bluuebunny/crossref_metadata_2025 huggingface dataset:
Family Self-Care in Chronic Disease Management: An Evolving Care Pattern?
Authors: Mestre Teresa Dionísio , Caldeira Ermelinda Valente , Lopes Manuel José
Published: February 2024

Introduction

Self-care emerges in the family context, despite being seen as an individual determinant of health. The family, understood as a system and social unit, converges to a pattern of self-care and not to a sum of it, assuming relevance at certain moments of the life cycle, particularly in the management of chronic disease.

Purpose

To perform the transposition of individual self-care to the family self-care, considering the current family's needs and characteristics, by adopting family self-care as the core concept of a care pattern as a determinant of family health.

Conclusion

The family unit is the most influential factor in the health status of individuals, and it will be through family self-care behaviors that families can be healthier by managing their diseases more effectively. They seek to achieve family health, maintaining health through health promotion and disease management practices, always mediated by family self-care behaviors.
Social Isolation in America? A 20-Year Snapshot
Authors: Roth Adam R.
Published: February 2024

This visualization provides a snapshot of social isolation in America over a 20-year period. The author leverages data from the American Time Use Survey to estimate the percentage of Americans who report a complete lack of social contact during a single day. Contrary to prior claims, there was no clear evidence of increasing isolation during the 2000s and 2010s. There was, however, a marked increase in the percentage of Americans who were socially isolated during the coronavirus pandemic. Adopting a micro view of social isolation contributes to contemporary debates by highlighting social interactions rather than broad assessments of social integration such as social relationships or group participation. Although these latter concepts are important in their own ways, focusing on social interactions speaks to issues that are often considered synonymous with social integration such as the exchange of support, resources, and feelings of belongingness.
Lower Trapezius Tendon Transfer With Achilles Tendon Allograft: A Technique Video
Authors: Forsythe Brian , Mirle Vikranth , Gamsarian Vahram , Forlenza Enrico , Tashjian Michelle , Beals Corey , Garrigues Grant E.
Published: February 2024

Background:

While small to medium rotator cuff tears demonstrate good outcomes with primary repair, large, irreparable cuff tears pose a significant clinical challenge with high re-tear rates and lower patient satisfaction. Tendon transfers are procedures that can restore motion and strength in the shoulder in the case of irreparable rotator cuff tears. Trapezius tendon transfers are suitable for large posterosuperior cuff tears as the lower trapezius has a vector of pull similar to that of the infraspinatus.

Indications:

Lower trapezius tendon transfers are indicated for young and active patients with irreparable posterior and posterosuperior rotator cuff tears causing significant weakness and loss of external rotation. Contraindications to the procedure include advanced osteoarthritis of the glenohumeral joint, advanced age, and deficiency of the subscapularis, deltoid, or trapezius muscles.

Technique Description:

Using a scapular incision, the trapezius muscle body and tendon are dissected from the scapular spine and mobilized. The plane of the infraspinatus into the glenohumeral joint is tunneled using blunt dissection, and the prepared allograft is passed through under arthroscopic visualization. The allograft insertion is stabilized with 3 knotless anchors and reinforced using medial row sutures from a concomitant supraspinatus repair. The proximal graft origin is fixed to the trapezius tendon using a Pulvertaft weave morphology to reconstruct the muscle-tendon unit.

Results:

Outcomes data from the literature demonstrate improvement in symptoms and patient satisfaction following the procedure. In a retrospective analysis of 41 patients, Elhassan et al demonstrated that 90% of patients experienced significant improvement in visual analog scale (VAS), Subjective Shoulder Value (SSV), and Disabilities of the Arm, Shoulder, and Hand (DASH) score at mean follow-up time of 14 months.

Discussion/Conclusion:

In appropriately indicated patients, the lower trapezius tendon transfer offers restoration of external rotation strength and range of motion, pain relief, low risk of complications, and reduced risk of revision compared with alternative procedures.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Understanding Health Inequalities Research Capacities: Insights and Recommendations From Comparing Two High Income Settings
Authors: Cash-Gibson Lucinda , Benach Joan
Published: February 2024

Generating evidence on health inequalities (HI) is necessary to raise awareness of these issues, describe and monitor their evolution, analyze their causes, and inform interventions aiming to improve health equity. Yet not all cities and countries have the capacity to produce this type of research. Recent research provides new contextual and causal insights into this research production process, and in-depth understanding on why and how this type of research is produced in certain settings. This article aims to analyze two recent case studies that have uniquely explored this process in two high producers of HI research and high-income country settings to identify learning and distil recommendations, which may be insightful for other settings. Expanding and investing in this line of research is critical, particularly in places with lower HI research output and related capacity, in order to identify key contextual conditions and mechanisms that may enable or hinder this process. This new knowledge could guide the development of new HI research capacity strengthening strategies to foster this research in different settings, worldwide. More understanding is also needed on the relationship between HI research, policy, and action in order to tackle HI.
Outcomes of subsequent antilymphoma therapies after second-line axicabtagene ciloleucel or standard of care in ZUMA-7
Authors: Ghobadi Armin , Munoz Javier , Westin Jason R. , Locke Frederick L. , Miklos David B. , Rapoport Aaron P. , Perales Miguel-Angel , Reagan Patrick M. , McGuirk Joseph , Jacobson Caron A. , Kersten Marie José , Avivi Irit , Peng Andrew , Schupp Marco , To Christina , Oluwole Olalekan O.
Published: February 2024

