bluuebunny/crossref_metadata_2025 huggingface dataset:
A post-COVID syndrome curriculum for continuing medical education (CME): in-person versus livestream
Authors: Mueller Michael , Ganesh Ravindra , Schroeder Darrell , Beckman Thomas J.
Published: August 2024

Background

Nearly 30% of patients with COVID-19 infection develop post-COVID Syndrome. Knowledge of post-COVID Syndrome is evolving, creating the need for adaptable curricula. Flipped classrooms (FC) are flexible and dynamic with demonstrated utility in continuing medical education (CME), yet there has been no research on application of FCs, or comparisons between livestream and in-person learning, in post-COVID CME.

Methods

We implemented a novel post-COVID curriculum using FCs for in-person and livestream participants at four Mayo Clinic CME conferences. Outcomes were validated measures of knowledge; perceptions of FCs and CME teacher effectiveness; and learner engagement. Pre-conferences surveys were a post-COVID knowledge test and the Flipped Classroom Perception Inventory (FCPI). Post-conference surveys were a post-COVID knowledge test, the FCPI, the CME Teaching Effectiveness Instrument (CMETE), and the Learner Engagement Inventory (LEI). Pre-post knowledge and FCPI scores were analyzed using linear mixed models. CMETE and LEI were compared for in-person versus livestream participants using the Wilcoxon rank-sum test.

Results

Overall, 59 participants completed the pre-test, and 72 participants completed the post-test, surveys. Participants were predominantly female (58%), were in nonacademic group practices (65%), and lacked prior experience with flipped classrooms (83%). Following the presentations, participants showed significant improvements in post-COVID knowledge (47% correct precourse to 54% correct postcourse, p-value = 0.004), and a trend toward improved FCPI scores. Teaching effectiveness, learner engagement, and pre-post change in COVID knowledge did not differ significantly between participants of in-person versus livestream sessions.

Conclusion

This post-COVID FC curriculum was feasible and associated with improved knowledge scores among a diverse population of physician learners in CME, without any apparent compromise in learner engagement, or in perceptions of teaching effectiveness and FCs, among livestream versus in-person participants.
High altitude polycythemia and its maladaptive mechanisms: an updated review
Authors: Tang Shijie , Zhou Wenwen , Chen Ling , Yan Hui , Chen Lei , Luo Fengming
Published: August 2024

High altitude polycythemia is a maladaptation of highlanders exposed to hypoxic environment, leading to high blood viscosity and severe cardiorespiratory dysfunction. Prolonged hypoxia causes respiratory depression and severe hypoxemia, and further mediates changes in genetic and molecular mechanisms that regulate erythropoiesis and apoptosis, ultimately resulting in excessive erythrocytosis (EE). This updated review investigated the maladaptive mechanisms of EE, including respiratory chemoreceptor passivation, sleep-related breathing disorders, sex hormones, iron metabolism, and hypoxia-related factors and pathways.
Exploring distribution and genomic diversity of begomoviruses associated with yellow mosaic disease of legume crops from India, highlighting the dominance of mungbean yellow mosaic India virus
Authors: Akram Mohammad , Kamaal Naimuddin , Pratap Aditya , Kumar Deepender , Muin Abdul , Sabale P. R. , Aidbhavi Revanasidda , Sunani Sunil Kumar , Rathore Meenal , Gupta Sanjeev , Singh N. P. , Dey N. , Dixit G. P. , Nair Ramakrishnan M.
Published: August 2024

Yellow mosaic disease (YMD) caused by several begomoviruses is one of the major constraints of over a dozen leguminous crops worldwide, particularly in Asian and Southeast Asian countries. The present study aimed to investigate the distribution, diversity and prevalence of begomoviruses associated with YMD in leguminous hosts in five agro-climatic zones of India, to assess the extent of their geographical presence and develop location and crop-specific distribution maps. One hundred and seventy-four leguminous plant samples were tested from 32 locations in India to detect YMD-causing viruses. Additionally, publicly available data were incorporated into this study to provide a comprehensive overview of their distribution in India. This resulted in 581 reports on the DNA-A component representing 119 locations, which were also utilized to depict the distribution of YMD-causing viruses on a map of India. In this study, 117 full-length DNA-A and 103 DNA-B components were successfully characterized, representing the detected mungbean yellow mosaic India virus (MYMIV), mungbean yellow mosaic virus (MYMV), and horsegram yellow mosaic virus in the collected samples. Phylogenetic analysis of isolates of these species showed no differentiation based on location in India. Diversity indices revealed the abundance (55.9%) and dominance (0.56) of MYMIV across 119 locations. These findings hold significant implications for legume researchers, offering insights into disease prevalence and geographic distribution. Furthermore, the distribution of YMD-causing viruses in different agro-climatic zones will help researchers in developing zone-specific YMD-resistant cultivars of the legume crops and would facilitate effective disease management options.
Case report: Successful radical surgery following complete pathological remission of advanced HCC with Tislelizumab/Lenvatinib plus TACE
Authors: Xie Yong , Lyu Tianshi , Zou Yinghua , Wang Jian
Published: August 2024

