bluuebunny/crossref_metadata_2025 huggingface dataset:
Distal medium vessel occlusions in acute ischaemic stroke – Stent retriever versus direct aspiration: A systematic review and meta-analysis
Authors: Toh Keith Zhi Xian , Koh Ming Yi , Loh Enver De Wei , Kwok Gabriel Yi Ren , Teo Yao Hao , Teo Yao Neng , Goh Claire Xin Yi , Syn Nicholas Li Xun , Ho Andrew Fu Wah , Sia Ching-Hui , Brouwer Patrick A , Andersson Tommy , Meyer Lukas , Fiehler Jens , Bhogal Pervinder , Sharma Vijay K , Tan Benjamin YQ , Yeo Leonard L L
Published: January 2023

Background

Acute ischaemic stroke due to distal medium vessel occlusion (AIS-DMVO) causes significant morbidity. Endovascular thrombectomy advancement has made treating AIS-DMVO with stent retrievers (SR) and aspiration catheters (AC) possible, however the optimal technique remains unknown. We performed a systematic review and meta-analysis to investigate the efficacy and safety of SR use compared to purely AC use in patients with AIS-DMVO.

Methods

We systematically searched PubMed, Cochrane Library and EMBASE, from inception to 2nd September 2022, for studies comparing SR or primary combined (SR/PC) against AC in AIS-DMVO. We adopted the Distal Thrombectomy Summit Group’s definition of DMVO. Efficacy outcomes were functional independence (modified Rankin Scale (mRS) 0–2 at 90 days), first pass effect (modified Thrombolysis in Cerebral Infarction scale (mTICI) 2c-3 or expanded Thrombolysis in Cerebral Infarction scale (eTICI) 2c-3 at first pass), successful final recanalisation (mTICI or eTICI 2b-3), and excellent final recanalisation (mTICI or eTICI 2c-3). Safety outcomes were symptomatic intracranial haemorrhage (sICH) and 90-day mortality.

Results

12 cohort studies and 1 randomised-controlled trial were included, involving 1881 patients with 1274 receiving SR/PC and 607 receiving AC only. SR/PC achieved higher odds of functional independence (odds ratio (OR) 1.33, 95% confidence interval (CI) 1.06–1.67) and lower odds of mortality (OR 0.69, 95% CI 0.50–0.94) than AC. Odds of successful/excellent recanalisation and sICH were similar between both groups. Stratified to compare only SR and only AC, the use of only SR, achieved significantly higher odds of successful recanalisation as compared to only AC (OR 1.80, 95% CI 1.17–2.78).

Conclusion

There is potential for efficacy and safety benefits in SR/PC use as compared to AC only in AIS-DMVO. Further trials are necessary to validate the efficacy and safety of SR use in AIS-DMVO.
Perioperative safety determinants in ethnic patient groups
Authors: Bloo Gerrit , Calsbeek Hiske , Westert Gert , Dekkers Wim , Akkersdijk George , Krugten Robbert Jan van , Wolff André P , Wollersheim Hub
Published: January 2023

Background

In a Dutch hospital, unexpectedly, safer perioperative care was found in non-western ethnic minority patients compared to Dutch ethnic majority patients undergoing high-risk surgery with a mortality risk >1%. We explored determinants in order to find tools for nurses and physicians to improve patients’ safety and safety experience during the perioperative period.

Methods

A qualitative grounded theory design was applied to understand patients’ perspective on their needs and safety in the perioperative period we interviewed patients ( n = 17).

Results

Three themes emerged: ‘Nurse & physician behaviour’, ‘Team performance’, and ‘Patient behaviour’. In the first theme ‘Nurse and physicians’ behaviour’, positive determinants related to an attitude of experienced professionals that provide patients with trust. On the other hand, negative determinants provide patients with experiences of unsafety. In the second theme ‘Team performance’, positive determinants involved effective communication and coordinated care of the nurses and physicians. Negative determinants related to visible disagreement about the treatment. In the third theme ‘Patient behaviour’, positive determinants related to seeking support from nurses, physicians, and family to recover and to endure an anxious period. Negative determinants related to missing appointments or not consulting the information provided.

Conclusion and practice implications

‘Nurse & physician behaviour’ and ‘Team performance’ are relevant determinants that contribute to patients’ experiences of safe care. Stimulating an active attitude of patients in seeking support may contribute to experiences of safe care. These results can be used to improve patients’ experience of safe care in an uncertain and vulnerable perioperative period.
Social care professionals’ perceived barriers to implementing attachment and trauma-informed care training in their practice
Authors: Roberts Georgia , Halstead Samantha , Pepper Rebecca , McDonnell Lynn
Published: January 2023

