bluuebunny/crossref_metadata_2025 huggingface dataset:
Mifepristone-Induced Hypothyroidism
Authors: Kalara Niketa , Manzano Alex
Published: August 2023

Medications are known to affect the thyroid physiology and are a known cause of hypothyroidism. There is an ever-growing list of medications that affect the thyroid by 1 or more mechanisms. Mifepristone is presently used for the treatment of mild autonomous cortisol secretion (MACS). Hypothyroidism is not a known side effect of this medication. We present a 71-year-old woman with newly diagnosed impaired fasting glucose, dyslipidemia, and osteopenia presenting with a 3-year history of unintentional 15-pound weight gain (despite exercise and a good diet) and increased anxiety. Her physical examination was pertinent for mild lower extremity edema, easy bruising, and skin thinning. Workup revealed adrenocorticotropic hormone (ACTH)-independent MACS from bilateral micronodular hyperplasia of the adrenals. Since she was not a surgical candidate, medical management with mifepristone was chosen. While on mifepristone, she complained of excessive fatigue, a workup done revealed new-onset hypothyroidism. Given her symptoms and bloodwork, she was started on levothyroxine. After stopping mifepristone, she was biochemically and clinically euthyroid and was eventually off levothyroxine. The mechanism by which mifepristone induces hypothyroidism is unknown. Except for a multicenter case series suggesting that mifepristone increases thyroid hormone requirements in patients with central hypothyroidism, to the best of our knowledge, the literature on euthyroid patients developing hypothyroidism secondary to mifepristone is scarce. In conclusion, while the hypothyroidism seems reversible our case highlights the importance of getting baseline thyroid function tests (TFTs) and repeating them while on the medication. Treatment of hypothyroidism is based on symptoms and bloodwork.
Glomus Tumor of the Stomach Presenting With Upper Gastrointestinal Bleeding: A Case Report
Authors: Mohamed Wael T. , Jahagirdar Vinay , Jaber Fouad , Ahmed Mohamed , Fatima Ifrah , Chhabra Rajiv , Tawfik Ossama
Published: August 2023

Gastric glomus tumor is a rare mesenchymal tumor of the gastrointestinal tract, accounting for approximately 1% of all gastrointestinal soft tissue tumors. We describe a unique case of a 27-year-old female patient who presented with recurrent episodes of overt gastrointestinal bleeding requiring multiple blood transfusions. The patient was diagnosed with a gastric ulcer detected on esophagogastroduodenoscopy (EGD), which was grossly suggestive of an ulcerated gastrointestinal stromal tumor (GIST). Preoperative diagnosis was difficult, requiring laparoscopic robotic-assisted local wedge resection of the gastric mass. Pathological diagnosis and immunohistochemical (IHC) studies were consistent with a glomus tumor. We emphasize that the gastric glomus tumor might present with life-threatening recurrent gastrointestinal hemorrhage. In addition, it might mimic GIST and require surgical resection. Pathological diagnosis and IHC studies are needed to confirm the diagnosis.
Anaplastic Large-Cell Lymphoma With Vitreous Humor Involvement
Authors: Caranfa Jonathan T. , Liang Michelle C.
Published: August 2023

Purpose: To describe a case of T-cell lymphoma with bilateral vitreous involvement. Methods: A case report was reviewed, and a literature review, including search terms such as “anaplastic large-cell lymphoma (ALCL)” and “T-cell lymphoma with ocular involvement”, was performed. Results: A 56-year-old man presented with slurred speech, left-sided weakness, and floaters in his right eye. He was found to have an enhancing right frontal lobe mass with biopsy positive for ALCL. The right eye demonstrated 2+ vitreous cell, with a vitreous biopsy consistent with ALCL. His floaters resolved, and the patient was asymptomatic until he developed floaters in his left eye 1½ years later. A subsequent vitreous biopsy revealed recurrence of ALCL in the fellow eye. Conclusions: ALCL is a rare T-cell lymphoma uncommonly reported as having vitreous infiltration.
Cleft Lip and Palate Care: A Healthcare Cost and Utilization Project Analysis
Authors: Khoo Kimberly H. , Lopez Christopher D. , Rivera Perla Krissia M. , Yusuf Cynthia T. , Lopez Joseph , Redett Richard J. , Yang Robin
Published: August 2023

Introduction:

Increasing emphasis on reduction of healthcare costs has caused rates of outpatient cleft lip and palate-related procedures to rise. This study aims to describe patient and hospital characteristics associated with cleft repair and related surgeries and to assess differences in these characteristics against those undergoing inpatient cleft procedures.

Methods:

Data was collected from the 2016 to 2018 National Inpatient Sample (NIS) and the 2016 to 2018 Nationwide Ambulatory Surgery Sample (NASS) from the Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ). The databases were queried for International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes and Current Procedural Terminology (CPT) codes, respectively, describing cleft lip and palate-related procedures. Variables described were categorized into 2 main groups of patient demographics and hospital characteristics.