The combination therapy of Tislelizumab plus Lenvatinib has recently emerged as the new standard of care for unresectable hepatocellular carcinoma (HCC). This treatment has demonstrated a significant reduction in tumor burden, raising the possibility of conversion therapy. However, the full safety and efficacy of this combination in real-world settings are not yet fully understood. We recently reported the case of a 36-year-old man with initially unresectable massive HCC, for whom radical surgery (RS) was contraindicated. After receiving Tislelizumab/Lenvatinib plus transarterial chemoembolization (TACE), the patient achieved complete pathological remission and subsequently underwent RS. The patient did not experience postoperative severe complications, and there was no recurrence during the follow-up period. Tislelizumab/Lenvatinib plus TACE therapy may lead to a complete pathological response in advanced HCC. Nevertheless, the safety of prolonged treatment needs to be assessed.
Worldwide burden of liver cancer due to metabolic dysfunction-associated steatohepatitis from 1990 to 2019: insights from the Global Burden of Disease study
Authors: Huang Minshan , Chen Hang , Wang Hui , Wang Xianmei , Wang Da , Li Yu , Zhou Qingqing , Zhang Dan , Li Mengwei , Ma Lanqing
Published: August 2024

Introduction

Metabolic dysfunction-associated steatohepatitis (MASH) is increasingly becoming a prevalent cause of hepatocellular carcinoma (HCC). Our study examines the burden of MASH-related HCC globally, regionally, and nationally, along with associated risk factors from 1990 to 2019, considering variables such as age, sex, and socioeconomic status.

Objective

We aimed to report the global, regional, and national burden of liver cancer due to MASH and its attributable risk factors between 1990 and 2019, by age, sex, and sociodemographic index (SDI).

Methods

Utilizing the Global Burden of Disease 2019 project, we analyzed data on prevalence, mortality, and disability-adjusted life years (DALYs) for liver cancer attributable to MASH across 204 countries. We provided counts and rates per 100,000 population, including 95% uncertainty intervals.

Results

In 2019, there were 46.8 thousand cases of MASH-related HCC, leading to 34.7 thousand deaths, and 795.8 thousand DALYs globally. While the prevalence increased by 19.8% since 1990, the death and DALY rates decreased by 5.3% and 15.1%, respectively. The highest prevalence was in High-income Asia Pacific, with the greatest increases observed in Australasia, Central Asia, and High-income North America. Southern Sub-Saharan Africa reported the highest death rate, while the lowest rates were in parts of Latin America, Central Sub-Saharan Africa, and Eastern Europe. DALY rates were the highest in Southern Sub-Saharan Africa and the lowest in Tropical Latin America.

Discussion

The burden of MASH-related HCC is expected to rise slightly over the next decade. This disease, which is not associated with the SDI, remains a major public health problem. In addition, the escalating rates of obesity, demographic shifts, and an aging population could position MASH as a leading factor in liver cancer cases, surpassing viral hepatitis. It is imperative, therefore, that the forthcoming years see the implementation of strategic interventions aimed at the early detection and prevention of liver cancer associated with MASH.
Clinical analysis of atlanto-occipital decompression in the management of chiari malformation with multi-segmental syringomyelia
Authors: Sun Yaning , Fang Jiangshun , Wang Shengjuan , Luan Jimei , Wang Na , Lv Lige , Xin Chaojun , Luo Pengyuan , Yue Yanke , Cheng Zhenghai , Yang Zhiguo , Chen Liuyin
Published: August 2024

Background

Chiari malformation type I with syringomyelia (CM-I-S) is a very common disease in neurosurgery. There are also various surgical methods. But it is controversial. There are few reports about children, especially the treatment of multi-segmental beaded syringomyelia. The purpose of this study was to explore the clinical effects of atlanto-occipital decompression (AOD) in the management of Chiari malformation type I (CM-I) with multi-segmental beaded syringomyelia (MSBS) in pediatric patients.

Methods

This retrospective study were pediatric patients with CM-I combined with MSBS who were treated in our hospital from January 2015 to December 2023. The patients who received the AOD treatment were screened according to inclusion and exclusion criteria. Outcomes were assessed by comparison of pre- and postoperative clinical, Chicago Chiari Outcome Scale (CCOS), the diameter and volume of the syringomyelia, morphological parameters of posterior cranial fossa (cervical spinal cord angle of medulla oblongata, CSC-MO) and complications in the enrolled children.

Results

This study ultimately included 21 eligible pediatric patients with CM-I and MSBS. All the patients successfully completed the operation, which consists of atlanto-occipital decompression, partial resection of the posterior arch of the atlas, electrocoagulation of the cerebellar tonsil, pseudomembrane resection of the central canal orifice (latch) of the spinal cord, and artificial dura mater expansion repair. No death, no relapses, no serious neurological dysfunction and other complications. At the last follow-up, the clinical symptoms of all patients basically disappeared. The results of magnetic resonance imaging (MRI) showed that the average preoperative cerebellar tonsillar hernia was 12.4 ± 4.6 mm, and the postoperative were all above the foramen magnum. The average preoperative syringomyelia volume was 11.7 ± 3.7 cm2, and the syringomyelia disappeared or significantly shrunk after operation, with the volume unable to be accurately measured. The median preoperative CSC-MO was 132.5°, and the median postoperative CSC-MO was 150°, with a significant difference. The median preoperative pain and non-pain score of CCOS was 4 and 3 respectively. The symptoms disappeared after operation, and the score was 4. Only 5 children had cerebrospinal fluid leakage.

