bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of a telehealth physiotherapist-delivered intensive dietary weight loss program combined with exercise in people with knee osteoarthritis and overweight or obesity: study protocol for the POWER randomized controlled trial
Authors: Bennell Kim L. , Jones Sarah E. , Hinman Rana S. , McManus Fiona , Lamb Karen E. , Quicke Jonathan G. , Sumithran Priya , Prendergast Jodie , George Elena S. , Holden Melanie A. , Foster Nadine E. , Allison Kim
Published: July 2022

Background

Obesity is associated with knee osteoarthritis (OA). Weight loss, alongside exercise, is a recommended treatment for individuals with knee OA and overweight/obesity. However, many patients cannot access weight loss specialists such as dietitians. Innovative care models expanding roles of other clinicians may increase access to weight loss support for people with knee OA. Physiotherapists may be well placed to deliver such support. This two-group parallel, superiority randomized controlled trial aims to compare a physiotherapist-delivered diet and exercise program to an exercise program alone, over 6 months. The primary hypothesis is that the physiotherapist-delivered diet plus exercise program will lead to greater weight loss than the exercise program.

Methods

88 participants with painful knee OA and body mass index (BMI) > 27 kg/m2will be recruited from the community. Following baseline assessment, participants will be randomised to either exercise alone or diet plus exercise groups. Participants in the exercise group will have 6 consultations (20–30 min) via videoconference with a physiotherapist over 6 months for a strengthening exercise program, physical activity plan and educational/exercise resources. Participants in the diet plus exercise group will have 6 consultations (50–75 min) via videoconference with a physiotherapist prescribing a ketogenic very low-calorie diet with meal replacements and educational resources to support weight loss and healthy eating, plus the intervention of the exercise only group. Outcomes are measured at baseline and 6 months. The primary outcome is percentage change in body weight measured by a blinded assessor. Secondary outcomes include self-reported knee pain, physical function, global change in knee problems, quality of life, physical activity levels, and internalised weight stigma, as well as BMI, waist circumference, waist-to-hip ratio, physical performance measures and quadriceps strength, measured by a blinded assessor. Additional measures include adherence, adverse events, fidelity and process measures.

Discussion

This trial will determine whether a physiotherapist-delivered diet plus exercise program is more effective for weight loss than an exercise only program. Findings will inform the development and implementation of innovative health service models addressing weight management and exercise for patients with knee OA and overweight/obesity.

Trial registration

NIH US National Library of Medicine,Clinicaltrials.govNCT04733053 (Feb 1 2021).
Digital pain extent is associated with pain intensity but not with pain-related cognitions and disability in people with chronic musculoskeletal pain: a cross-sectional study
Authors: Luque-Suarez Alejandro , Falla Deborah , Barbero Marco , Pineda-Galan Consolacion , Marco Derboni , Giuffrida Vincenzo , Martinez-Calderon Javier
Published: July 2022

Background

To evaluate whether digital pain extent is associated with an array of psychological factors such as optimism, pessimism, expectations of recovery, pain acceptance, and pain self-efficacy beliefs as well as to analyse the association between digital pain extent and pain intensity and pain-related disability in people with chronic musculoskeletal pain.

Methods

A descriptive cross-sectional study conducted in a primary health care setting was carried out including 186 individuals with chronic musculoskeletal pain. Patient-reported outcomes were used to assess psychological factors, pain intensity, and pain-related disability. Digital pain extent was obtained from pain drawings shaded using a tablet and analysed using novel customized software. Multiple linear regression models were conducted to evaluate the association between digital pain extent and the aforementioned variables.

Results

Digital pain extent was statistically significantly associated with pain intensity. However, digital pain extent was not associated with any psychological measure nor with pain-related disability.

Discussion

The results did not support an association between digital pain extent and psychological measures.
Case control study investigating the clinical utility of NPWT in the perineal region following abdominoperineal resection for rectal adenocarcinoma: a single center study
Authors: Salmenkylä Tellu , Kilpivaara Katariina , Ohtonen Pasi , Rautio Tero , Mäkäräinen Elisa
Published: July 2022

Background

Perineal wound complications are common after abdominoperineal resection (APR) for rectal adenocarcinoma. Delayed wound healing may postpone postoperative adjuvant therapy and, therefore, lead to a worse survival rate. Negative-pressure wound therapy (NPWT) has been suggested to improve healing, but research on this subject is limited.

Methods

The aim of this study was to assess whether NPWT reduces surgical site infections (SSI) after APR for rectal adenocarcinoma when the closure is performed with a biological mesh and a local flap. A total of 21 consecutive patients had an NPWT device (Avelle, Convatec™) applied to the perineal wound. The study patients were compared to a historical cohort in a case–control setting in relation to age, body mass index, tumor stage, and length of neoadjuvant radiotherapy. The primary outcome was the surgical site infection rate. The secondary outcomes were the wound complication rate, the severity of wound complications measured by the Clavien–Dindo classification, length of hospital stay, and surgical revision rate.

