bluuebunny/crossref_metadata_2025 huggingface dataset:
Co-expression pan-network reveals genes involved in complex traits within maize pan-genome
Authors: Cagirici H. Busra , Andorf Carson M. , Sen Taner Z.
Published: December 2022

Background

With the advances in the high throughput next generation sequencing technologies, genome-wide association studies (GWAS) have identified a large set of variants associated with complex phenotypic traits at a very fine scale. Despite the progress in GWAS, identification of genotype-phenotype relationship remains challenging in maize due to its nature with dozens of variants controlling the same trait. As the causal variations results in the change in expression, gene expression analyses carry a pivotal role in unraveling the transcriptional regulatory mechanisms behind the phenotypes.

Results

To address these challenges, we incorporated the gene expression and GWAS-driven traits to extend the knowledge of genotype-phenotype relationships and transcriptional regulatory mechanisms behind the phenotypes. We constructed a large collection of gene co-expression networks and identified more than 2 million co-expressing gene pairs in the GWAS-driven pan-network which contains all the gene-pairs in individual genomes of the nested association mapping (NAM) population. We defined four sub-categories for the pan-network: (1) core-network contains the highest represented ~ 1% of the gene-pairs, (2) near-core network contains the next highest represented 1–5% of the gene-pairs, (3) private-network contains ~ 50% of the gene pairs that are unique to individual genomes, and (4) the dispensable-network contains the remaining 50–95% of the gene-pairs in the maize pan-genome. Strikingly, the private-network contained almost all the genes in the pan-network but lacked half of the interactions. We performed gene ontology (GO) enrichment analysis for the pan-, core-, and private- networks and compared the contributions of variants overlapping with genes and promoters to the GWAS-driven pan-network.

Conclusions

Gene co-expression networks revealed meaningful information about groups of co-regulated genes that play a central role in regulatory processes. Pan-network approach enabled us to visualize the global view of the gene regulatory network for the studied system that could not be well inferred by the core-network alone.
Mannitol for prevention of acute kidney injury after liver transplantation: a randomized controlled trial
Authors: Emara Moataz Maher , Diab Doaa Galal , Yassen Amr Mohamed , Abo-Zeid Maha A.
Published: December 2022

Background

Acute kidney injury (AKI) is a common complication after liver transplantation, which is associated with increased morbidity and mortality. Therefore, this study investigated mannitol as an oxygen-free radical scavenger and its role in the prevention of early AKI after living donor liver transplantation (LDLT).

Methods

A total of 84 adult patients who underwent LDLT were randomly assigned to two equal groups: the M group, where patients received 1 g/kg mannitol 20%, or the S group, where patients received an equal volume of saline. The primary outcome was the incidence of early AKI, defined as a 0.3 mg/dl increase in the serum creatinine 48 h postoperatively. Laboratory assessments of the graft and creatinine were recorded until 3 months after transplantation besides the post-reperfusion syndrome and the intraoperative hemodynamic measurements.

Results

The AKI incidence was comparable between groups (relative risk ratio of 1.285, 95% CI 0.598–2.759, P = 0.518). Moreover, AKI stages and serum creatinine 3 months after transplantation, P = 0.23 and P = 0.25, respectively. The incidence of the post-reperfusion syndrome was comparable in both groups, 29/39 (74.4%) and 31/41 (75.6%) in M and S groups, respectively, P = 0.897. The intraoperative hemodynamic parameters showed no significant difference between groups using the area under the curve.

Conclusion

The current LDLT recipient sample was insufficient to demonstrate that pre-reperfusion 1 g/kg mannitol infusion would reduce the risk of early AKI or post-reperfusion syndrome.

Clinical trial registration number

Pan African Clinical Trials Registry (PACTR202203622900599); https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=21511.
Incidence and risk factors for acute shoulder pain after hepatectomy: a nested case-control study
Authors: Yang Yuecheng , Zhang Yunkui , Dai Sheng Ling , Wang Lu , Zhang Jun
Published: December 2022

Background

Shoulder pain is commonly reported after hepatic surgery; however, the factors affecting post-hepatectomy shoulder pain remain unclear. This study aimed to determine the incidence and risk factors of shoulder pain after hepatectomy.

Methods

This prospective cohort study recruited 218 patients who underwent hepatic resection at our hospital from June to September 2022. Data were obtained from electronic medical records and follow-up assessments on the second postoperative day. All patients denied chronic pain before surgery. In this cohort study, patients were grouped according to the appearance of shoulder pain. Demographic information and perioperative data were compared between the two groups. The relationship between shoulder pain and independent variables was assessed using univariate binary logistic regression analysis. The potential risk factors were analyzed using multivariable binary logistic regression.

Results

Of the 218 patients enrolled in this cohort study, 91 (41.7%) reported shoulder pain. Patients in the case group were significantly younger than those in the control group (P = 0.001). Epidural anesthesia was used more frequently in the case group (P = 0.012). Patients over 60 years of age showed a lower incidence of shoulder pain than younger patients (P = 0.028). According to multivariable binary logistic regression analysis, advanced age and epidural anesthesia were associated with risk of shoulder pain (advanced age: odds ratio [OR] [95% confidence interval (CI)]: 0.96 [0.94, 0.99],P = 0.002; epidural anesthesia: OR [95% CI]: 2.08 [1.18, 3.69],P = 0.012).

