bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance-Enhancing Drugs in Healthy Athletes: An Umbrella Review of Systematic Reviews and Meta-analyses
Authors: Warrier Alec A. , Azua Eric N. , Kasson Luke B. , Allahabadi Sachin , Khan Zeeshan A. , Mameri Enzo S. , Swindell Hasani W. , Tokish John M. , Chahla Jorge
Published: September 2023

Context:

Many clinicians, trainers, and athletes do not have a true understanding of the effects of commonly used performance-enhancing drugs (PEDs) on performance and health.

Objective:

To provide an evidence-based review of 7 commonly used pharmacological interventions for performance enhancement in athletes.

Data Sources:

PubMed and Scopus databases were searched on April 8, 2022.

Study Selection:

Systematic reviews (SRs) and meta-analyses (MAs) assessing the performance-enhancing effects of the following interventions were included: androgenic anabolic steroids (AAS), growth hormone (GH), selective androgen receptor modulators (SARMs), creatine, angiotensin-converting enzyme (ACE)-inhibitors, recombinant human erythropoietin (rHuEPO), and cannabis.

Study Design:

Umbrella review of SRs and MAs.

Level of Evidence:

Level 4.

Data Extraction:

Primary outcomes collected were (1) body mass, (2) muscle strength, (3) performance, and (4) recovery. Adverse effects were also noted.

Results:

A total of 27 papers evaluating 5 pharmacological interventions met inclusion criteria. No studies evaluating SARMs or ACE-inhibitors were included. AAS lead to a 5% to 52% increase in strength and a 0.62 standard mean difference in lean body mass with subsequent lipid derangements. GH alters body composition, without providing a strength or performance benefit, but potential risks include soft tissue edema, fatigue, arthralgias, and carpel tunnel syndrome. Creatine use during resistance training can safely increase total and lean body mass, strength, and performance in high-intensity, short-duration, repetitive tasks. Limited evidence supports rHuEPO benefit on performance despite increases in both VO2max and maximal power output, and severe cardiovascular risks are documented. Cannabis provides no performance benefit and may even impair athletic performance.

Conclusion:

In young healthy persons and athletes, creatine can safely provide a performance-enhancing benefit when taken in controlled doses. AAS, GH, and rHuEPO are associated with severe adverse events and do not support a performance benefit, despite showing the ability to change bodily composition, strength, and/or physiologic measures. Cannabis may have an ergolytic, instead of ergogenic, effect.
The past, present and future of anticholinergic drugs
Authors: Healy David
Published: September 2023

In current medical practice, it is difficult to find any reports claiming that drugs that are primarily anticholinergic or those that have significant anticholinergic effects have any therapeutic benefits. These drugs fell into disrepute within the mental health field from the mid-1960s onwards, and their supposed problems extended to elsewhere in medicine after that. There is considerable evidence that this disrepute stemmed more from marketing copy rather than from hard clinical trial data. Many apparent reviews appear to repeat prior claims rather than present substantial or new evidence. This article offers a perspective rather than a systematic review as there is little evidence other than claims to review. The aim is to challenge the conventional narrative that anticholinergic effects are uniquely hazardous by pointing to the uncertain basis for claims about the harms of anticholinergic drugs, antimuscarinic drugs in particular, ending with pointers to recent research that, if realized, might underpin important possible future benefits.
Anticholinergic action is rarely a good thing
Authors: Bishara Delia
Published: September 2023

The evidence for the risks associated with anticholinergic agents has grown considerably in the last two decades. Not only are they associated with causing peripheral side effects such as dry mouth, blurred vision and constipation, but they can also cause central effects such as cognitive impairment; and more recently, they have consistently been linked with an increased risk of dementia and death in older people. This paper reviews the evidence for the associations of anticholinergic agents and the risk of dementia and increased mortality in dementia.
The accessibility and safety of inserting proximal basilic and axillary veins central lines in neonates
Authors: Aly Hany , Mohamed Mohamed , Ejaz Sehar , Farghaly Mohsen A A , Malik Komail , Qattea Ibrahim
Published: September 2023

Objectives:

to evaluate the accessibility, success rate, and attributable complications and to describe the maneuver for central line insertion via proximal basilic or axillary veins in neonates.

Methods:

This retrospective study included all infants admitted to the neonatal intensive care unit and had an axillary central line inserted or attempted. Success rate, complications, and outcomes were reviewed.

Results:

Axillary central line was attempted in 85 infants and was successful in 78 infants with a success rate of 91.7%. The median postnatal age of patients was 8 days (2 days–92 days), and the median weight of patients at the procedure was 2600 g (590 g–3900 g). The median corrected gestational age of patients at the procedure was 36 weeks (23 weeks–46 weeks). No serious complication was observed in any of the 85 infants.

Conclusion:

This study demonstrated a high success rate for insertion of proximal basilic and axillary veins central lines in neonates with difficult vascular access. This procedure was feasible in very low birth and extremely low birth preterm infants, especially in those who failed previous central line attempts.
A community-based cross-sectional study of eye care service utilization among the adult population in southern Ethiopia
Authors: Merga Hailu , Amanuel Desalegn , Fekadu Lata , Dube Lamessa
Published: September 2023

Background:

Visual impairment, which is related to many eye diseases, is a major public health problem. If detected and treated early, it can be prevented; therefore, regular use of vision services is very important.

