bluuebunny/crossref_metadata_2025 huggingface dataset:
Canal Fill of the Forearm Bones When Placing Intramedullary Nails in the Pediatric and Adolescent Populations
Authors: Hamaker Max , Codd Casey M. , May Catherine C. , O’Hara Nathan N. , Abzug Joshua M.
Published: June 2023

Background:

In the lower extremity, studies have suggested an optimal nail diameter to medullary canal diameter (ND/MCD) ratio to minimize postoperative complications. The goal of this study was to determine whether a correlation exists between the occurrence of complications, angulation, and range of motion and the ratio of the ND/MCD in the upper extremity.

Methods:

A total of 85 radius and ulna fractures treated with flexible intramedullary nails had ND/MCD ratios measured. Random-effects models were developed to determine the association between complications and ND/MCD ratio, angulation and ND/MCD ratio, and range of motion and ND/MCD ratio. The results were reported for unadjusted models and adjusted models.

Results:

Of the 85 forearm fractures treated with intramedullary nailing, there were 3 complications. The average follow-up was 6 months. The ND/MCD ratios were categorized as <0.50, 0.50 to 0.59, and ≥0.60. There was not a significant association between the different ratios and angulation, or risk of complication. There was an association between the ND/MCD ratio ≥0.60 and decreased pronation of −1.58° (−2.77° to −0.38°) and supination of −2.68° (−4.91° to −0.46°) ( P < .05).

Conclusion:

This study found that there was not an association between the nail to canal diameter ratio and postoperative angulation in forearm fractures treated with flexible intramedullary nails. When choosing a flexible nail for forearm fractures, there does not appear to be an optimal ratio; it is therefore reasonable to use the ND that passes more easily.
A descriptive analysis of hospitalized adolescents facing chronic illnesses with different durations of disease
Authors: Favaretto Giovana Ribeiro de Souza , Machado Regina Celia Bueno , Urbano Mariana Ragassi , Balsanelli Júlia Dutra , Costa Sarah Conchon , Nunes Sandra Odebrecht Vargas
Published: June 2023

Objectives

To assess characteristics of hospitalized adolescents facing chronic diseases, correlating the perceptions of their illness, quality of life and the prevalence of risk behaviors, considering gender and the diseases’ durations.

Methods

The sample consisted of 61 adolescents, aged between 10 and 19 years, with chronic diseases, hospitalized at the University Hospital of the State University of Londrina. They answered a questionnaire and the scales World Health Organization Quality of Life (WHOQOL-BREF) and Illness Perception Questionnaire (IPQ). They were divided in groups, according to the durations of the disease: group 1 (up to 4 years) and group 2 (5 years or more).

Results

Group 2 demonstrated higher leisure activity ( p = 0.02) and more painful symptoms ( p = 0.02). In WHOQOL-BREF, group 2 had a higher quality of life in the domain on environment ( p = 0.02) and a higher total score ( p = 0.04). Lower scores on the IPQ were associated with higher scores on the WHOQOL-BREF. Positive correlation was found between WHOQOL-BREF total score and years of disease, in which male presented higher scores.

Conclusions

These findings may alert to the need for more knowledge about the diseases and the importance of encouraging ways to improve quality of life and care to reduce risky behaviors.
Early or late initiation of dabigatran versus vitamin-K-antagonists in acute ischemic stroke or TIA: The PRODAST study
Authors: Grosse Gerrit M , Hüsing Anika , Stang Andreas , Kuklik Nils , Brinkmann Marcus , Nabavi Darius , Sparenberg Paul , Weissenborn Karin , Gröschel Klaus , Royl Georg , Poli Sven , Michalski Dominik , Eschenfelder Christoph C , Weimar Christian , Diener Hans-Christoph ,   on behalf of the PRODAST Investigators
Published: June 2023

Background:

The optimal timing of initiating or resuming anticoagulation after acute ischemic stroke (AIS) or transient ischemic attack (TIA) in patients with atrial fibrillation (AF) is debated. Dabigatran, a non-vitamin K oral anticoagulant (NOAC), has shown superiority against vitamin K antagonists (VKA) regarding hemorrhagic complications.

Aims:

In this registry study, we investigated the initiation of dabigatran in the early phase after AIS or TIA.

Methods:

PRODAST (Prospective Record of the Use of Dabigatran in Patients with Acute Stroke or TIA) is a prospective, multicenter, observational, post-authorization safety study. We recruited 10,039 patients at 86 German stroke units between July 2015 and November 2020. A total of 3,312 patients were treated with dabigatran or VKA and were eligible for the analysis that investigates risks for major hemorrhagic events within 3 months after early (⩽ 7 days) or late (> 7 days) initiation of dabigatran or VKA initiated at any time. Further endpoints were recurrent stroke, ischemic stroke, TIA, systemic embolism, myocardial infarction, death, and a composite endpoint of stroke, systemic embolism, life-threatening bleeding and death.

