bluuebunny/crossref_metadata_2025 huggingface dataset:
Case report: Local bacteriophage therapy for fracture-related infection with polymicrobial multi-resistant bacteria: hydrogel application and postoperative phage analysis through metagenomic sequencing
Authors: Alt Volker , Gessner André , Merabishvili Maya , Hitzenbichler Florian , Mannala Gopala Krishna , Peterhoff David , Walter Nike , Pirnay Jean-Paul , Hiergeist Andreas , Rupp Markus
Published: July 2024

Fracture-related infections can be challenging, particularly with concomitant severe bone defects and multi-resistant microorganisms. We present a case of a 42-year-old patient with a fracture-related infection following a war injury from a gunshot, resulting in a 12-cm subtrochanteric segmental bone defect and the detection of four different multi-resistant Gram-negative bacteria. Due to antibiotic drug resistance, treatment with bacteriophages was considered. Phage susceptibility testing revealed the activity of a commercially available bacteriophage cocktail (Intesti bacteriophage, Eliava Institute, Tbilisi, Georgia). This phage cocktail was included in a modified two-stage Masquelet technique. During the first intervention, the bone was debrided and samples for microbiological and phage testing were harvested. The indwelling intramedullary rod was removed, and the bone defect was filled with a PMMA spacer loaded with colistin and the bone stabilized with a plate. During the second procedure, the PMMA spacer was removed and a silver-coated angular stable plate was implanted. The bone defect was filled with a fibular autograft and allograft cancellous bone chips. At the end of the procedure, the Intesti bacteriophage cocktail was injected into a DAC hydrogel and this bacteriophage hydrogel composite was then put onto the angular stable plate. Postoperatively the wound fluid was collected over 72 h, and high-throughput metagenomic sequencing was performed. This showed a time-dependent release of the bacteriophages in the wound fluid, with a relatively high concentration after 12 h, decreasing to DNA copies of 0 after 72 h. Furthermore, we have assessed the release of phages from DAC gel and the effect of DAC gel on the phages in vitro. The results showed a stable and rapid release of phages from the DAC gel (~1×103 PFU/mL). The clinical course of the patient showed no relapse of the infection with good bone consolidation of the bone defect after 1 year without the need for any surgical revision. To the best of our knowledge, this is the first case that shows the detection of bacteriophage DNA copies by high-throughput metagenomics sequencing in a patient with a complex fracture-related infection. Successful treatment of this case encourages further investigation of bacteriophage therapy in patients with complex bone and joint infections.
Causal effects of gut microbiota on risk of interstitial cystitis: a two-sample Mendelian randomization study
Authors: Gao Jianguo , Shao Sihai , Shen Yuefan
Published: July 2024

Background

The correlation between gut microbiota and interstitial cystitis has garnered significant attention in previous studies. Nevertheless, the causal relationship between them remains to be clarified.

Methods

Genetic variation serves as a tool in Mendelian randomization analyses, facilitating the inference of causal relationships between exposure factors and disease outcomes. In this study, summary statistics derived from a comprehensive genome-wide association study conducted by the MiBioGen consortium were utilized as exposure factors, while interstitial cystitis data sourced from the GWAS Catalog served as the disease outcome. Then, a two-sample Mendelian randomization analysis was performed by applying inverse variance-weighted, MR-Egger, Weighted Median, Simple Mode, and Weighted Mode. In addition, heterogeneity and horizontal pleiotropy were excluded by sensitivity analysis.

Results

IVW results confirmed that genus Haemophilus (OR = 2.20, 95% CI: 1.16–4.15, p = 0.015), genus Butyricimonas (OR = 2.26, 95% CI: 1.15–4.45, p = 0.018), genus Bacteroides (OR = 4.27, 95% CI: 1.36–13.4, p = 0.013) and Coprococcus1 (OR = 3.39, 95% CI: 1.28–8.99, p = 0.014) had a risk effect on interstitial cystitis. Sensitivity analysis did not find outlier SNPs.

Conclusion

Our analysis has identified a causal relationship between specific genera and interstitial cystitis. However, further validation through randomized controlled trials is essential to substantiate these findings.
Object recognition in primates: what can early visual areas contribute?
Authors: Quaia Christian , Krauzlis Richard J.
Published: July 2024

Introduction

If neuroscientists were asked which brain area is responsible for object recognition in primates, most would probably answer infero-temporal (IT) cortex. While IT is likely responsible for fine discriminations, and it is accordingly dominated by foveal visual inputs, there is more to object recognition than fine discrimination. Importantly, foveation of an object of interest usually requires recognizing, with reasonable confidence, its presence in the periphery. Arguably, IT plays a secondary role in such peripheral recognition, and other visual areas might instead be more critical.

Methods

To investigate how signals carried by early visual processing areas (such as LGN and V1) could be used for object recognition in the periphery, we focused here on the task of distinguishing faces from non-faces. We tested how sensitive various models were to nuisance parameters, such as changes in scale and orientation of the image, and the type of image background.

Results

We found that a model of V1 simple or complex cells could provide quite reliable information, resulting in performance better than 80% in realistic scenarios. An LGN model performed considerably worse.