Objective:

This study aimed to assess the proportion of utilization of eye care services and associated factors among the rural community population in southern Ethiopia.

Methods:

A community-based cross-sectional study design with a two-stage cluster random sampling technique was conducted to collect data from adults aged 40 years and above using interviewer-administered questionnaires. Kebeles were randomly selected by the lottery method, and systematic random sampling with proportional distribution was used to select the households. An adult individual was randomly selected from a household when there was more than one adult available. A binary logistic regression model was used to establish the association between eye care service utilization and the variables that might affect it.

Results:

Of the 551 study population, 510 responded to this study, and the response rate was 92.6%. The mean age of the respondents was 52.2 years. The rate of eye care service utilization was 29% (95% confidence interval (0.25, 0.33)). The study shows that older participants, aged 65 and above (adjusted odds ratio: 4.04; 95% confidence interval (2.20, 7.43)), having previous eye problems (adjusted odds ratio: 10.04; 95% confidence interval (5.81, 17.33)), the presence of systemic illness (adjusted odds ratio: 2.52; 95% confidence interval (1.21, 5.21)), and having awareness about regular checkups (adjusted odds ratio: 11.75; 95% confidence interval (6.62, 20.84)) were found to be the predictors of eye care service utilization.

Conclusion:

In this study, utilization of eye care services was low. Older age, previous eye problems, systemic illness, and awareness about checkups were found to be predictors of eye care service utilization. Hence, there is a need to increase the absorption of existing ophthalmic services and create awareness of the use of ophthalmology services to reduce preventive blindness.
In-Hospital Mortality Risk and Discharge Disposition Following Hip Fractures: An Analysis of the Texas Trauma Registry
Authors: Martinez Victor H. , Quirarte Jaime A. , Treffalls Rebecca N. , McCormick Sekinat , Martin Case W. , Brady Christina I.
Published: September 2023

Background

In-hospital mortality and discharge disposition following traumatic hip fractures previously reported in the literature, has mainly focused on a nationwide scale, which may not be reflective of unique populations.

Objective

Our aim was to characterize demographics, hospital disposition, and associated outcomes for patients with the most common hip fractures.

Methods

A retrospective study utilizing the Trauma Registry from the Texas Department of State Health Services. Patient demographics, injury characteristics, and outcomes, such as in-hospital mortality, and discharge dispositions, were collected. The data were analyzed via univariate analysis and multivariate regressions.

Results

There were 17,104 included patients, composed of 45% femoral neck fractures (FN) and 55% intertrochanteric fractures (IT). There were no differences in injury severity score (ISS) (9 ± 1.8) or age (77.4 ± 8 years old) between fracture types. In-hospital mortality risk was low but different among fracture types (intertrochanteric, 1.9% vs femoral neck, 1.3%, P = .004). However, when controlling for age, and ISS, intertrochanteric fractures and Hispanic patients were associated with higher mortality ( P < .001, OR 1.5, 95% CI 1.1-2.0). Uninsured, and Black/African American ( P = .05, OR 1.2, 95% CI 1.1-1.3) and Hispanic ( P < .001, OR 1.2, 95% CI 1.1-1.3) patients were more likely to be discharged home after adjusting for age, ISS, and payment method.

Conclusion

Regardless of age, severity of the injury or admission hemodynamics, intertrochanteric fractures and Hispanic/Latino patients had an increased risk of in-hospital mortality. Patients who were uninsured, Hispanic, or Black were discharged home rather than to rehabilitation, regardless of age, ISS, or payment method.
An APOS Analysis of Grade 11 Learners’ Errors and Misconceptions Under Hyperbolic Functions: A Case Study at a Rural High School in Limpopo Province in South Africa
Authors: Matindike Fanuel , Makonye Judah Paul
Published: September 2023

This paper reports on the findings of a baseline study that fed on to a broader investigation exploring ICT integration in the teaching of functions. The baseline study was premised on the observation that the notion of function, despite being a fundamental and central idea in the mathematics school curriculum, presents pedagogical challenges to both teachers and learners. The study used the qualitative case study design to investigate Grade 11 mathematics learners’ errors and misconceptions under hyperbolic functions at a rural high school in the Limpopo province of South Africa. Informed by the constructivist APOS theory conception levels, learners’ errors were detected from their written responses in a diagnostic test. The learners were then individually interviewed during task-based interviews to infer on the misconceptions underlying their errors. Qualitative analysis of the data revealed the following categories of misconceptions: algebraic, conceptual, asymptotic, graphical, and notational misconceptions. The study established that errors, if diagnosed and corrected, are springboards and milestones to the formulation and construction of proper mathematical ideas. To resolve learners’ misconceptions, this study recommends that teachers should use explorative and discovery pedagogical strategies to enable learners realize their own misconceptions and self-correct. Based on the findings of this study, the integration of Information and Communication Technologies (ICTs) in teaching functions as an intervention strategy will be explored.
Global Stock Market Volatility and Its Spillover on the Indian Stock Market: A Study Before and During the COVID-19 Period
Authors: Prasad Saroj S. , Verma Ashutosh , Bakhshi Priti , Prasad Shantanu
Published: September 2023

