bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating the public health impact had tobacco-free nicotine pouches been introduced into the US in 2000
Authors: Lee Peter N. , Fry John S. , Ljung Tryggve
Published: May 2022

Background

For smokers not intending to quit, switching to a reduced-risk nicotine product should be healthier than continuing smoking. We estimate the health impact, over the period 2000–2050, had the nicotine pouch ZYN hypothetically been introduced into the US in 2000. ZYN’s toxicant profile and method of use is like that for Swedish snus, a product with known health effects much less than smoking.

Methods

Our modelling approach is similar to others developed for estimating potential effects of new tobacco products. It starts with a simulated cohort of 100,000 individuals in the year 2000 subdivided by age, sex, and smoking status (including years since quitting). They are followed annually accounting for births, net immigrations, deaths and product use changes, with follow-up carried out in the Base Case (ZYN not introduced) and Modified Case (ZYN introduced). Using informed assumptions about initiation, quitting and switching rates, distributions of the population over time are then constructed for each Case, and used to estimate product mortality based on assumptions about the relative risk according to product use.

Results

Whereas in both Base and Modified Cases, the prevalence of any current product use is predicted to decline from about 22% to 10% during follow-up, in the Modified Case about 25% of current users use ZYN by 2050, about a quarter being dual users and the rest ZYN-only users. Over the 50 years, deaths at ages 35–84 from product use among the 100,000 are estimated as 249 less in the Modified than the Base Case, equivalent to about 700,000 less in the whole US. Sensitivity analyses varying individual parameter values confirm the benefits of switching to ZYN, which increase as either the switching rate to ZYN increases or the initiation rate of ZYN relative to smoking increases. Even assuming the reduction in excess mortality risk using ZYN use is 20% of that from smoking rather than the 3.5% assumed in the main analyses, the reduction in product-related deaths would still be 213, or about 600,000 in the US.

Conclusions

Although such model-based estimates involve uncertainties, the results suggest that introducing ZYN could substantially reduce product-related deaths.
Outcomes of modular endoprosthesis reconstruction versus cement spacer reconstruction following resection of proximal humeral tumors
Authors: Ebeid Walid Atef , Eldaw Sherif , Badr Ismail Tawfeek , Mesregah Mohamed Kamal , Hasan Bahaa Zakarya
Published: May 2022

Background

There is no agreement about the best reconstructive option following resection of proximal humerus tumors. The purpose of this study was to compare the functional outcomes of endoprosthesis reconstruction versus nail cement spacer reconstruction after wide resection of proximal humeral tumors.

Methods

This retrospective comparative study included 58 patients with proximal humerus tumors who had undergone tumor resection and reconstruction with modular endoprosthesis (humeral hemiarthroplasties) or cement spacer. Medical records were reviewed for the epidemiological, clinical, radiological, and operative data. Lung metastasis, local recurrence, and complication were also reviewed. The functional outcome was evaluated using the Musculoskeletal Tumor Society scoring (MSTS) system.

Results

Nineteen patients with a mean age of 33.4 ± 17.5 years underwent reconstruction by modular endoprosthesis, and 39 patients with a mean age of 24.6 ± 14.3 years underwent reconstruction by cement spacer. The mean MSTS score was 24.8 ± 1.1 in the endoprosthesis group and 23.9 ± 1.4 in the spacer group, P = 0.018. Complications were reported in 5 (26.3%) patients in the endoprosthesis group and 11 (28.2%) patients in the spacer group, P = 0.879. There were no statistically significant differences in the functional outcomes in both patient groups with or without axillary or deltoid resection.

Conclusions

Both endoprostheses and cement spacers are durable reconstructions with almost equal functional outcomes with no added advantage of the expensive endoprosthesis.
The prevalence of musculoskeletal pain and therapy needs in adults with Osteogenesis Imperfecta (OI) a cross-sectional analysis
Authors: Barlow Sophie , Dove Lucy , Jaggi Anju , Keen Richard , Bubbear Judith
Published: May 2022

Background

Osteogenesis Imperfecta affects approximately 1 in every 10,000 people. Musculoskeletal disorders and pain are common in adults with Osteogenesis Imperfecta, but specific knowledge of the problems people have is lacking. Access to therapy services for adults with Osteogenesis Imperfecta is variable. We designed this analysis to better understand the musculoskeletal disorders and consequent therapy needs for adults with Osteogenesis Imperfecta. 

Methods

This study was a cross-sectional analysis of outpatients with Osteogenesis Imperfecta. Adults attending a newly established multidisciplinary clinic at a tertiary centre in 2019 were included. A highly specialist physiotherapist worked within the clinic to offer therapy input if required and to refer patients to appropriate therapy as needed. People over the age of 18 were included if they had a diagnosis of Osteogenesis Imperfecta. Data were collected over a five month period using routinely collected clinical information and patient reported outcomes.

Results

Over five months 50 patients attended the clinic. Musculoskeletal pain was a significant feature reported by 84% of patients. Over 50% of patients reported persistent pain for longer than one year duration and the most common site of pain was in the spine (46%). No difference in pain between types of OI and age. Forty five per cent (n = 19) of patients reported moderate to severe problems with mobility on the EQ-5D with over half reporting problems with self-care and ability to carry out usual activities. Over 50% of patients in clinic also reported anxiety (EQ-5D). During the consultation 70% of patients received therapy input which was either advice in clinic or an onward referral to the appropriate service. The referral rate to specialist out-patient rehabilitation services at a tertiary centre was 30%.

