bluuebunny/crossref_metadata_2025 huggingface dataset:
Islam’s weight in global history: A response to Sidaway
Authors: Llopart i Olivella Pol , Mostowlansky Till
Published: May 2023

In this commentary, we discuss three major themes that Sidaway raises in his article, ‘Beyond the Decolonial: Critical Muslim Geographies’: the problem of Muslims as ‘others’; the fraught role of religion as a universal category; and Muslim geographies as perceived in area studies and global history. Along these lines, we argue that Sidaway makes a number of important interventions aimed at changing the social science focus on Muslims in the West, highlighting the importance of Islamic concepts, and dislocating spaces of Islam from predefined geographical areas. After a critical discussion of the specific approaches presented in the article, we follow up on Sidaway's encouragement to think beyond the decolonial. We see this as an invitation to formulate our own vision of a new global history of Islam that takes into account traces of the influence of Muslims and of Islam more broadly speaking from Indigenous Australia to China to the Americas, and from everyday culture in Europe to extinct empires in Iberia, Sicily, and the Balkans. From this perspective, we argue, a more serious engagement with the multitude of global Islamic influences beyond Muslim communities might turn into a powerful force of decolonization.
Intersectional Research as a Methodology for Shaping Transition Research in Support of Equitable Postschool Outcomes
Authors: Trainor Audrey A. , Romano Lindsay
Published: May 2023

Disparities in postschool outcomes between student groups associated with intersecting historical marginalizations such as ableism, racism, classism, and linguicism remain stark. Critical research methods have contributed to the development of equity-focused research. In this conceptual paper, we examine intersectional research, one critical methodology focused on equity. In a recent study of postsecondary transitions of multilingual students with disabilities in the northeastern United States, we found this methodology to be productive in examining marginalization and equitable transition outcomes. First, we define intersectionality and provide a rationale for its use. We then share foundational claims of intersectional research, and we provide illustrative examples from our study. The discussion identifies implementation strategies. Last, we share implications such as tensions, benefits, and insights from our application and the extant literature.
China's adherence to international human rights treaties: An empirical assessment
Authors: Song Esther E. , Yang Joanne
Published: May 2023

Despite China's growing participation and accession to international human rights treaties, there exists a wide perception that China violates international human rights norms. When empirically assessing whether China adheres to international human rights norms outlined in international human rights law, we find that there is variation across treaties and across time—China shows relatively higher adherence to norms pertaining to gender equality, economic rights, social and cultural rights, compared to rights to freedom from torture. Improvements in adherence to gender equality, economic rights, social and cultural rights have shown relative improvement over time compared to rights to freedom from torture due to previous efforts to improve welfare under Hu-Wen administration (2002–2012). We additionally find that the variation in adherence across treaties stems from China's distinct human rights norms, which prioritize economic development and national sovereignty over indivisibility of human rights. Our findings contribute to furthering existing understanding of China's relationship with the international human rights regime.
Partial Humeral Head Arthroplasty, Glenoid Allograft Augmentation, and Open Bankart Reconstruction for Critical Glenoid Bone Loss and Engaging Hill-Sachs Lesion
Authors: Young Bradley L. , Karas Spero G.
Published: May 2023

Background:

Shoulder instability with critical bipolar bone loss can be difficult to treat. Anterior glenoid bone block augmentation and partial humeral head resurfacing is a viable option.

Indications:

This procedure is indicated in patients with both critical anterior glenoid bone loss (≥20%) and an engaging Hill-Sachs lesion.

Technique Description:

A deltopectoral approach is performed, followed by a subscapularis tenotomy. The Hill-Sachs lesion is resurfaced with a partial humeral head arthroplasty. The anterior glenoid bone loss is replaced with a prefabricated allograft. An open Bankart repair is then performed.

Results:

Three case reports give evidence that this technique is a viable surgical option for patients with critical glenoid bone loss and an engaging Hill-Sachs lesion.

Discussion/Conclusion:

Partial humeral head resurfacing, glenoid allograft augmentation, and open Bankart is a viable surgical option for patients with critical anterior glenoid bone loss and an engaging Hill-Sachs lesion.

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.
Real-world experience with low-dose IL-2 for children and young adults with refractory chronic graft-versus-host disease
Authors: Wobma Holly , Kapadia Malika , Kim Haesook T. , Alvarez-Calderon Francesca , Baumeister Susanne H. C. , Duncan Christine , Forrest Suzanne , Gorfinkel Lev , Huang Jennifer , Lehmann Leslie E. , Li Hojun , Schwartz Marc , Koreth John , Ritz Jerome , Kean Leslie S. , Whangbo Jennifer S.
Published: May 2023