Conclusions

The incidence of acute shoulder pain after hepatectomy is 41.7%. The application of epidural anesthesia is an independent risk factor for shoulder pain after hepatectomy, whereas advanced age is a protective factor.
Subclinical left ventricular myocardial dysfunction in patients with obstructive sleep apnea syndrome: insights from noninvasive left ventricular myocardial work analysis
Authors: Jin Shan , Ding Xueyan , Guo Dichen , Qin Yunyun , Zhu Weiwei , Zhao Zhiling , Guo Xiheng , Li Yidan , Lu Xiuzhang , Cai Qizhe
Published: December 2022

Background

Obstructive sleep apnea syndrome (OSAS) is associated with various cardiovascular diseases and has aroused public concern. Early detection for declining myocardial function is of great significance. This study was aimed at noninvasively evaluating the subclinical left ventricular (LV) myocardial dysfunction with LV pressure–strain loop (PSL) in patients with OSAS having normal LV ejection fraction.

Methods

We enrolled 200 patients with OSAS who visited the Beijing Chaoyang Hospital between February 2021 and December 2021. According to the apnea–hypopnea index (AHI), patients were divided into mild, moderate, and severe groups. The global longitudinal strain (GLS) of the left ventricle was analyzed by two-dimensional speckle tracking echocardiography. The LV PSL was used to assess global work index (GWI), global constructive work (GCW), global waste work (GWW), and global work efficiency (GWE), and comparisons were made among groups.

Results

GLS was significantly lower in the severe group than in mild and moderate group. GWI, GCW, and GWE were lower in the severe group than in mild and moderate groups. GWW was significantly higher in the severe group than in the mild group. GLS, GWI, and GWE were moderately correlated with AHI (Spearman’s ρ = −0.468, −0.321, and −0.319, respectively; P < 0.001), whereas GCW and GWW showed a weak correlation with AHI (Spearman’s ρ = −0.226 and 0.255 respectively; P < 0.001). Multiple regression analyses revealed AHI was independently associated with GWI after adjusting for SBP, GLS, e’, etc. AHI was independently associated with GCW after adjusting for SBP, GLS, etc.

Conclusions

The LV PSL is a new technique to noninvasively detect myocardial function deterioration in patients with OSAS and preserved LV ejection fraction. Increased severity of OSAS was independent associated with both decreased GWI and GCW.
The risk factors for deep venous thrombosis in critically ill older adult patients: a subgroup analysis of a prospective, multicenter, observational study
Authors: Li Li , Zhen Junhai , Huang Liquan , Zhou Jia , Yao Lina , Xu Lingen , Zhang Weimin , Zhang Gensheng , Chen Qijiang , Cheng Bihuan , Gong Shijin , Cai Guolong , Jiang Ronglin , Yan Jing
Published: December 2022

Background

Older adult patients mainly suffer from multiple comorbidities and are at a higher risk of deep venous thrombosis (DVT) during their stay in the intensive care unit (ICU) than younger adult patients. This study aimed to analyze the risk factors for DVT in critically ill older adult patients.

Methods

This was a subgroup analysis of a prospective, multicenter, observational study of patients who were admitted to the ICU of 54 hospitals in Zhejiang Province from September 2019 to January 2020 (ChiCTR1900024956). Patients aged > 60 years old on ICU admission were included. The primary outcome was DVT during the ICU stay. The secondary outcomes were the 28- and 60-day survival rates, duration of stay in ICU, length of hospitalization, pulmonary embolism, incidence of bleeding events, and 60-day coagulopathy.

Results

A total of 650 patients were finally included. DVT occurred in 44 (2.3%) patients. The multivariable logistic regression analysis showed that age (≥75 vs 60-74 years old, odds ratio (OR) = 2.091, 95% confidence interval (CI): 1.308-2.846, P = 0.001), the use of analgesic/sedative/muscarinic drugs (OR = 2.451, 95%CI: 1.814-7.385, P = 0.011), D-dimer level (OR = 1.937, 95%CI: 1.511-3.063, P = 0.006), high Caprini risk score (OR = 2.862, 95%CI: 1.321-2.318, P = 0.039), basic prophylaxis (OR = 0.111, 95%CI: 0.029-0.430, P = 0.001), and physical prophylaxis (OR = 0.322, 95%CI: 0.109-0.954, P = 0.041) were independently associated with DVT. There were no significant differences in 28- and 60-day survival rates, duration of stay in ICU, total length of hospitalization, 60-day pulmonary embolism, and coagulation dysfunction between the two groups, while the DVT group had a higher incidence of bleeding events (2.6% vs. 8.9%, P < 0.001).

Conclusion

In critically ill older adult patients, basic prophylaxis and physical prophylaxis were found as independent protective factors for DVT. Age (≥75 years old), the use of analgesic/sedative/muscarinic drugs, D-dimer level, and high Caprini risk score were noted as independent risk factors for DVT.

Trial registration

Chinese Clinical Trial Registry (ChiCTR1900024956).URL: http://www.chictr.org.cn/listbycreater.aspx.
Trends and influence factors in the prevalence, intervention, and control of metabolic syndrome among US adults, 1999–2018
Authors: Yang Chaojun , Jia Xiaocan , Wang Yuping , Fan Jingwen , Zhao Chenyu , Yang Yongli , Shi Xuezhong
Published: December 2022

Aim

We aimed to describe the trends in the prevalence, intervention, and control of metabolic syndrome (MetS) among US adults through 1999–2018. Additionally, the influence factors of MetS and its control were further explored.

