bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-pharmacological, psychosocial MAKS-s intervention for people with severe dementia in nursing homes: results of a cluster-randomised trial
Authors: Kratzer André , Diehl Kristina , Gefeller Olaf , Meyer Sebastian , Graessel Elmar
Published: December 2022

Background

Severe dementia is one of the most challenging conditions when caring for people in nursing homes. A manualised non-pharmacological, psychosocial group intervention especially adapted to the needs of people with severe dementia (PWSDs) is currently still lacking. To close this gap, we adapted the evidence-based multicomponent non-pharmacological MAKS intervention (Motor stimulation, ADL stimulation, Cognitive [german: Kognitive] stimulation, and Social functioning in a group setting) to the special needs of PWSDs called the MAKS-s intervention, where the s stands for severe dementia.

Methods

In a prospective, multicentre, cluster-randomised trial with a waitlist control group design, 26 nursing homes comprising 152 PWSDs were randomly assigned to either the MAKS-s intervention group (IG) or control group (CG) – 121 PWSDs were still alive after the 6-month intervention period (t6) and included in the intention-to-treat (ITT) sample. The two primary outcomes, behavioural and psychological symptoms (BPSDs, measured with NPI-NH) and quality of life (QoL, measured with QUALIDEM), and the secondary outcome, activities of daily living (ADLs, measured with ADCS-ADL-sev), were assessed at baseline (t0) and at t6. Mixed ANOVAs were computed to investigate possible effects of the MAKS-s intervention on the outcomes.

Results

In the ITT sample, BPSDs and QoL did not change significantly over time, and group assignment did not affect them, although the IG participants had significantly better overall QoL than the CG participants. ADLs decreased significantly over time, but group assignment did not affect them. Analyses in the per protocol (PP) sample showed comparable results, with the exception that the IG participants showed a significantly greater increase in BPSDs than the CG participants did.

Discussion

Under the situational conditions of the Covid-19 pandemic, no beneficial effects of the MAKS-s intervention on BPSDs, QoL, or ADLs were observed. This finding also means that under ‘normal circumstances’ (i.e., if there had been no pandemic), we could not make any statements about the effect or non-effect of MAKS-s. In order to be able to address the hypotheses formulated here, the study will have to be repeated incorporating helpful experiences of the present study.

Trial registration

https://doi.org/10.1186/ISRCTN15722923 (Registered prospectively, 07. August 2019).
The Impact of Controlling Nutritional Status (CONUT) score on functional prognosis in hospitalized elderly patients with acute osteoporotic vertebral fractures
Authors: Yamaura Tetsuto , Arizumi Fumihiro , Maruo Keishi , Kishima Kazuya , Yoshie Norichika , Kusukawa Tomoyuki , Imamura Fumiaki , Tachibana Toshiya
Published: December 2022

Background

Nutritional status, which is associated with osteoporosis and muscle weakness is considered an important factor in the management of acute osteoporotic vertebral fracture (AOVF). However, few reports have investigated the nutritional status of hospitalized patients with AOVF and the impact of malnutrition on their functional prognosis. This study aimed to evaluate the nutritional status of hospitalized elderly patients with AOVF using the Controlling Nutritional Status (CONUT) score and to determine the usefulness of the CONUT score in predicting their functional prognosis.

Methods

The CONUT score on admission was retrospectively calculated for 134 hospitalized elderly patients (mean age 83 ± 7.6 years, 66% female) with AOVF who received conservative treatment between 2017 and 2020. Functional outcome was assessed by comparing ambulatory ability before the onset of AOVF and upon discharge. Patients were divided into two groups: CONUT-high ( ≥ 4) and CONUT-low ( ≤ 3), according to receiver operating characteristic (ROC) analysis to predict decline in ambulatory ability upon discharge. Logistic regression analysis was performed to obtain odds ratios (OR) and 95% confidence intervals (CI) of the relationships between the nutritional status and ambulatory ability. The discriminative power of the CONUT score was then compared with other nutritional assessment tools such as the Geriatric Nutritional Risk Index (GNRI) and prognostic nutritional index (PNI) by ROC analysis.

Results

81% of hospitalized patients with an AOVF were malnourished at the time of admission. The CONUT-high group had a significantly higher rate of decline in ambulatory ability (P < 0.001) than the CONUT-low group. Logistic regression analysis revealed the CONUT score ( ≥ 4) as an independent risk factor for a decline in ambulatory ability (OR 3.44, 95% CI 1.61–7.37, P = 0.0014). ROC analysis showed that the area under the curve (AUC) for the CONUT score (AUC = 0.724) was significantly greater than that for the GNRI (AUC = 0.624, P = 0.021) and PNI (AUC = 0.636, P = 0.0008).

Conclusions

This study showed that 81% of hospitalized elderly patients with AOVFs were malnourished and that the CONUT score was a useful predictive factor of functional prognosis.
The mastery lifestyle intervention to reduce biopsychosocial risks for pregnant Latinas and African Americans and their infants: protocol for a randomized controlled trial
Authors: Ruiz R. Jeanne , Grimes Kristyn , Spurlock Elizabeth , Stotts Angela , Northrup Thomas F. , Villarreal Yolanda , Suchting Robert , Cernuch Melissa , Rivera Liza , Stowe Raymond P. , Pickler Rita H.
Published: December 2022

Background

Pregnant Mexican Americans (hereafter called Latinas) and Black/African American women are at increased risk for psychological distress, contributing to preterm birth and low birthweight; acculturative stress combined with perceived stress elevates depressive symptoms in Latinas. Based on our prior research using a psychoneuroimmunology framework, we identified psychological and neuroendocrine risk factors as predictors of preterm birth in Latina women that are also identified as risk factors for Black/African American women.

