bluuebunny/crossref_metadata_2025 huggingface dataset:
Autoimmune hepatitis in Egyptian children: A single center experience
Authors: Mogahed Engy , El-Karaksy Hanaa , Zaki Heba , Abdullatif Hala
Published: March 2022

Background and aim

Autoimmune hepatitis (AIH) has variable clinical manifestations and should be considered in the diagnostic work-up of any patient with cryptogenic liver disease. The aim of the study was to determine the clinical, biochemical, histopathological characteristics and treatment outcome of AIH in Egyptian children.

Patients and methods

This observational study was conducted at the Pediatric Hepatology Unit at Cairo University Pediatric Hospital, Egypt. All children (<18 years of age) presenting from 2009 to 2016 with established diagnosis of AIH were included. Medical history, clinical examination, and results of investigations were retrieved from patients’ files. The main outcome measures included the rate of remission, relapses, and mortality.

Results

The study included 34 children with AIH. Twenty patients (58%) presented with chronic liver disease. There was a history of concomitant autoimmune diseases in 5 patients. Transaminases were elevated in all patients. There was synthetic dysfunction in 58%. Twenty-four patients (70.5%) had AIH-1, while nine patients (26.4%) had AIH-2 and one patient (2.9%) had autoantibody negative AIH. Piecemeal necrosis was observed in the liver biopsy of 79% of our cohort. Approximately 80% achieved biochemical remission (88% received combined therapy of prednisolone and azathioprine). About half of the patients developed relapses. One patient died of liver cell failure.

Conclusion

In children with liver disease, a diagnosis of AIH should be considered. In those patients, AIH-1 is more common than AIH-2. Prednisolone monotherapy or combined with azathioprine could achieve remission, but relapse is still common. Treatment non-adherence is the main risk factor for relapse.
Science, beliefs, sociocultural and economic influences on doctorates in South African universities
Authors: Falade Bankole Adebayo , Fafowora Bimbo Lolade
Published: March 2022

This paper examines the scientific and non-scientific influences on doctorates in South African universities by analyzing the acknowledgements in their theses. The data was extracted from 5644 PhD theses drawn from four South African universities. Using data-mining techniques, we identified sources of inspiration, targets of dedication and subjects of acknowledgement. The findings show that over 90% of doctoral candidates expressed appreciation to supervisors and other academics and colleagues, as had been found in previous research. We also found that almost half of the sample acknowledged funding agencies, which indicates the strong role of external finance. The spread of academic networks across Africa, North America and Europe was noteworthy. The findings also show the strong role of religious beliefs, as 39% of the theses acknowledged the assistance of God. The figure was as high as 51% in one of the universities and statistically significant across institutions and faculties. Religious beliefs among scientists also confirm previous research in the US, indicating that ‘scientists are still keeping the faith’.
Measuring Social Distance Toward Individuals With Special Needs
Authors: Firat Tahsin , Koyuncu İlhan
Published: March 2022

Discovering social approaches to individuals with special needs and to what extent the society wants to interact with such people is of importance to fathom out not only the social responses to individuals with special needs but also the social reflections toward inclusive policies. This descriptive study accordingly aimed to investigate the level of social distance toward individuals with special needs and the factors affecting social distance. A total of 659 randomly sampled people from the southeastern region of Turkey participated in the study. Of the participants, 395 (60%) are female, and 264 (40%) are male. Their ages ranged from 16 to 64 years with a mean age of 28.4 years. Data were collected through the Bogardus Social Distance Scale developed to measure the level of social distance among people. Research results indicate that gifted individuals were the most accepted by the participants with regard to getting married and being close kin by marriage. The greatest social distance was expressed toward individuals with intellectual disabilities and autism. Social distance toward individuals with special needs did not differ significantly according to education level, contact frequency, and gender of the participants.
Reference Walking Speeds for Healthy Young Adults in Qatar: Moderating Effect of Obesity and Physical Activity
Authors: Majed Lina , Sayegh Suzan , Chrismas Bryna C. R.
Published: March 2022

Walking speed (WS) is considered an important indicator for overall health. Despite this, there is a paucity of data relating to WS values in the Arab region. The present study aims to establish preferred (PWS) and maximal walking speeds (MWS) in young adults in Qatar and examine how gender, body mass index, and physical activity (PA) components influence WS. One hundred ninety-six healthy participants (age: 22 ± 2 years; 60% females) performed a standardized walking test on a flat 10-m pathway, completed the short form of the International PA Questionnaire, and had their height and weight measured. PWS and MWS were normalized for height (rPWS and rMWS). Results. Females demonstrated slower PWS, MWS, and rMWS compared to males. Moreover, MWS and rMWS were lower in obese participants compared to underweight, normal weight and overweight individuals. There was a significant positive relationship only between vigorous PA and rPWS and rMWS. This is the first study to establish reference WS values for healthy young adults in Qatar. Overall, we demonstrated that WS was lower compared to similar adults worldwide. The established healthy walking values can serve as reference for clinical evaluations within Qatar. Future PA guidelines and public health interventions should focus on WS values.
Acceptability of Exercise in Urban Emergency Department Patients With Metabolic Syndrome, Including a Subset With Venous Thromboembolism
Authors: Stewart Lauren K , Kline Jeffrey A
Published: March 2022