Discussion

Because peripheral recognition is both crucial to enable fine recognition (by bringing an object of interest on the fovea), and probably sufficient to account for a considerable fraction of our daily recognition-guided behavior, we think that the current focus on area IT and foveal processing is too narrow. We propose that rather than a hierarchical system with IT-like properties as its primary aim, object recognition should be seen as a parallel process, with high-accuracy foveal modules operating in parallel with lower-accuracy and faster modules that can operate across the visual field.
Intermediate catheter use is associated with intraprocedural rupture during coil embolization of ruptured intracranial aneurysms: a retrospective propensity score-matched study
Authors: Fuga Michiyasu , Ishibashi Toshihiro , Aoki Ken , Kato Naoki , Kan Issei , Hataoka Shunsuke , Nagayama Gota , Sano Tohru , Tanaka Toshihide , Murayama Yuichi
Published: July 2024

Introduction

An intermediate catheter (IMC) may pose a risk of intraprocedural rupture (IPR) during coil embolization of ruptured intracranial aneurysms (RIAs), because the pressure on the microcatheter and coil might be more direct. To verify this hypothesis, this study explored whether use of an IMC might correlate with an increased rate of IPR during coil embolization for RIAs.

Methods

We retrospectively reviewed 195 consecutive aneurysms in 192 patients who underwent initial coil embolization for saccular RIAs at our institution between January 2007 and December 2023. Patients were divided into two groups with aneurysms treated either with an IMC (IMC group) or without an IMC (non-IMC group). To investigate whether IMC use increased the rate of IPR, a propensity score-matched analysis was employed to control for age, sex, maximal aneurysm size, neck size, bleb formation, aneurysm location, proximal vessel tortuosity, balloon-assisted coiling, type of microcatheter, and type of framing coil.

Results

Ultimately, 43 (22%) coil embolization used IMC. In univariate analysis, the incidence of IPR was significantly higher in the IMC group compared with the non-IMC group (14.0 vs. 3.3%, p = 0.016). Propensity score matching was successful for pairs of 26 aneurysms in the IMC group and 52 aneurysms in the non-IMC group. The incidence of IPR was still significantly higher in the IMC group than in the non-IMC group (23.1 vs. 3.8%, p = 0.015). No significant differences in the incidences of ischemic complications and IMC-related parent artery dissection were observed between the two groups.

Discussion

When using IMC for coil embolization of RIAs, the surgeons should be more careful and delicate in manipulating the microcatheter and inserting the coils to avoid IPR.
Comparative effectiveness of non- pharmacological treatments in patients with persistent postural-perceptual dizziness: a systematic review and effect sizes analyses
Authors: Suica Zorica , Behrendt Frank , Ziller Carina , Gäumann Szabina , Schädler Stefan , Hilfiker Roger , Parmar Katrin , Gerth Hans Ulrich , Bonati Leo H. , Schuster-Amft Corina
Published: July 2024

Introduction

The patho-psychological mechanisms of persistent postural-perceptual dizziness (PPPD) appear to be very complex, and a multimodal, multidisciplinary approach is suggested for treating patients with PPPD. The aim of this review was to provide a comprehensive overview of non-pharmacological treatments and their comparative effectiveness in patients with PPPD.

Methods

Scopus, Web of Science, PsycINFO, Medline, Embase, CINAHL, Cochrane Library and ClinicalTrials.gov were searched in April 2022 with a search update in August 2023. Only randomized controlled trials (RCTs) were included. There was no restrictions regarding publication date. Two reviewers independently identified eligible trials, extracted data, double-checked all extracted information from the included articles and assessed the risk of bias using the Cochrane risk of bias tool. A qualitative synthesis was performed, considering methodological heterogeneity between trials. Finally, an effect size analysis was performed for each treatment comparison. The standardized mean differences (SMD) and their corresponding 95% confidence intervals (95%CI) were calculated for each trial using Review Manager 5.4.

Results

Thirteen RCTs (618 patients with moderate or mild dizziness) out of 1,362 references describing seven different non-pharmacological comparisons were selected. Nine trials included patients with PPPD, and four trials included patients with functional dizziness. The trials used different interventions that were classified as: (1) psychotherapeutic interventions (cognitive behavioral therapy, patient education), (2) physiotherapeutic interventions/training (vestibular rehabilitation, optokinetic stimulation), (3) stimulation procedures (vagus nerve stimulation, transcranial direct current stimulation) and (4) device application (visual desensitization using personalized glasses). However, most of the trials investigated the effects of single interventions, rather than multimodal interdisciplinary treatment of patients with PPPD. The SMD for dizziness handicap and severity was between 0.04 and 0.52 in most trials. In one trial using visual desensitization, the SMD was 1.09 (strong effect on the severity of dizziness) and 1.05 (strong effect on dizziness handicap).

Discussion

Several individual interventions have shown benefits in the treatment of patients with PPPD with small to moderate effects. However, the multimodal treatment or a combination of vestibular rehabilitation with visual desensitization, cognitive behavioral therapy including patient education, and medication support should be further investigated. Future trials should include a large sample size with severe dizziness, and provide a longer follow-up period.

