bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Anxiety and Depression in Outcomes of Patients with Total Ankle Replacement
Authors: Nam Hannah , Martinazzi Brandon J. , Kirchner Gregory , Bonaddio Vincenzo , Koroneos Zachary , Manto Kristen , Ptasinski Anna , Aynardi Michael C.
Published: November 2022

Category:

Ankle Arthritis; Ankle; Other

Introduction/Purpose:

Pain control is important following TAA. Prior studies have reported that anxiety and depression are associated with worse outcomes after orthopaedic surgery. However, the association between anxiety and depression on patient reported outcomes following TAA is not well-defined. Therefore, the purpose of this study was to investigate the effects of anxiety and depression on postoperative reported pain control following TAA.

Methods:

Following institutional review board approval, a retrospective chart review was conducted for all patients that underwent TAA from 2018-2021 at our institution. Patients were separated into two groups. Group A consisted of patients with a documented pre-operative history of anxiety and depression and Group B consisted of patients without documented anxiety or depression. Electronic records were reviewed at 2- and 6-weeks following surgery. Statistical analysis was then run to determine the relative risk of poorly controlled pain postoperatively in patients with and anxiety and depression.

Results:

At our institution, from 2018-2021, 56 patients underwent TAA. The mean age of our cohort was 60.9 (Range, 56-83). In our cohort, 31 patients were male, 25 were female, the mean patient BMI was 33.8 (Range, 21-56.2), 8 patients reported poor pain control (14.3%) and 24 patients had anxiety or depression (42.9%). Of the patients with anxiety or depression, 4 reported poor pain control. There was no statistically significant increased risk of poor pain control in patients with a history of anxiety or depression (RR: 1.5; 95% CI: 0.4145 to 5.4279).

Conclusion:

Despite the increased risk of poor outcomes reported in patients with a history of anxiety and depression, the results from our cohort indicate that a history of anxiety or depression is not associated with going on to have poor pain control following TAA. Albeit, our sample size was small, warranting further investigation.
Connecting Fibers Between ATFL's Inferior Fascicle and CFL Transmit Tension Between Both Ligaments
Authors: Nunes Gustavo A. , Dalmau-Pastor Miki , Vega Jordi , Cordier Guillame
Published: November 2022

Category:

Basic Sciences/Biologics; Ankle

Introduction/Purpose:

The lateral ligament complex of the ankle has been extensively studied. Recently an anatomical study described a connection between anterior talofibular ligament inferior fascicle (ATFLif) and calcaneofibular ligament (CFL). The applicability and the mechanical role of these connections have not yet been studied and need to be clarified. The purpose of this study is to evaluate the connection between ATFLif and CFL through a dynamic measurement analysis.

Methods:

An anatomical study was performed in 13 fresh-frozen below-the-knee ankle specimens. Each specimen was dissected in a protocolized manner until the lateral ligaments were exposed. A complete injury to both ATFL's fascicles was created in the proximal third of the ligament. A displacement transducer specifically design was inserted in the CFL and in the lateral part of the calcaneus to test its lengthening. A traction of 1 kg weight (9.8 N) was applied to ATFLif while the transducer measured the lengthening that this force created in the CFL.

Results:

A total of 13 ankle specimens were carefully dissected. One specimen with signals of a prior traumatic injury of the ATFLif was excluded. A total of 12 specimens were included, 7 females and 5 males with an average age of 74 years (52-88 years). The right ankle was dissected in 6 specimens. ATFL was identified as a two-fascicled ligament in all cases. The fibers connecting the ATFLif and CFL were observed in all specimens. The displacement transducer showed lengthening in the CFL in all measurements with a median of 0.59 mm (SD 0.34).

Conclusion:

Connecting fibers between ATFLif and CFL are robust enough to transmit tension from one structure to the other.In the case of associated proximal lesions of the ATFLif and CFL, ligaments repair with a single suture may be considered. This can be applied in surgical procedures in patients with lateral ankle instability.
Gender and Geographic Trends Amongst Foot & Ankle Surgeons: Where are We and Where Do We Need to Improve?
Authors: Okereke Robyn , Janney Cory , Safavi Kiya Shazadeh , Rezvani Aryan
Published: November 2022

Category:

Other

Introduction/Purpose:

Clinical and elective experiences as well as the guidance of mentors are all critical factors in the pursuance of orthopedic residencies and fellowships. Women have historically been underrepresented in orthopedics. Some propose that the root cause lies in the lack of availability in the aforementioned factors. Previous studies demonstrated geographic differences in sex representation in orthopedic residency programs. Studies over geographic distributions of orthopedic foot and ankle (OFA) surgeons showed high variation in geographic density of OFA surgeons throughout the U.S. This study seeks to determine both the gender and geographic distributions of OFA surgeons as well as to determine geographic patterns between their training locations and current practices.

Methods:

AOFAS data regarding fellowship completion from 1988 through 2021 was analyzed with regards to gender and fellowship location. Internet searches were performed for all those identified within the database for their medical school, residency, and current practice location. This biographical data was obtained from their front-facing biographical webpage or hospital affiliation. States were placed into regions and subsequent divisions as defined according to the US Census Bureau definition: Northeast (New England and Middle Atlantic), Midwest (East North Central and West North Central), South (South Atlantic, East South Central, and West South Central) and West (Mountain and Pacific).