Metabolic syndrome (MetS) afflicts more than one-third of US adults. In venous thromboembolism (VTE), MetS increases the risk of recurrence and severity of the post-pulmonary embolism syndrome, disproportionately affecting persons of color in urban settings. Exercise can positively modulate components of MetS. Our objective was to survey a sample of urban emergency department (ED) patients with MetS on their exercise habits and interest in increasing activity levels and to compare ± VTE patients. This survey study consisted of: (1) International Physical Activity Questionnaire, and (2) Likert scale gauging interest in increasing activity levels. Any adult ED patient with a composite MetS profile was included. We surveyed 247 patients with an average age of 59 years and 57% reported Black race. Only 9% met recommendations for vigorous exercise and 28% for moderate activity, with no significant difference in the 18% with prior VTE. Fifty-seven percent responded positively regarding motivation in increasing activity. This survey presents novel data supporting the need and feasibility of an interventional study examining exercise as an adjuvant therapy in patients with MetS and VTE.
The Prevalence and Sociodemographic Correlates of Social Anxiety Disorder: A Focused National Survey
Authors: Ambusaidi Aamal , Al-Huseini Salim , Alshaqsi Hiba , AlGhafri Manal , Chan Moon-Fai , Al-Sibani Nasser , Al-Adawi Samir , Qoronfleh M. Walid
Published: March 2022

Background

Social Anxiety Disorder (SAD) is among the most common anxiety disorders worldwide with data largely emerging from the Euro-American and Pacific Rim populations. In contrast, there is a dearth of studies among the populations of Arabian Gulf countries including Oman. This study has two interrelated aims: (i) to explore the prevalence of SAD among Omani adults, and (ii) to tease out the links between socio-demographic factors and SAD in Oman.

Methods

A cross-sectional study via an online survey was conducted among 1019 adult Omani nationals residing in Oman. The presence of SAD was assessed using the Arabic version of the Liebowitz Social Anxiety Scale (LSAS).

Results

Nearly half the participants (45.9%, n = 468) exhibited “caseness” for SAD as defined by LSAS. In the multivariate logistic analysis, participants below 40 years of age were 1.6 times (OR = 1.568, p = .026) more likely to have caseness for SAD than those who were 40 and older. Women were 1.3 times (OR = 1.348, p = .038) more likely to exhibit caseness for SAD than men. Participants who had secondary or undergraduate education were respectively 1.5 times (OR = 1.45, p = .014) and 2.5 times (OR = 2.509, p < .001) to have caseness for SAD than those who were graduates.

Conclusion

The present data suggest that 45.9% of the participants reached the cut-off for caseness in LSAS, which is high compared to reports from other populations. The present accrued frequency is discussed within the context of the accrued response rate, socio-cultural factors as well as the tendency for self-reported measures to “produce” spurious results is also highlighted which, in turn, calls for studies that adopt more inclusive survey methods.
Union Budget 2021 and Economic Growth: Inclusion and Exclusion in Emerging India
Authors: Kumar Ajit
Published: March 2022

This note contextualises the ‘choice’ India exercised in her Union Budget 2021. This budget stressed on privatisation and economic growth. As the Indian social structure evolved historically, it came to comprise several communities excluded from mainstream life. Independent India evolved a development trajectory that combined democratic structures with participative decision-making processes buttressed by constitutional provisions in the form of quotas/reservations in legislatures, education and jobs. This trajectory succeeded in forming an elite section from some of the Scheduled Caste (SC) and Other Backward Classes (OBC) communities and from them a techno-managerial elite has emerged who could professionally find a place in the expanding private sector. But the Indian development trajectory has failed in case of the Scheduled Tribes (STs)/indigenous peoples or First Nations category. This failure means that the historical mission of the Indian development trajectory is yet incomplete.
The interrelationship of chronic cough and depression: a prospective population-based study
Authors: Arinze Johnmary T. , Hofman Amy , de Roos Emmely W. , de Ridder Maria A.J. , Verhamme Katia M.C. , Stricker Bruno , Brusselle Guy G. , Luik Annemarie I.
Published: March 2022

Background

Chronic cough is a debilitating medical condition that is often complicated by psychomorbidities such as depressive symptoms. Nevertheless, little is known about the impact of chronic cough on the risk of developing depression. Therefore, we investigated the association between chronic cough and prevalent, incident and recurrent depression in a population-based sample of middle-aged and older persons.

Methods

Within the Rotterdam Study, a population-based cohort, we defined chronic cough as reporting daily coughing for ⩾3 months. Depression was assessed using the Center for Epidemiologic Studies Depression scale, clinical interviews and medical records. Associations between chronic cough and depression were determined with linear, logistic and Cox regression analyses.

Results

The study included 5877 participants (mean±sdage 72±8 years, 59% female) who contributed 37 287 person-years of follow-up. At baseline, participants with chronic cough reported more depressive symptoms (adjusted standardised mean difference 0.15, 95% CI 0.07–0.22) compared to those without chronic cough. Over time, chronic cough was associated with an increased risk of depression in participants with a history of depression (hazard ratio (HR) 1.45, 95% CI 1.13–1.84), but not in those without a history of depression (HR 0.91, 95% CI 0.68–1.22).

Conclusions

Adults with chronic cough have a disproportionate burden of depressive symptoms and an increased risk of recurrent depression. This highlights the importance of screening for depression in patients with chronic cough.
Self-help cognitive behavioural therapy for anxiety in pulmonary hypertension: pilot randomised controlled trial
Authors: Rawlings Gregg H. , Beail Nigel , Armstrong Iain , Thompson Andrew R.
Published: March 2022

Objective

People with pulmonary hypertension (PH) are at an increased risk of experiencing anxiety disorders. This study developed and tested the acceptability, feasibility and preliminary effectiveness of a cognitive behavioural self-help intervention for anxiety in adults with PH using a pilot randomised control trial design.