Clinical trial registration

PROSPERO CRD42022320344.
Therapy-resistant autoimmune nodopathy with anti-neurofascin 155 antibodies: a case report
Authors: Talers Teodors , Pastare Daina , Karelis Guntis , Sankova Eva
Published: July 2024

This study reports the case of a previously healthy man in his late 20s who began experiencing symptoms 3 months before admission to our hospital, including arm and leg weakness and distal hypesthesia. Initially, the patient responded to corticosteroid therapy. However, as his symptoms progressed, he underwent plasmapheresis and received intravenous immunoglobulin therapy, neither of which led to any discernible improvement. With rapid symptom progression during subsequent hospital visits, further investigation led to the detection of neurofascin 155 antibodies. Based on existing evidence of its efficacy, rituximab treatment was initiated. To date, the patient has received three doses of rituximab, which has been partially ineffective. Thus, treatment is ongoing and includes a combination of rituximab and subcutaneous immunoglobulin.
Dynamic topological data analysis: a novel fractal dimension-based testing framework with application to brain signals
Authors: El-Yaagoubi Anass B. , Chung Moo K. , Ombao Hernando
Published: July 2024

Topological data analysis (TDA) is increasingly recognized as a promising tool in the field of neuroscience, unveiling the underlying topological patterns within brain signals. However, most TDA related methods treat brain signals as if they were static, i.e., they ignore potential non-stationarities and irregularities in the statistical properties of the signals. In this study, we develop a novel fractal dimension-based testing approach that takes into account the dynamic topological properties of brain signals. By representing EEG brain signals as a sequence of Vietoris-Rips filtrations, our approach accommodates the inherent non-stationarities and irregularities of the signals. The application of our novel fractal dimension-based testing approach in analyzing dynamic topological patterns in EEG signals during an epileptic seizure episode exposes noteworthy alterations in total persistence across 0, 1, and 2-dimensional homology. These findings imply a more intricate influence of seizures on brain signals, extending beyond mere amplitude changes.
Neurological symphony: post-acute COVID-19 syndrome, an innovative pathophysiological exploration from neuraltherapeutic medicine
Authors: Bustamante Carlos , Pinilla Bonilla Laura Bibiana , Restrepo Juan Carlos
Published: July 2024

The SARS-CoV-2 pandemic has affected 771 million people and caused 6.9 million confirmed deaths as of November 2023. Beyond the adversity, a crucial and less-explored chapter unfolds: adaptive sequelae. These have altered social, mental, and emotional conditions, leaving an imprint on biological systems. While some cases fully resolve the pathological process post-acute infection, others persist with symptoms, posing a challenge that underscores the need to comprehend pathophysiology from innovative perspectives. The article delves into “Long COVID” or Post-Acute COVID-19 Syndrome (PACS), where symptoms persist for ≥4 weeks irrespective of initial severity. Risk factors include a history of severe illness, in-hospital management, and intensive care. This article also explores theories, derived from various experimental models, that have demonstrated the involvement of the nervous system in coordination with the psychoneuroimmunoendocrine axes in the expression of inflammation. It is posited that PACS involves processes of peripheral and central sensitization (corticalization), facilitating dishomeostasis and the chronicity of the inflammatory process. In this context, various therapeutic strategies grounded in modulating the inflammatory reflex are reviewed, primarily through the infiltration of local anesthetics via linear and non-linear approaches. Neural therapeutic use is considered to stimulate the regulatory inflammatory circuits coordinated by the neuroimmune-endocrine system.
Phytonutrients in the promotion of healthspan: a new perspective
Authors: Jacquier Emma F. , Kassis Amira , Marcu Diana , Contractor Nikhat , Hong Jina , Hu Chun , Kuehn Marissa , Lenderink Christopher , Rajgopal Arun
Published: July 2024

Considering a growing, aging population, the need for interventions to improve the healthspan in aging are tantamount. Diet and nutrition are important determinants of the aging trajectory. Plant-based diets that provide bioactive phytonutrients may contribute to offsetting hallmarks of aging and reducing the risk of chronic disease. Researchers now advocate moving toward a positive model of aging which focuses on the preservation of functional abilities, rather than an emphasis on the absence of disease. This narrative review discusses the modulatory effect of nutrition on aging, with an emphasis on promising phytonutrients, and their potential to influence cellular, organ and functional parameters in aging. The literature is discussed against the backdrop of a recent conceptual framework which describes vitality, intrinsic capacity and expressed capacities in aging. This aims to better elucidate the role of phytonutrients on vitality and intrinsic capacity in aging adults. Such a review contributes to this new scientific perspective—namely—how nutrition might help to preserve functional abilities in aging, rather than purely offsetting the risk of chronic disease.
Metabolites from traditional Chinese botanical drugs with anti-hepatitis B virus activity - a review
Authors: Li Nannan , Feng Xue , An Cheng , Liu Guijian , Liu Chao
Published: July 2024