Results:

A total of 271 patients were included from the NIS and 3122 patients from the NASS. In both settings, the most common insurance used for cleft lip surgeries was Medicaid (46.7% vs 50.7%); the same was true for cleft palate (50.7% vs 53.5%). The distribution of zip code-based income quartiles was similar between settings for both cleft procedures. The most common location and teaching status of the hospitals was urban, teaching hospitals.

Conclusion:

This study demonstrates that patient and hospital characteristics are similar between inpatient and outpatient cleft surgeries. Patients were primarily in the 2 lower income quartiles and enrolled in Medicaid. More granular studies defining the social determinants of health in the cleft lip and palate populations may improve care for these patients.
Water-based drilling fluid with palygorskite: cutting carrying and contaminants
Authors: Santanna Vanessa Cristina , Araújo Gabriela Carlos Nunes , Andrade da Silva Maria Thayse , Castro Dantas Tereza Neuma de , Pimentel Patrícia Mendonça
Published: August 2023

In the petroleum industry, one of the most important functions fluids must perform is to carry cuttings efficiently. In this context, the contamination of drilling fluids represents a challenge to the industry because it alters the properties of these fluids. This work compares two drilling fluids (one palygorskite-based and the other polymer-based), evaluating the effects of contaminants on these drilling fluids and their ability to carry cuttings. A contaminant is considered to be any material that causes undesirable changes in the properties of the drilling fluid. Contamination of an aqueous drilling fluid by calcium hydroxide (Ca(OH)2) and brine can increase the filtrate volume, decrease the perforation rate and alter the rheological properties of the fluid. This work analyses the effects of contamination by Ca(OH)2 and brine on the properties of salted water-based drilling fluids viscosified with palygorskite. For comparison, tests were performed with a polymeric drilling fluid. The cutting-carrying capacity of these fluids was verified using the empirical correlations of Moore (1974), Chien (1994) and Walker & Mayes (1975). The results show that the drilling fluid with palygorskite is resistant to contamination with Ca(OH)2 and brine, presenting low filtrate volume values. The drilling fluid with palygorskite presented greater slip velocities than the polymeric drilling fluid. Regarding the cutting-carrying capacity, the drilling fluid with palygorskite presented positive transport ratio values (>0), making it suitable for carrying rock cuttings. However, the polymeric drilling fluid showed better performance in terms of cutting-carrying capacity.
Nanoscale modeling of dynamically tunable planar optical absorbers utilizing InAs and InSb in metal-oxide-semiconductor–metal configurations
Authors: Dixit Kirtan P. , Gregory Don A.
Published: August 2023

The attainment of dynamic tunability in spectrally selective optical absorption has been a longstanding objective in modern optics. Typically, Fabry–Perot resonators comprising metal and semiconductor thin films have been employed for spectrally selective light absorption. In such resonators, the resonance wavelength can be altered via structural modifications. The research has progressed further with the advent of specialized patterning of thin films and the utilization of metasurfaces. Nonetheless, achieving dynamic tuning of the absorption wavelength without altering the geometry of the thin film or without resorting to lithographic fabrication still poses a challenge. In this study, the incorporation of a metal-oxide-semiconductor (MOS) architecture into the Fabry–Perot nanocavity is shown to yield dynamic spectral tuning in a perfect narrowband light absorber within the visible range. Such spectral tuning is achieved using n-type-doped indium antimonide and n-type-doped indium arsenide as semiconductors in a MOS-type structure. These semiconductors offer significant tuning of their optical properties via electrically induced carrier accumulation. The planar structure of the absorber models presented facilitates simple thin-film fabrication. With judicious material selection and appropriate bias voltage, a spectral shift of 47 nm can be achieved within the visible range, thus producing a discernible color change.
Quantitative evaluation of myocardial layer-specific strain using two-dimensional speckle tracking echocardiography in septic patients
Authors: Zhang Jin , Zhu Jing , Xie Tian , Sun Fan , Wang Ni , Guo Feng-Mei
Published: August 2023

Background

Although global longitudinal strain (GLS) is proven to be reduced and associated with adverse outcomes in septic patients, it has not been elucidated whether or not layer-specific strains are reduced. We aimed to explore the layer-specific strains of left ventricular (LV) for assessing myocardial dysfunction in septic patients.

Methods

A prospective observational study of patients with sepsis was conducted in a tertiary hospital in China. Routine two-dimensional speckle tracking echocardiography was performed within 24 h of enrollment. Demographic data, laboratory values, and clinical outcomes were collected.

Results

We recruited 79 septic patients finally. The mean age of septic patients was 59.4 years old and 45 (57.0%) were male. The median Acute Physiology Age and Chronic Health Evaluation (APACHE II) score, and mean sequential organ failure assessment (SOFA) score of all patients were 19.0 and 7.7, respectively. According to the left ventricular ejection fraction (LVEF) value of 50%, the patients were categorized into two groups: SICM (sepsis-induced cardiomyopathy, LVEF < 50%, n = 22) and non-SICM group ( LVEF ≥ 50%, n = 57). The median LVEF of SICM and non-SICM patients were 41.9% and 58.7%, and SICM patients had less negative layer-specific strain and global strain than that of non-SICM patients. The echocardiographic comparison of non-SICM and healthy controls was conducted to explore the myocardial injuries of non-SICM patients and the non-SICM had worse LS-epi than that of controls (-18.5% vs. -21.4%, p = 0.024).