Methods

Individuals with PH recruited from pulmonary hypertension associations were randomised to either receive a newly developed self-help intervention (n=37) or a wait-list condition (n=40). Acceptability was explored using mixed-methods questionnaires. A 2×3 repeated-measures analysis of variance was used to explore anxiety (GAD-7), depression (PHQ-9), health-related quality of life (emPHAsis-10), dyspnoea (D-12), self-mastery (Self-Mastery Scale) and mood-related cognitions and behaviours (CBP-Q) at baseline, post-intervention and 1-month follow up. A mediation analysis was performed to examine potential mechanisms of change.

Results

Dropout was low at 15.6%. All participants would recommend the intervention to another person with PH and felt it had helped with their anxiety. Participants in the intervention group reported a reduction in anxiety, depression and cognitive and behavioural processes linked with mood disorders, compared to the control group. Change in unhelpful cognitions and behaviours mediated the relationship between intervention condition and change in anxiety and depression.

Discussion

The intervention was found to be acceptable, feasible and safe. Anxiety at baseline was higher than previously observed, which could be associated with the additional burden caused by COVID-19 as the intervention was trialled during the pandemic. Findings add to the growing evidence supporting the use of psychological therapies, including cognitive behavioural therapy, in this clinical group.
An international survey on nasal nitric oxide measurement practices for the diagnosis of primary ciliary dyskinesia
Authors: Beydon Nicole , Ferkol Thomas , Harris Amanda Lea , Colas Murielle , Davis Stephanie D. , Haarman Eric , Hogg Claire , Kilbride Emma , Kouis Panayotis , Kuehni Claudia E. , Latzin Philipp , Marangu Diana , Marthin June , Nielsen Kim G. , Robinson Phil , Rumman Nisreen , Rutter Matthew , Walker Woolf , Lucas Jane S.
Published: March 2022

Nasal nitric oxide (nNO) measurements are used in the assessment of patients suspected of having primary ciliary dyskinesia (PCD), but recommendations for performing such measurements have not focused on children and do not include all current practices. To guide the development of a European Respiratory Society-supported technical standard for nNO measurement in children, an international online survey was conducted to better understand current measurement practices among providers involved in PCD diagnostics.

78 professionals responded, representing 65 centres across 18 countries, mainly in Europe and North America. Nearly all centres measured nNO in children and more than half performed measurements before 5 years of age. The test was often postponed in children with signs of acute airway infection. In Europe, the electrochemical technique was more frequently used than chemiluminescence. A similar proportion of centres performed measurements during exhalation against a resistance (49 out of 65) or during tidal breathing (50 out of 65); 15 centres used only exhalation against a resistance and 15 used only tidal breathing. The cut-off values used to discriminate PCD were consistent across centres using chemiluminescence analysers; these centres reported results as an output (nL·min−1). Cut-off values were highly variable across centres using electrochemical devices, and nNO concentrations were typically reported as ppb.

This survey is the first to determine real-world use of nNO measurements globally and revealed remarkable variability in methodology, equipment and interpretation. These findings will help standardise methods and training.
First record of the brachiopod Erymnaria in the Chruteren Member (Euthal Formation) from a new Palaeogene site in the Brülisau Schuppenzone of northeastern Switzerland (Canton St. Gallen) with remarks on shell asymmetry
Authors: Sulser Heinz , Menkveld-Gfeller Ursula , Bolliger Thomas , Kürsteiner Peter , Tschanz Karl
Published: March 2022

A small, smooth-shelled rhynchonellid brachiopod, Erymnaria Cooper, 1959 was discovered in a previously unknown locality in the so-called Brülisau Schuppenzone (imbricate zone) of the South Helvetic region of northeastern Switzerland. It is the first record of this genus in this region and in Switzerland in general. It is comparable to the type species of Erymnaria, E. polymorpha (Massalongo, 1850). Its specific identity is currently undetermined, and the species is referred to Erymnaria sp. 1. The main characteristic of Erymnaria sp.1 is its asymmetric shell. This prompted a comparison of E. sp. 1 with other known asymmetric brachiopods. Questions of asymmetry and variability within the same genus and with brachiopods in general are discussed. Another, larger brachiopod species found at the new site is tentatively named Erymnaria? sp. 2. The site can be assigned to the Chruteren Member (Euthal Formation) of Early Ypresian age, dated by large Foraminifera. Thus, the previous distribution area of the Chruteren Member can be extended.
Peptidylarginine deiminase 2 promotes T helper 17-like T cell activation and activated T cell-autonomous death (ACAD) through an endoplasmic reticulum stress and autophagy coupling mechanism
Authors: Yang Yi-Fang , Wang Chuang-Ming , Hsiao I.-Hsin , Liu Yi-Liang , Lin Wen-Hao , Lin Chih-Li , Hung Hui-Chih , Liu Guang-Yaw
Published: March 2022