This study investigates the impact of global stock market volatility on the Indian stock markets before and during the COVID-19 pandemic period. The study focuses on 11 stock markets, including Brazil, Canada, China, France, Hong Kong, India, Japan, Russia, Turkey, the UK, and the US, and applies the threshold generalized autoregressive conditional heteroskedasticity (TGARCH) model to capture the current asymmetry in returns influenced by past negative/positive shocks, and the diagonal Baba Engle Kraft Kroner (BEKK) model to examine the cohesion of the Indian equity market with global markets. The importance of the Indian stock market lies in its ability to provide capital to companies, attract foreign investment, and provide investment opportunities for both domestic and international investors. Data for the study was sourced from https://www.investing.com for the period September 2019 to September 2021 and Stata software was used for data analysis. The study finds that Brazil, Canada, France, Russia, UK, and the USA are the primary sources of financial weight on India’s stock returns. The results suggest that Indian investors can diversify their funds into other asset classes while restricting investments in these markets, particularly during downturns. Investors can make informed decisions to diversify their portfolio and minimize risk. The results can also benefit society by promoting a more stable and resilient financial system. The study can also be expanded to include other financial and economic indicators such as inflation and interest rates to provide a more comprehensive analysis of the impact of global market volatility on Indian equity markets.
Framing Dalits in Sikh Religion and History
Authors: Kaur Kulbir
Published: September 2023

This work is an enquiry into the role and status of the Dalits or the Untouchable castes among the Sikhs. An attempt has been made to trace the ‘Dalit history’ with reference to the works dealing with the issues of caste and Dalits in the Sikh social system. The various sections of the article have covered studies which, on the one hand, emphasize on the denial of the caste system among the Sikhs, highlighting its egalitarian nature and on the other hand there are studies focusing on the existence of caste in Sikhism.
Feasibility of a Bullying Bystander Intervention (STAC) Parent Module for Rural Schools
Authors: Midgett Aida , Doumas Diana M. , Hausheer Robin , Bond Laura , Buller Mary K. , Peralta Claudia , Peck Matt , McCormick Hailey
Published: September 2023

The purpose of this study was to assess the feasibility of parent training designed as a companion module to a bullying bystander intervention (STAC) for middle school students in rural communities. Parents ( N = 23) invited from three rural middle schools viewed a parent training and completed measures to assess limited efficacy through immediate program outcomes (e.g., knowledge, confidence, self-efficacy, attitudes, behavioral intentions) and program feasibility, as well as participated in focus groups to provide feedback about program acceptability, demand, practicality, and online delivery adaptation. Parents reported increases in knowledge and confidence in supporting their adolescents to intervene in bullying situations, confidence and comfort in managing bullying, bullying self-efficacy, communication self-efficacy, responsibility to actively engage in bullying prevention, and anti-bullying attitudes from pre-training to post-training. Parents also reported behavioral intentions to use strategies they learned to support their adolescents to intervene in bullying situations. Further, parents’ responses suggested high levels of program acceptability, as well as interest in an interactive, self-paced online parent training. Themes from focus groups ( n = 12) revealed a need for bullying prevention training for both students and parents in rural communities and found the training to be useful, easy to understand, and relevant and appropriate for their community. Parents identified barriers including cost, time, program flexibility, and the importance of parent buy-in. Parents also provided feedback specific to an online training, including a preference for a smartphone application and design elements to increase engagement. Implications for program development for rural communities are discussed.
Multi-index assessment of road blockage risk due to seismic event-induced building debris
Authors: Chu Yi-Chang , Yang Cheng-Tao , Yeh Chin-Hsun , Lin Szu-Yun
Published: September 2023

The accessibility of road systems is key to facilitating emergency responses in the aftermath of a severe disaster. However, collapsed buildings and debris may cause road blockages, impeding disaster relief efforts after a major earthquake. This study aims to present an efficient and generic assessment method for evaluating the risk of road blockage due to seismic event-induced debris. First, the probability of building collapse in city blocks and the effects of building debris after an earthquake scenario are estimated based on building types, seismic design levels, soil conditions, and local ground motion intensities of the adopted earthquake scenario. Subsequently, the seismic risk of road sections is assessed by considering the collective effects of nearby street profiles, including building materials, heights, and the shape factor of city blocks. This study considers various interpretive building environment parameters and employs three post-earthquake risk indexes to represent different aspects of seismic risk of a road system, including passability loss, affected road length ratio, and road interruption severity. To demonstrate the applicability of the proposed method, the rescue routes in Taipei City, Taiwan, are adopted as a case study. The proposed method can effectively distinguish high-risk roads as valuable information, and the results have been provided to local government disaster relief units for reference.
Thermal softening properties of various wood species within an annual ring
Authors: Horiyama Hiroaki , Miyoshi Yuka , Kojiro Keisuke , Furuta Yuzo
Published: September 2023