The majority of patients with chronic graft-versus-host disease (cGVHD) are steroid refractory (SR), creating a need for safe and effective therapies. Subcutaneous low-dose interleukin-2 (LD IL-2), which preferentially expands CD4+ regulatory T cells (Tregs), has been evaluated in 5 clinical trials at our center with partial responses (PR) in ∼50% of adults and 82% of children by week 8. We now report additional real-world experience with LD IL-2 in 15 children and young adults. We conducted a retrospective chart review of patients with SR-cGVHD at our center who received LD IL-2 from August 2016 to July 2022 not on a research trial. The median age at start of LD IL-2 was 10.4 years (range, 1.2-23.2 years) at a median of 234 days from cGVHD diagnosis (range, 11-542 days). Patients had a median of 2.5 (range, 1-3) active organs at LD IL-2 start and received a median of 3 (range, 1-5) prior therapies. The median duration of LD IL-2 therapy was 462 days (range, 8-1489 days). Most patients received 1 × 106 IU/m2 per day. There were no serious adverse effects. The overall response rate in 13 patients who received >4 weeks of therapy was 85% (complete response, n = 5; PR, n = 6) with responses in diverse organs. Most patients significantly weaned corticosteroids. Tregs preferentially expanded with a median peak fold increase of 2.8 in the ratio of Tregs to CD4+ conventional T cells (range, 2.0-19.8) by 8 weeks on therapy. LD IL-2 is a well-tolerated, steroid-sparing agent with a high response rate in children and young adults with SR-cGVHD.
MAF functions as a pioneer transcription factor that initiates and sustains myelomagenesis
Authors: Katsarou Alexia , Trasanidis Nikolaos , Ponnusamy Kanagaraju , Kostopoulos Ioannis V. , Alvarez-Benayas Jaime , Papaleonidopoulou Foteini , Keren Keren , Sabbattini Pierangela M. R. , Feldhahn Niklas , Papaioannou Maria , Hatjiharissi Evdoxia , Sudbery Ian M. , Chaidos Aristeidis , Caputo Valentina S. , Karadimitris Anastasios
Published: May 2023

Deregulated expression of lineage-affiliated transcription factors (TFs) is a major mechanism of oncogenesis. However, how the deregulation of nonlineage affiliated TF affects chromatin to initiate oncogenic transcriptional programs is not well-known. To address this, we studied the chromatin effects imposed by oncogenic MAF as the cancer-initiating driver in the plasma cell cancer multiple myeloma. We found that the ectopically expressed MAF endows myeloma plasma cells with migratory and proliferative transcriptional potential. This potential is regulated by the activation of enhancers and superenhancers, previously inactive in healthy B cells and plasma cells, and the cooperation of MAF with the plasma cell-defining TF IRF4. Forced ectopic MAF expression confirms the de novo ability of oncogenic MAF to convert transcriptionally inert chromatin to active chromatin with the features of superenhancers, leading to the activation of the MAF-specific oncogenic transcriptome and the acquisition of cancer-related cellular phenotypes such as CCR1-dependent cell migration. These findings establish oncogenic MAF as a pioneer transcription factor that can initiate as well as sustain oncogenic transcriptomes and cancer phenotypes. However, despite its pioneer function, myeloma cells remain MAF-dependent, thus validating oncogenic MAF as a therapeutic target that would be able to circumvent the challenges of subsequent genetic diversification driving disease relapse and drug resistance.
Physiological and molecular response and tolerance of Macleaya cordata to lead toxicity
Authors: Zhang Hongxiao , Hu Linfeng , Du Xinlong , Sun Xijing , Wang Ting , Mu Zhiying
Published: May 2023

Background

Macleaya cordata is a traditional medicinal herb, and it has high tolerance and accumulation ability to heavy metals, which make it a good candidate species for studying phytoremediation. The objectives of this study were to investigate response and tolerance of M. cordata to lead (Pb) toxicity based on comparative analysis of transcriptome and proteome.

Results

In this study, the seedlings of M. cordata cultured in Hoagland solution were treated with 100 µmol·L− 1 Pb for 1 day (Pb 1d) or 7 days (Pb 7d), subsequently leaves of M. cordata were taken for the determination of Pb accumulation and hydrogen peroxide production (H2O2), meanwhile a total number of 223 significantly differentially expressed genes (DEGs) and 296 differentially expressed proteins (DEPs) were screened between control and Pb treatments. The results showed leaves of M. cordata had a special mechanism to maintain Pb at an appropriate level. Firstly, some DEGs were iron (Fe) deficiency-induced transporters, for example, genes of vacuolar iron transporter and three ABC transporter I family numbers were upregulated by Pb, which can maintain Fe homeostasis in cytoplasm or chloroplast. In addition, five genes of calcium (Ca2+) binding proteins were downregulated in Pb 1d, which may regulate cytoplasmic Ca2+ concentration and H2O2 signaling pathway. On the other hand, the cysteine synthase upregulated, glutathione S-transferase downregulated and glutathione reductase downregulated in Pb 7d can cause reduced glutathione accumulation and decrease Pb detoxification in leaves. Furthermore, DEPs of eight chlorophyll a/b binding proteins, five ATPases and eight ribosomal proteins can play a pivotal role on chloroplast turnover and ATP metabolism.

Conclusions

Our results suggest that the proteins involved in Fe homeostasis and chloroplast turnover in mesophyll cells may play key roles in tolerance of M. cordata to Pb. This study offers some novel insights into Pb tolerance mechanism of plants, and the potential valuable for environmental remediation of this important medicinal plant.
The association of cardiac troponin and cardiovascular events in patients with concomitant heart failure preserved ejection fraction and atrial fibrillation
Authors: Kim Bum Sung , Kwon Chang Hee , Chang Haseong , Choi Ji-Hoon , Kim Hyun-Joong , Kim Sung Hea
Published: May 2023

Background

Limited data are available for risk stratification in patients with atrial fibrillation (AF) and combined heart failure with preserved ejection fraction (HFpEF). We aimed to explore the prognostic utility of high-sensitivity cardiac troponin I (hs-cTnI) in patients with newly detected AF and concomitant HFpEF.