The optimal management of patients with relapsed/refractory large B-cell lymphoma (LBCL) after disease progression or lack of response to second-line (2L) therapy remains unclear. Here, we report outcomes among patients who received subsequent antilymphoma therapy per investigator discretion separately by their randomized 2L arm in ZUMA-7, namely axicabtagene ciloleucel (axi-cel) vs standard of care (SOC). Progression-free survival (PFS) and overall survival (OS) were calculated from 3L therapy initiation. In the SOC arm, 127 of 179 randomized patients (71%) received 3L therapy. Median PFS among those who received 3L cellular immunotherapy (n = 68) vs those who did not (n = 59) was 6.3 vs 1.9 months, respectively; median OS was 16.3 vs 9.5 months, respectively. In the axi-cel arm, 84 of 180 randomized patients (47%) received 3L therapy. Median PFS among those who received 3L chemotherapy (n = 60) vs cellular immunotherapy (n = 8) was 1.7 vs 3.5 months, respectively; median OS was 8.1 months vs not reached, respectively. Of the 60 patients who received 3L chemotherapy, 10 underwent stem cell transplantation (SCT) after salvage chemotherapy. Median PFS was 11.5 vs 1.6 months, and median OS was 17.5 vs 7.2 months for those who did vs did not reach SCT, respectively. Eight patients received 3L cellular immunotherapy after 2L axi-cel. Of these, 6 patients received subsequent SCT in any line; all 6 were alive at data cutoff. These findings help inform subsequent treatment choices after 2L therapy failure for relapsed/refractory LBCL. The trial was registered at www.clinicaltrials.gov as #NCT03391466.
Hypertension treatment for patients receiving ibrutinib: a multicenter retrospective study
Authors: Samples Laura , Voutsinas Jenna , Fakhri Bita , Khajavian Sirin , Spurgeon Stephen , Stephens Deborah , Skarbnik Alan , Mato Anthony , Broome Catherine , Gopal Ajay , Smith Stephen , Lynch Ryan , Rainey Magdalena , Kim Myung Sun , Barrett-Campbell Odeth , Hemond Emily , Tsang Mazie , Ermann Daniel , Malakhov Nikita , Rao Danielle , Shakib-Azar Mehrdad , Morrigan Beth , Chauhan Ayushi , Plate Thomas , Gooley Ted , Ryan Kellie , Lansigan Frederick , Hill Brian , Pongas Georgios , Parikh Sameer A. , Roeker Lindsey , Allan John N. , Cheng Richard , Ujjani Chaitra , Shadman Mazyar
Published: February 2024

Although Bruton tyrosine kinase inhibitors (BTKis) are generally well tolerated and less toxic than chemotherapy alternatives used to treat lymphoid malignancies, BTKis like ibrutinib have the potential to cause new or worsening hypertension (HTN). Little is known about the optimal treatment of BTKi-associated HTN. Randomly selected patients with lymphoid malignancies on a BTKi and antihypertensive drug(s) and with at least 3 months of follow-up data were sorted into 2 groups: those diagnosed with HTN before BTKi initiation (prior-HTN), and those diagnosed with HTN after BTKi initiation (de novo HTN). Generalized estimating equations assessed associations between time varying mean arterial pressures (MAPs) and individual anti-HTN drug categories. Of 196 patients included in the study, 118 had prior-HTN, and 78 developed de novo HTN. Statistically significant mean MAP reductions were observed in patients with prior-HTN who took β blockers (BBs) with hydrochlorothiazide (HCTZ), (−5.05 mmHg; 95% confidence interval [CI], 10.0 to −0.0596; P = .047), and patients diagnosed with de novo HTN who took either an angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) with HCTZ (−5.47 mmHg; 95% CI, 10.9 to −0.001; P = .05). These regimens also correlated with the greatest percentages of normotensive MAPs. Treatment of HTN in patients taking a BTKi is challenging and may require multiple antihypertensives. Patients with prior-HTN appear to benefit from combination regimens with BBs and HCTZ, whereas patients with de novo HTN appear to benefit from ACEi/ARBs with HCTZ. These results should be confirmed in prospective studies.
M1 cholinergic signaling in the brain modulates cytokine levels and splenic cell sub-phenotypes following cecal ligation and puncture
Authors: Abraham Mabel N. , Nedeljkovic-Kurepa Ana , Fernandes Tiago D. , Yaipen Omar , Brewer Mariana R. , Leisman Daniel E. , Taylor Matthew D. , Deutschman Clifford S.
Published: February 2024

Background

The contribution of the central nervous system to sepsis pathobiology is incompletely understood. In previous studies, administration of endotoxin to mice decreased activity of the vagus anti-inflammatory reflex. Treatment with the centrally-acting M1 muscarinic acetylcholine (ACh) receptor (M1AChR) attenuated this endotoxin-mediated change. We hypothesize that decreased M1AChR-mediated activity contributes to inflammation following cecal ligation and puncture (CLP), a mouse model of sepsis.

Methods

In male C57Bl/6 mice, we quantified basal forebrain cholinergic activity (immunostaining), hippocampal neuronal activity, serum cytokine/chemokine levels (ELISA) and splenic cell subtypes (flow cytometry) at baseline, following CLP and following CLP in mice also treated with the M1AChR agonist xanomeline.

