during pregnancy is also undetermined. The current study aimed to evaluate the influence of pregnancy in patients with symptomatic adenomyosis.

Methods

This study retrospectively enrolled patients diagnosed with adenomyosis by magnetic resonance imaging between 2015 and 2022 at The University of Tokyo Hospital. Uterine size changes were evaluated by two imaging examinations. In the pregnancy group, the patients did not receive any hormonal and surgical treatments, except cesarean section, but experienced pregnancy and delivery between the first and second imaging examinations. In the control group (nonpregnancy group), the patients experienced neither hormonal and surgical treatments nor pregnancy from at least 1 year before the first imaging to the second imaging. The enlargement rate of the uterine size per year (percentage) was calculated by the uterine volume changes (cm3) divided by the interval (years) between two imaging examinations. The enlargement rate of the uterine size per year was compared between the pregnancy group and the control group.

Results

Thirteen and 11 patients with symptomatic adenomyosis were included in the pregnancy group and in the control group, respectively. The pregnancy group had a lower enlargement rate per year than the control group (mean ± SE: −7.4% ± 3.6% vs. 48.0% ± 18.5%, P < 0.001), indicating that the size of the uterus with adenomyosis did not change in the pregnancy group.

Conclusions

Pregnancy is associated with reduced progression of symptomatic adenomyosis.
Occult lymph node metastasis is not a favorable factor for resected NSCLC patients
Authors: Cai Jing-Sheng , Yang Fan , Wang Xun
Published: September 2023

Background

This study was to compare the clinical presentations and survivals between the non-small cell lung cancer (NSCLC) patients with occult lymph node metastasis (OLNM) and those with evident lymph node metastasis (ELNM). We also intended to analyze the predictive factors for OLNM.

Methods

Kaplan–Meier method with log-rank test was used to compare survivals between groups. Propensity score matching (PSM) was used to reduce bias. The least absolute shrinkage and selection operator (LASSO)-penalized Cox multivariable analysis was used to identify the prognostic factors. Random forest was used to determine the predictive factors for OLNM.

Results

A total of 2,067 eligible cases (N0: 1,497 cases; occult N1: 165 cases; evident N1: 54 cases; occult N2: 243 cases; evident N2: 108 cases) were included. The rate of OLNM was 21.4%. Patients with OLNM were tend to be female, non-smoker, adenocarcinoma and had smaller-sized tumors when compared with the patients with ELNM. Survival curves showed that the survivals of the patients with OLNM were similar to those of the patients with ELNM both before and after PSM. Multivariable Cox analysis suggested that positive lymph nodes (PLN) was the only prognostic factor for the patients with OLNM. Random forest showed that clinical tumor size was an important predictive factor for OLNM.

Conclusions

OLNM was not rare. OLNM was not a favorable sign for resected NSCLC patients with lymph node metastasis. PLN determined the survivals of the patients with OLNM. Clinical tumor size was a strong predictive factor for OLNM.
Exploring the prognostic significance of PKCε variants in cervical cancer
Authors: Zafar Sameen , Khan Khushbukhat , Badshah Yasmin , Shahid Kanza , Trembley Janeen H. , Hafeez Amna , Ashraf Naeem Mahmood , Arslan Hamid , Shabbir Maria , Afsar Tayyaba , Almajwal Ali , Razak Suhail
Published: September 2023

Background

Protein Kinase C-epsilon (PKCε) is a member of the novel subfamily of PKCs (nPKCs) that plays a role in cancer development. Studies have revealed that its elevated expression levels are associated with cervical cancer. Previously, we identified pathogenic variations in its different domains through various bioinformatics tools and molecular dynamic simulation. In the present study, the aim was to find the association of its variants rs1553369874 and rs1345511001 with cervical cancer and to determine the influence of these variants on the protein-protein interactions of PKCε, which can lead towards cancer development and poor survival rates.

Methods

The association of the variants with cervical cancer and its clinicopathological features was determined through genotyping analysis. Odds ratio and relative risk along with Fisher exact test were calculated to evaluate variants significance and disease risk. Protein-protein docking was performed and docked complexes were subjected to molecular dynamics simulation to gauge the variants impact on PKCε’s molecular interactions.

Results

This study revealed that genetic variants rs1553369874 and rs1345511001 were associated with cervical cancer. Smad3 interacts with PKCε and this interaction promotes cervical cancer angiogenesis; therefore, Smad3 was selected for protein-protein docking. The analysis revealed PKCε variants promoted aberrant interactions with Smad3 that might lead to the activation of oncogenic pathways. The data obtained from this study suggested the prognostic significance of PRKCE gene variants rs1553369874 and rs1345511001.