Methods/design

In this prospective, randomized controlled trial with parallel group design we will explore psychosocial, neuroendocrine, and birth outcome effects of the Mastery Lifestyle Intervention (MLI). The MLI is a culturally relevant, manualized, psychosocial, group intervention integrating two cognitive behavioral therapies for both pregnant Latinas and Black/African American women (total n = 221). Study inclusion criteria are: women with current pregnancy at 14–20 weeks gestation, ability to read and speak English or Spanish, self-identify as Latina of Mexican heritage or Black/African American, 18–45 years old, born in the US or Mexico, and currently living in the US. Participants must receive Medicaid or other government-supported insurance, and meet screening criteria for anxiety, depressive symptoms, or stress. Participants are randomly assigned to either the intervention (MLI) or usual care group (UCG) in groups of 6–8 participants that occur over 6 consecutive weeks. Data are collected at 3 time points: enrollment (14–20 weeks gestation), following treatment (20–26 weeks), and 6 weeks after treatment (32–36 weeks gestation). Additional outcome, mediating, and moderating data are collected from the electronic health record during pregnancy and at birth. Analyses will primarily use generalized linear mixed modeling (GLMM) to evaluate the relationships between predictors and outcomes.

Discussion

This RCT will test the efficacy of two combined third generation cognitive behavioral therapies (the MLI), given in a group format over 6 sessions, as compared to a usual prenatal care group, for both Latina and African American pregnant women. If efficacious, it may be provided as an adjunct to routine prenatal care and improve mental health, as well as babies being born too small and too soon.

Trial registration

The trial was retrospectively registered at ClinicalTrials.gov. Bethesda (MD): National Library of Medicine. Identifier NCT05012072, Reducing Pregnancy Risks: The Mastery Lifestyle Intervention (MLI); August 19, 2021. The trial is currently recruiting participants.
Time trends in episiotomy and severe perineal tears in Portugal: a nationwide register-based study
Authors: Teixeira Cristina , Lorthe Elsa , Barros Henrique
Published: December 2022

Introduction

Rates of episiotomy and severe perineal tears (SPT) are indicators of the quality of obstetric care. Time-trends in the reported occurrence of episiotomy and SPT can contribute to understand both, changes in care and in the frequency of risk factors. Therefore, we aimed to estimate time trends in the frequency of SPT in Portugal and its relationship with episiotomy.

Methods

We conducted a nationwide register-based study using data from the national inpatient database of all Portuguese public hospitals between 2000 and 2015. Time-trend analysis using joinpoint regression models was performed to identify trends (joinpoints) and compare time changes in the prevalence of SPT and risk factors expressed as annual percentage changes (APC) with 95% Confidence Intervals (95% CI). Poisson regression models were fitted to estimate whether time-trends in SPT rates were explained by changes in risk factors and to assess the association between episiotomy and SPT. Adjusted relative risk (aRR) and their respective 95% CI were obtained.

Results

From 908,999 singleton vaginal deliveries, 20.6% were instrumental deliveries, 76.7% with episiotomy and 0.56% were complicated by SPT. Among women with non-instrumental deliveries and no episiotomy SPT decreased from 2009 onwards (1.3% to 0.7%), whereas SPT kept increasing in women with episiotomy for both non-instrumental (0.1% in 2000 to 0.4% in 2015) and instrumental deliveries (0.7% in 2005 to 2.3% in 2015). Time-trends in potential risk factors did not explain the observed increase in SPT. Episiotomy was associated with a decrease in SPT with adjusted RR varying between 2000 and 2015 from 0.18 (95%CI:0.13–0.25) to 0.59 (95%CI:0.44–0.79) for non-instrumental deliveries and from 0.45 (95%CI:0.25–0.81) to 0.50 (95%CI:0.40–0.72) for instrumental deliveries.

Conclusions

Our findings suggest that episiotomy rate could safely further decrease as the main factor driving SPT rates seems to be an increase in awareness and reporting of SPT particularly among women who underwent an episiotomy.
Association of labor epidural analgesia use with exclusive breastfeeding up to six months: a online-based cross sectional survey in Jiaxing, China
Authors: Fu Chun-Yan , Wang Li-Zhong , Tang Xue-Juan , Xia Feng
Published: December 2022

Background

The impact of labor epidural analgesia (LEA) on breastfeeding remains controversial. The aim of this study was to assess the relationship between LEA use and exclusive breastfeeding (EBF) up to 6 months.

Methods

This was a cross-sectional survey on healthy mothers who had vaginal delivery with infants aged 7-12 months from seven maternal health WeChat groups in Jiaxing, China. Data including EBF status up to 6 months, maternal sociodemographic characteristics, LEA use in labor, breastfeeding supports during hospitalization and reasons for stopping EBF were collected using online self-administered questionnaires in October 2021. A multivariable logistic regression model was used to determine the potential association of LEA use with EBF up to 6 months by the adjusted odds ratio (AOR) and 95% confidence interval (CI).

