bluuebunny/crossref_metadata_2025 huggingface dataset:
Return to Play and Player Performance After Foot Fracture in UEFA Soccer Players
Authors: Diaz Connor C. , Lavoie-Gagne Ophelie Z. , Korrapati Avinaash , John Nalin S. , Diaz Mariah I. , Forlenza Enrico M. , Trasolini Nicholas A. , Forsythe Brian
Published: March 2022

Background:

There is a paucity of information on rate and time to return to play (RTP) in elite-level soccer players who have sustained foot fractures.

Purpose:

To (1) determine the rate and timing of RTP after foot fracture (eg, tarsal, metatarsal, or phalangeal), (2) investigate foot fracture reinjury incidence after RTP, and (3) evaluate performance after foot fracture as compared with matched, uninjured controls.

Study Design:

Descriptive epidemiology study.

Methods:

Athletes sustaining foot fractures were identified across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A) between 2000 and 2016. Injured athletes were matched to controls (1:1) using demographic characteristics and performance metrics from 1 season before injury. The authors recorded RTP rate, reinjury incidence, player characteristics associated with RTP within 2 seasons of injury, player availability, field time, and performance metrics during the 4 seasons after injury.

Results:

A total of 192 elite soccer players sustaining a foot fracture were identified; 40 players (20.8%) underwent operative treatment. Athletes missed an average of 69.41 ± 59.43 days and 5.15 ± 23.28 games. In the 4 seasons after injury, 80% of players returned to play, with 72% returning to play within 1 season of injury. Nine players (5%) sustained a subsequent foot fracture. Athletes with a foot fracture demonstrated significantly longer league retention compared with uninjured controls ( P < .001). Elite soccer players older than 30 years of age were less likely to RTP (odds ratio, 0.67; P = .002), whereas career experience, field position, and baseline performance showed no significant association with RTP rates. Injured athletes demonstrated similar performance to controls during the 4 years after injury, and there were no position-dependent differences on subgroup analysis. The players who underwent operative treatment had more assists per 90 minutes and more team points per game during the first season after injury compared with athletes treated nonoperatively.

Conclusion:

Foot fractures in elite soccer players resulted in moderate loss of play time (69.41 days). RTP rates were high at 80%, although players older than 30 years of age were less likely to RTP. On RTP, athletes who sustained a foot fracture maintained performance similar to preinjury levels and to uninjured controls.
Transformation of Clinical Nursing Practice Following a Caring-based Educational Intervention: A Qualitative Perspective
Authors: Bellier-Teichmann Tanja , Roulet-Schwab Delphine , Antonini Matteo , Brandalesi Vanessa , O’Reilly Louise , Cara Chantal , Brousseau Sylvain , Delmas Philippe
Published: March 2022

Introduction

Hemodialysis (HD) patients experience numerous physical and psychological symptoms on a daily basis. These symptoms have a heavy impact on their quality of life, which is a key indicator of their survival in the short term. Numerous empirical studies have shown that the quality of the nurse-patient relationship (NPR) is essential in promoting positive outcomes for patients. When patients receive caring, their autonomy and independence grows, their sense of hope increases, their quality of life improves, and their sense of satisfaction with nursing care received rises. Inversely, the presence of dehumanizing practices in hemodialysis settings can contribute to delay healing for patients. In light of the importance of the quality of the relationship between nurses and HD patients and of the benefits to be had from a quality relationship, an educational intervention based on Watson's Theory of Human Caring was delivered to HD nurses.

Objective

The purpose of this study was to explore qualitatively the perceptions of nurses working with HD patients in French-speaking Switzerland regarding changes to their clinical practice after receiving an educational intervention intended to reinforce caring attitudes and behaviors towards patients.

Methods

The method used was that of consensual qualitative research (CQR). Sixteen semi-structured interviews were conducted with hemodialysis nurses post-intervention.

Results

The results evidence a transformation of clinical nursing practice illustrated by three core ideas: (1) caring practice was reinforced; (2) new practices emerged; and (3) some limitations appeared.

