bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between socioeconomic status and physical activity among older adults: cross-sectional results from the OUTDOOR ACTIVE study
Authors: Stalling Imke , Albrecht Birte Marie , Foettinger Linda , Recke Carina , Bammann Karin
Published: May 2022

Background

Regular physical activity (PA) is an important strategy for healthy ageing. Socioeconomic status was found to be a key determinant of PA, however, evidence on associations between socioeconomic status and PA among older adults is limited. The aim of this study was to contribute to research on the associations of socioeconomic status and PA among older adults by including self-reported and objectively measured PA data. Furthermore, we examined the self-reported PA data more closely by looking at the activities separately.

Methods

Cross-sectional data of 1507 participants (52.5% female) of the OUTDOOR ACTIVE study between 65 and 75 years, residing in Bremen, Germany, were included in the analyses. Self-reported PA was assessed via questionnaire and comprised all organised and non-organised activities. For analyses, mean hours per week of total and moderate to vigorous PA, and mean metabolic equivalents per week were used. Objectively measured PA was assessed using accelerometers over seven consecutive days. Socioeconomic status was included as an additive social class index containing education, income, and occupation. To test for associations between PA and socioeconomic status, linear regressions were carried out.

Results

Self-reported PA showed significant negative associations with socioeconomic status for both men and women. Objectively measured PA was positively associated with socioeconomic status, which was significant in men but not in women. When examining physical activities separately, time spent on housework, gardening, biking, and walking decreased with increasing socioeconomic status. Women in the second SES quintile and men in the third quintile reported the most, and women in the first quintile and men in the fifth quintile the least hours per week spent on exercise.

Conclusions

The results of this study contributed to the existing research gap on the associations of socioeconomic status and PA among older adults. Moreover, we provided information on both self-reported and objectively measured PA, and showed the discrepancies in the two methods’ results. These findings can help to develop PA promotion interventions targeting specific socioeconomic status groups and to develop accurate, valid, and reliable self-reported and objective measurements of PA for older adults.
Characteristics of step responses following varying magnitudes of unexpected lateral perturbations during standing among older people – a cross-sectional laboratory-based study
Authors: Batcir Shani , Shani Guy , Shapiro Amir , Melzer Itshak
Published: May 2022

Introduction

The inability to recover from unexpected lateral loss of balance may be particularly relevant to the problem of falling.

Aim

We aimed to explore whether different kinematic patterns and strategies occur in the first recovery step in single-step trials in which a single step was required to recover from a fall, and in multiple-step trials in which more than one step was required to recover from a fall. In addition, in the multiple-step trials, we examined kinematic patterns of balance recovery where extra steps were needed to recover balance.

Methods

Eighty-four older adults (79.3 ± 5.2 years) were exposed to unannounced right/left perturbations in standing that were gradually increased to trigger a recovery stepping response. We performed a kinematic analysis of the first recovery step of all single-step and multiple-step trials for each participant and of total balance recovery in the multiple-step trial.

Results

Kinematic patterns and strategies of the first recovery step in the single-step trials were significantly dependent on the perturbation magnitude. It took a small, yet significantly longer time to initiate a recovery step and a significantly longer time to complete the recovery step as the magnitude increased. However, the first recovery step in the multiple-step trials showed no significant differences between different perturbation magnitudes; while, in total balance recovery of these trials, we observed a small, yet significant difference as the magnitude increased.

Conclusions

At relatively low perturbation magnitudes, i.e., single-step trials, older adults selected different first stepping strategies and kinematics as perturbation magnitudes increased, suggesting that this population activated pre-planned programs based on the perturbation magnitude. However, in the first recovery step of the multiple-step trials, i.e., high perturbation magnitudes, similar kinematic movement patterns were used at different magnitudes, suggesting a more rigid, automatic behavior, while the extra-steps were scaled to the perturbation magnitude. This suggest that older adults activate pre-planned programs based on the magnitude of the perturbation, even before the first step is completed..
Evolution and spread of a highly drug resistant strain of Mycobacterium tuberculosis in Papua New Guinea
Authors: Bainomugisa Arnold , Lavu Evelyn , Pandey Sushil , Majumdar Suman , Banamu Jennifer , Coulter Chris , Marais Ben , Coin Lachlan , Graham Stephen M. , du Cros Philipp
Published: May 2022

Background

Molecular mechanisms determining the transmission and prevalence of drug resistant tuberculosis (DR-TB) in Papua New Guinea (PNG) are poorly understood. We used genomic and drug susceptibility data to explore the evolutionary history, temporal acquisition of resistance and transmission dynamics of DR-TB across PNG.

Methods

We performed whole genome sequencing on isolates from Central Public Health Laboratory, PNG, collected 2017–2019. Data analysis was done on a composite dataset that also included 100 genomes previously sequenced from Daru, PNG (2012–2015).