Results:

1,088 OFA surgeons were analyzed. 168 (15.3%) were female and 922 (84.7%) were male. Female-held OFA fellowship positions increased over time, currently sitting at 13 (22% of all fellowship positions), with a maximum of 15 (25%) in 2017. Geographically, the Pacific had most females (n=26, 15.6% of females), while East South Central had least (n=10, 6.0%). The South Atlantic had most males (n=193, 20.9% of males) while East South Central had least (n=59, 5.3%). The region with the most OFA surgeons in total was the South Atlantic (n=218, 20.0% of the total) whereas the regions with the least were East South Central and New England (n=59, 5.4% in each).

Conclusion:

Although the amount of female OFA surgeons has increased, the numbers are still low. Geographically, the East South Central division of the U.S consistently had the least number of OFA surgeons whereas the South Atlantic division had the highest.
The Ponseti Method for the Treatment of Clubfeet Associated with Down Syndrome
Authors: Portalatin Edwin , Parenti Sarah , Polk Jordan L. , Jo Chan-Hee , Zide Jacob R. , Riccio Anthony
Published: November 2022

Category:

Other

Introduction/Purpose:

This study aims to compare treatment characteristics and outcomes of clubfoot patients with Down Syndrome (DS) to those with idiopathic clubfoot treated with the Ponseti method.

Methods:

A retrospective review of prospectively gathered data was performed at a single institution over an 18-year period. Patients with idiopathic clubfeet (IC) and clubfeet associated with DS who were less than one-year old and treated by the Ponseti method were included. Initial Dimeglio score, number of casts, need for tendoachilles tenotomy, recurrence, and need for further surgery were recorded. Outcomes were classified using the Richards classification system.

Results:

24 clubfeet in 15 patients with DS, and 320 IC in 225 patients were identified with an average follow-up of 62 and 65 months respectively. DS patients presented for treatment at an older age (54 vs. 16 days, p=0.000) and with lower initial Dimeglio scores (11.1 vs. 13.7, p=0.000). Tendoachilles tenotomy was performed in 79% of IC and 75% of the DS clubfeet (p=0.64). Recurrence rates were not statistically different between the groups, nor was the need for later surgery. However, recurrences in the DS group were significantly less likely to require intra-articular surgery (4.2% vs. 34.4%, p=0.02). Clinical outcomes were 83% 'good', 13% 'fair', and 4% 'poor' in DS patients, and 69% 'good', 27% 'fair', and 4% 'poor' in the idiopathic cohort (p=0.1).

Conclusion:

Despite milder deformity and older age at presentation, DS associated clubfeet have similar recurrence rates and clinical outcomes as their idiopathic counterparts. When deformities do relapse in DS patients, significantly less intra-articular surgery is required than for idiopathic clubfeet.
Median Nerve Assessment With Ultrasonography: Cross-Sectional Area Measurements Preoperatively and Postoperatively in a Patient With Bilateral Carpel Tunnel Syndrome
Authors: Pedigo Gabriela
Published: November 2022

Ultrasonography (US) is a useful and economical tool that can help diagnose carpal tunnel syndrome by measuring the cross-sectional area (CSA), of the median nerve, at the wrist. This is a longitudinal case study evaluating the measurements of the right and left median nerves pre and post carpal tunnel (CT) release surgery. The US measurements of the median nerves were obtained preoperatively, one week postoperatively, and one month postoperatively on a patient who had same-day bilateral CT release surgery. The sonographic findings showed a decrease in the CSA of the median nerves bilaterally.
Airway inflammation and hyperresponsiveness in subjects with respiratory symptoms and normal spirometry
Authors: Boulet Louis-Philippe , Boulay Marie-Ève , Côté Andréanne , FitzGerald J. Mark , Bergeron Céline , Lemière Catherine , Lougheed M. Diane , Vandemheen Katherine L. , Aaron Shawn D.
Published: November 2022

Background

Subjects without a previous history of asthma, presenting with unexplained respiratory symptoms and normal spirometry, may exhibit airway hyperresponsiveness (AHR) in association with underlying eosinophilic (type 2 (T2)) inflammation, consistent with undiagnosed asthma. However, the prevalence of undiagnosed asthma in these subjects is unknown.

Methods

In this observational study, inhaled corticosteroid-naïve adults without previously diagnosed lung disease reporting current respiratory symptoms and showing normal pre- and post-bronchodilator spirometry underwent fractional exhaled nitric oxide (FENO) measurement, methacholine challenge testing and induced sputum analysis. AHR was defined as a provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 s (PC20) <16 mg·mL−1and T2 inflammation was defined as sputum eosinophils >2% and/orFENO>25 ppb.

Results

Out of 132 subjects (mean±sdage 57.6±14.2 years, 52% female), 47 (36% (95% CI 28–44%)) showed AHR: 20/132 (15% (95% CI 9–21%)) with PC20<4 mg·mL−1and 27/132 (21% (95% CI 14–28%)) with PC204–15.9 mg·mL−1. Of 130 participants for whom sputum eosinophils,FENOor both results were obtained, 45 (35% (95% CI 27–43%)) had T2 inflammation. 14 participants (11% (95% CI 6–16%)) had sputum eosinophils >2% and PC20≥16 mg·mL−1, suggesting eosinophilic bronchitis. The prevalence of T2 inflammation was significantly higher in subjects with PC20<4 mg·mL−1(12/20 (60%)) than in those with PC204–15.9 mg·mL−1(8/27 (30%)) or ≥16 mg·mL−1(25/85 (29%)) (p=0.01).