Social care professionals support many children and their families with experiences of developmental trauma. There is a notable gap in research exploring the barriers these professionals face to working with an attachment and trauma-informed approach in the UK. The present study explores social care professionals’ reported barriers to using trauma and attachment principles in their practice. A thematic analysis was performed on responses drawn from a questionnaire completed by a sample of social care staff ( n = 98) who had received attachment and trauma-informed work training. These items explored barriers to working in an attachment and trauma-informed way on a personal and professional level, an organisational level, as well as what may overcome their identified barriers. Four main themes emerged from the analysis: (1) the widespread impact of trauma, (2) lack of funding, (3) inconsistent supportive culture, (4) inconsistent multiagency approach to trauma-informed care. Findings suggest that a whole systems approach to attachment and trauma is needed, in which there is an awareness of the impact of trauma, structures are in place to best support staff in their work, and everyone has a shared understanding and approach to working with these children and families. This study presents a promising start to identifying and making recommendations about what social care staff require to work in an attachment and trauma-informed way.
A Structured Discharge Education Intervention for Parents of Newly Diagnosed Pediatric Oncology Patients
Authors: Landier Wendy , York Jocelyn M. , Wadhwa Aman , Adams Kandice , Henneberg Harrison M. , Madan-Swain Avi , Benton Beth , Slater Valencia , Zupanec Sue , Miller Jeneane , Tomlinson Kathryn , Richman Joshua S. , Bhatia Smita
Published: January 2023

Background: Parents of children newly diagnosed with cancer require specialized knowledge and skills in order to safely care for their children at home. The Children's Oncology Group (COG) developed expert consensus recommendations to guide new diagnosis education; however, these recommendations have not been empirically tested. Methods: We used a sequential two-cohort study design to test a nurse-led Structured Discharge Teaching Intervention (SDTI) that operationalizes the COG expert recommendations in the setting of a tertiary children's hospital. Outcomes included parent Readiness for Hospital Discharge Scale (RHDS); Quality of Discharge Teaching Scale (QDTS); Post-Discharge Coping Difficulty (PDCD); Nurse Satisfaction; and post-discharge unplanned healthcare utilization. Results: The process for discharge education changed significantly before and after implementation of the SDTI, with significantly fewer instances of one-day discharge teaching, and higher involvement of staff nurses in teaching. Overall, parental RHDS, QDTS, and PDCD scores were similar in the unintervened and intervened cohorts. Almost 60% of patients had unplanned healthcare encounters during the first 30 days following their initial hospital discharge. Overall nurse satisfaction with the quality and process of discharge education significantly increased post-intervention. Discussion: Although the structure for and process of delivering discharge education changed significantly with implementation of the SDTI, parent RHDS and QDTS scores remained uniformly high and PDCD scores and non-preventable unplanned healthcare utilization remained similar, while nurse satisfaction with the quality and process of discharge education significantly improved, suggesting that further testing of the SDTI across diverse pediatric oncology settings is warranted.
Ferro-ferri-katophorite, a new clinoamphibole from the silicocarbonatite dykes in Sierra de Maz, La Rioja, Argentina
Authors: Colombo Fernando , Rius Jordi , Molins Elies , Biglia Héctor , Galliski Miguel Á. , Márquez-Zavalía María Florencia , Baldo Edgardo G. A. , Kriscautzky Agustín
Published: January 2023

Ferro-ferri-katophorite (IMA2016–008), ideally Na(NaCa)(Fe2+4Fe3+)(Si7Al)O22(OH)2, was found as xenocrysts up to 3 cm long and replacement rims around aegirine–augite in silicocarbonatite dykes cropping out in the Sierra de Maz, La Rioja province, NW Argentina. Ferro-ferri-katophorite is black and has vitreous lustre and a pale green streak. The new mineral is brittle, with perfect {110} cleavage and has a Mohs hardness of 6. The measured density is 3.32(1) g/cm3. In plane-polarised light it is strongly pleochroic, X = light greenish brown, Y = dark greyish brown and Z = dark greyish olive green. Absorption (very strong) is Z > Y > X. The orientation is: Z ∥ b, and X forms a small angle with [001]. Ferro-ferri-katophorite is biaxial (–), with α = 1.688(3), β = 1.697(3), γ = 1.698(3) and 2V(calc) = 36.7°. It is monoclinic, space group C2/m, a = 9.8270(7), b = 18.0300(8), c = 5.316(4) Å, β = 104.626(4)°, V = 911.4(6) Å3 and Z = 2. The strongest five lines in the powder X-ray diffraction pattern [d in Å (I)(hkl)] are: 8.416(100)(110), 3.135(50)(310), 2.815(26)(330), 2.720(18)(151) and 1.4422(15)($\bar{6}$61). The chemical composition is SiO2 43.08, TiO2 2.76, ZrO2 0.15, Al2O3 8.76, V2O3 0.07, Fe2O3 9.28, FeO 13.85, MnO 0.43, MgO 6.88, CaO 6.58, ZnO 0.06, Na2O 5.55, K2O 1.18, Cl 0.01, H2O calc 1.36, total 99.95 wt.%. The formula unit (confirmed by single-crystal structural analysis) is (Na0.74K0.23)Σ0.97(Ca1.08Na0.91Mn0.01)Σ2.00(Fe2+1.78Mg1.57Fe3+1.07Ti4+0.32Al0.19Mn2+0.04Zr0.01V3+0.01Zn0.01)Σ5.00(Si6.61Al1.39)Σ8.00O22(OH1.59O0.61)Σ2.00. Aluminium is strongly ordered at the T(1) site. Ferro-ferri-katophorite is the 9th species carrying the katophorite root name and is related to katophorite by the Fe2+ + Fe3+ → Mg2+ + Al3+ substitution. Type material was deposited at the Museo de Mineralogía “Stelzner”, Universidad Nacional de Córdoba, Argentina, under catalogue number MS003341.
A novel Mcl-1 inhibitor synergizes with venetoclax to induce apoptosis in cancer cells
Authors: Zhao Tianming , He Qiang , Xie Shurong , Zhan Huien , Jiang Cheng , Lin Shengbin , Liu Fangshu , Wang Cong , Chen Guo , Zeng Hui
Published: January 2023

Background

Evading apoptosis by overexpression of anti-apoptotic Bcl-2 family proteins is a hallmark of cancer cells and the Bcl-2 selective inhibitor venetoclax is widely used in the treatment of hematologic malignancies. Mcl-1, another anti-apoptotic Bcl-2 family member, is recognized as the primary cause of resistance to venetoclax treatment. However, there is currently no Mcl-1 inhibitor approved for clinical use.

