bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Differences Between Non-Hispanic White and African American Patients With Sports Medicine–Related Hip Disabilities
Authors: Brown Marsalis , Udawatta Thiran , Flesch Lance , Strnad Gregory J. , Briskin Isaac , Jones Morgan , Kaar Scott , Rosneck James T. , Farrow Lutul D.
Published: February 2022

Background:

Racial disparities within the field of orthopaedics are well-documented in the spinal surgery, knee arthroplasty, and hip arthroplasty literature. Not much is known about racial differences in patients with sports medicine–related hip disabilities.

Purpose:

To investigate whether differences exist between African American and non-Hispanic White (White) patients evaluated for hip disabilities.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

We performed a multicenter retrospective cohort study of 905 patients who were evaluated over a 1-year period for hip-related orthopaedic concerns. Patient demographic data, disability characteristics, and hip radiographic findings were obtained from electronic medical records. We also obtained data on whether patients were offered physical therapy, magnetic resonance imaging (MRI), and/or surgery. Comparisons by race and insurance status were evaluated using univariate and multivariate analyses.

Results:

African Americans comprised a significantly lower proportion of the patients evaluated for hip-related disabilities compared with Whites (6.5% vs 93.5%; P < .001). A significantly smaller proportion of African Americans with hip disabilities was recommended for surgery than White patients (35.6% vs 54.6%; P = .007). Cam deformities were more common in White vs African American patients (39.7% vs 23.7%; P = .021), as were labral tears (54.1% vs 35.6%; P = .009). Logistic regression demonstrated that neither race nor insurance status were significant determinants in surgery recommendations. Conversely, race was a determinant of whether an MRI was performed, as White patients were 2.74 times more likely to have this procedure. There were no differences with respect to obtaining an MRI between private and Medicaid insurance.

Conclusion:

Compared with White patients, there were differences in both the proportion of African Americans evaluated for hip-related disabilities and the proportion receiving a surgery recommendation. African Americans with sports medicine–related hip issues were also less likely to obtain an MRI. With regard to observed pathology, African American patients were less likely to have cam deformities and labral tears than White patients.
Photochromic Microcapsules for Textile Materials by Spray Drying: Part 2—Exergy Analysis of Spray Drying Process
Authors: Çay Ahmet , Morsümbül Seniha , Kumbasar Emriye Perrin Akçakoca
Published: February 2022

In this study, the second part of a three-part series, exergy analysis of microencapsulation of photochromic dyes by the spray drying method was investigated. Since the spray dryers are thermal systems, energetic examination of the system components is an important issue for sustainable production with high efficiency. Exergy analysis is an important tool used in recent years for the analysis, design, and performance evaluation of thermal systems. The spray drying process was investigated considering two subsystems: the heater and the dryer sections. An exergy model for the process of encapsulation of spirooxazine-based photochromic dye with ethyl cellulose by the spray drying method was proposed. The highest exergy efficiency was achieved at a drying temperature of 120 °C and using an aqueous system as the solvent.
The Effect of Arm Postures and Garment Style on Local Mobility and Thermal Insulation
Authors: Zhang Zhaohua , Ni Jun , Zhou Ying
Published: February 2022

Heat transfer in clothing can be influenced by posture change of the human body and garment pattern design. In this study, the volume of the air gaps and the contact area were investigated for different arm postures of a thermal manikin using a three-dimensional body scanner, and the effect of garment pattern design was analyzed. Furthermore, the local thermal insulation of different body parts of the thermal manikin was tested for six kinds of arm postures when the manikin was dressed in various experimental garments. Both arm postures and garment styles had a strong effect on the local air gap distributions. The air gap volume decreased, and the contact area increased with the growth of protraction angles of arms. The human tests also indicated that the range of arm motion was improved, and better flexibility was perceived compared with the original style. A significant positive correlation between thermal insulation and air gap volume ( r = 0.753, p < 0.001) was found.
Plasma Vitamin B-12 Levels and Risk of Alzheimer’s Disease: A Case-Control Study
Authors: Shrestha Lochana , Shrestha Bikal , Gautam Keyoor , Khadka Sagar , Mahara Rawal Namrata
Published: February 2022

Introduction: Vitamin B-12 deficiency is a frequent condition in the elderly population. High homocysteine levels, which can contribute to arterial damage and blood clots in blood vessels, usually indicate a deficiency in vitamin B-12. Different studies have shown an association of raised total homocysteine with incident Alzheimer’s disease. This study aimed to evaluate the association between vitamin B-12 levels and the risk of Alzheimer’s disease (AD). Methods: A case-control study with a sample size of 90 was conducted at Tertiary hospital, Kathmandu. The participants who visited the psychiatric outpatient department from 2019 onward at Tertiary hospital, Kathmandu, were recruited. The Mini-Mental State Examination (MMSE) was administered to the participants by a trained medical doctor. The medical doctor used the MMSE scores to classify the participants into two groups: the healthy control group and the AD group. Results: The AD group had higher percentages of hypertension (20.9%), diabetes (13.6%), smoking habit (27.3%), vitamin B-12 deficiency (22.7%), and alcohol consumption (13.8%) relative to the control group. Among these features, a significant association was found between alcohol and vitamin B-12 status and between systolic blood pressure and MMSE score. Conclusion: This study concluded that there is an association between low levels of vitamin B-12 and the risk of AD. Further studies are needed to determine the cause-effect.
Effect of temperature and pressure on the interfacial morphology and bond strength of thermally laminated glycol-modified polyethylene terephthalate/styrene-co-butadiene block copolymer films and comparison with coextruded (polyethylene terephthalate/styrene-co-butadiene block copolymer/polyethylene terephthalate) and polyethylene terephthalate/styrene-co-butadiene block copolymer/polyethylene terephthalate films heated with applied pressure after extrusion
Authors: Ishida Katsunori , Nishitsuji Shotaro , Miyata Ken
Published: February 2022