Methods

We included participants older than 20 using the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 (n = 22,114). The rate of prevalence, intervention, and control of MetS were caculated by survey weights. Joinpoint regression and survey-weighted generalized linear models were used to analyze trends and influence factors, respectively.

Results

The prevalence of MetS increased from 28.23 to 37.09% during 1999–2018 (P for trend < 0.05). The former smoker (OR = 1.20, 95%CI: 1.07, 1.36) and current smoker (OR = 1.27, 95%CI: 1.11, 1.45) increased the prevalence of MetS. While vigorous activity (OR = 0.53, 95%CI: 0.47, 0.61) decreased it. Among MetS components, the prevalence of elevated blood-glucose (from 21.18 to 34.68%) and obesity (from 44.81 to 59.06%) raised (P for trend < 0.05), with an uptrend in the use of antidiabetic (from 9.87 to 28.63%) and a downtrend of vigorous activity (from 23.79 to 16.53%) (P for trend < 0.05). Decreased trends were observed in the control of Hb1Ac (< 7%) (from 87.13 to 84.06%) and BMI (<25 kg/m2) (from 11.36 to 7.49%). Among MetS underwent antidiabetic, 45–64 years old and male decreased the control of Hb1Ac (< 7%). The control of BMI (<25 kg/m2) among individuals with physical activity was reduced mainly in the population of younger (aged 20–44 years old), male, non-Hispanic black, middle income and smoker (former and current).

Conclusions

The prevalence of MetS increased significantly through 1999–2018. Elevated blood glucose and obesity were the main causes of MetS burden. Quitting smoking and increasing physical activity may decrease the prevalence of MetS. In the control of blood-glucose and obesity, we should screen out the focus population to modify treatment and improve lifestyle.
Hyperammonemia in a pregnant woman with citrullinemia type I: a case report and literature review
Authors: Zhou Yimeng , Dou Xiaoguang , Zhang Chong , He Rong , Ding Yang
Published: December 2022

Background

Citrullinemia type I (CTLN1) is a rare urea cycle disorder (UCD) with few adult cases described so far. Diagnosis of late-onset CTLN1 is difficult, and delayed treatment may increase the risk of severe hyperammonemia. Pregnancy is an important risk factor for women with CTLN1. However, the clinical manifestations of CTLN1 in a pregnant woman may be mistaken for pregnancy side effects and ultimately delay a timely diagnosis.

Case presentation

A 34-year-old woman developed vomiting and disturbance of consciousness after 12 weeks of gestation. A blood test showed hyperammonemia (454 μg/dL) with normal liver function tests. She fell into a deep coma, and her serum ammonia level increased to 800 μg/dL. Continuous renal replacement therapy (CRRT) was administered as a diagnostic treatment for UCD and serum ammonia. This patient’s case was complicated by co-infection; her dependents decided to withdraw life support and the patient died. She was diagnosed with CTLN1 by analyses of plasma amino acids, urinary orotic acid, and second-generation gene sequencing.

Discussion and conclusion

When a patient displays symptoms of emesis and disturbance of consciousness in early pregnancy, blood ammonia should be monitored, and UCD should be considered, particularly for patients with hyperammonemia in the absence of severe liver function abnormalities.
Comparison of cerebral oxygen desaturation events between children under general anesthesia and chloral hydrate sedation - a randomized controlled trial
Authors: Gude Philipp , Weber Thomas P. , Dazert Stefan , Teig Norbert , Mathmann Philipp , Georgevici Adrian I. , Neumann Katrin
Published: December 2022

Background

During pediatric general anesthesia (GA) and sedation, clinicians aim to maintain physiological parameters within normal ranges. Accordingly, regional cerebral oxygen saturation (rScO2) should not drop below preintervention baselines. Our study compared rScO2 desaturation events in children undergoing GA or chloral hydrate sedation (CHS).

Methods

Ninety-two children undergoing long auditory assessments were randomly assigned to two study arms: CHS (n = 40) and GA (n = 52). Data of 81 children (mean age 13.8 months, range 1–36 months) were analyzed.

In the GA group, we followed a predefined 10 N concept (no fear, no pain, normovolemia, normotension, normocardia, normoxemia, normocapnia, normonatremia, normoglycemia, and normothermia). In this group, ENT surgeons performed minor interventions in 29 patients based on intraprocedural microscopic ear examinations.

In the CHS group, recommendations for monitoring and treatment of children undergoing moderate sedation were met. Furthermore, children received a double-barreled nasal oxygen cannula to measure end-tidal carbon dioxide (etCO2) and allow oxygen administration. Chloral hydrate was administered in the parent’s presence. Children had no intravenous access which is an advantage of sedation techniques.

In both groups, recommendations for fasting were followed and an experienced anesthesiologist was present during the entire procedure.

Adverse event (AE) was a decline in cerebral oxygenation to below 50% or below 20% from the baseline for ≥1 min. The primary endpoint was the number of children with AE across the study arms. Secondary variables were: fraction of inspired oxygen (FIO2), oxygen saturation (SpO2), etCO2, systolic and mean blood pressure (BP), and heart rate (HR); these variables were analyzed for their association with drop in rScO2 to below baseline (%drop_rScO2).