Methods

Paired parental and Mcl-1 knockout H1299 cells were used to screen and identify a small molecule named MI-238. Immunoprecipitation (IP) and flow cytometry assay were performed to analyze the activation of pro-apoptotic protein Bak. Annexin V staining and western blot analysis of cleaved caspase 3 were employed to measure the cell apoptosis. Mouse xenograft AML model using luciferase-expressing Molm13 cells was employed to evaluate in vivo therapeutic efficacy. Bone marrow samples from newly diagnosed AML patients were collected to evaluate the therapeutic potency.

Results

Here, we show that MI-238, a novel and specific Mcl-1 inhibitor, can disrupt the association of Mcl-1 with BH3-only pro-apoptotic proteins, selectively leading to apoptosis in Mcl-1 proficient cells. Moreover, MI-238 treatment also potently induces apoptosis in acute myeloid leukemia (AML) cells. Notably, the combined treatment of MI-238 with venetoclax exhibited strong synergistic anti-cancer effects in AML cells in vitro, MOLM-13 xenografts mouse model and AML patient samples.

Conclusions

This study identified a novel and selective Mcl-1 inhibitor MI-238 and demonstrated that the development of MI-238 provides a novel strategy to improve the outcome of venetoclax therapy in AML.
Sustainable development goal 13 and switching priorities: addressing climate change in the context of pandemic recovery efforts
Authors: Filho Walter Leal , Minhas Aprajita , Schmook Birgit , Mardero Sofia , Sharifi Ayyoob , Paz Shlomit , Kovaleva Marina , Albertini Maria Cristina , Skouloudis Antonis
Published: January 2023

The COVID-19 pandemic has had many deep social and economic impacts that go beyond health issues. One consequence is that the pandemic has made it even harder to mobilize the financial resources needed to pursue SDG 13 (Climate Action) as a whole and to fund climate change mitigation and adaptation efforts in particular. This is especially acute in respect of the efforts to achieve the targets set by the Paris Agreement and by the recent decisions in Glasgow. This paper looks at how the COVID-19 pandemic has accelerated poverty and undermined climate change mitigation and adaptation efforts, as a result of the switches in priorities and funding. Using a review of the recent literature, an analysis of international trends, and a survey among climate scientists, it identifies some of the impacts of the pandemic on climate change mitigation and adaptation efforts and discusses their implications. The findings indicate a decrease in funding to climate change research since the pandemic crisis. The bibliometric analysis reveals that a greater emphasis has been placed on the relationship between COVID-19 and poverty when compared to the interrelations between COVID-19 and climate change. Addressing climate change is as urgent now as it was before the pandemic crisis started, and efforts need to be made to upkeep the levels of funding needed to support research in this field.
Estimation of genotype by temperature-humidity index interactions on milk production and udder health traits in Montbeliarde cows
Authors: Vinet Aurélie , Mattalia Sophie , Vallée Roxane , Bertrand Christine , Cuyabano Beatriz C. D. , Boichard Didier
Published: January 2023

Background

Heat stress negatively influences cattle welfare, health and productivity. To cope with the forecasted increases in temperature and heat waves frequency, identifying high-producing animals that are tolerant to heat is of capital importance to maintain milk production. This study, based on the joint analysis of on-farm performance and weather data, had two objectives: (1) to determine the response in production performances (milk, fat and protein yields, fat and protein contents) and udder health (somatic cell score) to temperature-humidity index (THI) variations in Montbeliarde cows, and (2) to estimate the interactions between genotype and THI, to enable the identification of the most adapted animals for facing the expected increases in temperature.

Results

Test-day records from first and second lactations from 2016 to 2020 were associated with the average THI during the three days before the test-day record. In total, 446,717 test-day records from 55,650 cows in first lactation and 457,516 test-day records from 58,229 cows in second lactation were analysed. The optimal THI was below 55 (i.e. ~ 12–13 °C) for all traits. Individual responses to THI were estimated by random regression models, which also included individual responses to days in milk. Regardless of the stage of lactation, genetic correlations along the THI gradient were above 0.80, which suggests that genotype-by-THI interactions were weak for production and udder health traits. Nevertheless, a variability in the individual slope of decay could be highlighted at high THI. The genetic correlation between production level at moderate THI and the slope at high THI was negative, while for somatic cell score, it was positive, indicating that heat stress amplifies the susceptibility to mastitis.

