bluuebunny/crossref_metadata_2025 huggingface dataset:
Design of a Real-Time Physical Activity Detection and Classification Framework for Individuals With Type 1 Diabetes
Authors: Cho Sunghyun , Aiello Eleonora M. , Ozaslan Basak , Riddell Michael C. , Calhoun Peter , Gal Robin L. , Doyle Francis J.
Published: February 2023

Background:

Managing glycemia during and after exercise events in type 1 diabetes (T1D) is challenging since these events can have wide-ranging effects on glycemia depending on the event timing, type, intensity. To this end, advanced physical activity-informed technologies can be beneficial for improving glucose control.

Methods:

We propose a real-time physical activity detection and classification framework, which builds upon random forest models. This module automatically detects exercise sessions and predicts the activity type and intensity from tri-axial accelerometer, heart rate, and continuous glucose monitoring records.

Results:

Data from 19 adults with T1D who performed structured sessions of either aerobic, resistance, or high-intensity interval exercise at varying times of day were used to train and test this framework. The exercise onset and completion were both predicted within 1 minute with an average accuracy of 81% and 78%, respectively. Activity type and intensity were identified within 2.38 minutes and from the exercise onset. On participants assigned to the test set, the average accuracy for activity type and intensity classification was 74% and 73%, respectively, if exercise was announced. For unannounced exercise events, the classification accuracy was 65% for the activity type and 70% for its intensity.

Conclusions:

The proposed module showed high performance in detection and classification of exercise in real-time within a minute of exercise onset. Integration of this module into insulin therapy decisions can help facilitate glucose management around physical activity.
A Preliminary Study in Immune Response of BALB/c and C57BL/6 Mice with a Locally Allergic Rhinitis Model
Authors: Zhang Qidi , Zhu Wanting , Zou Zhixin , Yu Wenting , Gao Pei , Wang Ying , Chen Jianjun
Published: February 2023

Background

BALB/c and C57BL/6 mouse strains are commonly used in allergy research. The current study investigated the immunological differences between these two mouse strains with a locally allergic rhinitis model.

Methods

Eighteen BALB/c and eighteen C57BL/6 mice received different doses of ovalbumin (OVA) intranasally for eight weeks (each mouse strain has three subgroups, 25 mg/mL group, 0.25 mg/mL group, and the PBS group). The allergic symptoms, OVA-specific serum antibody (IgE, IgG1, IgG2a), cytokines (IL-4, IFN-γ, IL-10) in the splenic culture supernatant, infiltrating eosinophils and goblet cells in local nasal mucosa were measured. RNA-seq technology was applied to detect differential gene expression in the local nasal mucosa.

Results

With the same dose of OVA stimulation, the exacerbation of allergic symptoms was more pronounced in C57BL/6 than in BALB/c. BALB/c serum IgE, IgG1, and IgG2a gradually increased, and C57BL/6 produced fewer serum antibodies IgE and IgG1, while IgG2a never increased. BALB/c spleen cell culture supernatant IL-4 and IL-10 increased with increasing dose, and IFN-γ increased significantly in the intermediate dose group, while IL-4, IL-10, and IFN-γ did not increase in C57BL/6. The infiltration of eosinophils and goblet cells in both mice was proportional to the dose, while C57BL/6 was elevated more than BALB/c. RNA-seq suggested that the innate immune response, immune system process function, Jun kinase (JNK) pathway, and MAPKK pathway were upregulated in C57BL/6 compared to BALB/c. The core genes responsible for the differential immune response in both mice with allergic rhinitis were Kng2, Kng1, Gnb3, Lpar3, Lpar1, Pik3r1, Pf4, Apob, Rps9, and Fbxo2.

Conclusion

There are significant differences in the immunologic responses between BALB/c mice and C57BL/6 mice. BALB/c mice developed mild local allergic inflammatory reactions and strong systemic immune responses. In contrast, C57BL/6 mice had stronger local allergic inflammatory responses and relatively mild systemic immune responses. Different mice strains can be selected according to the research purpose.
The efficacy of telemedicine for pain management in patients with cancer: a systematic review and meta-analysis
Authors: Chen Wenyu , Huang Jie , Cui Zhifang , Wang Lei , Dong Liang , Ying Weifeng , Zhang Ye
Published: February 2023

Background:

Pain is the most common cancer-related symptom, but it is often undertreated. Telemedicine is widely used in cancer treatment, but its effectiveness is uncertain.

Objective:

We aimed to evaluate the impact of telemedicine intervention on pain in patients with cancer.

Design:

Methodological quality and risk-of-bias evaluation were conducted, and the sources of heterogeneity were explored through subgroup analysis and sensitivity analysis.

Data Sources and Methods:

PubMed, Embase, Web of Science, Cochrane Library, and clinical trial databases were searched up to 16 August 2022. Randomized controlled trials of the impact of telemedicine intervention regarding pain in patients with cancer were included, and the results related to pain were extracted.