Results:

Major bleeding event rates per 10,000 treatment days ranged from 1.9 for late administered dabigatran to 4.9 for VKA. Early or late initiation of dabigatran was associated with a lower hazard for major hemorrhages as compared to VKA use. The difference was pronounced for intracranial hemorrhages with an adjusted hazard ratio (HR) of 0.47 (95% confidence interval (CI): 0.10–2.21) for early dabigatran use versus VKA use and an adjusted HR of 0.09 (95% CI: 0.00–13.11) for late dabigatran use versus VKA use. No differences were found between early initiation of dabigatran versus VKA use regarding ischemic endpoints.

Conclusions:

The early application of dabigatran appears to be safer than VKA administered at any time point with regards to the risk of hemorrhagic complications and in particular for intracranial hemorrhage. This result, however, must be interpreted with caution in view of the low precision of the estimate.
Simulating shot selection strategies and scoring outcomes in Super Netball’s ‘Power 5’ period
Authors: Fox Aaron S , Bruce Lyndell
Published: June 2023

In 2020, Australia's elite-level netball league introduced the ‘Super Shot’ – an opportunity for teams to gain two versus one goal per shot during the final 5 minutes of each quarter (i.e. Power 5 period). In this study, we ran simulations of Power 5 periods to: (i) identify expected scoring outcomes from Super Shot selection strategies and (ii) examine how Super Shot selection strategies could impact the scoring margin between teams. We ran simulations emulating Power 5 periods with different Super Shot selection strategies for teams individually and when competing against one another, and examined the scoring outputs and margins. A greater tendency for attempting Super Shots was a high-risk: high-reward strategy, where this strategy could result in both high- and low-scoring outcomes (i.e. increased scoring volatility). Average margins were not largely affected by Super Shot selection strategy in simulations between teams, yet the more volatile scoring with a higher tendency for Super Shot attempts led to wider margin ranges. We propose that a singular ‘optimal’ Super Shot selection strategy does not exist and that the match scenario should be a key driver in determining a team’s strategy.
Single cell RNA-sequencing of human precision-cut lung slices: A novel approach to study the effect of vaping and viral infection on lung health
Authors: Crue Taylor , Lee Grace Yihua , Peng Joyce Yao-chun , Schaunaman Niccolette , Agraval Hina , Day Brian J. , Dimasuay Kris Genelyn , Cervantes Diana , Nouri Hamid , Nichols Taylor , Hartsoe Paige , Numata Mari , Petrache Irina , Chu Hong Wei
Published: June 2023

Vaping is an increasing health threat in the US and worldwide. The damaging impact of vaping on the human distal lung has been highlighted by the recent epidemic of electronic cigarette or vaping use-associated lung injury (EVALI). The pathogenesis of EVALI remains incompletely understood, due to a paucity of models that recapitulate the structural and functional complexity of the human distal lung and the still poorly defined culprit exposures to vaping products and respiratory viral infections. Our aim was to establish the feasibility of using single cell RNA-sequencing (scRNA-seq) technology in human precision-cut lung slices (PCLS) as a more physiologically relevant model to better understand how vaping regulates the antiviral and pro-inflammatory response to influenza A virus infection. Normal healthy donor PCLS were treated with vaping extract and influenza A viruses for scRNA-seq analysis. Vaping extract augmented host antiviral and pro-inflammatory responses in structural cells such as lung epithelial cells and fibroblasts, as well as in immune cells such as macrophages and monocytes. Our findings suggest that human distal lung slice model is useful to study the heterogeneous responses of immune and structural cells under EVALI conditions, such as vaping and respiratory viral infection.
Challenging Behavior in Context: A Case Study on How People, Space, and Activities Interact
Authors: Roos Berit Ann , Mobach Mark , Heylighen Ann
Published: June 2023

Aim:

We aim to gain insight into the interaction between challenging behavior as shown by individuals with an intellectual impairment, and space, and to explore the possibilities of using routinely collected data to this end.

Background:

Research on challenging behavior shown by intellectually impaired individuals links their behavior to context, which includes space. Unfortunately, research about this link is hard to conduct, since these individuals may have difficulties expressing themselves verbally and react extremely to sensory stimuli.

Method:

We conducted a single-case study, focusing on a Dutch very-intensive care facility. We analyzed data routinely collected by the healthcare organization in search of time-space configurations that provide insights into the resident–space interaction. As sensitizing concepts, we used three different contexts the residents interact with—space, people, and activities.

Findings:

The study exemplified reported interactions that were direct, for example, between the residents and the spatial context, and indirect, for example, through other contexts (people and activities). Space impacts on residents’ senses intensely and acts as a lightning rod for their perceived stress. People also influence residents substantially. Caregivers may both have positive or adverse effects, for example, absenteeism or schedule change. Co-residents may trigger challenging behavior directly by a mere presence or transfer of their stress. Transitions between activities cause unpredictability and are triggers for residents, which interact with space.