Dynamic mechanical analysis (DMA) measurements of water-saturated earlywood (EW) and latewood (LW) of various wood species in the temperature range from 0 to 100 °C were focused to clarify the differences in thermal softening properties within an annual ring. The following results were obtained. The peak of tanδ caused by micro-Brownian motion of lignin was observed in both EW and LW all species. For softwoods, the peak temperatures of tanδ of EW appeared at higher temperatures than those of LW. For hardwoods, in the other hand, the peak temperatures of tanδ were slightly different between EW and LW in the diffuse-porous wood, whereas the temperatures were almost the same in the ring-porous wood. It was found that the difference in peak temperature of tanδ between EW and LW varied greatly among species. The difference in peak temperature between EW and LW was relatively large for softwoods. In addition, the thermal softening properties both in the radial and tangential directions differed depending on the species, so this suggested that there was anisotropy in the thermal softening properties depending on the species.
Coffee consumption and periodontitis: a Mendelian Randomization study
Authors: Liao Wan-Zhe , Zhou Zhi-Yi , Lin Zi-Kai , Xie Shuo-Jia , Zheng Ya-Fang , Wang Jun-Tao , Zheng Jun-Huang , Chen Hao-Kai , Chen Wu-Shu , Guo Xu-Guang
Published: September 2023

Background

Coffee is one of the most consumed beverages in the world, coffee consumption has been growing in the United States over the past 20 years. Periodontitis is defined by the pathologic loss of the periodontal ligament and destruction of the connective tissue attachment and alveolar bone loss and is related to different systemic diseases and conditions. However, the causality has remained unclarified, thus we regarded discovering the causal relationship between coffee consumption and the liability to periodontitis as the objective of the study.

Methods

Coffee consumption was subdivided into binary coffee consumption and continuous coffee consumption to refine the study design. Genetic instruments were stretched from the MRC-IEU’s (MRC Integrative Epidemiology Unit) output from the GWAS pipeline using phesant-derived variables based on the UK Biobank, the Gene-Lifestyle Interactions in Dental Endpoints (GLIDE) project, and the joint meta-analysis of a recent GWAS. The IVW (Inverse Variance Weighted) was regarded as the primary method to estimate the causality, a scatter plot revealed the intuitive result, and tests for stability were also carried out.

Results

An effect of continuous coffee consumption on the risk of periodontitis was found, with per SD of coffee consumed increases, the risk of periodontitis rises by 1.04% (Odds Ratio of IVW is 1.0104), while the effect of binary coffee consumption on periodontitis did not meet the requirement of indicating a strong causal association, neither were the reverse causality analyses.

Conclusions

The study indicated the causality of continuous coffee consumption to the risk of periodontitis with a relatively small scale of effect estimate and no strong evidence for an effect of binary coffee-consuming behavior on periodontitis. There was also no intensive evidence suggesting reverse causality.
Comparison of the effect of autoclaved and non-autoclaved live soil exposure on the mouse immune system
Authors: Kummola Laura , González-Rodríguez Martín I. , Marnila Pertti , Nurminen Noora , Salomaa Tanja , Hiihtola Lotta , Mäkelä Iida , Laitinen Olli H. , Hyöty Heikki , Sinkkonen Aki , Junttila Ilkka S.
Published: September 2023

Background

. Lack of exposure to the natural microbial diversity of the environment has been linked to dysregulation of the immune system and numerous noncommunicable diseases, such as allergies and autoimmune disorders. Our previous studies suggest that contact with soil material, rich in naturally occurring microbes, could have a beneficial immunoregulatory impact on the immune system in mice and humans. However, differences in the immunomodulatory properties of autoclaved, sterile soil material and non-autoclaved, live soil material have not been compared earlier.

Results

. In this study, we exposed C57BL/6 mice to autoclaved and live soil powders that had the same rich microbiota before autoclaving. We studied the effect of the soil powders on the mouse immune system by analyzing different immune cell populations, gene expression in the gut, mesenteric lymph nodes and lung, and serum cytokines. Both autoclaved and live soil exposure were associated with changes in the immune system. The exposure to autoclaved soil resulted in higher levels of Rorγt, Inos and Foxp3 expression in the colon. The exposure to live soil was associated with elevated IFN-γ concentration in the serum. In the mesenteric lymph node, exposure to live soil reduced Gata3 and Foxp3 expression, increased the percentage of CD8 + T cells and the expression of activation marker CD80 in XCR1+SIRPα− migratory conventional dendritic cell 1 subset.

Conclusions

. Our results indicate that exposure to the live and autoclaved soil powders is not toxic for mice. Exposure to live soil powder slightly skews the immune system towards type 1 direction which might be beneficial for inhibiting type 2-related inflammation. Further studies are warranted to quantify the impact of this exposure in experimental type 2 inflammation.
Stoichiometry of carbon, nitrogen and phosphorus is closely linked to trophic modes in orchids
Authors: Minasiewicz Julita , Zwolicki Adrian , Figura Tomáš , Novotná Alžběta , Bocayuva Melissa F. , Jersáková Jana , Selosse Marc-André
Published: September 2023

Background

Mycorrhiza is a ubiquitous form of symbiosis based on the mutual, beneficial exchange of resources between roots of autotrophic (AT) plants and heterotrophic soil fungi throughout a complex network of fungal mycelium. Mycoheterotrophic (MH) and mixotrophic (MX) plants can parasitise this system, gaining all or some (respectively) required nutrients without known reciprocity to the fungus. We applied, for the first time, an ecological stoichiometry framework to test whether trophic mode of plants influences their elemental carbon (C), nitrogen (N), and phosphorus (P) composition and may provide clues about their biology and evolution within the framework of mycorrhizal network functioning.

