bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing hypertension detection and control through a hypertension certification program for pharmacists: A cluster randomized trial (The RxPATH Study)
Authors: Watson Kaitlyn E. , Chan Jonathan C.H. , Pan Bo , Al Hamarneh Yazid N. , Tsuyuki Ross T.
Published: May 2024

Importance:

We designed an online educational program for primary care health care providers, the Hypertension Canada Professional Certification Program (HC-PCP), based upon its 2020 guidelines.

Objective:

The objective was to determine the effect of the HC-PCP, taken by pharmacists, on systolic blood pressure (BP) in patients with poorly controlled hypertension.

Design:

Stepped wedge cluster randomized trial (unit of randomization was the pharmacy).

Participants:

Patients with poorly controlled hypertension (BP >140/90 mmHg or >130/80 mmHg [diabetes]) in community pharmacies in Alberta, Canada, were recruited by their pharmacist.

Intervention:

Pharmacists completed the HC-PCP program, then provided care to their patients with poorly controlled hypertension according to what they learned in the course.

Control:

Pharmacists were given a copy of the Hypertension Canada guidelines and provided their usual care to their patients prior to undertaking the HC-PCP later.

Main outcome and measure:

The primary outcome was a difference in change in systolic BP at 3 months between groups, while the secondary outcome was patient satisfaction with using the Consultation Satisfaction Questionnaire.

Results:

We enrolled 890 patients from 59 pharmacies (including 104 pharmacists). Using a linear mixed-effect model with BP reduction as the dependent variable and independent variables of treatment allocation, baseline BP, site effect and patient effect, the intervention was associated with a 4.76 mmHg (95% confidence interval, 2.02–7.50, p < 0.0001) systolic BP reduction at 3 months. Patient satisfaction with using the Consultation Satisfaction Questionnaire was high at 75.9 (/90).

Conclusion and relevance:

Most educational programs are not evaluated at the patient care level. The HC-PCP taken by pharmacists resulted in a 4.76 mmHg systolic BP reduction in their patients over 3 months. This would have major implications for public health, reducing heart disease, stroke and kidney failure.
From conspiracy to normalcy: The mainstreaming of QAnon in “Disney grooming” messages online
Authors: Peterka-Benton Daniela , Benton Bond , Penney Joel
Published: May 2024

In March of 2022, The Walt Disney Company voiced opposition to Florida’s “Parental Rights in Education” (“Don’t Say Gay”) in support of LGBTQ+ stakeholders within the company and the public. This research studied a dataset of 68,481 tweets where the company’s stance was constructed as “grooming” children, that is, manipulating children for sexual abuse. Tweets were collected from March 13, 2022 to May 16, 2022 representing a 2-month period from Disney’s stance against "Parental Rights in Education.” As grooming is a term often associated with human trafficking and Disney is a major media company, this study is interested in potential linkages to QAnon messaging. QAnon is a conspiracy that proposes a “cabal of elites” is trafficking and abusing children. This thematic connection has been noted by previous scholarship and this study seeks to contribute to empirical validation of that connection. Results suggest that the accounts having the most effect in terms of impact, views, shares, and followers are primarily accounts that have shared QAnon related conspiratorial content.
A comparative network analysis of the criminogenic needs of male emerging adult first-time offenders, repeated offenders, and university students
Authors: Tang Ming Chun , Leung Jacklyn , Chan Chung Yin Joie , Hung Suet Wai , Kwong Eva Y. W. , Chan Christian S.
Published: May 2024

We compared facets of criminogenic needs between male young offenders and university students in Hong Kong and assessed the interrelationships between criminogenic needs across the samples using network analysis. The participants, aged between 18 and 23 years old, were 183 incarcerated first-time offenders (age = 19.6 years), 214 incarcerated repeated offenders (age = 19.8 years), and 113 university students (age = 19.6 years). The results show that incarcerated emerging adults had significantly greater criminogenic needs as compared with university students, while no difference between first-time and repeated offenders was found. Gang membership did not have main or moderating effects on criminogenic needs. Regularized Graphical Gaussian Models revealed that the criminogenic needs were clustered comparably across the three groups, while the network comparison test showed that the first-time and repeated-offender networks had significant structure invariance compared with the non-offender network. Differences in highly central nodes in terms of expected influence and bridge expected influence between networks were revealed.
Neurosyphilis Manifesting as a Longitudinally Extensive Transverse Myelitis: A Case Report
Authors: Bou Gabriela A. , AlShaer Qasem N. , Harrison Taylor B. , Hutto Spencer K.
Published: May 2024

Background: Evaluating patients with ascending sensorimotor deficits has a broad differential diagnosis at initial presentation which can be further narrowed upon neurologic examination but may represent a diagnostic and therapeutic dilemma in light of findings raising suspicion for multiple possible etiologies. Data Collection: In this case, a 29-year-old patient presented with ascending bilateral lower extremity sensory loss, paresthesias, and weakness which progressed to the inability to ambulate. Conclusions: This case highlights the diagnostic approach to patients with bilateral lower extremity sensorimotor deficits, discusses the development of a comprehensive differential diagnosis, and further evaluates the most likely etiologies. Furthermore, this case reviews complexities related to clinical reasoning in the setting of diagnostic uncertainty, particularly when the neurologic structures affected portend high risk for severe disability and early treatment may improve outcome.
Golimumab and certolizumab pegol for the treatment of hidradenitis suppurativa: a literature review and future perspective
Authors: Heidari Amirhossein , Ghane Yekta , Heidari Nazila , Hosseini Seyedayin , Goodarzi Azadeh
Published: May 2024