Conclusions:

Living environments providing choice in nearness to the caregiver and distance to co-residents “high in tension,” lowering thresholds for transitions, and facilitating predictability would be beneficial for intellectually impaired individuals showing challenging behavior.
When a third party is a third chance: The impact of mediation on relationship quality with the firm in the post-recovery stage
Authors: Mardumyan Anna , Sabadie William
Published: June 2023

The demand for mediation, in which a neutral third party offers advice to resolve a customer–firm conflict, continues to increase steadily in Europe. This article is the first to consider the recourse to mediation as a stage of the service recovery journey and empirically examine how the intervention of a mediator affects customer relationship quality in the post-recovery stage. The results indicate that the mediation outcome affects customers’ loyalty intentions toward the firm through the mediating effect of distributive justice. Considering neutrality as the foundational element of the mediation process, this research reveals a moderating impact of the mediation type (internal vs external) on the relationship between the mediation outcome and customers’ loyalty intentions toward the firm. The findings highlight the efficiency of the internal mediation over the external one after a favorable outcome and encourage firms to leverage mediation strategically to maintain customers, because it represents the last chance for firms to recover from the service failure.
Working with Indigenous science(s) frameworks and methods: Challenging the ontological hegemony of ‘western’ science and the axiological biases of its practitioners
Authors: Harriden Kate
Published: June 2023

Globally, Indigenous scientific frameworks and methods have been damaged and derided by ‘western’ science, a strategy of the colonial project. Contemporary Australia is no exception, with the transmission of the suite of scientific values and practices formed over millennia in and for this place being actively prevented by legislation, government policies and colonial opprobrium. This paper shows how two crucial Indigenous science(s) frameworks, used alongside two Indigenous research methods, can transform hegemonic scientific research and fieldwork priorities and practices. This transformation occurs because of the focus of each framework. The first, centring country, requires decentring the human to bring forth the needs of the web of relationships that is country. The second framework, relational accountability, is about tending to a broad range of relationships, are often kin-based and including the other-than-human, with yindyamarra (or local equivalent). Relational accountability also offers an inbuilt ethic of care superior to institutional ethics protocols. By describing these frameworks and methods and discussing how and when to use them, this paper supports their greater understanding and more widespread use, particularly by Indigenous practitioners, so we may continue to (re)build what colonisation has damaged.
Rethinking Ignorance Through Confucianism and Daoism: Propriety, Transcendence, and Their Educational Implications
Authors: Zhu (朱彦臻) Yanzhen
Published: June 2023

Purpose

Ignorance has been seen as negative in the mainstream philosophical narrative and knowledge-based society. This study introduces Chinese epistemic traditions of Confucianism and Daoism as resources to reunderstand ignorance and current educational issues.

Design/Approach/Methods

Guided by hermeneutic openness, this study fuses ancient epistemic and modern educational horizons by reinterpreting early Confucian and Daoist classics.

Findings

The boundary between ignorance and knowledge is flexible and blurry in Confucianism and Daoism, and ignorance is distinctively understood as Confucian admissible propriety and Daoist transcendence of conventional knowledge. Rooted in these epistemologies, Confucianism and Daoism have developed unique educational ideas and forms— congyou (从游) and zuowang (坐忘)—which advocate moral socialization and self-reflexivity beyond knowing through language. These traditions inspire today's educators and learners to find more space for self-formation, appropriate forgetting, and illuminating intuition in education.

Originality/Value

As an initial exploration, this study examines potential nonnegative ignorance and its educational implications in Confucian and Daoist wisdom. The findings are instructive for rethinking today's knowledge-based society and the text-oriented education of Chinese culture and can contribute to world epistemic diversity and cultural interactions.
Perceived Efficacy in Initiating Romantic Relationships and Single Emerging Adults’ Well-Being
Authors: Watkins Nicole K. , Beckmeyer Jonathon J.
Published: June 2023

Using data from 313 single emerging adults living in the United States, we explored initiation-efficacy (i.e., perceived abilities related to initiating romantic relationships) and if it was associated with well-being (life satisfaction, happiness with romantic experiences, and loneliness). Most participants indicated that it is not easy to ask someone out or tell someone they are interested in them and talking with someone they have feelings for is awkward. Initiation-efficacy was associated with well-being. Specifically, reporting that it is easy to ask someone out on a date was associated with greater life satisfaction and happiness with romantic experiences, but less loneliness. Further, emerging adults were lonelier when talking to someone they have feelings for was awkward. Finally, neither relationship desire or dismissal moderated associations between initiation-efficacy and well-being. However, relationship dismissal was associated with greater life satisfaction and happiness with romantic experiences and relationship desire was associated with more loneliness.
The Relationship Between Psychological Distress of Nursing Faculty With Burnout
Authors: Watson Mayantoinette F.
Published: June 2023

Introduction

Approximately 83% of U.S. workers suffer from work-related stress. Burnout affects approximately 38% of nurses and nurse faculty per year. Contributing factors, including growing levels of mental health issues, can be seen among nursing faculty, leading to more and more nurses leaving nursing academia.

Objectives

This study objective aimed to identify associations between psychological distress with burnout in nursing faculty teaching in an undergraduate nursing program.

Methods

A quantitative design was utilized using a descriptive method with a convenience sample of nursing faculty ( n  =  150) from the Southeastern United States The Kessler Psychological Distress Scale was correlated with the Oldenburg Burnout Inventory. Regression analysis was used to analyze the data.