Results

Of a total of 537 surveyed mothers, 408 (76.0%) delivered with LEA and 398 (74.1%) exclusively breastfed their infants until 6 months. All mothers delivered in the hospitals with active breastfeeding policies. There was no statistical difference in the rate of EBF up to 6 months between mothers with and without LEA (73.8% versus 75.2%, P = 0.748). Multivariable logistic regression analysis indicated that only increased maternal age (AOR = 0.906, 95% CI 0.854-0.961, P = 0.001) and perceived insufficient breast milk (AOR = 0.129, 95% CI 0.082-0.204, P <  0.001) were associated with lower odds of EBF up to 6 months. The top three reasons for non-EBF were no or insufficient breast milk (41.7%), inability to breastfeed infants after return to work (27.3%), and maternal related factors (24.4%).

Conclusions

LEA does not affect EBF up to 6 months. Other factors such as health education and breastfeeding-friendly hospital strategies may be much more important to breastfeeding outcomes compared to LEA use.
Axenfeld-Rieger syndrome: a novel histopathologic finding associated with corneal abnormalities
Authors: Yu Ting , Dai Zhihao , Peng Rongmei , Xiao Gege , Zhang Pei , Ma Siyi , Hong Jing
Published: December 2022

Background

Axenfeld-Rieger syndrome (ARS) is a rare kind of anterior segment dysgenesis (ASD). The most common ocular features of ARS are posterior embryotoxon and iris hypoplasia, while some patients may manifest as corneal opacity and edema. However, the current understanding of how ARS affects the cornea is still incomplete. This study reports a novel histopathological finding of ARS, complicating corneal abnormalities, including congenital corneal opacity and irreversible endothelial decompensation.

Methods

This retrospective study included 6 eyes of 3 ARS patients, 5 of which underwent keratoplasty for irreversible endothelial decompensation from May 2016 to January 2019. No eye had a history of surgery. We reviewed the data of epidemiology, clinical manifestations and histopathologic examinations.

Results

Five eyes developed irreversible endothelial decompensation, among which 4 were born with corneal opacity. One eye exhibited transparent cornea but showed a continuous loss of endothelial cells in the absence of surgery and elevated intraocular pressure thereafter. Anterior segment optical coherence tomography photographs showed that anterior synechia existed in the area with corneal opacities, where we found the interlayer splitting of the Descemet membrane inserted by hypoplastic iris and a basement membrane-like structure under a light microscope.

Conclusion

Anterior synechia might be associated with corneal abnormalities in ARS patients. The novel histopathologic finding revealed the internal relation between anterior segment dysgenesis and would help explore the inner mechanism of corneal abnormalities in ARS.
Exploring the lived experience of mental health and coping during unemployment
Authors: Arena Andrew F. , Harris Marnie , Mobbs Sophia , Nicolopoulos Alexandra , Harvey Samuel B. , Deady Mark
Published: December 2022

Background

Unemployment is known to involve various psychosocial challenges that can negatively impact mental health. However, the intricacies of how individuals experience these challenges and strive to cope within the context of varied sociocultural and individuating factors, remain comparatively understudied. The present qualitative study used an interpretative phenomenological approach to explore the lived experiences of mental health and coping during unemployment.

Methods

Fifteen Australian adults who had recently experienced unemployment (for ≥3 months in the last 2 years), despite being available for and able to work, participated in semi-structured interviews from August to September 2021. Maximum variation sampling ensured participants represented diverse sociodemographic backgrounds. Interviews were audio-recorded, transcribed verbatim and analysed using reflexive thematic analysis within NVivo12 software.

Results

Four major themes were identified: 1) disrupted identity and direction in life; 2) navigating conflicting views of contribution and progress; 3) knowing how to cope is not enough; and 4) unemployment as a catalyst for new understandings. Unemployment disrupted participants’ sense of purpose, identity and visions for the future. It signified a perceived failure to meet societal standards of value based upon the economic functions of work, which participants struggled to reconcile with their own priorities for work that satisfied psychosocial needs. Participants were aware of effective coping strategies, although these had mixed positive and negative effects on mental health, or were difficult to mobilise during unemployment. The COVID-19 pandemic, while normalising unemployment to some degree, exacerbated future uncertainty and prevented engagement with known coping strategies (e.g., social interaction). However, unemployment could also instigate growth through re-defining markers of achievement, re-aligning goals with one’s core values, and developing greater compassion.