Conclusions

This analysis highlights the high prevalence of MSK pain in adults with OI and the effect on physical function and emotional wellbeing. This study demonstrates the diverse needs of the adult Osteogenesis Imperfecta population and the need for suitable multidisciplinary therapy services.
Can metformin relieve tibiofemoral cartilage volume loss and knee symptoms in overweight knee osteoarthritis patients? Study protocol for a randomized, double-blind, and placebo-controlled trial
Authors: Ruan Guangfeng , Yuan Shiwen , Lou Aiju , Mo Yingqian , Qu Yuan , Guo Dongmei , Guan Shangqi , Zhang Yan , Lan Xiaoyong , Luo Jun , Mei Yifang , Zhang Hongwei , Wu Weirong , Dai Lie , Yu Qinghong , Cai Xiaoyan , Ding Changhai
Published: May 2022

Background

Osteoarthritis (OA) is the most common joint disease, and is most frequently seen in the knees. However, there is no effective therapy to relieve the progression of knee OA. Metformin is a safe, well-tolerated oral medication that is extensively used as first-line therapy for type 2 diabetes. Previous observational studies and basic researches suggested that metformin may have protective effects on knee OA, which needs to be verified by clinical trials. This study, therefore, aims to examine the effects of metformin versus placebo on knee cartilage volume loss and knee symptoms in overweight knee OA patients by a randomized controlled trial over 24 months.

Methods

This protocol describes a multicenter, randomized, double-blind, and placebo-controlled clinical trial aiming to recruit 262 overweight knee OA patients. Participants will be randomly allocated to the two arms of the study, receiving metformin hydrochloride sustained-release tablets or identical inert placebo for 24 months (start from 0.5 g/day for the first 2 weeks, and increase to 1 g/day for the second 2 weeks, and further increase to 2 g/day for the remaining period if tolerated). Primary outcomes will be changes in tibiofemoral cartilage volume and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score over 24 months. Secondary outcomes will be changes in visual analogue scale (VAS) knee pain, tibiofemoral cartilage defects, effusion-synovitis volume, and tibiofemoral bone marrow lesions maximum size over 24 months. The primary analyses will be intention-to-treat analyses of primary and secondary outcomes. Per-protocol analyses will be performed as the secondary analyses.

Discussion

If metformin is proved to slow knee cartilage volume loss and to relieve knee symptoms among overweight knee OA patients, it will have the potential to become a disease modifying drug for knee OA. Metformin is a convenient intervention with low cost, and its potential effects on slowing down the structural progression and relieving the symptoms of knee OA would effectively reduce the disease burden worldwide.

Trial registration

ClinicalTrials. govNCT05034029. Registered on 30 Sept 2021.
Intra-articular opening wedge osteotomy for varus ankle arthritis with computer-assisted planning and patient-specific surgical guides: a retrospective case series
Authors: Ma Xin-long , Ma Jian-xiong , Zhao Xing-wen , Du Yu-ren , Wang Ying , Bai Hao-hao , Lu Bin
Published: May 2022

Background

Computer-assisted preoperative planning, combined with PSI has become an effective technique for treating complex limb deformities. The purpose of this study was to evaluate the efficacy and safety of the novel technique in corrective osteotomy for intra-articular varus ankle deformities associated with osteoarthritis and ankle instability.

Methods

Nineteen patients with intra-articular varus ankle arthritis were reviewed between April 2017 and June 2019, including ten men and nine women with a mean age of 58.3 ± 9.9 years (range, 38 to 76 years). All patients underwent intra-articular opening wedge osteotomy assisted by 3D virtual planning and PSI. Weight-bearing radiographs were used to assess the radiographic results, including TAS angle, TT angle, TMM angle, TC angle, TLS angle, opening-wedge angle, and wedge height. Functional outcomes were assessed by the AOFAS score, VAS score, and ROM of the ankle.

Results

The average follow-up time was 32.2 ± 9.0 months (range, 22 to 47 months). The average union time was 4.4 ± 0.9 months (range, 3.0 to 6.5 months). The TAS angle significantly changed from 84.1 ± 4.6° preoperatively to 87.7 ± 3.1° at the 1-year follow-up and 86.2 ± 2.6° at the latest follow-up. Similarly, the TT angle, TMM angle and TC angle changed significantly at the 1-year follow-up compared with the preoperative assessment and remained stable until the last follow-up. However, the TLS was not corrected significantly. The postoperative obtained opening-wedge angle, and wedge height showed no significant change with preoperative planning. The overall complication rate was 15.8%. The mean VAS score improved from 5.3 ± 0.6 to 2.7 ± 0.7. The mean AOFAS score improved from 56.2 ± 7.6 to 80.6 ± 4.6. However, the ROM showed no significant change.