Results

The SSI rate was 33% (7/21) in the NPWT group and 48% (10/21) in the control group, p = 0.55. The overall wound complication rate was 62% (13/21) in NPWT patients and 67% (14/21) in the control group, p > 0.90. The length of hospital stay was 15 days in the NPWT group and 13 in the control group, p = 0.34. The wound severity according to the Clavien–Dindo classification was 3b in 29% (6/21) of the NPWT group and in 38% (8/21) of the control group. A surgical revision had to be performed in 29% (6/21) of the cases in the NPWT group and 38% (8/21) in the control group, p = 0.73.

Conclusion

NPWT did not statistically decrease surgical site infections or reduce wound complication severity in perineal wounds after APR in this case–control study. The results may be explained by technical difficulties in applying NPWT in the perineum, especially in female patients. NPWT devices should be further developed to suit the perineal anatomy before their full effect can be assessed.

Trial registration The study was registered as a prospective registry study (266/2018, registered 15th of November 2018)
Effectiveness of health education intervention on diabetes mellitus among the teachers working in public sector schools of Pakistan
Authors: Kumar Ramesh , Rehman Sidra , Baloch Gul Muhammad , Vankwani Muskan , Somrongthong Ratana , Pongpanich Sathirakorn
Published: July 2022

Background

Diabetes Mellitus (DM) is considered as one of the major public health problems globally. Health education strategies can help in managing blood glucose level and complications among DM patients. Health education intervention is effective to manage and control the blood glucose levels among diabetic patients. This study explored the effectiveness of health education intervention on DM among school teachers in public sector schools of Pakistan.

Methods

This was quasi-experimental study where baseline & end line assessments were conducted on teachers of public sector schools of Sindh province, Pakistan, from October to December 2019. Pretested structured questionnaire was used in this study. Participants (n = 136). were randomly selected from the list of government schools registered with district education department An intervention comprised of health education sessions with DM patients was undertaken after conducting baseline assessment followed by end line assessment. The institutional review board of Health Services Academy Pakistan ethically approved this study.

Results

All the respondents completed post-test with mean ± SD age of participants being 39.2 ± 1.34 years. Female teachers comprised 65% out of which 70% were living in rural areas. Knowledge on DM pre-test score was 20.03 ± 3.31 that increased in post-test to 49.11 ± 2.21 (p < 0.05). Mean score of information on symptoms and causes of DM was 1.98 ± 0.21 for pre-test whereas for post-test it was 4.78 ± 0.12 (p < 0.05). The effect of intervention was significant on diabetes related complications (p < 0.05), symptoms (p < 0.05), overall score (p < 0.05) and preventive practices (p < 0.05).

Conclusions

The study provides evidence of the importance and effectiveness of health education intervention related to diabetes among school teachers, which has a positive impact on the knowledge and practices. We concluded that the health education session sensitized the teachers and they can bring cogent changes to enhance their knowledge about diabetes and its risks.
Protective effect of a nanofilled resin-based coating on wear resistance of glass ionomer cement restorative materials
Authors: Moghimi Milad , Jafarpour Dana , Ferooz Reihaneh , Bagheri Rafat
Published: July 2022

Background

The effect of nanofilled resin-based coating on the wear resistance of glass ionomer cements (GICs) is still controversial. This study aims to compare the wear resistance of four encapsulated GICs including two conventional and two resin-modified, and to evaluate the effect of G-Coat Plus on the wear resistance of GICs.

Methods

A total of 80 disk-shaped specimens were prepared from two CGICs (riva self cure (SDI) and Equia Forte Fil (GC) and two RM- GICs (Ketac Nano (3 M/ESPE) and Fuji II LC (GC). The specimens of each material were divided into two groups (n = 10) based on the surface protection: no coating (NC), and coating with G-Coat Plus (GCP). All specimens were then placed in distilled water for 24 h at 37 °C. The specimens were subjected to thermocycling for 120,000 cycles using a chewing simulator. Wear resistance was measured using a specific formula. Data was analyzed using Kruskal–Wallis test.

Results

There was no significant difference in volume loss (mm3) between coated and uncoated groups for all materials (P > 0.05). Ketac Nano showed significantly lower volume loss (0.65 ± 0.12) compared to all other groups (P < 0.05) among uncoated specimen, and significantly lower than Fuji II LC (P = 0.035) and Equia Forte Fil (P = 0.040) among coated groups. However, no statically significant difference was observed between volume loss of coated Ketac Nano with that of riva self cure (P = 0.087).

Conclusions

Coating with GCP did not affect the wear depth of GICs, and Ketac Nano showed significantly lower volume loss regardless of coating.
Postmenopausal women's experiences of a resistance training intervention against vasomotor symptoms: a qualitative study
Authors: Berin Emilia , Spetz Holm Anna-Clara , Hammar Mats , Lindh-Åstrand Lotta , Berterö Carina
Published: July 2022

Introduction

Resistance training may be an effective intervention to improve menopausal symptoms and increase women’s quality of life. However, most postmenopausal women do not perform regular resistance training. The purpose of this study was to explore postmenopausal women’s experiences of participation in a resistance-training intervention to find barriers and motivators for the training.