Conclusion

Through further in vitro and in vivo validation, these variants can be used at the clinical level as novel prognostic markers and therapeutic targets against cervical cancer.
Cost-effectiveness analysis of pembrolizumab in combination with chemotherapy compared with chemotherapy alone as first-line treatment for patients with advanced biliary tract cancer in China
Authors: Zheng Zhiwei , Fang Ling , Cai Hongfu
Published: September 2023

Objective

The objective of this study is to evaluate the cost-effectiveness of adding pembrolizumab to the standard first-line therapy of advanced biliary tract cancer (BTC) with gemcitabine and cisplatin from the perspective of the Chinese healthcare system.

Methods

The partitioned survival model developed from clinical data obtained in The KEYNOTE-966 trial served as the basis for a simulation in the TreeAge Pro 2011 software. The objective of the research was to estimate the 10-year life expectancy and total healthcare costs of patients with BTC, utilizing primary outcomes that evaluated costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). To establish the willingness-to-pay (WTP) threshold, the 2022 Chinese per capita gross domestic product (GDP) of $37304.346/QALY was adopted. Furthermore, sensitivity analysis was conducted to ascertain the study’s results under varying levels of uncertainty.

Results

Compared to chemotherapy alone, the addition of pembrolizumab to chemotherapy has been shown to yield an incremental gain of 0.184 quality-adjusted life years (QALY) at an additional cost of $103940.706. This translates into an incremental cost-effectiveness ratio (ICER) of $564895.141/QALY, which exceeds the willingness-to-pay (WTP) threshold in China. One-way sensitivity analyses performed on the model recognize the utility of PD, subsequent cost, and the cost of Pembrolizumab 100 mg had a major influence on the outcomes. However, no parameter elicited an ICER lower than the willingness-to-pay (WTP) threshold.

Conclusions

Based on the perspective of the Chinese healthcare system, the utilization of pembrolizumab in combination with chemotherapy as an first-line treatment option for BTC does not appear to be a cost-effective approach compared to chemotherapy as a standalone therapy.
Clinical trials in cancer screening, prevention and early diagnosis (SPED): a systematic mapping review
Authors: O’Dowd Emma L. , Merriel Samuel W. D. , Cheng Vinton W. T. , Khan Sam , Howells Lynne M. , Gopal Dipesh P. , Roundhill Elizabeth A. , Brennan Paul M. , Crosbie Philip A. J. , Neal Richard D. , Brown Karen , Crosbie Emma J. , Baldwin David R.
Published: September 2023

Background

Global annual cancer incidence is forecast to rise to 27.5 M by 2040, a 62% increase from 2018. For most cancers, prevention and early detection are the most effective ways of reducing mortality. This study maps trials in cancer screening, prevention, and early diagnosis (SPED) to identify areas of unmet need and highlight research priorities.

Methods

A systematic mapping review was conducted to evaluate all clinical trials focused on cancer SPED, irrespective of tumour type. The National Cancer Research Institute (NCRI) portfolio, EMBASE, PubMed and Medline were searched for relevant papers published between 01/01/2007 and 01/04/2020. References were exported into Covidence software and double-screened. Data were extracted and mapped according to tumour site, geographical location, and intervention type.

Results

One hundred seventeen thousand seven hundred one abstracts were screened, 5157 full texts reviewed, and 2888 studies included. 1184 (52%) trials focussed on screening, 554 (24%) prevention, 442 (20%) early diagnosis, and 85 (4%) a combination. Colorectal, breast, and cervical cancer comprised 61% of all studies compared with 6.4% in lung and 1.8% in liver cancer. The latter two are responsible for 26.3% of global cancer deaths compared with 19.3% for the former three. Number of studies varied markedly according to geographical location; 88% were based in North America, Europe, or Asia.

Conclusions

This study shows clear disparities in the volume of research conducted across different tumour types and according to geographical location. These findings will help drive future research effort so that resources can be directed towards major challenges in cancer SPED.
circFNDC3B promotes esophageal squamous cell carcinoma progression by targeting MYO5A via miR-370-3p/miR-136-5p
Authors: Song Dan , Ye Ziqi , Chen Fangyu , Zhan Liangliang , Sun Xinchen
Published: September 2023

Background

Esophageal squamous cell carcinoma (ESCC) is a prevalent malignant tumor worldwide. Circular RNA (circRNA) is of great value in tumorigenesis progression. However, the mechanism of circFNDC3B in ESCC remains to be clarified.

Methods

Firstly, the circular characteristics of circFNDC3B were evaluated by Actinomycin D and RNase R measurements. The functions of circFNDC3B in ESCC cells were examined by CCK-8, EdU and flow cytometry. Subsequently, the molecular mechanism of circFNDC3B was explained using luciferase reporter gene detection. Finally, we constructed xenograft model to prove the role of circFNDC3B in vivo.