Conclusions

Asthma, underlying T2 airway inflammation and eosinophilic bronchitis may remain undiagnosed in a high proportion of symptomatic subjects in the community who have normal pre- and post-bronchodilator spirometry.
European Respiratory Society guideline on various aspects of quality in lung cancer care
Authors: Blum Torsten Gerriet , Morgan Rebecca L. , Durieux Valérie , Chorostowska-Wynimko Joanna , Baldwin David R. , Boyd Jeanette , Faivre-Finn Corinne , Galateau-Salle Françoise , Gamarra Fernando , Grigoriu Bogdan , Hardavella Georgia , Hauptmann Michael , Jakobsen Erik , Jovanovic Dragana , Knaut Paul , Massard Gilbert , McPhelim John , Meert Anne-Pascale , Milroy Robert , Muhr Riccardo , Mutti Luciano , Paesmans Marianne , Powell Pippa , Putora Paul Martin , Rawlinson Janette , Rich Anna L. , Rigau David , de Ruysscher Dirk , Sculier Jean-Paul , Schepereel Arnaud , Subotic Dragan , Van Schil Paul , Tonia Thomy , Williams Clare , Berghmans Thierry
Published: November 2022

This European Respiratory Society guideline is dedicated to the provision of good quality recommendations in lung cancer care. All the clinical recommendations contained were based on a comprehensive systematic review and evidence syntheses based on eight PICO (Patients, Intervention, Comparison, Outcomes) questions. The evidence was appraised in compliance with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Evidence profiles and the GRADE Evidence to Decision frameworks were used to summarise results and to make the decision-making process transparent. A multidisciplinary Task Force panel of lung cancer experts formulated and consented the clinical recommendations following thorough discussions of the systematic review results. In particular, we have made recommendations relating to the following quality improvement measures deemed applicable to routine lung cancer care: 1) avoidance of delay in the diagnostic and therapeutic period, 2) integration of multidisciplinary teams and multidisciplinary consultations, 3) implementation of and adherence to lung cancer guidelines, 4) benefit of higher institutional/individual volume and advanced specialisation in lung cancer surgery and other procedures, 5) need for pathological confirmation of lesions in patients with pulmonary lesions and suspected lung cancer, and histological subtyping and molecular characterisation for actionable targets or response to treatment of confirmed lung cancers, 6) added value of early integration of palliative care teams or specialists, 7) advantage of integrating specific quality improvement measures, and 8) benefit of using patient decision tools. These recommendations should be reconsidered and updated, as appropriate, as new evidence becomes available.
Pathogen spectra in hospitalised and nonhospitalised children with community-acquired pneumonia
Authors: Wetzke Martin , Schütz Katharina , Kopp Matthias Volkmar , Seidenberg Jürgen , Vogelberg Christian , Ankermann Tobias , Happle Christine , Voigt Gesche , Köster Holger , Illig Thomas , Lex Christiane , Schuster Antje , Maier Ralph , Panning Marcus , Barten Grit , Rohde Gernot , Welte Tobias , Hansen Gesine
Published: November 2022

Background

Paediatric community-acquired pneumonia (CAP) is a leading cause of paediatric morbidity. However, particularly for outpatients with paediatric CAP, data on aetiology and management are scarce.

Methods

The prospective pedCAPNETZ study multicentrically enrols children and adolescents with outpatient-treated or hospitalised paediatric CAP in Germany. Blood and respiratory specimens were collected systematically, and comprehensive analyses of pathogen spectra were conducted. Follow-up evaluations were performed until day 90 after enrolment.

Results

Between December 2014 and August 2020, we enrolled 486 children with paediatric CAP at eight study sites, 437 (89.9%) of whom had radiographic evidence of paediatric CAP. Median (interquartile range) age was 4.5 (1.6–6.6) years, and 345 (78.9%) children were hospitalised. The most prevalent symptoms at enrolment were cough (91.8%), fever (89.2%) and tachypnoea (62.0%). Outpatients were significantly older, displayed significantly lower C-reactive protein levels and were significantly more likely to be symptom-free at follow-up days 14 and 90. Pathogens were detected in 90.3% of all patients (one or more viral pathogens in 68.1%; one or more bacterial strains in 18.7%; combined bacterial/viral pathogens in 4.1%). Parainfluenza virus andMycoplasma pneumoniaewere significantly more frequent in outpatients. The proportion of patients with antibiotic therapy was comparably high in both groups (92.4% of outpatientsversus86.2% of hospitalised patients).

Conclusion

We present first data on paediatric CAP with comprehensive analyses in outpatients and hospitalised cases and demonstrate high detection rates of viral pathogens in both groups. Particularly in young paediatric CAP patients with outpatient care, antibiotic therapy needs to be critically debated.
Impact of computed tomographic patterns and extent on clinical management and outcomes of patients with organising pneumonia
Authors: Huang Tang-Hsiu , Wei Sheng-Huan , Huang Li-Ting , Er Hong-Ping , Yu Yu-Ting , Lee Chung-Ta , Tseng Yau-Lin , Wu Chao-Liang
Published: November 2022

Background

Organising pneumonia (OP) has variable clinical and radiographic presentations and unstandardised treatments. Most patients with OP have favourable outcomes, but some develop respiratory insufficiency, experience recurrence or die. In this study we investigated the impact of computed tomographic (CT) patterns and extent of OP on the diagnostic and therapeutic management that patients received, and that on the therapeutic response and prognosis (particularly the risk of respiratory insufficiency and death).

