bluuebunny/crossref_metadata_2025 huggingface dataset:
A study protocol for a European, mixed methods, prospective, cohort study of the effectiveness of naloxone administration by community members, in reversing opioid overdose: NalPORS
Authors: Metrebian Nicola , Carter Ben , Eide Desiree , McDonald Rebecca , Neale Joanne , Parkin Stephen , Dascal Teodora , Mackie Clare , Day Ed , Guterstam Joar , Horsburgh Kirsten , Kåberg Martin , Kelleher Mike , Smith Josie , Thiesen Henrik , Strang John
Published: August 2023

Background

Worldwide, opioid use causes more than 100,000 overdose deaths annually. Naloxone has proven efficacy in reversing opioid overdoses and is approved as an emergency antidote to opioid overdose. Take home naloxone (THN) programmes have been introduced to provide ‘community members’, who are likely to observe opioid overdoses, with naloxone kits and train them to recognise an overdose and administer naloxone. The acceptability and feasibility of THN programmes has been demonstrated, but the real-life effectiveness of naloxone administration by community members is not known. In recent years, the approval of several concentrated naloxone nasal-spray formulations (in addition to injectable formulations, eg.prenoxad) potentially increases acceptability and scope for wider provision. This study aims to determine the effectiveness of THN (all formulations) in real-world conditions.

Methods

A European, multi-country, prospective cohort study, to assess the use of THN by community members to reverse opioid overdoses in a six-month, follow-up period. Participants provided with THN from participating harm reduction and drug treatment sites will be recruited to the study and followed-up for six months. We are particularly interested in the experiences of community members who have been provided with THN and have witnessed an opioid overdose. All participants who witness an opioid overdose during the six-month period (target approx. 600) will be asked to take part in a structured interview about this event. Of these, 60 will be invited to participate in a qualitative interview. A Post Authorisation Efficacy Study (PAES) for the concentrated nasal naloxone, Nyxoid, has been integrated into the study design.

Discussion

There are many challenges involved in evaluating the real-life effectiveness of THN. It is not possible to use a randomised trial design, recruitment of community members provided with THN will depend upon recruitment sites distributing THN kits, and the type of THN received by participants will depend on regulations and on local clinical and policy decision-makers. Following up this population, some of whom may be itinerant, over the 6-month study period will be challenging, but we plan to maintain contact with participants through regular text message reminders and staff contact.

Trial registration

ClinicalTrials.gov Identifier: NCT05072249. Date of Registration: 8.10.2021
Weight bias internalization and beliefs about the causes of obesity among the Canadian public
Authors: Forouhar Vida , Edache Iyoma Y. , Salas Ximena Ramos , Alberga Angela S.
Published: August 2023

Background

Explicit weight bias is known as negative attitudes and beliefs toward individuals due to their weight status and can be perpetuated through misconceptions about the causes of obesity. Individuals may also experience weight bias internalization (WBI) when they internalize negative weight-related attitudes and self-stigmatize. There is a paucity of research on the beliefs about the causes of obesity and the prevalence of WBI among public Canadian samples. The aim of this study was to describe these attitudes and beliefs about obesity among a large Canadian sample across the weight spectrum.

Methods

A Canadian sample of adults (N = 942; 51% Women; mean age group = 45–54 years; mean body mass index [BMI] = 27.3 ± 6.7 kg/m2) completed an online questionnaire. Participants completed the Modified Weight Bias Internalization Scale, the Anti-Fat Attitudes Questionnaire, and the Causes of Obesity Questionnaire.

Results

Mean WBI score within the entire sample was 3.38 ​​ ± 1.58, and females had higher mean scores as compared to males (p < 0.001). Mean scores were also higher among individuals with a BMI of > 30 kg/m2 (4.16 ± 1.52), as compared to individuals with a BMI of 25–30 kg/m2 (3.40 ± 1.50), and those with a BMI of 20–25 kg/m2 or below 18.5 kg/m2 (2.81 ± 1.44) (p < 0.001 for all). Forty four percent of Canadians believed behavioural causes are very or extremely important in causing obesity, 38% for environmental causes, 28% for physiological and 27% for psychosocial causes. Stronger beliefs in behavioural causes were associated with higher levels of explicit weight bias. No BMI differences were reported on the four different subscales of the Causes of Obesity Questionnaire.

Conclusions

Weight bias internalization is prevalent among Canadians across all body weight statuses, and the public endorses behavioural causes of obesity, namely physical inactivity and overeating, more than its other causes. Findings warrant the reinforcement of efforts aimed at mitigating weight bias by educating the public about the complexity of obesity and by highlighting weight bias as a systemic issue that affects all Canadians living in diverse body weight statuses.
Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review
Authors: Mitchell Eileen , Waring Tanisha , Ahern Elayne , O’Donovan Diarmuid , O’Reilly Dermot , Bradley Declan T.
Published: August 2023

Background

Homelessness is a complex societal and public health challenge. Limited information exists about the population-level health and social care-related predictors and consequences of persons with lived experience of homelessness (PEH). Studies that focus on population subgroups or ad hoc questionnaires to gather data are of relatively limited generalisability to whole-population health surveillance and planning. The aim of this study was to find and synthesise information about the risk factors for, and consequences of, experiencing homelessness in whole-population studies that used routine administrative data.