Conclusions

Experiences of mental health and coping during unemployment share complex relationships both with each other and with broader personal and sociocultural contexts. Service providers may better meet the mental health needs of those experiencing unemployment by balancing the economic and psychosocial functions of work, understanding that coping is a wholistic issue that goes beyond knowledge of effective strategies, and being aware of the opportunities for self-development that unemployment can create.
Effect of COVID-19 infection related experiences on social behaviors when a state of emergency is declared: a cohort study
Authors: Mori Takahiro , Nagata Tomohisa , Ikegami Kazunori , Hino Ayako , Tateishi Seiichiro , Tsuji Mayumi , Matsuda Shinya , Fujino Yoshihisa , Mori Koji ,   for the CORoNaWork project, Ogami Akira , Ando Hajime , Eguchi Hisashi , Muramatsu Keiji , Mafune Kosuke , Okawara Makoto , Kuwamura Mami , Matsugaki Ryutaro , Ishimaru Tomohiro , Igarashi Yu
Published: December 2022

Background

Restricting the movement of the public to gathering places and limiting close physical contact are effective measures against COVID-19 infection. In Japan, states of emergency have been declared in specific prefectures to reduce public movement and control COVID-19 transmission. We investigated how COVID-19 infection related experiences including people with a history of infection, people with a history of close contact, and people whose acquaintances have been infected, affected self-restraint from social behaviors during the second state of emergency in Japan.

Methods

A prospective cohort study was conducted among workers aged 20–65 years using data from an internet survey. The baseline survey was conducted on December 22–25, 2020, and a follow-up survey was on February 18–19, 2021. There were 19,051 participants who completed both surveys and were included in the final analysis. We identified eight social behaviors: (1) eating out (4 people or fewer); (2) eating out (5 people or more); (3) gathering with friends and colleagues; (4) day trip; (5) overnight trip (excluding visiting home); (6) visiting home; (7) shopping for daily necessities; and (8) shopping for other than daily necessities. We set self-restraint regarding each social behavior after the second state of emergency was declared in January 2021 as the dependent variable, and COVID-19 infection related experiences as independent variables. Odds ratios were estimated using multilevel logistic regression analyses nested in the prefecture of residence.

Results

Significant differences by COVID-19 infection related experiences were identified: compared to people without COVID-19 related experiences, people with a history of COVID-19 were less likely self-restraint from most social behaviors. People whose acquaintance had been diagnosed with COVID-19 were significantly more likely to refrain from most social behaviors. There was no significant difference in any social behaviors for people with a history of close contact only.

Conclusion

To maximize the effect of a state of emergency, health authorities should disseminate information for each person in the target population, taking into account potential differences related to the infection related experiences.
Gendered health consequences of unemployment in Norway 2000–2017: a register-based study of hospital admissions, health-related benefit utilisation, and mortality
Authors: Heggebø Kristian
Published: December 2022

Background

The existing literature indicates that unemployment leads to deteriorated mental and somatic health, poorer self-assessed health, and higher mortality. However, it is not clear whether and to what extent the health consequences of unemployment differ between men and women. According to social role theory, women can alternate between several roles (mother, wife, friend, etc.) that make it easier to deal with unemployment, whereas the worker role is more important for men, and unemployment could therefore be more harmful to them. Thus, gender differences in the health consequences of unemployment should decrease as society grows more gender equal. Accordingly, this study examines changes over time in the gendered health consequences of unemployment in Norway. 

Methods

Linked Norwegian administrative register data, covering the period from 2000 to 2017, were analysed by means of linear probability models and logistic regression. Four health outcomes were investigated: hospitalisation, receiving sick pay, disability benefit utilisation, and the likelihood of mortality. Two statistical models were estimated: adjusted for (1) age, and (2) additional sociodemographic covariates. All analyses were run split by gender. Three different unemployment cohorts (2000, 2006, and 2011) that experienced similar economic conditions were followed longitudinally until 2017.

Results

The empirical findings show, first, that hospital admission is somewhat more common among unemployed males than among unemployed females. Second, receiving sick pay is much more common post-unemployment for men than for women. Third, excess mortality is higher among unemployed males than among unemployed females. Fourth, there is no gender component in disability benefit utilisation. There is a remarkable pattern of similarity when comparing the results for the three different unemployment cohorts (2000; 2006; 2011). Thus, the gendered health consequences of unemployment have hardly changed since the turn of the century.

Conclusion

This paper demonstrates that the health consequences of unemployment are serious, gendered, and enduring in Norway.
Surgery for pilonidal sinus disease in Norway: training, attitudes and preferences—a survey among Norwegian surgeons
Authors: Odlo Mari , Horn Julie , Xanthoulis Athanasios
Published: December 2022

Background

Pilonidal sinus disease (PSD) is frequently observed in young adults. There is no wide consensus on optimal treatment in the literature, and various procedures are used in clinical practice. The objective of this study was to assess current practice, experience, training, and attitudes towards PSD surgery among Norwegian surgeons.

Methods

An online survey on PSD surgery was created and sent to all members of the Norwegian Surgical Association. Categorical data were reported as frequencies and percentages.

Results

Most currently practicing Norwegian surgeons used the Bascom’s cleft lift (93.2%) or minimally invasive procedures (55.4%). Midline excisions with primary closure (19.7%) or secondary healing (22.4%) were still used by some surgeons, though. Most surgeons had received training in PSD surgery supervised by a specialist, but only about half of them felt sufficiently trained. The surgeons generally performed few PSD operations per year. Many considered PSD as a condition of low surgical status and this patient group as underprioritized.