Results

Psychological distress was reported in 25% of the sample. Burnout was reported in 94% of the sample. Psychological distress and burnout were significantly correlated ( p < .05). Race, gender, and age ( p < .05) contributed to psychological distress.

Conclusion

Interventions promoting healthy mental well-being among nursing faculty are needed to address issues related to increasing rates of burnout and psychological distress. Implementation of workplace health promotion programs, increased mentorship, inclusion of diversity within nursing academia, and mental health awareness can improve mental health outcomes among nursing faculty. Further research is needed to explore the improvement of mental well-being among nursing faculty.
The Value of Mental Health Screening for Adolescents Attending School-Based Health Centers
Authors: Pulgaron Elizabeth R. , Smith Nicholas David W. , Armans Mira , Coto Jennifer , Maurer Michael , Gwynn Lisa
Published: June 2023

Although 65% of school-based health centers (SBHCs) offer mental health services, at-risk youth are commonly overlooked or do not follow up when referrals are made. Universal screenings may increase identification of those in need of mental health support. We examined the number of youth at three SBHCs referred for mental health consultations. Comparisons were made between provider referrals and those with elevated scores on the Youth Pediatric Symptom Checklist-17 (Y-PSC-17). Of the 585 patients in this study, 37 (6.32%) were referred solely by their Y-PSC-17 score, 36 (6.15%) youth were singularly referred by providers, and 19 (3.25%) were referred by both modalities. Almost three-quarters ( n = 67; 72.8%) of identified youth elected to receive psychotherapeutic services. Approximately half of the youth referred by providers ( n = 19; 52.8%) received individual services, while 36.11% ( n = 13) received group services. Smaller proportions of youth with elevated Y-PSC-17 scores received individual ( n = 7; 18.9%) and group services ( n = 11; 29.7%). Youth referred solely by a medical provider had significantly lower scores than those identified through an elevated Y-PSC-17 score. Findings highlight the necessity of universal screening in pediatric settings in addition to physician referrals to provide a supplemental layer of prevention and early identification of behavioral health concerns. In this study, 40% referrals would have been missed if both modalities were not in place. Educating medical providers on youth mental health concerns may enhance identification of those in need of mental health supports and in turn improve long-term outcomes.
Spiritual Well-Being and Related Factors in Children With Cancer
Authors: Juškauskienė Erika , Riklikienė Olga , Fisher John
Published: June 2023

Introduction: There are specific gaps that call for empirical research in the experiences of spiritual well-being among children 12 years old and younger with cancer. Understanding these relationships can help to develop holistic and family centered care in pediatric oncology wards. This study assessed the spiritual well-being of children with cancer in association with their general well-being, happiness, quality of life, pain intensity, and personal characteristics. Method: The data were collected in Lithuania between June 2020 and November 2021. Children with cancer ( N = 81) who were hospitalized at pediatric oncology–hematology centers participated in the study. Inclusion criteria were age (from 5 to 12 years old), diagnosis of oncologic disease for the first time, and absence of other chronic diseases. The instruments used were: Feeling Good, Living Life; Oxford Happiness Questionnaire, Short Form; Well-Being Index; PedsQL™3.0 Cancer Module, and a Wong-Baker FACES® Pain Rating Scale. Results: Communal and personal domains of spiritual well-being had the highest scores among pediatric oncology patients while both dimensions of the transcendental domain scored lowest. Age, level of education, and family composition revealed differences in children's spiritual health, happiness, and well-being, and church attendance was significant for overall spiritual well-being and its transcendental domain on lived experience dimension. Happiness had the strongest effect on all four domains of spiritual well-being. Discussion: Children emphasized the importance of spiritual aspects to feel better to a greater extent than they experienced in their lives. Despite their young age, children were familiar with family traditions, that is, religious practice and church attendance, and followed them in a particular sociocultural context.
Unintentional Programs: An Interproject Orientation for Aligning IT with Organizational Strategy
Authors: Wang Eric T. G. , Chiou Han-Chieh , Tai Jeffrey C. F.
Published: June 2023

This study proposes program orientation as an organizational culture that motivates organizations to manage interrelated projects like a program without a formal structure or program team. We hold that collaboration, with cooperation and coordination as its main elements, plays a critical role in aligning interrelated projects dynamically. The empirical results support our hypotheses that program orientation indirectly affects information systems alignment with interproject cooperation, coordination, and adaptability mediating its effects. This study thus confirms the benefit of treating interrelated projects as a program, even when they are not governed by a formal program structure.
The association between serum uric acid and creatine phosphokinase in the general population: NHANES 2015–2018
Authors: Chen Xinxin , You Jiuhong , Zhou Mei , Ma Hui , Huang Cheng
Published: June 2023

Background

The association between serum creatine phosphokinase (CPK), a standard biochemical measure of acute myocardial infarction, and serum uric acid (sUA) has not been studied. This study aimed to determine the association between sUA and CPK in the general population of the US.