Method

We performed a systematic search using EMBASE, MEDLINE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO research databases for English-language studies published from inception until February 2023 that reported analyses of administrative data about homelessness and health and social care-related predictors and consequences. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results

Of the 1224 articles reviewed, 30 publications met the inclusion criteria. The included studies examined a wide range of topic areas, and the homelessness definitions used in each varied considerably. Studies were categorised into several topic areas: Mortality, morbidity and COVID-19; health care usage and hospital re-admission; care home admission and shelter stay; and other (e.g. employment, crime victimisation). The studies reported that that the physical and mental health of people who experience homelessness was worse than that of the general population. Homeless individuals were more likely to have higher risk of hospitalisation, more likely to use emergency departments, have higher mortality rates and were at greater risk of needing intensive care or of dying from COVID-19 compared with general population. Additionally, homeless individuals were more likely to be incarcerated or unemployed. The effects were strongest for those who experienced being homeless as a child compared to those who experienced being homeless later on in life.

Conclusions

This is the first systematic review of whole-population observational studies that used administrative data to identify causes and consequences associated with individuals who are experiencing homelessness. While the scientific literature provides evidence on some of the possible risk factors associated with being homeless, research into this research topic has been limited and gaps still remain. There is a need for more standardised best practice approaches to understand better the causes and consequences associated with being homeless.
Protocol of a prospective community-based study about the onset and course of depression in a nationally representative cohort of adults in China: the China Depression Cohort Study-I
Authors: Li Xuting , Tian Yusheng , Phillips Michael R. , Xiao Shuiyuan , Zhang Xiaojie , Li Zongchang , Liu Jun , Li Lingjiang , Zhou Jiansong , Wang Xiaoping
Published: August 2023

Background

Depression is the second most important cause of disability worldwide. Reducing this major burden on global health requires a better understanding of the etiology, risk factors, and course of the disorder. With the goal of improving the prevention, recognition, and appropriate management of depressive disorders in China, the China Depression Cohort Study will establish a nationally representative sample of at least 85,000 adults (the China Depression Cohort Study-I) and 15,000 middle school students (the China Depression Cohort Study-II) and follow them over time to identify factors that influence the onset, characteristics, and course of depressive disorders. This protocol describes the China Depression Cohort Study-I.

Methods

A multistage stratified random sampling method will be used to identify a nationally representative community-based cohort of at least 85,000 adults (i.e., ≥ 18 years of age) from 34 communities in 17 of mainland China’s 31 provincial-level administrative regions. Baseline data collection includes 1) demographic, social and clinical data, 2) diagnostic information, 3) biological samples (i.e., blood, urine, hair), 4) brain MRI scans, and 5) environmental data (e.g., community-level metrics of climate change, air pollution, and socio-economic characteristics). Baseline findings will identify participants with or without depressive disorders. Annual reassessments will monitor potential risk factors for depression and identify incident cases of depression. Cox Proportional-Hazards Regression, Network analysis, Disease trajectory modelling, and Machine learning prediction models will be used to analyze the collected data. The study’s main outcomes are the occurrence of depressive disorders; secondary outcomes include adverse behaviors (e.g., self-harm, suicide), the recurrence of depression and the incidence other mental disorders.

Discussion

The China Depression Cohort Study-I will collect a comprehensive, nationally representative set of individual-level and community-level variables over time. The findings will reframe the understanding of depression from a ‘biology-psychology-society’ perspective. This perspective will improve psychiatrists’ understanding of depression and, thus, promote the development of more effective subgroup-specific antidepressant drugs and other interventions based on the new biomarkers and relationships identified in the study.

Trail registration

The protocol has been registered on the Chinese Clinical Trial Registry (No. ChiCTR2200059016).
The relationship between social capital and health from a configuration perspective: an evidence from China
Authors: Hao Chongqi , Guo Dan , Ren Hao , Wang Xuchun , Qiao Yuchao , Qiu Lixia
Published: August 2023

Background

The debate on the relationship between social capital and health is still ongoing. To enhance previous research, this study uses data drawn from China to analyse the situations in which social capital is related to good health and the various configurations that result in good health outcomes.

Methods

Using the data of China Family Panel Studies, the conditions of age, gender, marriage, education, income, structural social capital and cognitive social capital were included to analyse the sufficient and necessary conditions for achieving good general health and their different configurations using the fsQCA method.

Results

None of the listed conditions were prerequisites for excellent general health in terms of either their presence or their absence. The sufficiency analysis found 11 configurations with an average of 3–4 conditions per configuration; in no configuration was the condition of social capital present alone. Structured social capital and cognitive social capital exhibited negative states in configurations 1 and 2, respectively. The most prevalent factor in all configurations was the condition of age.