Results:

Twenty-one randomized controlled trials were selected from 1810 articles. A total of 1454 patients received telemedicine interventions, and 2213 received conventional medical services. Telemedical intervention had a positive effect on improving pain intensity [standard mean deviation (SMD) = −0.28, 95% confidence interval (CI): −0.49 to −0.06, p = 0.01] and pain interference (SMD = −0.41, 95% CI: −0.54 to −0.28, p < 0.00001), with statistical difference between the two groups. The subgroup analysis results showed that the telemedicine subgroup based on an application (SMD = −0.54, 95% CI: −0.91 to −0.18, p = 0.004) and the subgroup with intervention time ⩾ 6 months (SMD = −0.33, 95% CI: −0.52 to −0.13, p = 0.001), both demonstrated significant improvement regarding pain intensity, with significant statistical difference between the two groups. When the follow-up time was ⩾ 6 months, there was no significant difference (SMD = −0.24, 95% CI: −0.55 to 0.07, p = 0.13).

Conclusion:

Compared with conventional medical services, telemedicine intervention can improve the pain of patients with cancer and is effective and acceptable regarding symptom monitoring. Integrating telemedicine interventions into cancer pain management may be a feasible option. But its long-term effects still need to be confirmed with more high-quality randomized controlled trials in the future.

Registration:

https://www.crd.york.ac.uk/PROSPERO/ ; CRD42022361990
Axonal and myelin changes and their inter-relationship in the optic radiations in people with multiple sclerosis
Authors: Krijnen Eva A. , Ngamsombat Chanon , George Ilena C. , Yu Fang F. , Fan Qiuyun , Tian Qiyuan , Huang Susie Y. , Klawiter Eric C.
Published: February 2023

Background

The imaging g-ratio, estimated from axonal volume fraction (AVF) and myelin volume fraction (MVF), is a novel biomarker of microstructural tissue integrity in multiple sclerosis (MS).

Objective

To assess axonal and myelin changes and their inter-relationship as measured by g-ratio in the optic radiations (OR) in people with MS (pwMS) with and without previous optic neuritis (ON) compared to healthy controls (HC).

Methods

Thirty pwMS and 17 HCs were scanned on a 3Tesla Connectom scanner. AVF and MVF, derived from a multi-shell diffusion protocol and macromolecular tissue volume, respectively, were measured in normal-appearing white matter (NAWM) and lesions within the OR and used to calculate imaging g-ratio.

Results

OR AVF and MVF were decreased in pwMS compared to HC, and in OR lesions compared to NAWM, whereas the g-ratio was not different. Compared to pwMS with previous ON, AVF and g-ratio tended to be higher in pwMS without prior ON. AVF and MVF, particularly in NAWM, were positively correlated with retinal thickness, which was more pronounced in pwMS with prior ON.

Conclusion

Axonal measures reflect microstructural tissue damage in the OR, particularly in the setting of remote ON, and correlate with established metrics of visual health in MS.
Factors Influencing Hearing Help-Seeking and Hearing Aid Uptake in Adults: A Systematic Review of the Past Decade
Authors: Knoetze Megan , Manchaiah Vinaya , Mothemela Bopane , Swanepoel De Wet
Published: February 2023

This systematic review examined the audiological and nonaudiological factors that influence hearing help-seeking and hearing aid uptake in adults with hearing loss based on the literature published during the last decade. Peer-reviewed articles published between January 2011 and February 2022 were identified through systematic searches in electronic databases CINAHL, PsycINFO, and MEDLINE. The review was conducted and reported according to the PRISMA protocol. Forty-two articles met the inclusion criteria. Seventy (42 audiological and 28 nonaudiological) hearing help-seeking factors and 159 (93 audiological and 66 nonaudiological) hearing aid uptake factors were investigated with many factors reported only once (10/70 and 62/159, respectively). Hearing aid uptake had some strong predictors (e.g., hearing sensitivity) with others showing conflicting results (e.g., self-reported health). Hearing help-seeking had clear nonpredictive factors (e.g., education) and conflicting factors (e.g., self-reported health). New factors included cognitive anxiety associated with increased help-seeking and hearing aid uptake and urban residency and access to financial support with hearing aid uptake. Most studies were rated as having a low level of evidence (67%) and fair quality (86%). Effective promotion of hearing help-seeking requires more research evidence. Investigating factors with conflicting results and limited evidence is important to clarify what factors support help-seeking and hearing aid uptake in adults with hearing loss. These findings can inform future research and hearing health promotion and rehabilitation practices.
Growth Anthropometrics as a Metric of Malnutrition Disparities Among Young Children Affected by HIV who are Orphaned Maternally, Paternally, or Totally in Western Kenya: A Retrospective Chart Review
Authors: Jansen Shae , Apondi Edith , Ayaya Samuel O. , Kim Jiae , McHenry Megan S.
Published: February 2023

This retrospective study investigated growth outcomes of Kenyan children born to women living with HIV, comparing children who were orphaned maternally, paternally, and totally (both parents deceased) to those who were non-orphaned. We reviewed HIV clinic visits performed in Kenya from January 2011 to August 2016 in children 0 to 4 years of age. Malnutrition was assessed using stunting, underweight status, and wasting ( z-scores of ≤−2). Descriptive statistics, Chi-square, t-tests, multivariable logistic regression, and ANCOVA models were performed. Of 15 027 total children in the study population, 3.5% (n = 520) were orphaned maternally, 8.1% (n = 1222) were orphaned paternally, and 2.2% (n = 336) were orphaned totally. Children who were orphans had higher rates of malnutrition compared to non-orphans ( P < .001). Children who were orphaned maternally and totally had lower anthropometric mean scores, presented to clinic later, and were more likely to be living with HIV. Children who are orphaned maternally or totally should be targeted in interventional strategies.
Differentials in the Prevalence of Acute Respiratory Infections Among Under-Five Children: An Analysis of 37 Sub-Saharan Countries
Authors: Ekholuenetale Michael , Nzoputam Chimezie Igwegbe , Okonji Osaretin Christabel , Barrow Amadou , Wegbom Anthony Ike , Edet Clement Kevin
Published: February 2023

Objective

We investigated the prevalence and risk factors of ARI in children under 5 years old in 37 SSA countries.

