bluuebunny/crossref_metadata_2025 huggingface dataset:
From Serviced Sites to Peripheral Tenements: A Long-Arc History of Chennai’s Unaffordable Housing
Authors: Coelho Karen , Srivathsan A. , Pattnam Gayathri
Published: December 2022

Housing policies in India tend to reduce the urban housing challenge to a volumetric problem of increasing stock, particularly in the ‘affordable’ category, and increasingly by ‘crowding in private investment’. This standardised policy agenda has overwritten local histories and sociological understandings of housing as embedded in social relations. The singular focus on facilitating private markets in affordable housing is everywhere confounded by contextual factors that determine local geographies of housing, land markets and parameters of affordability.

What explains the conspicuous absence of private builders in Chennai’s affordable housing market, despite strong demand in this segment and over two decades of state policies aimed at incentivising their participation in this market? This article proposes that a long-range history of Chennai’s settlement and land use shifts, social/demographic changes, and housing policies from the early twentieth century can provide clues towards understanding its current housing market, and can contribute policy-relevant insights that expand the question of urban housing beyond measures of stocks and prices to qualitative concerns. The article employs archival material (including government reports, plans, policies and media reports) and primary data from a recent study by the authors on the supply, location and prices of current affordable housing stock in Chennai.
Explaining societal change through bricolage: Transformations in regimes of water governance
Authors: Mayaux Pierre-Louis , Dajani Muna , Cleaver Frances , Naouri Mohamed , Kuper Marcel , Hartani Tarik
Published: December 2022

This paper is motivated by the pressing need to understand how water use and irrigated agriculture can be transformed in the interests of both social and environmental sustainability. How can such change come about? In particular, given the generally mixed results of simplified, state-initiated projects of social engineering, what is the potential for transformations in societal regimes of governance to be anchored in the everyday practices of farmers? In this paper, we address these enduring questions in novel ways. We argue that the concept of bricolage, commonly applied to analysing community management of resources, can be developed and deployed to explain broad societal processes of change. To illustrate this, we draw on case studies of irrigated agriculture in Saharan areas of Algeria and in the occupied Golan Heights in Syria. Our case analysis offers insights into how processes of institutional, technological and ideational bricolage entwine, how the state becomes implicated in them and how multiple instances of bricolage accumulate over time to produce meaningful systemic change. In concluding, however, we reflect on the greater propensity of contemporary bricolage to rebalance power relations than to open the way to more ecological farming practices.
A systematic review of economic evaluations alongside studies within a trial (SWATs) for improving recruitment and retention in randomised controlled trials
Authors: Gkekas Athanasios , Evans Alex , Parker Adwoa , Ronaldson Sarah Jane , Torgerson David J
Published: December 2022

Aim

To review the cost-effectiveness of strategies to improve participant recruitment and retention in randomised controlled trials.

Methods

All included studies from the latest Cochrane recruitment and retention reviews were considered. To identify articles published since the Cochrane reviews, electronic databases were searched until March 2021. Hand searching of conference databases and journals was also undertaken. The inclusion criteria included Studies within a Trial (SWATs). The main outcome was the incremental cost-effectiveness ratio (ICER). Quality assessment of papers used the Cochrane risk of bias 1 tool. The CRD guidance was used to assess the quality of economic evaluation. Random-effect meta-analyses were undertaken. The GRADE certainty of evidence was applied for each strategy, and Trial Forge Guidance 2 was used for strategies included in meta-analyses to evaluate the uncertainty of the findings. Cost-effectiveness ranks summarise the cost-effectiveness of all strategies.

Results

We identified 6569 records and included 29 SWATs (earliest conducted in 1999 and latest in 2021) including more than 35,800 participants. There is no strategy we would recommend trial teams and researchers adopt with complete statistical certainty. Recruitment strategies which could be cost-effective include financial incentives, trial-branded pens, telephone reminders and pre-notification leaflets. Retention strategies which could be cost-effective include vouchers and trial-branded pens.

Conclusion

Future SWATs should replicate existing recruitment and retention strategies, rather than evaluate novel ones. We recommend that economic evaluations be carried out alongside all future SWATs, costs and benefits be recorded transparently, and the cost-effectiveness of existing recruitment or retention strategies be evaluated.
Delivery of noninvasive ventilation to people living with motor neuron disease in the UK
Authors: Musson Lucy S. , Baxter Susan K. , Norman Paul , O'Brien David , Elliott Mark , Bianchi Stephen , Kaltsakas Georgios , McDermott Christopher J. , Stavroulakis Theocharis , Hobson Esther V.
Published: December 2022

Objective

Noninvasive ventilation (NIV) improves survival and quality of life in motor neuron disease (MND), but many patients fail to receive effective ventilation. This study aimed to map the respiratory clinical care for MND patients at a service and individual healthcare professional (HCP) level to understand where attention may be needed to ensure all patients receive optimal care.

Methods

Two online surveys of HCPs working with MND patients in the UK were conducted. Survey 1 targeted HCPs providing specialist MND care. Survey 2 targeted HCPs working in respiratory/ventilation services and community teams. Data were analysed using descriptive and inferential statistics.

