bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 vaccination in pregnancy: the impact of multimorbidity and smoking status on vaccine hesitancy, a cohort study of 25,111 women in Wales, UK
Authors: Mhereeg Mohamed , Jones Hope , Kennedy Jonathan , Seaborne Mike , Parker Michael , Kennedy Natasha , Akbari Ashley , Zuccolo Luisa , Azcoaga-Lorenzo Amaya , Davies Alisha , Nirantharakumar Krishnarajah , Brophy Sinead
Published: September 2023

Background

Multimorbidity, smoking status, and pregnancy are identified as three risk factors associated with more severe outcomes following a SARS-CoV-2 infection, thus vaccination uptake is crucial for pregnant women living with multimorbidity and a history of smoking. This study aimed to examine the impact of multimorbidity, smoking status, and demographics (age, ethnic group, area of deprivation) on vaccine hesitancy among pregnant women in Wales using electronic health records (EHR) linkage.

Methods

This cohort study utilised routinely collected, individual-level, anonymised population-scale linked data within the Secure Anonymised Information Linkage (SAIL) Databank. Pregnant women were identified from 13th April 2021 to 31st December 2021. Survival analysis was employed to examine and compare the length of time to vaccination uptake in pregnancy by considering multimorbidity, smoking status, as well as depression, diabetes, asthma, and cardiovascular conditions independently. The study also assessed the variation in uptake by multimorbidity, smoking status, and demographics, both jointly and separately for the independent conditions, using hazard ratios (HR) derived from the Cox regression model.

Results

Within the population cohort, 8,203 (32.7%) received at least one dose of the COVID-19 vaccine during pregnancy, with 8,572 (34.1%) remaining unvaccinated throughout the follow-up period, and 8,336 (33.2%) receiving the vaccine postpartum. Women aged 30 years or older were more likely to have the vaccine in pregnancy. Those who had depression were slightly but significantly more likely to have the vaccine compared to those without depression (HR = 1.08, 95% CI 1.03 to 1.14, p = 0.002). Women living with multimorbidity were 1.12 times more likely to have the vaccine compared to those living without multimorbidity (HR = 1.12, 95% CI 1.04 to 1.19, p = 0.001). Vaccine uptakes were significantly lower among both current smokers and former smokers compared to never smokers (HR = 0.87, 95% CI 0.81 to 0.94, p < 0.001 and HR = 0.92, 95% CI 0.85 to 0.98, p = 0.015 respectively). Uptake was also lower among those living in the most deprived areas compared to those living in the most affluent areas (HR = 0.89, 95% CI 0.83 to 0.96, p = 0.002).

Conclusion

Younger women, living without multimorbidity, current and former smokers, and those living in the more deprived areas are less likely to have the vaccine, thus, a targeted approach to vaccinations may be required for these groups. Pregnant individuals living with multimorbidity exhibit a slight but statistically significant reduction in vaccine hesitancy towards COVID-19 during pregnancy.
Exploring the influence of behavioral factors on depression and anxiety scores during the COVID-19 pandemic: insights from the Virginia statewide COVIDsmart longitudinal study
Authors: Karpov Matvey V. , Bartholmae Marilyn M. , Levy Brian L. , Roess Amira A. , Renshaw Keith D. , Sill Joshua M. , Dodani Sunita
Published: September 2023

Background

Amidst the COVID-19 pandemic, there has been growing concern about the declining mental health and healthy behaviors compared to pre-pandemic levels. Despite this, there is a lack of longitudinal studies that have examined the relationship between health behaviors and mental health during the pandemic. In response, the statewide COVIDsmart longitudinal study was launched. The study’s main objective is to better understand the effects of the pandemic on mental health. Findings may provide a foundation for the identification of public health strategies to mitigate future negative impacts of the pandemic.

Methods

Following online recruitment in spring of 2021, adults, ages 18 to 87, filled out social, mental, economic, occupational, and physical health questionnaires on the digital COVIDsmart platform at baseline and through six monthly follow-ups. Changes in the participant’s four health behaviors (e.g., tobacco and alcohol consumption, physical activity, and social media use), along with sex, age, loneliness score, and reported social and economic (SE) hardships, were analyzed for within-between group associations with depression and anxiety scores using Mixed Models Repeated Measures.

Results

In this study, of the 669 individuals who reported, the within-between group analysis indicated that younger adults (F = 23.81, p < 0.0001), loneliness (F = 234.60, p < 0.0001), SE hardships (F = 31.25, p < 0.0001), increased tobacco use (F = 3.05, p = 0.036), decreased physical activity (F = 6.88, p = 0.0002), and both positive and negative changes in social media use (F = 7.22, p = 0.0001) were significantly associated with worse depression scores. Additionally, females (F = 6.01, p = 0.015), younger adults (F = 32.30, p < 0.0001), loneliness (F = 154.59, p < 0.0001), SE hardships (F = 22.13, p < 0.0001), increased tobacco use (F = 4.87, p = 0.004), and both positive and negative changes in social media use (F = 3.51, p = 0.016) were significantly associated with worse anxiety scores. However, no significant changes were observed in the within-between group measurements of depression and anxiety scores over time (p > 0.05). Physical activity was not associated with anxiety nor was alcohol consumption with both depression and anxiety (p > 0.05).