Conclusion

The AOD is safe and effective in CM-I with MSBS in pediatric patients. Pseudomembrane resection of the central canal orifice (latch) of the spinal cord is crucial for the treatment of syringomyelia.
Predictors of CPAP failure after less-invasive surfactant administration in preterm infants
Authors: Alsina-Casanova Miguel , Brito Nerea , Balcells-Esponera Carla , Herranz-Barbero Ana , Teresa-Palacio Marta , Soler-García Aleix , Agustí Carmen , Brullas Guillem , Clotet Jordi , Carrasco Cristina , Salvia Dolors , Aldecoa-Bilbao Victoria
Published: August 2024

Introduction

Less-invasive surfactant administration (LISA) is associated with better respiratory outcomes in preterm infants with respiratory distress syndrome. However, mechanical ventilation (MV) shortly after the LISA procedure has been related to lower survival. This study aimed to analyze the trends and main predictors of continuous positive airway pressure (CPAP) failure after LISA.

Material and methods

Preterm infants born between 230 and 336 weeks gestational age (GA) in two level III neonatal units who received surfactant were included (2017–2022). Demographic data, lung ultrasound (LUS) scores, the saturation/fraction of inspired oxygen (SF) ratio, technique, time to surfactant administration, and the main neonatal outcomes were collected.

Results

Over the study period, 289 inborn preterm infants received surfactant, 174 with the LISA method (60.2%). Patients who received surfactant after intubation in the delivery room (n = 56) were more immature and exhibited worse outcomes. Patients who received surfactant via an endotracheal tube in the neonatal intensive care unit (n = 59) had higher LUS scores and a lower SF ratio than those treated with LISA. The LISA method was associated with less death or bronchopulmonary dysplasia (BPD), with an adjusted odds ratio (aOR) = 0.37 [95% confidence interval (CI), 0.18–0.74, p = 0.006]. CPAP failure after LISA (defined as the need for intubation and MV in the first 72 h of life) occurred in 38 patients (21.8%), inversely proportional to GA (38.7% at 23–26 weeks, 26.3% at 27–30 weeks, and 7.9% at 30–33 weeks (p < 0.001). CPAP failure after LISA was significantly related to death, with an aOR = 12.0 (95% CI, 3.0–47.8, p < 0.001), and moderate to severe BPD, with an aOR = 2.9 (95% CI, 1.1–8.0, p = 0.035), when adjusting for GA. The best predictors of CPAP failure after LISA were GA, intrauterine growth restriction, temperature at admission, the SF ratio, and the LUS score, with a Nagelkerke's R2 = 0.458 (p < 0.001). The predictive model showed an area under the curve = 0.84 (95% CI, 0.75–0.93, p < 0.001).

Conclusions

CPAP failure after LISA is still common in extremely preterm infants, leading to an increase in death or disability. Clinicians must acknowledge the main risk factors of CPAP failure to choose wisely the right patient and the best technique. LUS and the SF ratio at admission can be useful when making these decisions.
Role of flavonoids in inhibiting triple-negative breast cancer
Authors: Wang Shuai , Wang Kuanyu , Li Cheng , Chen Jing , Kong Xiangding
Published: August 2024

Increasing incidences of metastasis or recurrence (or both) in triple-negative breast cancer (TNBC) are a growing concern worldwide, as these events are intricately linked to higher mortality rates in patients with advanced breast cancer. Flavonoids possess several pharmaceutical advantages with multi-level, multi-target, and coordinated intervention abilities for treating TNBC, making them viable for preventing tumor growth and TNBC metastasis. This review focused on the primary mechanisms by which flavonoids from traditional Chinese medicine extracts inhibit TNBC, including apoptosis, blocking of cell cycle and movement, regulation of extracellular matrix degradation, promotion of anti-angiogenesis, inhibition of aerobic glycolysis, and improvement in tumor microenvironment. This review aims to improve the knowledge of flavonoids as a promising pharmacological intervention for patients with TNBC.
A method for detecting ureteral stent encrustations in medical CT images based on Mask-RCNN and 3D morphological analysis
Authors: Hu Hongji , Yan Minbo , Liu Zicheng , Qiu Junliang , Dai Yingbo , Tang Yuxin
Published: August 2024

Objective

To develop and validate a method for detecting ureteral stent encrustations in medical CT images based on Mask-RCNN and 3D morphological analysis.

Method

All 222 cases of ureteral stent data were obtained from the Fifth Affiliated Hospital of Sun Yat-sen University. Firstly, a neural network was used to detect the region of the ureteral stent, and the results of the coarse detection were completed and connected domain filtered based on the continuity of the ureteral stent in 3D space to obtain a 3D segmentation result. Secondly, the segmentation results were analyzed and detected based on the 3D morphology, and the centerline was obtained through thinning the 3D image, fitting and deriving the ureteral stent, and obtaining radial sections. Finally, the abnormal areas of the radial section were detected through polar coordinate transformation to detect the encrustation area of the ureteral stent.