Results

At 48 h. post-CLP, activity in basal forebrain cells expressing choline acetyltransferase (ChAT) was half of that observed at baseline. Lower activity was also noted in the hippocampus, which contains projections from ChAT-expressing basal forebrain neurons. Serum levels of TNFα, IL-1β, MIP-1α, IL-6, KC and G-CSF were higher post-CLP than at baseline. Post-CLP numbers of splenic macrophages and inflammatory monocytes, TNFα+ and ILβ+ neutrophils and ILβ+ monocytes were higher than baseline while numbers of central Dendritic Cells (cDCs), CD4+ and CD8+ T cells were lower. When, following CLP, mice were treated with xanomeline activity in basal forebrain ChAT-expressing neurons and in the hippocampus was significantly higher than in untreated animals. Post-CLP serum concentrations of TNFα, IL-1β, and MIP-1α, but not of IL-6, KC and G-CSF, were significantly lower in xanomeline-treated mice than in untreated mice. Post-CLP numbers of splenic neutrophils, macrophages, inflammatory monocytes and TNFα+ neutrophils also were lower in xanomeline-treated mice than in untreated animals. Percentages of IL-1β+ neutrophils, IL-1β+ monocytes, cDCs, CD4+ T cells and CD8+ T cells were similar in xanomeline—treated and untreated post-CLP mice.

Conclusion

Our findings indicate that M1AChR-mediated responses modulate CLP-induced alterations in serum levels of some, but not all, cytokines/chemokines and affected splenic immune response phenotypes.
Comparison of effectiveness and safety of lasmiditan and CGRP-antagonists for the acute treatment of migraine in adults: systematic review and network meta-analysis of randomised trials
Authors: Deng Xinxin , Zhou Liying , Liang Cui , Shang Xue , Hui Xu , Liu Wendi , Liang Shanshan , Wang Yongsheng , Xu Meng , Guo Kangle , Yang Kehu , Li Xiuxia
Published: February 2024

Objective

To compare the outcomes associated with the use of lasmiditan, rimegepant, ubrogepant, and zavegepant for the acute management of migraine headaches.

Methods

We searched four electronic databases from database inception to August 31, 2023, to identify randomized controlled trials (RCTs) that report efficacy and safety for the acute treatment of migraine. The risk of bias in the included RCTs was evaluated according to the Cochrane tool, and the certainty of evidence using the CINeMA approach. We conducted frequentist network meta-analyses (NMA) to summarise the evidence. Data were analyzed using R-4.3.1.

Results

A total of 18 eligible studies including 10 different types of interventions with 22,429 migraine patients were included. NMA results showed that compared to ubrogepant (25 mg and 50 mg) and zavegepant, lasmiditan (100 mg and 200 mg) exhibits an elevated probability of achieving pain relief within a 2-hour interval. Similarly, relative to zavegepant, rimegepant (75 mg) and ubrogepant (50 mg and 100 mg) demonstrate an enhanced likelihood of sustaining pain relief over a 24-hour period. Furthermore, in contrast to ubrogepant (25 mg) and lasmiditan (50 mg), rimegepant (75 mg) presents a heightened probability of achieving freedom from photophobia within 2 h. Regarding safety, lasmiditan carries the highest risk of adverse events, which are associated with an increased incidence of adverse effects, including dizziness, somnolence, asthenia, paresthesia, and fatigue.

Conclusions

In this NMA, a spectrum of evidence ranging from very low to high levels underscores the favorable efficacy and tolerability of rimegepant 75 mg and ubrogepant 100 mg, positioning them as potential candidates for the acute management of migraine. Concurrently, lasmiditan (100 mg and 200 mg) exhibits notable efficacy, albeit accompanied by an increased susceptibility to adverse events. These findings should still be approached with caution, primarily due to the intrinsic limitations associated with indirect comparisons.
Actualizing sustainable transport: the interplay between public policy instruments and shared mobility providers’ business models
Authors: Kriukelyte Erika , Sochor Jana , Kramers Anna
Published: February 2024

Cities around the world are trying to understand if and how to regulate urban mobility in a way that stimulates innovation and supports business while also promoting public values and accelerating a sustainability transition. Service providers are also attempting to understand how to grow and thrive as a business as they challenge existing urban mobility structures and practices via new mobility services, new uses of public space, etc. Thus, this article seeks to understand the interplay between business models and public policies and, ultimately, the implications policy instruments have on shaping conditions for sustainable urban mobility. To address these questions, a qualitative approach is utilized, comprising case studies of two ‘new mobility’ service providers (Bolt and Tier) operating in three Northern European cities (Oslo, Stockholm, and Berlin) including interviews with these companies and local public actors. Findings show that the business models are influenced by legitimization on the national level, the local authorities’ and service providers’ approaches, and policy instruments related to the right to operate, including caps, geographic coverage, parking, geofencing, and data sharing. Utilizing business models and multi-level perspectives, the findings are discussed in relation to actualizing sustainable transport, e.g. interdependencies, goal alignment, and temporal and spatial considerations. The authors emphasize the importance of learning by doing, policy mixes (versus instruments), and purpose-driven collaboration among stakeholders.
Development of a coding SNP panel for tracking the origin of whole-exome sequencing samples
Authors: Huang Yong , Xiao Yuanyuan , Qu Shengqiu , Xue Jiaming , Zhang Lin , Wang Li , Liang Weibo
Published: February 2024