Conclusions

This study demonstrates the longitudinal changes in behaviors within the context of the COVID-19 pandemic. These findings may facilitate the design of preventative population-based health approaches during the COVID-19 pandemic or future pandemics.
Effectiveness of nicotine salt vapes, cytisine, and a combination of these products, for smoking cessation in New Zealand: protocol for a three-arm, pragmatic, community-based randomised controlled trial
Authors: Walker Natalie , Calder Amanda , Barnes Joanne , Laking George , Parag Varsha , Bullen Chris
Published: September 2023

Background

Combining short-acting nicotine replacement therapy with varenicline increases smoking cessation rates compared with varenicline alone, but not all people tolerate these medications or find them helpful. We aim to investigate the therapeutic potential of an analogous combination, by evaluating the effectiveness, safety, and acceptability of combining nicotine salt e-cigarettes with cytisine, compared to nicotine salt e-cigarettes or cytisine only, on smoking abstinence at six months.

Methods

A pragmatic, community-based, investigator-blinded, randomised superiority trial design will be utilised. Eligible participants will be people who smoke daily (N = 800, 90% power) from throughout New Zealand, who are: aged ≥ 18 years, motivated to quit in the next two weeks, able to provide online consent, willing to use e-cigarettes and/or cytisine, and have daily access to a mobile phone. Recruitment will utilise multi-media advertising. Participants will be randomised (3:3:2 ratio) to 12 weeks of: 1) e-cigarettes (closed pod system, 3% nicotine salt, tobacco flavour) plus cytisine; 2) e-cigarettes alone, or 3) cytisine alone. All groups will receive a six-month, text-message-based behavioural support programme. The primary outcome is self-reported, biochemically verified, continuous abstinence at six months post-quit date. Secondary outcomes, measured at quit date, then one, three, six, and 12 months post-quit date, include self-reported continuous abstinence, 7-day point prevalence abstinence, cigarettes smoked per day, withdrawal and urge to smoke, time to (re)lapse, treatment use and compliance, treatment crossover, dual-use, use of other cessation products, change in e-cigarette products, continuation of product use, acceptability, change in health state, health-related quality of life, change in body mass index, adverse events, and cost per quitter.

Discussion

Pragmatic trials are of particular value as they reflect the ‘real world’ impact of interventions. The trial will provide some of the first evidence on the effectiveness of combining nicotine salt e-cigarettes with cytisine for smoking cessation, in a country with strong tobacco control policy. Findings will be incorporated into relevant systematic reviews, informing practice and policy.

Trial registration

NCT05311085 ClinicalTrials.gov. Registered 5th April, 2022.
Correlations between geomagnetic field and global occurrence of cardiovascular diseases: evidence from 204 territories in different latitude
Authors: Chai Zheng , Wang Yan , Li Yi-Ming , Zhao Zhen-Gang , Chen Mao
Published: September 2023

Background

The correlation between stable geomagnetic fields and unstable geomagnetic activities with mortality, incidence, and prevalence of cardiovascular diseases (CVDs) remains ambiguous.

Method

To investigate the correlations between geomagnetic field (GMF) intensity and geomagnetic disturbance (GMD) and CVDs events in global, long-period scale, global and 204 countries and territories were included on the base of 2019 Global Burden of Disease study (GBD 2019). Data of GMF intensity, GMD frequency, CVDs events, weather and health economic indicators from 1996 to 2019 of included locations were collected. Linear regression and panel data modelling were conducted to identify the correlations between GMF intensity and CVDs events, multi-factor panel data analysis was also generated to adjust the effect of confounding factors.

Results

For the average data during 1996–2019, linear regression model revealed consistent positive correlations between total GMF (tGMF) intensity and mortality of total CVDs [coef = 0.009, (0.006,0.011 95%CI)], whereas negative correlations were found between horizonal GMF (hGMF) intensity and total CVD mortality [coef = -0.010 (-0.013, -0.007 95%CI)]. When considering the time trend, panel data analysis still demonstrated positive correlation between tGMF and total CVDs mortality [coef = 0.009, (0.008,0.009 95%CI)]. Concurrently, the hGMF negatively correlated with total CVDs mortality [coef = -0.008, (-0.009, -0.007 95%CI)]. When the panel models were adjusted for confounding factors, no reverse of correlation tendency was found between tGMF, hGMF and CVDs events. In high-income territories, positive correlation was found between geomagnetic storm (GMS) frequency and mortality of total CVDs [coef = 14.007,(2.785, 25.229 95%CI)], however, this positive trend faded away gradually with the latitude decreasing from polar to equator.

Conclusions

Stable and long-term horizontal component of GMF may be beneficial to cardiac health. Unstable and short-term GMF called GMD could be a hazard to cardiac health. Our results suggest the importance of regular GMF in maintaining cardio-health state and the adverse impacts of GMD on cardiac health.
Application value of CT radiomic nomogram in predicting T790M mutation of lung adenocarcinoma
Authors: Li Xiumei , Chen Jianwei , Zhang Chengxiu , Han Zewen , zheng Xiuying , Cao Dairong
Published: September 2023

Background

The purpose of this study was to develop a radiomic nomogram to predict T790M mutation of lung adenocarcinoma base on non-enhanced CT lung images.

Methods

This retrospective study reviewed demographic data and lung CT images of 215 lung adenocarcinoma patients with T790M gene test results. 215 patients (including 52 positive) were divided into a training set (n = 150, 36 positive) and an independent test set (n = 65, 16 positive). Multivariate logistic regression was used to select demographic data and CT semantic features to build clinical model. We extracted quantitative features from the volume of interest (VOI) of the lesion, and developed the radiomic model with different feature selection algorithms and classifiers. The models were trained by a 5-fold cross validation strategy on the training set and assessed on the test set. ROC was used to estimate the performance of the clinical model, radiomic model, and merged nomogram.