Results

For the detection of ureteral stent encrustations in the ureter, the algorithm’s confusion matrix achieved an accuracy of 79.6% in the validation of residual stones/ureteral stent encrustations at 186 locations. Ultimately, the algorithm was validated in 222 cases, achieving a ureteral stent segmentation accuracy of 94.4% and a positive and negative judgment accuracy of 87.3%. The average detection time per case was 12 s.

Conclusion

The proposed medical CT image ureteral stent wall stone detection method based on Mask-RCNN and 3D morphological analysis can effectively assist clinical doctors in diagnosing ureteral stent encrustations.
Genome-wide association study of Verticillium longisporum resistance in Brassica genotypes
Authors: Wang Yixiao , Fredua-Agyeman Rudolph , Yu Zhiyu , Hwang Sheau-Fang , Strelkov Stephen E.
Published: August 2024

Verticillium stripe, caused by Verticillium longisporum, presents an emerging threat to Canadian canola (Brassica napus). Initially detected in Manitoba in 2014, the presence of this pathogen has since been confirmed across western Canada. Infections by V. longisporum can result in yield losses of up to 50%, which is a cause for concern given the susceptibility of most commercial Canadian canola cultivars. The objective of this study was to screen a collection of 211 Brassica genotypes for their reactions to V. longisporum, and to use genome-wide association study (GWAS) to identify single nucleotide polymorphism (SNP) markers for resistance. The plant material consisted of 110 rutabaga (B. napus ssp. napobrassica), 35 canola, 40 Brassica rapa, and 15 Brassica oleracea accessions or cultivars, alongside 11 hosts of the European Clubroot Differential (ECD) set. These materials were screened for resistance under greenhouse conditions and were genotyped using a 19K Brassica SNP array. Three general linear models (GLM), four mixed linear models (MLM), and three GWAS methods were employed to evaluate the markers. Eleven non-commercial Brassica accessions and 9 out of 35 commercial canola cultivars displayed a low normalized area under the disease progress curve (AUDPCnorm.). The non-commercial accessions could prove valuable as potential sources of resistance against V. longisporum. Forty-five SNP markers were identified to be significantly associated with V. longisporum resistance using single-SNP based GWAS analysis. In comparison, haplotype-based GWAS analyses identified 10 to 25 haplotype blocks to be significantly associated with V. longisporum resistance. Between 20% and 56% of QTLs identified by the more conventional single-SNP based GWAS analysis were also detected by the haplotype-based GWAS analysis. The overlapping genomic regions identified by the two GWAS methods present promising hotspots for marker-assisted selection in the future development of Verticillium stripe-resistant canola.
Exploring the sports participation, muscle-strengthening exercise and active commuting with comorbidity of depression and anxiety among Chinese children and adolescents: a cross-sectional study
Authors: Feng Bin , Luo Fuchen , Chen Yu , Zhao Yuhang , Wang Ping , Bao Ran
Published: August 2024

Prior research has shown that physical activity (PA) is a crucial element for preserving and enhancing health, particularly among children and adolescents, and consistent engagement in PA offers numerous advantages for sustaining typical physical and mental well-being.

Purpose

Hence, the primary objective of this study was to examine the relationship between sport participation, muscle-strengthening exercise (MSE), and active commuting (AC) in the co-occurrence of depression and anxiety in Chinese children and adolescents.

Method

This cross-sectional investigation occurred in various cities across the southeastern region of China between March 2021 and October 2021. A convenient sampling method was utilized. We invited children and adolescents to participate in the questionnaire survey. A total of 1,996 participants completed the questionnaires with the endorsement of their parents or guardians under the supervision of schoolteachers and headmasters. Girls comprised 47.5% of the participants, and the average age of participants was 14.8 ± 2.0 years. We conducted a logistic regression analysis, including 95% confidence intervals, to explore the association between sports participation, MSE, AC, and the co-occurrence of depression and anxiety.

Results

No significant association was observed between weekday active commuting for travelling to and from school and MSE and the comorbidity of depression and anxiety in children and adolescents. A negative association was only detected for those who engaged in muscle-strengthening exercises 4 days a week (OR = 0.540, 95% CI = 0.345–0.845) compared to those who did not partake in such exercises.

Conclusion

The present study has provided evidence of the connection between sports participation and the co-occurrence of depression and anxiety among Chinese children and adolescents. Sports participation is more likely to help adolescents relieve anxiety and depression than AC, MSE. In forthcoming research, it is imperative to delve deeper into strategies that enhance the impact of sports on the mental well-being of children and young individuals. Furthermore, optimizing the magnitude of this effect may be achievable by focusing on neurobiological, behavioral, and psychosocial mechanisms.
One-year predictors of PTSD symptoms, anxiety, and depression in SARS-CoV-2 survivors: psychological flexibility and major life events as main predictive factors
Authors: Carvalho Sérgio A. , Pinto Helena , Carreiras Diogo , Palmeira Lara , Pereira Marco , Trindade Inês A.
Published: August 2024

Introduction

The COVID-19 pandemic held considerable health-related outcomes worldwide, including mental health challenges, with elevated risk of psychiatric sequelae.