Methods

Fifteen postmenopausal women with low physical activity, who participated in a randomized controlled trial evaluating the effect of a resistance-training program on vasomotor symptoms and health-related outcomes, were consecutively recruited to this qualitative study. After completion of the 15-week resistance-training program, they took part in individual semi-structured interviews, followed by a telephone interview 1 year later. All interviews were transcribed verbatim and thematic analysis was used to analyse the data.

Results

The analysis generated three themes that were involved at different time points. These were: “Trigger—Hopes of symptom relief”, “An evolving motivation as a driving force for change” and “Finding new triggers”. Accountability, and continuous professional and emotional support, were factors that fueled the women’s motivation to perform regular resistance training during the study. Resistance training improved general well-being and most women experienced improvement in vasomotor symptoms. The women’s motivation changed from being driven by a wish to improve bothersome symptoms, into a wish to achieve feelings of well-being and enjoyment. The change was seen regardless of effects of the intervention on vasomotor symptoms.

Conclusion

This first qualitative evaluation of physical exercise as an intervention to treat vasomotor symptoms in postmenopausal women, found that the symptoms acted as a motivational trigger to initiate resistance training in low-active women. The motivation to exercise changed during the intervention from a wish to ameliorate symptoms into something the women did for enjoyment and well-being in general. This change in motivating factors may have contributed to a behavior change since all participants had increased their physical activity after 1 year regardless of effects on VMS.

Trial registration The trial was preregistered at ClinicalTrials.gov; www.clinicaltrials.gov, ID: NCT01987778, date of first registration: 19/11/2013.
Antibacterial and anti-trichomunas characteristics of local landraces of Lawsonia inermis L.
Authors: Fatahi Bafghi M. , Salary S. , Mirzaei F. , Mahmoodian H. , Meftahizade H. , Zareshahi R.
Published: July 2022

Background

Henna (Lawsonia inermis) with anti-bacterial properties has been widely used in traditional medicine especially Persian medicine. Henna oil is suggested for diseases of infectious origin, such as cervical ulcers. Group B Streptococcus agalactiae, Pseudomonas aeruginosa and, Trichomonas vaginalis are involved in the infection of women especially cervicitis. Henna grows in dry and tropical regions. The main important landraces of henna landraces are cultivated in Kerman, Sistan and Baluchestan, Hormozgan, and Bushehr provinces in Iran.

Proper use of antimicrobial agents, use of new antimicrobial strategies, and alternative methods, such as herbal methods may help reduce drug resistance in the future. This study’s objective was to investigate the anti-Trichomonas vaginalis activity of three different henna landraces and antimicrobial effects against group B Streptococcus agalactiae and, Pseudomonas aeruginosa.

Methods

Total phenol content was measured by Folin ciocaltu method. Antibacterial effect of landraces of Henna against P. aeruginosa and S. agalactiae were assayed by well diffusion method and minimal inhibitory concentration assessments were done using the broth micro-dilution technique. Anti-Trichomonas effect of Henna landraces were assayed by Hemocytometery method.

Results

Total phenol content of Shahdad, Rudbar-e-Jonub, and Qaleh Ganj was 206.51, 201.96, and 254.85 μg/ml, respectively. Shahdad, Rudbar-e-Jonub, and Qaleh Ganj had MIC against GBS at 15, 15 and, 4 μg/ml. The growth inhibition diameter of the most effective henna (Shahdad landrace) at a concentration of 20 μg/ml on P. aeruginosa was 2.46 ± 0.15 cm and in the MIC method at a concentration of 5 μg/ml of Shahdad landrace, P. aeruginosa did not grow. IC50 of shahdad Henna after 24 h, 48 h, and 72 h was 7.54, 4.83 and 20.54 μg/ml, respectively. IC50 of Rudbar-e-Jonub extract was 5.76, 3.79 and 5.77 μg/ml in different days. IC50 of Qaleh Ganj extract was 6.09, 4.08 and 5.74 μg/ml in different days.

Conclusions

The amount of total phenol in Qaleh Ganj was higher than the other varieties. In the well diffusion method, Qaleh Ganj was more effective against group B Streptococcus (Gram-positive bacterium) than the other two landraces, and Shahdad landrace was more effective against P. aeruginosa (Gram-negative bacterium) than other. In the MIC method, the same result was obtained as in the well diffusion method, but at a lower concentration.
Health literacy training program for community healthcare providers using hybrid online team-based learning in Taiwan
Authors: Hsieh Jyh-Gang , Yu Jui-Hung , Wang Ying-Wei , Wei Mi-Hsiu , Chang Mei-Chuan , Wu Chao-Chun , Chia Shu-Li
Published: July 2022

Background

Health literacy (HL) has proven to be a determining factor influencing the health of individuals. Community health providers (CHPs) work on the front line of improving public HL. Increasing their understanding of HL and their ability to incorporate HL into healthcare can reduce obstacles in healthcare services. This study evaluated the effectiveness of an HL training program for CHP by using the hybrid online team-based learning (TBL) model.

