bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of elevated international normalized ratio on complications following total shoulder arthroplasty
Authors: Wang Kevin Y , Quan Theodore , Kapoor Shrey , Gu Alex , Best Matthew J , Kreulen R Timothy , Srikumaran Uma
Published: March 2022

Background

Identifying preoperative risk factors for complications following total shoulder arthroplasty (TSA) has both clinical and financial implications. The purpose of this study was to determine the influence of different degrees of preoperative INR elevation on complications following TSA.

Methods

Patients undergoing primary TSA from 2007 to 2018 were identified in a national database. Patients were stratified into 4 cohorts: INR of <1.0, INR of >1.0 to 1.25, INR of >1.25 to 1.5, and INR of >1.5. Postoperative complications were assessed. Multivariate logistic regressions were performed to adjust for differences in demographics and comorbidities among the INR groups.

Results

Following adjustment and relative to patients with an INR of <1.0, those with INR of >1.0–1.25, >1.25–1.5, and >1.5 had 1.6-times, 2.4-times, and 2.8-times higher odds of having postoperative bleeding requiring transfusion, respectively (p < 0.05 for all). Relative to patients with INR <1.0, those with INR of > 1.25–1.5 and INR of >1.5 had 7.8-times and 7.0-times higher odds of having pulmonary complications, respectively (p < 0.05 for both).

Discussion

With increasing INR levels, there is an independent and step-wise increase in odd ratios for postoperative complications. Current guidelines for preoperative INR thresholds may need to be adjusted for more predictive risk-stratification for TSA.

Level of Evidence

III
Psychosocial predictors of anxiety and depression in a sample of healthcare workers in Botswana during the COVID-19 pandemic: A multicenter cross-sectional study
Authors: Olashore Anthony A , Molebatsi Keneilwe , Musindo Otsetswe , Bojosi Kagiso , Obadia Isaac , Molefe-Baikai Onkabetse Julia , Tshitenge Stephane , Opondo Philip
Published: March 2022

Objectives:

This study aimed to investigate the psychological impact of the COVID-19 outbreak on healthcare workers across multiple hospitals in different districts in Botswana.

Methods:

We conducted a cross-sectional study in five public-funded hospitals from three districts in Botswana from 1 June 2020 to 30 October 2020. We used the neuroticism subscale of the 44-item Big Five Inventory, Patient Health Questionnaire, the Oslo 3-item Social Support Scale, the Anxiety Rating Scale, and the 14-item Resilience Scale to obtain data from 355 healthcare workers.

Results:

The participants’ mean age (standard deviation) was 33.77 (6.84) years. More females (207, 59%) responded than males (144, 41%). Anxiety and depression were experienced by 14% and 23% of the participants, respectively. After multiple regression analyses, neuroticism predicted depression ( B = 0.22; p < 0.01) and anxiety disorder ( B = 0.31; p < 0.01). Lower educational status ( B = −0.13; p = 0.007) predicted anxiety and younger age ( B = −0.10; p = 0.038) predicted depression, while resilience negatively correlated with both disorders.

Conclusion:

There is a need to develop and implement interventions targeted at these identified risk and protective factors that can be easily delivered to healthcare workers during this pandemic.
Policy parameters for optimising hospital ePrescribing: An exploratory literature review of selected countries of the Organisation for Economic Co-operation and Development
Authors: Perera Uditha T , Heeney Catherine , Sheikh Aziz
Published: March 2022

Objective

Electronic prescribing systems offer considerable opportunities to enhance the safety, effectiveness and efficiency of prescribing and medicines management decisions but, despite considerable investments in health IT infrastructure and healthcare professional training, realising these benefits continues to prove challenging. How systems are customised and configured to achieve optimal functionality is an increasing focus for policymakers. We sought to develop an overview of the policy landscape currently supporting optimisation of hospital ePrescribing systems in economically developed countries with a view to deriving lessons for the United Kingdom (UK).

Methods

We conducted a review of research literature and policy documents pertaining to optimisation of ePrescribing within hospitals across Organisation for Economic Co-operation and Development (OECD) countries on Embase, Medline, National Institute for Health (NIH), Google Scholar databases from 2010 to 2020 and the websites of organisations with international and national health policy interests in digital health and ePrescribing. We designed a typology of policies targeting optimisation of ePrescribing systems that provides an overview of evidence relating to the level at which policy is set, the aims and the barriers encountered in enacting these policies.

Results

Our database searches retrieved 11 relevant articles and other web resources mainly from North America and Western Europe. We identified very few countries with a national level strategy for optimisation of ePrescribing in hospitals. There were hotspots of digital maturity in relation to ePrescribing at institutional, specialisation, regional and national levels in the US and Europe. We noted that such countries with digital maturity fostered innovations such as patient involvement.