Results

Our study revealed that circFNDC3B was more stable than its linear RNA and prominently upregulated in ESCC. Functional findings suggested that silencing of circFNDC3B reduced the proliferation and enhanced apoptosis of ESCC cells in vitro. Meanwhile, knockdown of circFNDC3B attenuated tumor progression in vivo. Next, miR-370-3p/miR-136-5p was discovered to bind circFNDC3B. miR-370-3p/miR-136-5p reversed the promotive effect on cell proliferation and the inhibitory effect on cell apoptosis of circFNDC3B. MYO5A was a downstream target of miR-370-3p/miR-136-5p. CircFNDC3B served as a sponge for miR-370-3p/miR-136-5p and alleviated the prohibitory effect of miR-370-3p/miR-136-5p on MYO5A, which accelerated ESCC progression.

Conclusion

circFNDC3B positively adjusted the MYO5A expression via spongy miR-370-3p/miR-136-5p, hence achieving the cancer-promoting effect on ESCC. circFNDC3B was a prospective diagnosis marker for ESCC.
Clinical characteristics of infants hospitalized with early congenital syphilitic nephropathy: a single-center retrospective cross-sectional study in China
Authors: Wang Caiying , Lun Wenhui , Pang Lin
Published: September 2023

Background

Early studies claimed that early congenital syphilitic (CS) nephropathy was rare, and systematic studies about this disease are absent, which may lead to poor awareness of early CS nephropathy in clinicians and result in misdiagnosis and poor patient prognosis. The present study systematically and comprehensively analyzes the clinical characteristics of infants with early CS nephropathy hospitalized in Beijing Ditan Hospital, an infectious disease hospital in China in order to improve the understanding and management of this disorder.

Methods

Data of the children with early CS from July 1, 2008, to December 31, 2021, were collected from the electronic medical record system of the hospital. Each patient’s demographic characteristics, clinical history, mother’s history of syphilitic infection, and laboratory values were extracted. The patients were enrolled to either the nephropathy group or the non-nephropathy group depending on diagnosis. Descriptive statistics was used to report basic demographics, clinical and laboratory test values, and variables were compared between the two groups by nonparametric tests, t test or χ2 tests.

Results

Of the 122 children with early CS enrolled, 24(19.7%) were diagnosed with early CS nephropathy. All of the children with CS nephropathy were young infants < 6 months old. A majority of them showed typical congenital syphilitic skin lesions, but a quarter of them did not have skin lesions. Compared with non-nephropathic children with early CS, those with nephropathy had higher frequency of hepatosplenomegaly, fever, edema, gastrointestinal (GI) symptoms, and anemia, as well as decreased C3 levels. Urinalysis results showed hematuria in all patients with early CS nephropathy, with proteinuria and renal function impairment in 91.7% and 12.5% of the patients, respectively. Nephritic-type nephrotic syndrome and glomerulonephritis were diagnosed in 45.8% and 54.2% of these patients, respectively. All infants with CS nephropathy were cured or improved after appropriate treatments.

Conclusion

Infants with early CS nephropathy often presented with nephritic-type nephrotic syndrome or glomerulonephritis, and the typical skin lesions, fever, hepatosplenomegaly, and edema, etc., were its common clinical presentations, and these characteristics could help with the diagnosis. But for infants with nephropathy who did not have typical clinical presentations, CS should also be screened as an important etiology to avoid misdiagnosis.
Towards an integrative hope-dysfunctional beliefs perspective to personal recovery in schizophrenia: a path analysis
Authors: Wong Daniel Fu Keung , Cheung Yves Cho Ho , Zhuang Xiaoyu , Ng Yat-nan Petrus , Oades Lindsey G. , Ye Shengquan Sam
Published: September 2023

Background

Evidence shows that negative symptoms of schizophrenia and underlying dysfunctional cognition are related to persistently low functioning and quality of life. However, despite the abundance of existing recovery programs for people with schizophrenia, few have examined whether and how the widely-adopted hope-motivation recovery pathway and the deficit-oriented cognitive pathway might converge to influence functioning and quality of life.

Methods

A cross-sectional, quantative survey recruited a convenient sample of adult outpatients with DSM-5 schizophrenia spectrum disorders and low social functioning (n = 124). Self-reported measurements included personal recovery (30-item Mental Health Recovery Measure), social functioning (8-item Social Functioning Questionnaire), hope (12-item Hope Scale), quality of life (28-item World Health Organization Quality of Life Scale-Abbreviated Version-Hong Kong), defeatist beliefs (15-item extracted from Dysfunctional Attitude Scale), and asocial beliefs (15-item extracted from Revised Social Anhedonia Scale). Correlation analysis and structural equation modelling was applied to investigate how the two pathways intertwined to predict social functioning and quality of life.