Whole-exome sequencing (WES) is widely used to diagnose complex genetic diseases and rare conditions. The implementation of a robust and effective quality control system for sample identification and tracking throughout the WES process is essential. We established a multiplex panel that included 22 coding single-nucleotide polymorphism (cSNP) loci. The personal identification and paternity identification abilities of the panel were evaluated, and a preliminary validation of the practical feasibility of the panel was conducted in a clinical WES case. These results indicate that the cSNP panel could be a useful tool for sample tracking in WES.
Natural genetic variation in GLK1-mediated photosynthetic acclimation in response to light
Authors: Muino Jose M. , Großmann Christopher , Kleine Tatjana , Kaufmann Kerstin
Published: February 2024

Background

GOLDEN-like (GLK) transcription factors are central regulators of chloroplast biogenesis in Arabidopsis and other species. Findings from Arabidopsis show that these factors also contribute to photosynthetic acclimation, e.g. to variation in light intensity, and are controlled by retrograde signals emanating from the chloroplast. However, the natural variation of GLK1-centered gene-regulatory networks in Arabidopsis is largely unexplored.

Results

By evaluating the activities of GLK1 target genes and GLK1 itself in vegetative leaves of natural Arabidopsis accessions grown under standard conditions, we uncovered variation in the activity of GLK1 centered regulatory networks. This is linked with the ecogeographic origin of the accessions, and can be associated with a complex genetic variation across loci acting in different functional pathways, including photosynthesis, ROS and brassinosteroid pathways. Our results identify candidate upstream regulators that contribute to a basal level of GLK1 activity in rosette leaves, which can then impact the capacity to acclimate to different environmental conditions. Indeed, accessions with higher GLK1 activity, arising from habitats with a high monthly variation in solar radiation levels, may show lower levels of photoinhibition at higher light intensities.

Conclusions

Our results provide evidence for natural variation in GLK1 regulatory activities in vegetative leaves. This variation is associated with ecogeographic origin and can contribute to acclimation to high light conditions.
Effective dose of propofol combined with intravenous esketamine for smooth flexible laryngeal mask airway insertion in two distinct age groups of preschool children
Authors: Zhang Bin , Li Mingzhuo , Han Yuejiao , Zhao Xianliang , Duan Chunhong , Wang Junxia
Published: February 2024

Background

There is limited research on the combined use of propofol and esketamine for anesthesia induction during flexible laryngeal mask airway (FLMA) in pediatric patients, and the effective dosage of propofol for FLMA smooth insertion remains unclear. We explored the effective dose of propofol combined with intravenous esketamine for the smooth insertion of FLMA in two distinct age groups of preschool children.

Methods

This is a prospective, observer-blind, interventional clinical study. Based on age, preschool children scheduled for elective surgery were divided into group A (aged 1–3 years) and group B (aged 3–6 years). Anesthesia induction was started with intravenous administration of esketamine (1.0 mg.kg− 1) followed by propofol administration. The FLMA was inserted 2 min after propofol administration at the target dose. The initial dose of propofol in group A and group B was 3.0 mg.kg− 1 and 2.5 mg.kg− 1, respectively. The target dose of propofol was determined with Dixon’s up-and-down method, and the dosing interval of propofol was 0.5 mg.kg− 1. If there was smooth insertion of FLMA in the previous patient, the target dose of propofol for the next patient was reduced by 0.5 mg.kg− 1; otherwise, it was increased by 0.5 mg.kg− 1. The median 50% effective dose (ED50) for propofol was estimated using Dixon’s up-and-down method and Probit analysis, while the 95% effective dose (ED95) was estimated through Probit analysis. Vital signs and adverse events during induction were recorded.

Results

Each group included 24 pediatric patients. Using Dixon’s up-and-down method, the ED50 of propofol combined with esketamine for smooth insertion of FLMA in group A was 2.67 mg.kg− 1 (95%CI: 1.63–3.72), which was higher than that in group B (2.10 mg. kg− 1, 95%CI: 1.36–2.84) (p = 0.04). Using Probit analysis, the ED50 of propofol was calculated as 2.44 (95% CI: 1.02–3.15) mg.kg− 1 in group A and 1.93 (95% CI: 1.39–2.32) mg.kg− 1 in group B. The ED95 of propofol was 3.72 (95%CI: 3.07–15.18) mg.kg− 1 in group A and 2.74 (95%CI: 2.34–5.54) mg.kg− 1 in group B. In Group B, one pediatric patient experienced laryngospasm.

Conclusion

The effective dose of propofol when combined with intravenous esketamine for smooth insertion of FLMA in children aged 1–3 years is 2.67 mg.kg− 1, which is higher than that in children aged 3–6 years (2.10 mg. kg− 1).