Conclusions

We found that, whilst helpful to achieve certain aims, coordinated strategies within and across countries for optimisation of ePrescribing systems are rare, even in countries with well-established ePrescribing and digital health infrastructures. There is at present little policy focus on maximising the utility of ePrescribing systems.
Patterns of Otorhinolaryngological Manifestations of Covid-19: A Longitudinal Questionnaire-Based Prospective Study in a Tertiary Hospital in Saudi Arabia
Authors: Alrusayyis Danah , Aljubran Hussain , Alshaibani Askar , Alsharhan Salma , AlSaied Abdulmalik , ALEnazi Abdulaziz , Alghamdi Amal , Alshahrani Saad , Salam Abdul , Al Bar Mohammed
Published: March 2022

Objective:

Many studied investigated the manifestations of COVID-19, yet few described the pattern and severity of otolaryngological symptoms. We aim to describe the picture of COVID-19-associated otorhinolaryngological manifestations and recovery to explore individualized treatment, onward referral, and complications prevention.

Design:

Prospective longitudinal questionnaire-based study.

Setting:

The online questionnaire was filled 3 times through a remote interview over a period of 1 month from June 2020 to July 2020.

Participants:

Patients with confirmed COVID-19 by RT-PCR who were clinically stable.

Main Outcome Measures:

Date of diagnosis, sociodemographic data, and the presence of predictive factors, such as nasal and paranasal disease, anosmia and dysgeusia. Validated tools were used, such as Sino-nasal Outcome Test (SNOT-22), smell test (medical academy screening tool), Voice Handicap Index (VHI), and Reflux Symptoms Index (RSI).

Result:

The questionnaire was sent to 363 patients and the response rate was 70.80% (n = 257). The mean age was 34.58 years (SD = 11.22) and the rate of male participants was 60.7%. The most common otorhinolaryngological symptoms at the time of enrollment was fever (48.6%), whilst the commonest severe symptom was cough (57%). After 1 month, only 11 participants had persistent severe symptoms, especially sleep and psychological symptoms (73%), and the majority were female (63.6%). All of them had at least 1 comorbidity. There was a significant difference between the mean age of participants with severe symptoms (mean = 27.45, SD = 8.39) and without severe symptoms (mean = 34.90, SD = 2.53, t(255) = 2.17, P = .031).

Conclusion:

COVID-19 has a wide-ranged spectrum of presentations, with otorhinolaryngological symptoms being the commonest and most serious. Studying these symptoms is vital to advance management options.
Corruption in Public Administration as a Brake on Transition to Industry 4.0
Authors: Němec Daniel , Machová Zuzana , Kotlán Igor , Kotlánová Eva , Kliková Christiana
Published: March 2022

The transition to Industry 4.0 presumes the use of innovation potential which is also determined by the institutional environment, including the level of corruption and its perception. The post-communist countries of Central and Eastern Europe are characterized by a higher level of corruption and higher share of the shadow economy, which can fundamentally reduce their innovation potential and thus become the brake on the transition to Industry 4.0. The aim of this paper is thus to evaluate the effects of corruption in public administration on the size and structure of the shadow economy, and to determine whether the existence of corruption may affect the transition of a country and society to Industry 4.0. Based on an extended DSGE (Dynamic Stochastic General Equilibrium) model and using the data for the Czech Republic, the paper finds that corruption in public administration has a much more destructive and long-term effect on the capital accumulation than on the size of the workforce. In that sense, corruption can become a significant obstacle to the transition, underlining that the task of public policies is not only to support digitization, robotization, and further development of technologies, but especially to ensure a transparent non-corrupt environment of public administration.
Predictors of Attitudes Toward Pharmacological Cognitive Enhancers in College Students
Authors: Hayes Lisa J. , Bays R. Brooke , Arthur Sydney , Ghani Natalie , Vazquez Cinthya
Published: March 2022

The misuse of pharmacological cognitive enhancers (PCEs) in an academic context is a growing area of concern, particularly as rates of PCE use among emerging adults have increased over time. The aim of this study was to identify potential targets for future preventive interventions by examining several social-cognitive variables as risk factors for PCE use. Using a sample of 335 undergraduate college students, attitudes toward cheating, academic locus of control, and perfectionism were measured as potential predictors of attitudes toward PCE use and beliefs about fairness. Results were that attitudes toward cheating and socially prescribed perfectionism predicted attitudes toward PCE use. Attitudes toward cheating and other-oriented perfectionism predicted beliefs about fairness. These results highlight perfectionism as a target for preventive interventions and underscore the need for colleges and universities to consider PCE use in their policies surrounding academic honesty.
Emergency Department Visits Within 90 Days of Anterior Cruciate Ligament Reconstruction
Authors: Kammien Alexander J. , Zhu Justin R. , Gouzoulis Michael J. , Moore Harold G. , Galivanche Anoop R. , Medvecky Michael J. , Grauer Jonathan N.
Published: March 2022

Background:

Emergency department (ED) visits after orthopaedic surgery such as anterior cruciate ligament reconstruction (ACLR) affect patients and health care systems and should be better understood.

Purpose:

To determine the incidence, predictors, and reasons for ED visits within 90 days after ACLR.

Study Design:

Descriptive epidemiologic study.