Results

The incidence of AE across groups was not different. The analysis of secondary endpoints showed evidence that %drop_rScO2 is more dependent on HR and FIO2 than on BP and etCO2.

Conclusions

This study highlights the strong association between HR and rScO2 in children aged < 3 years, whereas previous studies had primarily discussed the role of BP and etCO2. Prompt HR correction may result in shorter periods of cerebral desaturation.

Trial registration

The study was retrospectively registered with the German Clinical Trials Registry (DRKS00024362, 04/02/2021).
Centering Indigenous knowledge in suicide prevention: a critical scoping review
Authors: Sjoblom Erynne , Ghidei Winta , Leslie Marya , James Ashton , Bartel Reagan , Campbell Sandra , Montesanti Stephanie
Published: December 2022

Background

Indigenous peoples of Canada, United States, Australia, and New Zealand experience disproportionately high rates of suicide as a result of the collective and shared trauma experienced with colonization and ongoing marginalization. Dominant, Western approaches to suicide prevention—typically involving individual-level efforts for behavioural change via mental health professional intervention—by themselves have largely failed at addressing suicide in Indigenous populations, possibly due to cultural misalignment with Indigenous paradigms. Consequently, many Indigenous communities, organizations and governments have been undertaking more cultural and community-based approaches to suicide prevention. To provide a foundation for future research and inform prevention efforts in this context, this critical scoping review summarizes how Indigenous approaches have been integrated in suicide prevention initiatives targeting Indigenous populations.

Methods

A systematic search guided by a community-based participatory research (CBPR) approach was conducted in twelve electronic bibliographic databases for academic literature and six databases for grey literature to identify relevant articles. the reference lists of articles that were selected via the search strategy were hand-searched in order to include any further articles that may have been missed. Articles were screened and assessed for eligibility. From eligible articles, data including authors, year of publication, type of publication, objectives of the study, country, target population, type of suicide prevention strategy, description of suicide prevention strategy, and main outcomes of the study were extracted. A thematic analysis approach guided by Métis knowledge and practices was also applied to synthesize and summarize the findings.

Results

Fifty-six academic articles and 16 articles from the grey literature were examined. Four overarching and intersecting thematic areas emerged out of analysis of the academic and grey literature: (1) engaging culture and strengthening connectedness; (2) integrating Indigenous knowledge; (3) Indigenous self-determination; and (4) employing decolonial approaches.

Conclusions

Findings demonstrate how centering Indigenous knowledge and approaches within suicide prevention positively contribute to suicide-related outcomes. Initiatives built upon comprehensive community engagement processes and which incorporate Indigenous culture, knowledge, and decolonizing methods have been shown to have substantial impact on suicide-related outcomes at the individual- and community-level. Indigenous approaches to suicide prevention are diverse, drawing on local culture, knowledge, need and priorities.
Driving under the influence of cannabis: perceptions from Canadian youth
Authors: Donnan Jennifer R. , Drakes Dalainey H. , Rowe Emily C. , Najafizada Maisam , Bishop Lisa D.
Published: December 2022

Background

Cannabis legalization is intended to protect the public from potential harm by restricting access and promoting greater awareness of cannabis-related risks. Youth are at a greater risk for experiencing road-related harms due to their own or others’ use of cannabis. This qualitative research explored youths’ perceptions about cannabis and road safety.

Methods

A qualitative study using focus groups (FG) was conducted with youth (age 13-18) and young adults (age 19-25) who resided in Newfoundland and Labrador. Using semi-structured interview questions, the facilitator asked participants to share their opinions about cannabis and road safety. All sessions were hosted virtually using Zoom with recruitment until saturation was met. All sessions were audio recorded, de-identified, and transcribed. Analysis utilized an inductive thematic approach informed by Braun and Clarke’s (2006) method and inductive coding was facilitated using NVivo.

Results

Six youth (n = 38) and five young adult (n = 53) FG were conducted. Five prominent themes emerged throughout discussions across both age groups including: a) normalization of driving under the influence of cannabis, b) knowledge and awareness, c) perceptions of risk, d) modes of transportation, and e) detection. Variation in perceptions appeared to be influenced by lack of awareness of the impact of cannabis on driving ability, residence in urban versus rural locations, type of vehicle driven (e.g., car vs. off-road vehicles), and gender.

Conclusion

The themes uncovered from this research will help inform future enhancement of cannabis policy to ensure the safety of all citizens. These findings will also support the inclusion of youth-focused education that will equip youth with informed decision-making strategies regarding road safety. Furthermore, these findings can be utilized to inform the refinement of cannabis driving policies to ensure the safety of all citizens on or off the road.
Community efforts to monitor and manage Aedes mosquitoes (Diptera: Culicidae) with ovitraps and litter reduction in east Tennessee
Authors: Day C. A. , Trout Fryxell R. T.
Published: December 2022

Background

East Tennessee (USA) is burdened by mosquito-borne La Crosse virus disease, but minimal resources for mosquito surveillance, management, or related community education exist in the region. To address these needs, we developed a program to train middle and high school educators in basic medical entomology. The educators then used their skills in the classroom to teach students about La Crosse virus disease and conduct mosquito collection experiments. As a case study of a potential application of classroom-collected data, we also partnered with a local non-profit organization to assess the potential for a volunteer litter cleanup to reduce mosquito populations in a Tennessee neighborhood.