Methods

This study aimed to test the longitudinal (1 year) predictive role of psychosocial factors on post-traumatic stress disorder (PTSD), anxiety, and depressive symptoms in SARS-CoV-2 survivors (N = 209 at T1; N = 61; attrition rate 70.83%), through Pearson’s correlation analyses and longitudinal multiple regression analyses. Participants (age M = 35.4, SD = 10.1) completed online self-report questionnaires of psychosocial variables, PTSD, anxiety, and depression.

Results

Depression and anxiety symptoms were increased, and 42% of survivors presented clinically meaningful PTSD symptoms. PTSD symptoms were longitudinally predicted by having children (β = 0.32, p < 0.01), number of recent major life events (β = 0.34, p < 0.01), and psychological flexibility (β = −0.36, p < 0.01). Number of major life events (β = 0.29, p < 0.05) and psychological flexibility (β = −0.29, p < 0.05) predicted anxiety. Number of recent major life events (β = 0.32, p < 0.01) was the sole predictor of depressive symptoms.

Discussion

Psychosocial variables contribute to the long-term harmful effects of the COVID-19 pandemic on psychopathological symptoms. These results suggest that, during the pandemic, mental health was impacted by both socio-contextual factors and individual self-regulatory skills, namely the ability to respond flexibily to contextual cues and guide behavior according to the direct experience. Specifically, results point out the importance of societal incentives to reduce parental burden and socioeconomic losses, as well as to promote adaptive psychological skills such as psychological flexibility.
The chain mediating effects of resilience and perceived social support in the relationship between perceived stress and depression in patients with COVID-19
Authors: Wang Lingling , Yu Jing , Diao Xuqian , Zhang Yuanbei , Miao Ye , He Wei
Published: August 2024

Introduction

Perceived stress and depression were indirect effects of the COVID-19 pandemic, especially in square-cabin hospitals. It was paramount to understand their mediating effects, which might detonate factors that led to mental illness.

Materials and methods

We conducted a cross-sectional study to investigate perceived stress and depressive symptoms among patients with COVID-19 in Shanghai square-cabin hospitals from April 18 to May 19, 2022. The questionnaire included the Perceived Stress Scale 10, Patient Health Questionnaire 9, Perceived Social Support Scale, and the Connor-Davidson Resilience Scale 10.

Results

This study investigated the chain-mediating roles of perceived social support and resilience in the relationship between perceived stress and depression. Perceived stress positively predicted depression (r = 0.613, p < 0.01), negatively correlated with perceived social support (r = −0.318, p < 0.01) and resilience (r = −0.398, p < 0.01). In the chain mediating model, perceived stress had significant direct predictive effects on depression, and significant indirect predictive effects on depression through perceived social support and/or resilience.

Conclusion

It showed that higher perceived social support and resilience were associated with lower perceived stress among COVID-19 patients, which might lead to symptoms of mild depression, and highlights the importance of resilience and perceived social support in reducing depressive symptoms.
How study-related positive emotions and academic psychological capital mediate between teacher-student relationship and academic performance: a four-wave study among high school students
Authors: Carmona-Halty Marcos , Alarcón-Castillo Karina , Semir-González Carla , Sepúlveda-Páez Geraldy , Mena-Chamorro Patricio , Barrueto-Opazo Francisca , Salanova Marisa
Published: August 2024

This article presents a theory-driven model in which teacher-student relationships and academic performance are indirectly related through study-related positive emotions and academic psychological capital. A sample of 1,054 Chilean high school students (50.4% females) aged 12–17 (M = 14.46, SD = 1.74) participated in the study. Through structural equation modeling, the direct and indirect effects of the proposed model were calculated. The results show that study-related positive emotions and academic psychological capital mediate between the teacher-student relationship and academic performance. These results have significant implications for improving teaching competencies through positive psychological interventions aimed at developing skills in students and thus improving students' academic performance and general well-being in educational settings.
Different perspectives of prison guards and mental health workers in forensic care
Authors: Timar Jasvant , Buurman Evi , Westen Koen , Delespaul Philippe
Published: August 2024

Objectives

This study investigates the differences in treatment perspectives of prison guards and mental health practitioners within a Psychiatric Prison Unit (PPU).

Methods

This qualitative study uses questionnaires and focus groups to explore the relationships between prison guards (N = 4) and mental health professionals (N = 6) working at the Psychiatric Prison Unit in Zwolle, the Netherlands. Two questionnaires (the Recovery Attitude Questionnaire and the Recovery Knowledge Inventory) were completed by the participants. A selected subsample based on diverging beliefs concerning treatment perspectives was recruited for additional focus groups. The dialogues were transcribed and coded into a comprehensive scheme. Responses were analyzed to describe perceptions and attitudes of respondents towards forensic care.

Results

This study identified three main themes: policy, communication, and person-dependent factors. Understaffing and high turnover rates in the correctional facility led to prioritization of safety concerns over treatment objectives. Guards and mental health professionals had different communication styles which hindered the alignment of treatment goals. Person-dependent factors, including personality traits and individual attributes, were significant in shaping collaborative interactions.