Conclusions

Accurate correction and satisfactory functional recovery were attained with computer-assisted planning and PSI in the corrective osteotomy of intra-articular varus ankle deformities.
Patients undergoing colorectal surgery at a Veterans Affairs Hospital do not experience racial disparity in length of stay either before or after implementing an enhanced recovery pathway
Authors: Rentas C. , Baker S. , Goss L. , Richman J. , Knight S. J. , Key C. , Morris M.
Published: May 2022

Background

Enhanced Recovery Pathways (ERP) have been shown to reduce racial disparities following surgery. The objective of this study is to determine whether ERP implementation mitigates racial disparities at a Veterans Affairs Hospital.

Methods

A retrospective cohort study was conducted using data obtained from the Veterans Affairs Surgical Quality Improvement Program. All patients undergoing elective colorectal surgery following ERP implementation were included. Current procedural terminology (CPT) codes were used to identify patients who underwent similar procedures prior to ERP implementation.

Results

Our study included 417 patients (314 pre-ERP vs. 103 ERP), 97.1% of which were male, with an average age of 62.32 (interquartile range (IQR): 25–90). ERP patients overall had a significantly shorter post-operative length of stay (pLOS) vs. pre-ERP patients (median 4 days (IQR: 3–6.5) vs. 6 days (IQR: 4–9) days (p < 0.001)). Within the pre-ERP group, median pLOS for both races was 6 days (IQR: 4–6; p < 0.976) and both groups experienced a decrease in median pLOS (4 vs. 6 days; p < 0.009 and p < 0.001) following ERP implementation.

Conclusions

Racial disparities did not exist in patients undergoing elective surgery at a single VA Medical Center. Implementation of an ERP significantly reduced pLOS for black and white patients.
Needle tract seeding and abdominal recurrence following pre-treatment biopsy of gastrointestinal stromal tumors (GIST): results of a systematic review
Authors: Jakob Jens , Salameh Rashad , Wichmann David , Charalambous Nicos , Zygmunt Anne-Christine , Kreisel Inga , Heinz Judith , Ghadimi Michael , Ronellenfitsch Ulrich
Published: May 2022

Background

Gastrointestinal stromal tumors (GIST) are rare abdominal tumors. Pretreatment biopsies may be used to diagnose a GIST and enable tailored treatment. Some experts are skeptical about biopsies because they fear tumor cell seeding. The objective of this study was to determine if pretreatment biopsy is associated with increased tumor recurrence.

Methods

We performed a systematic literature search and included studies assessing the oncological outcome of GIST patients who underwent a pre-treatment core needle biopsy or fine needle aspiration. We assessed methodological quality with the Newcastle-Ottawa-Scale for non-randomized studies. This review was registered in the PROSPERO database (CRD42021170290).

Results

Three non-randomized studies and eight case reports comprising 350 patients were eligible for inclusion. No prospective study designed to answer the review question was found. One case of needle tract seeding after percutaneous core needle biopsy of GIST was reported. None of the studies reported an increased rate of abdominal recurrence in patients with pretreatment biopsy.

Conclusions

The existing evidence does not indicate a relevant risk of needle tract seeding or abdominal recurrence after pre-treatment biopsy of GIST. Biopsy can safely be done to differentiate GIST from other tumors and to select the most appropriate treatment.
Pancreatic surgery during the COVID-19 pandemic 2020–2021: an observational cohort study from a third level referral center
Authors: Hansen Carsten Palnæs , Storkholm Jan Henrik , Sillesen Martin Hylleholt , Krohn Paul Suno , Burgdorf Stefan Kobbelgaard , Hillingsø Jens Georg
Published: May 2022

Background

During the COVID pandemic there has been limited access to elective surgery including oncologic surgery in several countries world-wide. The aim of this study was to investigate if there was any lockdown effect on pancreatic surgery with special focus on malignant pancreatic and periampullary tumours.

Methods

Patients who underwent pancreatic surgery during the two Danish lockdown periods from 11. March 2020 and the following 12 months were compared with patients who were operated the preceding 3 years. Data on patients’ characteristics, waiting time, operations, and clinical outcomes were evaluated.

Results

During lockdown and the previous three years the annual number of resections were 242, 232, 253, and 254, respectively (p = 0.851). Although the numbers were not significantly different, there were fluctuations in operations and waiting time during the lockdown. During the second outbreak of COVID October 2020 to March 2021 the overall median waiting time increased to 33 days (quartiles 26;39) compared to 23 (17;33) days during the first outbreak from March to May 2020 (p = 0.019). The same difference was seen for patients with malignant tumours, 30 (23;36) vs. 22 (18;30) months (p = 0.001). However, the fluctuations and waiting time during lockdown was like the preceding three years. Neither 30- nor 90-days mortality, length of stay, number of extended operations, and complications and tumour stage were significantly different from previous years.

Conclusions

There were significant fluctuations in waiting time for operations during the lockdown, but these variations were not different from the preceding three years, wherefore other explanations than an impact from COVID are conceivable.
Mental distress and associated factors among women who experienced gender based violence and attending court in South Ethiopia: a cross-sectional study
Authors: Sewalem Jerusalem , Molla Alemayehu
Published: May 2022

Background

Gender-based violence is an act that has physical, psychological, and sexual consequences for women. It is a widespread issue, particularly in developing countries, and it causes women mental distress. Despite the fact that gender-based violence has a significant impact on mental distress, there have no study in Ethiopia. As a result, the purpose of this study was to determine the prevalence and associated factors of mental distress among mothers who had experienced gender-based violence and were in court.