Results

Responses from 55 HCPs providing specialist MND care who worked at 21 MND care centres and networks and 13 Scotland Health Boards were analysed from Survey 1. Responses from 85 HCPs from respiratory/ventilation services and 73 HCPs from community teams, representing 97 services, were analysed from Survey 2. Significant differences in practice were identified at each stage of the respiratory care pathway as well as evidence of the need for improvement. This included when patients were referred to respiratory services, the time taken waiting to commence NIV, the availability of sufficient NIV equipment and provision of services, particularly out of hours.

Conclusion

We have highlighted significant disparity in MND respiratory care practices. Increased awareness of the factors that influence NIV success and the performance of individuals and services is important for optimal practice.
Conservative oxygen supplementation during helmet continuous positive airway pressure therapy in patients with COVID-19 and respiratory failure: a pilot study
Authors: Iacovelli Alessandra , Nicolardi Maria Luisa , Baccolini Valentina , Olmati Federica , Attilia Ilenia , Baiocchi Pia , D'Antoni Letizia , Menichini Ilaria , Migliarini Ambra , Pellegrino Daniela , Petroianni Angelo , Piamonti Daniel , Tramontano Angela , Villari Paolo , Palange Paolo
Published: December 2022

Background

Respiratory failure is a severe complication in coronavirus disease 2019 (COVID-19) pneumonia that, in addition to oxygen therapy, may require continuous positive airway pressure (CPAP) support. It has been postulated that COVID-19 lung injury may share some features with those observed in hyperoxic acute lung injury. Thus, a correct target arterial oxygen tension (PaO2) during oxygen supplementation may be crucial to protect the lung from further tissue damage. The aims of this study were: 1) to evaluate the effects of conservative oxygen supplementation during helmet CPAP therapy on mortality and intensive care unit (ICU) admission in patients with COVID-19 and respiratory failure, and 2) to evaluate the effect of conservative oxygen supplementation on new-onset organ failure and secondary pulmonary infections.

Methods

This was a single-centre, historically controlled study of patients with severe respiratory failure due to COVID-19 pneumonia, receiving either conservative or nonconservative oxygen supplementation during helmet CPAP. A cohort receiving conservative oxygen supplementation was studied prospectively in which oxygen supplementation was administered with a targetPaO2<100 mmHg. Results of this cohort were compared with those of a cohort who had received liberal oxygen supplementation.

Results

71 patients were included in the conservative cohort and 75 in the nonconservative cohort. Mortality rate was lower in the conservative cohort (22.5%versus62.7%; p<0.001). Rates of ICU admission and new-onset organ failure were lower in the conservative cohort (14.1%versus37.3%; p=0.001 and 9.9%versus45.3%; p<0.001, respectively).

Conclusions

In patients with COVID-19 and severe respiratory failure, conservative oxygen supplementation during helmet CPAP was associated with improved survival, lower ICU admission rate and less new-onset organ failure.
NSD1 gene evolves under episodic selection within primates and mutations of specific exons in humans cause Sotos syndrome
Authors: Romero Vanessa I. , Arias-Almeida Benjamin , Aguiar Stefanie A.
Published: December 2022

Background

Modern human brains and skull shapes differ from other hominids. Brain growth disorders as micro- (ASPM, MCPH1) and macrocephaly (NFIX, GLI3) have been highlighted as relevant for the evolution in humans due to the impact in early brain development. Genes associated with macrocephaly have been reported to cause this change, for example NSD1 which causes Sotos syndrome.

Results

In this study we performed a systematic literature review, located the reported variants associated to Sotos syndrome along the gene domains, compared the sequences with close primates, calculated their similarity, Ka/Ks ratios, nucleotide diversity and selection, and analyzed the sequence and structural conservation with distant primates. We aimed to understand if NSD1 in humans differs from other primates since the evolution of NSD1 has not been analyzed in primates, nor if the localization of the mutations is limited to humans. Our study found that most variations causing Sotos syndrome are in exon 19, 22 and 10. In the primate comparison we did not detect Ka/Ks ratios > 1, but a high nucleotide diversity with non-synonymous variations in exons 10, 5, 9, 11 and 23, and sites under episodic selection in exon 5 and 23, and human, macaque/colobus/tarsier/galago and tarsier/lemur/colobus. Most of the domains are conserved in distant primates with a particular progressive development from a simple PWWP1 in O. garnetti to a complex structure in Human.

Conclusion

NSD1 is a chromatin modifier that suggests that the selection could influence brain development during modern human evolution and is not present in other primates; however, nowadays the nucleotide diversity is associated with Sotos syndrome.
Transcriptional responses of human intestinal epithelial HT-29 cells to spore-displayed p40 derived from Lacticaseibacillus rhamnosus GG
Authors: Kang Soo Ji , Moon Jeong A , Son Do Yeong , Hong Kwang Won
Published: December 2022

Backgrounds

The aims of this study were to construct spore-displayed p40, a Lacticaseibacillus rhamnosus GG-derived soluble protein, using spore surface display technology and to evaluate transcriptional responses in human intestinal epithelial cells.

Results

p40 was displayed on the surface of Bacillus subtilis spores using spore coat protein CotG as an anchor protein. Effects of spore-displayed p40 (CotG-p40) on gene expression of intestinal epithelial cell line HT-29 were evaluated by transcriptome analysis using RNA-sequencing. As a result of differentially expressed gene (DEG) analysis, 81 genes were up-regulated and 82 genes were down-regulated in CotG-p40 stimulated cells than in unstimulated cells. Gene ontology enrichment analysis showed that CotG-p40 affected biological processes such as developmental process, metabolic process, cell surface receptor linked signaling pathway, and retinoic acid metabolic process. Gene-gene network analysis suggested that 10 DEGs (EREG, FOXF1, GLI2, PTGS2, SPP1, MMP19, TNFRSF1B, PTGER4, CLDN18, and ALDH1A3) activated by CotG-p40 were associated with probiotic action.