Hidradenitis suppurativa (HS) is an inflammatory skin condition with an underlying inflammatory process. Due to the limited efficacy of available treatments, HS remains a therapeutic challenge. The safety and efficacy of tumor necrosis factor-α (TNF-α) inhibitors, adalimumab, infliximab, and etanercept, are well studied in this patient population, and in some cases, HS was unresponsive to them. In recent years, evidence has been growing regarding the application of other anti-TNFs, including certolizumab pegol (CPZ) and golimumab. We sought to evaluate the overall safety and efficacy of golimumab and CPZ in the management of HS. A comprehensive search was performed on the PubMed, Scopus, Web of Science, and Ovid Embase databases, as well as the Google Scholar search engine from initiation to 31 August 2023. A total of nine and four studies used CPZ and golimumab to treat HS, respectively. Individuals with concomitant inflammatory immune-mediated diseases, pregnant females, and patients who were refractory to previous treatments achieved a Hidradenitis Suppurativa Clinical Response following CPZ administration. Also, golimumab showed promise in treating recalcitrant HS after the failure of other treatments, such as adalimumab and anti-interleukin-1. CPZ and golimumab can be efficacious treatment options for moderate-to-severe HS, especially in patients who are unresponsive to other TNF inhibitors, such as adalimumab.
Information and communication technology devices availability and utilization in the implementation of government curriculum in Nigerian senior secondary schools
Authors: Ezeodo Calista Chinwe , Aroh Patricia Nwamaka
Published: May 2024

This study investigated the extent of availability and utilization of information communication technology (ICT) devices in the implementation of Government Curriculum in Nigerian senior secondary schools. A descriptive survey research design was adopted in the study. The population of the study comprised all the (99) Government teachers in the forty-seven (47) secondary schools in the zone. Total enumeration sampling technique was used to sample all the 99 Government teachers used for the study. A Checklist on Available ICT Devices (CAICTD) and structured Questionnaire on Extent, Bottlenecks and Strategies for Improving Effective Utilization of ICT Devices (QEBSUICTD), were used for gathering data for this study. Percentage, mean, t-test and ANOVA were in the data analysis. The findings among others revealed low availability and utilization of ICT devices in senior secondary schools in Obollo-Afor Education Zone. The study recommended among others that the governments through relevant agencies should procure more ICT devices and organize ICT seminars and workshops for teachers to help them appreciate the need to utilize ICT devices in the implementation of Government curriculum.
Community pharmacy professionals’ knowledge, attitude, and practice toward nutrition and lifestyle counseling in Gondar City, Ethiopia
Authors: Belachew Eyayaw Ashete , Shibe Biniam Siyum , Tefera Aschalew Mulatu , Wondm Samuel Agegnew
Published: May 2024

Background:

Community pharmacy professionals play a vital role in health care, have a greater impact on public health programs, and play a critical role in patient counseling for both non-pharmacological and pharmacological management. This study aimed to evaluate the knowledge, attitude, and practice of community pharmacy professionals toward nutrition and lifestyle counseling in Gondar City, Ethiopia.

Methods:

A cross-sectional survey was undertaken in Northwestern Ethiopia from May to June 2021. Face-to-face structured interviews were performed to collect data using a specially created questionnaire. Descriptive, independent t-test, and one-way ANOVA analyses were used. A significant difference was defined as a p-value of less than 0.05.

Results:

This survey drew 100 community pharmacy professional from a pool of 105 participants, with a 95.2% response rate. More than a third of the participants ( n = 43, 43%) defined medical nutrition therapy as the use of food to prevent disease, and almost half of the participants ( n = 51, 51%) viewed therapeutic nutrition to be part of their job responsibilities. More than half (64%) believe that patients should be provided a combination of nutritional and pharmacological treatments in the majority of cases. The majority of participants (75%) gave patients counseling on drug-food interactions.

Conclusion:

The majority of community pharmacy professionals said they knew a lot about medical nutrition therapy and were enthusiastic about nutrition evaluation and medical nutrition therapy, they see these tasks as part of their job, and they practiced dietary counseling that was limited to pregnancy and chronic diseases.
The challenging diagnosis of synovitis–acne–pustulosis–hyperostosis–osteitis (SAPHO) syndrome: A rare case report
Authors: El Harras Yahya , Imrani Kaoutar , Setti Sara ES , Moatassim Billah Nabil , Nassar Ittimade
Published: May 2024

Considered rare, the synovitis–acne–pustulosis–hyperostosis–osteitis (SAPHO) syndrome is a distinct clinical entity, associating skin manifestations and osteoarticular symptoms. Anterior chest wall pain centered at sternoclavicular and sternocostal joints is an important and characteristic clinical finding that can lead to its diagnosis. Radiologists and clinicians must be aware of synovitis–acne–pustulosis–hyperostosis–osteitis syndrome as it can mimic some of the more common disease entities such as Paget’s disease. We report the case of a 63-year-old male patient, with no significant medical history, who presented to the dermatology department, with severe palmar and plantar pustulosis associated with polyarthralgia. Computerized tomography scan showed sternoclavicular hyperostosis, in favor of SAPHO syndrome, with regression of clinical symptoms after non-steroidal anti-inflammatory drug treatment.
Women and Peace Theory and Civil Conflict Intensity
Authors: Woo Byung-Deuk , Nam Hoshik
Published: May 2024