This study focuses on controlling the interfacial adhesive strength between heat-sealed styrene-co-butadiene block copolymer (SBC) and glycol-modified polyethylene terephthalate (PETG) multilayer films. In comparison, the interfacial bond strength of coextruded PETG/SBC/PETG films was weaker. The lamella structures of SBC and free polybutadiene increased the interfacial adhesive strength. The coextruded films with applied thermal pressing were also examined. When exposed to heat, the interfacial adhesive strength improved. The butadiene layer segregated along the adhesive interface, as observed by transmission electron microscopy. The butadiene layer improved the interfacial adhesive strength. The applied pressure caused the butadiene layer to segregate in a parallel manner along the adhesive interface. The developed lamellar structure did not increase adhesive strength. We considered that the adhesive strength decreased due to a thinner butadiene layer with higher pressure. We concluded that adhesive segregation along the adhesive interface improved the bond strength.
Platelet-rich plasma (PRP) augmentation does not result in more favourable outcomes in arthroscopic meniscal repair: a meta-analysis
Authors: Migliorini Filippo , Cuozzo Francesco , Cipollaro Lucio , Oliva Francesco , Hildebrand Frank , Maffulli Nicola
Published: February 2022

Background

The efficacy and safety of platelet-rich plasma (PRP) augmentation for arthroscopic meniscal repair is controversial. This meta-analysis compared arthroscopic meniscal repair performed in isolation or augmented with PRP.

Methods

The present study was conducted according to PRISMA 2020 guidelines. Pubmed, Web of Science, Google Scholar and Embase were accessed in August 2021. All the clinical trials which compared arthroscopic meniscal repair performed in isolation or augmented with PRP were included.

Results

Eight hundred thirty-seven patients were included: 38% (318 of 837 patients) were women; the mean age of the patients was 35.6 (range, 20.8–64.3) years; the mean follow-up was 26.2 (range, 6–54) months. Similarity was found in analogue scale (VAS) (P = 0.5) and Lysholm (P = 0.9), and International Knee Documentation Committee (IKDC) scores (P = 0.9). Similarity was found in the rate of failure (P = 0.4) and rate of revision (P = 0.07).

Conclusion

The current published scientific evidence does not support PRP augmentation for arthroscopic meniscal repair.
Re-evaluating the case for poecilogony in the gastropod Planaxis sulcatus (Cerithioidea, Planaxidae)
Authors: Fassio Giulia , Bouchet Philippe , Oliverio Marco , Strong Ellen E.
Published: February 2022

Background

Planaxis sulcatushas been touted as a textbook example of poecilogony, with members of this wide-ranging Indo-Pacific marine gastropod said to produce free-swimming veligers as well as brooded juveniles. A recent paper by Wiggering et al. (BMC Evol Biol 20:76, 2020) assessed a mitochondrial gene phylogeny based on partial COI and 16S rRNA sequences for 31 individuals supplemented by observations from the brood pouch of 64 mostly unsequenced individuals. ABGD and bGYMC supported three reciprocally monophyletic clades, with two distributed in the Indo-Pacific, and one restricted to the northern Indian Ocean and Red Sea. Given an apparent lack of correlation between clade membership and morphological differentiation or mode of development, the reported 3.08% maximum K2P model-corrected genetic divergence in COI among all specimens was concluded to represent population structuring. Hence, the hypothesis that phylogenetic structure is evidence of cryptic species was rejected andP. sulcatuswas concluded to represent a case of geographic poecilogony.

Results

Our goal was to reassess the case for poecilogony inPlanaxis sulcatuswith a larger molecular dataset and expanded geographic coverage. We sequenced an additional 55 individuals and included published and unpublished sequence data from other sources, including from Wiggering et al. Our dataset comprised 108 individuals (88 COI, 81 16S rRNA) and included nine countries unrepresented in the previous study. The expanded molecular dataset yielded a maximum K2P model-corrected genetic divergence among all sequenced specimens of 12.09%. The value of 3.08% erroneously reported by Wiggering et al. is the prior maximal distance value that yields a single-species partition in ABGD, and not the maximum K2P intraspecific divergence that can be calculated for the dataset. The bGMYC analysis recognized between two and six subdivisions, while the best-scoring ASAP partitions recognized two, four, or five subdivisions, not all of which were robustly supported in Bayesian and maximum likelihood phylogenetic analyses of the concatenated and single gene datasets. These hypotheses yielded maximum intra-clade genetic distances in COI of 2.56–6.19%, which are more consistent with hypothesized species-level thresholds for marine caenogastropods.