Results

Three demographic features (gender, smoking, emphysema) and ten radiomic features (Kruskal-Wallis as selection algorithm, LASSO Logistic Regression as classifier) were determined to build the models. The AUC of the clinical model, radiomic model, and nomogram in the test set were 0.742(95%CI, 0.619–0.843), 0.810(95%CI, 0.696–0.907), 0.841(95%CI, 0.743–0.938), respectively. The predictive efficacy of the nomogram was better than the clinical model (p = 0.042). The nomogram predicted T790M mutation with cutoff value was 0.69 and the score was above 130.

Conclusion

The nomogram developed in this study is a non-invasive, convenient, and economical method for predicting T790M mutation of lung adenocarcinoma, which has a good prospect for clinical application.
Operative strategies for ankylosing spondylitis-related thoracolumbar kyphosis: focus on the cervical stiffness, coronal imbalance and hip involvement
Authors: Zhang Wei , Yin Wen , Cui Xilong , Chai Zihao , Zheng Guohui , Ding Ya , Wang Hongliang , Zhai Yunlei , Yu Haiyang
Published: September 2023

Background

Cervical stiffness, coronal imbalance and limited hip movement all play crucial roles in designing the corrective surgery for ankylosing spondylitis-related thoracolumbar kyphosis (AS-TLK). However, a comprehensive classification and tailored strategies for directing clinical work are lacking. This study aims to investigate the types and surgical strategies for AS-TLK that consider cervical stiffness, coronal imbalance and hip involvement as the key factors.

Methods

25 consecutive AS-TLK patients were divided into three types according to their accompanying features: Type I: with a flexible cervical spine; Type IIA: with a stiff cervical spine; Type IIB: with coronal imbalance; Type IIC: with limited hip movement. Type III is the mixed type with at least two conditions of Type II. Individual strategies were given correspondingly. Spinal-pelvic-femoral parameters were measured, Scoliosis Research Society outcome instrument-22 (SRS-22) was used and complications were recorded and analysed.

Results

All patients (Type I 10, Type II 8 and Type III 7) underwent surgery successfully. 13 cases with 16 complications were recorded and cured. The patients were followed up for 24–65 months with an average of 33.0 ± 9.6 months. Both the sagittal and coronal parameters were corrected and decreased significantly (all, p < 0.05). SRS-22 scores showed a satisfactory outcome.

Conclusion

Thoracolumbar kyphosis secondary to ankylosing spondylitis are complex and variable. Considering the factors of cervical stiffness, coronal imbalance and hip involvement assists in making decisions individually and achieving a desired surgical result.
The V-shaped curve relationship between fasting plasma glucose and human serum albumin in a large health checkup population in China
Authors: Wang Chenxu , Cao Lei , Mei Wendan , Fang Yicheng , Ren Xia , Hu Jian , Su Fan , Tavengana Grace , Jiang Mingfei , Wu Huan , Wen Yufeng
Published: September 2023

Background

This study aimed to investigate the relationship between fasting plasma glucose (FPG) and human serum albumin (HSA) in a large health checkup population in China.

Methods

In this cross-sectional health checkup study, we enrolled a population of 284,635 subjects from Wuhu between 2011 and 2016. All participants completed the physical examination, blood biochemical examination, and blood routine examination.

Results

The prevalence of diabetes in men and women was 6.11% and 2.98%, respectively. The average level of HSA and FPG was significantly higher in men than in women (48.44 ± 3.25 vs. 47.14 ± 3.22, P < 0.0001; 5.50 ± 1.26 vs. 5.26 ± 0.94, P < 0.0001). There were significant differences in blood biochemistry and blood routine values by gender. After adjusting for confounding factors, the results showed that FPG and HSA were a V-shaped curve, and the threshold value of HSA was 40.7 mmol/L. FPG and HSA still showed a V-shaped curve after stratification by gender and age. In the male group, FPG decreased with HSA when HSA<42.3 mmol/L, and increased when HSA ≥ 42.3 mmol/L. In the female group, FPG decreased with HSA when HSA<35.7 mmol/L, and increased when HSA ≥ 35.7 mmol/L. In the age<65 group, FPG decreased with HSA when HSA<37.5 mmol/L, and increased when HSA ≥ 37.5 mmol/L. In the age ≥ 65 group, FPG decreased with HSA when HSA<43.2 mmol/L, and increased when HSA ≥ 43.2 mmol/L.

Conclusions

A V-shape relationship exists between fasting plasma glucose and human serum albumin among the Chinese health checkup population studied.
“Evolution” of intravascular leiomyomatosis
Authors: Chen Li , Yang Yunping , Zhao Chengzhi
Published: September 2023

Background

Intravenous leiomyomatosis (IVL) is a rare and specific type of smooth muscle tumor that is histologically benign but has a malignant biological behavior. It is commonly associated with a history of uterine leiomyomas.

Case presentation

A 36-year-old woman, G1P1, presented to the hospital with left lower abdominal pain for 2 months and she has accepted hysteroscopic myomectomy about 1 year ago. Ultrasound venography, echocardiography and computed tomography venography (CTV) of inferior vena cava were performed, which revealed IVL located in left intramural myometrium walls growing along the left ovarian vein reaching the level of the lumbar 5-sacral 1 disc. Laparoscopic bilateral salpingo-oophorectomy and hysterectomyis were scheduled. The IVL in the left ovarian vein and parauterine venous plexus were detected and excised completely during surgery. IVL was diagnosed by postoperative pathology and immunohistochemistry. The patient recovered well after surgery. No surgical-related or anesthesia-related complications occurred.The 3-month follow-up CTV of inferior vena cava and echocardiography examination revealed normal.