Results

Asocial beliefs and hope separately mediated two partial mediation pathways from defeatist beliefs to recovery outcomes (social functioning and personal recovery). Meanwhile, defeatist beliefs, social functioning, and personal recovery further predicted quality of life.

Conclusions

This is one of the very few studies that provides empirical evidence of a deficit-strength linkage in the recovery from schizophrenia. Remediation of dysfunctional beliefs and the injection of hope and successful experiences should be undertaken concurrently in recovery as they are associated with differential effects on enhancing social functioning and personal recovery, which then converge and contribute to a better quality of life.
Transdiagnostic considerations of the relationship between reward sensitivity and psychopathological symptoms - a cross-lagged panel analysis
Authors: Potsch L. , Rief W.
Published: September 2023

Background

Reward sensitivity constitutes a potential key mechanism regarding the etiology and maintenance of mental disorders, especially depression. However, due to a lack of longitudinal studies, the temporal dynamics are not clear yet. Although some evidence indicates that reward processing could be a transdiagnostic mechanism of disorders, these observations could be also a product of comorbidity with depression. This study aimed at investigating the temporal dynamics of reward sensitivity and the course of psychopathological symptoms in a longitudinal investigation, while taking a possible mediating role of depression into account.

Methods

We conducted a three-wave longitudinal online survey with a 4-week interval. A total of N = 453 participants filled out all three questionnaires. Reward sensitivity was assessed with the Positive Valence System Scale-21 (PVSS-21), depression with the Patient Health Questionnaire (PHQ-9), eating disorder symptoms with the Eating Disorder Examination-Questionnaire-8 (EDE-Q-8), social anxiety with the Mini-social phobia inventory (Mini-SPIN) and alcohol consumption with the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Cross-lagged panels and mediation analyses were calculated using path analyses.

Results

Depressive and eating disorder symptoms predicted reward insensitivity at later points in time. Effects were larger from T2 to T3. A bidirectional relationship concerning social anxiety was found. Higher alcohol consumption predicted higher reward sensitivity. Depression at T2 fully mediated the association between psychopathological symptoms at T1 and reward sensitivity at T3 for social anxiety and eating disorder symptoms.

Conclusions

Our findings imply that reduced reward sensitivity seems to be a consequence rather than an antecedent of psychopathological symptoms. Comorbid depression plays a crucial role in other mental disorders regarding observed hyposensitivity towards rewards. Therefore, our results do not support a transdiagnostic notion of reward sensitivity, but they indicate a potential role of reward sensitivity for symptom persistence.

Trial registration

The study was preregistered at the Open Science Framework (OSF) (https://archive.org/details/osf-registrations-6n3s8-v1; registration DOI https://doi.org/10.17605/OSF.IO/6N3S8).
The effect of web-based educational interventions on mental health literacy, stigma and help-seeking intentions/attitudes in young people: systematic review and meta-analysis
Authors: Nazari Abouzar , Garmaroudi Gholamreza , Foroushani Abbas Rahimi , Hosseinnia Maede
Published: September 2023

Objectives

This study aims to provide a systematic review and meta-analysis of the literature on The Effect of Web-Based Educational Interventions on Mental Health Literacy, Stigma and Help-seeking intentions/attitudes in young people.

Methods

Articles in English published between April 1975 and February 2023 were retrieved from seven databases, leading to a total of 2023 articles identified.

Results

20 studies were included after applying exclusion criteria, 10 of which were eligible for meta-analysis. Results showed that web-based educational interventions had a significant positive effect on mental health literacy knowledge (SMD = 0.70, 95% CI = [0.16, 1.25]), but not on stigma (SMD = -0.20, 95% CI = [-0.48, 0.08]) or help-seeking intentions/attitudes (SMD = 0.48, 95% CI = [-0.50, 1.46]).