Methods

A quasi-experimental study and focused group interviews were conducted. We developed a six weeks HL online course for CHPs. The program included teaching videos for pre-class preparation, a 90-min online TBL model, and a case discussion in the last two weeks. Team application activities were designed for each class to enhance knowledge application. A total of 81 CHPs from 20 public health centers took the course and provided complete data for analysis. Learning effectiveness was evaluated based on the familiarity, attitude, and confidence in implementing HL practices, course satisfaction, and participants’ learning experiences.

Results

The comparison showed that the participants’ familiarity with HL (4.29 ± 1.76 vs 6.92 ± 1.52, p < .001), attitude (7.39 ± 1.88 vs 8.10 ± 1.44, p = .004), and confidence in implementing HL practices (6.22 ± 1.48 vs 7.61 ± 1.34, p < .001) increased after the course. The average satisfaction with the teaching strategies was 4.06 ± .53 points, the average helpfulness to practice was 4.13 ± .55 points, and the overall feedback on satisfaction with learning was 4.06 ± .58 points (the full score was 5 points). According to the learning experience of the 20 participants in the focus group discussion, the experiences of teaching strategies and the learning experiences of the HL course were summed up into two categories, seven themes, and 13 subthemes. The results showed a positive experience with the hybrid online TBL program.

Conclusion

The use of hybrid online TBL model is a feasible and valid approach for the HL training of CHPs. The result can serve as a reference for the on-the-job training of various healthcare workers.
A multi-layer soft lattice based model for Chinese clinical named entity recognition
Authors: Guo Shuli , Yang Wentao , Han Lina , Song Xiaowei , Wang Guowei
Published: July 2022

Objective

Named entity recognition (NER) is a key and fundamental part of many medical and clinical tasks, including the establishment of a medical knowledge graph, decision-making support, and question answering systems. When extracting entities from electronic health records (EHRs), NER models mostly apply long short-term memory (LSTM) and have surprising performance in clinical NER. However, increasing the depth of the network is often required by these LSTM-based models to capture long-distance dependencies. Therefore, these LSTM-based models that have achieved high accuracy generally require long training times and extensive training data, which has obstructed the adoption of LSTM-based models in clinical scenarios with limited training time.

Method

Inspired by Transformer, we combine Transformer with Soft Term Position Lattice to form soft lattice structure Transformer, which models long-distance dependencies similarly to LSTM. Our model consists of four components: the WordPiece module, the BERT module, the soft lattice structure Transformer module, and the CRF module.

Result

Our experiments demonstrated that this approach increased the F1 by 1–5% in the CCKS NER task compared to other models based on LSTM with CRF and consumed less training time. Additional evaluations showed that lattice structure transformer shows good performance for recognizing long medical terms, abbreviations, and numbers. The proposed model achieve 91.6% f-measure in recognizing long medical terms and 90.36% f-measure in abbreviations, and numbers.

Conclusions

By using soft lattice structure Transformer, the method proposed in this paper captured Chinese words to lattice information, making our model suitable for Chinese clinical medical records. Transformers with Mutilayer soft lattice Chinese word construction can capture potential interactions between Chinese characters and words.
Mobile health application for Thai women: investigation and model
Authors: Kongjit Chalermpon , Nimmolrat Acrapol , Khamaksorn Achara
Published: July 2022

Background

Women’s mobile health (m-health) applications are currently widely used for health education, medication, prevention of illness, etcetera. However, women are extremely sensitive to their design. While the number of m-health applications for women is increasing, many are of poor quality and have development issues.

Objective

This paper aims to develop and evaluate an m-health application for Thai women based on a user-centred design (UCD). Current women’s m-health applications were investigated to identify any lack of development in usability, functionality and graphical user interface. The results were evaluated and used to create criteria for the trial of a prototype application.

Methods

UCD methodology was used to design a graphical user interface, analyse the application’s functionality, and enhance its usability. Data from thirty female end-users were collected and maintained locally, and thirteen information technology (IT) experts provided feedback on the prototype trial. Interviews and questionnaires were used to gather user data and identify problems.

Results

The average scores of the evaluation by the end-users (n = 30) and IT experts (n = 13) were compared using a t-test statistical analysis. For the first version, the end-users gave higher usability scores (average = 4.440), with no statistical significance and a P value of 0.05. In comparison, lower scores for functionality were given by the IT experts (average = 4.034), with no statistical significance and a P value of 0.05. For the second version, the average scores from the end-users were higher than those from the IT experts. The highest score was related to usability (average = 4.494), with no statistical significance and a P value of 0.05. The lowest score was for the user interface from the group of IT experts (average = 4.084), with no statistical significance and a P value of 0.05.