Conclusions

This study demonstrates the regulatory effects of CotG-p40 on proliferation and homeostasis of HT-29 cells. This study provided comprehensive insights into the transcriptional response of human intestinal epithelial cells stimulated by CotG-p40.
The point-of-care D-dimer test provides a fast and accurate differential diagnosis of Stanford Type A aortic syndrome and ST-elevated myocardial infarction in emergencies
Authors: Chang Xiaoxin , Yao Jianhua , Xu Yawei
Published: December 2022

Background

The research of the sensitivity and specificity point-of-care testing (POCT) of D-dimer as a diagnostic protocol for differential diagnosis of Stanford Type A aortic syndrome (hereafter as TAAS) mimicking ST-elevated myocardial infarction (STEMI) with regular STEMI in the emergency department is limited.

Methods

Full medical information of 32 patients confirmed TAAS and 527 patients confirmed STEMI from January 1st, 2016 to October 1st, 2021 were retrospectively analyzed in Shanghai Tenth People’s Hospital of Tongji University.

Results

The baseline characteristics of two groups of patients were well-balanced post propensity score matching (PSM) analysis, and each group had 32 patients enrolled. Patients in the STEMI group had higher positive cardiac troponin I (cTNI) (0.174 ng/ml vs. 0.055 ng/ml,P = 0.008) results but lower D-dimer (0.365μg/ml vs. 31.50μg/ml,P < 0.001) results than the TAAS group. The D-dimer cutoff value of 2.155μg/ml had the best sensitivity of 100% and specificity of 96.9%, and the positive predictive value (PPV) as well as the negative predictive value (NPV) of the cutoff value were 96.9 and 100%, respectively, in total 64 patients, the area under the curve (AUC) values were 0.998 (95% CI:0.992-1.000,P < 0.001) for the D-dimer. No significant correlation between the D-dimer concentration and the time from symptoms onset to first medical contact in both groups (TAAS group: r = − 0.248,P = 0.170; STEMI group:r = − 0.159,P = 0.383) or significant correlation between D-dimer and creatine clearance (TAAS group:r = − 0.065,P = 0.765; STEMI group:r = 0.222,P = 0.221). The total in-hospital mortality for the patients with TAAS presenting as STEMI was 62.5% (20/32). The mortality rate for TAAS patients confirmed by computed tomography angiography (CTA) was significantly lower (40% vs. 82.4%,P = 0.014) than the mortality rate for TAAS patients confirmed by coronary angiography (CAG) and had a longer average survival time (log-rank = 0.015), less peri-surgical complications especially gastrointestinal hemorrhage (0.00% vs. 55.6%,P < 0.001). CTA diagnosis can reduce the mortality rate by 67.5% (95%CI:0.124-0.850,P = 0.16).

Conclusions

The POCT D-dimer with cut-off 2.155μg/ml would be useful to rule-out TAAS mimicking STEMI from regular STEMI prior to reperfusion therapy. CTA diagnosis is effective in reducing the probability of perioperative complications and lowering perioperative mortality than CAG diagnosis in TAAS patients.
Sleep quality and influencing factors and correlation with T-lymphocyte subpopulation counts in patients with pulmonary tuberculosis: a cross-sectional study
Authors: Zhang Hailin , Li Ao , Jiang Youli , Chen Wenqiu , Wang Jin , Zhang Peize , Deng Guofang , Wang Weiyu , Chen Jingfang , Lin Yi
Published: December 2022

Background

Patients diagnosed with pulmonary tuberculosis (TB) have poor sleep quality due to multiple factors. We aimed to assess the sleep status and related factors of TB patients in Shenzhen, China.

Methods

A questionnaire survey was conducted on 461 TB patients hospitalized at Shenzhen Third People’s Hospital from March 2021 to January 2022, and sleep quality was assessed using the Pittsburgh sleep quality index (PSQI).

Results

A total of 459 valid questionnaires were collected, and 238 of the 459 TB patients had general or poor sleep quality (PSQI > 5). Patients’ gender, marriage, nutritional screening score, family atmosphere, fear of discrimination, fear of interactions, and the impact of the disease on their work life had significant effects on sleep quality (P < 0.05); PSQI scores of TB patients were negatively correlated with lymphocyte counts (r =  − 0.296, P < 0.01), T-lymphocyte counts (r =  − 0.293, P < 0.01), helper T lymphocyte counts (r =  − 0.283, P < 0.01), killer T lymphocyte counts (r =  − 0.182, P < 0.05), and were positively correlated with depression scores (r = 0.424, P < 0.01). Multivariable logistic regression analysis showed that male (OR = 1.64,95% CI 1.11–2.42, P < 0.05), unmarried (OR = 1.57, 95% CI 1.02–2.42, P < 0.05), NRS score grade 3(OR = 5.35, 95% CI 2.08–15.73, P < 0.01), general family atmosphere (OR = 2.23, 95% CI 1.07–4.93, P < 0.05), and the disease affecting work (OR = 1.66, 95% CI 1.11–2.50, P < 0.05) were factors influencing poor sleep quality.