Do improved women’s descriptive representation in legislative branches and women’s participation in civil society decrease the intensity of civil conflicts? Is the impact of women’s presence in legislative branches on the conflict intensity magnified by women’s participation in civil society, and vice versa? In this study, we aim to expand the constructivist argument that equal gender roles in politics and civil society can bring about less intensive internal armed conflicts. Relying on time-series cross-national data on 151 countries from 1960 to 2016, we demonstrate that the increases in women’s descriptive representation in parliaments and women’s participation in civil society tend to decrease the predicted civil conflict intensity. In addition, we demonstrate that the deterrent effect of women’s descriptive representation is magnified by women’s participation in civil society and vice versa. These findings remain consistent in alternative model specifications with additional women-related control variables.
Revisiting the Validity of the Implicit Beliefs Measure: Focusing on Dimensionality and Discriminability of the CNAAQ-2 (Conceptions of the Nature of Athletic Ability Questionnaire-2) in the Context of South Korean Adolescent Football Players
Authors: Jang Dojin , Hwang Soowoong , Kang Dongkyun
Published: May 2024

The aim of the current study was to verify the internal and external validity of the construct of implicit beliefs concept in the sports context, the Conceptions of the Nature of Athletic Ability Questionnaire-2 (CNAAQ-2). The data of this study were collected from 322 adolescent football players by using CNAAQ-2 and MT (Mental Toughness) Questionnaires. The CFA was employed to examine internal validity (dimensionality), and the ANOVA with the K-means cluster analysis was conducted to examine external validity (discriminability). The results of the CFA supported convergent and discriminant validity of the specific factors (incremental / entity belief) but did not support the significance of the general factor (implicit beliefs). The results of clustering showed that implicit beliefs propensity is divided into three clusters. ANOVA, which set these clusters as an independent variable, showed significant differences for the MT. Based on these results, considerations in the utilization of CNAAQ-2 were discussed.
The Role of Hospice Tours in Promoting Hospice Enrollment: A Study of Taiwanese Family Members
Authors: Huang Tzu-Ya , Chen Ru-Yih , Li Ying-Chun , Yin Chun-Hao , Hsu Chin-Hao , Chen Chia
Published: May 2024

In Taiwan, hospice nurses often take family members of terminally ill patients on hospice ward tours and provide information on transfers. We conducted a study to investigate the tour’s effectiveness in encouraging family members to transfer their loved ones to hospice. We conceptualized our study framework based on the Andersen healthcare utilization model. The hospice nurses invited family members who participated in the tour to complete the survey to investigate the tour and hospice facilities’ influence on their willingness to transfer. A total of 87 participants responded to the study, with an average age of 48.84 ± 12.08 years. Most participants were women (78.16%) and the children of patients (55.17%). The results showed that the tour significantly increased willingness scores (before 4.46 ± 0.73, after 4.74 ± 0.58, p = .0036). Practical and activity-related facilities had the highest influence scores. However, binary logistic regression revealed that patients aged ≥65 years (odds ratio [OR]: 0.281, 95% confidence interval [CI] [0.099, 0.797]) and higher influence scores for psychospiritual care features (OR: 0.182, 95% CI [0.040, 0.821]) negatively affected the change in willingness score, possibly due to family members’ anticipatory grief. Hospice tour guides should be able to identify, assess, and deal with this issue. Overall, hospice tours can effectively encourage transfer to the hospice ward, but addressing psychological barriers such as anticipatory grief is crucial for success.
Novel Histopathological Findings of Micro Bone Fragments and Epithelial Response in the Oral Mucosa in Bisphosphonate-Related Osteonecrosis of the Jaw
Authors: Koizumi Gaku , Hayashi Akinobu , Takigawa Akira , Yamada Rina , Murata Taku , Shimizu Kasumi , Watanabe Masatoshi , Arai Naoya
Published: May 2024

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) occurs in the jawbone and interfacing oral mucosa of patients treated with bisphosphonates. Herein, we report novel histopathological findings in the oral mucosa of a surgical specimen obtained from a 61-year-old man with BRONJ. The resected jawbone and adjacent oral mucosa were separated for histological examination. The mucosal tissue was examined using Von Kossa staining and immunohistochemical (CK5/6, p63) staining of non-decalcified paraffin sections. Pseudoepitheliomatous hyperplasia (PEH), a microscopic feature of the mucosal epithelium in BRONJ, was observed in soft tissue specimens, concomitant with inflammatory cell infiltration. Von Kossa staining revealed small fragments of necrotic bone, tens to hundreds of micrometers in size, scattered within the connective tissues; the PEH forefront contacted some of the bone fragments. Immunohistochemical staining demonstrated that occasionally, the PEH not only contacted but also encompassed the bone fragments. To our knowledge, this is the first report of presence of micro bone fragments and their association with PEH in the oral mucosa in BRONJ.
Religious Organizations as Racialized Organizations: Loose Coupling and Symbolic Allyship Between Denominational Racial Justice Statements and Congregational Practice
Authors: Lauve-Moon Tim A.
Published: May 2024