Conclusion

A UCD was utilised to construct a process taxonomy to understand, analyse, design and develop an application suitable for Thai women. It was found from an evaluation of the currently-available women’s m-health applications that usability is their main weakness; therefore, this aspect needed to be prioritised in the new design. According to the results, IT experts’ perspective of the development of an m-health application was different from that of end-users. Hence, it was evident that both end-users and IT experts needed to be involved in helping developers to analyse, prioritise and establish a strategy for developing an m-health application, particularly one for women’s health. This would give researchers an in-depth understanding of the end-users’ expectations.
Access to surgical care in Ethiopia: a cross-sectional retrospective data review
Authors: Meshesha Berhane Redae , Sibhatu Manuel Kassaye , Beshir Hassen Mohammed , Zewude Wuletaw Chane , Taye Desalegn Bekele , Getachew Edlawit Mesfin , Merga Kassa Haile , Kumssa Tsegaye Hailu , Alemayue Endawoke Amsalu , Ashuro Akililu Alemu , Shagre Mulatu Biru , Gebreegziabher Senedu Bekele
Published: July 2022

Background

Access to emergency and essential surgical care is still unmet and accessibility is disproportionately inequitable in Ethiopia and other low-and middle-income countries. The aim of this study was to assess surgical care access in terms of capability, capacity, and timeliness of care in different levels of health care in Ethiopia.

Methods

A cross-sectional study with retrospective data review was conducted in 172 health facilities from December 30, 2020 to June 10, 2021. Descriptive statistics such as median with interquartile range and proportion were computed using STATA Version 15 statistical software.

Results

Within a 90-day interval of the study period, 69,717 major and minor surgeries, and 33,052 bellwether procedures were performed, and major surgeries accounted for 58% of the surgeries. About 1.6%, 23.56%, 25.34%, and 32.2% of both major and minor, and 3.1%, 12.8%, 27.6%, and 45.3% of bellwether procedures were performed in health center OR blocks, primary, general, and specialized hospitals, respectively. Private hospitals performed 17.33% of major and minor and 11.2% of bellwether procedures for the period. The average pre-admission waiting time for surgical patients in primary, general, and specialized hospitals was 9.68, 37.6, and 35.9 days, respectively, whereas, in private hospitals, the average pre-admission waiting time was 1.42 days. On average, surgical patients traveled 5 Hrs, 11 Hrs, 28.4 Hrs, and 21.3 Hrs to access surgical services in primary, general, specialized, and private hospitals, respectively. The surgical workforce to the population served ratio was 7.5, 1.15, and 1.31/100.000 population in primary, specialized and general hospitals, respectively.

Conclusion

Most surgical procedures were performed in specialized hospitals, indicating that there is a burden in these health facilities. The pre-admission waiting time for surgical patients was long in higher-level public hospitals. Surgical patients traveled a long distance to access surgical service in higher level hospitals. The ratio of surgical workforce per 100,000 population served was low in all levels of public health facilities in general, and in higher level hospitals in particular. Efforts should therefore be made to strengthen all levels of the health system and improve surgical care access in terms of capacity, capability, and timeliness in the country.
Communication sheet eases barriers for Japanese patients and health professionals
Authors: Sonoda Kento , Takedai Teiichi , Salter Cynthia
Published: July 2022

Background

Language and cultural barriers can affect healthcare outcomes of minority populations. However, limited data are available on communication tools developed to address health disparities resulting from language and cultural barriers. Our study aimed to reduce communication barriers between Japanese patients and non-Japanese-speaking clinic staff by developing a Japanese-English Communication Sheet (JECS) to create more equitable clinical environments for Japanese patients in ambulatory care.

Methods

This study was conducted at a family health center in a United States urban setting, in the city of Pittsburgh, between November 2019 and August 2020. This study included Japanese adult patients who had health care office visits with one of two Japanese-speaking physicians and who completed a survey about the JECS. The JECS, written in Japanese and English, targets common sources of confusion by presenting common health questions, written in Japanese, and by explaining differences between common healthcare processes in Japan and the United States. Clinic staff who used the JECS with Japanese-speaking patients also were surveyed about the tool.

Results

Sixty Japanese patients met inclusion criteria and completed the survey. More than half of participants found the JECS useful, and those with self-reported limited English proficiency were most likely to report that the JECS was useful (p = 0.02). All nine non-Japanese speaking staff surveyed found the sheet helpful.

Conclusions

The JECS is a useful communication tool for addressing common barriers faced by Japanese patients seeking care at an American health center where Japanese-speaking physicians work but no clinic staff speak Japanese. A focused communication sheet can facilitate communication between patients and clinic staff and also reduce health inequities resulting from linguistic and cultural barriers. Additionally, using a communication sheet can advance quality and safety of patient care at the individual and institutional level.
Deficient DNA base-excision repair in the forebrain leads to a sex-specific anxiety-like phenotype in mice
Authors: Mueller Flavia S. , Amport René , Notter Tina , Schalbetter Sina M. , Lin Han-Yu , Garajova Zuzana , Amini Parisa , Weber-Stadlbauer Ulrike , Markkanen Enni
Published: July 2022

Background

Neuropsychiatric disorders, such as schizophrenia (SZ) and autism spectrum disorder (ASD), are common, multi-factorial and multi-symptomatic disorders. Ample evidence implicates oxidative stress, deficient repair of oxidative DNA lesions and DNA damage in the development of these disorders. However, it remains unclear whether insufficient DNA repair and resulting DNA damage are causally connected to their aetiopathology, or if increased levels of DNA damage observed in patient tissues merely accumulate as a consequence of cellular dysfunction. To assess a potential causal role for deficient DNA repair in the development of these disorders, we behaviourally characterized a mouse model in which CaMKIIa-Cre-driven postnatal conditional knockout (KO) of the core base-excision repair (BER) protein XRCC1 leads to accumulation of unrepaired DNA damage in the forebrain.