Conclusion

This study reviewed and analyzed the effect of web-based educational interventions on mental health literacy, stigma, and help-seeking intentions/attitudes among young people. The results showed that web-based educational interventions improved mental health literacy knowledge, but not stigma or help-seeking outcomes. The study suggested several recommendations to enhance the effectiveness of web-based educational interventions on stigma and help-seeking outcomes, such as using more rigorous designs and methods, more comprehensive and multifaceted interventions, more tailored and targeted interventions, and more collaborative and participatory approaches. The study concluded that web-based educational interventions may have a greater impact on reducing stigma and promoting help-seeking among young people, which may ultimately lead to better mental health outcomes and well-being for this population.
Mixed methods feasibility and usability testing of a childhood obesity risk estimation tool
Authors: Grove Grace , Ziauddeen Nida , Roderick Paul , Vassilev Ivaylo , Appleton Jane V. , Smith Dianna , Alwan Nisreen A.
Published: September 2023

Background

A Childhood Obesity Risk Estimation tool (SLOPE CORE) has been developed based on prediction models using routinely available maternity and early childhood data to estimate risk of childhood obesity at 4–5 years. This study aims to test the feasibility, acceptability and usability of SLOPE CORE within an enhanced health visiting (EHV) service in the UK, as one context in which this tool could be utilised.

Methods

A mixed methods approach was used to assess feasibility of implementing SLOPE CORE. Health Visitors (HVs) were trained to use the tool, and in the processes for recruiting parents into the study. HVs were recruited using purposive sampling and parents by convenience sampling. HVs and parents were invited to take part in interviews or focus groups to explore their experiences of the tool. HVs were asked to complete a system usability scale (SUS) questionnaire.

Results

Five HVs and seven parents took part in the study. HVs found SLOPE CORE easy to use with a mean SUS of 84.4, (n = 4, range 70–97.5) indicating excellent usability. Five HVs and three parents took part in qualitative work. The tool was acceptable and useful for both parents and HVs. Parents expressed a desire to know their child’s risk of future obesity, provided this was accompanied by additional information, or support to modify risk. HVs appreciated the health promotion opportunity that the tool presented and felt that it facilitated difficult conversations around weight, by providing ‘clinical evidence’ for risk, and placing the focus of the conversation onto the tool result, rather than their professional judgement. The main potential barriers to use of the tool included the need for internet access, and concerns around time needed to have a sensitive discussion around a conceptually difficult topic (risk).

Conclusions

SLOPE CORE could potentially be useful in clinical practice. It may support targeting limited resources towards families most at risk of childhood obesity. Further research is needed to explore how the tool might be efficiently incorporated into practice, and to evaluate the impact of the tool, and any subsequent interventions, on preventing childhood obesity.
The systematic development of guidance for parents on talking to children of primary school age about weight
Authors: Gillison Fiona B. , Grey Elisabeth B. , Baber Fran , Chater Angel , Atkinson Lou , Gahagan Alison
Published: September 2023

Background

The prevalence of overweight and obesity in children is increasing, alongside increases in rates of children’s anxiety and worry about their weight. In many countries children’s weight is measured, and parents are made aware if a child has been classified as having overweight or obesity. However, many parents are concerned that raising their child’s awareness of their weight, and talking to children about their weight could harm their wellbeing. The aim of this project was to develop guidance for parents on constructive ways to talk to children of primary school age about weight when they need to.

Methods

The project followed a mixed-methods design: Phase 1 involved the collation of evidence including (a) two previously published systematic literature reviews to identify the associations between parent–child weight talk, and broader health discussions, and children’s wellbeing, (b) interviews with children, and (c) development and refinement of narrative messaging (previously published). In Phase 2 we developed a conceptual model and mapped primary findings to techniques and content within a draft guidance document for parents on talking to children about weight. Phase 3 involved a modified Delphi process with 29 stakeholders to refine and agree a final version.

Results

An acceptable draft guidance was agreed following two stages of feedback from Delphi participants. Key areas for debate and adaptation included: encouraging discussion about health and growth with lesser focus on weight; finding ways to reduce stigma and perceptions of blame; emphasising a whole-family approach; inclusive representation of diversity among children and families.

Conclusions

Consensus on the content of guidance for parents on talking to children about weight was achieved through a process of evidence review and stakeholder and expert engagement. The next steps are to measure the impact of the resource on improving the experience of parents and children in communicating about weight.
How does HIV-related stigma correlate with HIV prevalence in African countries? Distinct perspectives from individuals living with and living without HIV
Authors: Simo Fotso Arlette , Wright Connor G. , Low Andrea
Published: September 2023

Background

Population-level research evaluating HIV-related stigma among countries with varied national HIV prevalence is scarce. To better understand HIV-related stigma and mitigate its potential negative effects, it is necessary to evaluate its relationship with HIV prevalence, as well as the mechanisms that influence it. This study aimed to analyze how HIV-related stigma correlates with subnational HIV prevalence in three African countries with varied HIV epidemics.