Methods

A cross-sectional study was conducted on 423 samples. The data was entered into Epi-data version 3.01 and analyzed with SPSS version 21. Binary logistic regression was used, and variables with p-values less than 0.05 were considered statistically significant with regard to mental distress at the respective 95% CI.

Result

The prevalence of mental distress was found to be 59.6% in this study. Mental distress was associated with factors such as a lack of social support, a lack of formal education, a husband's substance use, rural residence, age greater than 33 years, and a low family income.

Conclusion

The prevalence of mental distress is high when compared to the majority of previous findings from other countries. Screening and managing psychological distress in women with a history of violence is preferable, and integrating psychosocial care into court services is recommended.
The relationship between sleep quality, neck pain, shoulder pain and disability, physical activity, and health perception among middle-aged women: a cross-sectional study
Authors: Lee Myung Kyung , Oh Jihyun
Published: May 2022

Background

Sleep quality is an important physical requirement for a healthy life, and good sleep quality has been recognized as a significant component in physical and mental health and well-being. The purpose of this study was to identify the factors that affect sleep quality as well as the relationship between sleep quality and neck pain, shoulder pain and disability, physical activity, and health perception.

Methods

We conducted surveys on 494 women between the age of 35 and 64 years. The study evaluated neck pain, shoulder pain and disability, physical activity, self-health perception and sleep quality with self-reported questionnaires in middle-aged women. Data were analyzed using SPSS 23.0.

Results

The results showed that the more severe the neck pain and shoulder pain and disability, the worse the sleep quality was in middle-aged women and the better the health perception, the lower the sleep quality score was, indicating good sleep quality. Shoulder pain, self-perceived task difficulty, and health perception were identified as variables that affected the sleep quality in middle-aged women. The explanatory power of the model in explaining sleep quality was 22.9%.

Conclusions

Worsened shoulder pain, self-perceived task difficulty, and negative health perception can affect poor sleep quality; therefore, it is necessary to develop health interventions for pain management and emotional and social support for improving daily sleep quality. To improve the sleep quality in middle-aged women, healthcare workers should consider the subjects’ pain and functional disability, in accordance with their health perception.
Photoprotective effects of Sargassum thunbergii on ultraviolet B-induced mouse L929 fibroblasts and zebrafish
Authors: Chen Bei , Chen Honghong , Qu Haidong , Qiao Kun , Xu Min , Wu Jingna , Su Yongchang , Shi Yan , Liu Zhiyu , Wang Qin
Published: May 2022

Background

Chronic exposure to ultraviolet B (UVB) causes a series of adverse skin reactions, such as erythema, sunburn, photoaging, and cancer, by altering signaling pathways related to inflammation, oxidative stress, and DNA damage. Marine algae have abundant amounts and varieties of bioactive compounds that possess antioxidant and anti-inflammatory properties. Thus, the objective of this study was to investigate the photoprotective effects of an ethanol extract of Sargassum thunbergii.

Methods

Sargassum thunbergii phenolic-rich extract (STPE) was prepared, and its activity against UVB damage was evaluated using L929 fibroblast cells and zebrafish. STPE was extracted and purified by 40% ethanol and macroporous resin XDA-7. Reactive oxygen species (ROS) and antioxidant markers, such as superoxide dismutase (SOD), catalase (CAT) activities, and malondialdehyde (MDA) content were analyzed. The effect of STPE on UVB-induced inflammation was determined by inflammatory cytokine gene and protein expression. The expression of signaling molecules in the Nuclear Factor KappaB (NF-κB) pathway was determined by western blotting. DNA condensation was analyzed and visualized by Hoechst 33342 staining. In vivo evaluation was performed by tail fin area and ROS measurement using the zebrafish model.

Results

The total polyphenol content of STPE was 72%. STPE reduced ROS content in L929 cells, improved SOD and CAT activities, and significantly reduced MDA content, thereby effectively alleviating UVB radiation-induced oxidative damage. STPE inhibited the mRNA and protein expression of TNF-α, IL-6, and IL-1α. STPE reversed DNA condensation at concentrations of 20 and 40 μg/mL compared with the UVB control. Moreover, STPE inhibited NF-κB signaling pathway activation and alleviated DNA agglutination in L929 cells after UVB irradiation. Additionally, 1.67 μg/mL STPE significantly increased the tail fin area in zebrafish, and 0.8–1.6 μg/mL STPE effectively eliminated excessive ROS after UVB radiation.

Conclusions

STPE inhibited UVB-induced oxidative stress, inflammatory cytokine expression, and DNA condensation via the downregulation of the NF-κB signaling pathway, suggesting that it prevents UVB-induced photodamage, and has potential for clinical development for skin disease treatment.
Implementation of an unconscious bias course for the National Research Mentoring Network
Authors: Javier Damaris , Solis Linda Grace , Paul Mirabelle Fernandes , Thompson Erika L. , Maynard Grace , Latif Zainab , Stinson Katie , Ahmed Toufeeq , Vishwanatha Jamboor K.
Published: May 2022

Purpose

Increased awareness and mitigation of one’s unconscious bias is a critical strategy in diversifying the Science, Technology, Engineering, Mathematics, and Medicine (STEMM) disciplines and workforce. Greater management of unconscious bias can enhance diverse recruitment, persistence, retention, and engagement of trainees. The purpose of this study was to describe the implementation of an asynchronous course on unconscious bias for people in STEMM. Specifically, we explored who engaged with the course and reflections from participation.