In the post-Civil Rights era, many predominantly white religious denominations issued statements denouncing racism and challenging their congregations to take organizational action to undo racism, but do these statements translate into actions? New institutionalism theorizes that loose coupling between statements and actions is normative for organizations as they balance signaling support to their external environment while simultaneously maintaining the good faith of internal membership, but Ray contends that because organizations are racialized, this disconnect maintains racial inequality. Building on new institutionalism, I develop the concept of symbolic allyship: symbolic actions that mark the organization as an ally, but these symbolic actions vary in the degree to which they pose organizational risk in maintaining member confidence. Using a nationally representative sample of American congregations within predominantly white denominations that have implored their congregations to act to address racism, I employ latent class analysis to test the prevalence and shape of congregational loose coupling between symbolic statements and symbolic actions. Results suggest that loose coupling between statements and actions is the norm. Further, results provide some evidence that congregations trend toward engaging in symbolic actions that have lower potential costs to the good faith of members. Because these forms of symbolic allyship signal support to the outside world, they may also mask lower levels of organizational change and reinforce racial inequality. Finally, regression analysis illustrates that the ideological mismatch between more progressive denominational statements and more conservative local political and theological cultures helps in understanding this pervasive loose coupling.
Horseshoe Retinal Tear Minutes After Use of a New Pilocarpine Formulation in a Presbyopic, Emmetropic Man
Authors: Eaddy Isabel C. , Moushmoush Obadah , Sabbagh Omar , Barazi Muhi Dean , Sabbagh Osama
Published: May 2024

Purpose: To examine the risks associated with the use of pilocarpine hydrochloride 1.25% ophthalmic solution prescribed for presbyopia. Methods: The adverse ocular events reported after the use of pilocarpine were compared with the symptoms experienced by a 62-year-old presbyopic man shortly after he took pilocarpine. Results: Soon after instilling pilocarpine, the patient reported symptoms, including eye pain, hazy vision, and floaters. An examination showed a horseshoe retinal tear, vitreous hemorrhage, and posterior vitreous detachment, for which the patient received extensive clinical and surgical management. Conclusions: This case highlights the need for comprehensive eye examinations and patient education about the warning signs of retinal tears or detachments before prescribing pilocarpine for presbyopia. Vigilance regarding the potential rare adverse effects of this new pilocarpine ophthalmic solution is warranted.
Negative Association of Cognitive Performance With Blood Serum Neurotoxicity and Its Modulation by Human Herpes Virus 5 (HHV5) Seropositivity in Healthy Women
Authors: James Lisa M , Tsilibary Effie-Photini , Wanberg Erik J , Georgopoulos Apostolos P
Published: May 2024

Identification of early influences on cognitive decline is of paramount importance in order to stem the impacts of decrements in cognitive functioning and to potentially intervene. Thus, here we focused on 132 healthy adult women (age range 26-98 years) to (a) determine whether factors circulating in serum may exert neurotoxic effects in vitro, (b) evaluate associations between serum neurotoxicity and cognitive performance, and (c) assess the influence of human herpes virus (HHV) seroprevalence and other factors on apoptosis and cognitive performance. The results documented that the addition of serum from healthy adult women to neural cell cultures resulted in apoptosis, indicating the presence of circulating neurotoxic factors in the serum. Furthermore, apoptosis increased with age, and was associated with decreased cognitive performance. Stepwise regression evaluating the influence of 6 HHVs on apoptosis and cognitive function revealed that only HHV5 (cytomegalovirus; CMV) seropositivity was significantly associated with apoptosis and cognitive decline, controlling for age. These findings document neurotoxic effects of serum from healthy women across the adult lifespan and suggest a unique detrimental influence associated with CMV seropositivity.
Identification of Key Genes and Pathways for Anaerobic Germination Tolerance in Rice Using Weighted Gene Co-Expression Network Analysis (WGCNA) in Association with Quantitative Trait Locus (QTL) Mapping
Authors: Yin Ming , Zheng Zhenzhen , Zhang Yue , Wang Shanwen , Zuo Liying , Lei Yuxin , Zhao Yaqiong , Zhao Xiuqin , Fu Binying , Shi Yingyao , Xu Jianlong , Wang Wensheng
Published: May 2024

Background

Rice is one of the most important food crops in the world, and with the development of direct seeding methods for rice, exposure to anaerobic stress has become a major factor limiting its growth.

Results

In this experiment, we tested the tolerance to anaerobic germination of rice varieties NIP and HD84, and they were used as parents to construct a DH (doubled-haploid) population. The transcriptomes of NIP (highly tolerant) and HD86 (intolerant), and their progeny HR (highly tolerant) and NHR (intolerant) were sequenced from normal and anaerobic environments. The differentially-expressed genes (DEGs) were subjected to GO (Gene ontology), KEGG (Kyoto Encyclopedia of Genes and Genomes), and WGCNA analyses. QTL mapping of the DH population identified tolerance to anaerobic germination-related chromosomal segments. The transcriptome results from 24 samples were combined with the anaerobic stress QTL results for 159 DH population lines to construct a metabolic network to identify key pathways and a gene interaction network to study the key genes. Essential genes were initially subjected to rigorous functional validation, followed by a comprehensive analysis aimed at elucidating their potential utility in domestication and breeding practices, particularly focusing on the exploitation of dominant haplotypes.