Results

Sampled isolates represented 14 of the 22 PNG provinces, the majority (66/94; 70%) came from the National Capital District (NCD). In the composite dataset, 91% of strains were Beijing 2.2.1.1, identified in 13 provinces. Phylogenetic tree of Beijing strains revealed two clades, Daru dominant clade (A) and NCD dominant clade (B). Multi-drug resistance (MDR) was repeatedly and independently acquired, with the first MDR cases in both clades noted to have emerged in the early 1990s, while fluoroquinolone resistance emerged in 2009 (95% highest posterior density 2000–2016). We identified the presence of a frameshift mutation within Rv0678 (p.Asp47fs) which has been suggested to confer resistance to bedaquiline, despite no known exposure to the drug. Overall genomic clustering was significantly associated with rpoC compensatory and inhA promoter mutations (p < 0.001), with high percentage of most genomic clusters (12/14) identified in NCD, reflecting its role as a potential national amplifier.

Conclusions

The acquisition and evolution of drug resistance among the major clades of Beijing strain threaten the success of DR-TB treatment in PNG. With continued transmission of this strain in PNG, genotypic drug resistance surveillance using whole genome sequencing is essential for improved public health response to outbreaks. With occurrence of resistance to newer drugs such as bedaquiline, knowledge of full drug resistance profiles will be important for optimal treatment selection.
Maintenance Therapy with Aromatase Inhibitor in epithelial Ovarian Cancer (MATAO): study protocol of a randomized double-blinded placebo-controlled multi-center phase III Trial
Authors: McLaughlin Pamela M. J. , Klar Maximilian , Zwimpfer Tibor A. , Dutilh Gilles , Vetter Marcus , Marth Christian , du Bois Andreas , Schade-Brittinger Carmen , Reuss Alexander , Bommer Claudine , Kurzeder Christian , Heinzelmann-Schwarz Viola
Published: May 2022

Background

A high percentage of epithelial ovarian cancers (EOC) express the estrogen receptor (ER), which is an ideal target for endocrine therapy. Letrozole is a proven, potent aromatase inhibitor, extensively tested and used in the treatment of ER positive breast cancer. In addition, it seems a potent drug for patients with heavily pre-treated OC as demonstrated in several distinctive settings. However, it has never been evaluated prospectively in a maintenance setting for ovarian cancer after standard of care. The here proposed trial aims to define a population of EOC patients, who would benefit from the effectiveness of the generic agent letrozole, with little expected toxicity and thus beneficial impact on overall quality of life (QoL).

Methods

In this international multicenter randomized, placebo-controlled phase III trial at clinical centers in Switzerland, Germany and Austria, we plan to include 540 patients with primary, newly diagnosed FIGO Stage II to IV and histologically confirmed low- or high-grade serous or endometrioid epithelial ovarian/fallopian tube/peritoneal cancer. Patients are randomized in a 1:1 ratio into two groups: receiving blinded study treatment (letrozole or placebo tablets). When assuming a HR of 0.7, a median PFS of 18 months in the control arm and a median PFS of 25.7 months in the treatment arm, a two-sided alpha level of 5%, 3.5 years recruitment and 1.5 years observation time, we expect 330 events to have occurred within these 5 years in the total cohort yielding a power of 90%. Follow-up data for the whole cohort will be collected for up to 10 years and for the low-grade cancer for up to 12 years.

Discussion

The here proposed randomized phase III trial aims to identify patients with EOC in the maintenance setting, who benefit from the effectiveness of the letrozole, by proving its efficacy whilst maintaining a high standard of QoL due to the limited toxicity expected in comparison to the current alternative drugs on the market for this treatment phase.

Trial registration

This trial is registered at clinicaltrials.gov under the identifier NCT04111978. Registered 02 October 2019.
Image-guided navigation for locally advanced primary and locally recurrent rectal cancer: evaluation of its early cost-effectiveness
Authors: Lindenberg Melanie , Kramer Astrid , Kok Esther , Retèl Valesca , Beets Geerard , Ruers Theo , van Harten Wim
Published: May 2022

Background

A first pilot study showed that an image-guided navigation system could improve resection margin rates in locally advanced (LARC) and locally recurrent rectal cancer (LRRC) patients. Incremental surgical innovation is often implemented without reimbursement consequences, health economic aspects should however also be taken into account. This study evaluates the early cost-effectiveness of navigated surgery compared to standard surgery in LARC and LRRC.

Methods

A Markov decision model was constructed to estimate the expected costs and outcomes for navigated and standard surgery. The input parameters were based on pilot data from a prospective (navigation cohortn = 33) and retrospective (control groupn = 142) data. Utility values were measured in a comparable group (n = 63) through the EQ5D-5L. Additionally, sensitivity and value of information analyses were performed.

Results

Based on this early evaluation, navigated surgery showed incremental costs of €3141 and €2896 in LARC and LRRC. In LARC, navigated surgery resulted in 2.05 Quality-Adjusted Life Years (QALYs) vs 2.02 QALYs for standard surgery. For LRRC, we found 1.73 vs 1.67 QALYs respectively. This showed an Incremental Cost-Effectiveness Ratio (ICER) of €136.604 for LARC and €52.510 for LRRC per QALY gained. In scenario analyses, optimal utilization rates of the navigation technology lowered the ICER to €61.817 and €21.334 for LARC and LRRC. The ICERs of both indications were most sensitive to uncertainty surrounding the risk of progression in the first year after surgery, the risk of having a positive surgical margin, and the costs of the navigation system.