Conclusion

In these times of global pandemic where the issue of the humanization of nursing care is front and center, this professional development activity helped reinforce caring-based practice. This practice needs to be developed within the various care units in order to guarantee and promote quality of care and patient safety.
Visualizing Racial-Ethnic Differences in the Division of Housework among Different-Sex Couples in the United States
Authors: Pessin Léa , Pojman Elena Maria
Published: March 2022

Recent research shows important racial/ethnic differences in how individuals spend time in housework. Yet our understanding of how the racial/ethnic makeup of couples shapes gender equality in the division of housework remains limited. The authors use couple-level data from the 2017–2019 waves of the Panel Study of Income Dynamics to visually illustrate how each partner’s race/ethnicity and their combination are associated with the gender division of housework among Black, Hispanic, and white individuals. The results show significant heterogeneity in the share of housework and total housework hours among racial/ethnic groups, underscoring the need for a couple-level understanding of how the racial/ethnic makeup of couples may shape the gender division of housework.
Supernatural Sociology: Americans’ Beliefs by Race/Ethnicity, Gender, and Education
Authors: Silva Tony , Woody Ashley
Published: March 2022

The authors analyze the 2020–2021 Chapman University Survey of American Fears ( n = 1,035), the most recent nationally representative survey to examine fears of and beliefs about supernatural and paranormal phenomena, including ghosts, hauntings, zombies, psychics, telekinesis, Bigfoot or Sasquatch, Atlantis, and extraterrestrial visitation. This research examines how supernatural beliefs vary by race/ethnicity, gender, and education after adjustment for other demographic characteristics and religiosity. There were five gender differences, such that women were more likely than men to believe in or fear all nonmaterial or spiritual supernatural phenomena, as well as Atlantis. People with a bachelor’s degree or higher were less likely to believe in extraterrestrial visitation, hauntings, Bigfoot or Sasquatch, and Atlantis. There were also six beliefs and fears for which racial/ethnic differences emerged. The results highlight how gender, education, and race/ethnicity are strongly related to complex belief systems, including supernatural phenomena.
Between Isolation and Autonomy: A Study of the Anti-caste Struggle in the University of Hyderabad
Authors: Sannaki Munna
Published: March 2022

The Chinese adage goes: ‘Teach a person how to catch a fish but don’t catch one’. For a long time, Dalits have been represented or led by socio-economically dominant communities in all disciplines and walks of life. However, Dalits have been trying by their own means to maintain their autonomy in all domains. Specifically, in self-respect struggles or anti-caste movements, there are enough examples to reinforce the idea that isolated struggles led by Dalit-Bahujan’s must be acknowledged as autonomous. This article analyses Ambedkar’s engagement with parties led by caste elites, while maintaining his social/political/cultural autonomy. This article also draws attention to how caste elites have tried to appropriate Dalit-Bahujan movements. This article was presented at the South Asia Anthropologists Group (SAAG) Annual Conference. The main idea of this article is to register the autonomy and isolation of Dalit students’ struggle through a case study at the University of Hyderabad. The anti-caste ‘Rohith Vemula’ struggle provides an instance of how political representation was practiced and how autonomy can be maintained in future struggles. The article argues this case out through the author’s experiential opinions as a participant, Ambedkar’s views and the carefully carved out vision of Dalit-Bahujan political movements.
Introduction to a review series on immunotherapies for nonmalignant hematologic diseases
Authors: Bollard Catherine M.
Published: March 2022

This Review Series, edited by past Associate Editor Catherine Bollard, looks at the role of immunotherapy in nonmalignant hematologic diseases. These 3 state-of-the-art reviews focus on the role of complement and complement inhibitors across a spectrum of diseases, the special immunologic challenges of hematopoietic stem cell transplant for nonmalignant diseases where patients have an intact immune system, and the hematologic complications of immune checkpoint inhibitors.
Increased MYD88 blood transcript in a mouse model of Alzheimer’s disease
Authors: Cucos Catalina Anca , Dobre Maria , Dragnea Elena Mihaela , Manda Gina , Milanesi Elena
Published: March 2022

Background

Neuroinflammation plays a prominent role in Alzheimer’s disease (AD), both in pathogenesis and disease progression. It has been shown that TLR/MYD88 signaling is involved in the chronic low-grade sterile inflammation associated with AD. Several studies have evidenced high levels of MYD88 in the brain of patients and animal models of AD, but no study has assessed so far its levels in blood.

Methods

In this study we evaluated the blood mRNA levels of MYD88 in a mouse model of AD, and also the putative effect of Rivastigmine treatment on MYD88 expression. Twenty-eight transgenic APP/TAU mice (AT) and twenty-two control C57/BL6j mice (WT) were included in this study, out of which five transgenic AT and five WT mice were treated with Rivastigmine.

Results

Increased MYD88 transcript in the whole blood from AT mice as compared to WT controls was found, which seems to increase in time due to disease progression and not to aging. This finding suggests that blood leukocytes are primed to develop TLR/MYD-mediated inflammatory processes. Moreover, results indicate that MYD88 blood levels were not modulated by the diseases-specific treatment with Rivastigmine.