Methods:

Patients who had undergone ACLR between 2010 and 2020 were identified in a national database, and 90-day ED visits, readmissions, risk factors, and primary diagnoses for visits were determined. One-year postoperative data were used to establish baseline weekly ED visits for the cohort. Patient age, sex, Elixhauser comorbidity index, region of the country (Northeast, Midwest, West, South), and insurance coverage (Medicare, Medicaid, and commercial) were extracted, and these variables were compared using univariate analysis and multivariate logistic regression.

Results:

Out of 81,179 patients, ED visits were identified for 6764 (8.3%), and readmissions were identified for 592 (0.7%). Overall, 5300 patients had 1 ED visit, 1020 patients had 2 visits, 275 patients had 3 visits, and 169 patients had ≥4 or more visits; visits occurred within 2 weeks of surgery 38% of the time. Notably, weekly visits returned to baseline at week 3. Independent predictors of ED utilization from multivariate analysis were insurance type (relative to commercial insurance: Medicaid [odds ratio [OR], 2.41; 95% CI, 2.23-2.60] and Medicare [OR, 1.38; 95% CI, 1.19-1.60]), higher Elixhauser comorbidity index (per 2-point increase: OR, 2.24; 95% CI, 2.18-2.29), younger age (per 10-year decrease: OR, 1.23; 95% CI, 1.21-1.24), female sex (OR, 1.05; 95% CI, 1.02-1.08), and region of the country (relative to the West: Midwest [OR, 1.33; 95% CI, 1.26-1.39], Northeast [OR, 1.24; 95% CI, 1.18-1.30], and South [OR, 1.17; 95% CI, 1.12-1.23]). In the first 2 weeks, 67.5% of ED visits were for issues involving the surgical site, most commonly surgical-site pain (29% of all visits). In the total 90-day period, 39.4% of visits involved the surgical site.

Conclusion:

Within 90 days of ACLR, >8% of patients visited the ED, while 0.7% were readmitted. ED visits increased in the first 2 postoperative weeks and returned to baseline rates around week 3. Within the first 2 weeks, two-thirds of visits involved the surgical site. Younger patients, patients with greater comorbidity burden, those in certain regions of the country, and those with Medicaid had greater odds of ED utilization.
A Novel Approach to Link Genetics and Human MRI Identifies AKAP7-Dependent Subicular/Prefrontal Functional Connectivity as Altered in Suicidality
Authors: Poblete Guillermo , Nguyen Tien , Gosnell Savannah , Sofela Olutayo , Patriquin Michelle , Mathew Sanjay J. , Swann Alan , Nielsen David A. , Kosten Thomas R. , Salas Ramiro
Published: March 2022

Background

Brain imaging and genetics are fields acquiring data at increasing speed, but more information does not always result in a better understanding of the underlying biology. We developed the ProcessGeneLists (PGL) approach to use genetics and mRNA gene expression data to generate regions of interest for imaging studies.

Methods

We applied PGL to past suicide attempt (ATT): We averaged the mRNA expression levels of genes (n = 130) possibly associated with ATT (p ≤ 10−3 in a published genome-wide association study, GWAS) in each brain region studied in the Human Allen Brain Atlas (6 ex-vivo brains, 158 to 946 regions/brain have mRNA expression data) and compared that to the averaged mRNA expression levels of all other genes in each region in each brain in the atlas.

Results

PGL revealed 8 regions where “attempt-related genes” were differentially expressed (Wilcoxon test with Bonferroni correction 8.88−11 = <p < = 0.046). Using resting state functional connectivity (RSFC), we studied those regions in psychiatric inpatients (male/female, n = 132 with [ATT], n = 291 without [NAT] past attempt, unrelated to those in the GWAS). Among the 8 PGL-identified regions, the subiculum showed higher RSFC with habenula (p < 10−6) and dorsolateral prefrontal cortex (dlPFC pFWE < 0.05) in ATT. We genotyped one single nucleotide polymorphism (SNP) in each of the five genes (within 130 from GWAS) with most important subicular expression. AKAP7 (A-Kinase Anchoring Protein 7, important in hippocampal memory processes) showed an interaction between genotype, ATT, and subiculum/dlPFC RSFC.

Conclusion

PGL uncovered a brain function/genotype interaction in ATT by using published GWAS data to inform imaging studies. This could inform individualized therapies in the future.
No child is an island – The life situation before and during treatment for children exposed to family violence
Authors: Onsjö Marja , Strand Jennifer , Axberg Ulf
Published: March 2022

Compelling evidence indicates that child maltreatment is a risk factor for developing serious psychopathology. Trauma-focused treatment has been found to be effective, but not all children benefit from it. Interventions that consider multiple aspects of treatment that could improve the efficacy need to be developed. The present study explored how children exposed to family violence described their life situation before and during their contact with the child and adolescent mental health service. Thirteen children and adolescents were interviewed and we analysed the material using thematic analysis. Several of the participants reported continued violence, conflict and insecurity at home, in school and in other contexts. These results indicate how important it is never to assume that because children exposed to family violence are in treatment, they are safe in their homes. Interventions should therefore include continuous assessment of ongoing victimization and safety planning, considering children, not as isolated units, but in the context of complex life situations in which their well-being is affected by their parents, siblings and friends.
Development of Community Pharmacy Competencies
Authors: Parinyarux Pantira , Dhippayom Teerapon , Wongpoowarak Payom , Kitikannakorn Nantawarn
Published: March 2022

Objective

This study aimed to develop a consensus statement of competencies for community pharmacists in Thailand.