Conclusion

The results show that pyruvate decarboxylase (PDC) and alcohol dehydrogenase (ADH) are the starting signals of energy metabolism for coleoptile length growth, the auxin transporter EXPA is the determining signal for coleoptile length growth. The pivotal genes Os05g0498700 and Os01g0866100 exert a negative regulatory influence on coleoptile length, ultimately enhancing tolerance to anaerobic germination in rice. Analyses of breeding potential underscore the additional value of Os05g0498700-hyp2 and Os01g0866100-hyp2, highlighting their potential utility in further improving rice through breeding programs. The results of our study will provide a theoretical basis for breeding anaerobic-tolerant rice varieties.
Effect of esketamine on the ED50 of propofol for successful insertion of ureteroscope in elderly male patients: a randomized controlled trial
Authors: Luo Xin , Hao Wen-Wen , Zhang Xue , Qi Yu-Xuan , An Li-Xin
Published: May 2024

Background

Propofol is effective and used as a kind of routine anesthetics in procedure sedative anesthesia (PSA) for ureteroscopy. However, respiratory depression and unconscious physical activity always occur during propofol-based PSA, especially in elderly patients. Esketamine has sedative and analgesic effects but without risk of cardiorespiratory depression. The purpose of this study is to investigate whether esketamine can reduce the propofol median effective dose (ED50) for successful ureteroscope insertion in elderly male patients.

Materials and methods

49 elderly male patients undergoing elective rigid ureteroscopy were randomly divided into two groups: SK Group (0.25 mg/kg esketamine+propofol) and SF Group (0.1 µg/kg sufentanil+propofol). Patients in both two groups received propofol with initial bolus dose of 1.5 mg/kg after sufentanil or esketamine was administered intravenously. The effective dose of propofol was assessed by a modified Dixon’s up-and-down method and then was adjusted with 0.1 mg/kg according to the previous patient response. Patients’ response to ureteroscope insertion was classified as “movement” or “no movement”. The primary outcome was the ED50 of propofol for successful ureteroscope insertion with esketamine or sufentanil. The secondary outcomes were the induction time, adverse events such as hemodynamic changes, hypoxemia and body movement were also measured.

Result

49 patients were enrolled and completed this study. The ED50 of propofol for successful ureteroscope insertion in SK Group was 1.356 ± 0.11 mg/kg, which was decreased compared with that in SF Group, 1.442 ± 0.08 mg/kg (P = 0.003). The induction time in SK Group was significantly shorter than in SF Group (P = 0.001). In SK Group, more stable hemodynamic variables were observed than in SF Group. The incidence of AEs between the two groups was not significantly different.

Conclusion

The ED50 of propofol with esketamine administration for ureteroscope insertion in elderly male patients is 1.356 ± 0.11 mg/kg, significantly decreased in comparsion with sufentanil.

Trial registration

Chinese Clinical Trial Registry, No: ChiCTR2300077170. Registered on 1 November 2023. Prospective registration. http://www.chictr.org.cn.
Patterns and outcomes of patients with abdominal injury: a multicenter study from Iran
Authors: Mirzamohamadi Sara , HajiAbbasi Mohammad Navid , Baigi Vali , Salamati Payman , Rahimi-Movaghar Vafa , Zafarghandi Mohammadreza , Isfahani Mehdi Nasr , Fakharian Esmaeil , Saeed-Banadaky Seyed Houssein , Hemmat Morteza , Sadrabad Akram Zolfaghari , Daliri Salman , Pourmasjedi Sobhan , Piri Seyed Mohammad , Naghdi Khatereh , Yazdi Seyed Amir Miratashi
Published: May 2024

Background

Injury is one of the leading causes of death worldwide, and the abdomen is the most common area of trauma after the head and extremities. Abdominal injury is often divided into two categories: blunt and penetrating injuries. This study aims to determine the epidemiological and clinical characteristics of these two types of abdominal injuries in patients registered with the National Trauma Registry of Iran (NTRI).

Methods

This multicenter cross-sectional study was conducted with data from the NTRI from July 24, 2016, to May 21, 2023. All abdominal trauma patients defined by the International Classification of Diseases; 10th Revision (ICD-10) codes were enrolled in this study. The inclusion criteria were one of the following: hospital length of stay (LOS) of more than 24 h, fatal injuries, and trauma patients transferred from the ICU of other hospitals.

Results

Among 532 patients with abdominal injuries, 420 (78.9%) had a blunt injury, and 435 (81.7%) of the victims were men. The most injured organs in blunt trauma were the spleen, with 200 (47.6%) and the liver, with 171 (40.7%) cases, respectively. Also, the colon and small intestine, with 42 (37.5%) cases, had the highest number of injuries in penetrating injuries. Blood was transfused in 103 (23.5%) of blunt injured victims and 17 (15.2%) of penetrating traumas (p = 0.03). ICU admission was significantly varied between the two groups, with 266 (63.6%) patients in the blunt group and 47 (42%) in penetrating (p < 0.001). Negative laparotomies were 21 (28%) in penetrating trauma and only 11 (7.7%) in blunt group (p < 0.001). In the multiple logistic regression model after adjusting, ISS ≥ 16 increased the chance of ICU admission 3.13 times relative to the ISS 1–8 [OR: 3.13, 95% CI (1.56 to 6.28), P = 0.001]. Another predictor was NOM, which increased ICU chance 1.75 times more than OM [OR: 1.75, 95% CI (1.17 to 2.61), p = 0.006]. Additionally, GCS 3–8 had 5.43 times more ICU admission odds than the GCS 13–15 [OR:5.43, 95%CI (1.81 to 16.25), P = 0.002] respectively.