Peptididylarginine deiminase type 2 (PADI2) catalyzes the conversion of arginine residues to citrulline residues on proteins. We demonstrate that PADI2 induces T cell activation and investigate how PADI2 promotes activated T cell autonomous death (ACAD). In activated Jurkat T cells, overexpression of PADI2 significantly increases citrullinated proteins and induces endoplasmic reticulum (ER) stress and unfolded protein response (UPR) signaling, ultimately resulting in the expression of autophagy-related proteins and autophagy. PADI2 promoted autophagy and resulted in the early degradation of p62 and the light chain 3B (LC3B)-II accumulation. In Jurkat T cells, silencing the autophagy-related gene (Atg) 12 protein inhibits PADI2-mediated autophagy and promotes ER stress and apoptosis, whereas overexpression of Atg12 decreased ER stress and prolonged autophagy to promote cell survival. Additionally, PADI2 regulates T cell activation and the production of Th17 cytokines in Jurkat T cells (interleukins 6, IL-17A, IL-17F, IL-21, and IL-22). In Jurkat T cells, silencing IL-6 promotes autophagy mediated by PADI2 and inhibits PADI2-induced apoptosis, whereas silencing Beclin-1 increases the activation and survival of Th17-like T cells while decreasing autophagy and apoptosis. PADI2 silencing alleviates ER stress caused by PADI2 and decreases cytokine expression associated with Th17-like T cell activation and ACAD. We propose that PADI2 was involved in Th17 lymphocyte ACAD via a mechanism involving ER stress and autophagy that was tightly regulated by PADI2-mediated citrullination. These findings suggest that inhibiting Th17 T cell activation and the development of severe autoimmune diseases may be possible through the use of novel antagonists that specifically target PADI2.
Unraveling the development behind unisexual flowers in Cylindropuntia wolfii (Cactaceae)
Authors: Ramadoss Niveditha , Orduño-Baez Amy , Portillo Carlos , Steele Scarlet , Rebman Jon , Flores-Rentería Lluvia
Published: March 2022

Background

In certain unisexual flowers, non-functional sexual organs remain vestigial and unisexuality can be overlooked leading to the ambiguous description of the sexual systems. Therefore, to accurately describe the sexual system, detailed morphological and developmental analyses along with experimental crosses must be performed. Cylindropuntia wolfii is a rare cactus endemic to the Sonoran Desert in southern California and northern Baja California that was described as gynodioecious by morphological analysis. The aims of our project include accurately identifying the sexual system of C. wolfii using histological and functional studies and characterizing the developmental mechanisms that underlie its floral development.

Methods

Histological analyses were carried out on different stages of C. wolfii flowers and controlled crosses were performed in the field.

Result

Our results identified C. wolfii to be functionally dioecious. The ovule and anther development differed between staminate and pistillate flowers. In vivo pollen germination tests showed that the pollen of staminate and pistillate flowers were viable and the stigma and style of both staminate and pistillate flowers were receptive. This suggests that there are no genetic or developmental barriers in the earlier stages of pollen recognition and pollen germination.

Conclusions

Despite being functionally dioecious, we observed that functionally pistillate individuals produced fruits with a large number of aborted seeds. This implies that not only does this species have low reproductive success, but its small population sizes may lead to low genetic diversity.
The aluminum distribution and translocation in two citrus species differing in aluminum tolerance
Authors: Zhang Han , Li Xin-yu , Lin Mei-lan , Hu Ping-ping , Lai Ning-wei , Huang Zeng-rong , Chen Li-song
Published: March 2022

Background

Many citrus orchards of south China suffer from soil acidification, which induces aluminum (Al) toxicity. The Al-immobilization in vivo is crucial for Al detoxification. However, the distribution and translocation of excess Al in citrus species are not well understood.

Results

The seedlings of ‘Xuegan’ [Citrus sinensis (L.) Osbeck] and ‘Shatianyou’ [Citrus grandis (L.) Osbeck], that differ in Al tolerance, were hydroponically treated with a nutrient solution (Control) or supplemented by 1.0 mM Al3+ (Al toxicity) for 21 days after three months of pre-culture. The Al distribution at the tissue level of citrus species followed the order: lateral roots > primary roots > leaves > stems. The concentration of Al extracted from the cell wall (CW) of lateral roots was found to be about 8 to 10 times higher than in the lateral roots under Al toxicity, suggesting that the CW was the primary Al-binding site at the subcellular level. Furthermore, the Al distribution in CW components of the lateral roots showed that pectin had the highest affinity for binding Al. The relative expression level of genes directly relevant to Al transport indicated a dominant role of Cs6g03670.1 and Cg1g021320.1 in the Al distribution of two citrus species. Compared to C. grandis, C. sinensis had a significantly higher Al concentration on the CW of lateral roots, whereas remarkably lower Al levels in the leaves and stems. Furthermore, Al translocation revealed by the absorption kinetics of the CW demonstrated that C. sinensis had a higher Al retention and stronger Al affinity on the root CW than C. grandis. According to the FTIR (Fourier transform infrared spectroscopy) analysis, the Al distribution and translocation might be affected by a modification in the structure and components of the citrus lateral root CW.

Conclusions

A higher Al-retention, mainly attributable to pectin of the root CW, and a lower Al translocation efficiency from roots to shoots contributed to a higher Al tolerance of C. sinensis than C. grandis. The aluminum distribution and translocation of two citrus species differing in aluminum tolerance were associated with the transcriptional regulation of genes related to Al transport and the structural modification of root CW.
The genetic control of polyacetylenes involved in bitterness of carrots (Daucus carota L.): Identification of QTLs and candidate genes from the plant fatty acid metabolism
Authors: Dunemann Frank , He Wanying , Böttcher Christoph , Reichardt Sven , Nothnagel Thomas , Heuvelmans Paul , Hermans Freddy
Published: March 2022

Background

Falcarinol-type polyacetylenes (PAs) such as falcarinol (FaOH) and falcarindiol (FaDOH) are produced by several Apiaceae vegetables such as carrot, parsnip, celeriac and parsley. They are known for numerous biological functions and contribute to the undesirable bitter off-taste of carrots and their products. Despite their interesting biological functions, the genetic basis of their structural diversity and function is widely unknown. A better understanding of the genetics of the PA levels present in carrot roots might support breeding of carrot cultivars with tailored PA levels for food production or nutraceuticals.