Results

We analysed C:N:P stoichiometry of 24 temperate orchid species and P concentration of 135 species from 45 plant families sampled throughout temperate and intertropical zones representing the three trophic modes (AT, MX and MH). Welch’s one-way ANOVA and PERMANOVA were used to compare mean nutrient values and their proportions among trophic modes, phylogeny, and climate zones. Nutrient concentration and stoichiometry significantly differentiate trophic modes in orchids. Mean foliar C:N:P stoichiometry showed a gradual increase of N and P concentration and a decrease of C: nutrients ratio along the trophic gradient AT < MX < MH, with surprisingly high P requirements of MH orchids. Although P concentration in orchids showed the trophy-dependent pattern regardless of climatic zone, P concentration was not a universal indicator of trophic modes, as shown by ericaceous MH and MX plants.

Conclusion

The results imply that there are different evolutionary pathways of adaptation to mycoheterotrophic nutrient acquisition, and that the high nutrient requirements of MH orchids compared to MH plants from other families may represent a higher cost to the fungal partner and consequently lead to the high fungal specificity observed in MH orchids.
Maternal COVID-19 causing intrauterine foetal demise with microthrombotic placental insufficiency: a case report
Authors: Nonn Olivia , Bonstingl Lilli , Sallinger Katja , Neuper Lena , Fuchs Julia , Gauster Martin , Huppertz Berthold , Brislinger Dagmar , El-Heliebi Amin , Fluhr Herbert , Kampelmühler Eva , Klaritsch Philipp
Published: September 2023

Background

Pregnant women have an increased risk of getting infected with SARS-CoV-2 and are more prone to severe illness. Data on foetal demise in affected pregnancies and its underlying aetiology is scarce and pathomechanisms remain largely unclear.

Case

Herein we present the case of a pregnant woman with COVID-19 and intrauterine foetal demise. She had no previous obstetric or gynaecological history, and presented with mild symptoms at 34 + 3 weeks and no signs of foetal distress. At 35 + 6 weeks intrauterine foetal death was diagnosed. In the placental histopathology evaluation, we found inter- and perivillous fibrin depositions including viral particles in areas of degraded placental anatomy without presence of viral entry receptors and SARS-CoV-2 infection of the placenta.

Conclusion

This case demonstrates that maternal SARS-CoV-2 infection in the third trimester may lead to an unfavourable outcome for the foetus due to placental fibrin deposition in maternal COVID-19 disease possibly via a thrombogenic microenvironment, even when the foetus itself is not infected.
Spatial distribution of COVID-19 patients in Sri Lanka
Authors: Galgamuwa Lahiru Sandaruwan , Liyanawahunge Nishan Madhushanka , Ratnayake Chamilka Gayashini , Hakmanage Navodi Mekala , Aslam Fahim , Dharmaratne Samath D.
Published: September 2023

Background

A new type of viral pneumonia, which has been named Coronavirus disease (COVID-19) began in Wuhan, China in late 2019 and has spread across the world since then. It has claimed more than 370 million confirmed cases and over 5.6 million deaths have been reported globally by the end of January 2022. This study aimed to analyze the trends, highly-nuanced patterns, and related key results relative to COVID-19 epidemiology in Sri Lanka.

Methods

Data on COVID-19 from March 2020 to January 2022 were obtained from published databases maintained by the Epidemiology Unit of the Ministry of Health in Sri Lanka and information regarding populations in administrative districts was obtained from the Department of Census and Statistics, Sri Lanka. Descriptive spatiotemporal analysis and autocorrelations were analyzed using SPSS statistical software.

Results

In Sri Lanka, the first case of COVID-19 was a Chinese national and the first local case was identified in the second week of March. As of 31st of January 2022, a total of 610,103 COVID-19 cases had been recorded in the country, and 15,420 patients had died. At the beginning, the disease was mainly concentrated in the Western province and with time, it spread to other provinces. However, very low numbers of patients were identified in the North, Eastern, North Central, and Uva provinces until April 2021. The peak of COVID-19 occurred in August and September 2021 in all provinces in Sri Lanka. Then a decreasing trend of COVID-19 cases showed after September 2021.