Conclusion

This study found that the liver and spleen are mostly damaged in blunt injuries. Also, in most cases of penetrating injuries, the colon and small intestine had the highest frequency of injuries compared to other organs. Blunt abdominal injuries caused more blood transfusions and ICU admissions. Higher ISS, lower GCS, and NOM were predictors of ICU admission in abdominal injury victims.
Disability level’s impact on blood pressure-mortality association in older long-term care adults: evidence from a large Chinese cohort study
Authors: Zhong Yue , Feng Chuanteng , Hou Lisha , Yang Ming , Zhang Xinjun , Wu Jinhui , Dong Birong , Jia Peng , Yang Shujuan , Dou Qingyu
Published: May 2024

Background

Evidence of the optimal blood pressure (BP) target for older adults with disability in long-term care is limited. We aim to analyze the associations of BP with mortality in older adults in long-term care setting with different levels of disability.

Methods

This prospective cohort study was based on the government-led long-term care programme in Chengdu, China, including 41,004 consecutive disabled adults aged ≥ 60 years. BP was measured during the baseline survey by trained medical personnel using electronic sphygmomanometers. Disability profile was assessed using the Barthel index. The association between blood pressure and mortality was analyzed with doubly robust estimation, which combined exposure model by inverse probability weighting and outcome model fitted with Cox regression. The non-linearity was examined by restricted cubic spline. The primary endpoint was all-cause mortality, and the secondary endpoints were cardiovascular and non-cardiovascular mortality.

Results

The associations between systolic blood pressure (SBP) and all-cause mortality were close to a U-shaped curve in mild-moderate disability group (Barthel index ≥ 40), and a reversed J-shaped in severe disability group (Barthel index < 40). In mild-moderate disability group, SBP < 135 mmHg was associated with elevated all-cause mortality risks (HR 1.21, 95% CI, 1.10–1.33), compared to SBP between 135 and 150 mmHg. In severe disability group, SBP < 150 mmHg increased all-cause mortality risks (HR 1.21, 95% CI, 1.16–1.27), compared to SBP between 150 and 170 mmHg. The associations were robust in subgroup analyses in terms of age, gender, cardiovascular comorbidity and antihypertensive treatment. Diastolic blood pressure (DBP) < 67 mmHg (HR 1.29, 95% CI, 1.18–1.42) in mild-moderate disability group and < 79 mmHg (HR 1.15, 95% CI, 1.11–1.20) in severe disability group both demonstrated an increased all-cause mortality risk.

Conclusion

The optimal SBP range was found to be higher in older individuals in long-term care with severe disability (150-170mmHg) compared to those with mild to moderate disability (135-150mmHg). This study provides new evidence that antihypertensive treatment should be administered cautiously in severe disability group in long-term care setting. Additionally, assessment of disability using the Barthel index can serve as a valuable tool in customizing the optimal BP management strategy.

Trial registration

Chinese Clinical Trial Registry (Registration Number: ChiCTR2100049973).
Eyelid retraction during smiling in a patient with monocular congenital ptosis: a case report
Authors: Zhao Yiyang , Fu Jing , Hao Jie
Published: May 2024

Background

Blepharoptosis is a common symptom in ophthalmology clinic, but eyelid retraction when smiling in a ptosis eye is a rare manifestation. Here we report a novel manifestation that eyelid retraction during smiling in a patient with monocular congenital ptosis.

Case description

A 10-year-old girl with isolated and mild unilateral congenital ptosis showed eyelid retraction in ptotsis eye when smiling together with a lid lag on downgaze. She didn’t have any systematic and ocular diseases other than myopia and astigmatism.Eyelid retraction during smiling is 5 mm, resulting in a significant difference in the height of bilateral palpebral fissures.As for ptosis, is mild.The margin to reflex distance 1 is 1.0 mm on the right eye(ptosis eye) and 3.0 mm on the left eye. A lid lag of 1.0 mm on downward gaze was noted on the right, she could close her eyes fully while sleeping.The ice pack test, laboratory test for thyroid function, whole-exome sequencing (WES) and magnetic resonance imaging(MRI) of the orbital and ocular motor nerves showed normal results.Her symptoms alleviated after 6 months, with the retraction of the right upper eyelid when smiling was approximately 3 mm, thus the difference in the palpebral fissure height when smiling was smaller than that at the initial presentation.

Conclusion

Blepharoptosis may accompanied with abnormal innervation like eyelid retraction, this phenomenon can be alleviated with age.The results of the levator muscle function test should be carefully examined to determine whether it is ptosis in an impaired innervation eyelid.
Corneal densitometry in Chinese adults with healthy corneas: associations with sex, age, ocular metrics, and optical characteristics
Authors: Ning Jiliang , Sun Siyu , Zhang Qiaosi , Jin Lin , Liu Xiaoyu , Xu Jun , Zhang Lijun
Published: May 2024

Background

Standardized corneal densitometry (CD) values in large samples of healthy Chinese individuals are scarce. Therefore, we aimed to determine the standard CD values using a Scheimpflug camera in healthy corneas, investigate the correlations of sex, age, and ocular parameters with corneal density, and explore the impact of corneal density on the forward scattering and optical quality of the eye.