Conclusion

There were 72.2% (57) septic patients presented with non-SICM (LVEF ≥ 50%), and the strain value of epicardium of them was less negative than healthy controls.
Evaluation of predictive capability of Bayesian spatio-temporal models for Covid-19 spread
Authors: Lawson Andrew B.
Published: August 2023

Background

Bayesian models have been applied throughout the Covid-19 pandemic especially to model time series of case counts or deaths. Fewer examples exist of spatio-temporal modeling, even though the spatial spread of disease is a crucial factor in public health monitoring. The predictive capabilities of infectious disease models is also important.

Methods

In this study, the ability of Bayesian hierarchical models to recover different parts of the variation in disease counts is the focus. It is clear that different measures provide different views of behavior when models are fitted prospectively. Over a series of time horizons one step predictions have been generated and compared for different models (for case counts and death counts). These Bayesian SIR models were fitted using MCMC at 28 time horizons to mimic prospective prediction. A range of goodness of prediction measures were analyzed across the different time horizons.

Results

A particularly important result is that the peak intensity of case load is often under-estimated, while random spikes in case load can be mimicked using time dependent random effects. It is also clear that during the early wave of the pandemic simpler model forms are favored, but subsequently lagged spatial dependence models for cases are favored, even if the sophisticated models perform better overall.

Discussion

The models fitted mimic the situation where at a given time the history of the process is known but the future must be predicted based on the current evolution which has been observed. Using an overall ‘best’ model for prediction based on retrospective fitting of the complete pandemic waves is an assumption. However it is also clear that this case count model is well favored over other forms. During the first wave a simpler time series model predicts case counts better for counties than a spatially dependent one. The picture is more varied for morality.

Conclusions

From a predictive point of view it is clear that spatio-temporal models applied to county level Covid-19 data within the US vary in how well they fit over time and also how well they predict future events. At different times, SIR case count models and also mortality models with cumulative counts perform better in terms of prediction. A fundamental result is that predictive capability of models varies over time and using the same model could lead to poor predictive performance.

In addition it is clear that models addressing the spatial context for case counts (i.e. with lagged neighborhood terms) and cumulative case counts for mortality data are clearly better at modeling spatio-temporal data which is commonly available for the Covid-19 pandemic in different areas of the globe.
Bioinformatics analysis of hedgehog interacting protein in colorectal cancer: a study based on GEO data and TCGA data
Authors: Fu Fengyihuan , Zhang Yuan , Feng Jubin , Nie Yuqiang
Published: August 2023

Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide. Hedgehog Interacting Protein (HHIP) is evolutionarily conserved protein, which are important morphogens for a wide range of developmental processes,However, the specific role and mechanism of HHIP in CRC remains not fully understood. In this study, we first performed pan-cancer analysis for HHIP’s expression via The Cancer Genome Atlas (TCGA) and The Genotype-Tissue Expression (GTEx) data and found that HHIP might be a potential anti-oncogene for CRC. Subsequently, non-coding RNAs (ncRNAs) contributing to down-regulated HHIP expression were identified through a combination of a series of in silico analyses, including expression and correlation analysis. Finally, the LINC02381/miR-577 complex was identified as the top potential upstream regulator of HHIP in CRC. In addition, HHIP expression level was significantly correlated with tumor immune cell infiltration, biomarkers of immune cells, and immune checkpoint expression. Overall, our findings clarified ncRNAs-mediated down-regulation of HHIP which was associated with poor prognosis and tumor immune infiltration in CRC.
Protective role of thymoquinone in hyperlipidemia-induced liver injury in LDL-R−/−mice
Authors: Wang Fei , Yao Wei , Yu Dexin , Hao Yuhua , Wu Yuling , Zhang Xiaoqing
Published: August 2023

Background

Hyperlipidemia, a heterogeneous group of disorders characterized by elevated plasma lipids in the blood, causes severe health problems, leading to fatty liver disease and nonalcoholic fatty liver disease. Thymoquinone, the major active chemical component of Nigella sativa, reportedly exerts a vast array of biological effects. Various studies have reported that Thymoquinone protects against liver injury.

Aims

The aim of this study was to investigate the possible protective effects of Thymoquinone against liver injury in hyperlipidemia-induced LDL-R−/− mice.

Methods

Eight-week-old male LDL-R−/− mice were randomly divided into three groups: a control group fed a normal diet and two groups fed a high-cholesterol diet or high-cholesterol diet mixed with Thymoquinone. All groups were fed different diets for 8 weeks. Blood samples were obtained from the inferior vena cava and collected in serum tubes. The samples were then stored at − 80 °C until used. Longitudinal sections of liver tissues were fixed in 10% formalin and then embedded in paraffin for histological evaluation. The remainder of the liver tissues were snap-frozen in liquid nitrogen for reverse transcription-polymerase chain reaction or western blotting.