Methods

Data from Demographic and Health Survey (DHS) of 37 African countries was examined in this analysis. Data from children under the age of 5 years old were examined. Forest plot was used to identify disparities in the occurrence of ARIs across SSA countries.

Results

We observed a higher prevalence of ARI among children under 5 in Uganda, Kenya, Sao Tome and Principe (9% each), Gabon, Chad, Eswatini (8% each), Burundi, Ethiopia, Congo Democratic Republic (7.0% each). The prevalence of ARI among under-five children who sought medical advice/treatment from health facility was higher in South Africa (88%), Sierra Leone (86%), Tanzanian (85%), Guinea (83%) and Uganda (80%). The prevalence rate of ARI among under-five children who received antibiotics was higher in Tanzania (61%), Sao Tome and Principe (60%), Rwanda and Congo (58% each), Angola (56.0%), Mozambique (54.0%), Kenya (53.0%), Namibia (52.0%) and Gabon (50.0%). This study found that the household wealth index, maternal education, and urban residence were significantly associated with ARI (p <0.001). A higher prevalence of ARI was observed among urban residents, low income families, and those with mothers with lower education.

Conclusion

ARI prevalence could be reduced by improving household socioeconomic status, child nutrition and community awareness of indoor and outdoor pollution. Interventions and programs focused on early diagnosis, treatment and prevention of ARIs are crucial in reducing ARIs particularly in developing countries.
Knowledge, Attitude, and Practice of Nurses Toward the Initial Managements of Acute Poisoning in Public Hospitals of Bahir Dar City, Northwest Ethiopia 2022: Cross-Sectional Study
Authors: Adal Ousman , Hiamanot Yigremew , Zakir Abdulkadir , Regassa Redeat , Gashaw Asnake
Published: February 2023

Introduction

Poisoning is a common cause of medical visits and hospitalizations around the world. The knowledge, attitude, and practice of nurses in the management of acute poisoning are very poor in developing countries, such as Ethiopia. According to the previous study, 75% and 45% of nurses had unsatisfactory knowledge and practice, respectively.

Objectives

This study aimed to assess the knowledge, attitude, and practice of nurses toward the initial management of acute poisoning.

Method

An institution-based cross-sectional study design was used to recruit 422 nurses from public hospitals of Bahir Dar city in Ethiopia. A systematic random sampling method and an English version of self-administered questionnaires were used to collect the data. The data were entered into Epi Data and analyzed using SPSS version 25.

Results

The study recruited 422 nurses, with a response rate of 100%; 248 (58.8%) and 264 (62.2%) of the nurses had good knowledge and practice, respectively. Slightly more than half (57.6%) of the nurses had a positive attitude. Nurses who worked in an emergency and intensive care unit had twice the odds of having more knowledge and practice than those who worked in an outpatient department (AOR = 2.1, CI: (1.019, 4.540), p = 0.001). Nurses who have MSc degree were twice (AOR = 2.1, CI: (1.019, 4.540), p = 0.001) and three times (AOR = 3.1, CI: (1.012, 7.140), p = 0.002) to have good knowledge and practice than those who have a diploma.

Conclusion

Slightly more than half of nurses had good knowledge, practice, and a positive attitude. Educational status, working in an emergency department, and having training in poison management have been significantly associated with the knowledge and practice of nurses. The authors recommended that there is a need to empower the attitude, knowledge, and practice of nurses through consistent training, accessing, and updating guidelines (poisoning management protocol). The author also suggested that the poison management protocol be incorporated into the Ethiopian nursing curriculum (certificates).
Estimating the prevalence of primary headache disorders in university students: Application of the Croatian version of the HARDSHIP questionnaire
Authors: Jakuš Lukrecija , Mahović Darija , Jokić Claire Alexandra Sangster , Bračić Matea , Jurak Ivan
Published: February 2023

Background:

Studies reporting the prevalence of headaches in Croatia have methodological differences that make it difficult to consolidate their results. This study aimed to assess the prevalence of the most common primary headaches in a student population using the standardized HARDSHIP questionnaire (in Croatian).

Methods:

This cross-sectional epidemiological study collected data regarding the 1-year prevalence of headaches in a student population using the diagnostic algorithm of the HARDSHIP questionnaire. The chi-squared test was used to analyze gender differences, and Cramer’s V was used for effect size interpretation.

Results:

The questionnaire was administered to 1350 university students enrolled in health profession programs (81.3% female; 18.7% male; average age: 23 years). The 1-year prevalence of migraine was 38.9% (male: female ratio, 1:1.5), and that of tension-type headache was 35.6% (male: female ratio, 1:0.9). Overall, 91.0% of participants responded positively to the question regarding the incidence of headache in the past 12 months.