Conclusion

Adding navigation system use is expected to be cost-effective in LRRC and has the potential to become cost-effective in LARC. To increase the probability of being cost-effective, it is crucial to optimize efficient use of both the hybrid OR and the navigation system and identify subgroups where navigation is expected to show higher effectiveness.
Three-arm phase II trial comparing camrelizumab plus chemotherapy versus camrelizumab plus chemoradiation versus chemoradiation as preoperative treatment for locally advanced esophageal squamous cell carcinoma (NICE-2 Study)
Authors: Yang Yang , Zhu Li , Cheng Yan , Liu Zhichao , Cai Xiaoyue , Shao Jinchen , Zhang Ming , Liu Jun , Sun Yifeng , Li Yin , Yi Jun , Yu Bentong , Jiang Hongjing , Chen Hezhong , Yang Hong , Tan Lijie , Li Zhigang
Published: May 2022

Background

Preoperative chemoradiotherapy (CRT) with CROSS regimen has been the recommended treatment for locally advanced esophageal squamous cell carcinoma (ESCC). The addition of programmed cell death protein 1 (PD-1) inhibitor to preoperative CRT may further improve oncologic results. Preoperative camrelizumab plus chemotherapy has been demonstrated as a promising treatment modality based on results of the phase II NICE study (ChiCTR1900026240).

Methods

The NICE-2 study is designed as a three-arm, multicenter, prospective, randomized, phase II clinical trial, comparing camrelizumab plus chemotherapy (IO-CT) and camrelizumab plus CRT (IO-CRT) versus CRT as preoperative treatment for locally advanced ESCC. A total of 204 patients will be recruited from 8 Chinese institutions within 1.5 years. The primary endpoint is pathological complete response (pCR) rate and secondary endpoints include event-free survival (EFS), R0 resection rate, and adverse events.

Discussion

This is the first prospective randomized controlled trial to explore commonly used neoadjuvant treatments in clinical practice, which will provide high-level evidence of neoadjuvant treatment for patients with locally advanced ESCC. The purpose of this study is to establish the optimal modality of IO-CT, IO-CRT and CRT as preoperative treatment for locally advanced ESCC. The Institution Review Committee approved this study protocol in August 2021 and patient enrollment was started in September 2021.

Trial registration

ClinicalTrial.gov: NCT05043688 (August 29, 2021). The trial was prospectively registered.
The oncogenic role of tubulin alpha-1c chain in human tumours
Authors: Hu Xinyao , Zhu Hua , Chen Biao , He Xiaoqin , Shen Yang , Zhang Xiaoyu , Xu Yangtao , Xu Ximing
Published: May 2022

Tubulin alpha-1c chain (TUBA1C), a subtype of α-tubulin, has been shown to be involved in cell proliferation and cell cycle progression in several cancers and to influence cancer development and prognosis. However, a pancancer analysis of TUBA1C to reveal its immunological and prognostic roles has not been performed. In this study, we first downloaded raw data on TUBA1C expression in cancers from The Cancer Genome Atlas (TCGA) database and multiple other databases and analysed these data with R software to investigate the prognostic and immunological value of TUBA1C in cancers. Immunohistochemical analysis was performed in gliomas to further validate our findings. Overall, TUBA1C was overexpressed in most cancers, and overexpression of TUBA1C was linked to poor prognosis and higher tumour grade in patients. In addition, TUBA1C expression was associated with tumour mutation burden (TMB), microsatellite instability (MSI), the tumour microenvironment (TME) and the infiltration of immune cells. TUBA1C was also coexpressed with most immune-related genes and influenced immune-related pathways. Immunohistochemical analysis showed that TUBA1C expression was highest in glioblastoma (GBM) tissues, second highest in low-grade glioma (LGG) tissues and lowest in normal tissues. Our study indicated that TUBA1C might be a biomarker for predicting the immune status and prognosis of cancers, offering new ideas for cancer treatment.
A multicenter, dose-finding, phase 1b study of imatinib in combination with alpelisib as third-line treatment in patients with advanced gastrointestinal stromal tumor
Authors: Pantaleo Maria A. , Heinrich Michael C. , Italiano Antoine , Valverde Claudia , Schöffski Patrick , Grignani Giovanni , Reyners Anna K. L. , Bauer Sebastian , Reichardt Peter , Stark Daniel , Berhanu Ghimja , Brandt Ulrike , Stefanelli Tommaso , Gelderblom Hans
Published: May 2022

Background

Acquired resistance to approved tyrosine kinase inhibitors limits their clinical use in patients with gastrointestinal stromal tumor (GIST). This study investigated the safety, tolerability and efficacy of alpelisib, a phosphatidylinositol 3-kinase inhibitor, used in combination with imatinib in patients with advanced GIST who had failed prior therapy with both imatinib and sunitinib.

Methods

This phase 1b, multicenter, open-label study consisted of 2 phases: dose escalation and dose expansion. Dose escalation involved 200 mg once daily (QD) alpelisib, initially, followed by 250 and 350 mg. These were combined with 400 mg QD imatinib until maximum tolerated dose (MTD) and/or a recommended phase 2 dose (RP2D) of alpelisib in combination with imatinib was determined. This MTD/RP2D dose was tested to evaluate the clinical activity of this combination in dose expansion.