Results

CaMKIIa-Cre expression caused specific deletion of XRCC1 in the dorsal dentate gyrus (DG), CA1 and CA2 and the amygdala and led to increased DNA damage therein. While motor coordination, cognition and social behaviour remained unchanged, XRCC1 KO in the forebrain caused increased anxiety-like behaviour in males, but not females, as assessed by the light–dark box and open field tests. Conversely, in females but not males, XRCC1 KO caused an increase in learned fear-related behaviour in a cued (Pavlovian) fear conditioning test and a contextual fear extinction test. The relative density of the GABA(A) receptor alpha 5 subunit (GABRA5) was reduced in the amygdala and the dorsal CA1 in XRCC1 KO females, whereas male XRCC1 KO animals exhibited a significant reduction of GABRA5 density in the CA3. Finally, assessment of fast-spiking, parvalbumin-positive (PV) GABAergic interneurons revealed a significant increase in the density of PV+ cells in the DG of male XRCC1 KO mice, while females remained unchanged.

Conclusions

Our results suggest that accumulation of unrepaired DNA damage in the forebrain alters the GABAergic neurotransmitter system and causes behavioural deficits in relation to innate and learned anxiety in a sex-dependent manner. Moreover, the data uncover a previously unappreciated connection between BER deficiency, unrepaired DNA damage in the hippocampus and a sex-specific anxiety-like phenotype with implications for the aetiology and therapy of neuropsychiatric disorders.
Clinical performance testing of the automated haematology analyzer XN-31 prototype using whole blood samples from patients with imported malaria in Japan
Authors: Komaki-Yasuda Kanako , Kutsuna Satoshi , Kawaguchi Miki , Kamei Mina , Uchihashi Kinya , Nakamura Keiji , Nakamoto Takato , Ohmagari Norio , Kano Shigeyuki
Published: July 2022

Background

The automated haematology analyzer XN-31 prototype (XN-31p) is a new flow cytometry-based device developed to measure the number and the ratio of malaria-infected red blood cells (MI-RBC) with a complete blood count (CBC). The XN-31p can provide results in about one minute and also can simultaneously provide information on the malaria parasite (Plasmodium) species. In this study, clinical testing of the XN-31p was performed using blood samples from patients with imported malaria in Japan.

Methods

Blood samples were collected from 80 patients who visited the hospital of the National Center for Global Health and Medicine, Tokyo, Japan, for malaria diagnosis from January 2017 to January 2019. The test results by the XN-31p were compared with those by other standard methods, such as microscopic observation, rapid diagnostic tests and the nested PCR.

Results

Thirty-three patients were diagnosed by the nested PCR as being malaria positive (28 Plasmodium falciparum, 2 Plasmodium vivax, 1 Plasmodium knowlesi, 1 mixed infection of P. falciparum and Plasmodium malariae, and 1 mixed infection of P. falciparum and Plasmodium ovale), and the other 47 were negative. The XN-31p detected 32 patients as “MI-RBC positive”, which almost matched the results by the nested PCR and, in fact, completely matched with the microscopic observations. The ratio of RBCs infected with malaria parasites as determined by the XN-31p showed a high correlation coefficient of more than 0.99 with the parasitaemia counted under microscopic observation. The XN-31p can analyse the size and nucleic acid contents of each cell, and the results were visualized on a two-dimensional cytogram termed the “M scattergram”. Information on species and developmental stages of the parasites could also be predicted from the patterns visualized in the M scattergrams. The XN-31p showed a positive coincidence rate of 0.848 with the nested PCR in discriminating P. falciparum from the other species.

Conclusions

The XN-31p could rapidly provide instructive information on the ratio of MI-RBC and the infecting Plasmodium species. It was regarded to be of great help for the clinical diagnosis of malaria.
“We think about the quantity more”: factors influencing emerging adults’ food outlet choice in a university food environment, a qualitative enquiry
Authors: Mensah Daniel Opoku , Oyebode Oyinlola
Published: July 2022

Background

In recent decades, the food environment has seen rapid transformation globally, altering food availability and access along with how people interact with the food environment and make food-related choice.

Objectives & method

This explorative study aimed to identify the factors that shape the decision-making process for food outlet choices among emerging adults in a Ghanaian University food environment. The study uses focus group discussions in combination with novel dyadic interviews with best friend pairs. Verbatim transcripts were analysed thematically using NVivo 12.

Results

Drawing on socio-ecological model (SEM) of behaviour, the study used testimony from 46 participants aged 18–25, 47% female, including individuals from major ethnicities and religions in Ghana, and identified three interwoven levels of influence shaping emerging adults’ choices of food outlet. The main factors influencing food outlet choice were identified as food prices, spatial accessibility, budget, and food quantity/satiety with additional factors including hygiene, variety of foods, food quality and taste preferences as well as societal factors such as ambience and peer influence.