Conclusions

The optimal THI for French Montbeliarde cows is below 55 for production and udder health traits. Genetic-by-THI interactions are weak in French Montbeliarde cows for production and udder health traits, but not all animals react in the same way to high temperatures. Even if there is little room for improvement, using a heat tolerance index in cattle selection would be relevant to anticipate the expected increases in temperature. Further investigations are needed to interpret this variability on production traits. However, the current selection for mastitis resistance seems appropriate to adapt cattle to rising temperatures.
Selection signatures for local and regional adaptation in Chinese Mongolian horse breeds reveal candidate genes for hoof health
Authors: Han Haige , Randhawa Imtiaz A. S. , MacHugh David E. , McGivney Beatrice A. , Katz Lisa M. , Dugarjaviin Manglai , Hill Emmeline W.
Published: January 2023

Background

Thousands of years of natural and artificial selection since the domestication of the horse has shaped the distinctive genomes of Chinese Mongolian horse populations. Consequently, genomic signatures of selection can provide insights into the human-mediated selection history of specific traits and evolutionary adaptation to diverse environments. Here, we used genome-wide SNPs from five distinct Chinese Mongolian horse populations to identify genomic regions under selection for the population-specific traits, gait, black coat colour, and hoof quality. Other global breeds were used to identify regional-specific signatures of selection.

Results

We first identified the most significant selection peak for the Wushen horse in the region on ECA23 harbouring DMRT3, the major gene for gait. We detected selection signatures encompassing several genes in the Baicha Iron Hoof horse that represent good biological candidates for hoof health, including theCSPG4,PEAK1,EXPH5,WWP2andHAS3genes. In addition, an analysis of regional subgroups (Asian compared to European) identified a single locus on ECA3 containing theZFPM1gene that is a marker of selection for the major domestication event leading to the DOM2 horse clade.

Conclusions

Genomic variation at these loci in the Baicha Iron Hoof may be leveraged in other horse populations to identify animals with superior hoof health or those at risk of hoof-related pathologies. The overlap between the selection signature in Asian horses with the DOM2 selection peak raises questions about the nature of horse domestication events, which may have involved a prehistoric clade other than DOM2 that has not yet been identified.
Effects of diets with different amino acid release characteristics on the gut microbiota and barrier function of weaned pigs
Authors: Mi Mengmeng , Shen Zhiwen , Hu Nianzhi , Zhang Qiyu , Wang Bin , Pan Li , Qin Guixin , Bao Nan , Zhao Yuan
Published: January 2023

Background

The absorption and utilization of proteins by animals is affected by the amino acid (AA) release characteristics of their diets. In the present study, we aimed to determine the effects of diets with various amino acid release characteristics on the intestinal barrier function and diversity of gut microbiota of weaned pigs.

Results

Forty-eight pigs (7.45 ± 0.58 kg) were fed with diets having different amino acid release characteristics during a period of 28 days. We used a 2 × 3 full-factor (two protein levels and three protein sources with differing amino acid release characteristics) experimental design, with normal (standard terminal ileal digestibility of 17.5%) or low (standard terminal ileal digestibility of 14.9%) protein levels as the first factor. Casein (CAS), corn gluten meal (CGM) and a MIX diet were used as protein sources. Due to the more balanced release of amino acids, the diamine oxidase (DAO) concentrations in the CAS and MIX groups were significantly lower than those in the CGM group (P < 0.05); Reducing the dietary protein content from 17.5% to 14.9% had no significant effects on the levels of serum DAO or D-lactic acid. By contrast, it increased the microbial diversity (chao1 and ACE values) and the number of Lactobacillus in the jejunum (P < 0.05). The CAS-containing diet and the MIX diet resulted in significantly higher microbial diversity (Simpson and Shannon) than the CGM-containing diet in the jejunum.

Conclusion

The balanced release of amino acids in CAS and MIX diets maintained intestinal barrier function and increased gut microbiota diversity. These findings could potentially provide a scientific reference for the rational preparation of piglet feed.
The cost of illness analysis of inflammatory bowel disease
Authors: Pakdin Majid , Zarei Leila , Bagheri Lankarani Kamran , Ghahramani Sulmaz
Published: January 2023

Background

Inflammatory bowel disease (IBD) is a chronic inflammatory condition involving individuals across all age groups. Recent data suggests the increase in the prevalence of IBD and the surge in applying the biologic drugs in which both change the cost of IBD in recent years. Comprehensive assessment of direct and indirect cost profiles associated with IBD in our area is scarce. This study aimed to determine the economic burden of IBD in Iran from a societal perspective, using cost diaries.

Methods

Patients available on clinic registry and hospital information system (HIS), who were diagnosed with IBD, were invited to take part in this study. Demographic and clinical data, the healthcare resource utilization or cost items, absenteeism for the patients and their caregivers were obtained. The cost of the used resources were derived from national tariffs. The data regarding premature mortality in IBD patients was extracted from HIS. Productivity loss was estimated based on the human capital method. Then, cost date were calculated as mean annual costs per patient.

Results

The cost diaries were obtained from 240 subjects (Ulcerative colitis: n = 168, Crohn’s disease, n = 72). The mean annual costs per patient were 1077 US$ (95% CI 900–1253), and 1608 (95% CI 1256, 1960) for the patients with ulcerative colitis and Crohn’s disease, respectively. Of the total costs, 58% and 63% were in terms of the indirect costs for the patients with ulcerative colitis and Crohn’s disease, respectively. The cost of illness for country was found to be 22,331,079 US$ and 15,183,678 US$ for patients with ulcerative colitis and Crohn’s disease, respectively. Highest nationwide economic burden of IBD was found for patients older than 40 years were estimated to be 8,198,519 US$ and 7,120,891 US$, for ulcerative colitis and Crohn’s disease, respectively.