Results

Fifty-six patients were enrolled, 21 and 35 in the dose escalation and expansion phases, respectively. The MTD of alpelisib given with imatinib was determined as 350 mg QD. Combination treatment showed partial response in 1 (2.9%) and stable disease in 15 (42.9%) patients. Median progression-free survival was 2 months (95% CI 1.8–4.6). Overall, 92.9% patients had adverse events (AEs) while 46.4% had grade 3/4 AEs, hyperglycemia being the most common (23.2%).

Conclusions

The MTD of alpelisib was estimated as 350 mg QD when used in combination with imatinib 400 mg QD after oral administration in patients with advanced GIST. The safety and tolerability profile of this combination was acceptable; however, the combination did not demonstrate sufficient clinical activity to justify additional clinical testing.

Trial registration

ClinicalTrials.govNCT01735968 (date of initial registration 28/11/2012).
Cost-effectiveness of using artificial intelligence versus polygenic risk score to guide breast cancer screening
Authors: Mital Shweta , Nguyen Hai V.
Published: May 2022

Background

Current guidelines for mammography screening for breast cancer vary across agencies, especially for women aged 40–49. Using artificial Intelligence (AI) to read mammography images has been shown to predict breast cancer risk with higher accuracy than alternative approaches including polygenic risk scores (PRS), raising the question whether AI-based screening is more cost-effective than screening based on PRS or existing guidelines. This study provides the first evidence to shed light on this important question.

Methods

This study is a model-based economic evaluation. We used a hybrid decision tree/microsimulation model to compare the cost-effectiveness of eight strategies of mammography screening for women aged 40–49 (screening beyond age 50 follows existing guidelines). Six of these strategies were defined by combinations of risk prediction approaches (AI, PRS or family history) and screening frequency for low-risk women (no screening or biennial screening). The other two strategies involved annual screening for all women and no screening, respectively. Data used to populate the model were sourced from the published literature.

Results

Risk prediction using AI followed by no screening for low-risk women is the most cost-effective strategy. It dominates (i.e., costs more and generates fewer quality adjusted life years (QALYs)) strategies for risk prediction using PRS followed by no screening or biennial screening for low-risk women, risk prediction using AI or family history followed by biennial screening for low-risk women, and annual screening for all women. It also extendedly dominates (i.e., achieves higher QALYs at a lower incremental cost per QALY) the strategy for risk prediction using family history followed by no screening for low-risk women. Meanwhile, it is cost-effective versus no screening, with an incremental cost-effectiveness ratio of $23,755 per QALY gained.

Conclusions

Risk prediction using AI followed by no breast cancer screening for low-risk women is the most cost-effective strategy. This finding can be explained by AI’s ability to identify high-risk women more accurately than PRS and family history (which reduces the possibility of delayed breast cancer diagnosis) and fewer false-positive diagnoses from not screening low-risk women.
Stigma and mental health challenges among adolescents living with HIV in selected adolescent-specific antiretroviral therapy clinics in Zomba District, Malawi
Authors: Kip Esther C. , Udedi Michael , Kulisewa Kazione , Go Vivian F. , Gaynes Bradley N.
Published: May 2022

Background

Of the 1.8 million adolescents between the ages of 10 and 19 living with HIV globally in 2020; approximately 1.5 million of these live in sub-Saharan Africa. These adolescents living with HIV (ALHIV) are at higher risk of experiencing mental health problems than those without; in Malawi, 18.9% have a depressive disorder. ALHIV can face numerous psychosocial challenges, but little is known about how ALHIV in Malawi perceive these stressors. Understanding psychosocial challenges of ALHIV is a key step in ensuring good mental health care. The aim of this study was to assess the psychosocial challenges faced by ALHIV attending adolescent-specific ART program in Zomba, Malawi.

Methods

Between April and May 2019, we engaged a purposive sample of ALHIV ages 12–18 (n = 80) in a series of eight focus groups drawing from four Teen Clubs linked to an adolescent-specific ART program. Data were analyzed inductively and deductively to identify themes related to ALHIV psychosocial experiences.

Results

Two themes that emerged from the study include: 1) stigma and discrimination within communities and families; 2) non-adherence to medications. HIV-related stigma was associated with increased psychological distress; physical and emotional/verbal abuse; low social support, isolation, and a feeling of rejection; and risky health behaviors such as medication hiding and non-adherence to ART. Discriminatory actions were manifested in a form of being given separate utensils for their meals and mistreatment at school. Furthermore, some parents did not allow their children to play with the participants out of fear that HIV transmission.

Conclusions

Stigma and discrimination are overlooked potential barriers to HIV treatment and care. If HIV services are to effectively meet ALHIVs' needs, mental health interventions are needed to prevent and manage depression and improve adherence to ART. These findings highlight the crucial need to develop culturally relevant mental interventions aimed at helping ALHIV to cope with these diverse challenges.
Population exposure to alcohol and junk food advertising during the 2018 FIFA world cup: implications for public health
Authors: Alfayad Khaldoon , Murray Rachael L. , Britton John , Barker Alexander B.
Published: May 2022

Background

Advertising alcoholic drinks and food high in fat, sugar, and salt (HFSS) is a driver of alcohol use and HFSS consumption, among children and young people. Whilst advertising legislation and broadcasting regulation protect children from alcohol and HFSS imagery, the 2018 FIFA World Cup, which attracted a global audience, was sponsored and partnered by alcohol and HFSS brands. This study investigated the exposure of viewers to HFSS and alcohol imagery in a selection of group matches, and the final match, of the FIFA 2018 World Cup.