Methods

From August 2014 to December 2016, 2,361 patients with newly detected AF were polled in a retrospective single-center registry. Of which, 634 patients were eligible for HFpEF diagnosis (HFA-PEFF score ≥ 5) and 165 patients were excluded with exclusion criteria. Finally, 469 patients are classified into elevated or non-elevated hs-cTnI groups based on the 99th percentile upper reference limit (URL). The primary outcome was the incidence of major adverse cardiac and cerebrovascular events (MACCE) during follow-up.

Results

In 469 patients, 295 were stratified into the non-elevated hs-cTnI group (< 99th percentile URL of hs-cTnI) and 174 were placed in the elevated hs-cTnI group (≥ 99th percentile URL of hs-cTnI). The median follow-up period was 24.2 (interquartile range, 7.5–38.6) months. During the follow-up period, 106 patients (22.6%) in the study population experienced MACCE. In a multivariable Cox regression model, the elevated hs-cTnI group had a higher incidence of MACCE (adjusted hazard ratio [HR], 1.54; 95% confidence interval [CI], 1.08–2.55; p = 0.03) and coronary revascularization-caused readmission (adjusted HR, 3.86; 95% CI, 1.39–15.09; p = 0.02) compared with the non-elevated hs-cTnI group. The incidence of heart failure-caused readmission tended to occur more frequently in the elevated hs-cTnI group (8.5% versus 15.5%; adjusted HR, 1.52; 95% CI, 0.86–2.67; p = 0.08).

Conclusions

One-fifth of patients with AF and concomitant HFpEF experienced MACCE during follow-up, and elevated hs-cTnI was independently associated with higher risk of MACCE, as driven by heart failure and revascularization-caused readmission. This finding suggested that hs-cTnI may be a useful tool in individualized risk stratification of future cardiovascular events in patients with AF and concomitant HFpEF.
Pembrolizumab induced-C3 glomerulonephritis and RBC cast nephropathy: a case report
Authors: Yang Zhi , Xu Huan , Gou Shenju , Wu Hongyan , Hu Zhangxue
Published: May 2023

Background

Immune checkpoint inhibitors (ICIs) are increasingly being used in the treatment of several cancers. Pembrolizumab is an anti-programmed cell death-1 (anti-PD-1) monoclonal antibody that is approved for the treatment of metastatic non-small cell lung cancer (NSCLC). Pembrolizumab-associated renal toxicity is relatively rare, even in pembrolizumab-associated glomerulonephritis. In this study, we report a rare case of pembrolizumab-induced C3 glomerulonephritis (C3GN) and RBC cast nephropathy.

Case presentation

A 68-year-old man with NSCLC was receiving treatment with pembrolizumab. After 19 cycles of pembrolizumab therapy, he presented with gross hematuria, severe lower-limb edema and oliguria. Laboratory tests revealed hypoalbuminemia, increased serum creatinine and low serum C3 level. Renal biopsy revealed a typical membranoproliferative glomerulonephritis accompanied by remarkable RBC casts in tubular cavities and tubulointerstitial infiltration of CD8-positive lymphocytes. Based on C3-only immunofluorescence deposit on glomeruli, a diagnosis of C3GN was made. Pembrolizumab was considered the cause of C3GN. Pembrolizumab was discontinued immediately, and 60 mg/day of prednisone was initiated. One dose of cyclophosphamide (400 mg, IV) was also administered. Upon treatment, his symptoms improved rapidly and serum creatinine decreased a lot. However, the patient became dialysis dependent eventually.

Conclusion

This is the first case of C3GN with RBC cast nephropathy caused by ICIs. This rare case caused by the prolonged use of pembrolizumab further strengthens the relationship between ICIs and C3GN. Thus, periodic evaluation of urine and renal function is recommended in patients receiving pembrolizumab and other ICIs.
Placenta-associated adverse pregnancy outcomes in women experiencing mild or severe hyperemesis gravidarum – a systematic review and meta-analysis
Authors: Moberg Tilda , Van der Veeken Lennart , Persad Emma , Hansson Stefan R. , Bruschettini Matteo
Published: May 2023

Background

Nausea and vomiting in pregnancy (NVP) affects 50–80% of pregnant women and is correlated to the level of human chorionic gonadotropin (hCG). Hyperemesis gravidarum (HG) is a severe condition, with an incidence of 0.2–1.5%, characterized by consistent nausea, vomiting, weight loss and dehydration continuing after the second trimester.

Aim

The aim of this systematic review was to investigate a potential correlation between NVP or HG with adverse pregnancy outcomes and hCG levels.

Method

A systematic search in PubMed, Embase and CINAHL Complete was conducted. Studies on pregnant women with nausea in the first or second trimester, reporting either pregnancy outcomes or levels of hCG were included. The primary outcomes were preterm delivery (PTD), preeclampsia, miscarriage, and fetal growth restriction. Risk of bias was assessed using ROBINS-I. The overall certainty of evidence was assessed using GRADE.