Conclusion

The medication was found to be the greatest contributor of direct medical costs. Productivity loss in terms of long-term disability and premature mortality were major components of IBD’s economic burden in Iran.
What predicts large vessel occlusion in mild stroke patients?
Authors: Lu Zhengzhao , Xiong Yunyun , Yang Kaixuan , Gu Hongqiu , Duan Chunmiao , Zhao Xingquan , Meng Xia , Wang Yongjun
Published: January 2023

Background and purpose

Mild acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) may benefit from thrombolysis or thrombectomy therapy. However, the predictors for LVO in mild AIS patients have not been extensively explored. We aimed to investigate the predictors for LVO in mild AIS patients.

Methods

We collected the data of consecutive AIS patients with a National Institutes of Health Stroke Scale (NIHSS) score ≤ 5 from The Third China National Stroke Registry - a prospective nationwide registry of AIS or transient ischemic attack (TIA) patients in China from August 2015 to March 2018. Patients were divided into LVO and non-LVO group based on the vascular imaging during the hospitalization. Multivariable regression analyses involving clinical characteristics and NIHSS subitems was performed to detect the predictors for LVO.

Result

A total of 7653 mild AIS patients from The Third China National Stroke Registry were included in this study. Among them, 620 patients (8.1%) had LVO. The level of consciousness (adjusted odds ratio, 1.87; 95% confidence interval, 1.08 to 3.23), visual field (adjusted odds ratio, 2.10; 95% confidence interval, 1.43 to 3.06) and sensory (adjusted odds ratio, 0.75; 95% confidence interval, 0.60 to 0.94) were predictors for mild AIS patients with LVO.

Conclusions

Impaired LOC, visual field and sensory were independently predictors for LVO in mild stroke patients. Further studies are warranted to test these predictors in prehospital setting and in other population.
Patterns of staging, treatment, and mortality in gastric, colorectal, and lung cancer among older adults with and without preexisting dementia: a Japanese multicentre cohort study
Authors: Morishima Toshitaka , Kuwabara Yoshihiro , Saito Mari Kajiwara , Odani Satomi , Kudo Haruka , Kato Mizuki , Nakata Kayo , Miyashiro Isao
Published: January 2023

Background

Little is known about dementia’s impact on patterns of diagnosis, treatment, and outcomes in cancer patients. This study aimed to elucidate the differences in cancer staging, treatment, and mortality in older cancer patients with and without preexisting dementia.

Methods

Using cancer registry data and administrative data from 30 hospitals in Japan, this multicentre retrospective cohort study examined patients aged 65–99 years who were newly diagnosed with gastric, colorectal, or lung cancer in 2014–2015. Dementia status (none, mild, and moderate-to-severe) at the time of cancer diagnosis was extracted from clinical summaries in administrative data, and set as the exposure of interest. We constructed multivariable logistic regression models to analyse cancer staging and treatment, and multivariable Cox regression models to analyse three-year survival.

Results

Among gastric (n = 6016), colorectal (n = 7257), and lung (n = 4502) cancer patients, 5.1%, 5.8%, and 6.4% had dementia, respectively. Patients with dementia were more likely to receive unstaged and advanced-stage cancer diagnoses; less likely to undergo tumour resection for stage I, II, and III gastric cancer and for stage I and II lung cancer; less likely to receive pharmacotherapy for stage III and IV lung cancer; more likely to undergo tumour resection for all-stage colorectal cancer; and more likely to die within three years of cancer diagnosis. The effects of moderate-to-severe dementia were greater than those of mild dementia, with the exception of tumour resection for colorectal cancer.

Conclusion

Older cancer patients with preexisting dementia are less likely to receive standard cancer treatment and more likely to experience poorer outcomes. Clinicians should be aware of these risks, and would benefit from standardised guidelines to aid their decision-making in diagnosing and treating these patients.
Implementation of an integrated care strategy for child contacts of tuberculosis patients: a quasi-experimental study protocol
Authors: Benjumea-Bedoya Dione , Villegas Arbeláez Esteban , Martínez-Peñaloza Daniela , Beltrán-Arroyave Claudia Patricia , Restrepo Gouzy Andrea Victoria , Marín Diana , Cadavid Álvarez Lina Marcela , Molinares Beatriz , Montes Zuluaga Fernando Nicolás , Pulido Duarte Henry , Suárez Parra Pedro Mauricio , Alzate Ángel Juan Carlos , Vélez-Parra Guillermo , Realpe Teresa , Vásquez Villa Marisol , Ríos Buitrago Stefani Yamile , Puerta Zapata Jenifer , Arango García Lisandra María , Perea Torres Yesenia , Pérez Doncel Natalia , Arbeláez Montoya María Patricia , Robledo Jaime
Published: January 2023

Background

Childhood tuberculosis continues to be a major public health problem. Although the visibility of the epidemic in this population group has increased, further research is needed.

Objective

To design, implement and evaluate an integrated care strategy for children under five years old who are household contacts of bacteriologically confirmed pulmonary tuberculosis patients in Medellín and the Metropolitan Area.