Methods

The frequency and duration of appearances (to the nearest second) of branding from two sponsors (McDonald’s and Budweiser), one official partner (Coca-Cola) and the official sports drink (Powerade) were recorded during all active play in live coverage of a sample of 13 matches (Six in Group A, which included the host nation, Russia, which has stringent alcohol promotion regulations in place; six in Group G, which featured England; and the final) broadcast in the UK. We used census and viewing data to calculate gross and per capita impressions generated by this imagery in the UK population.

Results

The 13 matches included 1262 min of active play and a total of 1806 appearances of alcohol and HFSS food advertisements, delivering approximately 7.5 billion branded HFSS impressions, including 759 million to children (age < 16 years), and 3.3 billion alcohol impressions, including 385 million to children, in the UK. Appearances of HFSS and alcohol brands were not statistically different between the games in either group.

Conclusion

UK advertising legislation and broadcasting regulations intended to prevent exposure to alcohol and HFSS imagery and advertising in UK television was circumvented completely by sponsorship arrangements in the 2018 FIFA World Cup. Preventing this exposure therefore requires revision of existing advertising and broadcasting controls to include sponsorship.
Accuracy of death certifications of diabetes, dementia and cancer in Australia: a population-based cohort study
Authors: Xu Zhiwei , Hockey Richard , McElwee Paul , Waller Michael , Dobson Annette
Published: May 2022

Background

National mortality statistics are only based on the underlying cause of death, which may considerably underestimate the effects of some chronic conditions.

Methods

The sensitivity, specificity, and positive and negative predictive values for diabetes (a common precursor to multimorbidity), dementia (a potential accelerant of death) and cancer (expected to be well-recorded) were calculated from death certificates for 9 056 women from the 1921–26 cohort of the Australian Longitudinal Study on Women’s Health. Log binomial regression models were fitted to examine factors associated with the sensitivity of death certificates with these conditions as underlying or contributing causes of death.

Results

Among women who had a record of each of these conditions in their lifetime, the sensitivity was 12.3% (95% confidence interval, 11.0%, 13.7%), 25.2% (23.7%, 26.7%) and 57.7% (55.9%, 59.5%) for diabetes, dementia and cancer, respectively, as the underlying cause of death, and 40.9% (38.8%, 42.9%), 52.3% (50.6%, 54.0%) and 67.1% (65.4%, 68.7%), respectively, if contributing causes of death were also taken into account. In all cases specificity (> 97%) and positive predictive value (> 91%) were high, and negative predictive value ranged from 69.6% to 84.6%. Sensitivity varied with age (in different directions for different conditions) but not consistently with the other sociodemographic factors.

Conclusions

Death rates associated with common conditions that occur in multimorbidity clusters in the elderly are underestimated in national mortality statistics, but would be improved if the multiple causes of death listed on a death certificate were taken into account in the statistics.
Adolescent health outcomes: associations with child maltreatment and peer victimization
Authors: Salmon Samantha , Garcés Dávila Isabel , Taillieu Tamara L. , Stewart-Tufescu Ashley , Duncan Laura , Fortier Janique , Struck Shannon , Georgiades Katholiki , MacMillan Harriet L. , Kimber Melissa , Gonzalez Andrea , Afifi Tracie O.
Published: May 2022

Background

Child maltreatment (CM) and peer victimization (PV) are serious issues affecting children and adolescents. Despite the interrelatedness of these exposures, few studies have investigated their co-occurrence and combined impact on health outcomes. The study objectives were to determine the overall and sex-specific prevalence of lifetime exposure to CM and past-month exposure to PV in adolescents, and the impact of CM and PV co-occurrence on non-suicidal self-injury, suicidality, mental health disorders, and physical health conditions.

Methods

Adolescents aged 14–17 years (n = 2,910) from the 2014 Ontario Child Health Study were included. CM included physical, sexual, and emotional abuse, physical neglect, and exposure to intimate partner violence. PV included school-based, cyber, and discriminatory victimization. Logistic regression was used to compare prevalence by sex, examine independent associations and interaction effects in sex-stratified models and in the entire sample, and cumulative effects in the entire sample.

Results

About 10% of the sample reported exposure to both CM and PV. Sex differences were as follows: females had increased odds of CM, self-injury, suicidality, and internalizing disorders, and males had greater odds of PV, externalizing disorders, and physical health conditions. Significant cumulative and interaction effects were found in the entire sample and interaction effects were found in sex-stratified models, indicating that the presence of both CM and PV magnifies the effect on self-injury and all suicide outcomes for females, and on suicidal ideation, suicide attempts, and mental health disorders for males.