Conclusions

Our findings suggest that PSD surgery in Norway has been moving away from midline excisions and towards off-midline flap procedures and minimally invasive techniques. PSD and its treatment have a low status among many Norwegian surgeons. This study calls for attention to this underprioritized group of patients and shows the need for consensus in PSD treatment such as development of national guidelines in Norway. Further investigation on training in PSD and the role of supervision is needed.
Influence of the contact area of the sub-antral space with sinus bone and the Schneiderian membrane on osteogenesis in lateral window sinus elevation surgery: a prospective experiment
Authors: She Xiao , Zhang Dongjiao , Xu Xin , Zhang Zhanwei , Ji Chonghao , Li Zechuan , Song Dawei
Published: December 2022

Background

Osteogenesis of lateral window sinus elevation surgery is the key to placement of the subsequent implant, excessive collapse of the sub-antral space may adversely affect long-term stability of implants. At present, few studies focus on the influence of the contact area of the sub-antral space on osteogenesis. This study evaluated whether the change in the contact area of the sub-antral space with maxillary sinus bone and the Schneiderian membrane can affect osteogenesis.

Methods

Cone beam computed tomography (CBCT) images were collected of patients requiring maxillary sinus floor elevation (residual bone height < 6 mm) for standard-length implant placement before surgery, after surgery, and at 6-month follow-up visits. The postoperative sub-antral space volume (V1) and surface area (S1), and the remaining volume after six months of healing (V2) were measured. Then, the contact area of sub-antral space with maxillary sinus bone (Sbc) and the Schneiderian membrane (Smc), the absorbed volume during healing (Va), and the percentage of remaining volume (V2%) and absorbed volume (Va%) were calculated. The correlation between anatomical parameters was analyzed using multiple linear regression.

Results

A total of 62 maxillary sinuses from 56 patients were augmented, of which 57 were considered for the final analysis (5 withdrew due to perforation). Multiple linear regression results demonstrated that Sbc was significantly positively correlated with Va (β coefficient = 0.141, p < 0.01) without correlation between Smc and Va (β coefficient =  − 0.046, p = 0.470). There was a positive correlation between Sbc and V2% (β coefficient = 2.269, p < 0.05).

Conclusions

This study confirmed that the size of the Sbc in lateral window sinus elevation surgery affected osteogenesis after six months of healing. Clinicians should assess the sinus contour type preoperatively, then consider whether it is necessary to expand the range of the Schneiderian membrane elevation to avoid excessive collapse of the sub-antral space.

Trial registration: Chinese Clinical Trial Registry (ChiCTR), ChiCTR2200057924. Registered 22 March 2022–Retrospectively registered.
Resection of inferior vena cava, abdominal aorta, bilateral common iliac arteries, and bilateral partial external iliac arteries with artificial vessel replacement during radical endometrial cancer surgery: a case report
Authors: Yang Linlin , Yang Hongying , Zhao He , Hu Zaoxiu , Shen Zhenglei , Zhao Lingfeng , Tan Shufen , Zhu Lei , Xu Ruolan , Liu Hui , Ding Chunyan , Qin Yan , Zhao Yanfei
Published: December 2022

Background

Endometrial carcinoma (EC) is a common malignant tumor of the female reproductive system, often accompanied by lymph node metastasis. Artificial vascular implantation is a common surgical treatment for mediastinal tumors and abdominal aortic aneurysms but is rarely used in gynecological surgery.

Case presentation

A 54-year-old female patient was first admitted to the hospital in January 2018 due to “irregular vaginal bleeding over 3 months”. CT showed a mass in the uterine cavity, and several swollen lymph nodes in the retroperitoneum and pelvic cavity. The initial diagnosis was an endometrial malignant tumor. We performed radical endometrial cancer surgery with parallel resection of inferior vena cava, abdominal aorta, bilateral common iliac arteries, bilateral external iliac arteries, and artificial vessel replacement, which was successful, with good postoperative recovery and no lesion progression at 3 years postoperative follow-up.

Conclusion

This is an early case of gynecological clinical use of prostheses. Through multidisciplinary cooperation, the surgical resection rate of patients with EC in radical surgery was improved without serious fatal complications and achieved a high long-term postoperative survival rate.
Predicting perinatal mortality based on maternal health status and health insurance service using homogeneous ensemble machine learning methods
Authors: Bogale Dawit S. , Abuhay Tesfamariam M. , Dejene Belayneh E.
Published: December 2022

Background

Perinatal mortality in Ethiopia is the highest in Africa, with 68 per 1000 pregnancies intrapartum deaths. It is mainly associated with home delivery, which contributes to more than 75% of perinatal deaths. Financial constraints significantly impact timely access to maternal health care. Financial incentives, such as health insurance, may address the demand- and supply-side factors. This study, hence, aims to predict perinatal mortality based on maternal health status and health insurance service using homogeneous ensemble machine learning methods.

Methods

The data was collected from the Ethiopian demographic health survey from 2011 to 2019 G.C. The data were pre-processed to get quality data that are suitable for the homogenous ensemble machine-learning algorithms to develop a model that predicts perinatal mortality. We have applied filter (chi-square and mutual information) and wrapper (sequential forward and sequential backward) feature selection methods. After selecting all the relevant features, we developed a predictive model using cat boost, random forest, and gradient boosting algorithms and evaluated the model using both objective (accuracy, precision, recall, F1_score, ROC) and subjective (domain expert) based evaluation techniques.