Methods

We retrospectively studied 156 patients with OP followed at our hospital between 2010 and 2021. The diagnosis was confirmed histologically and verified by multidisciplinary specialists. We performed Firth's logistic regression to determine the relationship between CT features and aetiologies, management and outcomes including the risk of severe disease (defined as the need for supplemental oxygen or mechanical ventilation). We conducted Kaplan–Meier analyses to assess survival differences.

Results

Patients exhibiting multilobe involvement or mixed patterns, or both, were more likely to have secondary OP and receive immunosuppressants. Higher proportions of these patients experienced recurrence. Compared to patients with single-lobe involvement and single-pattern, they also had an enhanced risk of severe disease (the adjusted odds ratio for patients who simultaneously had multilobe involvement and mixed patterns was 27.64; 95% confidence interval 8.25–127.44). Besides, these patients had decreased survival probabilities.

Conclusion

Different CT features of OP impact patients’ management and prognosis. When treating patients with OP exhibiting multilobe involvement or mixed patterns, or both, it is important to identify the possible causative aetiology and follow closely for adverse outcomes.
Experimental system of care coordination for the home return of patients with metastatic cancer: a survey of general practitioners
Authors: Gimenez Laëtitia , Druel Vladimir , Bonnet Anastasia , Delpierre Cyrille , Grosclaude Pascale , Rouge-Bugat Marie-Eve
Published: November 2022

Background

To promote improved coordination between general practice and hospital, the French clinical trial CREDO (“Concertation de REtour à DOmicile”) is testing an innovative experimental consultation for patients with metastatic cancer who are returning home. This consultation involves the patient, the patient’s referring GP (GPref) and a GP with specific skills in oncology (GPonc) in a specialized care center. The objective of our study is to explore the satisfaction of GPsref about this consultation, in the phase of interaction between GPonc and GPref.

Methods

This observational, cross-sectional, multicenter study explored the satisfaction of GPsref who had participated in this type of consultation, via a telephone survey.

Results

One Hundred GPsref responded to the questionnaire between April and September 2019 (overall response rate: 55%). 84.5% were satisfied with the consultation, and the majority were satisfied with its methods. Half of the GPsref learned new information during the consultation, three-quarters noted an impact on their practice, and 94.4% thought that this type of coordination between the GPref and the oncology specialist could improve general practice - hospital coordination.

Conclusions

For GPs, the CREDO consultation seems to be practical and effective in improving the coordination between general medicine and hospital. GPs would benefit from such coordination for all patients with cancer, several times during follow-up and at each occurrence of a medically significant event.
Cardiometabolic profile of 15057 elderly Spanish workers: association of sociodemographic variables and tobacco consumption
Authors: Ramírez-Manent J. I. , Altisench Jané B. , Arroyo Bote S. , López Roig C. , González San Miguel H. , López-González A. A.
Published: November 2022

Background

Aging of the world population is one of the most significant demographic changes of our time. Populations older than 60 years are heterogeneous, and age is an independent cardiovascular risk factor aggravated by frailty, obesity, and diabetes, and influenced by several factors, including sex and socioeconomic status. The objective of this study was to calculate cardiovascular risk in workers of both sexes over 60 years of age and to assess whether there are difference s by sex, social class, smoking, and type of job.

Methods

A cross-sectional study was carried out in 15,057 elderly Spanish workers from different autonomous communities in Spain and with different labor occupations. Anthropometric, sociodemographic, clinical, and laboratory values were determined. People were classified according to age from 60 to 64 years inclusive and from 65 to 69 years, smokers and non-smokers, and both blue-collar and white-collar workers. Subsequently, a multivariate analysis was carried out.

Results

Men, blue-collar workers, smokers, and aging were factors that influenced cardiovascular risk: with an OR of 3.27 (95% CI: 2.64–4.05) in people 65 years of age or older versus the younger group, and an OR of 3.15 (95% CI: 2.69–3.69) in smokers versus non-smokers. A stronger independent association was found between smoking, age, and cardiovascular risk. The risk of developing non-alcoholic fatty liver and liver fibrosis was much higher in men than in women, with an OR of 4.06 (95% CI: 3.66–4.50) for the former and an OR of 2.10 (95% CI: 1.95–2.26) for the BARD index.

Conclusions

The highest risk groups were observed in male subjects with a history of smoking and blue-collar workers and, as such, should be considered for cardiovascular risk screening programs.
Point prevalence of SARS-CoV-2 infection in Sweden at six time points during 2020
Authors: Groenheit Ramona , Beser Jessica , Kühlmann Berenzon Sharon , Galanis Ilias , van Straten Edward , Duracz Jan , Rapp Marie , Hansson Disa , Mansjö Mikael , Söderholm Sandra , Muradrasoli Shaman , Risberg Anna , Ölund Richard , Wiklund Andreas , Metzkes Kristoffer , Lundberg Matilda , Bacchus Philip , Tegmark Wisell Karin , Bråve Andreas
Published: November 2022

Background

In order to estimate the prevalence and understand the spread of SARS-CoV-2 in Sweden, the Public Health Agency of Sweden, with support from the Swedish Armed Forces, conducted a series of point prevalence surveys between March and December 2020.

Methods

Sampling material and instructions on how to perform self-sampling of the upper respiratory tract were delivered to the homes of the participants. Samples were analysed by real-time PCR, and the participants completed questionnaires regarding symptoms.