Conclusion

Most TB patients had varying degrees of sleep disturbance, which may be affected by their gender, marriage, family atmosphere, nutritional status, the effect of the disease on work life, and, depression, as well as lower absolute T-lymphocyte subpopulation counts. Appropriate interventions should be implemented to improve their sleep quality, when treating or caring for such patients.
Long term trends of breast cancer incidence according to proliferation status
Authors: Klæstad Elise , Opdahl Signe , Raj Sunil Xavier , Bofin Anna Mary , Valla Marit
Published: December 2022

Background

Long-term breast cancer incidence trends according to proliferation status are poorly described. We studied time-trends in breast cancer incidence, using mitotic count and Ki-67 as markers of proliferation.

Methods

Among 83,298 Norwegian women followed for breast cancer occurrence 1961–2012, 2995 incident breast cancers were diagnosed. Ki-67 was assessed using immunohistochemistry on tissue microarrays and mitoses were counted on whole sections. We compared incidence rates according to proliferation status among women born 1886–1928 and 1929–1977, estimating age-specific incidence rate ratios. We performed multiple imputations to account for unknown proliferation status. Mean values of Ki-67 and mitotic counts were calculated, according to age and birth year. We performed separate incidence analyses for HER2+and triple negative breast cancers.

Results

Among women aged 40–69 years, incidence rates of tumours with low-proliferative activity were higher among those born in 1929 or later, compared to before 1929, according to Ki-67 and mitotic count. Incidence rates of tumours with high-proliferative activity were also higher in women born in 1929 or later compared to before 1929 according to Ki-67, but not according to mitotic count. Mean values of Ki-67 and mitotic count varied according to age and birth year. In subtype-specific analyses we found an increase of high-proliferative HER2+tumours according to Ki-67 in women born in 1929 or later, compared to before 1929.

Conclusions

There has been a temporal increase in both low- and high-proliferative breast cancers.
Clinical characteristics and survival analysis of Chinese ovarian cancer patients with RAD51D germline mutations
Authors: Yao Hongwen , Li Ning , Yuan Hua
Published: December 2022

Objectives

We aimed to describe the behavior among Chinese ovarian cancer patients with RAD51D germline mutations at our institution.

Methods

Next-generation sequencing (NGS) was conducted for the entire coding regions and exon/intron boundaries of the RAD51D genes in 781 Chinese ovarian cancer patients treated at our institution from January 1, 2015 to August 1, 2021. Clinicopathological characteristics, treatment modalities, and outcomes were assessed for ovarian cancer patients with RAD51D germline mutations.

Results

RAD51D germline pathogenic mutations were detected in 1.7% (13/781) of patients in this cohort. RAD51D c. 270_271dup (p. Lys91fs) mutation was the most common mutation which was found in 7 patients (7/13, 53.1%). Patients median age at diagnosis was 58 years (range: 45–69 years). 46.2% (6/13) of them were diagnosed after 60 years. Only 1 patient (1/13, 7.7%) had a family history of ovarian or breast cancer. And 1 patient (1/13, 7.7%) had a personal history of breast cancer. The FIGO 2014 distribution by stage was: stage II in 1 patient (7.7%), stage III in 9 patients (69.2%) and stage IV in 3 patient (23.1%). 92.3% (12/13) patients had high-grade serous carcinoma. 2 patients (2/13, 15.4%) had a primary peritoneal cancer. The majority of patients in the entire cohort were reported to be platinum sensitive (92.3%, 12/13) with a platinum-free interval (PFI) of > 6 months.

For patients who received PARPis for 2nd line maintenance treatment (n = 5), 2 patients discontinued PARPis treatment after 33.5 and 8.1 months of duration. Other 3 patients are still on therapy with a duration of 2.4, 13.8 and 30.1 months at the date of data cutoff. 1 patient received PARPi as salvage treatment with a duration of only 1.2 months.

Nine patients (9/13, 69.2%) relapsed during follow up and all of them relapsed within 2 years after diagnosis, among which 88.9% (8/9) were classified as platinum-sensitive recurrence (PSR), and only 1 patient was classified as platinum-resistant recurrence (PRR). Median PFS for the entire cohort was 17.3 months. Median PFS for the PSR subgroup was 15.9 months. 2 patients died during follow-up. The OS of these 2 patients was 17.2 and 39.6 months. The 5-year OS rate was 67.5%.

Conclusions

RAD51D germline mutations are more frequent in Chinese ovarian cancer patients than other population. Few patients have a family history of ovarian or breast cancer, and personal history of breast cancer. Most patients are diagnosed after 50 years. The sensitivity to PARP inhibitors of patients with RAD51D germline mutations need a further analysis.
A comprehensive study based on exosome-related immunosuppression genes and tumor microenvironment in hepatocellular carcinoma
Authors: Yang Zhan , Li Xinmiao , Pan Chaoran , Li Yifei , Lin Lifan , Jin Yan , Zheng Jianjian , Yu Zhengping
Published: December 2022

Background

Exosomes play an important role in the tumor microenvironment (TME) and the mechanisms of tumor immune escape in hepatocellular carcinoma (HCC). It is known that immunosuppressive genes, involved in the processes of tumor immunosuppression, are associated with cancer progression. This study aimed to explore the prognostic values of exosome-related immunosuppression genes (ERIGs) in HCC.