Methods

A quasi-experimental study in which approximately 300 children who are household contacts of bacteriologically confirmed pulmonary tuberculosis patients from Medellín and the Metropolitan Area will be evaluated and recruited over one year. A subgroup of these children, estimated at 85, who require treatment for latent tuberculosis, will receive an integrated care strategy that includes: some modifications of the current standardized scheme in Colombia, with rifampicin treatment daily for four months, follow-up under the project scheme with nursing personnel, general practitioners, specialists, professionals from other disciplines such as social work, psychology, and nutritionist. Additionally, transportation and food assistance will be provided to encourage treatment compliance. This strategy will be compared with isoniazid treatment received by a cohort of children between 2015 and 2018 following the standardized scheme in the country. The study was approved by the CIB Research Ethics Committee and UPB. ClinicalTrials.gov identifier NCT04331262.

Discussion

This study is expected to contribute to the development of integrated care strategies for the treatment of latent tuberculosis in children. The results will have a direct impact on the management of childhood tuberculosis contributing to achieving the goals proposed by the World Health Organization's End TB Strategy.

Trial registration

ClinicalTrials.gov identifier NCT04331262. Implementation of an Integrated Care Strategy for Children Contacts of Patients with Tuberculosis. Registered 2 April 2020.
The provision of the baby box was associated with safe sleep practices in a low-resource community: a randomized control trial in Ecuador
Authors: Feld Hartley , Osorio Janeth Ceballos , Bahamonde Marisol , Young Thomas , Boada Pablo , Rayens Mary Kay
Published: January 2023

Background

Sudden Unexpected Infant Deaths (SUID) can occur between 1 month and 1 year of age and are inequitably distributed with a greater burden in populations with numerous health disparities. Modifying the infant sleep environment to promote safe sleep is the most effective risk reduction strategy to reduce SUID. The provision of baby boxes with a mattress and infant supplies has been part of a larger anti-poverty social justice maternity package for decades in Finland. While infant mortality rates have generally improved after the maternity package was introduced, little is known about whether the provision of the baby box increased safe sleep practices. The purpose of the study was to evaluate whether the provision of a Finnish-style baby box reinforced safe infant sleep practice in the home in a low-resource community in Ecuador.

Methods

In this longitudinal randomized controlled trial all participants received the same safe sleep education in their third trimester of pregnancy (n = 100). This was followed by randomization into two groups; the control received a diaper bag and newborn gifts, and the intervention group received a baby box and the same gifts at each timepoint. Four infant sleep practices (room sharing, bed sharing/co-sleeping, position, and soft items in the sleep environment) were assessed at 1 month and 1 months post-delivery during a home visit where safe sleep education was also reinforced with both groups.

Results

Those in the baby box group were 2.5 times more likely to report safe sleep practices compared with mothers in the diaper bag group at 1 month (odds ratio [OR] = 2.45 and 95% confidence interval [CI]: 1.03–5.86; χ2 = 4.1, p = .043). The group difference was also present at 6-months post-birth: those in the baby box group were 2.9 times more likely to report safe sleep practices compared with those in the diaper bag group (OR = 2.86 and 95% CI: 1.16–7.05; χ2 = 5.2, p = .022).

Conclusions

While not all participants used the box regularly, the mothers who received the box were more likely to practice safe sleep at 1 month and 6 months. This suggests the baby box may have served as an important prompt towards safer infant sleep practice.

Trial registration

(Clinical Trial Registry, per clinicaltrials.gov: not applicable under 42 CFR 11.22(b) as the study Facility Location was not in the United States (took place in Ecuador), does not involve FDA IND or IDE, and does not involve a drug, biological or device product that is manufactured in and exported from the US for study in another country. The University of San Francisco Quito, Research Ethics Committee in Human Beings approved the study, #2017- 127 M. The University of Kentucky Office of Research Integrity also approved the study, IRB # 42965).
Association between continuity of care and treatment outcomes in psychiatric patients in Germany: a prospective cohort study
Authors: de Cruppé Werner , Assheuer Michaela , Geraedts Max , Beine Karl
Published: January 2023

Background

Continuity of care is considered an important treatment aspect of psychiatric disorders, as it often involves long-lasting or recurrent episodes with psychosocial treatment aspects. We investigated in two psychiatric hospitals in Germany whether the positive effects of relational continuity of care on symptom severity, social functioning, and quality of life, which have been demonstrated in different countries, can also be achieved in German psychiatric care.

Methods

Prospective cohort study with a 20-months observation period comparing 158 patients with higher and 165 Patients with lower degree of continuity of care of two psychiatric hospitals. Patients were surveyed at three points in time (10 and 20 months after baseline) using validated questionnaires (CGI Clinical Global Impression rating scales, GAF Global Assessment of Functioning scale, EQ-VAS Euro Quality of Life) and patient clinical record data. Statistical analyses with analyses of variance with repeated measurements of 162 patients for the association between the patient- (EQ-VAS) or observer-rated (CGI, GAF) outcome measures and continuity of care as between-subject factor controlling for age, sex, migration background, main psychiatric diagnosis group, duration of disease, and hospital as independent variables.

Results

Higher continuity of care reduced significantly the symptom severity with a medium effect size (p 0.036, eta 0.064) and increased significantly social functioning with a medium effect size (p 0.023, eta 0.076) and quality of life but not significantly and with only a small effect size (p 0.092, eta 0.022). The analyses of variance suggest a time-independent effect of continuity of care. The duration of psychiatric disease, a migration background, and the hospital affected the outcome measures independent of continuity of care.