Results

Our results demonstrated that Thymoquinone administration significantly reduced liver histological alterations by hyperlipidemia. Thymoquinone mitigated hyperlipidemia-induced liver injury as indicated by the suppression of metabolic characteristics, liver biochemical parameters, pyroptosis indicators, a macrophage marker, and the phosphatidylinositide 3-kinase signaling pathway.

Conclusions

Thymoquinone is a potential therapeutic agent for hyperlipidemia-induced liver injury.
Age-related changes in mobility assessments correlate with repetitive goal-directed arm-movement performance
Authors: Walz Isabelle Daniela , Waibel Sarah , Kuhner Andreas , Gollhofer Albert , Maurer Christoph
Published: August 2023

Background

There is ample evidence that mobility abilities between healthy young and elderly people differ. However, we do not know whether these differences are based on different lower leg motor capacity or instead reveal a general motor condition that could be detected by monitoring upper-limb motor behavior. We therefore captured body movements during a standard mobility task, namely the Timed Up and Go test (TUG) with subjects following different instructions while performing a rapid, repetitive goal-directed arm-movement test (arm-movement test). We hypothesized that we would be able to predict gait-related parameters from arm motor behavior, even regardless of age.

Methods

Sixty healthy individuals were assigned to three groups (young: mean 26 ± 3 years, middle-aged 48 ± 9, old 68 ± 7). They performed the arm-movement and TUG test under three conditions: preferred (at preferred movement speed), dual-task (while counting backwards), and fast (at fast movement speed). We recorded the number of contacts within 20 s and the TUG duration. We also extracted TUG walking sequences to analyze spatiotemporal gait parameters and evaluated the correlation between arm-movement and TUG results.

Results

The TUG condition at preferred speed revealed differences in gait speed and step length only between young and old, while dual-task and fast execution increased performance differences significantly among all 3 groups. Our old group’s gait speed decreased the most doing the dual-task, while the young group’s gait speed increased the most during the fast condition. As in our TUG results, arm-movements were significant faster in young than in middle-aged and old. We observed significant correlations between arm movements and the fast TUG condition, and that the number of contacts closely predicts TUG timefast and gait speedfast. This prediction is more accurate when including age.

Conclusion

We found that the age-related decline in mobility performance that TUG reveals strongly depends on the test instruction: the dual-task and fast condition clearly strengthened group contrasts. Interestingly, a fast TUG performance was predictable by the performance in a fast repetitive goal-directed arm-movements test, even beyond the age effect. We assume that arm movements and the fast TUG condition reflect similarly reduced motor function.

Trial registration

German Clinical Trials Register (DRKS) number: DRKS00016999, prospectively registered on March, 26, 2019.
The willingness and barriers to collaborate in the care of frail older adults: perspectives of primary care professionals
Authors: De Coninck Leen , Declercq Anja , Bouckaert Leen , Döpp Carola , Graff Maud J.L. , Aertgeerts Bert
Published: August 2023

Background

This study investigated the perspectives of primary care professionals, in particular general practitioners, registered nurses, physiotherapists and occupational therapists, on inter-professional collaboration, the barriers and the facilitators they perceive in the care of the frail older population.

Methods

We conducted a qualitative study. In-depth interviews with healthcare professionals were performed, using open-ended questions about their perceptions on the care of frail older adults and inter-professional collaboration. Data was analyzed following the Basic Logical Model of Abduction and Creswell’s coding method.

Results

Healthcare professionals indicated that when they explored problems complementary to the reasons for older people to contact a healthcare professional, these additional problems often seemed to be the main problem. They also stated that there was too little inter-professional collaboration in the care of complex chronic issues and lack of a shared vision on collaboration. Collaboration is still limited too much to contacting established professions. Health information technology can support both, inter-professional collaboration and working on an evidence-based manner. It can also be a facilitator to inform patients. The availability and use of health information technology differs between the professions. Success factors and barriers for sustainable collaboration were identified on several levels, namely innovation, individual, professional, patient, social context, context of the organization, economic and political context.

Conclusions

Our study shed light on the willingness and barriers in collaboration of healthcare professionals in primary care for older adults. There is little inter-professional collaboration, despite the willingness of the healthcare professionals to collaborate.
Esketamine versus placebo on time to remission in major depressive disorder with acute suicidality
Authors: Fu Dong-Jing , Zhang Qiaoyi , Shi Ling , Borentain Stephane , Guo Shien , Mathews Maju , Anjo Joana , Nash Abigail I. , O’Hara Marguerite , Canuso Carla M.
Published: August 2023

Background

Esketamine (ESK) nasal spray, taken with oral antidepressant therapy, is approved for the treatment of depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior. In pooled analyses of two pivotal phase 3 studies, ASPIRE I and II, remission rates were consistently higher among patients with MDD with active suicidality who were treated with ESK + standard of care (SOC) versus placebo (PBO) + SOC at all time points in the double-blind and most time points in the follow-up phases. The current analysis of the ASPIRE data sets assessed the effect of ESK + SOC versus PBO + SOC on additional remission-related endpoints: time to achieving remission and consistent remission, proportion of patients in remission and consistent remission, and days in remission.