Results

Perinatal mortality prediction models were developed using random forest, gradient boosting, and cat boost algorithms with the overall accuracy of 89.95%, 90.24%, and 82%, respectively. Risk factors of perinatal mortality were identified using feature importance analysis and relevant rules were extracted using the best performing model.

Conclusions

A prediction model that was developed using gradient boosting algorithms was selected for further use in the risk factor analysis, generating relevant rules, development of artifacts, and model deployment because it has registered better performance with 90.24% accuracy. The most determinant risk factors of perinatal mortality were identified using feature importance and some of them are community-based health insurance, mother's educational level, region and place of residence, age, wealth status, birth interval, preterm, smoking cigarette, anemia level, hemoglobin level, and marital status.
High-efficiency production of 5-hydroxyectoine using metabolically engineered Corynebacterium glutamicum
Authors: Jungmann Lukas , Hoffmann Sarah Lisa , Lang Caroline , De Agazio Raphaela , Becker Judith , Kohlstedt Michael , Wittmann Christoph
Published: December 2022

Background

Extremolytes enable microbes to withstand even the most extreme conditions in nature. Due to their unique protective properties, the small organic molecules, more and more, become high-value active ingredients for the cosmetics and the pharmaceutical industries. While ectoine, the industrial extremolyte flagship, has been successfully commercialized before, an economically viable route to its highly interesting derivative 5-hydroxyectoine (hydroxyectoine) is not existing.

Results

Here, we demonstrate high-level hydroxyectoine production, using metabolically engineered strains of C. glutamicum that express a codon-optimized, heterologous ectD gene, encoding for ectoine hydroxylase, to convert supplemented ectoine in the presence of sucrose as growth substrate into the desired derivative. Fourteen out of sixteen codon-optimized ectD variants from phylogenetically diverse bacterial and archaeal donors enabled hydroxyectoine production, showing the strategy to work almost regardless of the origin of the gene. The genes from Pseudomonas stutzeri (PST) and Mycobacterium smegmatis (MSM) worked best and enabled hydroxyectoine production up to 97% yield. Metabolic analyses revealed high enrichment of the ectoines inside the cells, which, inter alia, reduced the synthesis of other compatible solutes, including proline and trehalose. After further optimization, C. glutamicum Ptuf ectDPST achieved a titre of 74 g L−1 hydroxyectoine at 70% selectivity within 12 h, using a simple batch process. In a two-step procedure, hydroxyectoine production from ectoine, previously synthesized fermentatively with C. glutamicum ectABCopt, was successfully achieved without intermediate purification.

Conclusions

C. glutamicum is a well-known and industrially proven host, allowing the synthesis of commercial products with granted GRAS status, a great benefit for a safe production of hydroxyectoine as active ingredient for cosmetic and pharmaceutical applications. Because ectoine is already available at commercial scale, its use as precursor appears straightforward. In the future, two-step processes might provide hydroxyectoine de novo from sugar.
Rise of the natural red pigment ‘prodigiosin’ as an immunomodulator in cancer
Authors: Anwar Mohammed Moustapha , Albanese Chris , Hamdy Nadia M. , Sultan Ahmed S.
Published: December 2022

Cancer is a heterogeneous disease with multifaceted drug resistance mechanisms (e.g., tumour microenvironment [TME], tumour heterogeneity, and immune evasion). Natural products are interesting repository of bioactive molecules, especially those with anticancer activities. Prodigiosin, a red pigment produced bySerratia marcescens, possesses inherent anticancer characteristics, showing interesting antitumour activities in different cancers (e.g., breast, gastric) with low or without harmful effects on normal cells. The present review discusses the potential role of prodigiosin in modulating and reprogramming the metabolism of the various immune cells in the TME, such as T and B lymphocytes, tumour-associated macrophages (TAMs), natural killer (NK) cells, and tumour-associated dendritic cells (TADCs), and myeloid-derived suppressor cells (MDSCs) which in turn might introduce as an immunomodulator in cancer therapy.
Establishment and characterization of a new intrahepatic cholangiocarcinoma cell line derived from a Chinese patient
Authors: Miao Xin , Hu Jinjing , Chai Changpeng , Tang Huan , Zhao Zhenjie , Luo Wei , Zhou Wence , Xu Hao
Published: December 2022

Patients with intrahepatic cholangiocarcinoma (ICC) require chemotherapy due to late detection, rapid disease progression, and low surgical resection rate. Tumor cell lines are extremely important in cancer research for drug discovery and development. Here, we established and characterized a new intrahepatic cholangiocarcinoma cell line, ICC-X1. STR testing confirmed the absence of cross-contamination and high similarity to the original tissue. ICC-X1 exhibited typical epithelial morphology and formed tumor spheres in the suspension culture. The population doubling time was approximately 48 h. The cell line had a complex hypotriploid karyotype. The cell line exhibited a strong migration ability in vitro and cell inoculation into BALB/c nude mice led to the formation of xenografts. Additionally, ICC-X1 cells were sensitive to gemcitabine and paclitaxel but resistant to 5-fluorouracil and oxaliplatin. RNA sequencing revealed that the upregulated cancer-related genes were mainly enriched in several signaling pathways, including the TNF signaling pathway, NOD-like receptor signaling pathway, and NF-κB signaling pathway. The downregulated cancer-related genes were mainly enriched in the Rap1 signaling pathway and Hippo signaling pathway among other pathways. In conclusion, we have created a new ICC cell line derived from Chinese patients. This cell line can be used as a preclinical model to study ICC, specifically tumor metastasis and drug resistance mechanisms.
Impact of Malakit intervention on perceptions, knowledge, attitudes, and practices related to malaria among workers in clandestine gold mines in French Guiana: results of multicentric cross-sectional surveys over time
Authors: Longchamps Cécile , Galindo Muriel Suzanne , Lambert Yann , Sanna Alice , Mutricy Louise , Garancher Laure , Adenis Antoine , Nacher Mathieu , Suarez-Mutis Martha , Cairo Hedley , Hiwat Helen , Vreden Stephen , Douine Maylis
Published: December 2022