Methods

This paper used data from the nationally representative Population-based HIV Impact Assessment (PHIA) surveys conducted from 2015–2017 in Malawi, Zambia, and Tanzania. Each country's sub-national geographic divisions were used to categorize them as low (0–5.4%), middle (5.5–11.2%), and high (11.3–17.1%) HIV prevalence regions in the main analysis. Questions from the survey stigma module were used to measure HIV-related stigma. Logistic regression and multilevel models were performed to assess the associations between the level of sub-national HIV prevalence and HIV-related stigma measures among persons living with, and without, HIV.

Results

The results show that the odds of people living without HIV expressing stigmatizing behavior towards PLWH was significantly lower in regions of middle (OR = 0.80, 90%CI = (0.68–0.96)) and high (OR = 0.65, 90%CI = (0.53–0.80)) HIV prevalence when compared to low prevalence regions. The odds of reporting discriminatory attitudes were also lower for those in middle (OR = 0.87, 90%CI = (0.78–0.98)) and high (OR = 0.64, 90%CI = (0.56–0.73)) HIV prevalence regions compared to others. Living in middle and high HIV prevalence regions was associated with lower odds of expressing prejudice toward PLWH (OR = 0.84, 90%CI = (0.71–0.99) and OR = 0.60, 90%CI = (0.45–0.80), respectively) among people living without HIV. Notably, PLWH living in high prevalence regions had higher odds of reporting internalized stigma (OR = 1.48, 90%CI = (1.02–2.14)) compared to those living in low prevalence regions.

Conclusions

The results indicate that among people not living with HIV, subnational HIV prevalence was negatively associated with discriminatory attitudes and prejudice towards PLWH, but HIV prevalence was positively associated with self-reported internalized stigma among PLWH. These results provide insight on how resources could be invested to reduce HIV related stigma among both PLWH and those not living with HIV.
The role of intrapersonal and interpersonal factors in waterpipe cessation: a case-control study
Authors: Dadipoor Sara , Hemayatkhah Mojtaba , Eshaghi Sani Kakhaki Hadi , Mohseni Shokrollah , Fattahi Esmaeil , Shahabi Nahid , El-Shahawy Omar
Published: September 2023

Background

The prevalence of waterpipe smoking among women in southern Iran is significantly higher than women in other regions of Iran. We aimed to explore the effect of several demographic factors, knowledge, attitude, self-efficacy and social norms on a successful cessation of waterpipe smoking in the marginalized women of Bandar Abbas city, in the south of Iran.

Methods

This case-control study was conducted in 2022 among 731 women (246 subjects who successfully quit waterpipe smoking in the case group and 485 who smoked waterpipe in the control group). A cluster sampling method was used to collect the required data through face-to-face interviews and a researcher-made questionnaire. The questionnaire consisted of demographic information, behavioral information about waterpipe smoking and knowledge, attitude, self-efficacy and social norms. The data were analyzed in STATA 14 using univariate and multivariate regression analyses.

Results

The mean and standard deviation of age was 39.24 ± 11.93 and 37.18 ± 13.57 in the control and case groups, respectively. With an increase of one score in social norm (OR: 1.046), the odds of cessation were increased for 4%. With an increase of one score in self-efficacy (OR: 1.152), the odds of cessation were increased for 15%. With an increase of one score in knowledge (OR: 1.064), the odds of cessation were increased for 6%. With an increase of one score in attitude (OR: 1.215) the odds of cessation were increased for 21%.

Conclusion

The present findings revealed personal and interpersonal influential factors in successful waterpipe cessation. Women’s knowledge can be increased and their attitude can be changed. Important people in women’s lives can be influenced to, consequently, affect women positively and improve their self-esteem.
Perceived stigma of COVID-19 patients in Shanghai, China, in the third year of the pandemic: a cross-sectional social impact survey
Authors: Deng Ziru , Bernot Ausma , Davies Sara E.
Published: September 2023

Introduction

Social stigma associated with Covid-19 infection has been reported around the world. This paper investigates the level of self-reported perceived stigma among people infected with COVID-19 in Shanghai, China, in the third year of the pandemic to determine changes in perceived stigma and individual level variables associated with perceived stigma.

Methods

We conducted a self-reported two-part online survey (n = 144 responses) by employing a convenience sampling method of COVID-19 patients in Shanghai. The first part of the survey collects sociodemographic information of the respondents and the second part outlines 24 items of the Social Impact Scale (SIS), which measures individual level factors associated with stigma, namely social rejection, financial insecurity, internalized shame, and social isolation. We ran Wilcoxon signed-ranks test, Kruskal–Wallis test, and linear regression analysis to assess the levels of perceived stigma differences.