Results

The search resulted in 2023 potentially relevant studies; 23 were included. The evidence was uncertain for all outcomes, however women with HG had a tendency to have an increased risk for preeclampsia [odds ratio (OR) 1.18, 95% confidence of interval (CI) 1.03 to 1.35], PTD [OR 1.35, 95% CI 1.13 to 1.61], small for gestational age (SGA) [OR 1.24, 95% CI 1.13 to 1.35], and low birth weight (LBW) [OR 1.35, 95% CI 1.26 to 1.44]. Further, a higher fetal female/male ratio was observed [OR 1.36, 95% CI 1.15 to 1.60]. Meta-analyses were not performed for women with NVP; however, most of these studies indicated that women with NVP have a lower risk for PTD and LBW and a higher risk for SGA, and a higher fetal female/male ratio.

Conclusion

There may be an increased risk in women with HG and a decreased risk in women with NVP for adverse placenta-associated pregnancy outcomes, however the evidence is very uncertain.

Trial registration

PROSPERO: CRD42021281218.
Circulating tumor cells (CTCs) and hTERT gene expression in CTCs for radiotherapy effect with lung cancer
Authors: Xu Ying , Ren Xue , Jiang Tong , Lv Shuang , Gao Kuanke , Liu Yunen , Yan Ying
Published: May 2023

Background

Circulating tumor cells (CTCs) are important biological indicators of the lung cancer prognosis, and CTC counting and typing may provide helpful biological information for the diagnosis and treatment of lung cancer.

Methods

The CTC count in blood before and after radiotherapy was detected by the CanPatrol™ CTC analysis system, and the CTC subtypes and the expression of hTERT before and after radiotherapy were detected by multiple in situ hybridization. The CTC count was calculated as the number of cells per 5 mL of blood.

Results

The CTC positivity rate in patients with tumors before radiotherapy was 98.44%. Epithelial–mesenchymal CTCs (EMCTCs) were more common in patients with lung adenocarcinoma and squamous carcinoma than in patients with small cell lung cancer (P = 0.027). The total CTCs (TCTCs), EMCTCs, and mesenchymal CTCs (MCTCs) counts were significantly higher in patients with TNM stage III and IV tumors (P < 0.001, P = 0.005, and P < 0.001, respectively). The TCTCs and MCTCs counts were significantly higher in patients with an ECOG score of > 1 (P = 0.022 and P = 0.024, respectively). The TCTCs and EMCTCs counts before and after radiotherapy affected the overall response rate (ORR) (P < 0.05). TCTCs and ECTCs with positive hTERT expression were associated with the ORR of radiotherapy (P = 0.002 and P = 0.038, respectively), as were TCTCs with high hTERT expression (P = 0.012). ECOG score (P = 0.006) and post-radiation TCTCs count (P = 0.011) were independent factors for progression-free survival (PFS) and TNM stage (P = 0.054) and pre-radiation EMCTCs count (P = 0.009) were independent factors of overall survival (OS).

Conclusion

This study showed a high rate of positive CTC detection in patients with lung cancer, and the number, subtype, and hTERT-positive expression of CTCs were closely related to patients’ ORR, PFS, and OS with radiotherapy. EMCTCs, hTERT-positive expression of CTCs are expected to be important biological indicators for predicting radiotherapy efficacy and the prognosis in patients with lung cancer. These results may be useful in improving disease stratification for future clinical trials and may help in clinical decision-making.
The preferences for the telemedicine and standard health care services from the perspective of the patients with schizophrenia
Authors: Li Min , Chen Yanhan , Hu Xuefu , Wang Shunhong
Published: May 2023

Background

With the rapid development of telemedicine, has enabled new and various ways to deliver health care services for patients with schizophrenia. However, it is not clear that the newly emerged is better than the standard or not from the perspective of patients with schizophrenia. This study aims to explore their preferences between telemedicine and standard health care services and their associated factors.

Methods

The cross-sectional study was conducted at the Ningan hospital’s inpatient department in Yinchuan, and collected socio-demographic and clinical information, the preferences regarding telemedicine (WeChat, telephone, and Email), and the standard health care services (community health center and home visit). The socio-demographic and clinical characteristics associated with the five-health care service delivery ways were assessed by descriptive analysis, and the associated impact factors of preferences of patients with schizophrenia were analyzed by multiple logistic regression.

Results

Among the 300 participants, most of them chose WeChat (46.3%), some of them tended to telephone (35.4%) and community health center (11.3%), and a few of them accepted home visits (4.7%), and Email (2.3%). There are so many associated factors that affected the patients with schizophrenia to choose their favorite health care services, of which age, gender, employment, residence, and duration of illness were the independent impact factors.