Conclusions

Based on our analyses of a more comprehensive dataset, we conclude that the evidence marshalled by Wiggering et al. in support ofPlanaxis sulcatuscomprising a single widespread, highly variable species with geographic poecilogony is unconvincing and requires further investigation in an integrative taxonomic framework.
Plant community analysis along environmental gradients in moist afromontane forest of Gerba Dima, South-western Ethiopia
Authors: Dibaba Abyot , Soromessa Teshome , Warkineh Bikila
Published: February 2022

Background

This study was carried out in Gerba Dima Forest, South-Western Ethiopia, to determine the floristic composition, species diversity and community types along environmental gradients. Identifying and interpreting the structure of species assemblages is the main goal of plant community ecology. Investigation of forest community composition and structure is very useful in understanding the status of tree population, regeneration, and diversity for conservation purposes.

Method

Ninety sample plots having a size of 25 × 25 m (625 m2) were laid by employing stratified random sampling. Nested plots were used to sample plants of different sizes and different environmental variables. All woody plant species with Diameter at breast height (DBH) ≥ 2.5 cm and height ≥ 1.5 m were recorded in 25 m × 25 m plots. Hierarchical (agglomerative) cluster analysis was performed using the free statistical software R version 3.6.1 using package cluster to classify the vegetation into plant community types. Redundancy Analysis (RDA) ordination was used in describing the pattern of plant communities along an environmental gradient.

Result

One hundred and eighty plant species belonging to 145 genera, 69 families and comprising of 15 endemic species were recorded. Of these, 52 species (28.9%) were trees, 6 species (3.33%) were Trees/shrubs, 31 species (17.22%) were shrubs, 76 species (42.22%) were herbs, and 15 species (8.33%) were Lianas. Rubiaceae, Acanthaceae and Asteraceae were the richest family each represented by 11 genera and 11 species (6.11%), 9 genera and 11 species (6.11%), 6 genera and 11 species (6.11%), respectively of total floristic composition. Cluster analysis resulted in five different plant communities and this result was supported by the ordination result. RDA result showed altitude was the main environmental variable in determining the plant communities. The ANOVA test indicated that the five community types differ significantly from each other with regard to Electrical Conductivity and Potassium.

Conclusions

Description of floristic diversity of species in Gerba Dima forest revealed the presence of high species diversity and richness. The presence of endemic plant species in the study forest shows the potential of the area for biodiversity conservation.
Limitations of eDNA analysis for Carcinus maenas abundance estimations
Authors: Danziger Ariella M. , Olson Zachary H. , Frederich Markus
Published: February 2022

Background

Environmental DNA (eDNA) is an effective tool for the detection and monitoring of presence or absence of rare and invasive species. These techniques have been extended to quantify biomass in vertebrates, particularly in fish species. However, the efficacy of eDNA techniques to quantify biomass in invertebrate species has rarely been examined. This study tested whether eDNA could be used to determine the biomass of the world-wide invasive green crab, Carcinus maenas. In a controlled laboratory study, the relationship between biomass and C. maenas eDNA concentration was examined in the context of different biotic (activity) and abiotic (temperature) parameters.

Results

When incubating different numbers of crabs in sterile saltwater for up to 7 days, a relationship between eDNA concentration and biomass was observed at temperatures of 6.7 ℃ and 18.7 ℃, but not at 12.8 ℃. Additionally, motor activity, aggression level, time of sampling, and features of organismal decay had significant impact on the concentration of C. maenas eDNA collected.

Conclusions

We show that eDNA concentration did not correlate with biomass, and that biomass, temperature, organismal characteristics, and potentially many more parameters affect shedding and degradation rates for eDNA in this species, thus, impacting the recoverable eDNA concentration. Therefore, eDNA techniques are not likely to provide a reliable signal of biomass in the invasive invertebrate species C. maenas.
High-throughput qPCR and 16S rRNA gene amplicon sequencing as complementary methods for the investigation of the cheese microbiota
Authors: Dreier Matthias , Meola Marco , Berthoud Hélène , Shani Noam , Wechsler Daniel , Junier Pilar
Published: February 2022

Background

Next-generation sequencing (NGS) methods and especially 16S rRNA gene amplicon sequencing have become indispensable tools in microbial ecology. While they have opened up new possibilities for studying microbial communities, they also have one drawback, namely providing only relative abundances and thus compositional data. Quantitative PCR (qPCR) has been used for years for the quantification of bacteria. However, this method requires the development of specific primers and has a low throughput. The constraint of low throughput has recently been overcome by the development of high-throughput qPCR (HT-qPCR), which allows for the simultaneous detection of the most prevalent bacteria in moderately complex systems, such as cheese and other fermented dairy foods. In the present study, the performance of the two approaches, NGS and HT-qPCR, was compared by analyzing the same DNA samples from 21 Raclette du Valais protected designation of origin (PDO) cheeses. Based on the results obtained, the differences, accuracy, and usefulness of the two approaches were studied in detail.