Trial registration

Chinese Clinical Trial Registry Center (Registration Number: ChiCTR2100044317; Registration Date: 2021/03/16)
Knowledge, attitudes and beliefs toward polypharmacy among older people attending Family Medicine Clinic, Nairobi, Kenya
Authors: Kamau Maureen , Nyanja Njeri , Lusambili Adelaide M. , Shabani Jacob , Mohamoud Gulnaz
Published: February 2024

Background

Life expectancy has increased over the last century among older people, particularly those aged over 60 years. Aging is associated with increased disability, multiple chronic conditions, and increased use of health services managed with polypharmacy. There are few studies on polypharmacy and aging in sub-Saharan Africa, and it is unclear what older people know and their attitudes toward polypharmacy. This paper presents findings from a study that aimed to understand older people’s knowledge, attitudes and beliefs about polypharmacy.

Methods

A qualitative study using in-depth interviews of 15 patients aged 60 years and older who were taking more than five medications per day. The study was conducted at the Family Medicine Clinic (FMC), Aga Khan University Hospital, Nairobi. Data were analyzed using NVivo 12 software.

Result

Majority of participants had a good understanding of their underlying health conditions, but they did not know the specific names of the medications they were taking. Participants had diverse attitudes toward polypharmacy, with both positive and negative perceptions. Although adverse side effects were reported, participants remained positive because they believed these medicines were beneficial. Religion, faith and living healthy lifestyles were perceived to contribute to their positive attitude toward polypharmacy. Stigma and the cost of medication were reported as barriers.

Conclusion

This study provides valuable insights into the complexities of polypharmacy in older people. It highlights the importance of patient education, fostering strong patient-provider relationships, de-stigmatization, and improving medication affordability and accessibility. Further research could explore the polypharmacy of older people attending public institutions in rural Kenya.
The experience of bearing a child: implications on body boundaries and their link to preterm birth
Authors: Spaegele Nina , Ditzer Julia , Rodrigues Mariana , Talmon Anat
Published: February 2024

Background

Preterm birth, which occurs when a baby is born before 37 weeks, has enormous implications for public health. It is the leading cause of infant death and mortality in children under the age of five. Unfortunately, the multifaceted causes of preterm birth are not fully understood. One construct that has received increasing attention in women’s transition to motherhood is body boundaries, i.e., the metaphorical barriers that separate the self from the outer, surrounding “not self.” This study aims to examine the role of well-defined and disturbed body boundaries in predicting preterm birth.

Methods

A sample of 655 Israeli pregnant women reported their sense of body boundaries (BBS, as measured by the Sense of Body Boundaries Survey) pre- and postnatally. We performed a General Linear Model (GLM) testing the effect of the BBS total score on the days women delivered before their due date and controlling for whether it was the women’s first child.

Results

Our GLMs controlling for whether it was the women’s first child showed that the BBS total mean exhibited a significant predictive effect on the number of days delivered before the due date (F(57,313) = 3.65, p < .001).

Conclusions

These results demonstrate heterogeneity in women’s sense of body boundaries during pregnancy and are the first to disentangle a link between disturbed body boundaries and preterm birth. Mediating mechanisms in this relation, e.g., psychosocial stress, as well as clinical implications are discussed in detail.
The prevalence and comorbidity of mental health and substance use disorders in Scandinavian prisons 2010–2019: a multi-national register study
Authors: Bukten Anne , Virtanen Suvi , Hesse Morten , Chang Zheng , Kvamme Timo Lehmann , Thylstrup Birgitte , Tverborgvik Torill , Skjærvø Ingeborg , Stavseth Marianne R.
Published: February 2024

Background

Mental health disorders are common among people in prison, but their prevalence in the Scandinavian prison population remain unclear. In this multinational register study, we examined the prevalence of mental health disorders and the comorbidity of substance use disorders (SUDs) with other mental health disorders in this population. Further, we investigated how the prevalence of mental disorders at prison entry had changed in Norway, Denmark, and Sweden over the study period.

Methods

The three study cohorts included all individuals, aged 19 or older, whom had been imprisoned in Norway (2010–2019), Denmark (2011–2018), and Sweden (2010–2013). Mental disorders were defined as ICD-10 diagnoses (F-codes) registered in the national patient registers. The study prevalence was estimated based on recorded diagnoses during the entire study follow-up period in each respective country. The one-year prevalence of mental disorders was estimated for each calendar year for individuals entering prison during that year.

Results

The Scandinavian prison cohorts included 119 507 individuals released 191 549 times during the study period. Across all three countries a high proportion of both women (61.3%-74.4%) and men (49.6%-57.9%) had at least one mental health disorder during the observation period. The most prevalent disorders were SUDs (39.1%-44.0%), depressive disorder (8.1%-17.5%), and stress related disorder (8.8%-17.1%). Women (31.8%-41.1%) had higher levels of mental health and substance use comorbidities compared to men (20.8%-27.6%). The one-year prevalence of any mental health disorder increased over time with a 33% relative increase in Norway, 8% in Denmark, and 10% in Sweden. The proportion of individuals entering prison with a comorbid SUD and other mental disorder had also increased.