Conclusions

The cross-sectional study surveyed the preferences between telemedicine and standard health care services in patients with schizophrenia’s opinion, disclosed independent impact factors, as well as compared the advantage and disadvantages of these. According to our findings, the best health care services should be based on the preferences of the patients with schizophrenia and adapt to realistic conditions. This provides valuable evidence to improve the health care situation, facilitate the continuity of health care services, and achieve holistic rehabilitative outcomes for the patients with schizophrenia.
Food insecurity was negatively associated with adherence to the “fruits, vegetables, and foods rich in animal protein” dietary pattern among university students’ households: the 2018 Mexican National Household Survey
Authors: Betancourt-Núñez Alejandra , Nava-Amante Pablo Alejandro , Bernal-Orozco María Fernanda , Vizmanos Barbara , Vargas-García Elisa J. , Márquez-Sandoval Fabiola , Salas-García Miguel Amaury , Díaz-López Andrés
Published: May 2023

Background

University students are often affected by food insecurity (FI) and this situation has been associated with low consumption of fruit/vegetables and high intake of added sugars and sweet drinks. However, there needs to be more evidence on the association between FI and dietary patterns (DPs), assessing the overall diet and allowing analysis of commonly consumed food combinations. We aimed to analyze the association between FI and DPs in university students’ households.

Methods

We used data from 7659 university student households from the 2018 Mexican National Household Income and Expenditure Survey (ENIGH, for its acronym in Spanish). We obtained FI levels (mild, moderate, and severe) using the validated Mexican Food Security Scale (EMSA, Spanish acronym). Two DPs were identified by principal component analysis based on the weekly frequency of consumption of 12 food groups. Multivariate logistic regression adjusted by university student and household’s characteristics was applied.

Results

Compared to food security, households with mild-FI (OR:0.34; 95%CI:0.30, 0.40), moderate-FI (OR:0.20; 95%CI:0.16, 0.24) or severe-FI (OR:0.14; 95%CI:0.11, 0.19) were less likely to adhere to the dietary pattern “Fruits, vegetables and foods rich in animal protein” (fruits, vegetables, meat, fish or seafood, dairy products, and starchy vegetables). In addition, people with severe-FI (OR:0.51; 95% CI:0.34, 0.76) were also less likely to adhere to the dietary pattern “Traditional-Westernized” (pulses, oils or fats, sugar, sweets, industrialized drinks, foods made from corn/maize, wheat, rice, oats or bran, coffee, tea and eggs).

Conclusions

In these households FI impairs the ability to consume a healthy dietary pattern (fruits/vegetables and foods rich in animal protein). In addition, the intake of foods typical of the Mexican food culture reflecting the local Western dietary pattern is compromised in households with severe-FI.
Increasing urban health awareness in adolescents using an interactive approach: evidence from a school-based pre-post pilot study in Rome, Italy
Authors: Zjalic Doris , Perilli Alessio , Nachira Lorenza , Lanza Teresa Eleonora , Santoli Giuseppe , Paladini Andrea , Ricciardi Walter , Cadeddu Chiara
Published: May 2023

Background

Cities contribute to and are affected by the climate crisis, determining significant health issues in urban settings. Educational institutions have a privileged position to contribute to achieving the transformations needed for a healthier future, so Urban Health education is fundamental to empowering the health of the youth living in cities. This study aims to measure and raise the awareness of Urban Health among students attending a high school in Rome (Italy).

Methods

An interactive educational intervention, consisting of four sessions, was conducted in a Roman high school during spring 2022. Overall, 319 students aged between 13 and 18 attended the sessions and were asked to complete a 11-items questionnaire before and another after the interventions. Data was gathered anonymously and analyzed using descriptive and inferential statistics.

Results

Fifty-eight percent of respondents improved their post-intervention questionnaire score, while 15% did not improve and 27% got worse. The mean score significantly improved after the intervention (p < 0.001; Cohen’s d = 0.39).

Conclusions

The results suggest that school-based interventions using interactive approaches on Urban Health could be effective in increasing students’ awareness and promoting health especially in urban settings.
An increase in cesarean section rate during the first wave of COVID-19 pandemic in Iran
Authors: Gharacheh Maryam , Kalan Mohammad Ebrahimi , Khalili Narjes , Ranjbar Fahimeh
Published: May 2023

Background

The COVID-19 pandemic and its impact on healthcare services is likely to affect birth outcomes including the delivery mode. However, recent evidence has been conflicting in this regard. The study aimed to assess changes to C-section rate during the COVID-19 pandemic in Iran.

Methods

This is a retrospective analysis of electronic medical records of women delivered in the maternity department of hospitals in all provinces of Iran before the COVID-19 pandemic (February-August 30, 2019) and during the pandemic (February-August 30, 2020). Data were collected through the Iranian Maternal and Neonatal Network (IMAN), a country-wide electronic health record database management system for maternal and neonatal information. A total of 1,208,671 medical records were analyzed using the SPSS software version 22. The differences in C-section rates according to the studied variables were tested using the χ2 test. A logistic regression analysis was conducted to determine the factors associated with C-section.

Results

A significant rise was observed in the rates of C-section during the pandemic compared to the pre-pandemic (52.9% vs 50.8%;p = .001). The rates for preeclampsia (3.0% vs 1.3%), gestational diabetes (6.1% vs 3.0%), preterm birth (11.6% vs 6.9%), IUGR (1.2% vs 0.4%), LBW (11.2% vs 7.8%), and low Apgar score at first minute (4.2% vs 3.2%) were higher in women who delivered by C-section compared to those with normal delivery (P = .001).