Findings

The first survey in the Stockholm region in March 2020 included 707 participants and showed a SARS-CoV-2 prevalence of 2.5%. The following five surveys, performed on a national level, with between 2461 and 2983 participants, showed SARS-CoV-2 prevalences of 0.9% (April), 0.3% (May), 0.0% (August), 0.0% (September), and 0.7% (December). All positive cases who responded to questionnaires reported experiencing symptoms that occurred from 2 weeks before the date of sampling up to and including the date of sampling.

Interpretation

None of the individuals shown to be PCR-positive were asymptomatic at the time of sampling or in the 14 days prior to sampling. This is in contrast to many other surveys in which a substantial proportion of positive cases have been reported to be asymptomatic. Our surveys demonstrate a decreasing ratio between notified cases and the observed prevalence throughout the year, in line with increasing testing capacity and the consecutive inclusion of all symptomatic individuals in the case definition for testing.
Sport and self-esteem in people living with HIV: a cross-sectional study
Authors: Grandiere Perez Lucia , Allavena Clotilde , Sécher Solène , Durand Sylvain , Grégoire Antoine , Vandamme Yves-Marie , Hitoto Hikombo , Leautez-Nainville Sophie , Michau Christophe , Billaud Eric
Published: November 2022

Background

In the general population, sport activity is associated with better health and better self-esteem. Among people living with HIV (PLHIV), sport activity could also be associated with better self-esteem. The main objective of our study was to assess the association between sport activity and self-esteem among people living with HIV. The secondary objectives were to evaluate the associations between sport activity with fatigue as well as with pain.

Methods

We performed a cross-sectional observational study among PLHIV in our region (Pays de la Loire in France). Each adult seen in routine HIV care was invited to participate in the study. Participants were invited to fill out self-questionnaires about sport activity, self-esteem, fatigue, and pain. The 2 groups of participants with and without sport activity were compared with a T Student test for self-esteem, fatigue, and pain scales.

Results

Among the 1160 people included in the study, 47% performed sport activity. The self-esteem score was better in the “sporting group” compared with the “non sporting group” (Rosenberg mean scale 32.7 ± 5.1/40 vs 31.9 ± 5 p = 0.01). The Functional Assessment of Chronic Illness Therapy Fatigue scale showed a lower fatigue in the sporting group than in the non-sporting group (mean total score 125 ± 22 vs 118 ± 24 p < 0.0001). The sporting group had a lower mean pain score (1.1 ± 1.8) than the non sporting group (1.4 ± 1.9 p = 0.004).

Conclusions

Among PLHIV in our region, sport activity was associated with better self-esteem, lower fatigue and lower pain. Sport activity should be included in patient care for people living with HIV.
The cultural adaptation of the go wish card game for use in Flanders, Belgium: a public health tool to identify and discuss end-of-life preferences
Authors: Dupont Charlèss , Smets Tinne , Monnet Fanny , Eneslätt Malin , Tishelman Carol , Van den Block Lieve
Published: November 2022

Background

Public health tools like the Go Wish card game from the US, have been found useful to support people in reflecting on their end-of-life preferences, but a cultural adaptation is essential for their success. In the present study, we explore the necessary cultural adaptations to the Go Wish cards by applying an extensive, systematic, and community-engaging negotiating procedure to facilitate the use of the cards in the general population of Flanders, Belgium.

Methods

We used an iterative cultural adaptation process with repeated discussions with various community organizations and representatives of minority and religious groups. After that, the cards were evaluated by 12 healthcare professionals in relation to: linguistic equivalence to the original version, applicability, comprehensibility, and relevance per card. Additional testing with potential users preceded final adjustments.

Results

We found that stakeholders were keen to engage throughout the process of cultural adaptation and we were able to make a range of cultural adaptations for the use of the cards in Flanders. All original statements were rephrased from passive to more active statements. Sixteen out of 36 cards were adjusted to make them more culturally appropriate for use in Flanders, e.g., “to meet with clergy or a chaplain” to “having a spiritual counselor as support.” Three new cards were added: two with statements appropriate to the Belgian patient rights and euthanasia legislation and one extra Wild Card. Potential users (n = 33) felt that the cards supported conversations about end-of-life preferences.

Conclusion

By making community engagement a cornerstone of our adaption process, we developed a card set that potential end-users considered a supportive public health tool for reflecting and discussing end-of-life values and preferences. The described process is particularly valuable for culturally adapt interventions, especially given that community engagement in adapting interventions is essential to creating grounded interventions.
Patterns of health lifestyle behaviours: findings from a representative sample of Israel
Authors: Nudelman Gabriel , Yakubovich Sol
Published: November 2022

Background

Researchers are increasingly acknowledging the importance of understanding patterns of engagement in multiple, as opposed to isolated, health behaviours. Accordingly, several studies, targeting various geographical regions, have begun to identify and characterize unique classes of individuals in terms of their engagement in health behaviours, towards gaining insights that might guide tailored health interventions. Our study extends this stream of research to the Israeli context, as well as examines whether certain sociodemographic characteristics tend to be associated with affiliation to a specific group of individuals, i.e., class membership.

Methods

Two large representative samples were obtained from the 2010 and 2017 National Social Surveys of the Israel Central Bureau of Statistics. Latent Class Analysis was used to identify different classes, based on levels of engagement in five health behaviours: fruit-and-vegetable consumption, physical activity, smoking avoidance, sleep, and influenza vaccination. Multinomial logistic regression was applied to test the associations between sociodemographic characteristics (age, gender, religion, education level) and class membership.