Method

A five-part, asynchronous Unconscious Bias Course was developed and was hosted on a national mentoring platform starting in July 2020. To examine course engagement, we assessed the demographics of course participants and completion. Participant responses to reflection questions after each module were also synthesized using qualitative methods.

Results

Overall, 977 people registered for the course and 42% completed all modules. In the reflection responses, participants reflected on their unconscious biases in their lived experiences and how it relates to actions, judgements, external factors, stereotypes, and un-intentionality. Participants also reflected on microaggressions, their impact on the recipients and others, and the relationship between microaggressions and unconscious bias. Participants reported four key strategies used by allies against unconscious bias: immediately acting (83%), reflection (46%), improving the organizational culture (30%), and individual-level ally-ship (44%). Strategies for self-awareness included: reflection, pausing/breathing, and self-observation.

Conclusion

The assessment of the Unconscious Bias Course implementation revealed the course reached a wide cross-section of people in STEMM and demonstrated that participants were able to reflect on the underpinnings of the course. This course, and its suite of offerings, support a nationwide effort to mitigate bias and prepare individuals to be culturally competent in a diverse society in order to foster a STEMM environment that caters to individuals’ success and diversification of these fields.
Embracing uncertainty: medical student perceptions of a pediatric bootcamp developed in response to mandated changes during the pandemic
Authors: Lissinna Brittany , Rashid Marghalara , Foulds Jessica L. , Forbes Karen L.
Published: May 2022

Background

The start of the COVID-19 pandemic led to both shortened clinical rotations and consequent loss of embedded formal teaching time. In response to these learning gaps, a novel, virtual pediatric bootcamp was developed to provide a consolidated 3-week learning opportunity for clinical medical students. Pre-clinical students were encouraged but not required to participate, given the suspension of clinical patient experiences for all undergraduate medical learners and the uncertainty of when clinical rotations would resume. This group of students were particularly challenged with adapting their learning in response to the pandemic while also preparing to apply their pre-clinical knowledge to solve clinical problems.

Methods

A qualitative thematic analysis was used for this study. Ten semi-structured phone interviews were conducted with second-year medical students to explore their experiences and perceptions of the pediatric bootcamp. The six phases of thematic analysis proposed by Braun and Clark guided data analysis. To ensure rigour, the three aspects of rigour—credibility, transferability and confirmability were utilized throughout the project.

Results

Qualitative exploration from semi-structured phone interviews of second-year medical students’ perceptions and experiences of this new and unanticipated learning experience revealed four main themes: (a) clinical relevance, describing how students were pushed to think about clinical problems in a new way; (b) timing, which explored conflicts related to competing interests, mental preparedness, and the interval between learning and application; (c) teaching strategies, describing how active learning and interaction were facilitated and challenges that arose; and (d) learning resources, highlighting the curated and accessible resources made available to the students, as well as those resources that learners develop for themselves.

Conclusions

A novel three-week online case-based pediatric bootcamp fostered application of knowledge for clinical reasoning at a time when students were transitioning from preclinical to clinical learning. Students were stretched to balance competing priorities, and the bootcamp curated synchronous and asynchronous learner opportunities while allowing them to reflect on their own learning styles and effective virtual learning strategies. While bootcamps are often used to prepare learners for transitions between clinical stages, our findings suggest the bootcamp format can also facilitate transition from preclinical to clinical roles.
Rural-urban differences in workplace health promotion among employees of small and medium-sized enterprises in Germany
Authors: Lindert Lara , Kühn Lukas , Choi Kyung-Eun
Published: May 2022

Background

Rural and urban areas hold different health challenges and resources for resident small and medium-sized enterprises (SMEs) and their employees. Additionally, residents of urban and rural areas differ in individual characteristics. This study aims at investigating potential rural-urban differences (1) in the participation rate in workplace health promotion (WHP) and (2) in the relationship of WHP and health relevant outcomes in residents living in rural or urban German areas and working in SMEs.

Methods

Data of a large German Employee Survey in 2018 were used and analyzed by chi-square and t-tests and regression analyses regarding job satisfaction, sick days, and psychosomatic complaints. A total of 10,763 SME employees was included in analyses (23.9% living in rural, 76.1% living in urban areas).

Results

Analyses revealed higher participation rates for SME employees living in rural areas. SME employees living in urban areas reported more often the existence of WHP. Results showed (a) significance of existence of WHP for psychosomatic complaints and (b) significance of participation in WHP for job satisfaction in SME employees living in urban but not for those living in rural areas.

Conclusion

The revealed disparities of (1) higher participation rates in SME employees living in rural areas and in (2) the relationship of WHP aspects with health relevant outcomes are of special interest for practitioners (, e.g. human resource managers), politicians, and researchers by providing new indications for planning and evaluating WHP measures.
Reducing low-value radiological services in Norway –a qualitative multi-professional study on measures and facilitators for change
Authors: Andersen Eivind Richter , Hofmann Bjørn Morten , Kjelle Elin
Published: May 2022

Background

Overuse, underuse, and significant variation in the utilisation of radiological services are well documented in the literature. Several radiological examinations are identified as low-value examinations as they do not lead to a change in diagnosis or course of treatment. Even so, such examinations are frequently performed. Many measures for reducing low-value imaging have been carried out with variable outcomes. While there is little evidence as to why some measures work and others do not, adjusting to the context seems important for success. The objective of this study was to investigate which measures stakeholders consider appropriate for reducing the use of low-value imaging and what it takes to make them work.