Conclusions

The overall C-section rate during the first wave of COVID-19 pandemic was significantly higher than the pre-pandemic period. C-section was associated with adverse maternal and neonatal outcomes. Thus, preventing the overuse of C-section especially during pandemic becomes an urgent need for maternal and neonatal health in Iran.
Development and implementation of a distributed data network between an academic institution and state health departments to investigate variation in time to HIV viral suppression in the Deep South
Authors: Bassler John R. , Cagle Izza , Crear Danita , Kay Emma S. , Long Dustin M. , Mugavero Michael J. , Nassel Ariann F. , Ostrenga Lauren , Parman Mariel , Preg Summer , Wang Xueyuan , Batey D. Scott , Rana Aadia , Levitan Emily B.
Published: May 2023

Background

Achieving early and sustained viral suppression (VS) following diagnosis of HIV infection is critical to improving outcomes for persons with HIV (PWH). The Deep South of the United States (US) is a region that is disproportionately impacted by the domestic HIV epidemic. Time to VS, defined as time from diagnosis to initial VS, is substantially longer in the South than other regions of the US. We describe the development and implementation of a distributed data network between an academic institution and state health departments to investigate variation in time to VS in the Deep South.

Methods

Representatives of state health departments, the Centers for Disease Control and Prevention (CDC), and the academic partner met to establish core objectives and procedures at the beginning of the project. Importantly, this project used the CDC-developed Enhanced HIV/AIDS Reporting System (eHARS) through a distributed data network model that maintained the confidentiality and integrity of the data. Software programs to build datasets and calculate time to VS were written by the academic partner and shared with each public health partner. To develop spatial elements of the eHARS data, health departments geocoded residential addresses of each newly diagnosed individual in eHARS between 2012–2019, supported by the academic partner. Health departments conducted all analyses within their own systems. Aggregate results were combined across states using meta-analysis techniques. Additionally, we created a synthetic eHARS data set for code development and testing.

Results

The collaborative structure and distributed data network have allowed us to refine the study questions and analytic plans to conduct investigations into variation in time to VS for both research and public health practice. Additionally, a synthetic eHARS data set has been created and is publicly available for researchers and public health practitioners.

Conclusions

These efforts have leveraged the practice expertise and surveillance data within state health departments and the analytic and methodologic expertise of the academic partner. This study could serve as an illustrative example of effective collaboration between academic institutions and public health agencies and provides resources to facilitate future use of the US HIV surveillance system for research and public health practice.
Dietary insulin index and load and cardiometabolic risk factors among people with obesity: a cross-sectional study
Authors: Vajdi Mahdi , Ardekani Abnoos Mokhtari , Nikniaz Zeinab , Hosseini Babak , Farhangi Mahdieh Abbasalizad
Published: May 2023

Background

The hypothesis of the effect of the insulinogenic effects of diet on the development of cardiometabolic disorders has been suggested, but limited data are available for adults with obesity. This study aimed to determine the association of dietary insulin index (DII) and dietary insulin load (DIL) with cardiometabolic risk factors among Iranian adults with obesity.

Methods

The study was conducted with a total of 347 adults aged 20–50 years in Tabriz, Iran. Usual dietary intake was assessed through a validated 147-item food frequency questionnaire (FFQ). DIL was computed using published food insulin index (FII) data. DII was calculated by dividing DIL by the total energy intake of each participant. Multinational logistic regression analysis was performed to evaluate the association between DII and DIL and cardiometabolic risk factors.

Results

Mean age of participants was 40.78 ± 9.23 y, and mean body mass index (BMI) was 32.62 ± 4.80 kg/m2. Mean of DII and DIL was 73.15 ± 37.60 and 196,242 ± 100,181. Participants with higher DII had higher BMI, weight, waist circumference (WC), and blood concentrations of triglyceride (TG) and Homeostasis model assessment insulin resistance index (HOMA-IR) (P < 0.05). After taking potential confounders into account, DIL was positively associated with MetS (OR: 2.58; 95% CI: 1.03–6.46), and high blood pressure (OR: 1.61; 95% CI: 1.13–6.56). Moreover, after adjustment for potential confounders, moderate DII was associated with increased odds of MetS (OR: 1.54, 95% CI: 1.36–4.21), high TG (OR, 1.25; 95% CI, 1.17–5.02), and high blood pressure (OR: 1.88; 95% CI: 1.06–7.86).

Conclusion

This population-based study revealed that adults with higher DII and DIL associated with cardiometabolic risk factors and consequently, replacement of high with low DII and DIL may have reduce the risk of cardiometabolic disorders. Further studies with longitudinal design are required to confirm these findings.
Liver-specific metastases as an independent prognostic factor in cancer patients receiving hospice care in hospital
Authors: Huang Kun-Siang , Huang Yun-Hwa , Chen Chao-Tung , Chou Chia-Pei , Pan Bo-Lin , Lee Chih-Hung
Published: May 2023

Background

Survival prediction is important in cancer patients receiving hospice care. Palliative prognostic index (PPI) and palliative prognostic (PaP) scores have been used to predict survival in cancer patients. However, cancer primary site with metastatic status, enteral feeding tubes, Foley catheter, tracheostomy, and treatment interventions are not considered in aforementioned tools. The study aimed to investigate the cancer features and potential clinical factors other than PPI and PaP to predict patient survival.