Methods

A 2-round modified Delphi process was used to develop consensus among a panel of community pharmacy experts. A total of 18 experts from 6 stakeholders represented a panel of each pharmacy organization in Thailand. In the first experts were asked to rate their degree of agreement on whether a competency was essential using a 7-point Likert scale (1 = “not essential competency” to 7 = “the most essential competency”). Also, in the second round, they were asked to rate the competencies from a scale of “must be included” to “must be excluded.” Competencies considered “must be excluded” by a consensus of 80% or more of experts were removed from the community pharmacy competency list.

Results

Nearly half the experts had experience in their position for more than 10 years. The expert panels were typically committee members of the Community Pharmacy Association (Thailand) and community pharmacy clerkship preceptors (29.4% and 23.5%, respectively). The number of community pharmacy competencies on the initial list was 55 competencies. None of them was eliminated after the first round. Of 55 competencies, 11 were eliminated after the second round. The final list of competency statements was 44 competencies divided into 4 domains: personal competencies, pharmacy professional competencies, patient care competencies, and management competencies.

Conclusion

Community pharmacy competencies include having a positive attitude and being accountable for individual patient care, providing disease prevention and health promotion, and addressing morality and ethics in business.
CAISC: A software to integrate copy number variations and single nucleotide mutations for genetic heterogeneity profiling and subclone detection by single-cell RNA sequencing
Authors: Kannan Jeerthi , Mathews Liza , Wu Zhijie , Young Neal S. , Gao Shouguo
Published: March 2022

Background

Although both copy number variations (CNVs) and single nucleotide variations (SNVs) detected by single-cell RNA sequencing (scRNA-seq) are used to study intratumor heterogeneity and detect clonal groups, a software that integrates these two types of data in the same cells is unavailable.

Results

We developed Clonal Architecture with Integration of SNV and CNV (CAISC), an R package for scRNA-seq data analysis that clusters single cells into distinct subclones by integrating CNV and SNV genotype matrices using an entropy weighted approach. The performance of CAISC was tested on simulation data and four real datasets, which confirmed its high accuracy in sub-clonal identification and assignment, including subclones which cannot be identified using one type of data alone. Furthermore, integration of SNV and CNV allowed for accurate examination of expression changes between subclones, as demonstrated by the results from trisomy 8 clones of the myelodysplastic syndromes (MDS) dataset.

Conclusions

CAISC is a powerful tool for integration of CNV and SNV data from scRNA-seq to identify clonal clusters with better accuracy than obtained from a single type of data. CAISC allows users to interactively examine clonal assignments.
Evaluation of tree-based statistical learning methods for constructing genetic risk scores
Authors: Lau Michael , Wigmann Claudia , Kress Sara , Schikowski Tamara , Schwender Holger
Published: March 2022

Background

Genetic risk scores (GRS) summarize genetic features such as single nucleotide polymorphisms (SNPs) in a single statistic with respect to a given trait. So far, GRS are typically built using generalized linear models or regularized extensions. However, these linear methods are usually not able to incorporate gene-gene interactions or non-linear SNP-response relationships. Tree-based statistical learning methods such as random forests and logic regression may be an alternative to such regularized-regression-based methods and are investigated in this article. Moreover, we consider modifications of random forests and logic regression for the construction of GRS.

Results

In an extensive simulation study and an application to a real data set from a German cohort study, we show that both tree-based approaches can outperform elastic net when constructing GRS for binary traits. Especially a modification of logic regression called logic bagging could induce comparatively high predictive power as measured by the area under the curve and the statistical power. Even when considering no epistatic interaction effects but only marginal genetic effects, the regularized regression method lead in most cases to inferior results.

Conclusions

When constructing GRS, we recommend taking random forests and logic bagging into account, in particular, if it can be assumed that possibly unknown epistasis between SNPs is present. To develop the best possible prediction models, extensive joint hyperparameter optimizations should be conducted.
Full-length transcriptome reconstruction reveals genetic differences in hybrids of Oryza sativa and Oryza punctata with different ploidy and genome compositions
Authors: He Wenting , Zhang Xianhua , Lv Pincang , Wang Wei , Wang Jie , He Yuchi , Song Zhaojian , Cai Detian
Published: March 2022

Background

Allopolyploid breeding is an efficient technique for improving the low seed setting rate of autotetraploids in plant breeding and one of the most promising breeding methods. However, there have been few comprehensive studies of the posttranscriptional mechanism in allopolyploids.