Conclusions

While the incarceration rate has been decreasing during the past decade in the Scandinavian countries, an increasing proportion of people entering prison have a diagnosed mental health disorder. Our results suggest that prisons should provide adequate treatment and scale up services to accommodate the increasing proportion of people with complex health needs among incarcerated people.
SARS-CoV-2 seroprevalence and associated factors of infection before and after the Delta wave in French Polynesia: a cross-sectional study
Authors: Mendiboure Vincent , Teiti Iotefa , Aubry Maite , Teissier Anita , Paoaafaite Tuterarii , Vanhomwegen Jessica , Manuguerra Jean-Claude , Fontanet Arnaud , Cao-Lormeau Van-Mai , Madec Yoann
Published: February 2024

Background

French Polynesia (FP) comprises 75 inhabited islands scattered across five archipelagos. Between July and October 2021, the SARS-CoV-2 Delta variant triggered a much stronger second epidemic wave in FP than the original Wuhan strain, which was dominant from August 2020 to March 2021. Although previous seroprevalence surveys made it possible to determine the proportion of the population infected by SARS-CoV-2 on the two most populated islands (Tahiti and Moorea) after the first (20.6% in Tahiti and 9.4% in Moorea) and second (57.7% in Tahiti) epidemic waves, no data are available for more remote islands. We used blood samples and personal data collected before, during, and after the second wave from inhabitants of several islands within the five archipelagos to assess the prevalence of SARS-CoV-2 infections and identify associated factors.

Methods

Blood samples and personal data were collected between April and December 2021 as part of the MATAEA study, a cross-sectional survey conducted on a random sample of the adult population representative of the five FP archipelagos and stratified by age and gender. IgG antibodies targeting the SARS-CoV-2 nucleocapsid (N) protein were detected using a recombinant antigen-based microsphere immunoassay. Factors associated with anti-SARS-CoV-2-N seropositivity were identified using logistic regression models.

Results

Of 1,120 participants, 503 (44.9%) tested positive for anti-SARS-CoV-2-N antibodies, corresponding to a weighted prevalence of 56.8% for the FP population aged 18–69 years. The seroprevalence increased from 21.9% to 62.1% before and during/after the Delta wave. Of these infections, only 28.4% had been diagnosed by health professionals. The odds of being seropositive were lower in males, participants recruited before the Delta wave, those who had never been married, those with a diagnosed respiratory allergy, smokers, and those vaccinated against COVID-19.

Conclusions

Our results confirm the high impact of the Delta wave in FP. By the end of 2021, 56.8% of the FP population aged 18–69 years had been infected by SARS-CoV-2; the majority of these infections went undetected. Individuals with respiratory allergies were found to be less susceptible to SARS-CoV-2 infection.
Configurational paths to turnover intention among primary public health workers in Liaoning Province, China: a fuzzy-set qualitative comparative analysis
Authors: Li Xueying , Yang Chenxin , Liu Libing , Ding Yuanlu , Xue Jianchun , He Jiani , Wu Hui , Liu Li
Published: February 2024

Background

A stable public health workforce plays an indispensable role in the realization of the goal of health for all. However, there is an exodus of public health workers from the Centers for Disease Control and Prevention (CDC). Given the limited evidence on the mechanisms shaping turnover intention (TI) among public health workers, the study aims to investigate the triggering mechanisms of high and low turnover intention by combining job demands, job resources, and personal resources through a set theory perspective based on the Job-Demand-Resources (JD-R) model.

Methods

The cross-sectional study was conducted from September 7 to 18, 2020 at district (county) level CDC in Liaoning Province, China. A total of 584 public health professionals were included. Overcommitment, effort, social respect, occupational identity, job rewards, self-efficacy, and psychological resilience were included in the study as configuration factors. The data were gathered through an online questionnaire and were analyzed using multiple regression and fuzzy-set Qualitative Comparative Analysis (fsQCA).

Results

Social respect (B = -0.682, P < 0.001), occupational identity (B = -0.168, P < 0.001), and effort (B = 0.114, P < 0.001) were associated with turnover intention. Five configurations for high turnover intention and five for low turnover intention were obtained through the fsQCA, with occupational identity and effort playing an essential role in all pathways. Moreover, the configurations for low turnover intention are not the antithesis of the configurations for high turnover intention.

Conclusion

Managers should synthesize the combined effects of factors when implementing interventions and formulating policies. Given the vital role of occupational identity and effort, mechanisms for the rational distribution of work to avoid excessive efforts and measures to promote occupational identity should be implemented to reduce the turnover intentions of primary public health workers and encourage their intention to stay.
The triad of physiological challenges: investigating the intersection of sarcopenia, malnutrition, and malnutrition-sarcopenia syndrome in patients with COPD - a cross-sectional study
Authors: Yogesh M. , Patel Jenish , Makwana Naresh , Mody Mansi
Published: February 2024

Background

One of the most prevalent respiratory disorders in modern society is chronic obstructive pulmonary disease (COPD). Frequent comorbidities in patients with COPD are abnormal nutritional status and body composition variations. Malnutrition-sarcopenia syndrome, which occurs when the 2 conditions – malnutrition and sarcopenia – coexist, raises the risk of death more than either condition alone. The current study sought to determine the prevalence of malnutrition, sarcopenia, and malnutrition-sarcopenia syndrome in patients with COPD as well as the association between these diseases and the severity of COPD.