Results

A large carrot F2 progeny derived from a cross of a cultivated inbred line with an inbred line derived from a Daucus carota ssp. commutatus accession rich in PAs was used for linkage mapping and quantitative trait locus (QTL) analysis. Ten QTLs for FaOH and FaDOH levels in roots were identified in the carrot genome. Major QTLs for FaOH and FaDOH with high LOD values of up to 40 were identified on chromosomes 4 and 9. To discover putative candidate genes from the plant fatty acid metabolism, we examined an extended version of the inventory of the carrot FATTY ACID DESATURASE2 (FAD2) gene family. Additionally, we used the carrot genome sequence for a first inventory of ECERIFERUM1 (CER1) genes possibly involved in PA biosynthesis. We identified genomic regions on different carrot chromosomes around the found QTLs that contain several FAD2 and CER1 genes within their 2-LOD confidence intervals. With regard to the major QTLs on chromosome 9 three putative CER1 decarbonylase gene models are proposed as candidate genes.

Conclusion

The present study increases the current knowledge on the genetics of PA accumulation in carrot roots. Our finding that carrot candidate genes from the fatty acid metabolism are significantly associated with major QTLs for both major PAs, will facilitate future functional gene studies and a further dissection of the genetic factors controlling PA accumulation. Characterization of such candidate genes will have a positive impact on carrot breeding programs aimed at both lowering or increasing PA concentrations in carrot roots.
Prevalence of healthy aging among community dwelling adults age 70 and older from five European countries
Authors: Schietzel Simeon , Chocano-Bedoya Patricia O. , Sadlon Angelique , Gagesch Michael , Willett Walter C. , Orav Endel J. , Kressig Reto W. , Vellas Bruno , Rizzoli René , da Silva José A. P. , Blauth Michael , Kanis John A. , Egli Andreas , Bischoff-Ferrari Heike A.
Published: March 2022

Background

To compare the prevalence of healthy aging among adults age 70 and older from 5 European countries recruited for the DO-HEALTH clinical trial. Participants were selected for absence of prior major health events.

Methods

Cross-sectional analysis of DO-HEALTH baseline data. All 2,157 participants (mean age 74.9, SD 4.4; 61.7% women) were included and 2,123 had data for all domains of the healthy aging status (HA) definition. HA was assessed based on the Nurses` Health Study (NHS) definition requiring four domains: no major chronic diseases, no disabilities, no cognitive impairment (Montreal Cognitive Assessment, MoCA ≥25), no mental health limitation (GDS-5 <2, and no diagnosis of depression). Association between HA and age, BMI, gender, and physical function (sit-to-stand, gait speed, grip strength) was assessed by multivariate logistic regression analyses adjusting for center.

Results

Overall, 41.8% of DO-HEALTH participants were healthy agers with significant variability by country: Austria (Innsbruck) 58.3%, Switzerland (Zurich, Basel, Geneva) 51.2%, Germany (Berlin) 37.6%, France (Toulouse) 36.7% and Portugal (Coimbra) 8.8% (p <0.0001). Differences in prevalence by country persisted after adjustment for age. In the multivariate model, younger age (OR = 0.95, 95% CI 0.93 to 0.98), female gender (OR = 1.36, 95% CI 1.03 to 1.81), lower BMI (OR = 0.94, 95% CI 0.91 to 0.96), faster gait speed (OR = 4.70, 95% CI 2.68 to 8.25) and faster performance in sit-to-stand test (OR = 0.90, 95% CI 0.87 to 0.93) were independently and significantly associated with HA.

Conclusions

Despite the same inclusion and exclusion criteria preselecting relatively healthy adults age 70 years and older, HA prevalence in DO-HEALTH varied significantly between countries and was highest in participants from Austria and Switzerland, lowest in participants from Portugal. Independent of country, younger age, female gender, lower BMI and better physical function were associated with HA.

Trial registration

DO-HEALTH was registered under the protocol NCT01745263 at the International Trials Registry (clinicaltrials.gov), and under the protocol number 2012–001249-41 at the Registration at the European Community Clinical Trial System (EudraCT).
Association between social capital and frailty and the mediating effect of health-promoting lifestyles in Chinese older adults: a cross-sectional study
Authors: Hu Shan , Jin Canhuan , Li Shaojie
Published: March 2022

Background

To explore the association between social capital and frailty and the mediating effect of health-promoting lifestyles among Chinese older adults, while providing scientific evidence for frailty intervention.

Methods

In May 2021, a cross-sectional study was conducted among 674 Chinese older adults in Changsha city. Data was collected using the Chinese Shortened Social Capital Scale (comprising structural social capital and cognitive social capital as two subscales), a simplified version of the Health-Promoting Lifestyle Profile and the Tilburg Frailty Indicator. Linear regression analysis was used to examine the association between social capital and frailty. Structural equation modeling was used to test the mediating effect of health-promoting lifestyles.

Results

Cognitive social capital was significantly negatively associated with frailty and its three dimensions (physical, psychological, and social frailty), but structural social capital was not. Health-promoting lifestyles played a mediating role in the associations of cognitive social capital with frailty, physical and psychological frailty, but not with social frailty.