Conclusions:

We report a high prevalence of primary headaches among students of health professions in Croatia. The differences in prevalence may be attributed to various sociocultural, geographical, genetic, and methodological differences. Population-specific studies may facilitate a more accurate assessment of headache prevalence and enable more effective targeting of public health activities.
A flexible ultra-highly sensitive capacitive pressure sensor for basketball motion monitoring
Authors: Gao Huijie , Chen Tiangeng
Published: February 2023

Recently, flexible sensors with high sensitivity have been applied in wearable sports sensing field. Here, we reported a flexible and sensitive capacitive pressure sensor based on nylon textile and polyvinylidene fluoride (PVDF) dielectric film. From the experimental results, the sensor has an extremely high sensitivity of 33.5 kPa−1, a low detection limit of 0.84 Pa, a quick response time of 27 ms. Moreover, the pressure sensor shows excellent reliability under over 100,000 working cycles. With their superior overall performance, capacitive sensors have effectively proved their enormous potential for basketball motion monitoring. This research will promote the development of wearable sports sensors.
A review on microfluidic-assisted nanoparticle synthesis, and their applications using multiscale simulation methods
Authors: Agha Abdulrahman , Waheed Waqas , Stiharu Ion , Nerguizian Vahé , Destgeer Ghulam , Abu-Nada Eiyad , Alazzam Anas
Published: February 2023

Recent years have witnessed an increased interest in the development of nanoparticles (NPs) owing to their potential use in a wide variety of biomedical applications, including drug delivery, imaging agents, gene therapy, and vaccines, where recently, lipid nanoparticle mRNA-based vaccines were developed to prevent SARS-CoV-2 causing COVID-19. NPs typically fall into two broad categories: organic and inorganic. Organic NPs mainly include lipid-based and polymer-based nanoparticles, such as liposomes, solid lipid nanoparticles, polymersomes, dendrimers, and polymer micelles. Gold and silver NPs, iron oxide NPs, quantum dots, and carbon and silica-based nanomaterials make up the bulk of the inorganic NPs. These NPs are prepared using a variety of top-down and bottom-up approaches. Microfluidics provide an attractive synthesis alternative and is advantageous compared to the conventional bulk methods. The microfluidic mixing-based production methods offer better control in achieving the desired size, morphology, shape, size distribution, and surface properties of the synthesized NPs. The technology also exhibits excellent process repeatability, fast handling, less sample usage, and yields greater encapsulation efficiencies. In this article, we provide a comprehensive review of the microfluidic-based passive and active mixing techniques for NP synthesis, and their latest developments. Additionally, a summary of microfluidic devices used for NP production is presented. Nonetheless, despite significant advancements in the experimental procedures, complete details of a nanoparticle-based system cannot be deduced from the experiments alone, and thus, multiscale computer simulations are utilized to perform systematic investigations. The work also details the most common multiscale simulation methods and their advancements in unveiling critical mechanisms involved in nanoparticle synthesis and the interaction of nanoparticles with other entities, especially in biomedical and therapeutic systems. Finally, an analysis is provided on the challenges in microfluidics related to nanoparticle synthesis and applications, and the future perspectives, such as large-scale NP synthesis, and hybrid formulations and devices.

Graphical abstract
Impact of bystander cardiopulmonary resuscitation on neurological outcomes in patients undergoing veno-arterial extracorporeal membrane oxygenation
Authors: Shimai Ryosuke , Ouchi Shohei , Miyazaki Tetsuro , Hirabayashi Koji , Abe Hiroshi , Yabe Kosuke , Kakihara Midori , Maki Masaaki , Isogai Hiroyuki , Wada Takeshi , Ozaki Dai , Yasuda Yuki , Odagiri Fuminori , Takamura Kazuhisa , Yaginuma Kenji , Yokoyama Ken , Tokano Takashi , Minamino Tohru
Published: February 2023

Background

Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) requires a large amount of economic and human resources. The presence of bystander cardiopulmonary resuscitation (CPR) was focused on selecting appropriate V-A ECMO candidates.

Result

This study retrospectively enrolled 39 patients with V-A ECMO due to out-of-hospital cardiac arrest (CA) between January 2010 and March 2019. The introduction criteria of V-A ECMO included the following: (1) < 75 years old, (2) CA on arrival, (3) < 40 min from CA to hospital arrival, (4) shockable rhythm, and (5) good activity of daily living (ADL). The prescribed introduction criteria were not met by 14 patients, but they were introduced to V-A ECMO at the discretion of their attending physicians and were also included in the analysis. Neurological prognosis at discharge was defined using The Glasgow-Pittsburgh Cerebral Performance and Overall Performance Categories of Brain Function (CPC). Patients were divided into good or poor neurological prognosis (CPC ≤ 2 or ≥ 3) groups (8 vs. 31 patients). The good prognosis group had a significantly larger number of patients who received bystander CPR (p = 0.04). The mean CPC at discharge was compared based on the combination with the presence of bystander CPR and all five original criteria. Patients who received bystander CPR and met all original five criteria showed significantly better CPC than patients who did not receive bystander CPR and did not meet some of the original five criteria (p = 0.046).

Conclusion

Considering the presence of bystander CPR help in selecting the appropriate candidate of V-A ECMO among out-of-hospital CA cases.
Sustainable mobility strategies deconstructed: a taxonomy of urban vehicle access regulations
Authors: Fransen Koos , Versigghel Jente , Guzman Vargas Daniel , Semanjski Ivana , Gautama Sidharta
Published: February 2023

Background

In recent decades, cities worldwide are increasingly adopting vehicle access policies and technologies to alleviate the negative externalities related to high car use in the urban built environments. As such, car-oriented infrastructures and mobility policies implemented post-World War II are giving way to sustainable mobility strategies that aim to make cities healthier, more livable and more inclusive for all.