Results

The study finds that the overall level of self-reported stigma during the COVID-19 lockdowns in Shanghai in 2022 was at a lower level than that compared to the self-reported perceived stigma study in Wuhan in 2020. In Shanghai, the severity of the disease and hospitalization length had most impact on financial insecurity and feelings of social isolation. These experiences were not gendered. Recovery measures, including economic considerations, need to pay particular attention to those who experienced severe disease.
Oral health of people experiencing homelessness in London: a mixed methods study
Authors: Yusuf Huda , Golkari Ali , Kaddour Sarah
Published: September 2023

Background

Those experiencing homelessness have significant health and oral health needs and are at the extreme of health inequalities. The aim of the study was to conduct an oral health needs assessment for those experiencing homeless in London and impacts on their oral health-related quality of life.

Methods

The oral health needs assessment consisted of quantitative and qualitative methods. This included a survey questionnaire to assess perceived oral health needs, and oral health related quality of life. In addition, a focus group was conducted with 13 peer advocates.

Results

Findings from the focus group revealed numerous challenges for homeless populations to maintain good oral health and access to dental care including mental ill-health, stigma, costs, and chaotic lifestyles. A response rate of 79% (n = 315) was achieved for the questionnaire survey. Results showed high levels of unmet dental needs and risky health behaviours including 60% reporting being smokers, 39% consuming high amounts of sugar and 52.4% brushing their teeth less than twice a day. More than a third (32.1%) had experienced toothache. The majority of respondents 80% (n = 224) were very or fairly concerned about their dental health. There were significant associations between perceived oral health status and oral health-related quality of life.

Conclusion

Those experiencing homelessness in London were found to have high levels of unmet oral health needs, which significantly impacted on their oral health-related quality of life. Focusing on changing behaviours alone is insufficient and therefore addressing the structural determinants of homelessness is vital in improving oral and health outcomes of this vulnerable population.
Genome-wide DNA methylation analysis of Astragalus and Danshen on the intervention of myofibroblast activation in idiopathic pulmonary fibrosis
Authors: Liu Qingyin , Liu Xue , Wang Guoyu , Wu Fan , Hou Yuan , Liu Huaman
Published: September 2023

Background

Idiopathic pulmonary fibrosis (IPF), a chronic progressive interstitial lung disease of unknown etiology, is characterized by continuous damage to alveolar epithelial cells, abnormal repair of alveolar tissue, and alveolar wall scar formation. Currently, the recommended treatment for IPF in Western medicine is relatively limited. In contrast, traditional Chinese medicine and compound prescriptions show advantages in the diagnosis and treatment of IPF, which can be attributed to their multi-channel and multi-target characteristics and minimal side-effects. The purpose of this study was to further corroborate the effectiveness and significance of the traditional Chinese medications Astragalus and Danshen in IPF treatment.

Methods

We performed whole-genome methylation analysis on nine rat lung tissue samples to determine the epigenetic variation between IPF and non-fibrotic lungs using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses and quantitative reverse transcription polymerase chain reactions.

Results

We identified differentially methylated regions and 105 associated key functional genes in samples related to IPF and Chinese medicine treatment. Based on the methylation levels and gene expression profiles between the Chinese medicine intervention and pulmonary fibrosis model groups, we speculated that Astragalus and Salvia miltiorrhiza (traditionally known as Danshen) act on the Isl1, forkhead box O3, and Sonic hedgehog genes via regulation at transcriptional and epigenetic levels during IPF.

Conclusions

These findings provide novel insights into the epigenetic regulation of IPF, indicate the effectiveness of Astragalus and Danshen in treating IPF, and suggest several promising therapeutic targets for preventing and treating IPF.
Changes in the levels of free sialic acid during ex vivo lung perfusion do not correlate with pulmonary function. Experimental model
Authors: Hernández-Jiménez Claudia , Martínez-Cortés Javier , Olmos-Zuñiga J. Raúl , Jasso-Victoria Rogelio , López-Pérez María Teresa , Díaz-Martínez Néstor Emmanuel , Alonso-Gómez Marcelino , Guzmán-Cedillo Axel Edmundo , Baltazares-Lipp Matilde , Gaxiola-Gaxiola Miguel , Méndez-Bernal Adriana , Polo-Jeréz Adrián , Vázquez-Minero Juan Carlos , Hernández-Pérez Oscar , Fernández-Solís Christopher O.
Published: September 2023

Background

Ex vivo lung perfusion (EVLP) constitutes a tool with great research potential due to its advantages over in vivo and in vitro models. Despite its important contribution to lung reconditioning, this technique has the disadvantage of incurring high costs and can induce pulmonary endothelial injury through perfusion and ventilation. The pulmonary endothelium is made up of endothelial glycocalyx (EG), a coating of proteoglycans (PG) on the luminal surface. PGs are glycoproteins linked to terminal sialic acids (Sia) that can affect homeostasis with responses leading to edema formation. This study evaluated the effect of two ex vivo perfusion solutions on lung function and endothelial injury.