Results

We identified three distinct classes (denoted “healthy”, “unhealthy”, and “mixed”). Overall, the “healthy” class was characterized by healthy levels of fruit-and-vegetable consumption and physical activity, a low rate of currently-smoking individuals, and a high proportion of influenza vaccination. The “mixed” class was characterized by healthy levels of fruit-and-vegetable consumption and sleep duration, moderate levels of physical exercise, a high proportion of currently light smokers, and a low rate of vaccination. The “unhealthy” class was marked by relatively low levels of engagement in health behaviours. Generally, older, Jewish, and more-educated individuals were more likely to belong to the “healthy” class, while young, non-Jewish, and less-educated individuals were more likely to belong to the “unhealthy” class. We further identified differences between the 2010 and 2017 samples (e.g., differences in men’s likelihood of being in the “unhealthy” class), suggesting that some behavioural patterns might have changed over time.

Conclusion

This research identified three classes of engagement in health behaviours across two large and representative samples. Moreover, the classes were associated with unique sociodemographic characteristics. Consequently, our findings can highlight health-behavioural patterns relevant to different sub-populations that should be considered in public health interventions.
Care-seeking behaviour among febrile children under five in Togo
Authors: Kombate Gountante , Cakpo Gbènonminvo Enoch , Azianu Komi Ameko , Labité Matè Alonyenyo , van der Sande Marianne A. B.
Published: November 2022

Background

Fever is one of the warning signs of poor health in children. Care-seeking in febrile children is importance in reducing child deaths and morbidity. This care-seeking by parents in children with fever is however relatively low in sub-Sahara Africa. The aim of this study is to improve understanding of the behaviour of caregivers in seeking care for children under five with fever and to identify associated modifiable risk factors in Togo.

Methods

Data from a 2013–2014 cross-sectional nationally representative malaria indicator survey was used. Advice or care-seeking is defined as any child under 5 years of age with fever in the two weeks prior to the interview for whom advice or treatment was sought in a public medical area, private medical area, store, market, or from an itinerant medicine seller. Univariate and multivariate logistic regression analysis were performed using Generalized Linear Models.

Results

A total of 1359 febrile children out of 6529 children under five were enrolled. Care had been sought in 38.9% of cases. In multivariate analysis, independent risk factors associated with formal care seeking were accessibility to the nearest health center (aOR = 1.52, 95% CI [1.18–1.95], mother's education level secondary and above (aOR = 1.85, 95% [1.32–2.59]), mothers who identified as belonging to animist/traditionalist religions compared to mothers who belonged to a formal religion (catholic (aOR = 2. 28, 95% [1.55–3.37]), Muslim (aOR = 2.41, 95% [1.67–3.47]), and Protestant (aOR = 1.9, 95% [1.37–2.65]), Maritime region (aOR = 0.49, 95% [0.29–0.82]) compared to Lome commune.

Conclusion

Interventions should specifically target women with limited education, not identifying as part of an official church and at longer distance from health center.
Lymphocyte and CD62E expression in lichen planus and lichenoid reaction
Authors: Werneck Juliana Tristão , Souza Gonçalves Lúcio , Marques Letícia Côgo , Junior Arley Silva
Published: November 2022

Background

It is difficult to distinguish the clinical and histopathological aspects of oral lichen planus lesions from those of oral lichenoid reaction. Some criteria were proposed to distinguish them, mainly because they have different biological behaviors. The aim of the present study was to compare the lymphocyte population and the expression of E-selectin between these lesions.

Methods

Participants with a clinical diagnosis of oral lichen planus (GOLP) and oral lichenoid reaction (GOLR) who needed to perform a biopsy were selected. The tissue was frozen and immunostaining was performed for CD3/CD4, CD3/CD8, CD4/CLA, CD8/CLA, and CD62E. The analysis of each immunostaining was accomplished using the ImageJ program.

Results

In total, 25 participants with oral lichen planus and 11 with oral lichenoid reaction were seen. In the evaluation of CD3 + CD4+/CD3 + and CD3 + CD8+/CD3 + proportions, there was a higher percentage of these cells in the oral lichen planus group when compared with the oral lichenoid reaction group (p = 0.027 and p = 0.038 respectively). The average number of CLA + lymphocytes for CD4+/CLA + and CD8+/CLA + in both groups was not statistically significant (p = 0.840; d = 0.363). In GOLP, the number of CD4 + CLA+/E-selectin and CD8 + CLA+/E-selectin was not statistically significant (p = 0.951 and p = 0.454 respectively); neither in GOLR (p = 0.454 and p = 0.989 respectively).

Conclusion

Our results indicate that CD3 + CD4+, CD3 + CD8+, CD4 + CLA+, CD8 + CLA + lymphocytes and E-selectin are present in both lesions. However, the proportion of CD3 + CD4+/CD3 + and CD3 + CD8/CD3 + cells is higher in the oral lichen planus group when compared with the oral lichenoid reaction group, suggesting that these cells may be important for the etiopathogenic mechanism of these lesions.
Baduanjin exercise for balance function in community-dwelling older adults with cognitive frailty: a randomized controlled trial protocol
Authors: Zhang Yu , Wu Jiawei , Wang Xiaoqian , Zheng Guohua
Published: November 2022

Background

Balance function provides a physiological link between the physical and cognitive function, and is a potential predictor for cognitive frailty. As a gentle mind–body exercise, Baduanjin can develop flexibility and co-ordination, thus would be is helpful for the improvement of balance function. This trial will evaluate the effect of Baduanjin on balance function in older adults with CF.