Results

The results obtained using NGS (non-targeted) and HT-qPCR (targeted) show considerable agreement in determining the microbial composition of the cheese DNA samples studied, albeit the fundamentally different nature of these two approaches. A few inconsistencies in species detection were observed, particularly for less abundant ones. The detailed comparison of the results for 15 bacterial species/groups measured by both methods revealed a considerable bias for certain bacterial species in the measurements of the amplicon sequencing approach. We identified as probable origin to this PCR bias due to primer mismatches, variations in the number of copies for the 16S rRNA gene, and bias introduced in the bioinformatics analysis.

Conclusion

As the normalized microbial composition results of NGS and HT-qPCR agreed for most of the 21 cheese samples analyzed, both methods can be considered as complementary and reliable for studying the microbial composition of cheese. Their combined application proved to be very helpful in identifying potential biases and overcoming methodological limitations in the quantitative analysis of the cheese microbiota.
Emergence of polymyxin B-heteroresistant hypervirulent Klebsiella pneumoniae from an individual in the community with asymptomatic bacteriuria
Authors: Li Jun , Tang Mengli , Xia Fengjun , Min Changhang , Hu Yongmei , Wang Haichen , Zou Mingxiang
Published: February 2022

Background

The heteroresistance of polymyxin B, a last-resort antibiotic used to treat many serious bacterial infections, may lead to antibiotic treatment failure. However, polymyxin B-heteroresistant isolates are rare in individuals living in the community. We report a polymyxin B-heteroresistant hypervirulent Klebsiella pneumoniae (hvKP) isolate from an individual in the community with asymptomatic bacteriuria.

Results

The NYTJ35 isolate had multiple virulence genes that encoded a mucoid phenotype regulator (rmpA), aerobactin (iucABCD-iutA), salmochelin (iroBCDN), yersiniabactin (irp1–2 and ybtAEPQSTUX), and a truncated rmpA2. Infection of galleria mellonella larvae indicated the isolate was hypervirulent. Antimicrobial susceptibility testing showed it was susceptible to all tested antibiotics except polymyxin B. The proportion of surviving bacteria was 1.2 × 10− 7 based on the population analysis profile (PAP) method, suggesting the presence of polymyxin B heteroresistance. The isolate was not hypermucoviscous, but it was a strong biofilm producer. It had capsular serotype K1 and belonged to sequence type 23 (ST23). The isolate also had the D150G substitution in phoQ, which is known to confer polymyxin B resistance.

Conclusions

We identified the co-occurrence of hypervirulence and polymyxin B heteroresistance in a K. pneumoniae isolate from an individual with asymptomatic bacteriuria. We suggest the use of increased screening for hvKP in individuals living in the community.
Effect of active forced air warming during the first hour after anesthesia induction and intraoperation avoids hypothermia in elderly patients
Authors: Wang Jingyu , Fang Ping , Sun Gangqiang , Li Ming
Published: February 2022

Background

The study aimed at exploring an optimal temperature model of forced air warming during the first hour after induction and intraoperation to prevent hyperthermia for elderly patients undergoing laparoscopic abdominal surgery.

Methods

There were 218 patients that were randomly divided into 3 groups warmed with a forced-air warmer during surgery: Group L (intraoperative warming set to 38 °C, n = 63), Group H (intraoperative warming set to 42 °C, n = 65) and Group LH (intraoperative warming set to 42 °C for the first hour then set to 38 °C, n = 65). Core temperature in the preoperative room and PACU was measured by a tympanic membrane thermometer and in the operation room, a nasopharyngeal temperature probe was recorded. The rate of perioperative hypothermia, defined as a reduction in body temperature to < 36 °C was recorded as the primary outcome. Intraoperative anesthetic dosage, recovery time, adverse events, thermal comfort and satisfaction score were measured as secondary outcome.

Results

The incidence of intraoperative and postoperative hypothermia was significantly lower in Group LH and Group H than Group L (18.75 and 15.62% vs 44.44%, P<0.001; 4.69 and 4.69% vs 20.63%, P<.05). Anesthetic dosage of rocuronium was lower in Group L than other two groups, with the opposite result of recovery time. The number of patients with shivering was higher in Group L but sweating was higher in Group H. Both of the thermal comfort and satisfaction score was highest in Group LH.

Conclusion

A temperature pattern of forced air warming set at 42 °C during the first hour after anesthesia induction and maintained with 38 °C was a suitable choice for elderly patients undergoing laparoscopic abdominal surgery lasting for more than 120 min.

Trial registration

Chictr.org.cn ChiCTR-2,100,053,211.
Juxta-papillary duodenal diverticula are associated with pyogenic liver abscesses: a case control study
Authors: Shankar Uday , Bhandari Priyanka , Panchal Ankur , Weeks David , Wu Helen , Chen Fufei , Maheshwari Narinder , Bansal Raghav , Walfish Aaron , Baum Joel , Jamidar Priya A. , Aron Joshua
Published: February 2022

Background

Juxta-papillary duodenal diverticulum (JPDD) has been associated with obstructive jaundice and ascending cholangitis. Potential mechanisms include periampullary colonization of pathogenic bacteria and mechanical obstruction. However, the relation of JPDD with pyogenic liver abscess (PLA) has not been reported. Moreover, approximately one third of patients with PLA have no identifiable risk factors and are labelled as “cryptogenic”. We hypothesized that JPDD is an unidentified risk factor for cryptogenic PLA and the aim of this study was to examine this association.