Methods

Our first objective was to investigate the ability for educators and their students (schools) to collect high-quality mosquito surveillance data. In 2019 and 2020, we collected Aedes (Diptera: Culicidae) eggs during the same study period as schools and assessed whether data collected by schools reflected the same findings as our own data. Our second objective was to investigate the impact of a volunteer litter cleanup event on Aedes mosquito abundance. In 2021, we collected Aedes eggs before and after a neighborhood trash cleanup while schools conducted their own mosquito egg collections. Using the school collections as non-treatment sites, we used a Before-After-Control-Impact analysis to determine if there was a significant decline in egg abundance after the cleanup.

Results

In 2019, mosquito abundance trends were similar between our data and school data but differed significantly during some weeks. After refining our protocols in 2020, school data was highly similar to our data, indicating that schools consistently collected high-quality surveillance data in the program’s second year. In 2021, we found a significant decline in Aedes egg abundance after the litter cleanup event in comparison to the schools, but the number of adults reared from those eggs did not differ between sites after the cleanup.

Conclusion

The results of our work demonstrate the potential for community-driven programs to monitor mosquito abundance trends and for volunteer-based cleanup events to reduce the burden of Aedes mosquitoes. In the absence of infrastructure and resources, academic-community partnerships like the ones evaluated here, provide opportunities to help resource limited areas.
Predictors of physical violence against children in Rwanda: findings from a National Cross-Sectional Survey
Authors: Nyandwi Alypio , Fredinah Namatovu , Rusanganwa Vincent , Munyanshongore Cyprien , Nyirazinyoye Laetitia , Ndola Prata , Nshimiyimana Jean Damascene , Ingabire Marie-Gloriose , Anastasie Nyirabahinde , Salant Natasha , Mecthilde Kamukunzi , Emmanuel Hakomeza , Mukabutera Assumpta
Published: December 2022

Background

To address the challenges of limited national data on the prevalence and nature of violence experienced by children, Rwanda conducted, in 2015–2016, the first National Survey on Violence among female and male children and youth aged 13–24 years. To further contribute to these efforts to fill existing data gaps, we used the Rwanda survey data to assess the prevalence and predictors of physical violence (PV) in children aged 13–17.

Methods

A nationally representative sample of 618 male and 492 female children were analysed. Nationally representative weighted descriptive statistics were used to analyse the prevalence of PV self-reported by children, and logistic regression models were applied to investigate its predictors.

Results

Sixty percent of all children, including 36.53% of male and 23.38% of female children, reported having experienced any form of PV in their lifetime. Additionally, 21.81% of male children and 12.73% of female children reported experiences of PV within twelve months before the survey date. Older children (OR: 0.53 [0.40–0.72]), female children (OR: 0.43 [0.31–0.58]), and children not attending school (OR: 0.48 [0.31–0.73]) were less likely to be physically abused. However, sexually active children (OR: 1.66 [1.05–2.63]), children in households from the middle wealth quintile (OR: 1.63 [1.08–2.47]), children living in a larger family (OR: 1.55 [1.07–2.26]), and children who reported not feel close to both biological parents (OR: 2.14 [1.31–3.49]) had increased odds of reporting physical violence.

Conclusion

Higher rates of PV in children attending school were the key finding. There is an urgent need to design and implement particular national interventions to prevent and reduce the incidence of PV in schools in Rwanda. PV was also associated with poor parent-child relations. Parents and other adult caregivers should be sensitised to the consequences of PV on children and be urged to adopt positive parenting practices.
Intervention strategies to promote healthy and sustainable food choices among parents with lower and higher socioeconomic status
Authors: Vos Marjolijn , Deforche Benedicte , Van Kerckhove Anneleen , Michels Nathalie , Geuens Maggie , Van Lippevelde Wendy
Published: December 2022

Background

A global shift towards more healthy and sustainable diets is necessary for the prevention of obesity and chronic diseases, as well as for the growing pressure on our ecosystems. Given that parents are important actors in affecting dietary behaviors of their children, developing intervention strategies targeting families and their practices is promising to reach positive behavior change among children. Also, it is important to tailor these interventions to the needs of parents with different socioeconomic statuses (SES), given that health inequalities continue to grow. This study aims to investigate perspectives of lower and higher SES parents on the usability and acceptability of various innovative intervention strategies.

Methods

Fourteen focus groups and four individual interviews (n = 78, nlowerSES = 17; nhigherSES = 61) were conducted in Belgium. A semi-structured interview guide was used to facilitate the discussions. The interviews were recorded, transcribed, and analyzed via thematic content analysis using NVivo.

Results

To encourage healthy and sustainable food choices, interventions via online food shopping platforms and nudging strategies in grocery stores were mostly cited by higher SES parents, but these were less applicable for lower SES parents as they buy less online and mainly consider the price of products. Mobile applications that provide inspiration for healthy and sustainable recipes and easily accessible shopping lists received moderate support among lower and higher SES parents. Furthermore, both lower and higher SES parents showed interest in meal boxes delivered at home, but lower SES parents have not yet tried such meal boxes because of their higher prices. Still, both groups of SES parents mentioned many advantages of these meal boxes, such as the convenience and time-saving component, as well as the cooking inspiration aspect.