Conclusions

The relationship between social capital and health is both positive and negative, with cognitive social capital playing a larger role in the positive relationship than structural social capital. Social capital is neither a necessary nor a sufficient condition for health, and it must be combined with a variety of other factors to promote health. A variety of methods can be used to promote an individual's health, as different populations require different approaches to good general health, and no single pathway applies to all populations. In the Chinese population, an individual's age is a significant determinant of their health status.
Measuring changes in adult health and well-being during the COVID-19 pandemic and their relationship with adverse childhood experiences and current social assets: a cross-sectional survey
Authors: Bellis Mark A. , Hughes Karen , Ford Kat , Lowey Helen
Published: August 2023

Background

Adverse childhood experiences (ACEs) can impact mental and physical health, leaving people with less resilience to health challenges across the life-course. This study examines whether individuals’ levels and changes in levels of mental health, physical health and sleep quality reported across the first year of the COVID-19 pandemic are associated with ACEs and moderated by social assets such as having trusted family and friends.

Methods

A cross-sectional household telephone survey in England (a North West local authority) and Wales (nationally) using landline and mobile numbers stratified by health areas, deprivation quintile and age group and supplemented by an online survey. Data were collected from 4,673 English and Welsh residents aged ≥ 18 years during national COVID-19 restrictions (December 2020 to March 2021). Measures included nine types of ACE; self-reported mental health, physical health and sleep quality at time of survey (in pandemic) and one-year earlier (pre-pandemic); numbers of trusted family members and friends, knowledge of community help; and COVID-19 infection.

Results

ACEs were strongly related to moving into poorer mental health, physical health, and sleep categories during the pandemic, with likelihoods more than doubling in those with ≥ 4 ACEs (vs. 0). ACEs were also associated with increased likelihood of moving out of poorer health and sleep categories although this was for a much smaller proportion of individuals. Individuals with more trusted family members were less likely to move into poorer health categories regardless of ACE counts.

Conclusions

ACEs are experienced by large proportions of populations and are associated with poorer health even in non-pandemic situations. However, they also appear associated with greater vulnerability to developing poorer health and well-being in pandemic situations. There is a minority of those with ACEs who may have benefited from the changes in lifestyles associated with pandemic restrictions. Connectedness especially with family, appears an important factor in maintaining health during pandemic restrictions.
Prediction of hip joint function and analysis of risk factors for internal fixation failure after Femoral Neck System (FNS)
Authors: Zhang Yazhong , Zhang Xu , Li Chao , Lin Yan , Lv Yongxiang , Huang Shaolong , Wang Bin , Wang Yunqing , Zhu Ziqiang
Published: August 2023

Objective

Analysis of the risk factors affecting hip function and complications after femoral neck system (FNS) surgery for femoral neck fractures is of great significance for improving the procedure’s efficacy.

Methods

The data of patients with femoral neck fractures who underwent FNS surgery in our hospital between October 2019 and October 2020 were retrospectively analyzed. Age, gender, time from injury to operation, fracture classification, operation time, fracture reduction, and postoperative weight-bearing time information were set as potential factors that may affect the results. Hip Harris scores were performed at 12 months postoperatively, and postoperative complication data (e.g., femoral head necrosis, nonunion, and femoral neck shortness) were collected. The risk factors affecting hip function and complications after FNS surgery were predicted using linear and logistic regression analyses.

Results

A total of 69 cases of femoral neck fracture were included, with an average age of 56.09 ± 11.50 years. The linear analysis demonstrated that the age and fracture type of the patients were the risk factors affecting the Harris score of the hip joint after FNS surgery. Older patients with displaced femoral neck fractures had an inferior postoperative hip function. In addition, fracture type, reduction of the femoral neck, and postoperative weight-bearing significantly impacted postoperative complications. Displaced fractures, negative fixation, and premature weight-bearing (< 6 weeks) were risk factors for postoperative complications. The Harris score of patients with a shortened femoral neck in the included cases was not significantly different from that of patients without shortening (P = 0.25).

Conclusions

Advanced age and fracture type are important evaluation indicators of the Harris score after FNS internal fixation of femoral neck fractures in young patients. Fracture type, fracture reduction, and postoperative weight-bearing time are risk factors for complications after FNS.
Arthralgia in female Masters weightlifters
Authors: Huebner Marianne , Lavallee Mark E.
Published: August 2023

Background

Arthralgia or joint pain is a heterogeneous condition including organic and nonorganic joint pain. It is common in older populations, particularly in females. There is evidence that menopausal changes are associated with increased prevalence of arthralgia. While physical activities have been recommended to mitigate osteoarthritis (OA) and arthralgia, sport participation also carries risk factors due to excessive loading of some joints and possible injuries. The aim was to evaluate the association of training patterns, prior injuries, and severity of menopausal symptoms with arthralgia in female Masters weightlifters.

Methods

Competitive female Masters weightlifters (n=868, 30-78 years) from 30 countries completed an online survey including joint pain for different anatomical sites, weightlifting training and performance, sport history, and menopausal symptoms. Logistic regression models were used to estimate the association of training patterns, prior sport participation, and menopausal symptom severity with arthralgia separately for shoulders, spine, hips, knees, ankles, elbows, and hands.