Conclusions

Higher cognitive social capital was associated with a reduced likelihood of frailty. The health-promoting lifestyles partially mediated the association between cognitive social capital and frailty. The use of health-promoting lifestyles or appropriate cognitive social capital interventions may reduce frailty among older adults.
Diagnostic stewardship aiming at expectorated or induced sputum promotes microbial diagnosis in community-acquired pneumonia
Authors: Waagsbø Bjørn , Buset Eva Margrethe , Longva Jørn-Åge , Bjerke Merete , Bakkene Birgitte , Ertesvåg Anne-Stine , Holmen Hanne , Nikodojevic Marko , Tran To Thy , Christensen Andreas , Nilsen Einar , Damås Jan Kristian , Heggelund Lars
Published: March 2022

Purpose

Studies on aetiology of community-acquired pneumonia (CAP) vary in terms of microbial sampling methods, anatomical locations, and laboratory analyses, since no gold standard exists. In this large, multicentre, retrospective, regional study from Norway, our primary objective was to report the results of a strategic diagnostic stewardship intervention, targeting diagnostic yield from lower respiratory tract sampling. The secondary objective was to report hospitalized CAP aetiology and the diagnostic yield of various anatomical sampling locations.

Methods

Medical records from cases diagnosed with hospitalized CAP were collected retrospectively from March throughout May for three consecutive years at six hospitals. Between year one and two, we launched a diagnostic stewardship intervention at the emergency room level for the university teaching hospital only. The intervention was multifaceted aiming at upscaling specimen collection and enhancing collection techniques. Year one at the interventional hospital and every year at the five other emergency hospitals were used for comparison.

Results

Of the 1280 included cases of hospitalized CAP, a microbiological diagnosis was established for 29.1% among 1128 blood cultures and 1444 respiratory tract specimens. Blood cultures were positive for a pathogenic respiratory tract microbe in 4.9% of samples, whereas upper and lower respiratory tract samples overall provided a probable microbiological diagnosis in 21.3% and 47.5%, respectively. Expectorated or induced sputum overall provided aetiology in 51.7% of the samples. At the interventional hospital, the number of expectorated or induced sputum samples were significantly increased, and diagnostic yield from expectorated or induced sputum was significantly enhanced from 41.2 to 62.0% after the intervention (p = 0.049). There was an over-representation of samples from the interventional hospital during the study period. Non-typeable Haemophilus influenza and Streptococcus pneumoniae accounted for 25.3% and 24.7% of microbiologically confirmed cases, respectively.

Conclusion

Expectorated or induced sputum outperformed other sampling methods in providing a reliable microbiological diagnosis for hospitalized CAP. A diagnostic stewardship intervention significantly improved diagnostic yield of lower respiratory tract sampling.
Prognostic accuracy of time to sputum culture conversion in predicting cure in extensively drug-resistant tuberculosis patients: a multicentre retrospective observational study
Authors: Abubakar Muhammad , Ahmad Nafees , Atif Muhammad , Ahmad Izaz , Wahid Abdul , Khan Asad , Saleem Fahad , Ghafoor Abdul
Published: March 2022

Background

There was a lack of information about prognostic accuracy of time to sputum culture conversion (SCC) in forecasting cure among extensively drug-resistant tuberculosis (XDR-TB) patients. Therefore, this study evaluated the prognostic accuracy of SCC at various time points in forecasting cure among XDR-TB patients.

Methods

This retrospective observational study included 355 eligible pulmonary XDR-TB patients treated at 27 centers in Pakistan between 01-05-2010 and 30-06-2017. The baseline and follow-up information of patients from treatment initiation until the end of treatment were retrieved from electronic nominal recording and reporting system. Time to SCC was analyzed by Kaplan–Meier method, and differences between groups were compared through log-rank test. Predictors of time to SCC and cure were respectively evaluated by multivariate Cox proportional hazards and binary logistic regression analyses. A p-value < 0.05 was considered statistically significant.

Results

A total of 226 (63.6%) and 146 (41.1%) patients respectively achieved SCC and cure. Median time to SCC was significantly shorter in patients who achieved cure, 3 months (95% confidence interval [CI]: 2.47–3.53), than those who did not (median: 10 months, 95% CI: 5.24–14.76) (p-value < 0.001, Log-rank test). Patient’s age > 40 years (hazards ratio [HR] = 0.632, p-value = 0.004), baseline sputum grading of scanty, + 1 (HR = 0.511, p-value = 0.002), + 2, + 3 (HR = 0.523, p-value = 0.001) and use of high dose isoniazid (HR = 0.463, p-value = 0.004) were significantly associated with early SCC. Only SCC at 6 month of treatment had statistically significant association with cure (odds ratio = 15.603, p-value < 0.001). In predicting cure, the sensitivities of SCC at 2, 4 and 6 months were respectively 41.8% (95%CI: 33.7–50.2), 69.9% (95%CI: 61.7–77.2) and 84.9% (95%CI: 78.1–90.3), specificities were respectively, 82.8% (95%CI: 76.9–87.6), 74.6% (95%CI: 68.2–80.4) and 69.4% (95%CI: 62.6–75.5) and prognostic accuracies were respectively 65.9% (95%CI: 60.7–70.8), 72.7% (95%CI: 67.7–77.2) and 75.8% (95%CI: 71.0–80.1).