Conclusions

The cause of IVL is unknown, this observation demonstrates that hysteroscopic myomectomy might lead to the occurrence of IVL.
The effectiveness of mindfulness yoga on patients with major depressive disorder: a systematic review and meta-analysis of randomized controlled trials
Authors: Miao Chuyuan , Gao Yun , Li Xiaohua , Zhou Ying , Chung Joanne Wai-yee , Smith Graeme D.
Published: September 2023

Background

Mindfulness yoga is a type of exercise that emphasizes the integration of mindfulness or meditation into yoga. The aim of this study was to determine the effectiveness of mindfulness yoga intervention on major depressive disorder (MDD) patients.

Methods

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching nine databases, including PubMed, EMBASE, Web of Science, The Cochrane Library, MEDLINE, China National Knowledge Infrastructure (CNKI), Wanfang Data knowledge service platform, Chinese Biomedical Literature Database (CBM), and China Science and Technology Journal Database (VIP) from inception to April 2023. Primary outcomes included the severity of depression. Secondary outcomes included anxiety and rumination.

Results

Nine RCTs met our inclusion criteria (n = 581). The meta-analysis showed that mindfulness yoga significantly has a significant effect on depression (SMD = -0.53; 95%CI = -0.96 to -0.11; P < 0.05) among MDD patients. The only two RCTs involved also showed that mindfulness yoga could alleviate the anxiety level of MDD patients after intervention (SMD = -1.08; 95%CI = -1.64 to -0.52; P < 0.05). Meta-analysis did not reveal positive effects of the mindfulness yoga groups on rumination after intervention based on three RCTs (SMD = -0.33; 95%CI = -0.89 to 0.23; P > 0.05), but found a significant difference in the follow-up period based on two RCTs (MD = -7.42; 95%CI = -11.27 to -3.56; P < 0.05), compared with the control groups.

Conclusion

Although we were unable to provide conclusive evidence to support the effectiveness of mindfulness yoga in improving symptoms in MDD patients, we found the literature included in this study indicated that mindfulness yoga might have a potential benefit for MDD patients and should be a feasible, acceptable, and promising intervention.
Impact of using peer role-playing on the clinical skills performance of pediatric trainees
Authors: Xu Lingling , Liu Wangkai , Jiang Xiaoyun , Li Yijuan
Published: September 2023

Objective

The aim of this study was to evaluate the impact of peer role-playing on the clinical skills performance of pediatric trainees.

Methods

Seventy-eight clinical medicine trainees were randomly divided into a role-playing group and a traditional teaching group, with 39 students in each group. The role-playing group alternated between the roles of clinicians and patients, while the traditional teaching group received the bedside teaching mode of verbal instruction. After two weeks traineeship, mini-Clinical Evaluation Exercise(Mini-CEX) was used to evaluate the trainees’ competence in physician-patient communication and clinical practice. A questionnaire was given to the role-playing group to assess their satisfaction with the method.

Results

The Mini-CEX scores showed that the role-playing group had superior clinical skills (p < 0.05), including communication, history taking, professionalism, organization, clinical skills, and physical examination, compared to the traditional teaching group. Furthermore, trainee satisfaction was high with the role-playing method,and the satisfaction were more than 95%.

Conclusion

The role-playing method effectively improved the clinical skills of pediatric trainees, developed clinical communication skills, and enhanced the application of medical knowledge in a simulated medical environment.
Inhibition of COX-2 signaling favors E. coli during urinary tract infection
Authors: Mohanty Soumitra , Lindelauf Ciska , White John Kerr , Scheffschick Andrea , Ehrenborg Ewa , Demirel Isak , Brauner Hanna , Brauner Annelie
Published: September 2023

Background

To avoid the overuse of antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), acting via cyclooxygenase (COX) inhibition, have been used to reduce pain and as an alternative treatment for uncomplicated urinary tract infections (UTIs). However, clinical studies evaluating NSAIDs versus antibiotics have reported an increased risk of acute pyelonephritis. Therefore, we hypothesized that COX inhibition could compromise the innate immune response and contribute to complications in patients with uncomplicated UTI.

Results

We here demonstrate that in particular COX-2 inhibition led to decreased expression of the antimicrobial peptides psoriasin and human β-defensin-2 in human uroepithelial cells. Psoriasin expression was altered in neutrophils and macrophages. COX-2 inhibition also had impact on the inflammasome mediated IL-1β expression in response to uroepithelial E. coli infection. Further, COX-2 inhibition downregulated free radicals and the epithelial barrier protein claudin 1, favoring infectivity. In addition, conditioned media from COX-2 inhibited uroepithelial cells infected with E. coli failed to activate macrophages.

Conclusions

Taken together, our data suggests an adverse innate immune effect of COX-2 inhibition on uroepithelial cells during UTI.
Pharmacy-based methadone treatment in the US: views of pharmacists and opioid treatment program staff
Authors: Wu Li-Tzy , Mannelli Paolo , John William S. , Anderson Alyssa , Schwartz Robert P.
Published: September 2023

Background

The US federal regulations allow pharmacy administration and dispensing of methadone for opioid use disorder (PADMOUD) to increase the capability of opioid treatment programs (OTPs) in providing methadone maintenance treatment (MMT) for opioid use disorder (OUD) as part of a medication unit. However, there is a lack of research data from both pharmacy and OTP staff to inform the implementation of PADMOUD.