Conclusion

This study reveals agreement in the viewpoints between prison guards and mental health professionals but highlights the complex challenges in providing effective treatment within the confines of a correctional facility. These challenges are influenced by policy dynamics, communication limitations, and individual-specific factors.
A novel application of lemmatize and thematic analysis to understand protective measures perspectives of patients with chronic respiratory disease during the first outbreak of COVID-19 pandemic: a qualitative study
Authors: Palacios-Ceña Domingo , Peña-Otero David , Casanova-Macario Ciro , Cuenca-Zaldivar Juan Nicolas , Garcia-Bravo Cristina , Fernandez-de-las-Peñas Cesar , Díaz-Pérez David
Published: August 2024

Objective

To describe the perspectives of a group of COPD patients during the first outbreak of the COVID-19 pandemic and narrate the emotions and polarity (acceptance-rejection) regarding living with COPD during the pandemic.

Design/methods

We used a novel application of lemmatization and thematic analysis of participants’ narratives. A study was carried out with eight patients with moderate–severe-very severe COPD during the first outbreak of COVID-19 using purposive sampling. In-depth interviews and field notes from the researchers were used to collect data. A statistical content analysis (lemmatization) of the patients’ narratives was performed. Additionally, inductive thematic analysis was used to identify emerging themes. This study was conducted following the guidelines of Consolidated Criteria/Standards for Reporting Qualitative Research. The study was conducted in accordance with the principles articulated in the WMA Declaration of Helsinki. Participants provided verbal informed consent prior to their inclusion as previously described.

Results

The average age of our sample was 65 years, and 75% of the patients suffered from moderate COPD, 12.5% from severe COPD, and 12.5% from very severe COPD according to GOLD criteria. The lemmatized and sentiment analysis showed a predominance of positive emotions, and the polarity of the interviews indicated a very slight positive trend towards acceptance of the experience lived during the pandemic. Additionally, three main themes were identified: (1) Confinement and restriction measures, (2) COVID-19 and protective measures, and (3) Clinical care during the first outbreak of the pandemic.

Conclusion

Patients experienced confinement with a feeling of security and protection. They strictly respect social distancing. They used masks, but these caused them to feel short of breath and fatigue, especially FFP2 masks. Half of the patients rejected the possibility of being vaccinated. Finally, they were very satisfied with the clinical care they received in the COPD unit of their hospital. Our results show that COPD patients have not experienced a negative impact of the COVID-19 pandemic.
Short- and long-term impacts of the National Essential Medicines Policy on drug availability, price, and usage in a deprived rural county in southwestern China: an interrupted time series analysis across 8 years
Authors: Xiong Xuechen , Huo Zhaohua , Zhou Shuai , Bai Ge , He Shiying , Zhou Yinan , Jia Jing , Quan Jianchao , Luo Li
Published: August 2024

Background

China’s National Essential Medicines Policy (NEMP) has been implemented for over 15 years; yet empirical evidence on its long-term impacts is lacking, particularly in remote and rural regions. This study aims to assess the short-and long-term effects of NEMP on the drug availability, price, and usage in a deprived rural county in southwestern China.

Methods

A quasi-experimental design was employed, featuring a single-group pre-and-post comparison. We gathered 74,436 procurement records spanning from 2009 to 2016 from the drug warehouses of local medical institutions. Pharmaceutical data were analyzed quarterly, considering various policy and therapeutic attributes. Fisher’s Drug Price Index (DPI-F) was calibrated for the retail and wholesale prices of a consistent collection of 405 medications. We conducted interrupted time-series analysis to examine the immediate and enduring impacts of NEMP’s initial (commencing in January 2011) and second (starting from December 2015) stages.

Results

After initiation of NEMP, the number of available essential medicines surged by 115 but subsequently faced a steady quarterly decline (−9.1) in township healthcare centers (THCs, primary care). Conversely, county hospitals (secondary care) initially saw a reduction of 40 in drug availability but later exhibited a steady increase (+4.2 per quarter) up to the second-stage NEMP. Regarding price, THCs encountered abrupt (−26.1%/−15.9% in retail/wholesale price) and sustained (−0.2%/−0.3% per quarter) price drops after NEMP. The immediate price change after NEMP in county hospitals were milder but significant in non-essential medicines, and long-term declines were also observed in all drugs. As for total sales, a significant long-term disparity emerged between THCs (+0.9% per quarter) and county hospitals (+3.3% per quarter). Following the second-stage NEMP, retail prices in county hospitals further decreased, although wholesale prices did not; however, following price upward trends were observed in both THCs and county hospitals. Lastly, the influences of NEMP varied across different therapeutical categories of medicines.