Methods

The RNA-seq transcriptome data of 374 HCC patients were obtained from the Cancer Genome Atlas (TCGA) database. The TCGA cohort was randomly divided into the training cohort and validation cohort in a 1:1 ratio. WGCNA analysis and Pearson correlation analysis were used to identify ERIGs. The Lasso regression method was used to construct a 5-ERIG signature. The prognostic value of our signature was examined in the First Affiliated Hospital of Wenzhou Medical University (FAHWMU) cohort.

Results

Univariate Cox regression analysis was used to screen prognostic ERIGs. Subsequently, these prognostic ERIGs were included in Lasso regression analyses to identify 5 key ERIGs (ASAP1, IARS1, GTF3C2, TPD5L2 and SLC52A2) and construct a 5-ERIG signature. The patients in the low-risk group had better prognosis than those in the high-risk group. Univariate and multivariate cox regression revealed that risk score was an independent prognostic risk factor of HCC. Gene set enrichment analysis (GSEA) showed that this signature was highly associated with TME-related pathways. Subsequent analyses revealed the potential role of the signature in regulating the TME in HCC. In addition, a lower immunotherapy score was found in patients with high risk-score. Of note, this signature was confirmed to have a good performance in predicting HCC prognosis in the FAHWMU cohort. Moreover, knockdown of 5 ERIGs of this signature contributed to the suppression the Hep3B cell proliferation.

Conclusions

We generated a novel prognostic 5-ERIG signature to accurately predict the prognosis of patients with HCC, and this signature may serve as an indicator of immunotherapy for HCC.
Long-term self-reported health and disability after COVID-19 in public employees
Authors: Kröönström Linda Ashman , Krause Johanna , Larsson Simon B. , Sigström Robert , Sunnerhagen Katharina Stibrant
Published: December 2022

Background

Although the symptomatology has been assessed in multiple studies among persons recovering from coronavirus disease 2019 (COVID-19), less is known regarding long-term general health and disability. We aimed to assess long-term self-reported disability in public employees after predominantly mild COVID-19 in comparison with individuals who had negative COVID-19 polymerase chain reaction (PCR) test results.

Methods

Public employees within Region Västra Götaland were offered tests to identify SARS-CoV-2 infection (n = 56,221) and were invited to complete an online survey that included the World Health Organization Disability Assessment Schedule. Questionnaires were sent out between January 26 and March 5, 2021. A total of 14,222 (25.3%) employees responded, of which 10,194 (18%) were included (women n = 8749, 85.8%). Of these, 7185 (70.5%) participants had a negative PCR test result (controls). A total of 1425 (14%) had a positive PCR result and were categorized in the sub-acute phase (4–12 weeks post COVID-19), and 1584 (15.5%) had a positive PCR test and were categorized in the post COVID-19 phase (> 12 weeks).

Results

Fifty-two percent of controls rated disability of varying degrees, versus 73% and 64% of participants in the sub-acute and post COVID-19 phase, respectively. Being “emotionally affected” was the most frequently reported disability in the sub-acute phase, the post COVID-19 phase, as well as in controls. The proportion of participants reporting difficulties for 20–30 days was higher in the sub-acute phase than in the post COVID-19 phase (27.9% vs. 21.8%, p < 0.001) as well as in a comparison between participants in the post COVID-19 phase and controls (21.8% vs 14.2%, p < 0.001). Compared with controls, severe disability was more common in the post COVID-19 phase among both women (15.8% vs. 10.7%,), and men (9.8% vs. 6.8%).

Conclusions

Disability was present in all groups; however, reported disability was greater in the sub-acute phase than in the post COVID-19 phase. The higher levels of disability reported in the COVID-19 patient population may indicate a persisting need for rehabilitation and recovery. In general, women reported a greater degree of disability than men in the sub-acute and post COVID-19 phases.
Messaging preferences among Florida caregivers participating in focus groups who had not yet accepted the HPV vaccine for their 11- to 12-year-old child
Authors: Staras Stephanie A. S. , Bylund Carma L. , Mullis Michaela D. , Thompson Lindsay A. , Hall Jaclyn M. , Hansen Marta D. , Fisher Carla L.
Published: December 2022

Background

In the United States, human papillomavirus (HPV) vaccination rates remain low. The President’s Cancer Panel suggests that effective messaging about the HPV vaccination focus on the vaccine’s safety, efficacy, ability to prevent cancer, and recommendation at ages 11- to 12-years. We aimed to develop messages about HPV vaccine that include the President Cancer Panel’s suggestions and were acceptable to caregivers of adolescents.

Methods

From August to October 2020, we conducted one-hour, Zoom videoconference focus groups with caregivers who lived in Florida, had an 11- to 12-year-old child, and had not had any of their children receive the HPV vaccine. Focus group moderators asked caregivers to react to three videos of clinician (i.e., MD, DO, APRN, PA) recommendations and three text message reminders. Thematic analysis was conducted using the constant comparative method and led by one author with qualitative analysis expertise. Two additional authors validated findings.

Results

Caregivers (n = 25 in six groups) were primarily non-Hispanic white (84%) and educated (64% had at least an Associate’s degree). Approximately a third of caregivers had delayed (44%) or decided against a vaccine for their child (36%). Caregivers described six preferred message approaches: recognize caregivers’ autonomy, balanced benefits and risks, trustworthy sources, increased feasibility of appointment scheduling, information prior to decision point, and preferred personalized information. Caregivers expressed a desire to have the follow-up doses mentioned in the introduction.