Methods

Semi-structured interviews were conducted among radiographers, radiologists, radiological department managers, hospital clinicians, general practitioners, and health government/authorities’ representatives. The interview guide covered two broad areas: Experience with low-value services, and possible future measures deemed appropriate for reducing low-value services. Data were analysed in line with a qualitative framework analysis.

Results

The analysis included information from 27 participants. All participants acknowledged that low-value imaging was a problem, but few had very specific suggestions on reducing this in practice. Suggested measures were to stop referrals from being sent, provide support in assessing referrals, or change the healthcare system. Identified facilitators were categorised as management and resources, evidence, and experienced value. In general, appropriate measures should be practical, well-founded, and valuable.

Conclusions

This study provides insight into various stakeholders’ perceptions of suitable interventions to reduce low-value imaging. While many measures for reducing low-value imaging are available, contextual sensitivity is crucial to make them work.
Patient navigator team perceptions on the implementation of a citywide breast cancer patient navigation protocol: a qualitative study
Authors: Loo Stephanie , Mullikin Katelyn , Robbins Charlotte , Xiao Victoria , Battaglia Tracy A. , Lemon Stephenie C. , Gunn Christine ,   the TRIP Consortium
Published: May 2022

Background

In 2018 Translating Research Into Practice (TRIP), an evidence-based patient navigation intervention aimed at addressing breast cancer care disparities, was implemented across six Boston hospitals. This study assesses patient navigator team member perspectives regarding implementation barriers and facilitators one year post-study implementation.

Methods

We conducted in-depth qualitative interviews at the six sites participating in the pragmatic TRIP trial from December 2019 to March 2021. Navigation team members involved with breast cancer care navigation processes at each site were interviewed at least 12 months after intervention implementation. Interview questions were designed to address domains of the Consolidated Framework for Implementation Research (CFIR), focusing on barriers and facilitators to implementing the intervention that included 1) rigorous 11-step guidelines for navigation, 2) a shared patient registry and 3) a social risk screening and referral program. Analysis was structured using deductive codes representing domains and constructs within CFIR.

Results

Seventeen interviews were conducted with patient navigators, their supervisors, and designated clinical champions. Participants identified the following benefits provided by the TRIP intervention: 1) increased networking and connections for navigators across clinical sites (Cosmopolitanism), 2) formalization of the patient navigation process (Goals and Purpose, Access to Knowledge and Information, and Relative Advantage), and 3) flexibility within the TRIP intervention that allowed for diversity in implementation and use of TRIP components across sites (Adaptability). Barriers included those related to documentation requirements (Complexity) and the structured patient follow up guidelines that did not always align with the timeline of existing site navigation processes (Relative Priority).

Conclusions

Our analysis provides data using real-world experience from an intervention trial in progress, identifying barriers and facilitators to implementing an evidence-based patient navigation intervention for breast cancer care. We identified core processes that facilitated the navigators’ patient-focused tasks and role on the clinical team. Barriers encountered reflect limitations of navigator funding models and high caseload.

Trial registration

Clinical Trial Registration NumberNCT03514433, 5/2/2018.
The use of out-of-hours primary care during the first year of the COVID-19 pandemic
Authors: Ramerman Lotte , Rijpkema Corinne , Bos Nanne , Flinterman Linda E. , Verheij Robert A.
Published: May 2022

Background

In the Netherlands, General Practitioners (GP) are usually the first point of contact with a health professional for most health problems. Out-of-hours (OOH) primary care is provided by regional OOH services. Changes in consultation rates at OOH services may be regarded as a warning system for failures elsewhere in the healthcare system. Therefore in this study, we investigated how the COVID-19 pandemic changed the use of primary care OOH services during the first year of the pandemic.

Methods

Routine electronic health records data were used from 60% of OOH services in the Netherlands, collected by the Nivel Primary Care Database. We compared consultation rates per week (2020) for COVID-19-like symptoms and other health problems (e.g. small traumas, urinary tract infections), for different age groups, the proportion of remote consultations, and different levels of urgency during the pandemic compared to the same period in 2019.

Results

The number of consultations for COVID-19-like symptoms peaked at the start of the COVID-19 pandemic, while consultations for other health problems decreased. These changes in consultation rates differed between age groups. Remote consultations took place more frequently for all health problems, while the proportion of non-urgent health problems increased.

Conclusion

There were significant changes in the number of consultations and the proportion that were remote for COVID-19-like symptoms and other health problems. Especially care for babies and young children decreased, while the number of consultations for older adults remained stable. The continued use of OOH services by older adults suggests there were unmet care needs elsewhere in our healthcare system.
KMT2B promotes the growth of renal cell carcinoma via upregulation of SNHG12 expression and promotion of CEP55 transcription
Authors: Feng Jia-fu , Wang Jun , Xie Gang , Wang Yao-dong , Li Xiao-han , Yang Wen-yu , Yang Yu-wei , Zhang Bin
Published: May 2022

Background

This study aims to clarify the mechanistic action of long non-coding RNA (lncRNA) SNHG12 in the development of renal cell carcinoma (RCC), which may be associated with promoter methylation modification by KMT2B and the regulation of the E2F1/CEP55 axis.