Results

Arthralgia was most reported in knees (38.8%), shoulders (29.8%), hands/wrists (28.8%), and hips (24.9%). The prevalence of arthralgia was 51.5% in pre-menopausal women, 62.4% in women post natural menopause and 73.3% in women post medical or surgical menopause. Lifting heavier weights was associated with arthralgia in hips (OR=1.05, p=0.03), knees (OR=1.06, p=0.01), and hands/wrists (OR=1.05, p=0.04), but prior strength training was protective for arthralgia in the shoulders (OR=0.66, p=0.02). Prior injuries and psychological menopausal symptom severity were associated with an increased risk for arthralgia (p<0.01).

Conclusions

Arthralgia was common in competitive female weightlifters. Training frequency was not associated with arthralgia, but lifting heavier weights relative to age and body mass was. Prior injuries and menopausal symptoms were associated with arthralgia, but prior strength training was protective of arthralgia in the shoulders. Athletes, coaches and sports medicine professionals should be aware that prevalence of polyarthralgia increases in post-menopausal athletes.
Erectile function after different techniques of bulbar urethroplasty: does urethral transection make a difference?
Authors: Shalkamy Osama , Elsalhy Mohamed , Alghamdi Saleh Mohammed , Beaiti Mohammed , Abdel-Al Ibrahim , Faisal Mahmoud , Abouelgreed Tamer A. , Badran Yasser , Abdrabu Abdrabu , Al-Ayafi Mahdi , Bosily Mohanad Jebril , Shebl Salah E. , nematallah Ibrahim , Shafiea Ahmed , Elatreisy Adel
Published: August 2023

Purpose

We aimed to compare the impact of urethral transection after different techniques of bulbar urethroplasty on erectile function outcome.

Materials and methods

We retrospectively reviewed the records for 245 patients who underwent different urethroplasty techniques for bulbar urethral stricture between February 2013 and January 2021. The comparison between the transecting and non-transecting cohorts included patients’ demographics, clinicopathological features of the urethral stricture, post-urethroplasty erectile function, and success of urethroplasty. Outcomes were erectile function status verified by IIEF5-15 score at preoperative, three months, and 12 months post-surgery. We defined Post-urethroplasty ED as a decrease of 5 points or more.

Results

The urethroplasty success rate of the entire cohort was 86.9% after a mean follow-up of 45.59 ± 21 months. Out of 245 patients, 18 (7.3%) experienced 90-day complications. Transecting bulbar urethroplasty techniques were performed in 74 patients (30.2%), while non-transecting techniques were performed in 171 patients (69.8%). there were no differences between the cohorts regarding urethroplasty success (87.8% Vs. 86.5%, Mantel-Cox test p = 0.93) or postoperative complications (8.1% Vs. 7%, p = 0.73). Transient ED was evident in the transecting cohort as reported in 8.1% compared to 2.9% for the non-transecting (p = 0.07).Still, but de novo permanent ED was comparable (4.1% Vs. 2.9%, p = 0.65), for transecting and non-transecting, respectively.

Conclusions

Unfortunately, some patients who undergo transecting techniques of bulbar urethroplasty experience transient erectile dysfunction that can improve within the first post- urethroplasty year; however, de novo permanent erectile dysfunction is uncommon after different techniques of bulbar urethroplasty and is not predisposed by urethral transection.
The relationship between red blood cell distribution width and islet β-cell function indexes in patients with latent autoimmune diabetes in adults
Authors: Fu Xiuli , Tan Qin , Wei Wei , Ding Sheng , Wang Zhongjing
Published: August 2023

Aims

The objective of this study is to explore the relationship between red blood cell distribution and islet β-cell function indexes in patients with Latent Autoimmune Diabetes in Adults.

Methods

A total of 487 LADA patients were enrolled in this cross-sectional study. Patients were divided into three groups according to RDW tertiles. Clinical and laboratory measurements of age, height, weight, duration of diabetes, blood pressure, RDW, glycosylated hemoglobin A1c (HbA1c), C-peptide and blood lipids were performed. Homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of β-cell function (HOMA-β) were assessed using homeostasis model assessment (HOMA) based on fasting blood glucose (FBG) and fasting C-peptide index (FCP). Correlations and multiple linear regressions were implemented to determine the association of RDW and islet function indexes.

Results

As the increase of serum RDW level, the presence of β-cell secretion increased(P < 0.05). Correlation analysis indicated that there were significant correlations between RDW and male sex, age, duration, TG, Cr, FCP, and HOMA-β in all subjects. Multiple linear regressions indicated that RDW was significantly correlated with HOMA-β in the total population in both unadjusted and adjusted analysis. This finding could be reproduced in the subgroup of low GAD titers for HOMA-β. RDW were significantly associated with HbA1c in LADA patients with high GAD titers, but the correlation was not found in subgroup with low GAD titers in either unadjusted analyses or adjusted analysis.

Conclusions

RDW is associated with β-cell function assessed by HOMA-β after adjusting for covariates in LADA patients with low GAD titers.
Clinical outcomes of arch expansion with Invisalign: a systematic review
Authors: Ma Songyang , Wang Yunji
Published: August 2023

Objective

This study aims to assess the scientific evidence regarding the clinical outcomes of Invisalign therapy in controlling orthodontic tooth movement.