Methods

Post hoc analysis of pooled data from ASPIRE I and II (N = 451). Remission and consistent remission were defined as Montgomery-Åsberg Depression Rating Scale (MADRS) total score ≤ 12 at any given visit or two consecutive visits, respectively. Combined endpoints utilizing Clinical Global Impression-Severity of Suicidality-revised version [CGI-SS-r] ≤ 1 (i.e., not suicidal/questionably suicidal) along with the remission and consistent remission definitions (i.e., MADRS total score ≤ 12) were also examined.

Results

The median times to remission and consistent remission of MDD were significantly shorter in ESK + SOC versus PBO + SOC (15 versus 23 [p = 0.005] and 23 versus 50 days [p = 0.007], respectively) and a greater proportion of patients in ESK + SOC achieved remission and consistent remission by Day 25 (65.2% versus 55.5% and 54.2% versus 39.8%, respectively). Similar results were obtained using the combined endpoint for both remission definitions. The median percent of days in remission during the double-blind treatment phase was significantly greater in ESK + SOC (27.1% or 5 days) versus PBO + SOC (8.3% or 2 days; p = 0.006), and the significant difference was maintained during follow-up.

Conclusion

Treatment with ESK + SOC versus PBO + SOC resulted in significantly shorter time to remission, greater proportion of patients in remission, and greater percent of days in remission using increasingly rigorous definitions of remission. These findings underscore the clinical benefits of ESK for adults with MDD with suicidality.

Trial registration

ClinicalTrials.gov registry NCT03039192 (registered February 1, 2017) and NCT03097133 (registered March 31, 2017).
Moderating effects of suicide resilience and meaning in life on the association between entrapment and suicidal ideation in Chinese patients with ovarian cancer: a cross-sectional study
Authors: Zhang Yinying , Ding Xiaoping , Chen Jie , Liu Yilan , Wang Gang , Hu Deying
Published: August 2023

Background

Numerous studies have confirmed that patients with ovarian cancer have a relatively high risk of suicidality. Early identification of psychological factors related to suicidal ideation in patients with ovarian cancer may provide effective information for suicide prevention strategies. This study aimed to investigate whether and how suicide resilience and meaning in life moderate the relationship between entrapment and suicidal ideation in patients with ovarian cancer.

Methods

This was a cross-sectional investigation was conducted in 505 Chinese patients with ovarian cancer. Patients completed a battery of self-reported questionnaires that included the General Information Questionnaire, and Chinese versions of the Entrapment Scale, Scale for Suicidal Ideation, Suicide Resilience Inventory-25, and Meaning in Life Scale. Descriptive statistics, Pearson’ s chi-square, Pearson’ s correlation, and hierarchical multiple linear regression analysis were performed.

Results

In this study, the prevalence of suicidal ideation reported by patients with ovarian cancer was 32.07%. Patients’ suicidal ideation could be explained by the following three predictors: entrapment × suicide resilience × meaning in life (β = -0.169,p < 0.001), entrapment × suicide resilience (β = -0.148,p < 0.001), and entrapment × meaning in life (β = -0.107,p = 0.005).

Conclusion

These findings suggest that ovarian cancer patients are prone to suicidal ideation when they feel a sense of entrapment. Enhancing patients’ suicide resilience and meaning in life may be two targeted interventions to reduce suicidal ideation in ovarian cancer patients. In particular, considering both the protective effects of suicide resilience and meaning in life may yield better suicide prevention outcomes than considering only one of these factors.
Prevalence, diagnosis and treatment of ADHD in Arab and Jewish children in Israel, where are the gaps?
Authors: Shehadeh-Sheeny Amal , Baron-Epel Orna
Published: August 2023

Background

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder affecting children and causing significant impairment. It is not clear to what extent ADHD differs between population groups. This study aims to assess prevalence, diagnosis and treatment of ADHD among Arab and Jewish children of primary school age in Israel.

Methods

Cross-sectional survey, including 517 parents of children ages 7–10 (225 Jewish and 292 Arab) and 60 homeroom teachers of the corresponding children. Both parents and homeroom teachers completed the ADHD Rating Scale-V-RV. ADHD was defined according to DSM-5 ADHD criteria by both parents and teachers, or clinical diagnosis. In addition, parents reported ADHD medication and adherence to medication.

Results

Prevalence of ADHD was similar for both groups. Yet, seeking diagnosis was lower among Arab Muslim children (9.2%) compared to Jewish children (17.8%). Arab Muslim children received significantly less medication compared to Jewish children. Parental decision to seek diagnosis was associated with education (OR = 6.14, CI 1.74–21.71), not ethnicity. Ethnicity predicted parents’ decisions to pharmacologically treat their children with ADHD (OR = 7.61, CI 1.14–50.86) and adherence to medication (OR = 10.19, CI 1.18–88.01).