Conclusion

NEMP has successfully regulated drug prices in primary and secondary healthcare facilities in remote and rural areas, both short-term and long-term. However, a remarkable disparity in medicine availability and utilization was observed between different levels of facilities over time. Continuous monitoring is essential, with increased attention needed on the uneven impacts of the policy on diverse drugs, facilities, regions, and demographics.
Domestic violence and associated factors among pregnant women in sub-Saharan African countries from the recent demographic and health survey data: a multilevel analysis
Authors: Melkam Mamaru , Fentahun Setegn , Rtbey Gidey , Andualem Fantahun , Nakie Girum , Tinsae Techilo , Wassie Yilkal Abebaw , Lemma Seifu Beminate , Fente Bezawit Melak
Published: August 2024

Introduction

Intimate partner violence (IPV) is a human rights violation that often involves violence against women, which appears to be the most prevalent type of abuse. IPV is a global public health issue with major human rights violations. Pregnant women’s IPV needs special consideration because of the possible harm that might happen to mothers and their fetuses. The enormous global public health issue of IPV affects physical, mental, and sexual transgressions. Even though there were studies conducted on IPV among women, few studies were conducted among pregnant women in sub-Saharan African countries. Therefore, this study revealed IPV and associated factors among pregnant women from the recent Demographic and Health Survey (DHS) in sub-Saharan African countries.

Methods

Multilevel logistic regression analysis used data from the recent sub-Saharan African countries DHS was carried out using this secondary data. For this study, pregnant women between the ages of 15 and 49 were included; the total sample size was 17,672. Multilevel logistic regression models were calibrated to determine the associated factors at the individual and community level with IPV, with a 95% CI and AOR.

Results

The prevalence of IPV among pregnant women in 23 sub-Saharan African countries was 41.94%, with a 95% CI of 40.82 to 43.06%. Poorer and poorest [AOR = 1.92; 95% CI: (1.01, 3.67)] and [AOR = 2.01; 95% CI:(1.02, 3.92)], partner alcohol drink [AOR = 3.37;95% CI:(2.21, 5.14)], and no partner education [AOR = 2.01;95% CI:(1.12, 3.63)] were statistically associated factors with IPV among pregnant women.

Conclusion

The prevalence of IPV among pregnant women in sub-Saharan African countries was high (41.94%). Low economic status, partner drinking alcohol, and partner no education were the associated factors of IPV. This finding provides clues for policymakers and other organizations concerned about women.
Management of undernutrition during preconception and pregnancy in an urban setting in North India
Authors: Dhabhai Neeta , Chowdhury Ranadip , Taneja Sunita , Shekhar Medha , Kaur Jasmine , Mittal Pratima , Dewan Rupali , Bhandari Nita
Published: August 2024

Introduction

The prevalence of underweight in women of reproductive age (WRA) in South Asia remains unacceptably high. Underweight women suffer from lowered immunity, infertility, and a risk of developing non-communicable diseases. In pregnancy, undernutrition results in poor neonatal and maternal outcomes. We present the findings and the management strategy of undernutrition in the preconception and pregnancy phase intervention group in the WING study in low- to lower-middle-income neighborhoods of North India.

Methods

We analyzed data from the Women and Infants Integrated Interventions for Growth Study (WINGS) intervention group. In this individually randomized factorial design trial, 13,500 women were enrolled from low to middle-income neighborhoods of Delhi: 6,722 women in the preconception group and 2,640 from the pregnancy group. Food supplements in the form of locally prepared snacks were given to provide necessary calories and protein requirements as per the Body mass index (BMI) during the preconception period and each trimester of pregnancy. The snacks (sweet or savory) and milk or egg as a source of high-quality protein were delivered at home, and intakes were observed. Individual tracking and close monthly monitoring were done for compliance, besides screening and treatment of infections.

Results

The enrolled women's mean (SD) age was 24.2 (3.1) years. Approximately 35% of women had a height of < 150 cm, and 50% had schooling >12 years. 17% of women in preconception and 14 % in pregnancy intervention groups were Underweight. Approximately two-thirds of underweight women improved 9–12 months after management in the preconception group, and the same proportion improved 4 weeks after management during pregnancy. The proportion of women with inadequate weight gain (IWG) during pregnancy was higher in women who were underweight during preconception.

Discussion

A comprehensive approach to managing undernutrition with high-quality energy-dense food supplementation substantially improved weight gain in women during preconception and pregnancy.

Clinical trial registration

http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=19339%26EncHid=%26userName=societyforappliedstudies, identifier: Clinical Trial Registry India #CTRI/2017/06/008908.
Influences of public health emergency and social isolation on older adults’ wellbeing: evidence from a longitudinal study
Authors: Wang Yuzhou , Zhou Dong , Wang Chen
Published: August 2024

Previous research has identified social isolation as a significant detriment to the wellbeing of older adults. However, studies that consider endogenous issues are scarce. The present paper examines the impact of the recent exogenous shock, the COVID-19 pandemic on the wellbeing of the older adult population using a longitudinal dataset from China for the period 2016–2020. The results of this study indicate that the life satisfaction of Chinese older adults was negatively affected, e particularly in regions where social distancing measures were more strictly enforced. Declines in physical and mental health were found to be attributable to declines in life satisfaction. Those who experienced greater exposure to the pandemic were more likely to suffer from chronic disease, illness, and insomnia, and many found it challenging to complete tasks during the lockdown. Furthermore, heterogeneity estimation shows that these effects are stronger among the rural older adult, females, those without a spouse, and those with less education.
Exposure to per- and polyfluoroalkyl substances is associated with impaired cardiovascular health: a cross-sectional study
Authors: Zong Shuli , Wang Lin , Wang Sutong , Wang Yongcheng , Jiang Yuehua , Sun Liping , Zong Yingying , Li Xiao
Published: August 2024

Background

Per- and polyfluoroalkyl substance (PFAS) exposure and cardiovascular disease are controversial. We aimed to assess the association between serum PFAS exposure and cardiovascular health (CVH) in U.S. adults.