Methods

Data from the National Health and Nutrition Examination Survey (NHANES) 2015–2018 were used, including a total of 8,431 subjects aged ≥ 30 years. Weighted multiple regression analysis was used to estimate the independent relationship between sUA and CPK. Fitted smoothing curves and weighted generalized additive models were also performed.

Results

We found a positive relationship between sUA and CPK after adjusting for potential confounders. In subgroup analyses stratified by sex and race/ethnicity, sUA was positively correlated with CPK in each subgroup. The association between sUA and CPK followed an inverted U-shaped curve in females (turning point: sUA = 428.3 μmol/L).

Conclusions

Our study suggested that sUA level was positively correlated with CPK in the general population of the US. However, CPK increased with sUA until the turning point (sUA = 428.3 μmol/L) in females. Fundamental research and large sample prospective studies are needed to determine the exact mechanism of the association between sUA and CPK.
Klebsiella pneumoniae invasive syndrome with liver abscess and purulent meningitis presenting as acute hemiplegia: a case report
Authors: Chang Yu , Chen Jiann-Hwa , Chen Wei-Lung , Chung Jui-Yuan
Published: June 2023

Background

Klebsiella pneumoniae can infect a variety of sites, with the risk of infection being higher in the immunocompromised state such as diabetes mellitus. A distinct invasive syndrome has been detected mostly in Southeast Asia in the past two decades. A common destructive complication is pyogenic liver abscess that can be complicated by metastatic endophthalmitis as well as the involvement of the central nervous system, causing purulent meningitis or brain abscess.

Case presentation

We report a rare case of an invasive liver abscess caused by K. pneumoniae, with metastatic infections of meninges. A 68-year-old man with type 2 diabetes mellitus presented to our emergency department as sepsis. Sudden disturbed consciousness was noticed with presentation of acute hemiplegia and gaze preference mimicking a cerebrovascular accident.

Conclusions

The above case adds to the scarce literature on K. pneumoniae invasive syndrome with liver abscess and purulent meningitis. K. pneumoniae is a rare cause of meningitis and should raise suspicions about the disease in febrile individuals. In particular, Asian patients with diabetes presenting with sepsis and hemiplegia prompt a more thorough evaluation with aggressive treatment.
Acute uveitis caused by abnormal glucose and lipid metabolism: a case report
Authors: Bi Zhaojing , Liang Yan , Liu Shujun , Li Yuanbin
Published: June 2023

Purpose

This report describes a rare case of acute uveitis with severe anterior chamber inflammation due to abnormal glucose and lipid metabolism.

Case presentation

A 31-year-old male patient complained of redness in the right eye with decreased visual acuity for 3 days. Ocular examination revealed a milky white clouding of the right anterior chamber of the eye. Two clusters of yellowish-white exudates were visible on the surface of the iris in the upper nasal and temporal areas in addition to elevated intraocular pressure. He had a previous diagnosis of type 2 diabetes mellitus (T2DM). Laboratory tests suggested hyperlipidemia and ketoacidosis. After admission, topical glucocorticoids, mydriasis, and intraocular pressure-lowering drugs combined with hypoglycemic and lipid-lowering therapy and fluid replacement therapy were given immediately. After 10 days of treatment, the uveitis and systemic condition of the right eye were effectively controlled and improved.

Conclusion

Abnormal glucose and lipid metabolism leads to impairment of the blood-aqueous barrier, which causes a severe uveitis response in the anterior chamber. After the use of topical steroids and mydriatic eye drops combined with systemic hypoglycemic and lipid-lowering interventions, the condition was significantly relieved.
Transferability and sustainability of process-based multi-task adaptive cognitive training in community-dwelling older adults with mild cognitive impairment: a randomized controlled trial
Authors: Zhao Xia , Ji Caifang , Zhang Chen , Huang Cheng , Zhou Yuanyuan , Wang Lina
Published: June 2023

Background

Cognitive training shows promising effects for improving cognitive domains in individuals with mild cognitive impairment (MCI), including the crucial predictive factor of executive function (EF) for dementia prognosis. Few studies have paid sufficient emphasis on the training-induced effects of cognitive training programs, particularly with regards to targeting EF. A process-based multi-task adaptive cognitive training (P-bM-tACT) program targeting EF is required to examine direct, transfer, and sustainability effects in older adults with MCI.

Objective

This study aimed to evaluate the direct effects of a P-bM-tACT program on EF, the transfer effects on untrained cognitive domains, and further explore the sustainability of training gains for older adults with MCI in the community.

Methods

In a single-blind, randomized controlled trial, 92 participants with MCI were randomly assigned to either the intervention group, participating in a P-bM-tACT program (3 training sessions/week, 60 min/session for 10 weeks) or the wait-list control group, accepting a health education program on MCI (1 education session/ twice a week, 40–60 min/session for 10 weeks). The direct and transfer effects of the P-bM-tACT program were assessed at baseline, immediately after 10 weeks of training, and the 3-month follow-up. Repeated measures analysis of variance and a simple effect test were used to compare the direct and transfer effects over the 3-time points between the two groups.