Hepatitis B virus (HBV)-related liver disease poses a major threat to human health worldwide. Although interferon and nucleoside analogues are commonly administered for treating chronic HBV infection, their use is limited by considerable side effects, drug resistance and incapacity for HBV elimination. Hence, novel HBV therapeutics are urgently required. For numerous years, traditional Chinese botanical drugs have been widely used to treat HBV-related diseases. The natural metabolites derived from these traditional drugs exhibit significant anti-HBV effects and serve as potential novel drugs for treating HBV. For overall understanding the therapeutic potential of these metabolites, the anti-HBV effects and mechanisms of action of 107 natural metabolites are summarized in this article. Mechanistically, these natural metabolites exert their anti-HBV effects by influencing the expression and function of host and/or viral genes, which differs from the mechanism of action of nucleoside analogues. Indeed, combining natural metabolites with nucleoside analogues can exert synergistic effects. Accordingly, natural metabolites or their chemically modified derivatives represent potential novel drugs and adjuvants for anti-HBV treatment.
Modelling lung diffusion-perfusion limitation in mechanically ventilated SARS-CoV-2 patients
Authors: Miserocchi Giuseppe , Rezoagli Emanuele , Muñoz-Del-Carpio-Toia Agueda , Paricahua-Yucra Leydi Pamela , Zubieta-DeUrioste Natalia , Zubieta-Calleja Gustavo , Beretta Egidio
Published: July 2024

This is the first study to describe the daytime evolution of respiratory parameters in mechanically ventilated COVID-19 patients. The data base refers to patients hospitalised in the intensive care unit (ICU) at Arequipa Hospital (Peru, 2335 m) in 2021. In both survivors (S) and non-survivors (NS) patients, a remarkable decrease in respiratory compliance was observed, revealing a proportional decrease in inflatable alveolar units. The S and NS patients were all hyperventilated and their SatO2 was maintained at >90%. However, while S remained normocapnic, NS developed progressive hypercapnia. We compared the efficiency of O2 uptake and CO2 removal in the air blood barrier relying on a model allowing to partition between diffusion and perfusion limitations to gas exchange. The decrease in O2 uptake was interpreted as diffusion limitation, while the impairment in CO2 removal was modelled by progressive perfusion limitation. The latter correlated with the increase in positive end-expiratory pressure (PEEP) and plateau pressure (Pplat), leading to capillary compression, increased blood velocity, and considerable shortening of the air-blood contact time.
Does weed diversity mitigate yield losses?
Authors: Zingsheim Marie L. , Döring Thomas F.
Published: July 2024

While intensive control of weed populations plays a central role in current agriculture, numerous studies highlight the multifaceted contribution of weeds to the functionality and resilience of agroecosystems. Recent research indicates that increased evenness within weed communities may mitigate yield losses in contrast to communities characterized by lower diversity, since weed species that strongly affect crop yields, also dominate weed communities, with a concurrent reduction of evenness. If confirmed, this observation would suggest a paradigm shift in weed management towards promoting higher community diversity. To validate whether the evenness of weed communities is indeed linked to higher crop productivity, we conducted two field experiments: one analyzing the effects of a natural weed community in an intercrop of faba bean and oat, and the other analyzing the effects of artificially created weed communities, together with the individual sown weed species, in faba bean, oats and an intercrop of both crops. The evenness of the weed communities ranged from 0.2 to 0.9 in the natural weed community, from 0.2 to 0.7 in faba bean, from 0 to 0.8 in the intercrop and from 0.3 to 0.9 in oats. Neither the natural nor the artificial weed community showed significant effects of evenness on crop grain yield or crop biomass. The results of this study do not validate a positive relationship of crop productivity and weed evenness, possibly due to low weed pressure and the absence of competitive effects but suggest that also less diverse weed communities may be maintained without suffering yield losses. This is expected to have far reaching implications, since not only diverse weed communities, but also higher abundances of few weed species may contribute to ecosystem functions and may support faunal diversity associated with weeds.
MeJA-induced hairy roots in Plumbago auriculata L. by RNA-seq profiling and key synthase provided new insights into the sustainable production of plumbagin and saponins
Authors: Li Yirui , Zhao Zi-an , Hu Ju , Lei Ting , Chen Qibing , Li Jiani , Yang Lijuan , Hu Di , Gao Suping
Published: July 2024

Naturally synthesized secondary metabolites in plants are considered an important source of drugs, food additives, etc. Among them, research on natural plant medicinal components and their synthesis mechanisms has always been of high concern. We identified a novel medicinal floral crop, Plumbago auriculata L., that can be treated with methyl jasmonate (MeJA) for the rapid or sustainable production of natural bioactives from hairy roots. In the study, we globally analyzed the changes in the accumulation of plumbagin and others in the hairy roots of Plumbago auriculata L. hairy roots (PAHR) 15834 in P. auriculata L. based on 100 μmol/L of MeJA treatment by RNA-seq profiling, and we found that there was a significant increase in the accumulation of plumbagin and saponin before 24 h. To explain the principle of co-accumulation, it showed that MeJA induced JA signaling and the shikimic acid pathway, and the methylvaleric acid (MVA) pathway was activated downstream subsequently by the Mfuzz and weighted gene co-expression analysis. Under the shared metabolic pathway, the high expression of PAL3 and HMGR promoted the activity of the “gateway enzymes” phenylalanine ammonia lyase (PAL) and 3-hydroxy-3-methylglutaryl CoA reductase (HMGR), which respectively induced the high expression of key reaction enzyme genes, including chalcone synthase (CHS), isopentenyl diphosphate (IPP), and farnesyl pyrophosphate synthase (FPS), that led to the synthesis of plumbagin and saponin. We speculated that large amounts of ketones and/or aldehydes were formed under the action of these characteristic enzymes, ultimately achieving their co-accumulation through polyketone and high-level sugar and amino acid metabolism. The study results provided a theoretical basis for carrying out the factory refinement and biosynthesis of plumbagin and saponins and also provided new ideas for fully exploiting multifunctional agricultural crops and plants and developing new agricultural by-products.
Associations between media use at bedtime and sleep: a cross-sectional analysis on differences between girls and boys
Authors: Poulain Tanja , Hilbert Cornelia , Grundmann Annelie , Kiess Wieland
Published: July 2024