Materials and methods

An electronic search was conducted on PubMed, Cochrane Library, Web of Science, Embase, and Scopus from November 2015 to November 2022 to identify relevant articles. Methodological shortcomings were highlighted, and an evaluation of the quality of the included studies was completed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool.

Results

Fifteen non-randomized controlled trials were included in the analysis. Most non-randomized controlled trials (n=11; 73%) were rated with a moderate risk of bias according to the ROBINS-I tool. There were statistically significant differences between the pretreatment and posttreatment arches. The average expansion was significantly different from that predicted for each type of tooth in both the maxilla and mandible. Furthermore, the efficiency decreased from the anterior area to the posterior area in the upper arch.

Conclusion

Despite the fact that arch expansion with Invisalign® is not entirely predictable, clear aligner treatment is a viable option for addressing dentition crowding. The efficacy of expansion is greatest in the premolar area. More research focusing on treatment outcomes with different materials of aligners should be conducted in the future. Overcorrection should be considered when planning arch expansion with Invisalign. In the maxilla, the expansion rate decreases from the anterior to the posterior, and presetting sufficient buccal root torque of posterior teeth may result in improved efficiency of expansion.
Factorial structure and measurement invariance of the Chinese version of the Oral Health Impact Profile-14 among clinical populations and non-clinical populations: an evidence for public oral investigations
Authors: Yang Guang-Hui , Feng Yao , Xue Lan-Xin , Ou-Yang Ze-Yue , Yang Yi-Fan , Zhao Ya-Qiong , Zhao Jie , Hu Jing , Ye Qin , Su Xiao-Lin , Chen Ning-Xin , Zhong Meng-Mei , Feng Yun-Zhi , Guo Yue
Published: August 2023

Objective

Oral health-related quality of life (OHRQoL) is a multidimensional concept that is commonly used to examine the impact of oral health status on quality of life. The purpose of this study was to examine the optimal factor model of the Chinese version of the Oral Health Impact Profile (OHIP-14) questionnaire in clinical populations, measurement invariance across clinical status and gender cohorts. This would ensure equal validity of the Chinese version of OHIP-14 in different populations and further support public oral investigations.

Methods

The Chinese version of OHIP-14 was used to investigate 490 dental patients and 919 college students. Confirmatory factor analysis (CFA), item analysis and reliability, measurement invariance, and the t-test were used for data analyses.

Results

We found that the 7-factor structure had the best-fit index in the sample (CFI = 0.970, TLI = 0.952; SRMR = 0.029, RMSEA = 0.052(0.040,0.063)). The reliability of the scales was satisfactory (Cronbach’s α = 0.942). The error variance invariance fitted the data adequately in measurement invariance, indicating that measurement invariance is acceptable both across the clinical and non-clinical populations (∆CFI=-0.017, ∆RMSEA = 0.010) and across genders in the clinical population (∆CFI = 0.000, ∆RMSEA=-0.003). T-test for scores showed that the clinical populations scored significantly higher than the non-clinical populations, as did the overall score (t = 7.046, p < 0.001, d = 0.396), in terms of functional limitation (t = 2.178, p = 0.030, d = 0.125), physical pain (t = 7.880, p < 0.001,d = 0.436), psychological discomfort (t = 8.993, p < 0.001, d = 0.514), physical disability (t = 6.343, p < 0.001, d = 0.358), psychological disability (t = 5.592, p < 0.001, d = 0.315), social disability (t = 5.301, p < 0.001,d = 0.304), social handicap (t = 4.452, p < 0.001, d = 0.253), and that in the non-clinical populations, females scored significantly higher than males, as did in terms of physical pain (t = 3.055, p = 0.002, d = 0.280), psychological discomfort (t = 2.478, p = 0.014, d = 0.222), and psychological disability (t = 2.067, p = 0.039, d = 0.188).

Conclusion

This study found that the Chinese version of OHIP-14 has measurement invariance between the clinical and non-clinical populations and across genders in the clinical populations, and can be widely used in OHRQoL assessment for public oral investigations.
The caries impacts and experiences questionnaire for Turkish children by age groups’
Authors: Duman Sacide , Inceoglu Feyza
Published: August 2023

Background

The Caries Impacts and Experiences Questionnaire for Children (CARIES-QC) assess children’s effects of dental caries on their quality of life. This study aimed to determine the scale’s Turkish version (CARIES-QC/T) validity and reliability according to age groups and to create the scale that is specific to selected age groups.

Methods

Children were divided up into 3 age groups (5–7, 8–10 and 11–14 ages). Explanatory factor analysis (EFA) was used in the concept validation process. Confirmatory factor analysis (CFA) was used for cross-cultural validity. For each group, test-retest analyses were performed on 20 children. Inter-question correlation and Cronbach’s alpha were used to examine internal consistency.

Results

A total of 360 children (mean age; 9.04, 56.1% girls,) 120 children in each group, participated in the study. Questions 7 and 12 for the 5–7 age group, Questions 4 and 7 for the 8–10 and 11–14 age groups were excluded from the analysis (according to EFA results; factor loads < 0.30). Three modified CARIES-QC/T scales structures with a total of 10 questions were developed for the age groups of 5–7, 8–10, and 11–14.