Conclusions

Experiencing both CM and PV substantially increases the odds of poor health outcomes among adolescents, and moderating relationships affect females and males differently. Continued research is needed to develop effective prevention strategies and to examine protective factors that may mitigate these adverse health outcomes, including potential sex differences.
Risk factors and prognosis of spinal cord injury without radiological abnormality in children in China
Authors: Liang Jianmin , Wang Linyun , Hao Xiaosheng , Wang Guangliang , Wu Xuemei
Published: May 2022

Background

Compared to adults, spinal cord injury without radiographic abnormality (SCIWORA) is more common in children due to the congenital spinal soft tissue elasticity and immature vertebral bodies. In this study, we aimed to investigate the risk factors and prognosis associated with SCIWORA in China.

Method

We retrospectively examined patient records at the First Hospital of Jilin University from January 2007 to December 2020. Patients diagnosed with SCIWORA were included in the study group (n=16). The age, gender, history of trauma, symptoms, injury level of the spinal cord, the American Spinal Injury Association (ASIA) impairment score according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), as well as laboratory and imaging findings were analyzed.

Result

The study group included 16 patients with SCIWORA with a mean age of 6.69±2.51 y. The ISNCSCI impairment scale was significantly different between the pre-school age patients (≤7 years old) and school age patients (>7 years old) before (P=0.044) and after therapy (P=0.002). Similarly, magnetic resonance imaging demonstrated a significant difference in the spinal injury level between pre-school age and school age patients (P=0.041). Further, the study group was subdivided into three subgroups according to the cause of trauma: Dance, Taekwondo, or Falls. Magnetic resonance imaging revealed significant differences among the three subgroups (P=0.041).

Conclusion

Compared to school-age patients, pre-school-age patients were more vulnerable to SCIWORA with more severe ISNCSCI scores. Dance and Taekwondo are among the risk factors associated with SCIWORA in Chinese children.
Gender modified association of oral health indicators with oral health-related quality of life among Korean elders
Authors: Vu Huong , Vo Phuc Thi-Duy , Kim Hyun-Duck
Published: May 2022

Objective

To evaluate the association between oral health-related quality of life (OHRQoL) and oral health indicators including dental status, total occlusion force (TOF), number of natural and rehabilitated teeth (NRT), number of natural teeth (NT), and to explore the effect modification on the association by gender among Korean elders.

Methods

A total of 675 participants aged 65 or above recruited by a cluster-based stratified random sampling were included in this cross-sectional study. The 14-items Korean version of the Oral Health Impact Profile (OHIP) was used to measure OHRQoL. The responses about OHIP were dichotomized by the cut-off point of 'fairly often' to determine the ‘poor’ versus ‘fair’ OHRQoL. Age, gender, education level, alcohol drinking, smoking, metabolic syndrome, frailty, and periodontitis were considered as confounders. Multiple multivariable logistic regression analyses were applied to assess the adjusted association between oral health indicators and OHRQoL. Gender stratified analysis was also applied to explore the effect modification of the association.

Results

The prevalence of poor OHRQoL was 43.0%, which was higher in women, less-educated elders, alcohol non-drinkers and frailty elders (p < 0.05). Elders with poor OHRQoL also showed lower values of oral health indicators than elders with fair OHRQoL (p < 0.05). Those with NRT ≤ 24, NT ≤ 14, and TOF < 330 N increased the risk of poor OHRQoL by 2.3 times (OR = 2.26, confidence interval [CI] 1.54–3.31), 1.5 times (OR = 1.45, CI 1.02–2.07), and 1.5 times (OR = 1.47, CI 1.06–2.04), respectively. In women, the association of NRT ≤ 24 with poor OHRQoL increased from OR of 2.3 to OR of 2.4, while, in men, the association of TOF < 330 N with poor OHRQoL increased from OR of 1.5 to OR of 3.2.

Conclusion

Oral health indicators consisting of TOF, NRT, and NT were independently associated with poor OHRQoL among Korean elders. Gender modified the association of TOF and NRT. Preventive and/or curative management for keeping natural teeth and the rehabilitation of missing teeth to recover the occlusal force may be essential for reducing poor OHRQoL.
Correlation between periodontitis and prostate-specific antigen levels in the elderly Chinese male population
Authors: Mao Mengyun , Zhu Haihua , Xie Yanyi , Ni Da , Zhu Fudong , Chen Qianming
Published: May 2022

Background

The comparison of prostate-specific antigen (PSA) levels among older individuals with different periodontal statuses has not been fully investigated. Here we aimed to explore the correlation between the staging and grading of periodontitis and PSA levels in an elderly Chinese male population, which may lead to a biopsy recommendation and prevent prostate cancer as early as possible.

Methods

The study included 996 individuals aged ≥ 55 years who participated in routine postretirement physical examinations. Periodontal data included probing depth and gingival recession on four sites/tooth and on two diagonal quadrants (1–3 or 2–4) while excluding third molars, and clinical attachment loss was calculated. Periodontal status was classified as none, mild-moderate or severe periodontitis according to the Centers for Disease Control and Prevention and the American Academy of Periodontology case definition. Blood samples, oral health status and sociodemographic characteristics were collected by using general and oral examinations and questionnaires. Linear and logistic regressions were used to estimate the correlation between periodontitis severity and PSA levels, respectively.