Methods

The study was an analytical cross-sectional study conducted on hospitalized patients with COPD. The sample size of the study was calculated to be 160. A self-structured questionnaire was used to collect the data, containing sociodemographic characteristics, clinical profiles, anthropometric assessment, and bioimpedance indices. Sarcopenia was diagnosed with low muscle strength and muscle mass by the EWGSOP2 recommendations. Muscle mass is measured by BIA and muscle strength (Handgrip) was measured by a Hand Dynamometer. Assessment of the risk of malnutrition was performed using the Mini Nutritional Assessment-Short Form questionnaire and was confirmed by GLIM criteria. The COPD assessment test (CAT) tool determined the severity of the condition. For the data analysis, comparisons were made using Student’s t test and Mann–Whitney test in bivariate analysis. Multivariate logistic regression analyses were performed considering the outcomes of patients with COPD by CAT scores, prolonged length of stay, and hospital readmission 6 months after discharge.

Results

The mean age of the participants was 48 ± 5 years. Approximately 61.9% were found to be sarcopenic. Approximately 45.6% of participants had malnutrition. Malnutrition sarcopenia syndrome was diagnosed in 32.5% of patients. The study analysis revealed that patients with COPD with malnutrition-sarcopenia syndrome had more than twice the odds of prolonged hospital stay, re-admission within 6 months, and higher CAT scores.

Conclusion

The study revealed a high prevalence of sarcopenia, malnutrition, and malnutrition sarcopenia syndrome in patients with COPD. These conditions were found to be statistically significant with prolonged length of stay, re-admission within 6 months, and CAT scores. The findings highlight the importance of addressing these conditions as part of the management of the patients.
The effect of virtual reality on reducing patients’ anxiety and pain during dental implant surgery
Authors: Ghobadi Alireza , Moradpoor Hedaiat , Sharini Hamid , Khazaie Habibolah , Moradpoor Pooya
Published: February 2024

Background

Dental anxiety and pain pose serious problems for both patients and dentists. One of the most stressful and frightening dental procedures for patients is dental implant surgery; that even hearing its name causes them stress. Virtual reality (VR) distraction is an effective intervention used by healthcare professionals to help patients cope with unpleasant procedures. Our aim is to evaluate the use of high-quality VR and natural environments on dental implant patients to determine the effect on reducing pain and anxiety.

Methods

Seventy-three patients having two dental implant surgeries participated in a randomized controlled trial. One surgery was with VR, and one was without. Anxiety was measured with the the State-Trait Anxiety Inventory and the Modified Dental Anxiety Scale tests. The pain was measured with the Numerical Rating Scales. Patient satisfaction, surgeon distress, memory vividness, and time perception were evaluated. Physiological data were collected with biofeedback and neurofeedback device.

Results

VR effectively reduced anxiety and pain compared to no VR. Physiological data validated the questionnaire results. Patient satisfaction increased, with 90.4% willing to reuse VR. VR reduced time perception and memory vividness.

Conclusion

Psychometric and psychophysiological assessments showed that VR successfully reduced patient pain and anxiety. More dental clinicians should use VR technology to manage patient anxiety and pain.
Oral health, dental treatment, and medication related osteonecrosis of the jaw in multiple myeloma – a longitudinal cohort study
Authors: Olofsson Richard , Korytowska Magdalena , Almhöjd Ulrica , Almståhl Annica , Cevik-Aras Hülya
Published: February 2024

Objective

The objective of the present study was to investigate oral health status, oral health related quality of life, and identify risk factors associated with invasive dental treatment and medication related osteonecrosis of the jaw in patients with multiple myeloma.

Material and methods

Patients newly diagnosed with multiple myeloma (n = 144) referred between January 2015 and September 2022 were retrospectively included. The patients underwent a thorough clinical and radiological oral examination and odontogenic infections were treated before the start of bisphosphonate treatment. The patients were followed annually, including clinical and radiological examinations. The oral health related quality of life was investigated by the OHIP-14 questionnaire.

Results

Dental treatment (RR = 7.75), receiving combination antineoplastic therapy≥3 (RR =4.13), periodontitis (RR = 4.21), and reduced number of teeth (RR = 2.87) were associated with an increased risk of medication related osteonecrosis of the jaw. The response rate of the OHIP-14 questionnaire was 70.2%. Oral pain or discomfort in the mouth related to the medical treatment was reported by 30.5%.

Conclusion

Dental screening and treatment planning in patients with Multiple Myeloma may result in fewer oral infections and fewer interruptions of the medical treatment of myeloma.
Would you like to be a general practitioner? Baseline findings of a longitudinal survey among Danish medical trainees
Authors: Gjessing Sofie , Guldberg Trine Lignell , Risør Torsten , Skals Regitze Gyldenholm , Kristensen Jette Kolding
Published: February 2024

Background

Recruiting and securing primary care physician workforce has been the center of international attention for decades. In Denmark, the number of general practitioners has decreased by 8.5% since 2013. However, a rising population age and increasing prevalence of chronic diseases and multimorbidity place an even greater future need for general practitioners in Denmark. The choice of general practice as specialty has been associated with a range of both intrinsic and extrinsic factors, however, few studies have examined the recruitment potential that lies within medical trainees’ who are undecided about general practice specialization. The aim of this study was, therefore, to explore how medical trainees who are undecided about general practice specialization (GP-positive/undecided) differ from medical trainees who are either committed (GP-committed) or not committed to a general practice career (GP-non-committed) regarding factors related to future work life.

Methods

The present study concerns baseline findings from a longitudinal survey study. An online questionnaire was e-mailed to a national cohort of medical trainees during their transition from under- to postgraduate education. The associations between orientations towards general practice specialization and work-related factors and potential influencing factors, respectively, were analyzed using uni- and multivariable modified Poisson regression models.