Conclusions

Some questions on the Caries-QC/T scale should be eliminated, it was found when it was evaluated for age specificity. Although the results of the Caries-QC scale studies to be carried out in different societies and age groups vary, the high sample size in this study and the statistically strong results showed that the Caries-QC/T scale forms that we adapted could be used by the specified age groups.
Evaluation of anti-quorum sensing and antibiofilm effects of secondary metabolites from Gambeya lacourtiana (De Wild) Aubr. & Pellegr against selected pathogens
Authors: Talla Rostan Mangoua , Tamfu Alfred Ngenge , Wakeu Brussine Nadège Kweka , Ceylan Ozgur , Mbazoa Céline Djama , Kapche Gilbert Deccaux Wabo Fotso , Lenta Bruno Ndjakou , Sewald Norbert , Wandji Jean
Published: August 2023

Background

Microbial infections cause serious health problems especially with the rising antibiotic resistance which accounts for about 700,000 human deaths annually. Antibiotics which target bacterial death encounter microbial resistance with time, hence, there is an urgent need for the search of antimicrobial substances which target disruption of virulence factors such as biofilm and quorum sensing (QS) with selective pressure on the pathogens so as to avoid resistance.

Methods

Natural products are suitable leads for antimicrobial drugs that can inhibit bacterial biofilms and QS. Twenty compounds isolated from the medicinal plant Gambeya lacourtiana were evaluated for their antibiofilm and anti-quorum sensing effects against selected pathogenic bacteria.

Results

Most of the compounds inhibited violacein production in Chromobacterium violaceum CV12472 and the most active compound, Epicatechin had 100% inhibition at MIC (Minimal Inhibitory Concentration) and was the only compound to inhibit violacein production at MIC/8 with percentage inhibition of 17.2 ± 0.9%. Since the bacteria C. violaceum produces violacein while growing, the inhibition of the production of this pigment reflects the inhibition of signal production. Equally, some compounds inhibited violacein production by C. violaceum CV026 in the midst of an externally supplied acylhomoserine lactone, indicating that they disrupted signal molecule reception. Most of the compounds exhibited biofilm inhibition on Staphyloccocus aureus, Escherichia coli and Candida albicans and it was observed that the Gram-positive bacteria biofilm was most susceptible. The triterpenoids bearing carboxylic acid group, the ceramide and epicatechin were the most active compounds compared to others.

Conclusion

Since some of the compounds disrupted QS mediated processes in bacteria, it indicates that this plant is a source of antibiotics drugs that can reduce microbial resistance.
Development and comparison of machine learning-based models for predicting heart failure after acute myocardial infarction
Authors: Li Xuewen , Shang Chengming , Xu Changyan , Wang Yiting , Xu Jiancheng , Zhou Qi
Published: August 2023

Aims

Heart failure (HF) is one of the common adverse cardiovascular events after acute myocardial infarction (AMI), but the predictive efficacy of numerous machine learning (ML) built models is unclear. This study aimed to build an optimal model to predict the occurrence of HF in AMI patients by comparing seven ML algorithms.

Methods

Cohort 1 included AMI patients from 2018 to 2019 divided into HF and control groups. All first routine test data of the study subjects were collected as the features to be selected for the model, and seven ML algorithms with screenable features were evaluated. Cohort 2 contains AMI patients from 2020 to 2021 to establish an early warning model with external validation. ROC curve and DCA curve to analyze the diagnostic efficacy and clinical benefit of the model respectively.

Results

The best performer among the seven ML algorithms was XgBoost, and the features of XgBoost algorithm for troponin I, triglycerides, urine red blood cell count, γ-glutamyl transpeptidase, glucose, urine specific gravity, prothrombin time, prealbumin, and urea were ranked high in importance. The AUC of the HF-Lab9 prediction model built by the XgBoost algorithm was 0.966 and had good clinical benefits.

Conclusions

This study screened the optimal ML algorithm as XgBoost and developed the model HF-Lab9 will improve the accuracy of clinicians in assessing the occurrence of HF after AMI and provide a reference for the selection of subsequent model-building algorithms.
Patient safety topics, especially the second victim phenomenon, are neglected in undergraduate medical and nursing curricula in Europe: an online observational study
Authors: Sánchez-García Alicia , Saurín-Morán Pedro José , Carrillo Irene , Tella Susanna , Põlluste Kaja , Srulovici Einav , Buttigieg Sandra C , Mira José Joaquín
Published: August 2023