Methods/design

A total of 72 community-dwelling older adults with CF will be recruited and randomly allocated (1:1) into the Baduanjin exercise group or usual physical activity control group. All participants will undergo a health education program on nutrition and diet-related knowledge for 6 sessions (30 min per session) during the intervention period. Moreover, participants in the Baduanjin exercise group will receive a 24-week Baduanjin training course of 60 min per session and 3 sessions per week, while those in the usual physical activity control group will be required to maintain their original physical activity. Primary and secondary outcomes will be measured at baseline and after the 24-week intervention period. A mixed linear model will be constructed to analyse the intervention effects.

Discussion

This protocol presents an objective design of a randomized, single-blind trial that will evaluate the effectiveness and safety of traditional Chinese mind–body exercise Baduanjin training on the balance ability of community-dwelling older adults with cognitive frailty. If the results are as expected, this trial will provide evidence of the effect of Baduanjin exercise on balance in an older community-based population.

Trial registration

This trial was registered in the Chinese Clinical Trial Registry with code ChiCTR2100050857 and was approved on 5 September 2021.
Retraction Note: Improved glycemic control, pancreas protective and hepatoprotective effect by traditional poly-herbal formulation “Qurs Tabasheer” in streptozotocin induced diabetic rats
Authors: Ahmed Danish , Sharma Manju , Mukerjee Alok , Ramteke Pramod W. , Kumar Vikas
Published: November 2022

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/1472-6882-13-10.
Obesity promotes lipid accumulation in lymph node metastasis of gastric cancer: a retrospective case‒control study
Authors: Xiao Jian , Shen Kuan , Liu Kanghui , Wang Yuanhang , Fan Hao , Cheng Quan , Zhou Xinyi , Hu Li , Wang Gang , Xu Zekuan , Yang Li
Published: November 2022

Background

The connection between obesity, lipid accumulation, and lymph node metastasis (LNM) in gastric cancer (GC) is unclear.

Methods

The association of body mass index (BMI) and serum lipid levels with LNM was measured by calculating the odds ratio (OR) and 95% confidence interval (CI) in 1,058 eligible GC patients with a mean age of 61.4 years. Meanwhile, differentially expressed genes (DEGs) were identified between lymph node metastasis-positive (N +) and -negative (N0) groups using public RNA-seq data. Neutral lipids in human GC samples were detected by Oil red O staining. The expression of cluster of differentiation 36 (CD36), fatty acid synthase (FASN), and lipoprotein lipase (LPL) was detected by immunohistochemistry (IHC) and quantitative real-time PCR.

Results

Compared with normal-weight patients, overweight (OR = 2.02, 95% CI = 1.26–3.23) and obese (OR = 1.83, 95% CI = 1.15–2.91) patients showed increased ORs for LNM. However, no significant results were obtained for serum lipids in the multivariable-adjusted model (P > 0.05). Subgroup analysis suggested that increased low-density lipoprotein cholesterol was a risk factor in females (OR = 1.27, 95% CI = 1.02–1.59). Functional enrichment analysis of DEGs revealed a connection between lipid metabolism and LNM. Meanwhile, lipid staining showed a mass of lipids in obese N + tumor samples, and IHC analysis indicated an increase in LPL and CD36 expression in N + cases, implying a crucial role for exogenous lipid supply in LNM.

Conclusions

High BMI significantly increases the risk of LNM in GC and promotes lipid accumulation in GC cells in LNM.
Age-related changes in Folliculogenesis and potential modifiers to improve fertility outcomes - A narrative review
Authors: Esencan Ecem , Beroukhim Gabriela , Seifer David B.
Published: November 2022

Reproductive aging is characterized by a decline in oocyte quantity and quality, which is directly associated with a decline in reproductive potential, as well as poorer reproductive success and obstetrical outcomes. As women delay childbearing, understanding the mechanisms of ovarian aging and follicular depletion have become increasingly more relevant. Age-related meiotic errors in oocytes are well established. In addition, it is also important to understand how intraovarian regulators change with aging and how certain treatments can mitigate the impact of aging. Individual studies have demonstrated that reproductive pathways involving antimullerian hormone (AMH), vascular endothelial growth factor (VEGF), neurotropins, insulin-like growth factor 1 (IGF1), and mitochondrial function are pivotal for healthy oocyte and cumulus cell development and are altered with increasing age. We provide a comprehensive review of these individual studies and explain how these factors change in oocytes, cumulus cells, and follicular fluid. We also summarize how modifiers of folliculogenesis, such as vitamin D, coenzyme Q, and dehydroepiandrosterone (DHEA) may be used to potentially overcome age-related changes and enhance fertility outcomes of aged follicles, as evidenced by human and rodent studies.
EBV persistence in gastric cancer cases conventionally classified as EBER-ISH negative
Authors: Siciliano M. C. , Tornambè S. , Cevenini G. , Sorrentino E. , Granai M. , Giovannoni G. , Marrelli D. , Biviano I. , Roviello F. , Yoshiyama H. , Leoncini L. , Lazzi S. , Mundo L.
Published: November 2022

Background

The Epstein-Barr virus (EBV) causes various B-cell lymphomas and epithelial malignancies, including gastric cancer (GC) at frequencies ranging from 5 to 10% in adenocarcinomas (ADK) to 80% in GC with lymphoid stroma (GCLS). Using high-sensitivity methods, we recently detected EBV traces in a large cohort of EBV-negative B-cell lymphomas, suggesting a hit-and-run mechanism.