Conclusions

HPV vaccine messages, whether delivered by a clinician or via text message, will be more acceptable to caregivers if they approach HPV vaccination as the caregivers’ decision, and include information from trusted sources to help caregivers make an informed choice.
Contact network analysis of COVID-19 Delta variant outbreak in urban China —based on 2,050 confirmed cases in Xi’an, China
Authors: Zhangbo Yang , Zheng Chen , Hui Wang
Published: December 2022

Background

The purpose of this paper is to study how the Delta variant spread in a China city, and to what extent the non-pharmaceutical prevention measures of local government be effective by reviewing the contact network of COVID-19 cases in Xi’an, China.

Methods

We organize the case reports of the Shaanxi Health Commission into a database by text coding and convert them into a network matrix. Then we construct a dynamic contact network for the corresponding analysis and calculate network indicators. we analyze the cases’ dynamic contact network structure and intervals between diagnosis time and isolation time by using data visualization, network analysis method, and Ordinary Least Square (OLS) regression.

Results

The contact network for this outbreak in Xi’an is very sparse, with a density of less than 0.0001. The contact network is a scale-free network. The average degree centrality is 0.741 and the average PageRank score is 0.0005. The network generated from a single source of infection contains 1371 components. We construct three variables of intervals and analyze the trend of intervals during the outbreak. The mean interval (interval 1) between case diagnosis time and isolation time is − 3.9 days. The mean of the interval (interval 2) between the infector’s diagnosis time and the infectee’s diagnosis time is 4.2 days. The mean of the interval (interval 3) between infector isolation time and infectee isolation time is 2.9 days. Among the three intervals, only interval 1 has a significant positive correlation with degree centrality.

Conclusions

By integrating COVID-19 case reports of a Chinese city, we construct a contact network to analyze the dispersion of the outbreak. The network is a scale-free network with multiple hidden pathways that are not detected. The intervals of patients in this outbreak decreased compared to the beginning of the outbreak in 2020. City lockdown has a significant effect on the intervals that can affect patients’ network centrality. Our study highlights the value of case report text. By linking different reports, we can quickly analyze the spread of the epidemic in an urban area.
Social capital and wellbeing among Australian adults’ during the COVID-19 pandemic: a qualitative study
Authors: Green Heidi , Fernandez Ritin , Moxham Lorna , MacPhail Catherine
Published: December 2022

Background

COVID-19 has created global disruption, with governments across the world taking rapid action to limit the spread of the virus. Physical distancing and lockdowns abruptly changed living conditions for many, posing specific challenges of social isolation and lack of connectedness due to being physically and socially isolated from family and friends. Social capital is the bonding of individuals within a society that facilitates and shapes social interactions. The aim of this study was to qualitatively explore the impact that existing social capital has on Australians’ experience of lockdowns during the COVID-19 pandemic and the effect this has had on their wellbeing and quality of life.

Methods

Participants from various socioeconomic areas within Australia were purposively selected to participate in semi-structured interviews conducted via videoconferencing or telephone. Inductive thematic analysis of the data was undertaken.

Results

A total of 20 participants were interviewed ranging in age from 21 to 65 years, including 50% (n = 10) females, 40% (n = 8) males, 5% (n = 1) non-binary and 5% (n = 1) transgender. Three main themes emerged from the analysis of the data: No person is an island; Social engagement; and Loneliness and isolation. Individuals who resided in low socioeconomic areas, those who lived alone and had reduced social support expressed feelings of poorer wellbeing.

Conclusions

This study describes the lived-experiences of the influence of the COVID-19 pandemic on Australians’ social capital and wellbeing. The findings highlight the need for interventions to increase social support, social cohesion, and social connectedness, especially among Australians from low socioeconomic areas, to enhance their overall wellbeing.
The non-linear link between remnant cholesterol and diabetic retinopathy: a cross-sectional study in patients with type 2 diabetic mellitus
Authors: Pan Wushan , Han Yong , Hu Haofei , He Yongcheng
Published: December 2022

Objective

Research on residual cholesterol (RC) and diabetic retinopathy (DR) remains limited. As a result, the current study was designed to investigate the relationship between RC and DR in patients with type 2 diabetic mellitus (T2DM).

Methods

This cross-sectional study consecutively and non-selectively collected a total of 1964 type 2 diabetic mellitus patients in two hospitals in Taiwan from April 2002 to November 2004. A binary logistic regression model was then used to assess the independent relationship between RC level and DR and proliferative diabetic retinopathy (PDR). A generalized additive model (GAM) and smooth curve fitting were used to investigate the actual shape of the curve between them. It was stated that the data had been uploaded to the website:https://journals.plos.org/plosone.