Conclusion

Multi-component approaches that combine structural level interventions in food retailing along with individual level components may be effective at changing emerging adult consumption behaviour in SSA, although this needs to be studied.
Long-term intra- and inter-individual biological variation of serum lipid of HIV-infected and uninfected men participating in the Los Angeles Multi-Center AIDS Cohort Study (MACS)
Authors: Aziz Najib , Gjertson David W. , Mimiaga Matthew J. , Azarkman Chantel D. , Soto Rey , Alexopoulos Nicole , Detels Roger
Published: July 2022

Background

To assess the long-term biological coefficient of variation within individuals (CVI) and between individuals (CVG), effect of aging and cholesterol lowering drugs on blood levels of lipids in HIV-1-infected and -uninfected men.

Methods

Bloods were analyzed every six months over 17 years for total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) in 140 HIV-uninfected (38–66 years old) and 90 HIV-treated infected (48–64 years old) white Caucasian men to examine CVI, CVG, and the effect of cholesterol lowering drugs (CLDs) on lipid levels, and estimated changes per year of biomarkers.

Results

With exception of HDL-C, the long term CVI compared with CVG were higher for serum levels of TC, TGs, and LDL-C in both HIV-1 infected and uninfected men not taking CLDs. Excluding results of TGs in HIV positive men, the CVI compared with CVG were lower for serum levels of TC, HDL-C, and LDL-C in both groups not taking CLDs.

There were significant (p < 0.05) differences in the median serum values of lipid biomarkers among 77 HIV negative men taking and 63 not taking CLDs. Also, with exception of HDL, there were significant (p < 0.05) differences in the median values of TC, TGs and LDL-C among 28 HIV positive men taking or not taking CLDs.

Conclusion

Long term CVI and CVG of biomarkers will be useful for monitoring antiviral therapy side effects on lipid profiles in HIV-infected men. CVI of HIV-infected men for TC, TGs, HDL, LDL were higher significantly than CVI of HIV-uninfected men. Interestingly the long term CVI were higher than CVG for the men, who were on CLDs compared to men not on CLDs. The long-term pattern of CVI and CVG of lipid markers in both HIV-infected and uninfected men on CLDs differed from their short-term pattern.
Biodegradable and biocompatible exceedingly small magnetic iron oxide nanoparticles for T1-weighted magnetic resonance imaging of tumors
Authors: Lu Xuanyi , Zhou Huimin , Liang Zhiyu , Feng Jie , Lu Yudie , Huang Lin , Qiu Xiaozhong , Xu Yikai , Shen Zheyu
Published: July 2022

Magnetic resonance imaging (MRI) has been widely using in clinical diagnosis, and contrast agents (CAs) can improve the sensitivity MRI. To overcome the problems of commercial Gd chelates-based T1 CAs, commercial magnetic iron oxide nanoparticles (MIONs)-based T2 CAs, and reported exceedingly small MIONs (ES-MIONs)-based T1 CAs, in this study, a facile co-precipitation method was developed to synthesize biodegradable and biocompatible ES-MIONs with excellent water-dispersibility using poly (aspartic acid) (PASP) as a stabilizer for T1-weighted MRI of tumors. After optimization of the synthesis conditions, the final obtained ES-MION9 with 3.7 nm of diameter has a high r1 value (7.0 ± 0.4 mM−1 s−1) and a low r2/r1 ratio (4.9 ± 0.6) at 3.0 T. The ES-MION9 has excellent water dispersibility because of the excessive –COOH from the stabilizer PASP. The pharmacokinetics and biodistribution of ES-MION9 in vivo demonstrate the better tumor targetability and MRI time window of ES-MION9 than commercial Gd chelates. T1-weighted MR images of aqueous solutions, cells and tumor-bearing mice at 3.0 T or 7.0 T demonstrate that our ES-MION9 has a stronger capability of enhancing the MRI contrast comparing with the commercial Gd chelates. The MTT assay, live/dead staining of cells, and H&E-staining indicate the non-toxicity and biosafety of our ES-MION9. Consequently, the biodegradable and biocompatible ES-MION9 with excellent water-dispersibility is an ideal T1-weighted CAs with promising translational possibility to compete with the commercial Gd chelates.
Acceptability of supervised injection facilities among persons who inject drugs in upstate New York
Authors: Duncan Eliana , Shufelt Sarah , Barranco Meredith , Udo Tomoko
Published: July 2022

Background

Supervised injection facilities (SIFs) provide spaces where persons who inject drugs (PWID) can inject under medical supervision and access harm reduction services. Though SIFs are not currently sanctioned in most of the US, such facilities are being considered for approval in several Upstate New York communities. No data exist from PWID in Upstate New York, and little from outside major US urban centers, on willingness to use SIFs and associated factors.