Methods

TCGA and GEO databases were used to predict the involvement of SNHG12 in RCC. Knockdown of SNHG12/E2F1/CEP55 was performed. Next, SNHG12 expression and other mRNAs were quantified by RT-qPCR. Subsequently, CCK-8 was used to detect cell proliferation. Wound healing assay and Transwell assay were used to detect cell migration and invasion, respectively. The in vitro angiogenesis of human umbilical vein endothelial cells (HUVECs) was explored by matrigel-based capillary-like tube formation assay. ChIP assay was used to detect H3K4me3 in SNHG12 promoter region. The binding of E2F1 to CEP55 promoter region was analyzed with ChIP and dual luciferase reporter assays. RIP assay was used to detect the binding of SNHG12 to E2F1. Finally, the effect of SNHG12 on the tumor formation and angiogenesis of RCC was assessed in nude mouse xenograft model.

Results

SNHG12 was highly expressed in RCC tissues and cells, and it was related to the poor prognosis of RCC patients. SNHG12 knockdown significantly inhibited RCC cell proliferation, migration, and invasion and HUVEC angiogenesis. KMT2B up-regulated SNHG12 expression through modifying H3K4me3 in its promoter region. In addition, SNHG12 promoted CEP55 expression by recruiting the transcription factor E2F1. Knockdown of SNHG12 blocked E2F1 recruitment and down-regulated the expression of CEP55, thereby inhibiting tumor formation and angiogenesis in nude mice.

Conclusion

The evidence provided by our study highlighted the involvement of KMT2B in up-regulation of lncRNA as well as the transcription of CEP55, resulting in the promotion of angiogenesis and growth of RCC.
SHED-derived exosomes promote LPS-induced wound healing with less itching by stimulating macrophage autophagy
Authors: Xie Yunyi , Yu Le , Cheng Zhilan , Peng Yingying , Cao Zeyuan , Chen Beichen , Duan Yihong , Wang Yan
Published: May 2022

High-quality cutaneous wound healing is associated with rapid wound closure and a comfortable healing process. Currently, exosomes derived from mesenchymal stem cells displayed a prominent therapeutic effect on skin wound closure. But the therapeutic approaches for wound itching are very limited in clinical. Stem cells from human exfoliated deciduous teeth (SHED) may offer a unique exosome resource for cell-free therapeutics in potential clinical applications. Here, we investigated the common mechanisms underlying wound closure and unpleasant sensation of itching, focusing on the contribution of the SHED-derived exosome to immune response and wound itching during healing. The effects of SHED-derived exosomes on inflammatory wound healing were examined using lipopolysaccharide (LPS)-induced wounds in a mouse model. We found prolonged inflammation and distinct itch responses in skin wound tissue during LPS-induced wound healing. SHED-derived exosomes facilitated LPS-induced wound closure and relieved wound itching. Therefore, they are ideal for the treatment of wound healing. Macrophages in skin wound tissues are responsible for autophagy during wound healing. Macrophage autophagy also regulates cell proliferation, migration, and neuronal signal transduction in vitro. SHED-derived exosomes containing miR-1246 enhanced autophagy by regulating macrophage function through the AKT, ERK1/2, and STAT3 signaling pathways. Thus, SHED-derived exosomes promote wound healing with less itching in an LPS-induced wound model by stimulating macrophage autophagy, which has implications for the treatment of inflammatory wound healing.

Graphical Abstract
Patient reported outcomes in oncology: changing perspectives—a systematic review
Authors: Silveira Augusta , Sequeira Teresa , Gonçalves Joaquim , Lopes Ferreira Pedro
Published: May 2022

In public health context, oncology is associated with severe negative impact on patients and on their relatives’ quality of life. Over the last decades, survival has remained at 50% worldwide for some tumor locations. Patient reported outcomes (PROs) assessment and, the corresponding use in clinical practice, help establishing patient individualized profiling involving caregivers. The purpose of this systematic review was to examine critical success factors for PROs assessment in daily clinical oncology practice. Additionally, we investigated how PROs collection can change oncology perspectives for patients and caregivers. According to PRISMA guidelines, 83 studies were included in this systematic review, whether related with implementation in daily clinical practice or associated with its use in oncology. PROs assessment gathers multi-professional teams, biomedical and clinical expertise, patients, families and caregivers. Institutional involvement, first line for caregiver’s adherence, team continuous formation, encompassing training and support, design of clear workflows, continuous monitoring, and data analysis are crucial for implementation. PROs measures are decisive in oncology. Several items were improved, including caregiver–patient–physician communication, patient risk groups identification, unmet problems and needs detection, disease course and treatment tracking, prognostic markers, cost-effectiveness measurement and comfort/support provision for both patients and caregivers. Routine assessment and implementation of PROs in clinical practice are a major challenge and a paradigm transformation for future.
Ring finger protein 180 suppresses cell proliferation and energy metabolism of non-small cell lung cancer through downregulating C-myc
Authors: Ding Yi , Lu Yi , Xie Xinjie , Cao Lei , Zheng Shiying
Published: May 2022

Background

Non-small cell lung cancer (NSCLC) causes numerous deaths worldwide. however, biomarkers for NSCLC prognosis are scarce for its heterogeneity. Proteins containing the RING finger domain RING finger protein 180 (RNF180) is a key mediator for ubiquitination, which controls cell cycle and regulates progression in certain human tumors. However, the detailed function of RNF180 in NSCLC remains unclear. In the present study, we aimed to investigate the role of RNF180 and its molecule network in NSCLC.