Results

The average age of the participants was 64.10+/− 11.32 years old, with 42.92% being male. The prevalence of DR and PDR was 35.13 and 18.13%, respectively. The mean RC level was 30.57 ± 14.60 mg/dL. We found no significant association between RC and DR (OR = 1.001; 95% CI 0.991, 1.011) or PDR (OR = 1.008; 95% CI 0.995, 1.021) based on a fully adjusted logistic regression model. Results remained robust across a series of sensitivity analyses. However, a non-linear relationship was detected between RC and DR. Using a two-piece logistic regression model and a recursive algorithm, we found an inflection point of RC was 13.0 mg/dL. A 1-unit increase in the RC level was associated with 19.4% greater adjusted odds of DR (OR = 1.194; 95% CI 1.070, 1.333) when RC < 13.0 mg/dL. There was also a non-linear relationship between RC and PDR, and the inflection point of the RC was 39.0 mg/dL. When RC < 39.0 mg/dL, a 1-unit increase in the RC level was associated with 2.1% greater adjusted odds of PDR (OR = 1.021; 95% CI 1.004, 1.038).

Conclusion

This study demonstrates a non-linear relationship between RC and DR or PDR in type 2 diabetic mellitus patients. Our findings provide new insights into advancing research on the link between RC and DR or PDR.
Immediate and Delayed Post Space Preparations in Endodontically Treated Teeth: A Scoping Review
Authors: Mahmoudi Sadaf , Iranmanesh Pedram , Khazaei Saber , Jahromi Maryam Zare
Published: December 2022

Background

The aim of the present review was to identify the effect of the post-space preparation (PSP) timing (immediate or delayed) on endodontically treated teeth.

Methods

All studies in any language that compared the effect of immediate versus delayed PSP on the outcomes of an endodontically treated tooth were searched in PubMed, Scopus, Web of Science, Cochrane, ProQuest, WorldCat, and Google Scholar databases by two independent researchers until February 12, 2022. Studies assessing merely the immediate or delayed PSP were excluded. A descriptive analysis was performed to evaluate the study design and the characteristics of the included studies.

Results

The initial search yielded 2612 records, of which 68 were included. Except for one randomized controlled trial, all were in vitro. The evaluated variables were apical/coronal microleakage (n = 48/n = 1), post-bond strength (n = 8), bacterial infiltration (n = 7), presence of voids (n = 3), apical extrusion and residual of filling material (n = 1), and post-operative pain (n = 1). The number of publications had steady growth per year and fast growth per decade. "Post-space preparation" was the most popular keywords.

Conclusions

The present review highlights the need for further investigations due to the various design of studies, controversial results, and an inadequate number of randomized controlled trials.

Trial registration

Retrospectively registered. Open Science (https://doi.org/10.17605/OSF.IO/2YTM6).
Patients’ awareness regarding the quality of their oral hygiene: development and validation of a new measurement instrument
Authors: Eidenhardt Zdenka , Busse Sebastian , Margraf-Stiksrud Jutta , Deinzer Renate
Published: December 2022

Background

The present research aimed to develop and validate a standardised survey instrument for the assessment of patients' awareness of the quality of their oral hygiene performance.

Methods

A digital questionnaire was developed that assesses both patients' naïve self-perceptions of oral cleanliness (SPOCn) after tooth brushing and patients' perceptions after being informed how oral cleanliness may be captured in dentistry (SPOCd). Three studies (N = 56 adults, N = 66 adolescents and one of their parents, N = 24 university students) assessed the instrument’s feasibility (patient reports), reliability (internal consistency), validity (correlation with other constructs; sensitivity to manipulation of actual tooth brushing), and the correlation with actual oral cleanliness after tooth brushing.

Results

All study groups accepted the questionnaire well; average answering times were less than 5 min. Cronbach’s α exceeds 0.90; correlational analyses support the discriminant validity regarding oral hygiene related self-efficacy expectations and stages of change; manipulation of oral hygiene behaviour results in the expected changes of SPOC scores. Patients’ SPOC correlate only moderately with actual oral cleanliness. The comparison between SPOCd scores and actual oral cleanliness indicate that they considerably overestimate their oral hygiene performance.

Conclusions

The SPOC questionnaire is an easy-to-use, well-accepted, reliable and valid instrument for the assessment of patients’ awareness of the quality of their oral hygiene for research and clinical purposes. The results of the questionnaire may help to reveal unrealistic self-perceptions of patients regarding their oral hygiene. It can raise their awareness of the need to improve their skills and/or efforts in this regard.

Trial registration The third study was an interventional study and was registered in the appropriate national register (www.drks.de; ID: DRKS00018781; date of registration: 12/09/2019).
Efficacy, safety and therapeutic mechanism of Shen-Qi Xiao-Tan formula in the treatment of peripheral atherosclerosis in patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial protocol
Authors: Leng Yulin , Fu Xiaoxu , Qian Lisen , Li Qiqi , Gao Hong , Xie Hongyan , Xie Chunguang
Published: December 2022

Background

Peripheral atherosclerosis is a common macrovascular complication of diabetes, but the treatment is limited. Chinese herbal medicine is the complementary and alternative therapy to delay the progression of atherosclerosis and reduce blood glucose and lipids. Shen-Qi Xiao-Tan (SQXT) formula is one of the prescriptions commonly used to treat diabetic peripheral atherosclerosis, but there is still a lack of high-quality evidence-based evidence.

Methods

This is a randomized, double-blind, placebo-controlled add-on trial that is expected to enroll 114 diabetic patients with peripheral atherosclerosis. After a 2-week run-in period, participants will been randomly assigned in a 1:1 ratio and receive 12 weeks of usual treatment and SQXT formula (treatment group) or usual treatment and placebo (control group). The primary outcome is the change in carotid intima-media thickness from baseline to endpoint. The secondary outcomes are the structure and function of peripheral arteries, blood glucose and lipids, traditional Chinese medicine syndrome score, and quality of life, and safety and endpoint events are evaluated. To explore the therapeutic mechanism through oxidative stress, inflammation, and advanced glycation end products, and lipidomics will be used to screen for biomarkers for diagnosis and efficacy evaluation.