Conclusions

COVID-19 is an emerging public health problem in Western and Southern Sri Lanka where the population density is high. A decreasing trend of COVID-19 cases showed in all provinces after September 2021. Public awareness programs for the prevention and control of the disease in endemic regions are essential to reduce the incidence of this infection.
Perceived problematic alcohol use in the family and adolescents’ stress-related complaints: examining the buffering role of the school’s degree of student focus as rated by its teachers
Authors: Låftman Sara Brolin , Magnusson Charlotta , Olsson Gabriella , Wahlström Joakim , Modin Bitte
Published: September 2023

Background

A non-negligible proportion of children grow up with problematic alcohol use in the family. Problematic familial drinking can be regarded as a stressor, and prior studies have consistently reported poorer mental health among adolescents who are exposed. However, it is also of relevance to identify modifiable protective factors which may buffer against stress-related ill-health in this group of adolescents. One context where such factors may be present is the school. The aim of this study is to examine the relationship between perceived problematic familial alcohol use and students’ stress-related complaints, and specifically to explore if the school’s degree of student focus can buffer against any such negative health consequences of problem drinking at home.

Methods

Data were drawn from four separate surveys, the Stockholm School Survey (SSS) and the Stockholm Teacher Survey (STS) conducted in 2014 and 2016 among 7,944 students (~ 15–16 years) and 2,024 teachers in 147 Stockholm senior-level school units. Perceived problematic familial alcohol use was measured by one item in the SSS. Stress-related complaints were captured by co-occurring somatic complaints and psychological distress, and reported by students in the SSS. The school’s student focus was measured by an index based on teachers’ ratings of four items in the STS. A set of covariates at the student and the school level were also included. Two-level binary logistic and linear regression models were performed.

Results

Perceived problematic familial alcohol use was linked with an increased likelihood of reporting co-occurring somatic complaints as well as psychological distress. Cross-level interactions revealed that the association between perceived problematic familial alcohol use and co-occurring somatic complaints was weaker among students attending schools with stronger teacher-rated student focus. Regarding psychological distress, the association was weaker for students attending schools with intermediate or strong teacher-rated student focus, compared with those attending schools with weaker teacher-rated student focus.

Conclusions

The findings provide support for the assumption that favourable conditions in schools can buffer against negative health consequences of problematic conditions in the family, thus serving a compensatory role.
The influence of bystander presence on evaluations of public breastfeeding among adults in the United States
Authors: Houlihan Amy E. , Zaikman Yuliana , Alford Allison M.
Published: September 2023

Background

In general, people tend to support private breastfeeding more than public breastfeeding, and discomfort surrounding public breastfeeding may contribute to sub-optimal rates of breastfeeding in the United States. Few studies have systematically examined situational factors that contribute to (negative) reactions to public breastfeeding. It is unclear whether the physical location or the presence of others is more influential in shaping people’s evaluations of public breastfeeding. This study aimed to experimentally investigate the influence of location, bystander presence, bystander gender, and the breastfeeding woman’s use of a cover on people’s evaluations of breastfeeding images.

Method

A sample of adults residing in the United States was randomly assigned to view an image of a breastfeeding woman in an experimental study that examined four independent variables: breastfeeding location (public vs. private), bystander presence (present vs. not present), gender of bystander (male vs. female), and use of a cover (cover vs. no cover). Participants then reported their emotional reactions to, perceptions of, and behavioral intentions toward the breastfeeding woman. In addition, participants completed measures of sexism, traditional gender role endorsement, sexual comfort, body gaze, and breastfeeding knowledge and experience.

Results

Hierarchical regressions revealed no differences between private and public breastfeeding images. Perceptions of the breastfeeding woman were more favorable when she was alone than with others, and when she was covered than when she was not covered. Evaluations tended to be more favorable among participants who scored lower on hostile sexism, higher on benevolent sexism, higher on sexual comfort, and higher on breastfeeding knowledge.

Conclusion

The presence of bystanders may be more consequential than the physical location in shaping reactions to public breastfeeding. These findings can be applied to improve support for public breastfeeding, which may contribute to higher breastfeeding rates and the associated public health benefits.
Magnetic resonance imaging could precisely define the mean value of tendon thickness in partial rotator cuff tears
Authors: Longo Umile Giuseppe , De Salvatore Sergio , Zollo Giuliano , Calabrese Giovanni , Piergentili Ilaria , Loppini Mattia , Denaro Vincenzo
Published: September 2023

Purpose

Rotator Cuff (RC) lesions are classified in full-thickness and partial-thickness tears (PTRCTs). To our knowledge, no studies investigated the mean size of shoulder tendons in healthy and PTRCT patients using MRI scans. The aim of the study was to provide data to obtain and compare the mean value of tendon sizes in healthy and PTRCTs groups.

Methods

From 2014 to 2020, 500 were included in the study. They were divided into two groups: Group 1 (100 subjects) was composed of people positive for partial-thickness rotator cuff tears (PTRCTs), while the 400 subjects in Group 2 were negative for PTRCTs.

Results

Overall, of the patients included in the study, 231 were females and 269 were males. The mean age of the patients was 49 ± 12.7 years. The mean thickness of the supraspinatus tendon (SSP) was 5.7 ± 0.6 mm in Group 1, 5.9 ± 0.6 mm in Group 2 (p < 0.001). The mean length of the ISP tendon was 27.4 ± 3.2 mm in Group 1, 28.3 ± 3.8 mm in Group 2 (p = 0.004). The mean width of the SSP tendon was 17 ± 1.6 mm in Group 1, 17.6 ± 2 mm in Group 2 (p = 0.004). The mean width of the infraspinatus tendon (ISP) tendon was 17.7 ± 1.4 mm in Group 1, 18.3 ± 2.1 mm in Group 2 (p = 0.02).