Objectives

This study investigated associations between the use of electronic media and sleep in children and young adolescents, with a specific focus on the moderation of associations by sex and age.

Methods

Between 2021 and 2022, 453 10- to 14-year-old children participating in the LIFE Child cohort study (Germany) reported on their use of electronic media (daily screen time, use at bedtime, device ownership) and on their sleep difficulties (Sleep Self Report). Associations between media use and sleep as well as interactions with age and sex were assessed using linear regression analyses.

Results

The analyses revealed significant associations between the use of media at bedtime and bedtime problems (in girls only), sleep behavior problems (in girls only), and daytime sleepiness (in girls and boys). Daily screen time, in contrast, was associated with none of the sleep difficulties. The number of media devices owned by the child was only associated with bedtime problems in girls, and this association lost statistical significance once media use at bedtime was included as further predictor.

Conclusion

The findings underline the potentially sleep-disturbing role of electronic media at bedtime. Furthermore, they suggest that this effect is more pronounced in girls than in boys.
Associations between teacher–parent relationships and preschool children’s social behavior problems—the chain mediating roles of work–family conflict and parenting self-efficacy
Authors: Liu Guolei , Jin Zhen , Zheng Xinhong , Wang Zixian , Liu Weina
Published: July 2024

In the Chinese cultural context, the collaborative interaction characteristics among three key entities - families, kindergartens, and communities - and the mechanisms of their correlation with preschool children’s social behavior problems have not been fully understood yet. Based on ecological systems Theory and social support theory, this study aimed to examine the correlation between parent-teacher relationships and preschool children’s social behavior problems in Chinese kindergartens, as well as the mediating role of parents’ work–family conflict and parenting self-efficacy. Structural equation modeling was used to test the research hypotheses based on a questionnaire survey of 1,784 parents of preschool children. The main findings of this study are as follows: (1) Parents’ perceived positive parent-teacher relationships are negatively correlated with preschool children’s social problems. (2) Parents’ work–family conflict and parenting self-efficacy mediate the relationship between parent-teacher relationships and preschool children’s social behavior problems; (3) Parents’ work–family conflict and parenting self-efficacy play a chain mediating role in the influence of the parent-teacher relationship on preschool children’s social behavior problems. Taken together, the results collectively further elucidate the correlation between parent-teacher relationships and preschool children’s social behavior problems, while also discussing other relevant factors pertaining to children’s social behavior problems. Theoretically, this study expands the understanding of how external environmental resources interact with home and family education. Practically, this research indicates that governments, early childhood education institutions, and workplaces need to strengthen their support for family education of preschool children. The findings contribute to promoting a multi-faceted co-operation aimed at enhancing the quality of early childhood education and fostering the social adaptability and holistic development of preschool children.
Willingness to use smart fetal heart rate monitoring devices among pregnant women: an extension of the technology acceptance model
Authors: Wu Shan , Cui Bingsheng , Yu Xiaofan
Published: July 2024

The purpose of this study was to assess the significant factors that impact pregnant women’s willingness to use smart fetal heart-rate monitoring devices. We propose a research model that integrates technological factors (perceived compatibility and perceived credibility) and personal factors (health anxiety, personal physiological conditions, health consciousness, and health beliefs). The subjects of this study were Chinese women who were pregnant or had previously given birth. Data were collected and analyzed from 397 paper-and-pencil and electronic questionnaires. Our structural equation model indicated that perceived usefulness (β = 0.490, t = 7.591, p < 0.001), perceived ease of use (β = 0.352, t = 5.631, p < 0.001), health anxiety (β = 0.095, t = 2.664, p = 0.008), personal physiological conditions (β = 0.075, t = 2.142, p = 0.032), and health consciousness (β = 0.078, t = 2.110, p = 0.035) were the determinants of the intention to use smart fetal heart-rate monitoring devices, with perceived usefulness having the highest degree of influence. Furthermore, we discovered that the levels of perceived compatibility and perceived credibility did not have direct correlations with the intention to use these devices, but they did significantly influence the model. Perceived compatibility (β = 0.345, t = 6.601, p < 0.001) and perceived credibility (β = 0.519, t = 9.958, p < 0.001) significantly influences perceived ease of use. Perceived credibility (β = 0.421, t = 7.802, p < 0.001) significantly influences perceived usefulness. Based on these results, suggestions for future research are put forward.
Relational vulnerability in motherhood—an existential perspective on pain and exhaustion among women
Authors: Gebhardt Anja J. , Andermo Susanne , Arman Maria
Published: July 2024