Methods

Staff of a pharmacy (n = 8) and an OTP (n = 9) that participated in the first completed US trial on PADMOUD through electronic prescribing for methadone (parent study) were recruited to participate in this qualitative interview study to explore implementation-related factors for PADMOUD. Each interview was recorded and transcribed verbatim. NVivo was used to help identify themes of qualitative interview data. The Promoting Action on Research Implementation in Health Services (PARIHS) framework was used to guide the coding and interpretation of data.

Results

Six pharmacy staff and eight OTP staff (n = 14) completed the interview. Results based on PARIHS domains were summarized, including evidence, context, and facilitation domains. Participants perceived benefits of PADMOUD for patients, pharmacies, OTPs, and payers. PADMOUD was considered to increase access for stable patients, provide additional patient service opportunities and revenues for pharmacies/pharmacists, enhance the capability of OTPs to treat more new patients, and reduce patients’ cost when receiving medication at a pharmacy relative to an OTP. Both pharmacy and OTP staff were perceived to be supportive of the implementation of PADMOUD. Pharmacy staff/pharmacists were perceived to need proper training on addiction and methadone as well as a protocol of PADMOUD to conduct PADMOUD. Facilitators include having thought leaders to guide the operation, a certification program to ensure proper training of pharmacy staff/pharmacist, having updated pharmacy service software or technology to streamline the workflow of delivering PADMOUD and inventory management, and reimbursement for pharmacists.

Conclusion

This study presents the first findings on perspectives of PADMOUD from both staff of a community pharmacy and an OTP in the US. Finding on barriers and facilitators are useful data to guide the development of strategies to implement PADMOUD to help address the US opioid crisis.
Impact of thyroid hormone treatment on maternal pregnancy outcomes in women with subclinical hypothyroidism without TPOAb: a retrospective cross-sectional study
Authors: Sitoris Georgiana , Veltri Flora , Jelloul Emna , Kleynen Pierre , Rozenberg Serge , Poppe Kris G.
Published: September 2023

Background

Evidence on the impact of thyroid hormone treatment (LT4) on maternal pregnancy outcomes in women with subclinical hypothyroidism (SCH) without thyroid peroxidase antibodies (TPOAb) positivity is scarce.

Methods

Single centre, cross-sectional study in 1460 women screened for TSH, free T4 and TPOAb at median 13 (11–17) weeks of gestation during the period 2013–2014. Exclusion criteria were twin- and assisted reproduction pregnancies, TPO positivity, overt thyroid dysfunction, and treatment with LT4 before screening. The impact of LT4 on maternal pregnancy outcomes was investigated in a group of 53 women with SCH (TSH > 3.74 mIU/L) in which LT4 was initiated at median 13 (10–22) weeks (treated group). The control group included 18 women with SCH (TSH > 3.74 mIU/L). The prevalence of pregnancy complications in these two groups was compared with that in a euthyroid reference (REF) group of 1389 women (TSH ≤ 3.74 mIU/L).

Results

The prevalence of pre-eclampsia and gestational diabetes (GDM) was higher in the control group vs the REF group (16.7% vs 5.0% and 27.8% vs 18.9%; p = 0.017 and p = 0.016, respectively), but comparable in the treated group vs the REF group (7.6% vs 5.0% and 22.6% vs 18.9%; p = 0.918 and 0.676, respectively). The prevalence of iron-deficiency anaemia was lower in the treated vs the REF group (17.0% vs 32.5%; p = 0.017).

Conclusion

Pregnant women with untreated SCH and without TPOAb positivity had a higher prevalence of pre-eclampsia and GDM compared with euthyroid women, while this was not the case in women with treated SCH, even when it was initiated after the first trimester.
Perceptions of social media utilization among orthopaedic foot and ankle surgeons
Authors: Salimy Mehdi S. , Narain Ankur S. , Curtin Patrick B. , Bellinger Eric C. , Patel Abhay R.
Published: September 2023

Background

The growing social media presence in healthcare has provided physicians with new ways to engage with patients. However, foot and ankle orthopaedic surgeons have been found to underuse social media platforms despite their known benefits for patients and surgeons. Thus, this study sought to investigate the reasons for this phenomenon and to identify potential barriers to social media utilization in clinical practice.

Methods

A 19‐question survey was distributed to active attending physicians identified through the American Orthopaedic Foot & Ankle Society membership database. The survey included demographic, practice characteristics, and social media use questions assessed by a 5‐point Likert scale. Logistic regression was used to identify predictors of positive attitudes toward social media.

Results

Fifty‐eight surgeons were included. Most respondents were male (n = 43, 74.1%), in private practice (n = 31, 53.5%), and described their practice to be greater than 51% elective procedures (n = 46, 79.4%). The average years in practice was 14.8 years (standard deviation, SD: 10.0 years). A total of 32.8% (n = 19) of surgeons reported using social media as part of their clinical practice. Facebook (n = 19, 32.8%), a professional website or blog (n = 18, 31.0%), and LinkedIn (n = 15, 25.9%) were the most used platforms–primarily for practice marketing or brand development (n = 19, 32.8%). A total of 58.6% (n = 34) of surgeons reported they did not use social media. The primary reasons were the time commitment (n = 31, 53.5%), concerns about obscuring professional boundaries (n = 22, 37.9%), and concerns regarding confidentiality (n = 11, 19.0%). Many surgeons reported that social media positively influences foot and ankle surgery (n = 23, 39.7%), although no individual predictors for these views could be identified.