This study aims to assess the inclusion of second victims and other patient safety issues in the curricula of undergraduate medical and nursing degrees in the countries participating in the European Researchers’ Network Working on Second Victims (The ERSNT Consortium, COST Action 19,113). A review of medical and nursing school curricula in 206 universities was carried out, using their websites to search for subjects addressing “patient safety”, “quality of care”, “risk management”, “safe practices”, “interprofessional communication”, “adverse events”, and “second victims”. There was substantial variability in the extent of training for patient safety. Forty-four out of 88 nursing schools and 74 of 118 medical schools did not include any of the patient safety topics studied. The most frequent in both nursing and medicine was “interprofessional communication”, followed by “quality of care” and basic aspects on “patient safety”. The second victim phenomenon was present in only one curriculum of the total sample. Our study showed that patient safety, especially the second victim phenomenon, is still neglected in medical and nursing curricula in European universities, although positive initiatives were also found. Given the frequency with which adverse events occur in health centres and the need to prepare students to deal with them adequately, additional efforts are needed to introduce patient safety elements into medical and nursing education.
Completion of four or more ANC visits among women of reproductive age in Iganga district in Uganda: a quantitative study on the role of service-level factors
Authors: Muhirwe Lorna Barungi , Aagard Magdeline
Published: August 2023

Background

Evidence indicates that antenatal care (ANC) has both indirect and direct effects on maternal and perinatal morbidity and mortality reduction. In Uganda, the ANC attendance rate stands at 97.3% for one visit, but 59.9% for four or more visits. Given the imminent shift to the eight-contact ANC model in Uganda, combined with a lack of universal coverage for completion of four ANC visits, there is need for research that provides information on the factors that differentiate completers of recommended ANC attendances from non-completers. The aim of this quantitative study was to assess service- level factors affecting completion of ANC attendance defined by completion of four or more visits among women of reproductive age in Iganga district in Uganda.

Methods

Facility assessment scores on the service-level factors of interest for health facilities were obtained using a service level index tool. The relationship between the ANC completion rates of clients sampled from records at the health facilities and facility scores on service-level factors of interest were analyzed. Regression was conducted to determine the predictive relationship between ANC service availability, ANC service content, and ANC service organization, and completion of ANC attendance.

Results

The model was statistically significant, χ2 (6) = 26.118, p ˂ 0.05, and accounted for approximately 17.3% of the variance of ANC attendance completion (R2 = .173). Completion of ANC attendance was primarily predicted by better timing of provision of ANC services, and to a lesser extent by higher levels of availability of medicines and medical supplies.

Conclusions

This study demonstrated that service-level factors have a predictive value for completion of ANC attendance. The findings can be used to improve availability, content, and organization of ANC services with the aim of enhancing positive experiences for clients and motivating them to complete the recommended number of ANC visits.
Relationships between psychological characteristics, academic fit and engagement with academic performance in veterinary medical students
Authors: Muca Edlira , Molino Monica , Ghislieri Chiara , Baratta Mario , Odore Rosangela , Bergero Domenico , Valle Emanuela
Published: August 2023

Background

Recognition of the factors that influence academic performance in university students constitutes one of the key objectives of education researchers. Few studies have been conducted in this sphere in relation to veterinary students; however, considering the high levels of depression, anxiety symptoms, and decreased life satisfaction revealed in recent literature for this demographic, understanding these factors is of great importance. Moreover, the literature on veterinary education has mostly focused on cognitive factors as antecedents to academic performance, while very little attention has been directed toward personal characteristics.

Methods

The present cross-sectional study aims to investigate the relationships between psychological characteristics (internal locus of control and self-efficacy), academic fit, well-being (engagement and exhaustion), and academic performance (average grade) among veterinary students. The study was conducted in the Department of Veterinary Sciences at the University of Turin between September 2021 and January 2022 involving 231 students.

Results

The results of the Structural Equation Model confirmed a positive relationship between both internal locus of control and self-efficacy and academic fit, which in turn showed a positive relationship with engagement and a negative relationship with exhaustion. Finally, a significant positive relationship between engagement and academic performance was highlighted. Indirect effects were also significant, confirming the mediating role of academic fit and engagement.

Conclusions

The study contributes to the literature by demonstrating the direct and indirect relationships among the variables selected in a sample group of veterinary students. These findings provide information for practical interventions that could support the academic experience and prospects of veterinary students by improving their psychological parameters and well-being.
Despite low viral titer in saliva samples, Sanger-based SARS-CoV-2 spike gene sequencing is highly applicable for the variant identification
Authors: Ko Ko , Takahashi Kazuaki , Ito Noriaki , Sugiyama Aya , Nagashima Shintaro , Miwata Kei , Kitahara Yoshihiro , Okimoto Mafumi , Ouoba Serge , Akuffo Golda Ataa , E Bunthen , Akita Tomoyuki , Takafuta Toshiro , Tanaka Junko
Published: August 2023

Background

This study aimed to compare the performance of Sanger-based SARS-CoV-2 spike gene sequencing and Next Generation Sequencing (NGS)-based full-genome sequencing for variant identification in saliva samples with low viral titer.

Methods

Using 241 stocked saliva samples collected from confirmed COVID-19 patients between November 2020 and March 2022 in Hiroshima, SARS-CoV-2 spike gene sequencing (nt22735-nt23532) was performed by nested RT-PCR and Sanger platform using in-house primers. The same samples underwent full-genome sequencing by NGS using Illumina NextSeq2000.