Methods

We analyzed serum PFAS concentration data of U.S. adults reported in the National Health and Nutrition Examination Survey (NHANES) study (2005–2018). We employed two weighted logistic regression models and a restricted cubic spline (RCS) to examine the association between each PFAS and impaired CVH (defined as moderate and low CVH). Quantile g-computation (Qgcomp) and weighted quantile sum (WQS) analysis were used to estimate the effects of mixed exposures to PFASs on impaired CVH.

Results

PFAS were associated with an increased risk of impaired CVH (ORPFNA: 1.40, 95% CI: 1.09, 1.80; ORPFOA: 1.44, 95% CI: 1.10, 1.88; ORPFOS: 1.62, 95% CI: 1.25, 2.11). PFOA and PFOS exhibited nonlinear relationships with impaired CVH. Significant interactions were observed for impaired CVH between race/ethnicity and PFHxS (p = 0.02), marital status and PFOA (p = 0.03), and both marital status and race/ethnicity with PFOS (p = 0.01 and p = 0.02, respectively). Analysis via WQS and Qgcomp revealed that the mixture of PFAS was positively associated with an increased risk of impaired CVH.

Conclusion

PFNA, PFOA, and PFOS exposure are associated with an increased risk of impaired CVH in U.S. adults. Race/ethnicity and marital status may influence CVH. Reducing PFAS exposure could alleviate the burden of disease associated with impaired CVH.
Digital social media expression and social adaptability of the older adult driven by artificial intelligence
Authors: Gao Yuan , Liang Jiahui , Xu Zhengbing
Published: August 2024

Introduction

This study examines the impact of digital new media art on the health literacy and digital health literacy of older adults. It explores how digital new media art influences the social adaptability of the older adult, with a focus on variations in their engagement with digital technologies and community activities.

Methods

The research employed interviews and observations of older adult participants from communities A and B. Data were collected on their smartphone usage, community engagement, and access to technological infrastructure. The study also assessed their interaction with digital new media across various domains, including interpersonal communication, information retrieval, entertainment, practical applications, and mobile payments.

Results

The study found significant differences in engagement with digital new media art among the older adult. Participants with prior computer experience were generally more skilled in using smartphones and more active in community events. In contrast, individuals in community B showed lower acceptance of digital new media art and no clear association with community participation. There was substantial variability in their use of digital media for information retrieval, entertainment, practical applications, and mobile payments. Some older adult individuals demonstrated proficiency with these technologies, while others were more reserved.

Discussion

The findings suggest that digital new media art can enhance community participation and social adaptability among older adults, particularly those with prior computer experience. However, disparities in digital media usage highlight the need for targeted interventions to improve digital health literacy and engagement across different community settings. The study underscores the importance of addressing these disparities to ensure that all older adults can benefit from digital advancements, thereby improving their overall well-being and health literacy.
Sickle cell disease: a comparative perspective on global and national initiatives
Authors: Kumar Alok , Bhattacharya Sudip
Published: August 2024

Sickle cell disease (SCD) is a genetic disorder caused by mutations in the β-globin chain of hemoglobin, leading to abnormal red blood cells, severe pain, anemia, organ damage, and increased infection risk. Inherited in an autosomal recessive manner, it mainly affects regions with high malaria incidence, like sub-Saharan Africa, the Middle East, and the Indian subcontinent. Management includes blood transfusions, hydroxyurea, folic acid, iron chelators, and hematopoietic stem cell transplantation (HSCT), the only curative option but limited by donor compatibility. Comprehensive healthcare management (CHCM) emphasizes patient education, nutrition, prophylactic antibiotics, and early intervention to reduce morbidity and improve quality of life. SCD presents a significant global health burden, particularly in regions with limited healthcare access, contributing substantially to child mortality. In sub-Saharan Africa, India, and the Middle East, SCD is prevalent, with approximately 300,000 infants born annually with the condition. In the United States, about 100,000 individuals, predominantly African Americans, are affected. National initiatives, such as Nigeria’s National Sickle Cell Disease Control Program and India’s National Sickle Cell Anaemia Elimination Mission, aim to improve outcomes through early screening, public education, and enhanced healthcare access. Global efforts by the WHO, GSCDN, and SCDC focus on strategic policies, advocacy, and international collaboration to improve care and reduce mortality. Challenges in implementing SCD prevention programs include the need for extensive genetic screening, robust healthcare infrastructure, and overcoming cultural stigmas. Research funding disparities between the Global North and South further hinder advancements. Future research avenues include gene editing technologies, improving prenatal diagnosis, enhancing newborn screening, understanding genetic modifiers, developing new pharmacological agents, and optimizing stem cell transplants. Collaborative efforts among researchers, healthcare providers, policymakers, and patient advocacy groups are essential to translate research into practical applications, ensuring accessible, effective, and equitable advancements in SCD prevention and treatment.