Results

A total of 479 men had mild-moderate periodontitis and 355 had severe periodontitis; 162 men were periodontally healthy individuals. After adjusting for potential confounders, PSA levels were significantly lower in the individuals without periodontitis than in those with mild-moderate (P = 0.04) or severe (P = 0.03) periodontitis. However, PSA levels did not significantly correlate with periodontitis severity (P = 0.06). Although the ORs of elevated PSA were not significant, individuals with PSA ≥ 4.0 ng/mL were more likely to have periodontitis.

Conclusions

In a sample of an elderly Chinese male population, after adjusting for possible confounders, serum PSA levels in individuals with periodontitis were significantly higher than those in individuals without periodontitis, but serum PSA did not significantly correlate with periodontitis severity.
A new scoring system facilitating diagnosis of oral squamous malignancy on biopsy specimens
Authors: Wu Cheng-Lin , Huang Cheng-Chih , Wu Shang-Yin , Jiang Shih-Sheng , Tsai Fang-Yu , Hsiao Jenn-Ren
Published: May 2022

Background

Morphological evaluation of oral mucosal biopsy is sometimes inconclusive, which may delay the diagnosis and treatment of oral squamous malignancy. Immunohistochemical biomarkers denoting oral squamous malignancy would be clinically helpful in such scenario.

Methods

We first studied the expression patterns of four potential biomarkers (cytokeratin 13, cytokeratin 17, Ki-67 and laminin 5 gamma 2 chain) in an exploratory cohort containing 54 surgical specimens from confirmed oral squamous malignancies. A pattern score was assigned to each specific expression pattern of these four biomarkers. A total score from each specimen was then calculated by summing up the four pattern scores. A cut-off value of total score denoting oral squamous malignancy was then determined. Another 34 oral squamous malignancies that were misdiagnosed as non-malignant lesions on their pre-treatment biopsies were used as a validation cohort to test the clinical utility of this scoring system.

Results

In the exploratory cohort, fifty-two (96%) of the 54 confirmed oral squamous malignancies had a total score of 9 and above. In the validation cohort, thirty-one (91%) of the 34 pre-treatment oral biopsy specimens also had a total score of 9 or above, supporting the feasibility of using this scoring system to predict immediate risk of oral squamous malignancy.

Conclusions

Our four-biomarker “oral squamous malignancy scoring system” provides reliable prediction for immediate risk of oral squamous malignancy on pre-treatment oral biopsies.
Effectiveness of psychological techniques in dental management for children with autism spectrum disorder: a systematic literature review
Authors: AlBhaisi Ismail Nabil , Kumar Marisa Shanthini Thomas Santha , Engapuram Anissha , Shafiei Zaleha , Zakaria Ahmad Shuhud Irfani , Mohd-Said Shahida , McGrath Colman
Published: May 2022

Background

A rise in the reported numbers of children with Autism Spectrum Disorder (ASD) highlights the need for dental practitioners to be more familiar with the treatment approaches for these special needs children to ensure comfortable, well-accepted and efficient management while in dental office.

Aim

This paper aimed to acquire a deeper understanding of some of the innovative and best approaches to managing children with ASD in dental settings.

Design

A systematic literature search was performed in PubMed, Scopus, Web of Science, Cochrane databases, and grey literature based on the PRISMA 2020 statement, using main keywords such as: ‘management’, ‘dental’, ‘children’, and ‘Autism Spectrum Disorder’. Original full-text papers including randomised controlled trials (RCT) and all other designs of non-randomised controlled studies (NRS) reporting relevant intervention studies in English were included without any publication time limit. The quality of the evidence found eligible for the review were then assessed using the ROB-2 and ROBINS-I tools. Subsequently, the details of management interventions and impact of treatment approaches were compared and discussed.

Results

Out of the 204 articles found, 109 unrelated articles were excluded during the initial screening. The full papers of remaining 28 were retrieved and only 15 (7%) articles were eligible to be reviewed; eight RCTs with ‘some concerns’ and ‘high risk’ categories particularly concerning their randomisation design, and seven NSRs with ‘serious’ to ‘critical’ bias largely due to confounding factors.

Conclusion

Our review found inconclusive evidence on the strength of recent psychological and non-pharmacological approaches used to manage children with ASD in dental settings. Small sample size and lack of a control group in certain studies affected the strength of evidence and credibility of the findings. Nevertheless, this review shared informative details on some innovative approaches for better understanding of the management of children with ASD for dental professionals.
Dying in hospital in Germany – optimising care in the dying phase: study protocol for a multi-centre bottom-up intervention on ward level
Authors: Kremeike Kerstin , Ullrich Anneke , Schulz Holger , Rosendahl Carolin , Boström Kathleen , Kaur Sukhvir , Oubaid Nikolas , Plathe-Ignatz Christina , Leminski Christin , Hower Kira , Pfaff Holger , Hellmich Martin , Oechsle Karin , Voltz Raymond
Published: May 2022

Background

Hospitals are globally an important place of care for dying people and the most frequent place of death in Germany (47%), but at the same time, the least preferred one – for both patients and their relatives. Important indicators and outcome variables indexing quality of care in the dying phase are available, and various proposals to achieve corresponding quality objectives exist. However, they are not yet sufficiently adapted to the heterogeneous needs of individual hospital wards.