Conclusion

Education is critical in the help-seeking process, affecting the rate of ADHD diagnosis. Pharmacological treatment and adherence are correlated with ethnicity. Parents with limited education and minorities should be targeted for interventions to increase awareness regarding ADHD and treatment.
Alike but also different: a spatiotemporal analysis of the older populations in Zhejiang and Jilin provinces, China
Authors: Jiang Lei , Chen Xingyu , Liang Wenjie , Zhang Bo
Published: August 2023

According to the 7th National Population Census, China is experiencing rapid growth of its ageing population, with large spatial disparities in the distribution of older folks in different regions. And yet, scant comparative research has been conducted on the two regions of Zhejiang and Jilin in particular, which differ considerably in economic development but witness nearly the same ageing trend. In response, this article compares Zhejiang, an advanced economic province, with Jilin, with its relatively low level of economic development, to explore the ageing issue and analyse the spatial correlation between older populations and socioeconomic factors. Using the spatiotemporal data analysis and geographical detector approaches, we obtain three significant findings: 1. both provinces have maintained steady rates of increase in ageing; 2. the older populations in Zhejiang and Jilin are mostly concentrated in the provincial capitals and nearby cities with reasonably established economies; and 3. the factors, including local fiscal expenditures, beds in hospitals and nursing homes, and coverage of social security, show a highly similar spatial pattern between older populations in Zhejiang and Jilin. The q-values of all the selected socioeconomic factors in Jilin showed a growth trend, indicating that the spatial correlation between these factors and ageing is strengthening year on year, that is, the resources gained from the socioeconomic development of Jilin have shifted steadily toward old-age services. As a consequence, a vicious circle of the slowing down of the economic growth drives away working forces and quickens the pace of population ageing, is present. From a policy perspective, Jilin province is strongly dependent on state-owned enterprises characterised by institutional rigidity, an inflexible market economy and an under-developed private sector, all of which are profoundly influenced by ageing. The consequence is large population outflows of young people. In contrast, the economy of Zhejiang province is partially decoupled from the ageing trend, so the gap in level of development between its counties has been narrowing. The policy implication here is that Zhejiang represents an active private economy that has coped successfully with ageing by attracting young migrants and developing new forms of development, such as the digital economy.
Associations of sleep duration, daytime napping, and snoring with depression in rural China: a cross-sectional study
Authors: Zhang Xueyao , Li Guangxiao , Shi Chuning , Sun Yingxian
Published: August 2023

Background

Most adult patients with depression complain about sleep symptoms, including insufficient and excessive sleep. However, previous studies investigating the impact of sleep duration on depression have yielded conflicting results. Therefore, this study aimed to analyse the link between depression and sleep duration, daytime napping, and snoring among rural Chinese adults.

Methods

A cross-sectional study was conducted with 9104 individuals. Interviews were conducted with the participants regarding their sleep patterns and their daytime napping routines. The individuals were then assessed for depression using the Patient Health Questionnaire-9. The risk of depression was assessed using a multifactor binary logistic regression analysis. A generalized additive model was used to evaluate the nonlinear relationship between depression and sleep duration/nap time. Additionally, subgroup analysis was conducted to investigate the correlation between sleep duration, daytime napping, snoring, and depression.

Results

Less than 6 h or more than 8 h of nighttime sleep, daytime napping for more than 1 h, and snoring were all significantly associated with an increased risk of depression. A U-shaped relationship was found between the duration of nighttime sleep and depression. In addition, we found that the nighttime duration of sleep, daytime naps, and snoring had a significant combined effect on the risk of depression. The subgroup analysis further revealed that lack of sleep at night significantly increased the risk of depression in all subgroups. However, snoring and excessive nighttime sleep and napping were only associated with the risk of depression in some subgroups.

Conclusions

Lack of nighttime sleep (short sleep duration), excessive sleep, and napping for more than one hour during the day were associated with a high risk of depression and had a combined effect with snoring.
Gender differences in the association of individual and contextual socioeconomic status with hypertension in 230 Latin American cities from the SALURBAL study: a multilevel analysis
Authors: Coelho Débora Moraes , de Souza Andrade Amanda Cristina , Silva Uriel Moreira , Lazo Mariana , Slesinski S. Claire , Quistberg Alex , Diez-Roux Ana V. , de Lima Friche Amélia Augusta , Caiaffa Waleska Teixeira
Published: August 2023

Background

Despite global interest in gender disparities and social determinants of hypertension, research in urban areas and regions with a high prevalence of hypertension, such as Latin America, is very limited.

The objective of this study was to examine associations of individual- and area-level socioeconomic status with hypertension in adults living in 230 cities in eight Latin America countries.

Methods

In this cross-sectional study, we used harmonized data from 109,184 adults (aged 18–97 years) from the SALURBAL (Salud Urbana en America Latina/Urban Health in Latin America) project. Hypertension was assessed by self-report. Individual-, sub-city- and city-level education were used as proxies of socioeconomic status. All models were stratified by gender.

Results

Higher individual-level education was associated with lower odds of hypertension among women (university education or higher versus lower than primary: odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.61–0.74) but higher odds among men (OR = 1.65; 95%CI 1.47–1.86), although in men an inverse association emerged when measured blood pressure was used (OR = 0.86; 95%CI 0.76–0.97). For both genders, living in sub-city areas with higher educational achievement was associated with higher odds of hypertension (OR per standard deviation [SD] = 1.07, 95%CI = 1.02–1.12; OR = 1.11 per SD, 95%CI = 1.05–1.18, for women and men, respectively). The association of city-level education with hypertension varied across countries. In Peru, there was an inverse association (higher city level education was associated with lower odds of hypertension) in women and men, but in other countries no association was observed. In addition, the inverse association of individual-level education with hypertension became stronger (in women) or emerged (in men) as city or sub-city education increased.