Conclusion

In forecasting cure, SCC at month 6 of treatment performed better than SCC at 2 and 4 months. However, it would be too long for clinicians to wait for 6 months to decide about the regimen efficacy. Therefore, with somewhat comparable prognostic accuracy to that SCC at 6 month, using SCC at 4 month of treatment as a prognostic marker in predicting cure among XDR-TB patients can decrease the clinicians waiting time to decide about the regimen efficacy.
An open-label phase 2 trial to assess the efficacy, safety and pharmacokinetics of lanthanum carbonate in hyperphosphatemic children and adolescents with chronic kidney disease undergoing dialysis
Authors: Wasilewska Anna , Murray Rose Ann , Sundberg Aimee , Uddin Sharif , Achenbach Heinrich , Shavkin Aleksey , Szabó Tamás , Vergani Andrea , Umeh Obi
Published: March 2022

Background

This study assessed the efficacy, tolerability and pharmacokinetics (PK) of lanthanum carbonate (LC) in hyperphosphatemic children and adolescents with chronic kidney disease (CKD) undergoing dialysis.

Methods

This was a three-part, multicenter, open-label study of LC (oral powder formulation) in patients 10 to < 18 years old with CKD undergoing dialysis. In part 1, the single-dose PK of LC (500 mg, ≤12 years old; 1000 mg, > 12 years old) were summarized. In part 2, patients received calcium carbonate (CC [chewable tablet formulation]) (1500–6500 mg [total daily dose]) followed by LC (powder formulation) (1500–3000 mg [total daily dose]), or LC only (1500–3000 mg [total daily dose]), each for 8 weeks. During part 3, patients received LC (1500–3000 mg [total daily dose]) for up to 6 months. The primary efficacy endpoint was the proportion of LC-treated patients achieving serum phosphorus control after 8 weeks during parts 2 and/or 3, defined as: ≤1.94 mmol/L, < 12 years old; ≤1.78 mmol/L, ≥12 years old. Secondary efficacy endpoints included: the proportion of patients who achieved serum phosphorus control after 8 weeks of treatment with CC followed by 8 weeks of treatment with LC (with a washout period between treatments). The safety of LC and CC was also evaluated.

Results

In part 1, 20 patients received a single dose of LC. In part 2, 53 and 51 patients were treated with CC and LC for 8 weeks, respectively. During part 3, 42 patients received LC for up to 6 months. Most patients were white and male. For the primary efficacy endpoint, 50% (17/34) of patients who received LC for 8 weeks during parts 2 and/or 3 achieved serum phosphorus control. After 8 weeks of treatment with CC, 58.8% of patients achieved serum phosphorus control; after a subsequent washout period and 8 weeks of treatment with LC, 70.6% of patients achieved serum phosphorus control. Tmax and t1/2 occurred within 3–8 h and ~ 19 h, respectively; however, variability was observed. LC and CC were generally well tolerated.

Conclusions

These data support the use of LC to manage hyperphosphatemia in pediatric patients with CKD undergoing dialysis.

Trial registration

ClinicalTrials.gov identifier: NCT01696279; EudraCT identifier: 2012–000171-17.

Date of registration: 01/10/2012.
Association of fish oil containing lipid emulsions with retinopathy of prematurity: a retrospective observational study
Authors: Yang Rongqiang , Ding Hao , Shan Jing , Li Xiaole , Zhang Jian , Liu Guanghui , Zheng Hong , Su Yu , Yao Hongyang , Qi Kemin
Published: March 2022

Background

Retinopathy of prematurity (ROP) remains a leading cause of childhood blindness worldwide. This study aimed to investigate whether supplementation of n-3 polyunsaturated fatty acids (n-3 PUFAs) in parenteral nutrition may have beneficial effects on ROP in preterm infants.

Methods

A total of 89 preterm infants, admitted to Neonatal Intensive Care Unit (NICU) in Anhui Provincial Children’s Hospital from September 2017 to August 2020, were recruited in the study. Based on the medical documents, the subjects were categorised into two groups: administration of the fish oil emulsion (n=43) containing soy oil, medium-chain-triglycerides (MCT), olive oil and fish oil (6g/dL, 6g/dL, 5g/dL and 3g/dL respectively), and the soy oil emulsion (n=46) containing 10g/dL of soy oil and MCT each. At 4 weeks of hospitalization, ROP was screened and diagnosed. Fatty acids in erythrocytes were determined using gas chromatography.

Results

The averaged birth weight and gestational age were 1594±296 g and 31.9±2.3 wk, 1596±263 g and 31.6±2.3 wk respectively for preterm infants in the fish oil group and soy oil group. After 4 to 6 weeks of hospitalization, among all the preterm infants, 52 developed ROP (all stages) indicating an incidence of ROP at 58.43%. Although the incidence of ROP with any stages showed no differences between the two groups, the severe ROP incidence in the group with fish oil emulsions (2.33%) was significantly lower than that in the group with soy oil emulsions (23.91%) (P<0.05). After 14 days of nutrition support, the preterm infants administered fish oil emulsions had an increase in erythrocyte DHA content, with a reduction in ratio of arachidonic acid (AA) to DHA and an increase of n-3 index.

Conclusion

Supplementation of n-3 PUFAs through parenteral fish oil containing lipid emulsions resulted in an increase in erythrocyte DHA, and this might have beneficial effects on prevention of severe ROP in preterm infants.
The association of the age, period, and birth cohort with 15-year changes in body mass index and waist circumference in adults: Tehran lipid and glucose study (TLGS)
Authors: Barzin Maryam , Aryannezhad Shayan , Bagheri Mohammad , Mahdavi Maryam , Valizadeh Majid , Azizi Fereidoun , Hosseinpanah Farhad
Published: March 2022

Objective

To examine the association of age, period, and birth cohort with body mass index (BMI) and waist circumference (WC) changes among the participants of the Tehran Lipid and Glucose Study from 1999 to 2015.