Results

The P-bM-tACT program yielded a greater benefit of direct and transfer effects in the intervention group participants than in the wait-list control group. Combined with the results of simple effect tests, the direct and transfer effects of participants in the intervention group significantly increased immediately after 10 weeks of training compared to the baseline (F = 14.702 ~ 62.905, p < 0.05), and these effects were maintained at the 3-month follow-up (F = 19.595 ~ 122.22, p < 0.05). Besides, the acceptability of the cognitive training program was established with a high adherence rate of 83.4%.

Conclusions

The P-bM-tACT program exerted positive direct and transfer effects on the improvement of cognitive function, and these effects were sustained for 3 months. The findings provided a viable and potential approach to improving cognitive function in older adults with MCI in the community.

Trial registration

The trial was registered at Chinese Clinical Trials Registry on 09/01/2019 (www.chictr.org.cn; Number Registry: ChiCTR1900020585).
New-onset acute psychosis as a manifestation of lupus cerebritis following concomitant COVID-19 infection and vaccination: a rare case report
Authors: Fekih-Romdhane Feten , Ghrissi Farah , Hallit Souheil , Cheour Majda
Published: June 2023

Background

Rare cases of COVID-19 infection- and vaccine-triggered autoimmune diseases have been separately reported in the literature. In this paper, we report the first and unique case of new onset acute psychosis as a manifestation of lupus cerebritis following concomitant COVID-19 infection and vaccination in a previously healthy 26-year-old Tunisian female.

Case presentation

A 26-years old female with a family history of a mother diagnosed with schizophrenia, and no personal medical or psychiatric history, was diagnosed with mild COVID-19 infection four days after receiving the second dose of Pfizer-BioNTech COVID-19 vaccine. One month after receiving the vaccine, she presented to the psychiatric emergency department with acute psychomotor agitation, incoherent speech and total insomnia evolving for five days. She was firstly diagnosed with a brief psychotic disorder according to the DSM-5, and was prescribed risperidone (2 mg/day). On the seventh day of admission, she reported the onset of severe asthenia with dysphagia. Physical examination found fever, tachycardia, and multiple mouth ulcers. Neurological evaluation revealed a dysarthria with left hemiparesis. On laboratory tests, she had severe acute kidney failure, proteinuria, high CRP values, and pancytopenia. Immune tests identified the presence of antinuclear antibodies. Brain magnetic resonance imaging (MRI) revealed hyperintense signals in the left fronto-parietal lobes and the cerebellum. The patient was diagnosed with systemic lupus erythematosus (SLE) and put on anti-SLE drugs and antipsychotics, with a favorable evolution.

Conclusions

The chronological relationship between COVID-19 infection, vaccination and the first lupus cerebritis manifestations is highly suggestive, albeit with no certainty, of the potential causal link. We suggest that precautionary measures should be taken to decrease the risk of SLE onset or exacerbation after COVID-19 vaccination, including a systematic COVID-19 testing before vaccination in individuals with specific predisposition.
The role of sleep quality and perceived stress on depressive symptoms among tertiary hospital nurses: a cross-sectional study
Authors: Zhou Yi , Wang Sha , Liu Min , Gan Gang , Qin Ning , Luo Xiaofei , Zhang Chun , Xie Jianfei , Wang Kewei , Cheng Andy SK
Published: June 2023

Background

Nurses in tertiary hospitals are at high risk for depression. Understanding sleep quality and perceived stress may contribute to nurses’ mental health and health-related nursing productivity. The aim of this study was to investigate the role of sleep quality and perceived stress on depressive symptoms among nurses in tertiary hospitals.

Methods

A total of 2,780 nurses (overall response rate = 91.1%) were recruited through a cross-sectional survey in 23 tertiary hospitals in China. Questionnaires included the Self-Rating Depression Scale, the Pittsburgh Sleep Quality Index, and the Chinese Perceived Stress Scale. Variables that were significant in Chi-square tests were further entered into binary logistic stepwise regression.

Results

The prevalence of depressive symptoms was 60.3% (n = 1,676), of which 97.4% (n = 1,633) were female, and 77.8% were younger than 35 years (n = 1,304). Nurses who had moderate, poor, severe sleep quality and poor perceived pressure were more likely to be depressed. Master’s degree, 6–10 years of work, and physical activity were protective factors, while the opposite was the case for shift work and high dissatisfaction.

Conclusions

More than half of nurses working in tertiary care hospitals reported depressive symptoms, and lower sleep quality and higher perceived stress were more associated with this. Perceived stress is an interesting concept, which may provide a new entry point for the well-known idea that there is a relationship between poor sleep quality and depression. It is possible to reduce depressive symptoms among public hospital nurses by providing information on sleep health and stress relief.
Is bureaucracy being busted in research ethics and governance for health services research in the UK? Experiences and perspectives reported by stakeholders through an online survey
Authors: Snooks Helen , Khanom Ashrafunnesa , Ballo Rokia , Bower Peter , Checkland Katherine , Ellins Jo , Ford Gary A , Locock Louise , Walshe Kieran
Published: June 2023

Background

It has long been noted that the chain from identification of need (research gap) to impact in the real world is both long and tortuous. This study aimed to contribute evidence about research ethics and governance arrangements and processes in the UK with a focus on: what works well; problems; impacts on delivery; and potential improvements.