Conclusion

The social patterning of hypertension differs by gender and by the level of analysis highlighting the importance of context- and gender-sensitive approaches and policies to reduce the prevalence of hypertension in Latin America.
The effect of acidity on the physicochemical properties of two hydraulic calcium silicate-based cements and two calcium phosphate silicate-based cements
Authors: Yang Yan , Liu He , Wang Zhe-Jun , Hu Pei , Haapasalo Markus , Manso Adriana , Ma Jing-Zhi , Shen Ya
Published: August 2023

Background

Bioceramic cements have been widely used in endodontic treatment. This study aimed to compare the microhardness, elastic modulus, internal microstructure and chemical compositions of Biodentine, WMTA, ERRM Putty, iRoot FS and IRM after exposure to PBS, butyric acid, and butyric acid followed by PBS.

Methods

Specimens of each material were prepared and randomly divided into 5 subgroups (n = 5): subgroup A: PBS (pH = 7.4) for 4 days, subgroup B: PBS (pH = 7.4) for 14 days, subgroup C: butyric acid (pH = 5.4) for 4 days, subgroup D: butyric acid (pH = 5.4) for 14 days, subgroup E: butyric acid for 4 days followed by 10 days in contact with PBS. The surface microhardness, elastic modulus, internal morphologic and chemical compositions of specimens were analyzed.

Results

The microhardness and elastic modulus values of all materials were significantly higher in the presence of PBS compared to exposure to butyric acid, with the same setting time (P < 0.01). After 4-day exposure to butyric acid followed by 10-day exposure to PBS, the microhardness values returned to the same level as 4-day exposure to PBS (P > 0.05). Biodentine showed significantly higher microhardness and elastic modulus values than other materials, while IRM displayed the lowest (P < 0.01).

Conclusion

Biodentine seems the most suitable bioceramic cements when applied to an infected area with acidic pH. Further storage at neutral pH, e.g. PBS reverses the adverse effects on bioceramic cements caused by a low pH environment.
Nutritional status and quality of life among breast Cancer patients undergoing treatment in Addis Ababa, Ethiopia
Authors: Adam Ruth , Haileselassie Werissaw , Solomon Nabel , Desalegn Yakob , Tigeneh Wondemagegnhu , Suga Yisihak , Gebremedhin Samson
Published: August 2023

Background

The prevalence of malnutrition in cancer patients ranges from 30 to 60%. While it is known that malnutrition is prevalent among cancer patients, the relationship between undernutrition and quality of life among breast cancer patients has not been adequately explored. Therefore, the present study was aimed at assessing the association between undernutrition and quality of life among Breast Cancer patients under treatment in Addis Ababa, Ethiopia.

Methods

A cross-sectional study on breast cancer patients under treatment at the outpatient and in-patient departments of oncology centers of two tertiary hospitals in Addis Ababa – Tikur Anbessa Specialized Hospital (TASH) and St. Paul Millennium Medical College (SPHMMC) oncology was conducted from May 12 to August 26,2020. Nutritional status was assessed using Subjective Global Assessment (SGA) screening tool. Quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Cancer 30 (EORTC QLQ C30) a standard quality of life measurement scale for cancer patients. To determine the relationship between quality of life scores and nutritional status multivariable linear regression was fitted.

Results

A total of 411 breast cancer patients with mean age of 44.4 (± 11.47) years. And 393 (95.6%) of them female were included in the study. A high prevalence of moderate 127 (30.9%) and severe 106 (25.8%) malnutrition was observed. Moderate (β = −9.21 CI (− 14.59, − 4.67)) and severe (β = −17.81 CI (− 16.6, 2 − 2.91)) malnutrition were negatively associated with the overall quality of life. Malnutrition also showed negative associations with all domains of functional status (P < 0.05) and strong positive associations with symptom scores covered in the EORTC QLQ C-30 (P < 0.05).

Conclusion

This study indicated that malnutrition is a major problem among breast cancer patients and the nutritional status breast cancer patients was related to their quality of life….
Can clinical decision support systems be an asset in medical education? An experimental approach
Authors: Kafke Sean D. , Kuhlmey Adelheid , Schuster Johanna , Blüher Stefan , Czimmeck Constanze , Zoellick Jan C. , Grosse Pascal
Published: August 2023

Background

Diagnostic accuracy is one of the major cornerstones of appropriate and successful medical decision-making. Clinical decision support systems (CDSSs) have recently been used to facilitate physician’s diagnostic considerations. However, to date, little is known about the potential assets of CDSS for medical students in an educational setting. The purpose of our study was to explore the usefulness of CDSSs for medical students assessing their diagnostic performances and the influence of such software on students’ trust in their own diagnostic abilities.