Methods

This prospective cohort study included 4895 participants aged ≥20 years (41.3% men), who were divided into twelve gender stratified groups, having a ten-year age difference between them. Analyses were conducted to explicitly assess the association of age vs. period on BMI and WC changes. In addition, we evaluated BMI and WC changes among different birth cohorts.

Results

Upon 15 years of follow-up, the mean BMI of men and women increased from 26.0 ± 3.9 to 27.5 ± 4.3 kg/m2 and from 27.5 ± 4.8 to 29.9 ± 5.4 kg/m2 (P trend < 0.001), and this trend was accompanied by an increase in WC from 88.8 ± 10.9 to 97.8 ± 10.4 cm and from 87.3 ± 12.4 to 95.8 ± 12.1 cm, respectively (P trend < 0.001). Men and women in all age cohorts tended to have a rise in their BMI and WC with aging throughout the follow-up period. For men, this trend was more prominent in younger birth cohorts at phase III for BMI and at phases III and V for WC (indicating a significant negative association with birth cohort). For women, this trend was more prominent in older birth cohorts at both phases III and V for BMI and WC (indicating a significant positive association with the birth cohort).

Conclusion

The rise in BMI and WC was strongly associated with age in both sexes. The men born in the recent birth cohorts and the women born in earlier birth cohorts had the most alarming BMI and WC trends. More efforts must be spent on obesity prevention policies, especially for younger men.
Incidence and risk factors for chronic postsurgical pain following video-assisted thoracoscopic surgery: a retrospective study
Authors: Zhang Yingying , Zhou Rong , Hou Bailing , Tang Suhong , Hao Jing , Gu Xiaoping , Ma Zhengliang , Zhang Juan
Published: March 2022

Background

Video-assisted thoracoscopic surgery (VATS) has been widely used as an alternative for thoracotomy, but the reported incidence of chronic postsurgical pain (CPSP) following VATS varied widely. The purpose of this study was to investigate the incidence and risk factors for CPSP after VATS.

Methods

We retrospectively collected preoperative demographic, anesthesiology, and surgical factors in a cohort of patients undergoing VATS between January 2018 and October 2020. Patients were interviewed via phone survey for pain intensity, and related medical treatment 3 months after VATS. Univariate and multivariate analysis were used to explore independent risk factors associated with CPSP.

Results

2348 patients were included in our study. The incidence of CPSP after VATS were 43.99% (n = 1033 of 2348). Within those suffering CPSP, 14.71% (n = 152 of 1033) patients reported moderate or severe chronic pain. Only 15.23% (n = 23 of 152) patients with moderate to severe chronic pain sought active analgesic therapies. Age < 65 years (OR 1.278, 95% CI 1.057–1.546, P = 0.011), female (OR 1.597, 95% CI 1.344–1.898, P < 0.001), education level less than junior school (OR 1.295, 95% CI 1.090–1.538, P = 0.003), preoperative pain (OR 2.564, 95% CI 1.696–3.877, P < 0.001), consumption of rescue analgesia postoperative (OR 1.248, 95% CI 1.047–1.486, P = 0.013), consumption of sedative hypnotic postoperative (OR 2.035, 95% CI 1.159–3.574, P = 0.013), and history of postoperative wound infection (OR 5.949, 95% CI 3.153–11.223, P < 0.001) were independent risk factors for CPSP development.

Conclusions

CPSP remains a challenge in clinic because half of patients may develop CPSP after VATS.

Trial registration Chinese Clinical Trial Registry (ChiCTR2100045765), 2021/04/24
Facilitators and barriers to routine intimate partner violence screening in antenatal care settings in Uganda
Authors: Anguzu Ronald , Cassidy Laura D. , Beyer Kirsten M. M. , Babikako Harriet M. , Walker Rebekah J. , Dickson-Gomez Julia
Published: March 2022

Background

Uganda clinical guidelines recommend routine screening of pregnant women for intimate partner violence (IPV) during antenatal care (ANC). Healthcare providers play a critical role in identifying IPV during pregnancy in ANC clinics. This study explored facilitators and barriers for IPV screening during pregnancy (perinatal IPV screening) by ANC-based healthcare workers in Uganda.

Methods

We conducted qualitative in-depth interviews among twenty-eight purposively selected healthcare providers in one rural and an urban-based ANC health center in Eastern and Central Uganda respectively. Barriers and facilitators to IPV screening during ANC were identified iteratively using inductive-deductive thematic analysis.

Results

Participants had provided ANC services for a median (IQR) duration of 4.0 (0.1–19) years. Out of 28 healthcare providers, 11 routinely screened women attending ANC clinics for IPV and 10 had received IPV-related training. Barriers to routine IPV screening included limited staffing and space resources, lack of comprehensive gender-based violence (GBV) training and provider unawareness of the extent of IPV during pregnancy. Facilitators were availability of GBV protocols and providers who were aware of IPV (or GBV) tools tended to use them to routinely screen for IPV. Healthcare workers reported the need to establish patient trust and a safe ANC clinic environment for disclosure to occur. ANC clinicians suggested creation of opportunities for triage-level screening and modification of patients’ ANC cards used to document women’s medical history. Some providers expressed concerns of safety or retaliatory abuse if perpetrating partners were to see reported abuse.

Conclusions

Our findings can inform efforts to strengthen GBV interventions focused on increasing routine perinatal IPV screening by ANC-based clinicians. Implementation of initiatives to increase routine perinatal IPV screening should focus on task sharing, increasing comprehensive IPV training opportunities, including raising awareness of IPV severity, trauma-informed care and building trusting patient-physician relationships.