Methods

We conducted a retrospective chart review to identify cases of PLA (n = 66) and compare those to matched controls (n = 66). 66 patients met the study inclusion criteria of a diagnosis of PLA using computerized tomography (CT) imaging and either positive culture or confirmed resolution after antibiotic therapy. Patients with diagnoses of amebic liver abscess, traumatic liver abscess, post cholecystectomy liver abscess, concurrent acute cholecystitis, and hepatobiliary malignancy were excluded. Controls were identified from a radiology database and matched one-to-one with the cases by age and sex. Demographic and clinical data was extracted from electronic medical records. CT scan images of all cases and controls were reviewed by a single expert radiologist to identify the presence of JPDD. Statistical tests including Chi-square and t-test with multiple logistic regression were used to examine the group differences in JPDD and other factors.

Results

Among 132 study samples, 13.6% (9/66) of the cases were found to have JPDD, compared to 3.0% (2/66) among controls (p = 0.03). This corresponded to an odds ratio (OR) of 5.05 [OR 5.05; CI 1.05–24.4] on multiple logistic regression analysis. In addition, 1/3rd of PLA cases with JPDD had no other traditional risk factors (cryptogenic PLA). However, a statistically significant association of JPDD with cryptogenic PLA could not be established possibly because of a small number of cases. We found significantly high rate of diabetes mellitus (DM) (42.4%; n = 28/66) among cases compared to controls (21.2%; n = 14/66; p = 0.01).

Conclusion

We found a significant association between JPDD and PLA. We need studies with larger sample sizes to confirm this relationship and to explore if JPDD could be related to cryptogenic liver abscesses.
A new variant of Abernethy malformation treated by transhepatic interventional closure: a case report
Authors: Sieverding Ludger , Hofbeck Michael , Michel Jörg , Hornung Andreas , Scheckenbach Christian , Grözinger Gerd , Sturm Ekkehard , Warmann Steven W. , Hanser Anja
Published: February 2022

Background

Congenital portosystemic shunts (CPSS) are rare vascular malformations and can be classified into extrahepatic and intrahepatic shunts. Extrahepatic CPSS, also termed Abernethy malformations are associated with severe long-term complications including portopulmonary hypertension, liver atrophy, hyperammoniemia and hepatic encephalopathy. We report a hitherto undescribed variant of Abernethy malformation requiring an innovative approach for interventional treatment.

Case presentation

We describe a 31-year-old patient following surgical repair of atrioventricular septal defect at the age of 6 years. In the long-term follow-up he showed persistent pulmonary hypertension which deteriorated despite dual pulmonary vasodilative treatment. When he developed arterial desaturation and symptomatic hyperammoniemia detailed reassessment revealed as underlying cause a hitherto undescribed variant of Abernethy malformation connecting the portal vein with the right lower pulmonary vein. Following interdisciplinary discussions we opted for an interventional approach. Since the malformation was un-accessible to interventional closure via antegrade venous or retrograde arterial access, a transhepatic percutaneous puncture of the portal vein was performed. Temporary balloon occlusion of the malformation revealed only a slight increase in portal venous pressure. Interventional occlusion of the large vascular connection was achieved via this transhepatic approach by successive implantation of two large vascular occluding devices. The postinterventional course was unremarkable and both ammonia levels and arterial saturation normalized at follow-up of 12 months.

Conclusions

Portal vein anomalies should be included in the differential diagnoses of pulmonary hypertension or pulmonary arterio-venous malformations. Based on careful assessment of the anatomy and testing of portal vein hemodynamics interventional therapy of complex Abernethy malformations can be performed successfully in specialized centers.
Person-centered dementia care during COVID-19: a qualitative case study of impact on and collaborations between caregivers
Authors: Kazawa Kana , Kodama Ayuto , Sugawara Kaoru , Hayashi Mikio , Ota Hidetaka , Son Daisuke , Ishii Shinya
Published: February 2022

Background

Little is known about the actual impact of COVID-19 on caregivers of older people with dementia and resultant collaborations among them to provide continued person-centered care while undertaking infection control measures. In this study, we explored the impact of providing dementia care during COVID-19 on caregivers involved in dementia care.

Methods

This is an exploratory qualitative case study. The participants were family members living with older people with dementia, care managers, and the medical and long-term care facility staff. Data were collected from 46 caregivers via face-to-face and semi-structured interviews and analyzed using thematic analysis.

Results

The interviews identified 22 themes related to the impact of COVID-19 on different positions of the caregivers involved in dementia care and their collaboration, and we categorized them into six categories. The core themes were “re-acknowledgement of care priorities” and “rebuilding of relationships.” When caregivers’ perceptions were aligned in the decision-making processes regarding care priorities, “reaffirmation of trust” and “strengthening of intimate relationships” emerged as positive changes in their relationships. Furthermore, the differences in the ability of each caregiver to access and select correct and appropriate information about COVID-19, and the extent of infection spread in the region were related to “anxiety during COVID-19 pandemic” and caused a “gap in perception” regarding infection control.