Methods

Quantitative real-time polymerase chain reaction and immunohistochemical staining were used to analyze RNF180 levels. RNA interference and lentiviral-mediated vector transfections were performed to silence and overexpress RNF180 in NSCLC cells. Furthermore, Cell Counting Kit-8 was used for assessing biological function of RNF180 in cell proliferation and a xenograft model for examining its function in vivo. The activity of glycolysis was determined by examining the level of the extracellular acidification rate (ECAR).

Results

RNF180 expression decreased in NSCLC tissues, and its expression was positively correlated with the survival rate of patients with NSCLC. Moreover, RNF180 overexpression suppressed the proliferation and glycolytic activities in NSCLC cells and restricted its tumorigenicity in vivo. Furthermore, RNF180 silencing promoted the proliferation and glycolysis metabolism of NSCLC cells, whereas C-myc inhibitor disrupted these effects. The underlying anti-oncogene of RNF180 involved in C-myc downregulation via ubiquitin-dependent degradation.

Conclusions

Together, these results firstly indicated the anti-tumor properties of RNF180 and its correlation with NSCLC progression, thereby endorsing the potential role of RNF180 as an efficient prognostic biomarker for tumor recurrence.
Attitudes toward posthumous assisted reproduction in China: a multi-dimensional survey
Authors: Huang Jiliang , Li Jue , Xiao Wanfen , Li Zhiling
Published: May 2022

Background

Professional legislation and ethics guidelines for posthumous assisted reproduction (PAR) are lacking in China. This study aims to measure the attitudes of the general public, IVF couples, and assisted reproductive technology (ART) practitioners toward PAR in China.

Methods

A multi-dimensional survey was designed, and electronic questionnaires were used. General demographic data, reproductive viewpoints, attitudes toward PAR, interactive ability to predict the partner’s attitude toward PAR, and the legal attributes and rights to the disposal of posthumous embryos were evaluated.

Results

The study found that the traditional Chinese viewpoints of fertility had changed. The approval rates for PAR were 79.10%, 55.32%, and 58.89%, in the general public, IVF couples, and ART practitioners, respectively. Most participants agreed that the psychological well-being of offspring should be previously considered before making a PAR decision (81.84%, 73.61%, and 76.98%, respectively). Multivariable logistic regression analysis showed that age, marital status, and gender were common influencing factors, while occupation, religion, and pregnancy history showed no influence on support for PAR. Males and females showed similar predictive abilities for their partners’ attitudes toward PAR (57.87% for males, 61.12% for females). Intracouple agreement analysis showed that the consistent rate of consistency in attitudes toward PAR was 65.28%.

Conclusion

The findings suggested that the approval rate of PAR was relatively high in China. Legislation and ethics guidelines for PAR may be considered in China. The psychological well-being of offspring should be considered before the implementation of PAR. Due to the very large regional and demographic differences in China, investigation of a larger samples of participants is necessary.
Effect of herbal compounds on coronavirus; a systematic review and meta-analysis
Authors: Kesheh Mina Mobini , Shavandi Sara , Haeri Moghaddam Niloofar , Ramezani Moazzameh , Ramezani Fatemeh
Published: May 2022

Background

The new coronavirus (COVID-19) has been transmitted exponentially. Numerous studies have been performed in recent years that have shown the inhibitory effect of plant extracts or plant-derived compounds on the coronavirus family. In this study, we want to use systematic review and meta-analysis to answer the question, which herbal compound has been more effective?

Main body

The present study is based on the guidelines for conducting meta-analyzes. An extensive search was conducted in the electronic database, and based on the inclusion and exclusion criteria, articles were selected and data screening was done. Quality control of articles was performed. Data analysis was carried out in STATA software.

Conclusion

Due to the variety of study methods, definitive conclusions are not possible. However, in this study, we attempted to gather all the available evidence on the effect of plant compounds on SARS-COV-2 to be used for the development and use of promising antiviral agents against this virus and other coronaviruses. Trypthantrin, Sambucus extract, S. cusia extract, Boceprevir and Indigole B, dioica agglutinin urtica had a good effect on reducing the virus titer. Also among the compounds that had the greatest effect on virus inhibition, Saikosaponins B2, SaikosaponinsD, SaikosaponinsA and Phillyrin, had an acceptable selectivity index greater than 10. Andrographolide showed the highest selectivity index on SARS-COV-2. Our study confirmed insufficient data to support alkaloid compounds against SARS-COV-2, and the small number of studies that used alkaloid compounds was a limitation. It is recommended to investigate the effect of more alkaloid compounds against Corona virus.