Introduction

Stress-related ill-health like pain and exhaustion are demanding public health problems in Europe. In Sweden, women are particularly at risk to develop stress-related ill-health during a period in life that coincides with child-rearing years. When entering motherhood, Swedish women’s sick leave substantially increases. Yet, motherhood is rarely acknowledged in clinical encounters concerning pain and exhaustion although women suffer from these ailments more often than men. To incorporate motherhood as an existential dimension of health in the care of women living with pain and exhaustion might alleviate women’s suffering. But knowledge on women’s experiences of motherhood and health is scarce. Therefore, the aim of the study is to reach a deeper understanding of how women suffering from long-lasting pain and exhaustion experience their health in relation to motherhood.

Methods

Ricoeur’s interpretation theory has been applied to analyze 27 phenomenological interviews with 14 mothers suffering from long-lasting pain and exhaustion.

Results

These women’s experiences shed light on how closely motherhood is interwoven with the experience of their health and suffering: The women’s suffering seems to be rooted in a relational vulnerability that has been uncovered during motherhood. Further, the women suffer from a burden of difficult life experiences and inner conflicts. Reconciliation with life is possible when women find an existential shelter, which offers ways to relate to their suffering making the own suffering more bearable.
Cost of overweight, obesity, and related complications in Switzerland 2021
Authors: Steinl David , Holzerny Pascale , Ruckdäschel Stephan , Fäh David , Pataky Zoltan , Peterli Ralph , Schultes Bernd , Landolt Susanne , Pollak Timo
Published: July 2024

Background

The prevalence of obesity has increased significantly in recent decades. Today, it is estimated that more than one-third of the world’s population has overweight or obesity, rendering it one of the most significant global health concerns. This article provides a current estimate of the direct costs associated with managing overweight and obesity, including treatment of related complications, among adolescents (≥15 years) and adults in Switzerland.

Methods

Prevalence of overweight and obesity based on the BMI reported in the 2017 Swiss Health Survey was extrapolated to 2021. Systematic literature searches were performed to identify treatment costs and epidemiological data of obesity-related complications and costs were extrapolated to 2021. Costing methodology was based on available source data for individual related complications. Treatment costs for complications attributable to overweight and obesity were estimated by applying their population attributable fraction (PAF).

Results

More than 3.1 million inhabitants of Switzerland aged ≥15 years met the criteria for overweight or obesity in 2021. The prevalence of overweight increase over the past decades from 30.4% in 1992 to 41.9% in 2017 while prevalence of obesity doubled from 5.4 to 11.3%. Overall, the total attributable costs of overweight and obesity caused by seven assessed obesity-related complications (asthma, coronary heart disease, depression, diabetes mellitus, hypertension, osteoarthritis, and stroke) are estimated at CHF 3657–5208 million with most of the costs (97–98%) caused by the assessed obesity-related complications. Only 2–3% of the total costs were attributable to the combined direct management of overweight and obesity by bariatric surgery (CHF 83 million), pharmacological therapy (CHF 26 million) and dietary counseling (CHF 18 million).

Conclusion

Overweight and obesity impose a significant cost impact on the Swiss healthcare system, accounting for 4.2–6.1% of total healthcare expenditures in 2021. Notably, direct treatment of overweight and obesity accounts for only 0.08–0.18% of the total healthcare expenditures. The analysis also revealed a significant lack of available health economic evidence, necessitating the use of assumptions and approximations in this estimation. This is noteworthy, as respective data would be available in healthcare systems but are either unpublished or inaccessible.
Facilitators and barriers of help-seeking for persons with dementia in Asia—findings from a qualitative study of informal caregivers
Authors: Jeyagurunathan Anitha , Yuan Qi , Samari Ellaisha , Zhang Yunjue , Goveas Richard , Ng Li Ling , Subramaniam Mythily
Published: July 2024

Background and aim

The deterioration in cognition of persons with dementia (PWD) makes their caregivers key players in their help-seeking process. This study aimed to identify the facilitators and barriers of help-seeking for persons with dementia in Asia from the perspective of their informal caregivers.

Methods

A qualitative methodology was adopted in the current study. Twenty-nine informal caregivers of PWD in Singapore were interviewed between April 2019 and December 2020. All interviews were audio-recorded and transcribed verbatim for the analysis.

Results

The transcripts were analyzed using inductive thematic analysis. The results revealed four major themes with 12 sub-themes, including (1) Barriers to diagnosis-seeking (i.e., lack of knowledge and awareness of dementia, emotional denial, resistance from PWD, and delays in the healthcare system); (2) Facilitators of diagnosis-seeking (i.e., synergy between awareness of dementia and an active diagnosis-seeking intention and incidental diagnosis resulting from seeking treatment for comorbid conditions); (3) Barriers to treatment-seeking (i.e., challenges from PWD and disease, challenges faced by caregivers when seeking treatment for PWD, and challenges imposed by the COVID-19 pandemic); (4) Facilitators of treatment-seeking (i.e., caregivers’ capabilities of handling PWD, cooperation/compliance from PWD, and an integrated care plan for PWD).