Conclusion

Our study reveals the preferences of lower and higher SES parents for practical intervention strategies, providing insight in what features these strategies should have to be acceptable and useful. Hence, the findings can inform the development of a tailored family-based intervention strategy to improve parental food choices in favor of increased health and sustainability.
Implementing a multisector public-private partnership to improve urban hypertension management in low-and middle- income countries
Authors: Boch Johannes , Venkitachalam Lakshmi , Santana Adela , Jones Olivia , Reiker Theresa , Rosiers Sarah Des , Shellaby Jason T. , Saric Jasmina , Steinmann Peter , Ferrer Jose M. E. , Morgan Louise , Barshilia Asha , Albuquerque Edmir Peralta Rollemberg , Avezum Alvaro , Barboza Joseph , Baxter Yara C. , Bortolotto Luiz , Byambasuren Enkhtuya , Cerqueira Márcia , Dashdorj Naranjargal , Dib Karina Mauro , Guèye Babacar , Seck Karim , Silveira Mariana , Rollemberg Suely Miya Shiraishi , de Oliveira Renato W. , Luvsansambuu Tumurbaatar , Aerts Ann
Published: December 2022

Background

Cardiovascular disease presents an increasing health burden to low- and middle-income countries. Although ample therapeutic options and care improvement frameworks exist to address its prime risk factor, hypertension, blood pressure control rates remain poor. We describe the results of an effectiveness study of a multisector urban population health initiative that targets hypertension in a real-world implementation setting in cities across three continents. The initiative followed the “CARDIO4Cities” approach (quality of Care, early Access, policy Reform, Data and digital technology, Intersectoral collaboration, and local Ownership).

Method

The approach was applied in Ulaanbaatar in Mongolia, Dakar in Senegal, and São Paulo in Brazil. In each city, a portfolio of evidence-based practices was implemented, tailored to local priorities and available data. Outcomes were measured by extracting hypertension diagnosis, treatment and control rates from primary health records. Data from 18,997 patients with hypertension in primary health facilities were analyzed.

Results

Over one to two years of implementation, blood pressure control rates among enrolled patients receiving medication tripled in São Paulo (from 12·3% to 31·2%) and Dakar (from 6·7% to 19·4%) and increased six-fold in Ulaanbaatar (from 3·1% to 19·7%).

Conclusions

This study provides first evidence that a multisectoral population health approach to implement known best-practices, supported by data and digital technologies, and relying on local buy-in and ownership, can improve hypertension control in high-burden urban primary care settings in low-and middle-income countries.
Comparing oblique lumbar interbody fusion with lateral screw fixation and percutaneous endoscopic transforaminal discectomy (OLIF-PETD) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for the treatment of lumbar disc herniation complicated with lumbar instability
Authors: Deng Chen , Feng Haoyu , Ma Xun , Chen Chen , Mei Jun , Sun Lin
Published: December 2022

Objective

To evaluate the early clinical effect of oblique lumbar interbody fusion with lateral screw fixation and percutaneous endoscopic transforaminal discectomy (OLIF-PETD) in the treatment of lumbar disc herniation with lumbar instability.

Methods

A total of 22 patients with lumbar disc herniation and lumbar instability from August 2017 to August 2019 were enrolled in this retrospective study. The general information, perioperative indicators and complications were recorded. The clinical outcomes and radiological outcomes were evaluated before the operation, seven days after the operation, and at the last follow-up. Vertebral fusion and degree of multifidus muscle injury were evaluated at the last follow-up.

Results

In this study, OLIF + PETD showed shorter incision length compared to the MIS-TLIF (P < 0.001). In the two groups, the clinical outcomes and radiological outcomes were significantly improved compared with the preoperative (P < 0.001). At the seven days after the operation and the last follow-up, the VAS of OLIF + PETD group was lower than that of MIS-TLIF group (P < 0.05). OLIF + PETD could give superior outcome in restoring disc height (P < 0.001), but the fusion segment angle of OLIF + PETD group was larger compared to the MIS-TLIF group seven days after the operation and at the last follow-up (P < 0.05). In addition, the fusion rate was not significantly different between the two groups (P > 0.05), but OLIF + PETD could avoid the multifidus injury (P < 0.001).

Conclusion

Compared to MIS-TLIF, OLIF-PETD can achieve satisfactory decompression effects and fusion rates with less multifidus injury and postoperative low back pain, which may be an alternative choice for the treatment of lumbar disc herniation combined with lumbar instability.
Renal cell carcinoma: the population, real world, and cost-of-illness
Authors: Buja Alessandra , De Luca Giuseppe , Gatti Maura , Cozzolino Claudia , Rugge Massimo , Zorzi Manuel , Gardi Mario , Sepulcri Matteo , Bimbatti Davide , Baldo Vincenzo , Maruzzo Marco , Basso Umberto , Zagonel Vittorina
Published: December 2022

Background

The RCC treatment landscape has evolved dramatically over the past decade. The purpose of this study is to present a real-world data estimation of RCC’s cost-of-illness for this tumour’s clinical pathway.

Methods

This investigation is a population-based cohort study using real-world data, which considers all RCC incident cases diagnosed in Local Unit 6 of the Province of Padua in 2016 and 2017 as registered by the Veneto Cancer Registry. Data on drug prescriptions, the use of medical devices, hospital admissions, and visits to outpatient clinics and emergency departments were collected by means of administrative databases. We evaluated the costs of all healthcare procedures performed in the 2 years of follow-up post-RCC diagnosis. The overall and annual average real-world costs per patient, both as a whole and by single item, were calculated and stratified by stage of disease at diagnosis.