Background

Clandestine gold miners remain key hosts for malaria in French Guiana (FG) and contribute to imported malaria cases in Suriname and Brazil. The Malakit intervention, implemented in FG borders with Suriname and Brazil, provided gold miners with training on malaria and kits for self-diagnosis and self-treatment. Having shown a likely impact on malaria transmission, Suriname has now implemented it in routine care for cross-border moving populations. However, a decrease in malaria transmission is frequently associated with a decrease in risk perception, knowledge, and good practices regarding malaria. This study aims to describe the evolution of the perceptions, knowledge, attitudes, and practices (KAP) related to malaria among clandestine gold miners between 2015 and 2019, and to estimate the impact of Malakit on the FG/Suriname border.

Methods

The primary outcome was the overall KAP score over time and among participants and not participants in the Malakit intervention. A propensity score matching analysis and an inverse probability of treatment weighing analysis were used to estimate the Average Treatment effect on the Treated and the Average Treatment Effect of Malakit, respectively.

Results

Perception and knowledge scores were significantly lower in 2019 compared to 2015 (− 0.27 and − 0.23 points, respectively, p < 0.001) while attitude and practice scores were higher (+ 0.16 and + 0.47 points, respectively, p < 0.001). The overall KAP score was significantly higher among participants in Malakit with both propensity score matching (+ 0.72 points, 95%IC [0.29; 1.15]) and inverse probability of treatment weighting analysis (+ 0.70 points, 95%IC [0.34; 1.05]).

Conclusion

A decrease in perception and knowledge about malaria but an improvement of attitudes and practices as the incidence of malaria decreased are observed. The Malakit intervention seems to have a significant positive impact on the overall KAP related to malaria. The integration of this strategy into malaria control programmes could help to improve the KAP, even in areas where malaria is nearly eliminated, through optimal training and health empowerment.

Trial registrationClinicalTrials.gov registration number: NCT03695770.
Effects of vitamin D supplementation in endometriosis: a systematic review
Authors: Kalaitzopoulos Dimitrios Rafail , Samartzis Nicolas , Daniilidis Angelos , Leeners Brigitte , Makieva Sofia , Nirgianakis Konstantinos , Dedes Ioannis , Metzler Julian Matthias , Imesch Patrick , Lempesis Ioannis G.
Published: December 2022

Background

There is a growing body of human, animal and in vitro studies on vitamin D (vit D) substitution in endometriosis. The aim of this systematic review is to critically appraise and qualitatively synthesize the results of the available studies that examine the supplementation of vit D for endometriosis treatment.

Methods

A systematic search of the literature was conducted in four electronic databases (Medline, Cochrane, Scopus, Embase) and grey literature for original research articles on humans, animals and in vitro models published in any language.

Results

Four human studies, four animal studies and four in vitro studies were included. Quantitative synthesis of human studies showed no significant effect of vit D intake for dysmenorrhea (2 studies, 44 vit D vs 44 placebo, mean -0.71, 95% CI -1.94, 0.51) and non-cyclic pelvic pain (2 studies, 42 vit D vs 38 placebo, mean 0.34, 95% CI -0.02, 0.71). Regarding reproductive outcomes in women with endometriosis after in vitro fertilization, the only available study showed no differences between women taking vit D and women taking placebo. Three of the four included animal studies showed regression of endometriotic implants when treated with vit D. The in vitro studies demonstrated that vit D decreases invasion and proliferation of endometriotic lesions without affecting apoptosis.

Conclusions

Although in vitro and animal studies suggest regression of the endometriotic implants and decrease of invasion and proliferation after vit D supplementation, this was not reflected in the results of the meta-analysis, which showed no benefit of vit D supplementation in patients with endometriosis and dysmenorrhea or non-cyclic pelvic pain as well as on the outcome of IVF treatment. However, given the heterogeneity and the diversity of the available studies, more research is required to shed light on the role of vit D supplementation in women with endometriosis.
Favourable outcome of multisystem venous thrombosis associated with novel SERPINC1 mutation after treated with dabigatran: a case report with 7-year follow-up
Authors: Huang Teng , Liu Yu , Jiang Xiaofeng , Zhang Wei , Zhou Honglian , Hu Qi
Published: December 2022

Background

Mutations in SERPINC1
lead to deficiency in antithrombin (AT) which is an endogenous anticoagulant of
normal hemostasis and could result in venous
thromboembolism (VTE).