Conclusions

The present study clarified that the process of aligning the perceptions of caregivers to the objectives and priorities of care for older people with dementia during COVID-19 pandemic strengthened the relationships among caregivers. The findings of this study are useful for caregivers involved in person-centered dementia care.
Association between indoor ventilation frequency and cognitive function among community-dwelling older adults in China: results from the Chinese longitudinal healthy longevity survey
Authors: Wang Wenxin , Chen Jie , Jin Xurui , Ping Yongjing , Wu Chenkai
Published: February 2022

Backgrounds

Emerging evidence suggested that indoor air pollution caused long-term adverse effects on cognitive function among older adults who spend more than 85% of their time indoors. Although high indoor ventilation can mitigate the effect of indoor air pollution on cognition among the younger population, limited evidence revealed the association between indoor ventilation and cognition among older adults.

Methods

A total of 11,853 participants aged 65 and over (female, 54.5%; mean age, 83.6 years) were included from the 2017–2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Indoor ventilation frequency was measured by the self-reported frequency of opening windows per week in each season. Cognitive function was evaluated by the Mini-Mental State Examination (MMSE). Multivariate Poisson regression with robust error variance was applied to assess the association between overall indoor ventilation frequency and cognitive function. We fitted in two adjusted models: Model 1 was adjusted for demographic; model 2 was further adjusted for lifestyle, socioeconomic status, health conditions, and environmental factors. The same models were also applied to measure the association between seasonal indoor ventilation frequency and cognitive function.

Results

Of 11,853 older adults, 3035 (25.6%) had cognitive impairment. A high overall indoor ventilation frequency (indoor ventilation frequency: 6–8) was significantly associated with a 9% lower likelihood of cognitive impairment than low overall indoor ventilation frequency (indoor ventilation frequency: 0–3) among Chinese older adults [Relative risk (RR): 0.91, 95% Confidential Interval (CI): 0.83–0.99] in the full adjusted model. In the subgroup analysis in four seasons, high and intermediate indoor ventilation frequency in winter were significantly associated with 8% (RR: 0.92; 95%CI: 0.86–0.99) and 16% (RR: 0.84; 95%CI: 0.78–0.90) lower probability of cognitive impairment than low indoor ventilation frequency in the fully adjusted model among Chinese older adults, respectively.

Conclusions

In this nationally representative cohort, a higher frequency of house ventilation by opening windows was significantly associated with a lower risk of cognitive impairment among Chinese older adults aged 65 and over. These results offered robust evidence for policymaking and health intervention to prevent older adults from cognitive impairment or dementia in developing regions.
Angiotensin blockade therapy and survival in pancreatic cancer: a population study
Authors: Keith Scott W. , Maio Vittorio , Arafat Hwyda A. , Alcusky Matthew , Karagiannis Thomas , Rabinowitz Carol , Lavu Harish , Louis Daniel Z.
Published: February 2022

Background

Pancreatic cancer (PC) is one of the most aggressive and challenging cancer types to effectively treat, ranking as the fourth-leading cause of cancer death in the United States. We investigated if exposures to angiotensin II receptor blockers (ARBs) or angiotensin I converting enzyme (ACE) inhibitors after PC diagnosis are associated with survival.

Methods

PC patients were identified by ICD-9 diagnosis and procedure codes among the 3.7 million adults living in the Emilia-Romagna Region from their administrative health care database containing patient data on demographics, hospital discharges, all-cause mortality, and outpatient pharmacy prescriptions. Cox modeling estimated covariate-adjusted mortality hazard ratios for time-dependent ARB and ACE inhibitor exposures after PC diagnosis.

Results

8,158 incident PC patients were identified between 2003 and 2011, among whom 20% had pancreas resection surgery, 36% were diagnosed with metastatic disease, and 7,027 (86%) died by December 2012. Compared to otherwise similar patients, those exposed to ARBs after PC diagnosis experienced 20% lower mortality risk (HR=0.80; 95% CI: 0.72, 0.89). Those exposed to ACE inhibitors during the first three years of survival after PC diagnosis experienced 13% lower mortality risk (HR=0.87; 95% CI: 0.80, 0.94) which attenuated after surviving three years (HR=1.14; 95% CI: 0.90, 1.45).

Conclusions

The results of this large population study suggest that exposures to ARBs and ACE inhibitors after PC diagnosis are significantly associated with improved survival. ARBs and ACE inhibitors could be important considerations for treating PC patients, particularly those with the worst prognosis and most limited treatment options. Considering that these common FDA approved drugs are inexpensive to payers and present minimal increased risk of adverse events to patients, there is an urgent need for randomized clinical trials, large simple randomized trials, or pragmatic clinical trials to formally and broadly evaluate the effects of ARBs and ACE inhibitors on survival in PC patients.
Step-by-step and orderly lowering of the height of inferior vena cava tumor thrombus is the key to robot-assisted thrombectomy for Mayo III/IV tumor thrombus
Authors: Zhao Guo-Dong , Zhang Xiu-Ping , Hu Ming-Gen , Huang Qing-Bao , Xu Shuai , Wang Bao-Jun , Ma Xin , Zhang Xu , Zou Wen-Bo , Zhang Xuan , Zhao Zhi-Ming , Tan Xiang-Long , Chou Sai , Wang Gang , Liu Rong
Published: February 2022

Background

The surgical management of Mayo III/IV tumor thrombi is difficult and risky, and robotic surgery is even more difficult. The purpose of this study was to introduce the step-by-step and orderly lowering of the height of inferior vena cava tumor thrombus, which was the core technique of robot operation for Mayo III/IV tumor thrombus.