Purpose

Most of these strategies are considered as stand-alone cases related to a specific environmental, political and social urban context. However, similarities and patterns between different strategies can provide information on the replicability of mobility strategies in other urban contexts.

Methods

Through a literature review, this paper illustrates the wide range of urban vehicle access regulations (UVAR) applied within sustainable mobility strategies. In addition, we critically examine the process from ideation over design and implementation to operation phase for 12 West-European cities and define what measures are combined to end up with a sustainable mobility strategy.

Results

This results in a taxonomy of UVAR interventions, subdivided in three categories: spatial interventions, pricing aspects and regulatory measures. We also highlight a number of complementary supportive measures implemented to counter the often restrictive nature of UVAR.

Results

The paper shows that the strategies highlighted in the case studies are an amalgam of different UVAR and supportive measures. As such, deconstructing various sustainable mobility strategies enables us to shed light on the available UVAR options cities can combine to define consistent and robust sustainable mobility strategies.
LincRNA ZNF529-AS1 inhibits hepatocellular carcinoma via FBXO31 and predicts the prognosis of hepatocellular carcinoma patients
Authors: Ma Yang , Sun Wan-liang , Ma Shuo Shuo , Zhao Guanru , Liu Zhong , Lu Zheng , Zhang Dengyong
Published: February 2023

Background

Invasion and metastasis of hepatocellular carcinoma (HCC) is still an important reason for poor prognosis. LincRNA ZNF529-AS1 is a recently identified tumour-associated molecule that is differentially expressed in a variety of tumours, but its role in HCC is still unclear. This study investigated the expression and function of ZNF529-AS1 in HCC and explored the prognostic significance of ZNF529-AS1 in HCC.

Methods

Based on HCC information in TCGA and other databases, the relationship between the expression of ZNF529-AS1 and clinicopathological characteristics of HCC was analysed by the Wilcoxon signed-rank test and logistic regression. The relationship between ZNF529-AS1 and HCC prognosis was evaluated by Kaplan‒Meier and Cox regression analyses. The cellular function and signalling pathways involved in ZNF529-AS1 were analysed by GO and KEGG enrichment analysis. The relationship between ZNF529-AS1 and immunological signatures in the HCC tumour microenvironment was analysed by the ssGSEA algorithm and CIBERSORT algorithm. HCC cell invasion and migration were investigated by the Transwell assay. Gene and protein expression were detected by PCR and western blot analysis, respectively.

Results

ZNF529-AS1 was differentially expressed in various types of tumours and was highly expressed in HCC. The expression of ZNF529-AS1 was closely correlated with the age, sex, T stage, M stage and pathological grade of HCC patients. Univariate and multivariate analyses showed that ZNF529-AS1 was significantly associated with poor prognosis of HCC patients and could be an independent prognostic indicator of HCC. Immunological analysis showed that the expression of ZNF529-AS1 was correlated with the abundance and immune function of various immune cells. Knockdown of ZNF529-AS1 in HCC cells inhibited cell invasion and migration and inhibited the expression of FBXO31.

Conclusion

ZNF529-AS1 could be a new prognostic marker for HCC. FBXO31 may be the downstream target of ZNF529-AS1 in HCC.
CHARMS and PROBAST at your fingertips: a template for data extraction and risk of bias assessment in systematic reviews of predictive models
Authors: Fernandez-Felix Borja M. , López-Alcalde Jesus , Roqué Marta , Muriel Alfonso , Zamora Javier
Published: February 2023

Background

Systematic reviews of studies of clinical prediction models are becoming increasingly abundant in the literature. Data extraction and risk of bias assessment are critical steps in any systematic review. CHARMS and PROBAST are the standard tools used for these steps in these reviews of clinical prediction models.

Results

We developed an Excel template for data extraction and risk of bias assessment of clinical prediction models including both recommended tools. The template makes it easier for reviewers to extract data, to assess the risk of bias and applicability, and to produce results tables and figures ready for publication.

Conclusion

We hope this template will simplify and standardize the process of conducting a systematic review of prediction models, and promote a better and more comprehensive reporting of these systematic reviews.
Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic review
Authors: Nilsen Anita , Lichtwarck Bjørn , Eriksen Siren , Mork Rokstad Anne Marie
Published: February 2023

Background

The coronavirus 2019 (COVID-19) pandemic has led to a high rate of infections, frequent outbreaks, and high mortality rates in nursing homes (NH) worldwide. To protect and improve the treatment and care of the vulnerable NH population, it is pivotal to systematise and synthesise data from cases of COVID-19 among NH residents. In our systematic review, we therefore aimed to describe the clinical expressions, characteristics, and treatments of NH residents confirmed to have COVID-19.

Methods

We conducted two comprehensive literature searches in several electronic databases: (1) PubMed, (2) CINAHL, (3) AgeLine, (4) Embase, and (5) PsycINFO in April and July 2021. Of the 438 articles screened, 19 were included in our sample, and we used the Newcastle–Ottawa Assessment Scale to assess the quality of the reported studies. A weighted mean (Mweighted), was calculated to account for the large variation in sample sizes of the studies, and due to heterogeneity among the studies, we report our findings in a narrative synthesis.