Conclusion

The anatomical data present in this paper may serve as a tool for surgeons to properly manage PTRCTs. The findings of the present study aimed to set the first step towards reaching unanimity to establish international cut-off values to perform surgery. Additionally, they could widely increase diagnostic accuracy, improving both conservative and surgical approaches. Lastly, further clinical trials using more accurate diagnostic MRI tools are required to better define the anatomical differences between PTRCT and healthy patients.

Level of evidence

Level II, Retrospective Comparative Trial
Effect of day time on smartphone use posture and related musculoskeletal disorders risk: a survey among university students
Authors: Jacquier-Bret Julien , Gorce Philippe
Published: September 2023

Background

Musculoskeletal disorders (MSDs) are one of the most important problems among young smartphone users worldwide. Portability leads to a wide variety of postures during the different activities of the day. The objective evaluation of these postures coupled with ergonomic tools allows evaluating the level of MSD risk to which users are exposed.

Methods

The purpose was to investigate the effect of the time of day on the posture adopted during smartphone use among university students. The study was conducted through a cross-sectional survey of 263 university sports students. Four time of day, i.e. morning, afternoon, evening and night, and a taxonomy of 41 postures called SmarTaxo were considered. SmarTaxo included 18 sitting, 11 standing, 10 lying and 2 walking postures and their ergonomic score. After checking the normality of the data, a non-parametric Kruskal–Wallis test was used to study the effect of the time of day on the use duration of the different postures.

Results

The total mean duration use per typical weekday was 5.39 ± 2.19 h for males and 5.15 ± 1.60 h for females with maximal duration during evening. The average smartphone use durations were statistically longer in afternoon and evening for all sitting (9.44 and 9.22 min respectively, p < 0.05) and calling (3.38 and 3.33 min respectively, p < 0.05) postures. The longest duration for standing postures was recorded for afternoon (8.91 min, p < 0.05). The lying postures were significantly more present in evening (19.36 min). Some postures were more used during a time of day. The side-lying posture was used more in evening and has an ergonomic score of 6, i.e. a high MSD risk.

Conclusions

The survey showed that users are exposed to MSDs regardless of posture and time of day. Sitting postures are used more in the morning and afternoon while lying postures are used more in the evening. As long as the rate of use is so high (> 5 h per day), young people will remain highly exposed to MSDs.
Classifying patients with non-specific chronic low back pain using the impact stratification score in an online convenience sample
Authors: Rodriguez Anthony , Herman Patricia M. , Slaughter Mary E. , Edelen Maria Orlando , Hays Ron D.
Published: September 2023

Background

In 2014, the National Institute of Health Pain Consortium’s research task force (RTF) on research standards for chronic low back pain (CLBP) proposed the Impact Stratification Score (ISS) as a patient-reported outcome measure that could stratify patients by the impact CLBP has on their lives. This work compares three newly developed ISS-based classifications to the RTF’s original to provide an optimal recommendation.

Methods

The online sample included 1226 individuals from Amazon’s Mechanical Turk who indicated having non-specific CLBP, average age of 40, 49% female, and 67% White. Participants completed the PROMIS-29 v2.1 profile survey that contains the 9 ISS items as well the Roland-Morris Disability Questionnaire (RMDQ) and Graded Chronic Pain Scale (GCPS). Other items included high-impact chronic pain; not working due to health problems; overall health; and number of healthcare visits for back pain in the past 6 months. Three new classifications were created using quartiles (Classification 2), latent profile analysis (Classification 3), and one modeled after the GCPS (Classification 4). Classifications were subsequently compared to the RTF-proposed classification (Classification 1) on several concurrent and prognostic criteria.

Results

Classification 1 had three CLBP severity groups, four in Classification 2, three in Classification 3, and four in Classification 4. All novel classifications improved upon the original. Classification 2 performed best at minimizing the classification of those with negative outcomes into the lowest severity groups at baseline (e.g., 11% with RMDQ ≥ 7) and 6 months (e.g., 8.2% had fair/poor health). Classification 4 performed best at maximizing classification of those with negative outcomes into the most severe group concurrently (e.g., 100% had GCPS grade ≥ 2) and at 6 months (e.g., 100% with RMDQ ≥ 7).

Conclusions

We developed three ISS-based classification schemes and tested them against several outcomes. All three improved upon the original scheme. While appearing more optimal than other classifications in the lowest severity groups, Classification 2 presents some considerations and limitations. Given that Classification 4 was an improvement at the lowest end of severity and was the best at the highest end, it is our tentative recommendation that this approach be adopted to classify individuals with non-specific CLBP.
Posterior lumbar fusion surgery doesn’t change sexual activities in patients with lumbar degenerative disease: an observational study
Authors: Shimamura Yukitoshi , Kanayama Masahiro , Horio Michiko , Yamaguchi Ai , Oha Fumihiro , Tsujimoto Takeru , Tanaka Masaru , Hasegawa Yuichi , Endo Tsutomu , Hashimoto Tomoyuki
Published: September 2023

Background

There are few studies about sexual function in the patient with posterior lumbar spinal fusion for degenerative lumbar disease. The aim of this study is to investigate sexual activities in patients with lumbar degenerative disease before and after lumbar fusion surgery.