Methods

We conducted a retrospective study for cancer patients admitted to a hospice ward between January 2021 and December 2021. We examined the correlation of PPI and PaP scores with survival time since hospice ward admission. Multiple linear regression was used to test the potential clinical factors other than PPI and PaP for predicting survival.

Results

A total of 160 patients were enrolled. The correlation coefficients for PPI and PaP scores with survival time were -0.305 and -0.352 (both p < 0.001), but the predictabilities were only marginal at 0.087 and 0.118, respectively. In multiple regression, liver metastasis was an independent poor prognostic factor as adjusted by PPI (β = -8.495, p = 0.013) or PaP score (β = -7.139, p = 0.034), while feeding gastrostomy or jejunostomy were found to prolong survival as adjusted by PPI (β = 24.461, p < 0.001) or PaP score (β = 27.419, p < 0.001).

Conclusions

Association between PPI and PaP with patient survival in cancer patients at their terminal stages is low. The presence of liver metastases is a poor survival factor independent of PPI and PaP score.
Flowering phenophases influence the antibacterial and anti-biofilm effects of Thymus vulgaris L. essential oil
Authors: Bakó Csongor , Balázs Viktória Lilla , Kerekes Erika , Kocsis Béla , Nagy Dávid U. , Szabó Péter , Micalizzi Giuseppe , Mondello Luigi , Krisch Judit , Pethő Dóra , Horváth Györgyi
Published: May 2023

Background

Essential oils are becoming increasingly popular in medicinal applications because of their antimicrobial effect. Thymus vulgaris L. (Lamiaceae) is a well-known and widely cultivated medicinal plant, which is used as a remedy for cold, cough and gastrointestinal symptoms. Essential oil content of thyme is responsible for its antimicrobial activity, however, it has been reported that the chemical composition of essential oils influences its biological activity. In order to explore flowering phenophases influence on the chemical composition of thyme essential oil and its antibacterial and anti-biofilm activity, plant materials were collected at the beginning of flowering, in full bloom and at the end of flowering periods in 2019.

Methods

Essential oils from fresh and dried plant materials were distilled and analyzed with gas chromatography-mass spectrometry (GC-MS) and gas chromatography-flame ionization detection (GC-FID). The antibacterial activity was performed by broth microdilution and thin layer chromatography-direct bioautography (TLC-DB) assays and the anti-biofilm effect by crystal violet assay, respectively. Scanning electron microscopy was applied to illustrate the cellular changes of bacterial cells after essential oil treatment.

Results

Thymol (52.33–62.46%) was the main component in the thyme essential oils. Thyme oil distilled from fresh plant material and collected at the beginning of flowering period exerted the highest antibacterial and anti-biofilm activity against Haemophilus influenzae, H. parainfluenzae and Pseudomonas aeruginosa.

Conclusion

The different flowering periods of Thymus vulgaris influence the antibacterial and anti-biofilm activity of its essential oils, therefore, the collection time has to be taken into consideration and not only the full bloom, but the beginning of flowering period may provide biological active thyme essential oil.
Chemical profiling and cytotoxic potential of the n-butanol fraction of Tamarix nilotica flowers
Authors: Fayed Marwa A. A. , Bakr Riham O. , Yosri Nermeen , Khalifa Shaden A. M. , El-Seedi Hesham R. , Hamdan Dalia I. , Refaey Mohamed S.
Published: May 2023

Background

Cancer represents one of the biggest healthcare issues confronting humans and one of the big challenges for scientists in trials to dig into our nature for new remedies or to develop old ones with fewer side effects. Halophytes are widely distributed worldwide in areas of harsh conditions in dunes, and inland deserts, where, to cope with those conditions they synthesize important secondary metabolites highly valued in the medical field. Several Tamarix species are halophytic including T.nilotica which is native to Egypt, with a long history in its tradition, found in its papyri and in folk medicine to treat various ailments.

Methods

LC–LTQ–MS–MS analysis and 1H-NMR were used to identify the main phytoconstituents in the n- butanol fraction of T.nilotica flowers. The extract was tested  in vitro for its cytotoxic effect against breast (MCF-7) and liver cell carcinoma (Huh-7) using SRB assay.

Results

T.nilotica n-butanol fraction of the flowers was found to be rich in phenolic content, where, LC–LTQ–MS–MS allowed the tentative identification of thirty-nine metabolites, based on the exact mass, the observed spectra fragmentation patterns, and the literature data, varying between tannins, phenolic acids, and flavonoids. 1H-NMR confirmed the classes tentatively identified. The in-vitro evaluation of the n-butanol fraction showed lower activity on MCF-7 cell lines with IC50 > 100 µg/mL, while the higher promising effect was against Huh-7 cell lines with an IC50= 37 µg/mL.