Case presentation

A 61-year-old male patient
with recurrent thrombosis returned to the hospital with multiple cerebral
thrombosis after voluntary cessation
of dabigatran therapy. Laboratory tests revealed a type I AT deficiency in this
patient and further whole exome sequencing (WES) identified a novel
heterozygous frameshift duplication (c.233_236dup, p.Val80Alafs*26) in SERPINC1
gene. Long-term dabigatran treatment was given and no recurrence or side
effects were found within the followed 5 years.

Conclusion

A multisystem VTE patient with
a novel SERPINC1 mutation (c.233_236dup, p.Val80Alafs*26) reached a favourable
outcome after dabigatran treatment.
Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial
Authors: De Costa Ayesha , Oladapo Olufemi T. , Gupta Shuchita , Portela Anayda , Vogel Joshua P. , Souza Joao Paulo , Rao Suman , Minckas Nicole , Tuncalp Özge , Bahl Rajiv , Althabe Fernando
Published: December 2022

The WHO ACTION-I trial, the largest placebo-controlled trial on antenatal corticosteroids (ACS) efficacy and safety to date, reaffirmed the benefits of ACS on mortality reduction among early preterm newborns in low-income settings. We discuss here lessons learned from ACTION-I trial that are relevant to a strategy for ACS implementation to optimize impact. Key elements included (i) gestational age dating by ultrasound (ii) application of appropriate selection criteria by trained obstetric physicians to identify women with a likelihood of preterm birth for ACS administration; and (iii) provision of a minimum package of care for preterm newborns in facilities. This strategy accurately identified a large proportion of women who eventually gave birth preterm, and resulted in a 16% reduction in neonatal mortality from ACS use. Policy-makers, programme managers and clinicians are encouraged to consider this implementation strategy to effectively scale and harness the benefits of ACS in saving preterm newborn lives.
Women’s household decision-making power and contraceptive use in Mali
Authors: Seidu Abdul-Aziz , Ahinkorah Bright Opoku , Armah-Ansah Ebenezer Kwesi , Dadzie Louis Kobina , Aboagye Richard Gyan , Ameyaw Edward Kwabena , Budu Eugene , Zegeye Betregiorgis , Yaya Sanni
Published: December 2022

Background

Utilization of contraceptives remains low in several countries in sub-Saharan Africa despite evidence of its benefits. Several factors are associated with contraceptive use. However, little is known about the association between women’s decision-making capacity and the utilization of contraceptives in Mali. This study sought to determine the association between women’s household decision-making power and contraceptive use in Mali.

Methods

This study involved a cross-sectional analysis of data from the 2018 Mali Demographic and Health Survey. A total of 7893 married women were included in the final analysis. A binary logistic regression analysis was conducted with statistical significance set at p < 0.05.

Results

Contraceptive use among married women in Mali was 17.1%. The odds of using contraceptives were higher among women with joint decision-making with their husbands on how to spend respondent’s earnings [aOR = 1.79; 95% CI = 1.12, 2.85], joint decision-making with their husbands on what to do with their husband’s earnings [aOR = 1.43; 95% CI = 1.12, 1.83], and joint decision-making with their husbands on large household purchases [aOR = 1.32; 95% CI = 1.10, 1.59]. Deciding alone on a visit to family or relatives was associated with lower odds of contraceptive use [aOR = 0.72; 95% CI = 0.58, 0.89].

Conclusion

The study has revealed that joint household decision-making is positively associated with contraceptive use. Therefore, to achieve the Sustainable Development Goal 3, the ministry for the advancement of women, children and families and related stakeholders should unearth strategies to empower women in joint decision-making and encourage men’s involvement in contraceptive decision-making.
Ginger supplement significantly reduced length of hospital stay in individuals with COVID-19
Authors: Li Yaqi , Yang Dawei , Gao Xiwen , Ju Minjie , Fang Hao , Yan Zuoqin , Qu Huanru , Zhang Yuanhao , Xie Linshan , Weng Huifen , Bai Chunxue , Song Yuanlin , Sun Zhirong , Geng Wenye , Gao Xiang
Published: December 2022

Background

Evidence from previous studies has suggested that ginger extract exhibits the potential as an alternative treatment for Coronavirus disease 2019 (COVID-19). Here, we want to investigate whether ginger supplement improves the clinical manifestation of hospitalized COVID-19 individuals.

Methods

A total of 227 hospitalized individuals with COVID-19 were randomized to either the control (n = 132) or intervention group (n = 95). The intervention group took ginger supplement orally at the dosage of 1.5 g twice daily, until they were discharged from the hospital. Both groups received the same standard of general medical care during hospitalization, and the length of stay was recorded and compared between groups.

Results

Among all participants, a significant reduction in hospitalization time (the difference between the treatment and control groups was 2.4 d, 95% CI 1.6–3.2) was detected in response to the ginger supplement. This effect was more pronounced in men, participants aged 60 years or older, and participants with pre-existing medical conditions, relative to their counterparts (P-interactions < 0.05 for all).

Conclusion

Ginger supplement significantly shortened the length of stay of hospitalized individuals with COVID-19.

Trial registration:The trial was registered on the Chinese Clinical Trial Registry (ChiCTR2200059824).