Methods

Based on paper cases students had to diagnose two different patients using a CDSS and conventional methods such as e.g. textbooks, respectively. Both patients had a common disease, in one setting the clinical presentation was a typical one (tonsillitis), in the other setting (pulmonary embolism), however, the patient presented atypically. We used a 2x2x2 between- and within-subjects cluster-randomised controlled trial to assess the diagnostic accuracy in medical students, also by changing the order of the used resources (CDSS first or second).

Results

Medical students in their 4th and 5th year performed equally well using conventional methods or the CDSS across the two cases (t(164) = 1,30; p = 0.197). Diagnostic accuracy and trust in the correct diagnosis were higher in the typical presentation condition than in the atypical presentation condition (t(85) = 19.97; p < .0001 and t(150) = 7.67; p < .0001).These results refute our main hypothesis that students diagnose more accurately when using conventional methods compared to the CDSS.

Conclusions

Medical students in their 4th and 5th year performed equally well in diagnosing two cases of common diseases with typical or atypical clinical presentations using conventional methods or a CDSS. Students were proficient in diagnosing a common disease with a typical presentation but underestimated their own factual knowledge in this scenario. Also, students were aware of their own diagnostic limitations when presented with a challenging case with an atypical presentation for which the use of a CDSS seemingly provided no additional insights.
Meaning in life among nursing students: a latent profile analysis
Authors: Zhao Zhixin , Mei Yongxia , Wang Xiaoxuan , Jiang Hu , Wang Wenna , Lin Beilei , Zhang Zhenxiang
Published: August 2023

Background

Meaning in life, defined by an individual’s understanding and appreciation of life, is a vital aspect of a positive psychological state, that has a significant influence on physical and mental health. Therefore, improving the sense of meaning in life among nursing students has emerged as a crucial concern in nursing education. This study aimed to clarify the profiles and influencing factors of meaning in life among nursing students.

Methods

A descriptive cross-sectional online survey was conducted among nursing students in China from November 16, 2022, to January 17, 2023. The demographic information questionnaire and the meaning in life questionnaire (MLQ) were used to collect data. Latent profile analysis (LPA) was used to identify groups exhibiting distinct levels of meaning in life. Additionally, univariate analysis and multinominal logistic regression analysis were used to investigate the factors influencing each group. The reporting of this study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist.

Results

A total of 10,583 valid responses were received, and the analysis revealed four distinct profiles. The profiles identified were the medium meaning group (C1, 41.4%), medium fluctuation meaning-no motivation group (C2, 8.7%), lower meaning group (C3, 9.7%), and higher meaning group (C4, 40.2%). The univariate analysis revealed that age, gender, ethnicity, marital status, educational level, grade, university classification, student leadership experience, and political affiliation were factors that influenced the four latent profiles (P < 0.05). The multinomial logistic regression analysis showed that age, gender, ethnicity, education level, and student leadership experience were significant predictors of the various profiles (P < 0.05).

Conclusion

There is heterogeneous in meaning in life among nursing students in China. Nursing educators need to provide tailored guidance based on the latent classification characteristics of meaning in life among nursing students, aiming at improving their meaning in life and promoting the development of the nursing workforce.
An association between individual’s risk perceptions and delayed or foregone healthcare services during the COVID-19 pandemic in Korea
Authors: Hwang Jongnam , Kim Woong-Han , Heo Jongho
Published: August 2023

Background

Existing evidence highlights that the COVID-19 pandemic is associated with a large reduction in healthcare utilization for routine and less-urgent services around the world including Korea. During the COVID-19 pandemic, delayed and foregone healthcare are driven by various factors, and risk perception, a complex psychological construct, is one of them. The aim of this study was to examine how COVID-19 risk perceptions influence delayed and foregone care during the pandemic in Korea.

Methods

The Koreans’ Happiness Survey (KHS) 2020 was used to analyze responses from 13,491 individuals over 19 years of age residing in Korea. To assess delayed and foregone care, self-reported delayed or foregone care after the COVID-19 outbreak was used. COVID-19 risk perceptions were analyzed in terms of fear and severity of the pandemic based on responses from the participants. Logistic regression models, stratified by gender, were used to examine the relationship between COVID-19 risk perception and delayed/foregone healthcare.

Results

Among the total 13,491 individuals included in the study, 4.0% (n = 541) reported delayed and foregone care in 2020. The results showed that higher level of fear of COVID-19 was associated with an increased likelihood of reporting delayed and foregone care in Korean adults (OR = 1.36, 95% CI = 1.08–1.73). The gender-stratified model revealed that greater fear of COVID-19 was associated with higher odds of delayed and foregone healthcare (OR = 1.71, 95%CI = 1.23–2.39) among women while the perceived severity did not have any association. However, the perceived severity was associated with a higher likelihood of delayed and foregone care in men (OR = 1.17, 95%CI = 1.04–1.32), but no association was found between fear of COVID-19 and delayed and foregone healthcare in men.

Conclusions

To ensure the timely use of any needed healthcare services, it is worth considering establishing policy interventions to mitigate unnecessary fear and worries about COVID-19. This can be achieved by providing accurate information on the virus, protective measures, and treatment.