Methods

This multi-centre single-arm pre-post study aims at the development and implementation of context-specific measures in everyday clinical practice, followed by evaluating this approach. Therefore, (1) already existing measures regarding optimal care in the dying phase are identified applying a systematic literature review as well as an online survey and a symposium with experts. Supported by the thereby generated collection of measures, (2) a stratified sample of ten teams of different wards from two university hospitals select suitable measures and implement them in their everyday clinical practice. Circumstances of patients’ deaths on the selected wards are recorded twice, at baseline before application of the self-chosen measures and afterwards in a follow-up survey. Retrospective file analysis of deceased persons, quantitative staff surveys as well as qualitative multi-professional focus groups and interviews with relatives form the data basis of the pre-post evaluation. (3) Results are reviewed regarding their transferability to other hospitals and disseminated (inter-)nationally.

Discussion

Measures that are easy to implement and appropriate to the specific situation are supposed to significantly improve the quality of care during the dying phase in hospitals and contribute to the well-being of dying patients and their relatives. Successful implementation of those measures requires consideration of the individual conditions and needs of patients and their relatives—but also of the health professionals—on the different hospital wards. Therefore, a bottom-up approach, in which the ward-specific situation is first analysed in detail and then the staff itself selects and implements measures to improve care, appears most promising for optimising care in the dying phase in hospitals.

Trial registration

The study is registered in the German Clinical Trials Register (DRKS00025405).
Assessing the psychosocial work environment in the health care setting: translation and psychometric testing of the French and Italian Copenhagen Psychosocial Questionnaires (COPSOQ) in a large sample of health professionals in Switzerland
Authors: Peter Karin Anne , Golz Christoph , Bürgin Reto Arthur , Nübling Matthias , Voirol Christian , Zürcher Simeon Joel , Hahn Sabine
Published: May 2022

Background

Measuring work-related stress in a reliable way is important in the development of appropriate prevention and intervention strategies. Especially in multilingual studies the use of comparable and reliable instruments is crucial. Therefore, the aim of this study was to translate selected scales and single items from the German version of the Copenhagen Psychosocial Questionnaire (COPSOQ) into French and Italian and psychometrically test them in a sample of health professionals.

Methods

This study used cross-sectional data from health professionals at 163 randomised selected health organisations in Switzerland. Selected COPSOQ items/scales were backwards- and forwards- translated and cross-culturally adapted from German to French and Italian. Reliability was assessed with Cronbach alpha and intraclass correlation coefficients, construct validity with confirmatory factor analysis (CFA) and structural equation modelling as well as comparative fit index.

Results

Responses from 12,754 health professionals were included in the analysis. Of the overall 24 scales, 20 in the German version, 19 in the French version and 17 in the Italian version attained sufficient internal consistency with a threshold of 0.7 for Cronbach’s alpha. Predominantly high factor loadings on scale level are reported (> 0.35), as well as good and satisfactory fit values with RMSEA below 0.1, SRMR below 0.08 and CFI above 0.95. For 10 out of 15 scales, the test for factor invariance revealed a significant difference regarding the psychological constructs of the scales across the language versions.

Conclusions

The psychometric properties verify the underlying theoretical model of the COPSOQ questionnaire, which is to some extent comparable across the three language versions. Of the 10 scales with significant factor variance, four showed large differences, implying that revision is needed for better comparability. Potential cultural issues as well as regional differences may have led to the factor variance and the different reliability scores per scale across language versions. One known influencing factor for regional differences is culture, which should be considered in scale development. Moreover, emerging topics such as digitization should be considered in further development of the questionnaire.
Comparative 3D genome architecture in vertebrates
Authors: Li Diyan , He Mengnan , Tang Qianzi , Tian Shilin , Zhang Jiaman , Li Yan , Wang Danyang , Jin Long , Ning Chunyou , Zhu Wei , Hu Silu , Long Keren , Ma Jideng , Liu Jing , Zhang Zhihua , Li Mingzhou
Published: May 2022

Background

The three-dimensional (3D) architecture of the genome has a highly ordered and hierarchical nature, which influences the regulation of essential nuclear processes at the basis of gene expression, such as gene transcription. While the hierarchical organization of heterochromatin and euchromatin can underlie differences in gene expression that determine evolutionary differences among species, the way 3D genome architecture is affected by evolutionary forces within major lineages remains unclear. Here, we report a comprehensive comparison of 3D genomes, using high resolution Hi-C data in fibroblast cells of fish, chickens, and 10 mammalian species.

Results

This analysis shows a correlation between genome size and chromosome length that affects chromosome territory (CT) organization in the upper hierarchy of genome architecture, whereas lower hierarchical features, including local transcriptional availability of DNA, are selected through the evolution of vertebrates. Furthermore, conservation of topologically associating domains (TADs) appears strongly associated with the modularity of expression profiles across species. Additionally, LINE and SINE transposable elements likely contribute to heterochromatin and euchromatin organization, respectively, during the evolution of genome architecture.

Conclusions

Our analysis uncovers organizational features that appear to determine the conservation and transcriptional regulation of functional genes across species. These findings can guide ongoing investigations of genome evolution by extending our understanding of the mechanisms shaping genome architecture.