Results

Of 1,188 invited participants, 461 filled out key study variables concerning specialty preferences and rejections, corresponding to a response rate of 38.8%. We found significant positive associations between GP-positive/undecided orientation and valuing a good work/life balance and the opportunity to organize own working hours when compared to GP-non-committed respondents. Compared to the GP-committed orientations, the GP-positive/undecided orientation was associated with a positive attitude towards technology, working shift hours, and an openness towards several career paths. Across all orientations, undergraduate exposure to the specialties was found to be highly influential on the specialty preferences.

Conclusion

GP-positive/undecided medical trainees value autonomy over their working hours more than the GP-non-committed, but less than the GP-committed. However, the GP-positive/undecided respondents present more openness to different career opportunities and the use of technology in daily work. We suggest using this knowledge in the planning of recruitment strategies aiming to increase interest in general practice specialization.
PCDHGB7 hypermethylation-based Cervical cancer Methylation (CerMe) detection for the triage of high-risk human papillomavirus-positive women: a prospective cohort study
Authors: Cao Dan , Yang Zhicong , Dong Shihua , Li Yuhong , Mao Zhanrui , Lu Qi , Xu Peng , Shao Minfang , Pan Lei , Han Xu , Yuan Jiangjing , Fan Qiong , Chen Lei , Wang Yanzhong , Zhu Weipei , Yu Wenqiang , Wang Yudong
Published: February 2024

Background

Implementation of high-risk human papillomavirus (hrHPV) screening has greatly reduced the incidence and mortality of cervical cancer. However, a triage strategy that is effective, noninvasive, and independent from the subjective interpretation of pathologists is urgently required to decrease unnecessary colposcopy referrals in hrHPV-positive women.

Methods

A total of 3251 hrHPV-positive women aged 30–82 years (median = 41 years) from International Peace Maternity and Child Health Hospital were included in the training set (n = 2116) and the validation set (n = 1135) to establish Cervical cancer Methylation (CerMe) detection. The performance of CerMe as a triage for hrHPV-positive women was evaluated.

Results

CerMe detection efficiently distinguished cervical intraepithelial neoplasia grade 2 or worse (CIN2 +) from cervical intraepithelial neoplasia grade 1 or normal (CIN1 −) women with excellent sensitivity of 82.4% (95% CI = 72.6 ~ 89.8%) and specificity of 91.1% (95% CI = 89.2 ~ 92.7%). Importantly, CerMe showed improved specificity (92.1% vs. 74.9%) in other 12 hrHPV type-positive women as well as superior sensitivity (80.8% vs. 61.5%) and specificity (88.9% vs. 75.3%) in HPV16/18 type-positive women compared with cytology testing. CerMe performed well in the triage of hrHPV-positive women with ASC-US (sensitivity = 74.4%, specificity = 87.5%) or LSIL cytology (sensitivity = 84.4%, specificity = 83.9%).

Conclusions

PCDHGB7 hypermethylation-based CerMe detection can be used as a triage strategy for hrHPV-positive women to reduce unnecessary over-referrals.

Trial registration

ChiCTR2100048972. Registered on 19 July 2021.
Artificial intelligence in the risk prediction models of cardiovascular disease and development of an independent validation screening tool: a systematic review
Authors: Cai Yue , Cai Yu-Qing , Tang Li-Ying , Wang Yi-Han , Gong Mengchun , Jing Tian-Ci , Li Hui-Jun , Li-Ling Jesse , Hu Wei , Yin Zhihua , Gong Da-Xin , Zhang Guang-Wei
Published: February 2024

Background

A comprehensive overview of artificial intelligence (AI) for cardiovascular disease (CVD) prediction and a screening tool of AI models (AI-Ms) for independent external validation are lacking. This systematic review aims to identify, describe, and appraise AI-Ms of CVD prediction in the general and special populations and develop a new independent validation score (IVS) for AI-Ms replicability evaluation.

Methods

PubMed, Web of Science, Embase, and IEEE library were searched up to July 2021. Data extraction and analysis were performed for the populations, distribution, predictors, algorithms, etc. The risk of bias was evaluated with the prediction risk of bias assessment tool (PROBAST). Subsequently, we designed IVS for model replicability evaluation with five steps in five items, including transparency of algorithms, performance of models, feasibility of reproduction, risk of reproduction, and clinical implication, respectively. The review is registered in PROSPERO (No. CRD42021271789).

Results

In 20,887 screened references, 79 articles (82.5% in 2017–2021) were included, which contained 114 datasets (67 in Europe and North America, but 0 in Africa). We identified 486 AI-Ms, of which the majority were in development (n = 380), but none of them had undergone independent external validation. A total of 66 idiographic algorithms were found; however, 36.4% were used only once and only 39.4% over three times. A large number of different predictors (range 5–52,000, median 21) and large-span sample size (range 80–3,660,000, median 4466) were observed. All models were at high risk of bias according to PROBAST, primarily due to the incorrect use of statistical methods. IVS analysis confirmed only 10 models as “recommended”; however, 281 and 187 were “not recommended” and “warning,” respectively.

Conclusion

AI has led the digital revolution in the field of CVD prediction, but is still in the early stage of development as the defects of research design, report, and evaluation systems. The IVS we developed may contribute to independent external validation and the development of this field.