Methods

Here, we used routine and higher-sensitivity methods [droplet digital PCR (ddPCR) for EBV segments on microdissected tumour cells and RNAscope for EBNA1 mRNA] to assess EBV infection in a cohort of 40 GCs (28 ADK and 12 GCLS).

Results

ddPCR documented the presence of EBV nucleic acids in rare tumour cells of several cases conventionally classified as EBV-negative (ADK, 8/26; GCLS, 6/7). Similarly, RNAscope confirmed EBNA1 expression in rare tumour cells (ADK, 4/26; GCLS, 3/7). Finally, since EBV induces epigenetic changes that are heritable and retained after complete loss of the virus from the host cell, we studied the methylation pattern of EBV-specifically methylated genes (Timp2, Eya1) as a mark of previous EBV infection. Cases with EBV traces showed a considerable level of methylation in Timp2 and Eya1 genes that was similar to that observed in EBER-ISH positive cases and greater than cases not featuring any EBV traces.

Conclusions

These findings suggest that: (a) EBV may contribute to gastric pathogenesis more widely than currently acknowledged and (b) indicate the methylation changes as a mechanistic framework for how EBV can act in a hit-and-run manner. Finally, we found that the viral state was of prognostic significance in univariate and multivariate analyses.
A rare window into a back-reef fish community from the middle Miocene (late Badenian) Medobory Hills barrier reef in western Ukraine, reconstructed mostly by means of otoliths
Authors: Schwarzhans Werner , Klots Oleksandr , Ryabokon Tamara , Kovalchuk Oleksandr
Published: November 2022

The Medobory Hills barrier reef in western Ukraine represents a unique environment during the late Badenian that existed for a relatively brief time. Here, we describe 170 specimens of otoliths and scarce skeletal elements that were collected in the back-reef environment of the central part of the barrier reef in the city of Horodok. They represent a rare window into a reef-associated bony fish fauna. The otolith assemblage is very diverse and differs in several aspects from time-equivalent otolith associations described from other regions and environments within the former Paratethys. The Medobory back-reef otolith assemblage is dominated by a highly diverse gobioid community, several of which are believed to reflect specific reef adaptations that have not been identified elsewhere. A total of 26 species have been identified, of which eight are described as new, including two new genera. In the order in which they are described, the new taxa are as follows: Gobiidae: Gobius bratishkoi n. sp., Gobius ukrainicus n. sp., Parenypnias n. gen. inauditus n. sp., Parenypnias n. gen. kiselevi n. sp., Medoborichthys n. gen. podolicus n. sp., and Medoborichthys n. gen. renesulcis n. sp.; Blenniidae: Blennius vernyhorovae n. sp.; and Labridae: Coris medoboryensis n. sp. The environmental implications of the otolith-based fish fauna are discussed, and a supraregional correlation of late Badenian otolith associations throughout the Paratethys is presented.

ZooBank LSID: urn:lsid:zoobank.org:pub:BFD6A482-A250-4603-AD60-D94E7756D4FB https://zoobank.org/72CECD6E-B1C3-49FF-AFE1-C542140706D0.
Validation of dynamic [18F]FE-PE2I PET for estimation of relative regional cerebral blood flow: a comparison with [15O]H2O PET
Authors: Jakobson Mo Susanna , Axelsson Jan , Stiernman Lars , Riklund Katrine
Published: November 2022

Background

Dopamine transporter (DAT) imaging is used in the diagnostic work-up in suspected parkinsonian syndromes and dementia with Lewy bodies but cannot differentiate between these syndromes, and an extra brain imaging examination of the regional cerebral blood flow (rCBF) or glucose metabolism is often needed for differential diagnosis. The requirement of two different imaging examinations is resource-consuming and inconvenient for the patients. Therefore, imaging of both cortical blood flow and DAT imaging with the same radiotracer would be more convenient and cost-effective. The aim of this study was to test whether relative regional cerebral blood flow (rCBFR) can be measured with the DAT-specific positron emission tomography (PET) tracer [18F]FE-PE2I (FE-PE2I), by validation with cerebral perfusion measured with [15O]H2O PET (H2O).

Methods

The rCBFR was quantified by kinetic modeling for FE-PE2I (R1) and H2O (F). The R1 was calculated using the simplified reference tissue model, and F was calculated with a modified Koopman double-integration method. The linear relationship and intraclass correlation (ICC) between R1 and F were tested in image data derived from 29 patients with recent onset parkinsonism and 30 healthy controls.

Results

There was a strong linear correlation across all subjects between R1 and F in the frontal, parietal, temporal, cingulate and occipital cortex as well as in the striatum (r  ≥  0.731–0.905, p  < 0.001) with a good-to-excellent ICC, ranging from 0.727 to 0.943 (p < 0.001).

Conclusions

Our results suggest that FE-PE2I may be used as a proxy for cerebral perfusion, thus potentially serving as a radiotracer for assessment of both DAT availability and rCBFR in one single dynamic scan. This could be valuable in the differential diagnosis of parkinsonian syndromes.

Trial registration: EUDRA-CT 2015-003045-26. Registered 23 October 2015 https://www.clinicaltrialsregister.eu/ctr-search/search?query=2015-003045-26