Conclusion

Our results support continuity of care as a favorable clinical aspect in psychiatric patient treatment and encourage mental health care services to consider health service delivery structures that increase continuity of care in the psychiatric patient treatment course. In psychiatric health care services research patients’ motives as well as methodological reasons for non-participation remain considerable potential sources for bias.

Trial registration

This prospective cohort study was not registered as a clinical intervention study because no intervention was part of the study, neither on the patient level nor the system level.
Deliberation, context, emotion and trust – understanding the dynamics of adults’ COVID-19 vaccination decisions in Germany
Authors: Dasch Selina , Wachinger Jonas , Bärnighausen Till , Chen Simiao , McMahon Shannon A.
Published: January 2023

Background

Willingness to vaccinate against coronavirus disease 2019 (COVID-19), which is vital to successful vaccination campaigns, is wavering and suboptimal. In Germany, quantitative research highlighted concerns regarding the safety and efficacy of COVID-19 vaccines as barriers to uptake, but qualitative insights regarding individuals’ decisions about COVID-19 vaccines and how personal perceptions reflect or refute existing behavioral theories are lacking.

Methods

To identify how individuals make COVID-19 vaccination decisions within real-life contexts, we conducted 33 semi-structured, in-depth qualitative interviews with individuals in Germany between March and April 2021 using maximum variation sampling, focusing on perceptions of COVID-19 vaccines. Analysis, informed by a framework approach, began in the field via debriefings and was amplified upon the conclusion of data collection.

Results

Four interconnected themes (deliberation, context, emotion, trust) shaped respondents’ decisions about vaccination. Personal deliberation regarding benefits and risks of vaccines and perceptions of the broader social and political context sparked a spectrum of emotions that underpinned vaccination decisions. Trust in science and researchers emerged as a powerful protective factor facilitating the decision to get vaccinated even amidst a rapidly changing context and disconcerting information.

Conclusions

Our findings add to ongoing debates about the breadth of vaccination decisions by highlighting how respondents are influenced by their perceptions of the political context and the emotional heft of their decisions. The role of cognitive evaluation, context, and emotions mirrors other decision-making frameworks, particularly the Risk as Feelings Theory. We extend on the elements of this theory by highlighting trust as a protective factor when making decisions particularly in highly uncertain contexts. Success of vaccination campaigns, more important than ever as new variants of COVID-19 emerge, is interwoven with an ability to bolster trust in science. Communicating public-health decisions and information about vaccines transparently without instilling fear offers promising chances to strengthen public trust in COVID-19 vaccines.

Trial registration

German Clinical Trials Register (DRKS00024505).
Start small and let it build; a mixed-method evaluation of a school-based physical activity program, Kilometre Club
Authors: Schirmer Teisha , Bailey Andrew , Kerr Nicola , Walton Alison , Ferrington Linda , Cecilio Michael E.
Published: January 2023

Background

Despite the benefits of physical activity, there is minimal research focusing on factors that influence real-world school-based physical activity programs. Kilometre (KM) Club is an Australian grassroots program which aims to increase physical activity in students through the completion of an outside walk or run at school. This small-scale pilot evaluation aimed to examine families, teachers and principals’ perceptions of the benefits, enablers and barriers of KM Club. It also aimed to examine the effects of KM Club on student’s physical activity levels during the school day.

Methods

Four regional New South Wales (NSW) primary schools participated in this study. 26 families, four teachers, and two principals from School A, C, B and D completed semi-structured interviews to understand their perceptions of KM Club. 21 students completed emotional state-scales to understand their emotions when participating in KM Club. 141 students from Schools B, C and D participated in step-count measures using accelerometers.

Results

Families, teachers and principals reported a range of benefits such as improved social connectedness, wellbeing, home and classroom behaviours, participation in sport and fitness levels. Enablers consisted of champion engagement, incentives, versatile facilities and integration with other school activities. Identified barriers included the weather and environment, program timing and health issues. Most students reported that participating in KM Club made them feel proud, confident and fantastic. School B reported a significant increase in students' daily step counts on KM Club days compared to non-KM Club days (+ 15%; p = 0.001), while School C reported no significant changes (-5%; p = 0.26). School D reported a significant increase in the number of daily steps taken by KM Club participants compared with non-KM club participants (+ 10%; p = 0.024).

Conclusion

There is no one-size-fits-all approach to implementing school-based physical activity initiatives. However, it appears that flexible and adaptable factors are important to the successful implementation of school-based programs, such as KM Club. This study revealed a variety of self-reported health, wellbeing and educational benefits for students, as well as an increase in student’s physical activity levels at 2 of the 3 schools participating in the quantitative data collection. This pilot evaluation may help to inform future design, implementation and scale-up of KM Club and school-based health promotion programs, potentially improving child health, wellbeing and educational outcomes.

Trial registration

(LNR223 – LNR/19/NCC/45).
Mental health in children and adolescents with overweight or obesity
Authors: Förster Lucas-Johann , Vogel Mandy , Stein Robert , Hilbert Anja , Breinker Julius Lars , Böttcher Marleen , Kiess Wieland , Poulain Tanja
Published: January 2023

Background

Overweight and obesity represent huge concerns for children's physical and mental well-being. This study examined the relationship between body mass index (BMI) and health-related quality of life (HRQoL), somatoform complaints, and behavioral problems in children and adolescents. Additionally, the influence of sex, age, and socioeconomic status (SES) on these associations was considered.