Methods

We recruited 35 patients who underwent lumbar spinal fusion at the age of 55 years or younger. They were 17 men and 18 women with a mean age of 47.4 years. After informed consent, the patients were asked to complete anonymous questionnaire concerning sexual desire, activity, and satisfaction before and after surgery.

Results

In the presick period, 69% of the patients had sexual desire, and 79% achieved satisfaction during sexual activity. Lumbar degenerative disease decreased sexual desire and frequency of sexual activity in 40%, and 74% respectively. Before surgery, satisfaction in sexual activities decreased in 53%, and 55% of the patients felt discomfort during sexual activity. Adjustment in sexual position was required in 44% of man and 54% of woman. After surgery, Sexual desire, frequency of sexual activity and satisfaction did not regain after surgery in 94%, 93% and 92%, respectively.

Those who did not feel discomfort after surgery was significantly lower VAS in both low back pain and leg pain than the patients felt discomfort (low back pain; p = 0.024, leg pain; p = 0.046).

Conclusion

This study demonstrated that lumbar degenerative diseases decreased sexual desire, frequency of sexual activity and satisfaction, and little of the patients regained their sexual activities after posterior lumbar fusion surgery in the middle-aged patients.
Clusters of medical specialties around patients with multimorbidity – employing fuzzy c-means clustering to explore multidisciplinary collaboration
Authors: Verhoeff Marlies , Weil Liann I. , Chu Hung , Vermeeren Yolande , de Groot Janke , Burgers Jako S. , Jeurissen Patrick P. T. , Zwerwer Leslie R. , van Munster Barbara C.
Published: September 2023

Background

Hospital care organization, structured around medical specialties and focused on the separate treatment of individual organ systems, is challenged by the increasing prevalence of multimorbidity. To support the hospitals’ realization of multidisciplinary care, we hypothesized that using machine learning on clinical data helps to identify groups of medical specialties who are simultaneously involved in hospital care for patients with multimorbidity.

Methods

We conducted a cross-sectional study of patients in a Dutch general hospital and used a fuzzy c-means clustering algorithm for the analysis. We explored the patients’ membership degrees in each cluster to identify subgroups of medical specialties that provide care to the same patients with multimorbidity. We used retrospectively collected electronic health record data from 2017. We extracted data from 22,133 patients aged ≥18 years who had received outpatient clinical care for two or more chronic and/ or oncological diagnoses.

Results

We found six clusters of medical specialties and identified 22 subgroups. The clusters were labeled based on the specialties that most characterized them: 1. dermatology/ plastic surgery, 2. six specialties (gynecology/ rheumatology/ orthopedic surgery/ urology/ gastroenterology/ otorhinolaryngology), 3. pulmonology, 4. internal medicine/ cardiology/ geriatrics, 5. neurology/ physiatry (rehabilitation)/ anesthesiology, and 6. internal medicine. Most patients had a full or dominant membership to one of these clusters of medical specialties (11 subgroups), whereas fewer patients had a membership to two clusters. The prevalence of specific diagnosis groups, patient characteristics, and healthcare utilization differed between subgroups.

Conclusion

Our study shows that clusters and subgroups of medical specialties simultaneously involved in hospital care for patients with multimorbidity can be identified with fuzzy c-means cluster analysis using clinical data. Clusters and subgroups differed regarding the involved medical specialties, diagnoses, patient characteristics, and healthcare utilization. With this strategy, hospitals and medical specialists can further analyze which subgroups are target populations that might benefit from improved multidisciplinary collaboration.
A qualitative analysis of the impact of canine hypoadrenocorticism on the quality of life of owners
Authors: Hupfeld Julia , Dölle Michael , Volk Holger A. , Rieder Johanna
Published: September 2023

Background

Canine hypoadrenocorticism is a rare chronic disease, which demands intense dog-owner interaction, as its treatment requires to be individualised. The aim of this study was a qualitative analysis of the challenges owners face when dealing with the disease, especially regarding its management and how this affects quality of life. By promoting an online discussion between owners, we transcribed and summarised their experiential knowledge in dealing with the disease.

Methods

Owners were recruited for the online seminars via social media. After a theoretical introduction, participants were free to share experiences and ask questions. The recorded events were retrospectively analysed.

Results

Twenty-four owners of 22 Addisonian dogs took part in four events. Owners felt most “traumatised” when experiencing their dog’s acute adrenal crisis. The initial adjustment phase and distinguishing the non-specific symptoms of hypoadrenocorticism from those of other diseases were also challenging. Overall, owners were well informed on the disease and committed to its long-term adjustment.

Conclusions

Adrenal crisis and the initial adjustment phase may be more burdening to owners than expected. Understanding what their clients’ concerns are, can help veterinarians provide better care and reduce the negative impacts of canine hypoadrenocorticism. Promoting peer to peer support, as well as providing a framework for participative communication might also help.