Results

According to the mean weights (Mweighted), common symptoms and signs in NH residents confirmed to have COVID-19 were fever (53.7%), cough (56.5%), hypoxia (32.3%), and delirium or confusion (31.2%). Common comorbidities were hypertension (78.6%), dementia or cognitive impairment (55.3%), and cardiovascular diseases (52.0%). Six studies presented data concerning medical and pharmacological treatments, such as inhalers, oxygen supplementation, anticoagulation, and parenteral/enteral fluids or nutrition. The treatments were used to improve outcomes, as part of palliative care, or as end-of-life treatment. Transfers to hospital for NH residents with confirmed COVID-19 were reported in six of the included studies, and the rate of hospital transfers ranged from 6.9% to 50% in this population. In the 17 studies reporting mortality, 40.2% of the NH residents died during the studies’ observation periods.

Conclusions

Our systematic review allowed us to summarise important clinical findings about COVID-19 among NH residents and to identify the population’s risk factors for serious illness and death caused by the disease. However, the treatment and care of NH residents with severe COVID-19 warrant further investigation.
Injectable long acting antiretroviral for HIV treatment and prevention: perspectives of potential users
Authors: Slama Laurence , Porcher Raphael , Linard Françoise , Chakvetadze Catherine , Cros Agnès , Carillon Séverine , Gallardo Lucille , Viard Jean-Paul , Molina Jean-Michel
Published: February 2023

Background

The use of long acting injectable (LAA) antiretroviral drugs may be an alternative option for HIV treatment and prevention. Our study focused on patient perspectives to understand which individuals, among people with HIV (PWH) and pre-exposure prophylaxis (PrEP) users, would constitute the preferential target for such treatments in terms of expectations, tolerability, adherence and quality of life.

Methods

The study consisted in one self-administrated questionnaire. Data collected included lifestyle issues, medical history, perceived benefits and inconveniences of LAA. Groups were compared using Wilcoxon rank tests or Fisher’s exact test.

Results

In 2018, 100 PWH and 100 PrEP users were enrolled. Overall, 74% of PWH and 89% of PrEP users expressed interest for LAA with a significantly higher rate for PrEP users (p = 0.001). No characteristics were associated with acceptance of LAA in both groups in term of demographics, lifestyle or comorbidities.

Conclusion

PWH and PrEP users expressed a high level of interest in LAA, since a large majority seems to be in favor of this new approach. Further studies should be conducted to better characterize targeted individuals.
The effect of the 2009 revised U.S. guidelines for gestational weight gain on maternal and infant health: a quasi-experimental study
Authors: Collin Daniel F. , Pulvera Richard , Hamad Rita
Published: February 2023

Background

Excess gestational weight gain (GWG) has adverse short- and long-term effects on the health of mothers and infants. In 2009, the US Institute of Medicine revised its guidelines for GWG and reduced the recommended GWG for women who are obese. There is limited evidence on whether these revised guidelines affected GWG and downstream maternal and infant outcomes.

Methods

We used data from the 2004–2019 waves of the Pregnancy Risk Assessment Monitoring System, a serial cross-sectional national dataset including over 20 states. We conducted a quasi-experimental difference-in-differences analysis to assess pre/post changes in maternal and infant outcomes among women who were obese, while “differencing out” the pre/post changes among a control group of women who were overweight. Maternal outcomes included GWG and gestational diabetes; infant outcomes included preterm birth (PTB), low birthweight (LBW), and very low birthweight (VLBW). Analysis began in March 2021.

Results

There was no association between the revised guidelines and GWG or gestational diabetes. The revised guidelines were associated with reduced PTB (− 1.19% points, 95%CI: − 1.86, − 0.52), LBW (− 1.38% points 95%CI: − 2.07, − 0.70), and VLBW (− 1.30% points, 95%CI: − 1.68, − 0.92). Results were robust to several sensitivity analyses.

Conclusion

The revised 2009 GWG guidelines were not associated with changes in GWG or gestational diabetes but were associated with improvements in infant birth outcomes. These findings will help inform further programs and policies aimed at improving maternal and infant health by addressing weight gain in pregnancy.
A randomized controlled trial of surf and hike therapy for U.S. active duty service members with major depressive disorder
Authors: Walter Kristen H. , Otis Nicholas P. , Ray Travis N. , Glassman Lisa H. , Beltran Jessica L. , Kobayashi Elliott Kim T. , Michalewicz-Kragh Betty
Published: February 2023

Background

Major depressive disorder (MDD) is the most prevalent mental health disorder worldwide, including among U.S. service members. In addition to evidence-based treatments, activity-based approaches have been shown to effectively treat depressive symptoms, particularly when they occur in the natural environment.

Methods

This study compared two activity-based interventions, Surf Therapy and Hike Therapy, on depression outcomes among 96 active duty service members with MDD. Participants were randomized to 6 weeks of Surf or Hike Therapy. Clinician-administered and self-report measures were completed at preprogram, postprogram, and 3-month follow-up. A brief depression/anxiety measure was completed before and after each activity session.

Results

Multilevel modeling results showed that continuous depression outcomes changed significantly over time (ps < .001). Although service members in Hike Therapy reported higher average depression scores than those in Surf Therapy, the trajectory of symptom improvement did not significantly differ between groups. Regarding MDD diagnostic status, there were no significant differences between the groups at postprogram (p = .401), but Surf Therapy participants were more likely to remit from MDD than were those in Hike Therapy at the 3-month follow-up (p = .015).