Conclusion

Our study suggested that T.nilotica flowers' n-butanol fraction is representing a promising cytotoxic candidate against liver cell carcinoma having potential phytoconstituents with variable targets and signaling pathways.
How the COVID-19 pandemic affects the moral reasoning of pediatric residents and the general population
Authors: Jean-Tron M. G. , Ávila-Montiel D. , Hill-de Titto C. , Márquez-González H. , Chapa-Koloffon G. , Ávila-Hernández A. V. , Núñez-Benítez M. A. , Muñoz-Hernández O. , Garduño-Espinosa J.
Published: May 2023

Background

Kohlberg’s theory of moral development asserts that people progress through different stages of moral reasoning as their cognitive abilities and social interactions mature. Individuals at the lowest stage of moral reasoning (preconventional stage) judge moral issues based on self-interest, those with a medium stage (conventional stage) judge them based on compliance with rules and norms, and those at the highest stage (postconventional stage) judge moral issues based on universal principles and shared ideals. Upon attaining adulthood, it can be considered that there is stability in the stage of individuals’ moral development; however, the effect of a global population crisis such as the one experienced in March 2020, when the World Health Organization (WHO) declared the COVID-19 pandemic, is unknown. The purpose of this study was to evaluate the changes in the moral reasoning of pediatric residents before and after one year of the COVID-19 pandemic and compare them with a general population group.

Methods

This is a naturalistic quasi-experimental study conducted with two groups, one comprised 47 pediatric residents of a tertiary hospital converted into a COVID hospital during the pandemic and another group comprised 47 beneficiaries of a family clinic who were not health workers. The defining issues test (DIT) was applied to the 94 participants during March 2020, before the pandemic initiated in Mexico, and later during March 2021. To assess intragroup changes, the McNemar-Bowker and Wilcoxon tests were used.

Results

Pediatric residents showed higher baseline stages of moral reasoning: 53% in the postconventional group compared to the general population group (7%). In the preconventional group, 23% were residents and 64% belonged to the general population. In the second measurement, one year after the start of the pandemic, the group of residents had a significant decrease of 13 points in the P index, unlike the general population group in which a decrease of 3 points was observed. This decrease however, did not equalize baseline stages. Pediatric residents remained 10 points higher than the general population group. Moral reasoning stages were associated with age and educational stage.

Conclusions

After a year of the COVID-19 pandemic, we found a decrease in the stage of moral reasoning development in pediatric residents of a hospital converted for the care of patients with COVID-19, while it remained stable in the general population group. Physicians showed higher stages of moral reasoning at baseline than the general population.
Perspectives on an enhanced ‘Improving Access to Psychological Therapies’ (IAPT) service addressing the wider determinants of mental health: a qualitative study
Authors: Curtin Esther Louise , d’Apice Katrina , Porter Alice , Widnall Emily , Franklin Matthew , de Vocht Frank , Kidger Judi
Published: May 2023

Background

A new Health and Wellbeing pathway was introduced into the Improving Access to Psychological Therapies (IAPT) service in one geographical area of the UK in 2021 to address the wider determinants of mental health problems. It comprised assisted signposting to wider services and physical health promotion. This qualitative study aimed to understand stakeholders’ experiences of implementing and receiving this new support and the barriers and facilitators to its delivery.

Methods

Forty-seven interviews were conducted, with service developers (n = 6), service deliverers (n = 12), service users (n = 22) and community and clinical partners (n = 7), as part of a larger mixed-methods evaluation. Interviews were recorded, transcribed, and analysed using reflexive thematic analysis.

Results

Three themes spanned all participant groups and represented key aspects of the service: (1) identifying suitability, (2) a holistic service, and (3) moving forward. The sub-themes represent the barriers and facilitators to processes working in practice, lending insight into potential service improvements. These included strengthening the quality of communication during referral and assessment, tailoring the support and delivery mode, and increasing transparency around continued care to drive sustained benefits.

Limitations

Service users may have been selected due to their positive experiences of IAPT and were not demographically representative of the population, although participants’ experiences of the service did suggest variation in our sample.

Conclusions

The Health and Wellbeing pathway was perceived as having a positive impact on mental health and could reduce the burden on therapeutic services. However, service- and individual-level barriers need to be addressed to enhance statutory and community support links, manage service users’ expectations, and improve accessibility for certain groups.
Chronic pain self-management interventions in primary care – does it make any difference? A qualitative study
Authors: Hestmann Ragnhild , Bratås Ola , Grønning Kjersti
Published: May 2023

Background

Total recovery from chronic pain is difficult. It is therefore important for those who are suffering from chronic pain to find ways to self-manage their pain in daily life. Several chronic pain self-management interventions have been established, but more knowledge is needed to find out what and how it works. This study aimed to explore how the participants in two chronic pain self-management interventions in primary health care experienced the different components of the interventions, and whether the interventions induced any positive changes in the participants’ everyday lives.

Methods

A qualitative study nested within a randomized controlled study using semi-structured individual face-to-face interviews with 17 informants were conducted three months after the interventions. The data were analysed thematically using Systematic Text Condensation.

Results

The main finding was that the informants, from both interventions, self-managed their chronic pain differently in a positive way after they had participated in the self-management interventions. The participants gained new insight from lectures, learning from peers by sharing experiences and belonging to a group, and by recognizing the importance of being physically active.

Conclusion

This study shows that chronic pain self-management interventions consisting of components that learn the participants about chronic pain and include physical activity in a socially supportive environment, may contribute to a positive change in the lives of people living with chronic pain.