Results

By crossing cultivated rice (Oryza sativa, genome AA) with wild rice (Oryza punctata, genome BB), we created hybrid rice lines with different ploidy and genome compositions [diploid hybrid F01 (AB), allotetraploid hybrid F02 (AABB) and F03 (AAAB)]. The genetic differences of the hybrids and the mechanism of allopolyploid breeding dominance were revealed through morphological and cytological observations and single molecule real-time sequencing techniques. The tissues and organs of allotetraploid hybrid F02 exhibited "gigantism" and the highest levels of fertility. The numbers of non-redundant transcripts, gene loci and new isoforms in the polyploid rice lines were higher and the isoform lengths greater than those of the diploid line. Moreover, alternative splicing (AS) events occurred twice as often in the polyploid rice lines than the diploid line. During these events, intron retention dominated. Furthermore, a large number of new genes and isoforms specific to the lines of different ploidy were discovered.

Conclusions

The results indicated that alternative polyadenylation (APA) and AS events contributed to the complexity and superiority of polyploids in the activity of translation regulators, nucleic acid binding transcription factor activities and the regulation of molecular function. Therefore, these APA and AS events in allopolyploid rice were found to play a role in regulation. Our study provides new germplasm for polyploid rice breeding and reveals complex regulatory mechanisms that may be related to heterosis and fertility.
Methodological approaches to measuring the incidence of unplanned emergency department presentations by cancer patients receiving systemic anti-cancer therapy: a systematic review
Authors: Dufton P. H. , Gerdtz M. F. , Jarden R. , Krishnasamy M.
Published: March 2022

Background

The need to mitigate the volume of unplanned emergency department (ED) presentations is a priority for health systems globally. Current evidence on the incidence and risk factors associated with unplanned ED presentations is unclear because of substantial heterogeneity in methods reporting on this issue. The aim of this review was to examine the methodological approaches to measure the incidence of unplanned ED presentations by patients receiving systemic anti-cancer therapy in order to determine the strength of evidence and to inform future research.

Methods

An electronic search of Medline, Embase, CINAHL, and Cochrane was undertaken. Papers published in English language between 2000 and 2019, and papers that included patients receiving systemic anti-cancer therapy as the denominator during the study period were included. Studies were eligible if they were analytical observational studies. Data relating to the methods used to measure the incidence of ED presentations by patients receiving systemic anti-cancer therapy were extracted and assessed for methodological rigor. Findings are reported in accordance with the Synthesis Without Meta-Analysis (SWiM) guideline.

Results

Twenty-one articles met the inclusion criteria: 20 cohort studies, and one cross-sectional study. Overall risk of bias was moderate. There was substantial methodological and clinical heterogeneity in the papers included. Methodological rigor varied based on the description of methods such as the period of observation, loss to follow-up, reason for ED presentation and statistical methods to control for time varying events and potential confounders.

Conclusions

There is considerable diversity in the population and methods used in studies that measure the incidence of unplanned ED presentations by patients receiving systemic anti-cancer therapy. Recommendations to support the development of robust evidence include enrolling participants at diagnosis or initiation of treatment, providing adequate description of regular care to support patients who experience toxicities, reporting reasons for and characteristics of participants who are lost to follow-up throughout the study period, clearly defining the outcome including the observation and follow-up period, and reporting crude numbers of ED presentations and the number of at-risk days to account for variation in the length of treatment protocols.
Influence of synchronous primary care telemedicine versus in-person visits on diabetes, hypertension, and hyperlipidemia outcomes: a systematic review
Authors: Mabeza Russyan Mark S. , Maynard Kahtrel , Tarn Derjung M.
Published: March 2022

Background

Telemedicine can be used to manage various health conditions, but there is a need to investigate its effectiveness for chronic disease management in the primary care setting. This study compares the effect of synchronous telemedicine versus in-person primary care visits on patient clinical outcomes.

Methods

A systematic review of studies published in PubMed and Web of Science between 1996 and January 2021 was performed using keywords related to telemedicine, diabetes, hypertension, and hyperlipidemia. Included studies compared synchronous telemedicine versus in-person visits with a primary care clinician, and examined outcomes of hemoglobin A1c (HbA1c), blood pressure, and/or lipid levels.

Results

Of 1724 citations screened, 7 publications met our inclusion criteria. Included studies were published between 2000 and 2018. Three studies were conducted in the United States, 2 in Spain, 1 in Sweden, and 1 in the United Kingdom. The telemedicine interventions investigated were multifaceted. All included synchronous visits with a primary care provider through videoconferencing and/or telephone, combined with other components such as asynchronous patient data transmission. Five studies reported on HbA1c changes, 5 on blood pressure changes, and 3 on changes in lipid levels. Compared to usual care with in-person visits, telemedicine was associated with greater reductions in HbA1c at 6 months and similar HbA1c outcomes at 12 months. Telemedicine conferred no significant differences in blood pressure and lipid levels compared to in-person clinic visits.

Conclusions

A systematic review of the literature found few studies comparing clinical outcomes resulting from synchronous telemedicine versus in-person office visits, but the existing literature showed that in the primary care setting, telemedicine was not inferior to in-person visits for the management of diabetes, hypertension, or hypercholesterolemia. These results hold promise for continued use of telemedicine for chronic disease management.
Association between health-related physical fitness and self-reported health status in older Taiwanese adults
Authors: Su Yan-Jhu , Hsu Chen-Te , Liang Chyi , Lee Po-Fu , Lin Chi-Fang , Chen Hung-Ting , Ho Chien-Chang
Published: March 2022

Background

Aging is an inevitable process of life development. These physical changes may cause a decline in the functional adaptability and health of older adults. This study aims to determine if an association exists between health-related physical fitness measurements and self-reported health status in older Taiwanese adults.