Methods

This analysis included 285 PWID (mean age = 38.7; 57.7% male; 72.3% non-Hispanic white) recruited for a study on hepatitis C prevalence among PWID in Upstate New York, where participants were recruited from syringe exchange programs (n = 80) and able to refer other PWID from their injection networks (n = 223). Participants completed an electronic questionnaire that included a brief description of SIFs and assessed willingness to use SIFs. We compared sociodemographic characteristics, drug use/harm reduction history, healthcare experience, and stigma between participants who were willing vs. unwilling to use such programs.

Results

Overall, 67.4% were willing to use SIFs, 18.3% unwilling, and 14.4% unsure. Among those reporting being willing or unwilling, we found higher willingness among those who were currently homeless (91.8% vs. 74.6%; p = 0.004), who had interacted with police in the past 12 months (85.7% vs. 74.5%; p = 0.04), and who were refused service within a healthcare setting (100% vs. 77.1%; p = 0.03).

Conclusion

Our results support SIF acceptability in several Upstate New York PWID communities, particularly among those reporting feelings of marginalization. A large proportion reported being unsure about usage of SIFs, suggesting room for educating PWID on the potential benefits of this service. Our results support SIF acceptability in Upstate New York and may inform programming for underserved PWID, should SIFs become available.
Relationship between oral health literacy of caregivers and the oral health-related quality of life of children: a cross-sectional study
Authors: Velasco Sofia Rafaela Maito , Moriyama Caroline Moraes , Bonecker Marcelo , Butini Luciane , Abanto Jenny , Antunes José Leopoldo Ferreira
Published: July 2022

Background

Oral health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate oral health decisions. However, scientific evidence about the oral health literacy of caregivers and the children’s oral health-related quality of life. The purpose of this study was to verify the relationship between the level of oral health literacy of caregivers and the children's oral health-related quality of life (OHRQOL).

Methods

This study was conducted with children aged 2 to 4 in Diadema, São Paulo, Brazil. Six hundred thirty children were examined to assess the prevalence of dental caries (dmft index). Parents were interviewed to obtain sociodemographic status, oral conditions, and oral health literacy (OHL). The variable outcome was the children's OHRQOL as assessed by the Early Childhood Oral Health Impact Scale (ECOHIS). We fitted zero-inflated negative binomial regression (ZINB) models to evaluate associations between the study outcome and covariates in terms of PR (Prevalence Ratios), RR (Rate Ratios), and their respective Confidence Intervals (95% CI).

Results

Children's OHRQOL was not associated with OHL. Dental caries had a negative impact on the children's quality of life (p < 0.05). A reduced impact on OHRQOL is also associated with having siblings (PR = 0.70, 95% CI 0.52–0.95). A higher age of the mother reduced OHRQOL impacts (PR = 0.72, 95% CI 0.52–0.98).

Conclusions

The factors associated with children's OHRQOL were the number of siblings, the mothers' age, and dental caries. This study observed no association between parental OHL and children's OHRQOL.
ADaPTS “(AD)olescents (P)ath through (T)ransplant (S)ickle cell disease”
Authors: Bruce Aisha A. K. , Guilcher Gregory M. T. , Desai Sunil , Truong Tony H. , Leaker Michael , Alaazi Dominic A. , Pedersen Sasia J. V. , Salami Bukola
Published: July 2022

Background

Sickle cell disease is an inherited chronic hematological disorder with an average lifespan of fifty years. The human cost of sickle cell disease includes missed school days, occupational opportunities, social isolation, stigmatization, and psychological sequelae. Hematopoietic cell transplantation (HCT) is the only curative therapy available but comes with potential morbidity and mortality. Our study explores how quality of life (QoL) is affected from the perspective of an adolescent who has undergone a nonmyeloablative matched sibling donor HCT.

Methods

We employed multiple case study methodology with purposeful sampling by selecting information-rich cases. Data sources: 1) QoL inventories 2) patient interviews 3) parent interview 4) vital support interview 5) medical record analysis. Data analysis: Intra-case analysis by assembling evidence within a single case and then analyzing the differences within cases to create a rich case description. Next, a time series analysis was completed to track changes in patients’ QoL. We used multiple sources of data to compose a timeline and changes across time. Then, we employed pattern matching as an analytical technique allowing for examination of patterns across cases. Finally, we used cross case synthesis to review results of each case.

Results

Quality of life was reported across the physical, social and psychological domains for 5 participants. All had sickle cell HgSS genotype, 80% were male and 80% were born outside of Canada. Physical domain: pre-transplant, 100% of patients experienced pain, and the majority suffered from fatigue, insomnia, and fevers resulting in hospitalizations. Afterwards, participants reported improved physical wellbeing. Social domain: pre-transplant, QoL was poor characterized by stigma, social isolation, and parental absenteeism. Post-HSCT adolescents gained social acceptance in areas that had stigmatized and excluded them. They were able to participate freely in activities with peers and their social life vastly improved. Psychological pre-transplant life experiences were overshadowed by psychological stress. The majority commented that their future was bleak and may lead to premature death. Afterwards adolescents described a crisis free life with positive psychological outcomes.

Conclusions

Adolescents with sickle cell disease who undertook HCT demonstrated improved QoL one year post transplant with regard to physical, social and psychological well-being.