Methods

We divided ten landrace swine into two groups and subjected them to EVLP for 120 min: Group I (n = 5) was perfused with Steen® solution, and Group II (n = 5) was perfused with low-potassium dextran-albumin solution. Ventilatory mechanics, histology, gravimetry, and sialic acid concentrations were evaluated.

Results

Both groups showed changes in pulmonary vascular resistance and ventilatory mechanics (p < 0.05, Student’s t-test). In addition, the lung injury severity score was better in Group I than in Group II (p < 0.05, Mann–Whitney U); and both groups exhibited a significant increase in Sia concentrations in the perfusate (p < 0.05 t-Student) and Sia immunohistochemical expression.

Conclusions

Sia, as a product of EG disruption during EVLP, was found in all samples obtained in the system; however, the changes in its concentration showed no apparent correlation with lung function.
Efficacy of the shoelace technique for extremity fasciotomy wounds due to compartment syndrome
Authors: Onoe Atsunori , Muroya Takashi , Nakamura Yoshihiro , Nakamura Fumiko , Yagura Takuma , Nakajima Mari , Kishimoto Masanobu , Sakuramoto Kazuhito , Kajino Kentaro , Ikegawa Hitoshi , Kuwagata Yasuyuki
Published: September 2023

Background

The shoelace technique for compartment syndrome allows application of sustained tightening tension to an entire wound and intermittent tightening of the shoelace without requiring its replacement or anesthesia. We retrospectively evaluated the usefulness of the shoelace technique in the management of extremity fasciotomy wounds before and after its introduction in our institution.

Methods

We targeted 25 patients who were diagnosed as having compartment syndrome and underwent extremity fasciotomy at our hospital from April 2012 to December 2021. The N group, comprising 12 patients treated without the shoelace technique, and the S group, comprising 13 patients treated with the shoelace technique, were compared retrospectively for each outcome.

Results

There were no significant differences between the two groups in patient background. Compared with the N group patients, all of the S group patients avoided skin grafting (S group: n = 0, 0%; N group: n = 6, 50.0%; p < 0.01). However, there was no significant difference in the number of days to final wound closure (S group: 39.5 [IQR 24.3–58.0] days; N group: 24.0 [IQR 18.5–31.0] days, p = 0.06).

Conclusions

We considered the shoelace technique to be a useful wound closure method for fasciotomy wounds caused by compartment syndrome because it can significantly reduce the need for skin grafting and tends to shorten the wound closure period.
Adjunctive effect of collagen membrane coverage to L-PRF in the treatment of periodontal intrabony defects: a randomized controlled clinical trial with biochemical assessment
Authors: Mubarak Ramy , Adel-Khattab Doaa , Abdel-Ghaffar Khaled A. , Gamal Ahmed Youssef
Published: September 2023

Background

The innovation of leukocyte platelet-rich fibrin (L-PRF) has added enormous impact on wound healing dynamics especially the field of periodontal regeneration. The release of growth factors (GF) is thought to improve the clinical outcomes in infrabony defects. The aim of this study was to evaluate the clinical effect of covering L-PRF contained infrabony defects with collagen membranes (CM), and to compare their GF release profile to uncovered L-PRF defects and open flap debridement (OFD).

Methods

Thirty non- smoking patients with infrabony pockets participated to be randomly assigned to OFD group (n = 10), L-PRF group (n = 10), or L-PRF protected CM group (n = 10). Plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL) and the radiographic defect base fill (DBF) were measured at baseline and at 6 month following surgical intervention. Gingival crevicular fluid samples were obtained on days 1, 3, 5, 7, 14, 21 and 30 days following surgery for the Platelet Derived Growth Factor-BB (PDGF-BB) and Vascular Endothelial Growth Factors (VEGF) release profile evaluation.

Results

For all patients, a statistically significant (P ≤ 0.05) reduction in PI, GI, PD and CAL were reported throughout the study period. Differences between the three treatment modalities were not statistically significant. PRF + CM showed a statistically significant DBF compared to OFD and L-PRF groups at follow up. Quantitative analysis of PDGF-BB and VEGF levels demonstrated a statistically significant (P < 0.001) decline between measurement intervals for all groups with no statistically significant differences between the three groups.

Conclusion

Within the limitations of this study, L-PRF coverage with CM may augment defect base fill through its mechanical protective effect without enhancement in the release profile of VEGF and PDGF. The non-significant intergroup differences question the validity of the claimed extra physiologic concentration of GF offered by L-PRF harvests.

Trial registration

The present study was registered at ClinicalTrials.gov (NCT05496608), (11/08/2022).