Methods

A total of 22,389 Taiwanese adults aged 65 years or older were recruited as study participants. Demographic characteristics, life habits, anthropometric assessments, health-related physical fitness measurements, and self-reported health status from this dataset were analyzed using the chi-square test, one-way analysis of variance, and logistic regression analysis.

Results

The results showed that there was significant association between back scratch and self-reported health status (excellent/good) (odds ratio [OR], 1.003; 95% CI 1.000–1.006) after adjusting potential confounders (gender, height, weight, body mass index, education, monthly income, marital status, smoking status, and chewing betel nuts). However, adjusted OR for unhealthy status (poor/very poor) significantly decreased for chair sit-and-reach test (OR 0.994, 95% CI 0.988–0.999).

Conclusions

The present study reveals significant associations between health-related physical fitness measurements and self-reported health status in older Taiwanese adults. In particular, the waist-to-hip ratio could be involved in the cognitive process of one’s subjective health status, since individuals’ perception of their physical appearance affects their self-reported health. Future researches are suggested to investigate the causality between health-related physical fitness and subjective health status.
Higher hemoglobin levels are associated with better physical performance among older adults without anemia: a longitudinal analysis
Authors: Corona Ligiana Pires , Andrade Flavia Cristina Drumond , da Silva Alexandre Tiago , de Brito Tábatta Renata Pereira , Nunes Daniella Pires , de Oliveira Duarte Yeda Aparecida
Published: March 2022

Background

Anemia is the most common hematological abnormality among older adults, and it is associated with decreased physical performance. But the role of hemoglobin in the absence of anemia remains unclear. Thus, this study aimed to assess the impact of hemoglobin levels on physical performance in Brazilian older adults without anemia.

Methods

The study is longitudinal in that it relies on two waves of the Saúde, Bem-Estar e Envelhecimento (SABE; Health, Well-being, and Aging) study: 2010 and 2015-2016. Mixed-effects linear regression was used to determine the effects of the hemoglobin concentrations on the Short Physical Performance Battery-SPPB over time among the 1,023 who had complete data and did not have anemia in 2010. In the follow-up, there were 567 without anemia.

Results

In analyses adjusted for age, education, comorbidities, body mass index, and physical inactivity, we found a differential association between hemoglobin concentration and SBBP by sex, with a positive interaction (β Hb*female= 0.20, 95% CI 0.04,0.37). At lower levels of hemoglobin, women have lower levels of SPPB than men, but at higher levels of hemoglobin concentration, there are no sex differences in physical performance. In addition, higher age was negatively associated with SPPB levels and cardiometabolic diseases, other diseases, and physical inactivity. Education was positively associated with physical performance.

Conclusion

Our study demonstrates that higher hemoglobin levels were associated with better physical performance among older adults without anemia in Brazil. However, there were sex differences in this association. This finding is important because, in clinical practice, most health professionals focus on the World Health Organization definition of anemia. Our study suggests the importance of hemoglobin levels among older adults, even those without anemia, and highlights sex differences.
Body mass index and 12-year mortality among older Mexican Americans aged 75 years and older
Authors: Jadhav Reshma , Markides Kyriakos S. , Al Snih Soham
Published: March 2022

Background

The role of obesity in mortality in the very old and old-oldest Hispanic population has not been studied. The objective of this study was to examine the effect of body mass index (BMI) on 12-year mortality among older Mexican Americans aged 75 years and older.

Methods

Twelve year prospective cohort study consisting of a population-based sample of 1415 non-institutionalized Mexican American men and women aged 75 and older from 5 southwestern states: Arizona, California, Colorado, New Mexico, and Texas. Data was from Wave 5 of the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004/2005–2016). Socio-demographics, body mass index (BMI), self-reported medical conditions, disability, depressive symptoms, falls, Mini-Mental-State-Examination (MMSE), and Short Physical Performance Battery (SPPB) were assessed at baseline during 2004–2005. BMI (Kg/m2) was classified as underweight (< 18.5), normal weight (18.5 to < 25), overweight (25 to < 30), obesity category I (30 to < 35), and obesity category II/morbid obesity (≥ 35). For assessment of mortality, deaths were ascertained through the National Death Index and report from relatives. Cox proportional hazards regression analysis was performed to estimate the hazard ratio (HR) of 12-year mortality as a function of BMI categories at baseline.

Results

The mean BMI was 27.5 ± 1.7 with participants classified as 1.8% underweight, 30.8% normal weight, 39.2% overweight, 20.7% obesity category I, and 7.6% obesity category II/morbid obesity. Mexican Americans aged ≥75 years with overweight or obesity category I had a reduced HR of death (0.82, 95% CI = 0.70–0.96 and 0.75, 95% CI = 0.62–0.91, respectively) over 12-years of follow-up. The HR of death for underweight and obesity category II/morbid obesity participants was 1.59 (95% CI = 1.03–2.45) and 1.12 (95% CI = 0.85–1.46), respectively. Female participants and those with high scores in the MMSE and SPPB had decreased risk of death.