Conclusions

Foot and ankle orthopaedic surgeons tended to view social media use positively, but the time investment and concerns over professionalism and confidentiality pose challenges to its use. Given the influence of a surgeon's social media identity on patient satisfaction and practice building, efforts should be made to streamline social media use for foot and ankle surgeons to establish their online presence.

Level of evidence

Level IV, cross‐sectional study.
Post-trigger luteinizing hormone concentration to positively predict oocyte yield in the antagonist protocol and its association with genetic variants of LHCGR
Authors: Jin Hao , Yang Haiyan , Zheng Jiujia , Zhou Jiechun , Yu Rong
Published: September 2023

Background

The concentration of human chorionic gonadotropin (hCG)/ luteinizing hormone (LH) after triggering is generally accepted as a predictor of the normal ovarian response to the trigger, but few studies have explored the distribution model of concentration and its impact on oocyte yield. Genetic variations in LHCGR, known as a receptor for hCG and LH, also play a role in oocyte maturation and retrieval. The objective of the study was to investigate the impact of concentrations of hCG/LH after triggering on oocyte yield and its association with genetic variants of LHCGR.

Methods

A retrospective cohort study including 372 antagonist IVF cycles, in which 205 received the recombinant hCG trigger and 167 received the gonadotropin-releasing hormone agonist (GnRH-a) trigger, was conducted. The post-trigger concentrations of hCG/LH and the LHCGR N312S (rs2293275) genotype were evaluated in patients to analyse the impact of these factors on oocyte yield.

Results

The oocyte retrieval rate (ORR) increased significantly among the low-, medium- and high-hCG-concentration groups (0.91 ± 0.25, 0.99 ± 0.23 and 1.08 ± 0.19, P < 0.001) and among the low-, medium- and high-LH-concentration groups (0.80 ± 0.29, 0.95 ± 0.21 and 1.07 ± 0.19, P < 0.001). The Pearson correlation coefficient between the post-trigger hCG concentration and ORR was 0.242 (P < 0.001), and that between the LH concentration and ORR was 0.454 (P < 0.001). After adjustment for confounding factors, high post-trigger LH concentrations remained associated with the significantly higher ORRs (adjusted R2 = 0.541, P < 0.001). Patients with the AG genotype of LHCGR N312S were more likely to have low post-trigger LH concentrations (46.10 IU/L versus 60.91 IU/L, P < 0.001) and a significantly lower ORR (0.85 versus 0.96, P = 0.042) than patients with the GG genotype after the GnRH-a trigger.

Conclusions

The post-trigger LH concentration can positively predict oocyte yield in antagonist IVF cycles, and patients with the AG genotype of LHCGR rs2293275 could have a suboptimal oocyte yield using the GnRH-a trigger.
Upper body compression wear improves muscle oxygenation following intense video game training: a randomized cross-over study among competitive gamers
Authors: DiFrancisco-Donoghue Joanne , Rothstein Alexander , Jung Min-Kyung , Zwibel Hallie , Werner William G
Published: September 2023

Background

Esport players require a high number of action moves per minute to play, with substantial contractions of the wrist extensor muscles. Players frequently suffer from acute fatigue. The purpose of this study was to examine the use of below the elbow compression sleeves on Sm02 during intense aim training. Secondly, to examine players’ performance and perception with and without compression.

Methods

This study was conducted at the New York Institute of Technology and enrolled fifteen collegiate esport players, 2 women and 13 men (age 21.2 ± 2.2). All subjects signed written consent. Participants performed 3 high intensity bouts of an aim trainer followed by a 15-minute rest before doing another 3 bouts of high intensity training conducting the other arm of the study. The compression wear order was randomized. The primary outcome included Sm02 of the extensor carpi radialis longus using near-infrared spectrometry. Secondary outcomes included Kills Per Second (KPS), Score, Total Time to Kill (TTK), accuracy, and perceived performance.

Results

Following 15 min of recovery, there was a significant rise in Sm02 while wearing the compression sleeve compared to no compression sleeve (p = 0.004). No change in Sm02 was seen while gaming. In trials 1 and 2, wearing the compression sleeve resulted in a significant increase in KPS and score when compared to not wearing it (p = 0.002,0.006). Although TTK and accuracy did not alter, 46.7% of participants believed the compression sleeve aided their performance.

Conclusions

This study provides support that wearing below the elbow upper body compression sleeves while performing high intensity gaming may reduce fatigue, improve muscle recovery and gaming performance.

Trial registration

Clinicaltrials.gov identifier NCT05037071. Registered 08/09/2021. URL: Arm Compression on Muscle Oxygen Saturation - Full Text View - ClinicalTrials.gov
Use of electronic health record data mining for heart failure subtyping
Authors: Vuori Matti A. , Kiiskinen Tuomo , Pitkänen Niina , Kurki Samu , Laivuori Hannele , Laitinen Tarja , Mäntylahti Sampo , Palotie Aarno , FinnGen  , Niiranen Teemu J.
Published: September 2023

Objective

To assess whether electronic health record (EHR) data text mining can be used to improve register-based heart failure (HF) subtyping. EHR data of 43,405 individuals from two Finnish hospital biobanks were mined for unstructured text mentions of ejection fraction (EF) and validated against clinical assessment in two sets of 100 randomly selected individuals. Structured laboratory data was then incorporated for a categorization by HF subtype (HF with mildly reduced EF, HFmrEF; HF with preserved EF, HFpEF; HF with reduced EF, HFrEF; and no HF).