Method

A total of 18 patients were included in this study. The average tumor thrombus height was 2.4 cm above the level of the second porta hepatis (SPH), and 9 patients were prepared for cardiopulmonary bypass (CPB) before surgery. During the operation, the height of the tumor thrombus was lowered orderly for 2-3 times, and the blood flow blocking method was changed sequentially. The CPB was required when tumor thrombus in the atrium; After the height of the thrombus was lowered to the atrium entrance, CPB was stopped and the blood flow was blocked in the upper- and retro-hepatic inferior vena cava (IVC); After the tumor thrombus continued to descend to the lower part of the SPH, liver blood flow could be restored, and then, the blood flow was simply blocked in the retro-hepatic IVC to complete the removal of the thrombus and the repair or resection of the IVC. Finally, the diseased kidney and renal vein were removed.

Results

All operations were successfully completed, and 2 cases were transferred to laparotomy. Seven cases received CPB, while the other 11 did not. 15 patients underwent two times of the lowering of the tumor thrombus, 2 patients underwent one time and 1 patient underwent three times. The mean liver/IVC dissociation and vascular suspension time was 22.0 min. All patients had less than Clavien-Dindo grade III complications, no serious complications occurred during operation, and no patient died within 90 days.

Conclusions

The step-by-step and orderly decline of tumor thrombus height is the key to the success of robot Mayo III / IV tumor thrombus surgery. This method can shorten FPH and CPB time and improve the success rate of surgery.
Childhood trauma and current depression among Chinese university students: a moderated mediation model of cognitive emotion regulation strategies and neuroticism
Authors: Chu Qianqian , Wang Xiang , Yao Rui , Fan Jie , Li Ya , Nie Fei , Wang Lifeng , Tang Qiuping
Published: February 2022

Background

Childhood trauma (CT) is considered as a highly risk factor for depression. Although the pathway of CT to depression, especially the mediating or moderating effects of cognitive emotion regulation strategies (CERS) or neuroticism, have investigated by several studies, the results were inconsistent and there is a paucity of full models among these interactive factors. This study aims to examine the relationships among CT, adaptive / maladaptive CERS, neuroticism, and current depression symptoms in university students.

Methods

We recruited 3009 freshman of 2019, aged averagely 18.00 (SD = 0.772) years, from universities in Hunan province in 2019. A moderated mediation model was built to examine the relationships among CT, CERS, neuroticism, and current depression using the SPSS PROCESS 3.5 macro. We conducted bootstrapping of regression estimates with 5000 samples and 95% confidence interval.

Results

Results revealed that the significant mediating effects of adaptive CERS (β = 0.012; 95% CI: 0.006 to 0.018) and maladaptive CERS (β = 0.028; 95% CI: 0.016 to 0.040) between CT and depression were observed, accounting for 5.69% and 13.52% of the total effect respectively. Then, moderated mediation analyses results showed that neuroticism simultaneously moderated the direct effect of CT on current depression (β = 0.035; 95% CI: 0.001 to 0.009), and the indirect effects of CT on current depression through adaptive CERS (adaptive CERS – current depression: β = − 0.034; 95% CI: − 0.007 to − 0.001) and maladaptive CERS (maladaptive CERS – current depression: β = 0.157; 95% CI: 0.017 to 0.025). However, the moderating effects of neuroticism in the indirect paths from CT to adaptive CERS (β = 0.037; 95% CI: 0.000 to 0.014) and maladaptive CERS (β = − 0.001; 95% CI: − 0.006 to 0.005) were not significant.

Conclusions

This study provides powerful evidences through a large university students sample for the mediating role of adaptive / maladaptive CERS and the moderating role of neuroticism between CT and current depression. This manifests that cognitive emotion regulation may be a vital factor for people who suffered from CT and current depression. Furthermore, the influence of neuroticism in this process cannot be ignored.
Symptoms of depression and anxiety in Indonesian medical students: association with coping strategy and resilience
Authors: Ramadianto Adhitya Sigit , Kusumadewi Irmia , Agiananda Feranindhya , Raharjanti Natalia Widiasih
Published: February 2022

Background

Depression and anxiety are prevalent mental health issues among medical students due to the various challenges during medical education. These issues affect not only their quality of life, but also their academic and professional development. Coping strategy and resilience are two factors that may influence students’ mental health outcomes. Data of medical student mental health in Indonesia is scarce, hampering efforts to systematically address the problem. Hence, this study aims to estimate the prevalence of depressive and anxiety symptoms in Indonesian medical students, and their association with coping strategy and resilience.