Conclusion

The findings highlight the importance of raising public awareness, enabling health professionals to tailor psychosocial interventions better, and improving community support through dementia awareness and education.
Public opinion on alcohol policies in Sri Lanka
Authors: Chandraratne Nadeeka K. , Negi Nalin Singh , Siyambalapitiya Hasini , De Seram Sampath , Selladurai Nidarshana , Pieris Karieshini , Rothenstein-Henry Rachel , Murukutla Nandita
Published: July 2024

Background

Alcohol imposes a significant burden on health, social and economic systems in Sri Lanka. In the present economic crisis taxes on alcohol provides necessary revenue increases. Yet, the perception of the public on alcohol policies in Sri Lanka is not well explored.

Objectives

This opinion survey was conducted with the aim to understand the public’s awareness on alcohol harm, alcohol industry influences, barriers and facilitators for implementing alcohol control policies in Sri Lanka, and the level of public support for alcohol policies, particularly taxes on alcohol products.

Methods

A street intercept survey among 997 participants (with a ratio of 2:1 for males and females) selected through a cluster sampling method responded to an interviewer administered questionnaire. Bivariate and multivariate analyses were conducted to determine associations and a p < 0.05 was considered significant.

Results

Among the respondents, 36.1% have consumed alcohol at least once in their lifetime and 29.1% have consumed alcohol during the past 12 months with a significant gender difference (females - 2.8%; males- 43.4%; p < 0.001). Significant proportions of both men (81.4%) and women (71.8%); p < 0.017 agreed that policy measures to reduce alcohol consumption would benefit the government including a significant proportion (73.8%, p < 0.008) of alcohol users. The vast majority −72.8%- agreed that increasing alcohol prices would help address the alcohol consumption problem in Sri Lanka. Moreover, only 30.8% of men and 44.3% of women agreed that the government’s alcohol laws are currently strong enough to protect people from alcohol harm. The regression analysis revealed that men are 2.43 times more in agreement with the statement that “policy measures aimed at reducing alcohol consumption can benefit the public” as compared to women. However, individuals aged 50–64 years are 40% less likely to agree with this statement as compared to 18–33 years.

Conclusion

The majority of the public, including people who consume alcohol, are supportive of improving alcohol related policies, including taxes, and acknowledge negative impact of alcohol consumption on the country. This presents a clear opportunity for Sri Lanka to strengthen and enforce the alcohol related policies to protect and improve public health.
A comparative study of the physical activity guidelines for children and adolescents from five countries and WHO
Authors: Hu Donglin , Zhou Shi , Crowley-McHattan Zachary J. , Liu Zhiyun
Published: July 2024

This study presented a narrative review of the six latest sets of guidelines on physical activity for children and adolescents from Australia, Canada, China, the United Kingdom, the United States and WHO, and analysed the history of the development of the guidelines; the policy context in which the guidelines were developed; and the main subjects of the guidelines. The core elements of the latest guidelines were identified and compared, including frequency, intensity, duration (time), and type of physical activity, assessment intensity of physical activity, and risk prevention for physical activity participation. There is an urgent need for obtaining the latest scientific evidence to support and update the contents of the Chinese guidelines. We therefore make the following recommendations for future revisions of the Chinese guidelines based on the findings of this study: (1) to update the recommended frequency, intensity, duration, and type of physical activities that meet the needs for Chinese children and adolescents; (2) to update the methods for assessing physical activity intensity, and identifying and managing the risk factors in participating in physical activity; and (3) to incorporate analyses and reviews of school physical education curriculum for effectively achieving the adequate levels of physical activity.
Insights into the spectrum of transtibial prosthetic socket design from expert clinicians and their digital records
Authors: Dickinson A. S. , Steer J. W. , Rossides C. , Diment L. E. , Mbithi F. M. , Bramley J. L. , Hannett D. , Blinova J. , Tankard Z. , Worsley P. R.
Published: July 2024

Background

Transtibial prosthetic sockets are often grouped into patella tendon bearing (PTB) or total surface bearing (TSB) designs, but many variations in rectifications are used to apply these principles to an individual's personalised socket. Prosthetists currently have little objective evidence to assist them as they make design choices.

Aims

To compare rectifications made by experienced prosthetists across a range of patient demographics and limb shapes to improve understanding of socket design strategies.

Methodology

163 residual limb surface scans and corresponding CAD/CAM sockets were analysed for 134 randomly selected individuals in a UK prosthetics service. This included 142 PTB and 21 TSB designs. The limb and socket scans were compared to determine the location and size of rectifications. Rectifications were compiled for PTB and TSB designs, and associations between different rectification sizes were assessed using a variety of methods including linear regression, kernel density estimation (KDE) and a Naïve Bayes (NB) classification.