Results

In 86% of the cases, the algorithm-identified EF belonged to the correct HF subtype range. Sensitivity, specificity, PPV and NPV of the algorithm were 94–100% for HFrEF, 85–100% for HFmrEF, and 96%, 67%, 53% and 98% for HFpEF. Survival analyses using the traditional diagnosis of HF were in concordance with the algorithm-based ones. Compared to healthy individuals, mortality increased from HFmrEF (hazard ratio [HR], 1.91; 95% confidence interval [CI], 1.24–2.95) to HFpEF (2.28; 1.80–2.88) to HFrEF group (2.63; 1.97–3.50) over a follow-up of 1.5 years. We conclude that quantitative EF data can be efficiently extracted from EHRs and used with laboratory data to subtype HF with reasonable accuracy, especially for HFrEF.
From fossil trader to paleontologist: on Swiss-born naturalist Santiago Roth and his scientific contributions
Authors: Sánchez-Villagra Marcelo R. , Bond Mariano , Reguero Marcelo , Bartoletti Tomás
Published: September 2023

Roth’s explorations, the resulting collections many now allocated in La Plata, Zurich, Geneva and Copenhagen, and his significant contributions in geological—especially stratigraphic—and paleontological topics, are a paradigmatic case for the global history of paleontology and for the Swiss migration history in Latin America. His work included the discovery of a diverse megafauna from the Pampean region, of sites and strata in Patagonia of paleontological significance, and the recognition of a group of endemic ungulate mammals, Notoungulata. Roth’s discovery of a human skeleton associated with a glyptodont carapace is one of the first reports of the coexistence of humans with the extinct fauna of the South American Quaternary. Roth became a renowned scholar at the Museo de La Plata, which was a leading scientific institution in the nation-making of Argentina, particularly in the expansion of the Patagonian frontier. He also kept strong ties with his native Switzerland, where late in his adult life he obtained some formal training and tried to attract other Swiss nationals to work in natural sciences in Argentina. His biography sheds light about the circumstances of his scientific collection and career in the interstices between amateur and professional science, modernity and imperialism at the turn of the twentieth century.
Adherence enhancing interventions for pharmacological and oxygen therapy in patients with COPD: protocol for a systematic review and component network meta-analyses
Authors: Ammous Omar , Andreas Stefan , Friede Tim , Kampo Regina , Schwarz Sarah , Wollsching-Strobel Maximilian , Salem Susanna , Windisch Wolfram , Mathes Tim
Published: September 2023

Background

Chronic obstructive pulmonary disease (COPD) is characterised by hyperinflation and expiratory airflow limitation due to long-term exposure to irritants. The variety and complexity of COPD treatment and the possible added comorbidities may make the patients find it difficult to cope with the required medications. That is why supporting patients’ adherence is critical because not taking medications correctly increases the risk of complications and creates an additional financial burden. A range of interventions aiming to improve patient adherence were used, and most of them are complex since they involve a mix of elements. Furthermore, despite the variety of available tools, assessing adherence is challenging because clinicians usually do not get a concrete judgement if their patients followed their treatment plan reliably. We aim to evaluate the effectiveness of adherence-enhancing interventions for COPD patients, explore which intervention (component) works for which patients and check the factors influencing the implementation and participant responses.

Methods

We will perform a comprehensive literature search (Medline, Embase, Cochrane Library, trial registries) without restrictions on language and publication status, and we will include all controlled studies investigating the effect of adherence-enhancing intervention on patients with COPD. We plan to involve COPD patients in the systematic review development through two patient interviews (one before and one after the systematic review). Two reviewers will perform the screening, data extraction and risk of bias (ROB) assessment. For ROB, we will use ROB 2.0 to assess randomised controlled trials, and ROBINS-I to assess non-randomised studies. We will perform pair-wise random-effects meta-analyses and component network meta-analyses to identify the most effective components and combinations of components. We will use the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the quality of evidence. To determine the degree of complexity, we will use the iCAT_SR checklist, and then, following a logical model, we will group the interventions according to prespecified criteria.

Discussion

This systematic review aims to point out the most effective and implementable adherence-enhancing interventions by using methods for synthesising evidence on complex interventions and involving COPD patients all along with the review process.

Systematic review registration

PROSPERO CRD42022353977
Impact factors of Blastocystis hominis infection in persons living with human immunodeficiency virus: a large-scale, multi-center observational study from China
Authors: Zhang Shun-Xian , Wang Ji-Chun , Li Zhong-Wei , Zheng Jin-Xin , Zhou Wen-Ting , Yang Guo-Bing , Yu Ying-Fang , Wu Xiu-Ping , Lv Shan , Liu Qin , Chen Mu-Xin , Lu Yan , Dou Zhi-Hui , Zhang Da-Wei , Lv Wen-Wen , Wang Lei , Lu Zhen-Hui , Yang Ming , Zheng Pei-Yong , Chen Yue-Lai , Tian Li-Guang , Zhou Xiao-Nong
Published: September 2023

Background

Blastocystis hominis (Bh) is zoonotic parasitic pathogen with a high prevalent globally, causing opportunistic infections and diarrhea disease. Human immunodeficiency virus (HIV) infection disrupts the immune system by depleting CD4+ T lymphocyte (CD4+ T) cell counts, thereby increasing Bh infection risk among persons living with HIV (PLWH). However, the precise association between Bh infection risk and HIV-related biological markers and treatment processes remains poorly understood. Hence, the purpose of the study was to explore the association between Bh infection risk and CD4+ T cell counts, HIV viral load (VL), and duration of interruption in antiviral therapy among PLWH.