Methods

In total, we studied 2350 participants between the ages of 4 and 18 years (1213 4- to 10-years-old (child sample) and 1137 11-to 18-year-olds (adolescent sample)). To assess HRQoL, somatoform complaints, and behavioral difficulties, we applied the KIDSCREEN-27, a short form of the Giessen Complaints Questionnaire, and the Strengths and Difficulties Questionnaire (SDQ). The BMI was transformed to BMI standard deviation scores (BMI-SDS), according to German gender- and age-specific reference data. Associations were investigated using linear regression analyses. Each association was checked for interaction with sex, age, and SES.

Results

Regarding HRQoL, we found worsening scores in physical well-being and psychological well-being with increasing BMI-SDS. Somatoform complaints were not significantly associated with BMI-SDS. Conduct problems, peer relationship problems, and emotional problems (the latter only in the adolescent sample) were positively associated with BMI-SDS. While we did not observe any significant interactions with sex, we found some significant interactions with age and/or SES.

Conclusion

Our findings highlight the importance of mental difficulties in children and adolescents with higher BMI and, consequently, underline the relevance of including psychological interventions in the treatment of overweight or obesity.
Endobronchial metastasis secondary to occulting renal cell carcinoma: literature review and a rare case report
Authors: Abdul Rahman Seif-Aldin , Abdul Rahman Ali , Rajab Samer , Mansour Somar , Mansour Marah , Salloum Elias , Alshehabi Zuheir
Published: January 2023

Background

Endobronchial Metastasis from extrathoracic tumors is a rare neoplasm that accounts for approximately 1.1% of total endobronchial malignancies. The most common primary tumors associated with EBM are from the colorectal, breast, and kidney regions. Although it represents a late manifestation in the context of tumor progression, it can rarely antedate the diagnosis of the primary tumor.

Case presentation

A 67-years-old male was referred from another city hospital to our thoracic surgery department due to a 4-months history of hemoptysis and productive cough. A chest X-ray and computed tomography scan showed a soft-tissue mass within the left main bronchus and atelectasis of the anterior segment of the left upper lobe. Furthermore, a flexible bronchoscopy revealed a hypervascular lesion occluding completely the left upper lobe bronchus. The patient underwent lobectomy and pathological examination suggested endobronchial metastasis from clear cell renal cell carcinoma. A second computed tomography scan of the abdomen and pelvis showed a well-defined mass arising from the lateral aspect of the right kidney; therefore, the patient underwent right radical nephrectomy three weeks later and pathology confirmed the diagnosis of clear renal cell carcinoma with endobronchial metastasis.

Conclusion

Despite its rarity, physicians should consider the possibility of endobronchial metastases in the setting of endobronchial lesions. Proper diagnostic approaches should also be considered to rule out the potential of asymptomatic extrathoracic neoplasms. In this manuscript, we aimed to report a rare case -the first from Syria to our knowledge- of an endobronchial metastasis that preceded the diagnosis of renal cell carcinoma. Importantly, we reviewed the existing literature and discussed the diagnostic and treatment approaches.
Salivary microbiome and metabolome analysis of severe early childhood caries
Authors: Li Kai , Wang Jinmei , Du Ning , Sun Yanjie , Sun Qi , Yin Weiwei , Li Huiying , Meng Lingqiang , Liu Xuecong
Published: January 2023

Background

Severe early childhood caries (SECC) is an inflammatory disease with complex pathology. Although changes in the oral microbiota and metabolic profile of patients with SECC have been identified, the salivary metabolites and the relationship between oral bacteria and biochemical metabolism remains unclear. We aimed to analyse alterations in the salivary microbiome and metabolome of children with SECC as well as their correlations. Accordingly, we aimed to explore potential salivary biomarkers in order to gain further insight into the pathophysiology of dental caries.

Methods

We collected 120 saliva samples from 30 children with SECC and 30 children without caries. The microbial community was identified through 16S ribosomal RNA (rRNA) gene high-throughput sequencing. Additionally, we conducted non-targeted metabolomic analysis through ultra-high-performance liquid chromatography combined with quadrupole time-of-flight mass spectrometry to determine the relative metabolite levels and their correlation with the clinical caries status.

Results

There was a significant between-group difference in 8 phyla and 32 genera in the microbiome. Further, metabolomic and enrichment analyses revealed significantly altered 32 salivary metabolites in children with dental caries, which involved pathways such as amino acid metabolism, pyrimidine metabolism, purine metabolism, ATP-binding cassette transporters, and cyclic adenosine monophosphate signalling pathway. Moreover, four in vivo differential metabolites (2-benzylmalate, epinephrine, 2-formaminobenzoylacetate, and 3-Indoleacrylic acid) might be jointly applied as biomarkers (area under the curve = 0.734). Furthermore, the caries status was correlated with microorganisms and metabolites. Additionally, Spearman's correlation analysis of differential microorganisms and metabolites revealed thatVeillonella,Staphylococcus,Neisseria, andPorphyromonaswere closely associated with differential metabolites.

Conclusion

This study identified different microbial communities and metabolic profiles in saliva, which may be closely related to caries status. Our findings could inform future strategies for personalized caries prevention, detection, and treatment.