Results

Among 241 samples, 147 were amplified by both the Sanger and the Illumina NextSeq2000 NGS, 86 by Sanger only, and 8 were not amplified at all. The overall amplification rates of Illumina NextSeq2000 NGS and Sanger were 61% and 96.7%, respectively. At low viral titer (< 103 copies/mL), Illumina NextSeq2000 NGS provided 19.2% amplification, while Sanger was 89.7% (p < 0.0001). Both platforms identified 38 wild type, 54 Alpha variants, 84 Delta variants, and 57 Omicron variants.

Conclusions

Our study provided evidence to expand the capacity of Sanger-based SARS-CoV-2 spike gene sequencing for variants identification over full-genome by Illumina NextSeq2000 NGS for mass screening. Therefore, the feasible and simple Sanger-based SARS-CoV-2 spike gene sequencing is practical for the initial variants screening, which might reduce the gap between the rapid evolution of SARS-CoV-2 and its molecular surveillance.
Obesity and head and neck cancer risk: a mendelian randomization study
Authors: Gui Lin , He Xiaohui , Tang Le , Yao Jiarui , Pi Jinping
Published: August 2023

Background

Observational studies have reported controversial results on the association between obesity and head and neck cancer risk. This study aimed to perform a two-sample Mendelian randomization (MR) analysis to assess the causal association between obesity and head and neck cancer risk using publicly available genome-wide association studies (GWAS) summary statistics.

Methods

Single-nucleotide polymorphisms (SNPs) for obesity [body mass index (BMI), waist-to-hip ratio (WHR), whole body fat mass, lean body mass, and trunk fat mass] and head and neck cancer (total head and neck cancer, oral cavity cancer, oropharyngeal cancer, and oral cavity and oropharyngeal cancer) were retrieved from published GWASs and used as genetic instrumental variables. Five methods including inverse-variance-weighted (IVW), weighted-median, MR–Egger, weighted mode, and MR-PRESSO were used to obtain reliable results, and odds ratio with 95% confidence interval (CI) were calculated. Tests for horizontal pleiotropy, heterogeneity, and sensitivity were performed separately.

Results

Genetically predicted BMI was negatively associated with the risk of total head and neck cancer, which was significant in the IVW [OR (95%CI), 0.990 (0.984–0.996), P = 0.0005], weighted-median [OR (95%CI), 0.984 (0.975–0.993), P = 0.0009], and MR-PRESSO [OR (95%CI), 0.990 (0.984–0.995), P = 0.0004] analyses, but suggestive significant in the MR-Egger [OR (95%CI), 0.9980 (0.9968–0.9991), P < 0.001] and weighted mode [OR (95%CI), 0.9980 (0.9968–0.9991), P < 0.001] analyses. Similar, genetically predicted BMI adjust for smoking may also be negatively associated with the risk of total head and neck cancer (P < 0.05). Genetically predicted BMI may be negatively related to the risk of oral cavity cancer, oropharyngeal cancer, and oral cavity and oropharyngeal cancer (P < 0.05), but no causal association was observed for BMI adjust for smoking (P > 0.05). In addition, no causal associations were observed for other exposures and outcomes (all P > 0.05).

Conclusion

This MR analysis supported the causal association of BMI-related obesity with decreased risk of total head and neck cancer. However, the effect estimates from the MR analysis were close to 1, suggesting a slight protective effect of BMI-related obesity on head and neck cancer risk.
Lung function trajectories in patients with idiopathic pulmonary fibrosis
Authors: Neely Megan L , Hellkamp Anne S , Bender Shaun , Todd Jamie L , Liesching Timothy , Luckhardt Tracy R , Oldham Justin M , Raj Rishi , White Eric S , Palmer Scott M
Published: August 2023

Background

Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease characterised by decline in lung function. We evaluated trajectories of forced vital capacity (FVC) and diffusing capacity (DLco) in a cohort of patients with IPF.

Methods

Patients with IPF that was diagnosed or confirmed at the enrolling centre in the previous 6 months were enrolled into the IPF-PRO Registry between June 2014 and October 2018. Patients were followed prospectively, with lung function data collected as part of routine clinical care. Mean trajectories of FVC and DLco % predicted in all patients and in subgroups by characteristics assessed at enrolment were estimated using a joint model that accounted for factors such as disease severity and visit patterns.

Results

Of 1002 patients in the registry, 941 had ≥ 1 FVC and/or DLco measurement after enrolment. The median (Q1, Q3) follow-up period was 35.1 (18.9, 47.2) months. Overall, mean estimated declines in FVC and DLco % predicted were 2.8% and 2.9% per year, respectively. There was no evidence that the mean trajectories of FVC or DLco had a non-linear relationship with time at the population level. Patients who were male, white, had a family history of ILD, were using oxygen, or had prior/current use of antifibrotic therapy at enrolment had greater rates of decline in FVC % predicted. Patients who were male or white had greater rates of decline in DLco % predicted.

Conclusions

Data from the IPF-PRO Registry suggest a constant rate of decline in lung function over a prolonged period, supporting the inexorably progressive nature of IPF. A graphical abstract summarising the data in this manuscript is available at: https://www.usscicomms.com/respiratory/IPF-PRORegistry_LungFunctionTrajectories.

Trial registration

NCT01915511.