Methods

Online questionnaire widely distributed 20th May 2021, with request to forward to other interested parties. The survey closed on 18th June 2021. Questionnaire included closed and open questions related to demographics, role, study objectives.

Results

Responses were received from 252 respondents, 68% based in universities 25% in the NHS. Research methods used by respondents included interviews/focus groups (64%); surveys/questionnaires (63%); and experimental/quasi experimental (57%). Respondents reported that participants in the research they conducted most commonly included: patients (91%); NHS staff (64%) and public (50%). Aspects of research ethics and governance reported to work well were: online centralised systems; confidence in rigorous, respected systems; and helpful staff. Problems with workload, frustration and delays were reported, related to overly bureaucratic, unclear, repetitive, inflexible and inconsistent processes. Disproportionality of requirements for low-risk studies was raised across all areas, with systems reported to be risk averse, defensive and taking little account of the risks associated with delaying or deterring research. Some requirements were reported to have unintended effects on inclusion and diversity, particularly impacting Patient and Public Involvement (PPI) and engagement processes. Existing processes and requirements were reported to cause stress and demoralisation, particularly as many researchers are employed on fixed term contracts. High negative impacts on research delivery were reported, in terms of timescales for completing studies, discouraging research particularly for clinicians and students, quality of outputs and costs. Suggested improvements related to system level changes / overall approach and specific refinements to existing processes.

Conclusions

Consultation with those involved in Health Services Research in the UK revealed a picture of overwhelming and increasing bureaucracy, delays, costs and demoralisation related to gaining the approvals necessary to conduct research in the NHS. Suggestions for improvement across all three areas focused on reducing duplication and unnecessary paperwork/form filling and reaching a better balance between risks of harm through research and harms which occur because research to inform practice is delayed or deterred.
Embracing parenting role in childhood obesity
Authors: Ling Jiying , Gebremariam Mekdes
Published: June 2023

Active parental engagement is crucial in controlling childhood obesity. However, optimal strategies to engage parents and mechanisms linking parents’ involvement to childhood obesity prevention need further investigation. In this editorial, we provide a background to invite contributions to the BMC Public Health collection titled ‘Parenting role in childhood obesity’.
Reducing hospital readmissions amongst people experiencing homelessness: a mixed-methods evaluation of a multi-disciplinary hospital in-reach programme
Authors: Malden Stephen , Doi Lawrence , Ng Lauren , Cuthill Fiona
Published: June 2023

Introduction

People experiencing homelessness are at increased risk of experiencing ill-health. They are often readmitted to hospital after discharge, usually for the same or similar reasons for initial hospitalisation. One way of addressing this issue is through hospital in-reach initiatives, which have been established to enhance the treatment and discharge pathways that patients identified as homeless receive after hospital admission. Since 2020, the Hospital In-reach programme (which involves targeted clinical interventions and structured discharge support) has been piloted in two large National Health Service (NHS) hospitals in Edinburgh, United Kingdom (UK). This study describes an evaluation of the programme.

Methods

This evaluation used a mixed method, pre-post design. To assess the effect of the programme on hospital readmission rates from baseline (12 months pre-intervention) and follow-up (12 months post-intervention), aggregate data describing the proportions of homeless-affected individuals admitted to hospital during the evaluation period were analysed using Wilcoxon signed rank test, with level of significance set at p = 0.05. Qualitative interviews were conducted with fifteen programme and hospital staff (nurses, general practitioners, homeless link workers) to assess the processes of the programme.

Results

A total of 768 referrals, including readmissions, were made to the In-reach programme during the study period, of which eighty–eight individuals were followed up as part of the study. In comparison to admissions in the previous 12 months, readmissions were significantly reduced at 12 months follow-up by 68.7% (P = 0.001) for those who received an in-reach intervention of any kind. Qualitative findings showed that the programme was valued by hospital staff and homeless community workers. Housing services and clinical staff attributed improvements in services to their ability to collaborate more effectively in secondary care settings. This ensured treatment regimens were completed and housing was retained during hospital admission, which facilitated earlier discharge planning.

Conclusions

A multidisciplinary approach to reducing readmissions in people experiencing homelessness was effective at reducing readmissions over a 12-month period. The programme appears to have enhanced the ability for multiple agencies to work more closely and ensure the appropriate care is provided for those at risk of readmission to hospital among people affected by homelessness.
The effect of mobile app-based self-care training on the quality of marital relations and the severity of menopausal symptoms in postmenopausal women: a clinical trial study in Iran
Authors: Rafati Foozieh , Pourshahrokhi Najme , Bahador Raziyeh Sadat , Dastyar Neda , Mehralizadeh Akbar
Published: June 2023

Background

Educational interventions for self-care are a necessary solution to help postmenopausal women properly deal with menopausal problems. The present study aimed to investigate the effect of self-care training using an application on the quality of marital relations and the severity of menopausal symptoms in postmenopausal women in Iran.