Results

Differences in design features were apparent between PTB and TSB sockets, notably for paratibial carves, gross volume reduction and distal end elongation. However, socket designs varied across a spectrum, with most showing a hybrid of the PTB and TSB principles. Pairwise correlations were observed between the size of some rectifications (e.g., paratibial carves; fibular head build and gross volume reduction). Conversely, the patellar tendon carve depth was not associated significantly with any other rectification, indicating its relative design insensitivity. The Naïve Bayes classifier produced design patterns consistent with expert clinician practice. For example, subtle local rectifications were associated with a large volume reduction (i.e., a TSB-like design), whereas more substantial local rectifications (i.e., a PTB-like design) were associated with a low volume reduction.

Clinical implications

This study demonstrates how we might learn from design records to support education and enhance evidence-based socket design. The method could be used to predict design features for newly presenting patients, based on categorisations of their limb shape and other demographics, implemented alongside expert clinical judgement as smart CAD/CAM design templates.
Linking the impact of aspiration to host variables using the BOLUS framework: support from a rapid review
Authors: Palmer Phyllis M. , Padilla Aaron H.
Published: July 2024

Purpose

The purpose of this rapid review was to identify the level of evidence for a previously proposed theoretical framework to assess risks associated with prandial aspiration using the host as a central theme.

Methods

Covidence software was used to search two databases (PubMed and Web of Science). PEDro scale was utilized to determine the quality of individual studies. Data points were evaluated for level of support and determined to be either conclusive, suggestive, unclear, or not supportive. Within each component of the framework, data points were clustered to determine the level of evidence as strong, moderate, insufficient, or negative.

Results

The rapid review process resulted in a limited number of publications investigating host variables impact on outcomes for patients with swallowing disorders. Overall, it yielded 937 articles, of which, upon review, 16 articles were selected for data extraction. There was a strong level of evidence to support that (a) as viscosity and density of aspirate increased, so did the likelihood of general medical complications, (b) poor oral care and oral health increase the risk of a pulmonary or general medical complication, and (c) the presence of oropharyngeal or laryngeal tubes increases the risk of a pulmonary consequence. There was moderate evidence to support the impact of amount and frequency of aspiration on outcomes. There was insufficient evidence to determine relationships for all other aspects of the BOLUS framework.

Conclusion

Additional evidence to support the BOLUS framework was obtained; however, the number of studies was limited. A more thorough review such as a systematic review should be employed.
Clonal cytopenia of undetermined significance: definitions, risk and therapeutic targets
Authors: Taborda Cristian C. , Zeidan Amer M. , Mendez Lourdes M.
Published: July 2024

Cancer-related somatic genetic alterations are detectable in the blood of individuals without hematologic malignancy, reflecting the outgrowth of a mutated stem/progenitor cell population, a phenomenon termed clonal hematopoiesis (CH). When accompanied by an unexplained cytopenia(s), CH is further refined to clonal cytopenia of undetermined significance (CCUS) whereas, the finding of a mutation/alteration in the setting of a normal complement of blood counts is called clonal hematopoiesis of indeterminate potential (CHIP). CHIP and CCUS are now recognized precursor conditions to myeloid neoplasms. Advances in the understanding of the epidemiology and clonal metrics associated with evolution to a myeloid malignancy has permitted the elaboration of risk stratification tools poised for use in the clinic and initial clinical investigations seeking to disrupt the natural history of high risk CHIP and CCUS. In this review, we focus on CCUS and the current understanding of its classification, risk stratification and potential therapeutic targets
Quality-of-life survey of pancreatic cancer patients: a comparison between general public and physicians
Authors: Sasahara Yuriko , Takumoto Yuki , Watanabe Kaname , Takeda Hiroyuki , Umemoto Kumiko , Sunakawa Yu , Suzuki Naoki , Yoshioka Takashi , Kobayashi Satoshi , Ueno Makoto , Nakamura Sho , Akazawa Manabu , Narimatsu Hiroto
Published: July 2024

Background

Quality-of-life (QOL) is important for cancer patients with poor prognosis. However, conducting a QOL survey with patients is difficult. Therefore, we conducted a QOL survey with physicians. Specifically, this study aimed to clarify how physicians assess QOL in patients with pancreatic cancer by conducting a survey and comparing the results between physicians and the general public.

Methods

A survey was conducted by interviewing physicians administering chemotherapy to patients for recurrent/metastatic pancreatic cancer. This method is similar to that of the QOL survey conducted among the general public. Responses were evaluated using the composite time trade-off (cTTO) and the visual analog scale (VAS) for 11 pancreatic cancer status scenarios (survey scenarios). These scenarios consisted of patients’ health states as well as the types and grades of adverse events (AEs). Health status was classified into two categories: Stable disease (SD) and Progressive disease (PD). In addition, we conducted a survey using the EuroQol 5 Dimensions 5-Level (EQ-5D-5l) as reference values.

Results

Twenty physicians responded to the survey. SD had the highest mean QOL value for both assessment methods (Physicians: 0.78, General public: 0.63), whereas PD had the lowest mean QOL value (Physicians: 0.15, General public: −0.12). The physicians assigned higher QOL values on both the VAS and cTTO than the general public did in all survey scenarios.

Conclusions

The QOL values obtained from physicians were consistent with the degree of status in any assessment scenarios. Based on the differences in the QOL survey results between physicians and the general public, physicians tended to assign higher QOL values than the general public in cTTO and VAS assessments.