Limitations

The sample consisted of service members, so results may not generalize to other populations. Most participants received concurrent psychotherapy or pharmacotherapy, and, although statistically accounted for, results should be interpreted in this context.

Conclusions

Both Surf and Hike Therapies appear to be effective adjunctive interventions for service members with MDD. Research is needed to examine the effectiveness of these therapies as standalone interventions.

Trial registration

Clinical trials registration number

NCT03302611; First registered on 05/10/2017.
Real-time estimation and forecasting of COVID-19 cases and hospitalizations in Wisconsin HERC regions for public health decision making processes
Authors: Aravamuthan Srikanth , Mandujano Reyes Juan Francisco , Yandell Brian S. , Döpfer Dörte
Published: February 2023

Background

The spread of the COVID-19 (SARS-CoV-2) and the surging number of cases across the United States have resulted in full hospitals and exhausted health care workers. Limited availability and questionable reliability of the data make outbreak prediction and resource planning difficult. Any estimates or forecasts are subject to high uncertainty and low accuracy to measure such components. The aim of this study is to apply, automate, and assess a Bayesian time series model for the real-time estimation and forecasting of COVID-19 cases and number of hospitalizations in Wisconsin healthcare emergency readiness coalition (HERC) regions.

Methods

This study makes use of the publicly available Wisconsin COVID-19 historical data by county. Cases and effective time-varying reproduction number$$R_t$$Rtby the HERC region over time are estimated using Bayesian latent variable models. Hospitalizations are estimated by the HERC region over time using a Bayesian regression model. Cases, effective Rt, and hospitalizations are forecasted over a 1-day, 3-day, and 7-day time horizon using the last 28 days of data, and the 20%, 50%, and 90% Bayesian credible intervals of the forecasts are calculated. The frequentist coverage probability is compared to the Bayesian credible level to evaluate performance.

Results

For cases and effective$$R_t$$Rt, all three time horizons outperform the three credible levels of the forecast. For hospitalizations, all three time horizons outperform the 20% and 50% credible intervals of the forecast. On the contrary, the 1-day and 3-day periods underperform the 90% credible intervals. Questions about uncertainty quantification should be re-calculated using the frequentist coverage probability of the Bayesian credible interval based on observed data for all three metrics.

Conclusions

We present an approach to automate the real-time estimation and forecasting of cases and hospitalizations and corresponding uncertainty using publicly available data. The models were able to infer short-term trends consistent with reported values at the HERC region level. Additionally, the models were able to accurately forecast and estimate the uncertainty of the measurements. This study can help identify the most affected regions and major outbreaks in the near future. The workflow can be adapted to other geographic regions, states, and even countries where decision-making processes are supported in real-time by the proposed modeling system.
Inhibition of SMAD3 effectively reduces ADAMTS-5 expression in the early stages of osteoarthritis
Authors: Xiang Wei , Wang Chao , Zhu Zhoujun , Wang Dui , Qiu Zhenyu , Wang Weishan
Published: February 2023

Objective

As one of the most important protein-degrading enzymes, ADAMTS-5 plays an important role in the regulation of cartilage homeostasis, while miRNA-140 is specifically expressed in cartilage, which can inhibit the expression of ADAMTS-5 and delay the progression of OA (osteoarthritis). SMAD3 is a key protein in the TGF-β signaling pathway, inhibiting the expression of miRNA-140 at the transcriptional and post-transcriptional levels, and studies have confirmed the high expression of SMAD3 in knee cartilage degeneration, but whether SMAD3 can mediate the expression of miRNA-140 to regulate ADAMTS-5 remains unknown.

Methods

Sprague–Dawley (SD) rat chondrocytes were extracted in vitro and treated with a SMAD3 inhibitor (SIS3) and miRNA-140 mimics after IL-1 induction. The expression of ADAMTS-5 was detected at the protein and gene levels at 24 h, 48 h, and 72 h after treatment. The OA model of SD rats was created using the traditional Hulth method in vivo, with SIS3 and lentivirus packaged miRNA-140 mimics injected intra-articularly at 2 weeks, 6 weeks and 12 weeks after surgery. The expression of miRNA-140 and ADAMTS-5 in the knee cartilage tissue was observed at the protein and gene levels. Concurrently, knee joint specimens were fixed, decalcified, and embedded in paraffin prior to immunohistochemical, Safranin O/Fast Green staining, and HE staining analyses for ADAMTS-5 and SMAD3.

Results

In vitro, the expression of ADAMTS-5 protein and mRNA in the SIS3 group decreased to different degrees at each time point. Meanwhile, the expression of miRNA-140 in the SIS3 group was significantly increased, and the expression of ADAMTS-5 in the miRNA-140 mimics group was also significantly downregulated (P < 0.05). In vivo, it was found that ADAMTS-5 protein and gene were downregulated to varying degrees in the SIS3 and miRNA-140 mimic groups at three time points, with the most significant decrease at the early stage (2 weeks) (P < 0.05), and the expression of miRNA-140 in the SIS3 group was significantly upregulated, similar to the changes detected in vitro. Immunohistochemical results showed that the expression of ADAMTS-5 protein in the SIS3 and miRNA-140 groups was significantly downregulated compared to that in the blank group. The results of hematoxylin and eosin staining showed that in the early stage, there was no obvious change in cartilage structure in the SIS3 and miRNA-140 mock groups. The same was observed in the results of Safranin O/Fast Green staining; the number of chondrocytes was not significantly reduced, and the tide line was complete.