Methods

A large-scale multi-center cross-sectional study was conducted in China from June 2020 to December 2022. The genetic presence of Bh in fecal samples was detected by real-time fluorescence quantitative polymerase chain reaction, the CD4+ T cell counts in venous blood was measured using flowcytometry, and the HIV VL in serum was quantified using fluorescence-based instruments. Restricted cubic spline (RCS) was applied to assess the non-linear association between Bh infection risk and CD4+ T cell counts, HIV VL, and duration of interruption in highly active antiretroviral therapy (HARRT).

Results

A total of 1245 PLWH were enrolled in the study, the average age of PLWH was 43 years [interquartile range (IQR): 33, 52], with 452 (36.3%) being female, 50.4% (n = 628) had no immunosuppression (CD4+ T cell counts > 500 cells/μl), and 78.1% (n = 972) achieved full virological suppression (HIV VL < 50 copies/ml). Approximately 10.5% (n = 131) of PLWH had interruption. The prevalence of Bh was found to be 4.9% [95% confidence interval (CI): 3.8–6.4%] among PLWH. Significant nonlinear associations were observed between the Bh infection risk and CD4+ T cell counts (Pfor nonlinearity < 0.001, L-shaped), HIV VL (Pfor nonlinearity < 0.001, inverted U-shaped), and duration of interruption in HARRT (Pfor nonlinearity < 0.001, inverted U-shaped).

Conclusions

The study revealed that VL was a better predictor of Bh infection than CD4+ T cell counts. It is crucial to consider the simultaneous surveillance of HIV VL and CD4+ T cell counts in PLWH in the regions with high level of socioeconomic development. The integrated approach can offer more comprehensive and accurate understanding in the aspects of Bh infection and other opportunistic infections, the efficacy of therapeutic drugs, and the assessment of preventive and control strategies.

Graphical Abstract
The moderating role of optimism between social trauma and depression among Chinese college students: a cross-sectional study
Authors: Luo Jie , Cao Wei , Zhao Jianhua , Zeng Xiaojin , Pan Yun
Published: September 2023

Background

Although there is a robust relationship among social trauma, optimism, and depression, the inner mechanism of this correlation remains unclear and need to be further explored. The mainly purpose of the current study was to investigate the relationship between social trauma, optimism, and depression among college students in China. More specifically, examined the moderating role of the optimism between social trauma and depression in Chinese college students.

Methods

A sample of 464 Chinese college students (54.7% female, Mage=19.29) from three universities were selected by the convenient sampling, and the Social Trauma Questionnaire (STQ), the Optimism Questionnaire (OPQ), and the Self-Rating Depression (SDS) were completed by these Chinese undergraduates. The descriptive statistics, Pearson correlations, and hierarchical regression analysis were used to examine the results.

Results

(1) The social trauma was positively associated with depression, whereas the optimism was negatively associated with social trauma, and depression; (2) The social trauma had a significant correlation with depression, and the optimism could moderate the relationship between social trauma and depression. More specifically, the further study showed that there was a significant positive relation between social trauma and depression under the low optimism level, however, there was a non-significant relation between social trauma and depression under the high optimism level.

Conclusion

The optimism is the protective mechanism of college students’ mental health (e.g., depression), it could weaken the trauma that associated with social trauma among college students.
Prevalence of adenoid hypertrophy among 12-year-old children and its association with craniofacial characteristics: a cross-sectional study
Authors: Tse Kwan Lok , Savoldi Fabio , Li Kar Yan , McGrath Colman P. , Yang Yanqi , Gu Min
Published: September 2023

Background

Identifying the prevalence of adenoid hypertrophy (AH) and craniofacial factors associated with this condition requires studies with random sampling from the general population, and multiple criteria can be used for assessing AH on lateral cephalometric radiograph (LCR). The present analysis represents the first report performed according to these requirements in a large cross-sectional sample of children.

Methods

LCRs of 517 12-year-old children (286 males, 231 females) randomly selected from the general population were retrospectively retrieved. AH was defined using three criteria (At/Nd, Ad-Ba/PNS-Ba, 1-Npaa/Npa), and twelve craniofacial variables were measured (SNA, SNB, ANB, Wits, Cd-Gn, MnP^SN, MxP^MnP, TPFH/TAFH, OPT^SN, C2ps-C4pi^SN, H-CV, H-FH). Skeletal characteristics were compared between children with and without AH using Mann–Whitney U test. Binary logistic regression (adjusted for sex and skeletal growth) was used to independently quantify the association between craniofacial factors and AH.

Results

The prevalence of children with AH was 17.6% (according to At/Nd), 19.0% (according to Ad-Ba/PNS-Ba), and 13.9% (according to 1-Npaa/Npa). Children with AH presented greater antero-posterior jaw discrepancy (larger ANB, smaller SNB), greater mandibular divergence (larger MnP^SN), forward head posture (larger OPT^SN and C2ps-C4pi^SN), and anteriorly positioned hyoid bone (larger H-CV). Larger SNA (OR = 1.39–1.48), while smaller SNB (OR = 0.77–0.88) and Wits (OR = 0.85–0.87), were associated with greater likelihood of having AH, independently from the assessment method used.

Conclusions

The prevalence of children with AH ranged from 13.9 to 19.0% based on LCR. Greater antero-posterior maxillo–mandibular discrepancy and mandibular retrusion were independently associated with higher likelihood of having AH.