Methods

This retrospective observational study involved 990 healthy Chinese individuals, including 494 males and 496 females (mean age: 23.88 ± 6.90 years). The CD values at various depths and radial areas of 0–12 mm were measured using a Scheimpflug camera. Densitometric measurements were expressed in standardized grayscale units (GSU). The optical scatter index (OSI), modulation transfer function cutoff values (MTFcutoff), and Strehl’s ratio (SR) were also determined using an optical quality analysis system.

Results

The average CD within a 12 mm diameter area was 16.26 ± 1.35 GSU. The highest and lowest optical densities at different depths were observed in the anterior (21.41 ± 2.16 GSU) and posterior (12.00 ± 1.01 GSU) layers, respectively (P < 0.001). Similarly, the maximum and minimum optical densities at different radial areas were observed in the 10–12 mm (14.09 ± 0.93 GSU) and 2–6 mm (25.93 ± 4.77 GSU) circles, respectively (P < 0.001). There was no significant difference in the average CD within a 12 mm diameter area between males and females (P > 0.05). However, upon adjusting for age, central corneal thickness (CCT), corneal curvature, white-to-white (WTW) corneal diameter, and axial length, females exhibited a greater average CD within the 12 mm diameter and in the 6–10 mm and 10–12 mm circles than males. Age-related changes in CD were evident, except in the 2–6 mm circle. CCT, corneal curvature, WTW corneal diameter, and partial depth correlated with CD in the radial area, and CD in different areas correlated with the OSI, MTFcutoff, and SR (P < 0.05).

Conclusions

This study provides the normative CD measurement data of Chinese adults with healthy corneas, emphasizing the significance of sex, age, CCT, corneal curvature, and WTW corneal diameter in CD evaluation. Notably, elevated CD can lead to increased forward scattering within the eye, thereby affecting the optical quality.
Relationships between oral function, dietary intake and nutritional status in older adults aged 75 years and above: a cross-sectional study
Authors: Wu Xiaoqing , Xu Yanqiu , Liu Yajun , Ma Aiguo , Zhong Feng , Gao Tianlin , Cai Jing , Chen Yong , Wang Yali , Zhou Wenkai , Ma Yan
Published: May 2024

Background

Malnutrition is related to impaired oral health and function that causes poor dietary intake, declining the general health of older adults. The role of dietary intake in the association between oral function and nutritional status of Chinese older adults (aged 75 and above) was examined in this cross-sectional study.

Methods

Through the randomized cluster sampling method, 267 older adults living in rural areas of Qingdao, Shandong (aged 81.4 ± 4.3, 75–94 years) were chosen as the primary research participants. A Mini Nutritional Assessment - Short Form was used to determine nutritional status, and Food Frequency Questionnaire and 24-hour Food Intake Recall were used to assess dietary intake. The oral function was evaluated by analyzing the teeth, oral problems, bite force, tongue pressure, lip sealing pressure, chewing function questionnaire, whole saliva flow rate, 10-Item Eating Assessment Tool, and water swallow test.

Results

Based on the MNA-SF score, it was divided into a well-nourished group and a malnutrition group, with the malnutrition group comprising 40.6% of participants. The participants in the malnutrition group showed a higher rate of xerostomia, lower bite force, tongue pressure, and lip sealing pressure, and higher Chewing Function Questionnaire and 10-Item Eating Assessment Tool scores. Furthermore, their plant fat, iron, cereals and potatoes, vegetables, fruits, and seafood intake were relatively low. The regression model indicated that exercise frequency, stroke, chewing and swallowing function, intake of vegetables and fruits were risk factors for nutritional status of older adults.

Conclusion

Malnutrition was relatively common among the Chinese older adults aged 75 and above, and it was significantly correlated with exercise frequency, stroke, chewing and swallowing function, and intake of vegetables and fruits. Therefore, nutrition management should be carried out under the understanding and guidance of the oral function and dietary intake of the older adults.
Development and validation of a scale to measure hypertensive Chinese individual’s behavior toward salt reduction consumption
Authors: Han Le , Liu Ying , Liu Xiao , Xian Peng
Published: May 2024

Objective

This study aimed to develop and validate the Salt Reduction Behavior Scale (SRBS) to measure the behavior of hypertensive Chinese individuals in adhering to salt reduction practices.

Methods

The SRBS was constructed based on the Health Belief Model, consisting of five constructs: knowledge, perceived severity, perceived benefits, perceived barriers, and cues to action. Data were collected from 2,082 hypertensive patients in Beijing, China, who completed a questionnaire administered through an online platform. Kaiser-Meyer-Olkin (KMO) test was used to assess the adequacy of the sample and the Bartlett’s test of sphericity to examine the factorability of the dataset. Confirmatory Factor Analysis (CFA) was used to assess the structural validity and reliability of the SRBS.