Conclusions

This study showed the protective effect of overweight and obesity on mortality in Mexican Americans above 75 years of age, which might have implications when treating older adults with overweight and obesity.
Octogenarian patients with colon cancer – postoperative morbidity and mortality are the major challenges
Authors: Høydahl Øystein , Edna Tom-Harald , Xanthoulis Athanasios , Lydersen Stian , Endreseth Birger Henning
Published: March 2022

Background

Few studies have addressed colon cancer surgery outcomes in an unselected cohort of octogenarian patients. The present study aimed to evaluate the relative survival of octogenarian patients after a major resection of colon cancer with a curative intent.

Methods

All patients diagnosed with colon cancer at Levanger Hospital between 1980 and 2016 were included. We performed logistic regression to test for associations between 90-day mortality and explanatory variables. We performed a relative survival analysis to identify factors associated with short- and long-term survival.

Results

Among 237 octogenarian patients treated with major resections with curative intent, the 90-day mortality was 9.3%. Among 215 patients that survived the first 90 days, the 5 year relative survival rate was 98.7%. The 90-day mortality of octogenarian patients was significantly higher than that of younger patients, but the long-term survival converged with that of younger patients. Among octogenarian patients, the incidence of colon cancer more than doubled during our 37-year observation period. The relative increase in patients undergoing surgery exceeded the increase in incidence; hence, more patients were selected for surgery over time. A high 90-day mortality was associated with older age, a high American Society of Anaesthesiologists (ASA) score, and emergency surgery. Moreover, worse long-term survival was associated with a high Charlson Comorbidity Index, a high ASA score, a worse TNM stage, emergency surgery and residual tumours. Both the 90-day and long-term survival rates improved over time.

Conclusion

Among octogenarian patients with colon cancer that underwent major resections with curative intent, the 90-day mortality was high, but after surviving 90 days, the relative long-term survival rate was comparable to that of younger patients. Further improvements in survival will primarily require measures to reduce the 90-day mortality risk.
Correlation of LAGE3 with unfavorable prognosis and promoting tumor development in HCC via PI3K/AKT/mTOR and Ras/RAF/MAPK pathways
Authors: Li Yun , Xiong Hui
Published: March 2022

Background

Hepatocellular carcinoma (HCC) is one of the most common clinical malignancies quite susceptible to recurrence and metastasis. Despite several improvements in therapeutic approaches, the prognosis remains poor due to the limited treatment options. A bioinformatics analysis based on TCGA databases revealed that the recombinant human L antigen family member 3 (LAGE3) might function as an effective prognostic and diagnostic biomarker for HCC, as LAGE3, a protein-coding gene, maintains several important biological functions and has a physiological significance in the CTAG family while simultaneously being involved in regulating the occurrence and invasion of numerous types of tumors. However, the LAGE3 gene’s functional and regulatory mechanism in the progression of HCC remains unclear.

Methods

The LAGE3 level was investigated in 79 HCC tissues cases, ten HCC adjacent tissue cases, and six cases of normal liver tissues by IHC, while the LAGE3 level was evaluated in BEL-7404, SMCC-7721, Huh-7, HepG2, and MIHA cell lines by qRT-PCR and Western blot tests. Although the proliferation, migration, invasion, and apoptotic abilities of HCC cells were measured in vitro after silencing assay to probe the role of LAGE3 in HCC cells, the tumor xenograft growth experiment was used to verify the in vivo effect of LAGE3 gene knockdown on the growth of HCC tumors combined with bioinformatics analysis to study the LAGE3 mechanisms regulating HCC proliferation.

Results

Our results implied that LAGE3 was extensively expressed in HCC cell lines like BEL-7404, SMCC-7721, and Huh-7 cells as well as HCC tissues, but a lower expression was observed in HepG2 cells. Additionally, LAGE3 restrains cellular proliferation, promotes apoptotic pathways in HCC cells, and inhibits the growth of HCC tumors in vivo. Lastly, it was stated that LAGE3 might promote tumor development in HCC via PI3K/AKT/mTOR and Ras/RAF/MAPK pathways.

Conclusion

This study shows that the development of specific LAGE3 target drugs might become new effective treatment modalities for HCC patients.
Risk of developing depression among breast cancer patients in Palestine
Authors: Sadaqa Dana , Farraj Ahlam , Naseef Hani , Alsaid Hamza , Al-Shami Nimeh , AbuKhalil Abdallah Damin
Published: March 2022

Background

Breast cancer (BC) is the most common cancer among women. Studies have shown that cancer patients can develop depression impacting their quality of life, treatment outcomes, and survival rates. This study aimed to determine the risk factors, severity and prevalence of depression among females diagnosed with BC in multiple hospitals across Palestine.