Results

The analysis involved a population of 148 patients with a median age of 65.8 years, 66.22% of whom were male. Two years after diagnosis, the average total costs amounted to €21,429 per patient. There is a steady increment in costs with increasing stage at diagnosis, with a total amount of €41,494 spent 2 years after diagnosis for stage IV patients, which is 2.44 times higher than the expenditure for stage I patients (€17,037). In the first year, hospitalization appeared to be the most expensive item for both early and advanced disease. In the second year, however, outpatient procedures were the main cost driver in the earlier stages, whereas anticancer drugs accounted for the highest costs in the advanced stages.

Conclusions

This observational study provides real-world and valuable estimates of RCC’s cost-of-illness, which could enable policymakers to construct dynamic economic cost-effectiveness evaluation models based on real world costs’ evaluation.
Application of SPARK teaching in acute abdomen radiography teaching for undergraduate medical students
Authors: Li Yangsheng , Gao Chengcheng , Zhu Xiangwen , Zhu Jiying , Ding Zhongxiang , Han Zhijiang
Published: December 2022

Background

Acute abdomen is a series of acute and severe abdominal diseases commonly encountered in clinic. It is important to strengthen the image teaching of acute abdomen for undergraduates.

Aim

This study aimed to explore the application effect of SPARK[sub-speciality (S), problem-based learning (P), assessment (A), report (R) and reading skill (K)] teaching mode in the experimental teaching of acute abdomen for undergraduate medical students.

Methods

We selected a total of 58 third year medical students for observation. The students were divided into experimental group and control group. Among them, 29 students in the experimental group studied in SPARK teaching mode, 29 students in the control group studied in traditional teaching mode. The two groups of students were tested after the theory class, before and after the experimental class, and one week after the experimental class, to compare the application effects of the two teaching modes. After the test one week after the experimental class, the two groups of students jointly adopted SPARK mode to learn, and were tested again one month after the experimental class to compare whether the two groups of students achieved the same results. The total score of all tests was 150.

Results

The average scores of the experimental group and the control group after theory class were (69.0 ± 26.4) and (72.1 ± 24.1) respectively, with no statistical difference (t = 0.468, P = 0.642). The average scores of the experimental group before, after and one week after the experimental class were higher than those of the control group. The experimental group was (84.5 ± 23.1), (109.7 ± 23.8), (105.5 ± 31.0) respectively, and the control group was (52.8 ± 15.1), (93.8 ± 17.0), (80.0 ± 22.8) respectively. The differences were statistically significant (t = -6.195, P = 0.00; t = -2.919, P = 0.05; t = -3.569, P = 0.01). The average scores of the experimental group and the control group after one month were (99.0 ± 31.0) and (95.5 ± 25.6) respectively, and there was no significant difference between the two groups (t = -0.462, P = 0.646).

Conclusions

The SPARK teaching mode was helpful for undergraduate medical students to consolidate image foundation, improve image reading skills.
Evaluating the effects of simulated interprofessional teaching on the development of clinical core competence in nursing students: a mixed methods study
Authors: Zhou Xin-yi , Wang Yan-feng , Dou Chun-xia , Tian Xiao-ying , Su Jin , Chen Yan-ya , Yan Feng-xia , Yang Qiao-hong , Wang Wenru
Published: December 2022

Background

While single-method studies have reported on the effectiveness of simulated interprofessional teaching, our understanding of its full effects remains incomplete. Teaching design also provides no relevant theoretical guidance, which reduces the scientific quality and rigor of research. The purpose of this work was to study the effects of the simulated interprofessional education (SIPE) teaching model based on the 3P theory on the course of "Clinical Critical Thinking Training" through a convergent mixed method, and to provide the basis for future teaching design.

Methods

A convergent mixed-method design was used, which consisted of a survey and a semi-structured interview. Data collection took place from September 2021 to July 2022. A cluster sampling method was used to select 60 full-time nursing students from a school in China, and randomly divide them into a control group of 36 and an experimental group of 24. According to the principle of voluntary participation, 6 students majoring in clinical medicine and 6 students majoring in pharmacy were recruited to join the experimental group to form an interprofessional team. The students studied “Clinical Critical Thinking Training” together, in which the control group used traditional simulation teaching and the experimental group used SIPE. The CCTDI (California Critical Thinking Disposition Inventory) and AITCS-II Student (Assessment of Interprofessional Team Collaboration in Student Learning Scale) were used for quantitative evaluation before and after the course, and descriptive statistics and Mann–Whitney U test were used to compare the critical thinking and interprofessional collaboration skills of the two groups of students. Semi-structured interviews were used for qualitative evaluation. Thematic analysis was used to understand student development on the basis of inter-professional core competencies and learning experience.

Results

The students’ interprofessional cooperation abilities and critical thinking scores improved compared with the beginning of the course, but the scores of the experimental group were significantly higher than the control group (p < 0.05). Three themes emerged regarding simulated interprofessional teaching: clarifying team positioning, improving team efficiency, and optimizing the learning experience.