Conclusion

The results of in vitro and in vivo experiments preliminarily showed that the inhibition of SMAD3 significantly reduced the expression of ADAMTS-5 in early OA cartilage, and this regulation might be accomplished indirectly through miRNA-140.
No bladder irrigation versus continuous bladder irrigation after HoLEP: a propensity score matching analysis
Authors: Hao Yunwu , Chen Degang , Shen Xudong , Chen Yang , Hao Zongyao
Published: February 2023

Purpose

In this study, the feasibility of a no bladder irrigation strategy after transurethral holmium laser enucleation of the prostate (HoLEP) for the treatment of benign prostatic hyperplasia (BPH) was studied.

Methods

From August 2021 to December 2021, the clinical data of 62 patients who received no bladder irrigation after HoLEP (Group A) were studied. The control group contained the clinical data of 150 patients in the same therapy group (from January 2021 to July 2021) who received continuous bladder irrigation after HoLEP (Group B). The baseline was consistent after using the propensity score matching (PSM) method, and the differences between groups were compared. The pre- and postoperative complications, international prostate symptom score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax), and postvoid residual urine (PVR) of the two groups were compared, accompanied by a follow-up evaluation of surgical effects.

Results

47 pairs of patients were successfully matched by PSM. There was no statistically significant difference in the intraoperative conditions and the incidence of early postoperative complications between the two groups (P > 0.05). Before and one month after the surgery, significant differences were also found in the IPSS, QOL, Qmax, and PVR of both groups (P < 0.05). Within one month after the surgery, no statistically significant difference was found in IPSS, QOL, Qmax, PVR, or the incidence of early postoperative complications between the two groups (P > 0.05).

Conclusion

For appropriately selected patients according to the exclusion criteria, the no bladder irrigation strategy after HoLEP for BPH is safe and effective.
Resilience in advanced cancer caregiving promoted by an intimate partner’s support network: insights through the lens of complexity science. A framework analysis
Authors: Opsomer Sophie , Joossens Sofie , Lauwerier Emelien , De Lepeleire Jan , Pype Peter
Published: February 2023

Background

The tremendous physical and mental burden that comes with caregiving puts the intimate partners of patients diagnosed with advanced cancer at risk for mental disorders. However, most partners seem to be protected by resilience. Such a resilience process is promoted by certain individual characteristics (e.g., flexibility, positive attitude, internal strength, capacity to balance incoming and outgoing information, and ability to ask for and accept support and advice) and by the availability of a support network, consisting of family, friends, and healthcare professionals. Such a heterogeneous group striving towards the same goals can be considered a complex adaptive system (CAS), a concept stemming from complexity science.

Aims

To study the behavior of the support network through the lens of complexity science and to provide insights to the means by which an available network may promote resilience.

Methods

Nineteen interviews with members from the support networks of eight intimate partners were analyzed deductively using the CAS principles as a coding framework. Subsequently, the quotes under each principle were coded inductively to concretize patterns in the behavior of the support networks. Eventually, the codes were charted into a matrix to identify intra- and inter-CAS similarities, differences, and patterns.

Findings

The network’s behavior adapts dynamically to the changing circumstances as the patient’s prognosis worsens. Furthermore, the behavior is based on internalized basic rules (such as reassuring availability and maintaining communication without being intrusive), attractors (e.g., feeling meaningful, appreciated, or connected), and the history of the support network. However, the interactions are non-linear and often unpredictable due to the context member’s own concerns, needs, or emotions.

Conclusions

Applying the lens of complexity science to the behavior of an intimate partner’s support network gives us insight into the network’s behavioral patterns. Indeed, a support network is a dynamic system that behaves according to the principles of a CAS and adapts resiliently to the changing circumstances as the patient’s prognosis worsens. Moreover, the behavior of the support network appears to promote the intimate partner’s resilience process throughout the patient’s care period.
Response to Tsuda et al. “demonstrating the undermining of science and health policy after the Fukushima nuclear accident by applying the toolkit for detecting misused epidemiological methods”
Authors: Cléro Enora , Demoury Claire , Grosche Bernd , Liutsko Liudmila , Motreff Yvon , Ohba Takashi , Oughton Deborah , Pirard Philippe , Rogel Agnès , Schneider Thierry , Van Nieuwenhuyse An , Laurier Dominique , Cardis Elisabeth
Published: February 2023

Background

The SHAMISEN (Nuclear Emergency Situations - Improvement of Medical And Health Surveillance) European project was conducted in 2015-2017 to review the lessons learned from the experience of past nuclear accidents and develop recommendations for preparedness and health surveillance of populations affected by a nuclear accident. Using a toolkit approach, Tsuda et al. recently published a critical review of the article by Cléro et al. derived from the SHAMISEN project on thyroid cancer screening after nuclear accident.

Main body

We address the main points of criticism of our publication on the SHAMISEN European project.

Conclusion

We disagree with some of the arguments and criticisms mentioned by Tsuda et al. We continue to support the conclusions and recommendations of the SHAMISEN consortium, including the recommendation not to launch a mass thyroid cancer screening after a nuclear accident, but rather to make it available (with appropriate information counselling) to those who request it.