Methods

A cross-sectional study was conducted at different cancer treatment centers in Palestine using a previously developed questionnaire consisting of 23 questions to assess the severity of major depressive disorder among females diagnosed with breast cancer. The Patient Health Questionnaire-9 (PHQ-9) was included in the questionnaire.

Results

Out of 223 respondents, 79 (35.4%) have developed moderate to severe depression. Chi-square results revealed that the risk of developing moderate to severe depression was higher among females who suffer from side-effects related to BC treatment (P < 0.011), females who knew the BC stage at the diagnosis step (P < 0.031), and negative implications on BC patients in Palestine (P < 0.009).

Conclusion

Breast cancer patients have an increased risk of developing major depressive disorder. Patient assessment and treatment for depression at the time of BC diagnosis, during the treatment journey, and monitoring after treatment completion is essential for patient quality of life and BC treatment outcomes.
Gender differences in outpatients with dementia from a large psychiatric hospital in China
Authors: Zhou Jiaojiao , Guo Chengwei , Ren Li , Zhu Dandi , Zhen Wenfeng , Zhang Saina , Zhang Qing’e
Published: March 2022

Background

The sociodemographic characteristics and clinical features of dementia patients in psychiatric hospitals have not been thoroughly studied in China. This study aimed to explore the psychiatric outpatient attendance of dementia patients at a psychiatric hospital in China, with particular emphasis on gender differences.

Methods

This retrospective study examined outpatients with dementia from January 2013 to August 2019 using data in the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) in Beijing Anding Hospital. Age, sex, number of visits, use of drugs and comorbid conditions were extracted from medical records.

Results

Nine thousand four patients were recruited from a specific outpatient clinic of a hospital in Beijing, and the mean number of visits was 6.92. There were 3,433 (38.13%) male patients and 5,571 (61.87%) female patients. The most common comorbidities were generalized anxiety disorder, nonorganic insomnia, delusional disorder and depressive disorder. The proportion of patients using antidementia was the highest, with the rate of 68.3%, followed by benzodiazepines (48.83%), antipsychotics (45.43%), antidepressants (22.24%) and nonbenzodiazepines (19.96%). Patients with dementia showed a significant gender difference in average age (t = 6.36, P < 0.0001). Compared to male patients, female patients had a higher number of visits (7.40 ± 12.90 vs 6.15 ± 10.50, t = 4.81, P < 0.0001). There were significant differences in comorbidity composition between male and female patients (t = 23.09, P < 0.0001).

Conclusions

Our present findings suggested significant gender differences in the proportion of age, number of visits and comorbidity composition in outpatients with dementia.
Understanding how social support influences peer-delivered HIV prevention interventions among Ugandan female sex workers: a case study from HIV self-testing
Authors: McGowan Maureen , Roche Stephanie D. , Nakitende Aidah , Wachinger Jonas , Nanyiri Esther , Amongin Jocelyn , Nakabuye Ajiri , Musoke Daniel Kibuuka , McMahon Shannon A. , Bӓrnighausen Till , Ortblad Katrina F.
Published: March 2022

Background

Female sex workers (FSWs) have tightly connected peer networks and remain at high risk of HIV acquisition. Peer delivery of HIV prevention interventions, such as HIV self-testing (HIVST), is a recommended implementation strategy for increasing intervention uptake and continuation among FSWs. We analyzed qualitative data from a peer-delivered HIVST intervention among FSWs in urban Uganda to understand the ways social support within this peer network can motivate or discourage the uptake of peer-delivered HIVST.

Methods

Between February and April 2017, we conducted in-depth interviews (IDIs) with FSWs (n = 30) and focus group discussions (FGDs) with FSW peer educators (PEs, n = 5) finishing participation in a four-month randomized implementation trial testing models of peer-delivered HIVST in Kampala. FSW participants were ≥ 18 years old, self-reported exchanging sex for money or goods (past month) and had not recently tested for HIV (past 3 months). FSW PEs either directly distributed HIVST kits to participants or provided coupons exchangeable for HIVST kits from specified healthcare facilities. In the IDIs and FGDs, we asked participants to share their experiences receiving or delivering peer-delivered HIVST, respectively. Using a hybrid deductive and inductive coding approach, we arranged findings along the dimensions of an established social support theory: informational, instrumental, and emotional support.

Results

The median age of participants was 30 years (IQR: 27–33) and PEs was 33 years (IQR: 29–37). We found that social support within FSW peer networks both motivated and discouraged uptake of peer-delivered HIVST. For example, sharing positive HIVST experiences (informational support), directly delivering HIVST kits (instrumental support), and encouraging linkage to care (emotional support) motivated HIVST uptake among FSWs. Conversely, the spread of misinformation (informational support), limited HIVST kit availability fostering mistrust of PEs (instrumental support), and fear of social exclusion following HIV status disclosure (emotional support) discouraged HIVST uptake among FSWs.

Conclusions

In Uganda, social support (e.g., informational, instrumental, and emotional support) among FSW peers can work in ways that both motivate and discourage peer-delivered intervention uptake. Future FSW peer-delivered HIV prevention interventions should be designed around the dimensions of social support within FSW peer networks to maximize initial and repeat intervention delivery and uptake.