Methods

Undergraduate medical students from each year of study (Preclinical Year 1 to 4, Clinical Year 1 and 2) in the Faculty of Medicine Universitas Indonesia were randomly selected to participate in this cross-sectional study. The study questionnaire included sociodemographic characteristics, Depression Anxiety Stress Scale (DASS) to measure symptoms of depression and anxiety, Brief COPE to measure coping strategy, and Connor-Davidson Resilience Scale (CD-RISC) to measure resilience. Scores of depression and anxiety symptoms were analyzed by comparing them between different sociodemographic groups and by measuring their correlation with coping strategies and resilience. Multiple regression analyses were conducted to identify predictors of depression and anxiety symptoms.

Results

Among 532 respondents, 22.2% reported symptoms of depression and 48,1% reported anxiety, including 3.0% and 8.1% with extremely severe depression and anxiety, respectively. Students not living with immediate family had higher depression score; female students and those in Preclinical Year 1 and Clinical Year 1 showed higher anxiety scores. Dysfunctional coping strategies and lower resilience are predictors of higher depression and anxiety symptoms.

Conclusions

Students show different levels of depressive and anxiety symptoms, signifying different levels of mental health support needs from universal mental health promotion to psychiatric treatment. Prevention programs can be targeted towards students with risk factors, such as not living with immediate family, undergoing first year of preclinical studies or clinical rotations, coping with dysfunctional strategies, and having low resilience. Additionally, medical educators must be aware of other, non-student factors that may impact student mental health, such as curriculum design and learning experience.
Metabolic indexes of obesity in patients with common mental disorders in stable stage
Authors: Li Xiaoling , Shi Xiaojie , Tan Yukang , Yu Yang , Tang Chaohua , Xu Guohong , Zhang Xinglian , Liao Hairong , Mai Xiancong , Chen Wensheng , Luo Xin , Xu Caixia , Xie Guojun , Liang Jiaquan
Published: February 2022

Background

Obesity is a serious worldwide public health problem, especially for people with mental disorders.

Aim

To explore the related factors of obesity by analyzing the metabolic indexes of patients with common mental disorders in stable stage.

Methods

Five hundred seventy-six subjects with major depressive disorder (MDD), bipolar disorder (BD) or schizophrenia (SCZ) were included, who received fixed drug dose and routine drug treatment for 2 years or more. Their venous blood was collected, and the blood metabolic indexes were analyzed.

Results

BD and SCZ are more prone to obesity than MDD. Multiple linear regression analysis showed that the value of BMI increased with the increase of age(B = 0.084, p < 0.001), TG(B = 0.355, p = 0.024), LDL(B = 0.697, p < 0.001), LDH(B = 0.011, p = 0.002), SCr(B = 0.051, p < 0.001), UA(B = 0.014, p < 0.001), HbA1c(B = 0.702, p = 0.004) and hsCRP(B = 0.101, p < 0.001). And It decreased with the increase of HDL(B = -1.493, p < 0.001).

Discussion

People with mental disorders should regularly check blood indicators and strengthen weight management to reduce the risk of obesity and promote their health.
Evaluation of the uptake, retention and effectiveness of exercise referral schemes for the management of mental health conditions in primary care: a systematic review
Authors: Tomlinson-Perez Samuel , Machaczek Katarzyna Karolina , Firth Joseph , Pollard Nicholas , Meda Goutham , Keddie Ellis , Goyder Elizabeth
Published: February 2022

Background

Exercise is a recognised element of health-care management of mental-health conditions. In primary health care, it has been delivered through exercise referral schemes (ERS). The National Institute for Health and Care Excellence has highlighted uncertainty regarding the effectiveness of ERS in improving exercise participation and health outcomes among those referred for mental-health reasons. This review aims, therefore, to evaluate ERSs for individuals who are referred specifically for mental-health reasons.

Methods

Studies were reviewed that assessed the effectiveness of ERSs in improving initiation of and/or adherence to exercise and/or their effectiveness in improving long-term participation in exercise and health outcomes among primary care patients who had been referred to the scheme for mental-health reasons. The data were extracted and their quality assessed. Data were analysed through a narrative synthesis approach.

Results

Nine studies met the eligibility criteria. Three assessed clinical effectiveness of the schemes, eight assessed ERS uptake and/or adherence to the exercise schedule, and two assessed the impact of the ERSs on long-term exercise levels. In one study, it was found that ERSs that were based in leisure centres significantly improved long-term symptoms in those who had been referred due to their mental ill health (P<0.05). ERSs that involved face-to-face consultations and telephone calls had the highest rates of mean uptake (91.5%) and adherence (71.7%), but a difference was observed between uptake/adherence in trials (86.8%/55.3%) and in routine practice (57.9%/37.2%). ERSs that included face-to-face consultations and telephone calls increased the amount of long-term physical activity that was undertaken by people who had been referred for mental-health reasons (P=0.003).

Conclusions

Uptake and effectiveness of ERSs for mental health conditions was related to programme content and setting with more effective programmes providing both face-to-face and telephone consultations. Good uptake of yoga among those referred for mental health reasons suggests that mindful exercise options should be investigated further. Existing ERSs could be improved through application of individual tailoring and the provision of more face-to-face consultations, and social support. Further research is required to identify the types of ERSs that are most clinically effective for those with mental ill health.