Discussion

The objective of this trial is to evaluate the efficacy, safety and therapeutic mechanism of SQXT formula in the treatment of diabetic peripheral atherosclerosis. It will obtain high-quality evidence-based evidence and promote the treatment of diabetic macroangiopathy and the research and development of new drugs.

Trial registration

This trial is registered on Chinese Clinical Trials.gov with number ChiCTR2100047189 on 10 Jun 2021, and has been approved by the Ethical Review Committee of Hospital of Chengdu University of Traditional Chinese Medicine with number 2020KL-080.
Homeopathy for seasonal allergic rhinitis: rationale, design and methods of the three-armed randomized controlled HOMEOSAR trial
Authors: Siewert J. , Teut M. , Gaertner K. , Binting S. , Eberhardt C. , Ortiz M. , Grabowska W. , Reinhold T. , Roll S. , Stoeckigt B. , Willich S. N. , Cramer H. , Brinkhaus B.
Published: December 2022

Background

Patients with seasonal allergic rhinitis (SAR) frequently use homeopathic therapy. Although there is some evidence that homeopathy may be effective in treating symptoms of SAR, there is a lack of high-quality clinical trials. Therefore, the aim of the homeopathy for SAR (HOMEOSAR) trial is to determine the efficacy of individualized or standardized homeopathic drug treatment compared to placebo regarding rhinitis-related quality of life in patients with SAR.

Methods

This randomized, placebo-controlled, double-blind, three-armed intervention study will be conducted at two university hospital outpatient clinics for complementary and integrative medicine in Berlin and in 12 office-based practices specializing in homeopathic treatment in Germany. A total of 270 patients with clinical symptoms of SAR and positive allergy test to birch and grass pollen will receive homeopathic anamnesis and subsequently be randomized into (a) standardized homeopathic drug treatment with Galphimia Glauca (potency D6), (b) individualized homeopathic drug treatment (D6), or (c) placebo. All three groups can receive on-demand rescue medication as needed. Treatment will consist of two consultations and daily intake of the study medication for 4 weeks during the pollen season. The primary outcome is the mean overall score of the Rhinitis Quality of Life Questionnaire (RQLQ) in weeks 3 and 4, analyzed using analysis of covariance (adjusted for baseline RQLQ overall score and study center). A closed testing procedure will be used to control the overall type I error comparing the 3 treatment groups. Secondary outcomes include the overall RQLQ and its seven domain scores, responder status (decrease in RQLQ overall score of at least 0.5 points compared to the baseline value), use of rescue medication, intensity of total and individual SAR symptoms based on visual analog scale, generic health-related quality of life, safety, utilization of health care resources and associated costs. In addition, a qualitative data analysis is planned.

Conclusion

The results of our study will contribute to clarifying the possible therapeutic effects of homeopathic drug treatment for patients with SAR.

Trial registration

This study has been registered in the German Clinical Trial Registry with trial ID DRKS00018081 on June 09, 2020.
The effect of physician training and patient education on the discussion of care decisions at the internal medicine outpatient clinic
Authors: Briedé Saskia , de Winter Maria A. , van Charldorp Tessa C. , Kaasjager Karin A. H.
Published: December 2022

Background

Care decision discussions are intended to align treatment with the patient’s wishes, goals and values. To overcome the numerous barriers to such discussions, physicians as well as patients need tailored support. We evaluate the effect of a physicians’ training and a conversation aid for patients about care decisions on patient and physician outcomes.

Methods

At the internal medicine outpatient clinic of the University Medical Centre Utrecht, a 1:1 randomized, parallel-group study (patient conversation aid) was combined with a pre-post intervention (physicians’ training) design. Primary outcome was patient satisfaction, secondary outcomes were patient-doctor relationship, shared-decision-making, doctor preparedness and patient appreciation of the conversation aid.

Results

Between October 2018 and February 2020 11 physicians (36% residents, 73% female) and 185 patients (median age 58 years (interquartile range (IQR) 50–68), 60% male) participated. Only 28% of the patients reported a care decision discussion during the consultation. We found no effect of the interventions on patient satisfaction (effect sizes -0.14 (95% confidence interval (CI) -0.56–0.27) for conversation aid; 0.04 (95% CI -0.40–0.48) for physician’s training), nor on the patient-doctor relationship or shared-decision-making. However, physicians felt more prepared to discuss care decisions after training (median 3 (IQR 1–4) vs 1 (IQR 0–3), p = 0.015). Patients assessed the conversation aid informative and gave an overall mark of median 7 (IQR 7–8).

Conclusions

First steps towards fruitful discussions about care decisions were made: patients considered the conversation aid informative and physicians felt better prepared to discuss care decisions after training. The low number of care decision conversations patients reported shows exactly how important it is to focus on interventions that facilitate these discussions, for both the patient and physician. Further work needs to be done to establish the best way to empower patients and physicians.

Trial registration

Dutch trial register, trial 6998 (NTR 7188), registered 04/05/2018, https://www.trialregister.nl/trial/6998.