Results

The KMO analysis yielded a notably elevated value of 0.95, indicating that the data was highly suitable for Exploratory Factor Analysis (EFA). Bartlett’s test of sphericity yielded a statistically significant test statistic (P < 0.001). The 32-item SRB questionnaire demonstrated strong internal consistency with a Cronbach’s alpha coefficient of 0.923. A second-order Confirmatory Factor Analysis (CFA) revealed that, after removing the unrelated construct of barriers, SRB could be represented by four sub-constructs: knowledge, severity, benefits, and action. The final version of the SRBS consists of 21 items. These items displayed high factor loadings, indicating a strong relationship between the items and their respective sub-constructs. The discriminant validity analysis revealed that the SRBS sub-constructs were distinct from each other. The SRBS scores were positively correlated with self-reported salt reduction practices. This demonstrates that individuals with higher SRBS scores were more likely to engage in actual salt reduction behaviors, indicating concurrent validity.

Conclusion

The results illustrate that the Salt Reduction Behavior Scale is a robust and comprehensive instrument for assessing salt reduction behavior among hypertensive Chinese individuals. The scale’s specific sub-constructs provide a detailed understanding of their knowledge, attitudes, and practices related to salt consumption. Healthcare professionals and policymakers can utilize this tool to tailor interventions and educational programs to encourage healthier dietary habits, thereby reducing the risk of cardiovascular diseases in China.
Exploring presence practices: a study of unit managers in a selected Provincial Hospital in Free State Province
Authors: Smith Bernardine , Chukwuere Precious Chibuike , Sehularo Leepile Alfred
Published: May 2024

Background

Nursing presence depends on an individual’s belief system, truths, sensory experience, professional skills, and active listening. Thus, one may assume that presence occurs when nurses care for patients in a kind and compassionate way. This study aimed to explore and describe presence practices amongst unit managers in a selected provincial hospital in Free State Province.

Methods

A qualitative research approach with an exploratory descriptive contextual research design was employed in this study. A purposive nonprobability sampling technique was utilised to select participants. Data were collected through semi-structured interviews and analysed using the six steps of thematic qualitative data analysis. The study’s trustworthiness was ensured through ascertaining credibility, dependability, confirmability, transferability, and authenticity. Approval to conduct the study was obtained from the North-West University Health Research Ethics Committee (NWU-HREC), DoH in the Free State Province, and the CEO (the gatekeeper) of the selected hospital.

Results

Four themes were generated, namely, presence practices amongst unit managers in a selected provincial hospital in Free State, the impact of presence practices on hospital dynamics in a selected provincial hospital in Free State, unit managers’ practices of relational care and human connectedness in the unit, and the perceptions of unit managers on barriers to presence practices in a selected provincial hospital in Free State. Each of these themes presents categories and sub-categories. Unit managers actively foster supportive work cultures, effective management, human connectedness and relational care, and effective communication to yield team cohesion and positive impacts on patient care. Unit managers also display resilience and highlight the need for ongoing support from colleagues and top management.

Conclusion

Unit managers exhibit diverse presence practices which emphasise their commitment through visibility and accessibility despite staff shortages and resource constraints.
Health-related quality of life and subjective well-being among children aged 9–12 years in Shandong Province, China
Authors: Shi Zhao , Cao Aihua , Li Shunping , Wang Jianglin , Zhang Jin , Ratcliffe Julie , Chen Gang
Published: May 2024

Purpose

To investigate the health-related quality of life (HRQoL) and subjective well-being (SWB) of children aged 9–12 years in eastern China, and examine concordance within child self-reported and parent proxy-assessed.

Methods

Data was collected from 9 to 12 years old children (including their parents) in Shandong Province in 2018. Participants self-completed a hard-copy questionnaire including Child Health Utility 9D (CHU9D), Pediatric Quality of Life Inventory (PedsQL)™ 4.0 Short Form 15 Generic Core Scales (hereafter the PedsQL™), Student’s Life Satisfaction Scale (SLSS), as well as information on socio-demographic characteristics and self-report health status. Spearman’s correlation coefficients and the difference between sub-groups were conducted to assess and compare the agreement on HRQoL and SWB instruments. Exploratory factor analysis (EFA) was used to ascertain the number of unique underlying latent factors that were associated with the items covered by the two generic HRQoL and the SWB instruments. The concordance of child self-reported and parent proxy-assessed was analyzed using weighted kappa coefficient and Bland-Altman plots.

Results

A total of 810 children and 810 parents were invited to participate in the survey. A valid sample of 799 (98.6%) children and 643 (79.4%) parents completed the questionnaire. The child self-reported mean scores were CHU9D = 0.87, PedsQL™ = 83.47, and SLSS = 30.90, respectively. The parent proxy-assessed mean scores were PedsQL™ = 68.61 and SLSS = 31.23, respectively. The child self-reported PedsQL™ was moderately correlated with the CHU9D (r = 0.52). There was a weak correlation between CHU9D and SLSS (r = 0.27). The EFA result found 3 factors whilst seven SLSS items grouped into a standalone factor (factor 3), and the nine dimensions of CHU9D shared two common factors with the PedsQL™ (factor 1 and factor 2). A low level of concordance was observed across all comparisons and in all domains (weighted kappa < 0.20) between parents and their children. Furthermore, a high level of discordance was observed between child self-reported and father proxy-assessed.

Conclusions

CHU9D and PedsQL™ instruments have a higher agreement in measuring the HRQoL in children. CHU9D/PedsQL™ and SLSS instruments showed a low agreement and EFA result suggested that measuring SWB in children potentially may provide further information, which might be overlooked by using HRQoL instruments exclusively. Concordance of child self-reported and parent proxy-assessed was poor. Overall, mother-child concordance was higher than father-child concordance.