Methods

In this study, 60 postmenopausal women selected using the convenience sampling method were divided into two groups, intervention and control, using simple random allocation (lottery). The intervention group used the menopause self-care application for eight weeks in addition to routine care, but the control group only received the routine care. The Menopause Rating Scale (MRS) and the Perceived Relationship Quality Components (PRQC) questionnaire were completed in two stages, before and immediately after eight weeks, in both groups. Data were analyzed using SPSS software (version 16), descriptive (mean and standard deviation), and inferential (ANCOVA and Bonferroni post hoc) statistics.

Results

The ANCOVA results showed that the use of the menopause self-care application decreased the severity of the participants’ menopause symptoms (P = 0.001) and improved the quality of their marital relations (P = 0.001).

Conclusion

Implementation of a self-care training program through the application helped improve the quality of marital relations and reduce the severity of postmenopausal women's symptoms, so it can be used as an effective method to prevent the unpleasant consequences of menopause.

Trial registration

The present study was registered at https://fa.irct.ir/ on 2021–05-28 (registration number: IRCT20201226049833N1).
Moxibustion treatment for Parkinson’s disease: study protocol for a randomized controlled trial
Authors: Wu Chunxiao , Zhao Lijun , Guo Yuelin , Hao Xiaoqian , Fan Yaohua , Wu Peipei , Han Jiajun , Li Qinglian , Wang Xiaoling , Wang Qizhang , Luo Xiaodong , Zhu Meiling
Published: June 2023

Background

Parkinson’s disease (PD) is the second most common neurodegenerative disorder and seriously affects quality of life globally. Moxibustion is widely used to treat neurodegenerative diseases in the clinic and has achieved a beneficial clinical effect. However, strict control and high-quality randomized controlled trials are still lacking. Therefore, this trial aims to evaluate the clinical efficacy and safety of moxibustion in patients with PD and preliminarily explore the underlying mechanism.

Methods

This is a randomized, single-blind and placebo-controlled trial design in which 70 eligible participants will be randomly divided into a moxibustion group and a sham moxibustion group. Baihui (DU20) and Sishenchong (EX-HN1) are selected for both groups. The treatment will be performed for 30 min per session, two sessions a week for 8 weeks. The mean change in MDS-UPDRS scores (including MDS-UPDRS II, III subscale scores and total scores) from baseline to the observation points will be the primary outcome. The secondary outcomes will include scores on the Parkinson’s Disease Questionnaire-39 (PDQ-39), Fatigue Severity Scale (FSS), Parkinson Disease Sleep Scale (PDSS), Montreal Cognitive Assessment (MoCA), and Self-Rating Depression Scale (SDS) as well as the Wexner constipation score. All the above outcomes will be assessed at 4 and 8 weeks. Laboratory blood biochemical analysis and functional magnetic resonance imaging (fMRI) will be conducted at baseline and at the end of treatment to explore the potential mechanisms of moxibustion in regulating PD.

Discussion

In conclusion, the results of this trial will reveal whether moxibustion is effective for treating motor and nonmotor symptoms in PD. This trial will also preliminarily explore the underlying mechanism of the regulatory effect of moxibustion in PD, which will contribute to providing a theoretical basis for the treatment of PD.

Trial registration

ClinicalTrials.gov ChiCTR2000029745. Registered on 9 August 2021.
Mechanism of salidroside against coronary artery disease by network pharmacology analysis
Authors: Tao Lin , Liang Zhi-Fang , Miao Liu , Guo Yu-Jie , Li Ye , Liu Yan-Li , Fang Dong-Ming , Yang Zhi-Jie
Published: June 2023

Background

Rosenroot (Rhodiola rosea) is a traditional Chinese herbal medicine. It has been used to treat patients with coronary artery disease (CAD). Salidroside is the main active constituent of rosenroot. This study was designed to explore the mechanism of salidroside in treating CAD and its role in angiogenesis in CAD systematically.

Methods

In this study, potential targets related to salidroside and CAD were obtained from public databases. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), Disease Ontology (DO) and CellMarker enrichment analyses were performed. The binding of salidroside to angiogenesis-related targets was assessed by PyMOL and Ligplot. Furthermore, the effects of salidroside on collateral circulation were evaluated by correlation analysis of these angiogenesis-related targets with the coronary flow index (CFI), and the influence of salidroside on human umbilical vein endothelial cell (HUVEC) proliferation and migration was assessed.

Results

Eighty-three targets intersected between targets of salidroside and CAD. GO and KEGG analyses indicated that salidroside mainly treated CAD through angiogenesis and anti-inflammatory action. There were 12 angiogenesis-related targets of salidroside in coronary heart disease, among which FGF1 (r = 0.237, P = 2.597E-3), KDR (r = 0.172, P = 3.007E-2) and HIF1A (r = -0.211, P = 7.437E-3) were correlated with the coronary flow index (CFI), and salidroside docked well with them. Finally, cell experiments confirmed that salidroside promoted the proliferation and migration of HUVECs.

Conclusions

This study revealed the potential molecular mechanism of salidroside on angiogenesis in CAD and provided new ideas for the clinical application of salidroside in the treatment of CAD.