Conclusion

SIPE can build students' critical thinking, teamwork, and interprofessional core competencies, which makes it a useful teaching design.
Factors associated with sleep quality among nurse managers during regular prevention and control of the COVID-19 in China: a cross-sectional study
Authors: Chen Rong , Fang Pei , Tan Lanhui , Li Jia , Yu Liping
Published: December 2022

Background

Nurse managers play a pivotal role in quality patient care and staff satisfaction and retention. An overwhelming amount of work tasks and responsibilities might result in their sleep problems which are expected to aggravate in the context of the COVID-19, thereby affecting their overall health and work quality. However, little attention has been paid to sleep quality among nurse managers. This study aimed to investigate the prevalence of sleep disorders among nurse managers and identify related factors of sleep quality during regular prevention and control of the COVID-19 pandemic in China.

Methods

This cross-sectional online survey was conducted in 14 hospitals on a sample of 327 nurse managers in China. Participants were invited to complete the general demographic questionnaire, Pittsburgh Sleep Quality Index (PSQI) and Simplified Coping Style Questionnaire (SCSQ). Multiple linear regression analysis was used to explore the influencing factors of sleep quality among nurse managers.

Results

In this study, 43.7% of nurse managers suffered from sleep disorders. Active coping style and frequent exercise were positive factors that could influence nurse managers’ sleep quality, while passive coping style and age over 41 years old were negative predictors, collectively accounting for 52.0% of the variance of sleep quality.

Conclusions

The issue of sleep disorders among nurse managers during regular epidemic prevention and control period is underscored. Coping style and demographic factors including age and frequency of exercise can significantly affect nurse managers’ sleep quality. Healthcare administrators should pay more attention to nurse managers’ sleep disorders and implement targeted strategies based on influencing factors to ensure their sleep quality.
Speaking up about patient safety concerns: view of nursing students
Authors: Hoffmann Magdalena , Schwarz Christine Maria , Schwappach David , Banfi Chiara , Palli Christoph , Sendlhofer Gerald
Published: December 2022

Background

“Speaking up” is considered an important patient safety behaviour. The main idea is to voice patient safety concerns; however, several studies revealed that the organisational culture can be obstructive. In previous studies, we already identified barriers for doctors, nurses and medical students. In the current study, we explore how nursing students use “speaking up” during their internship in an academic teaching hospital.

Methods

Between 2019 and 2020, 212 nursing students were invited to take part in the survey. The validated Speaking Up about Patient Safety Questionnaire (SUPS-Q) was used to assess speaking up behaviours in nursing students. The SUPS-Q consisted of three behaviour related scales (11 items), three culture related scales (11 items), a question regarding barriers to speak up as well as a clinical vignette assessing a hypothetical speaking up situation.

Results

In total, 118 nursing students took part in the survey (response rate: 56%). Most of them noticed specific safety concerns, observed errors or rule violations. The vignette was seen as very realistic and harmful to the patient. However, the majority responded that they did not speak up and remained silent. They reported a rather discouraging environment and high levels of resignation towards speaking up. However, more advanced students were less likely to speak up than less advanced students (p = 0.027). Most relevant barriers were fear of negative reaction (64%), reaction not predictable (62%) and ineffectiveness (42%).

Conclusions

Survey results of nursing students imply that speaking-up behaviours and remaining silent are common behaviours and coexist in the same individual. The clinical vignette and barriers to speaking up revealed that a hierarchical system does not support speaking-up behaviours. Organizational development is needed to foster professional teamwork, support attentive listening, encourage critical thinking, and problem-solving skills.
HNRNPC, a predictor of prognosis and immunotherapy response based on bioinformatics analysis, is related to proliferation and invasion of NSCLC cells
Authors: Gu Zhuoyu , Yang Yang , Ma Qian , Wang Hui , Zhao Song , Qi Yu , Li Yixin
Published: December 2022

Background

Little is known about the relationship between N6-methyladenosine (m6A)-related genes and tumor immune microenvironment (TIME) in non-small cell lung cancer (NSCLC). It is unclear which m6A regulators are essential for NSCLC progression. The aim of this work was to excavate the role of m6A-related genes in the TIME and progression of NSCLC.

Methods

Based on bioinformatics analysis, heterogeneous nuclear ribonucleoprotein C (HNRNPC) was considered as the most influential m6A regulator. Further study was investigated using patient samples, stable cell lines, and xenograft mice models.

Results

The differentially expressed profiles of m6A-related genes were established in NSCLC, and the NSCLC samples were clustered into two subtypes with different immune infiltration and survival time. Next, we found that the risk score (RS) based on m6A-related genes was a predictor of prognosis and immunotherapy response for NSCLC, in which HNRNPC was considered as the most influential m6A regulator. In NSCLC patients, we confirmed that HNRNPC predicted poor prognosis and correlated with tumor invasion and lymph node metastasis. RNA-seq data revealed that HNRNPC was involved in cell growth, cell migration, extracellular matrix organization and angiogenesis. In vitro, we verified that HNRNPC knockdown attenuated the cell proliferation, clonogenicity, invasion and migration. In vivo,HNRNPC knockdown inhibited the tumor growth and lung metastasis. Additionally, HNRNPC knockdown was associated with high CD8 + T cell infiltration, along with elevated CD4 + T cell infiltration, collagen production and angiogenesis.

Conclusions

M6A regulator HNRNPC, a predictor of prognosis and immunotherapy response based on bioinformatics analysis, is related to proliferation and invasion of NSCLC cells.