Conclusions

Our results suggest that MYD88 might be a promising blood biomarker to monitor AD progression.
Maize plant architecture trait QTL mapping and candidate gene identification based on multiple environments and double populations
Authors: Fei Jianbo , Lu Jianyu , Jiang Qingping , Liu Zhibo , Yao Dan , Qu Jing , Liu Siyan , Guan Shuyan , Ma Yiyong
Published: March 2022

Background

The plant architecture traits of maize determine the yield. Plant height, ear position, leaf angle above the primary ear and internode length above the primary ear together determine the canopy structure and photosynthetic efficiency of maize and at the same time affect lodging and disease resistance. A flat and tall plant architecture confers an obvious advantage in the yield of a single plant but is not conducive to dense planting and results in high rates of lodging; thus, it has been gradually eliminated in production. Although using plants that are too compact, short and density tolerant can increase the yield per unit area to a certain extent, the photosynthetic efficiency of such plants is low, ultimately limiting yield increases. Genetic mapping is an effective method for the improvement of plant architecture to identify candidate genes for regulating plant architecture traits.

Results

To find the best balance between the yield per plant and the yield per unit area of maize, in this study, the F2:3 pedigree population and a RIL population with the same male parent were used to identify QTL for plant height (PH), ear height (EH), leaf angle and internode length above the primary ear (LAE and ILE) in Changchun and Gongzhuling for 5 consecutive years (2016–2020). A total of 11, 13, 23 and 13 QTL were identified for PH, EH, LAE, and ILE, respectively. A pleiotropic consistent QTL for PH overlapped with that for EH on chromosome 3, with a phenotypic variation explanation rate from 6.809% to 21.96%. In addition, there were major consistent QTL for LAE and ILE, and the maximum phenotypic contribution rates were 24.226% and 30.748%, respectively. Three candidate genes were mined from the three consistent QTL regions and were involved in the gibberellin-activated signal pathway, brassinolide signal transduction pathway and auxin-activated signal pathway, respectively. Analysis of the expression levels of the three genes showed that they were actively expressed during the jointing stage of vigorous maize growth.

Conclusions

In this study, three consistent major QTL related to plant type traits were identified and three candidate genes were screened. These results lay a foundation for the cloning of related functional genes and marker-assisted breeding of related functional genes.
Increased blastomere number is associated with higher live birth rate in day 3 embryo transfer
Authors: Tian Lifeng , Xia Leizhen , Liu Hongbo , Kou Yan , Huang Zhihui , Wu Xingwu , Fan Lu , Huang Jialyu , Wu Qiongfang
Published: March 2022

Purpose

To study the relationship between blastomere number and pregnancy outcomes of day 3 embryo transfers.

Methods

This retrospective cohort study included 2237 fresh single day 3 embryo transfer cycles from October 2013 to November 2020. Patients were divided into six groups according to the blastomere number on day 3: ≤ 6-cell (n = 100), 7-cell (n = 207), 8-cell (n = 1522), 9-cell (n = 187), 10-cell (n = 91) and ≥ 11-cell (n = 130). Generalized estimating equation analysis based on multivariate logistic regression model was performed to adjust for potential confounders.

Results

The live birth rate (LBR) was 19.0%, 27.1%, 38.9%, 32.1%, 44.0% and 53.8% for the ≤ 6-cell, 7-cell, 8-cell, 9-cell, 10-cell and ≥ 11-cell groups, respectively (P < 0.001). Specifically, the ≤ 6-cell group was associated with reduced LBR compared with the 8-cell group (aOR 0.50, 95% CI 0.29–0.86; P = 0.013). Conversely, the odds of live birth were significantly increased in patients transferred with 10-cell embryos (aOR 1.62, 95% CI 1.03–2.53; P = 0.035) and ≥ 11-cell embryos (aOR 2.14, 95% CI 1.47–3.11; P < 0.001) when using the 8-cell embryo group as reference. Similar trends were also observed in the rates of positive hCG test and clinical pregnancy, while no significant differences were detected in miscarriage risk.

Conclusion

Increased blastomere number was associated with higher LBR in fresh single day 3 embryo transfer cycles. This finding questions the consensus on the reduced developmental potential of fast-cleaving embryos. Further large prospective studies are warranted for confirmation.
Development and validation of a gradient boosting machine to predict prognosis after liver resection for intrahepatic cholangiocarcinoma
Authors: Ji Gu-Wei , Jiao Chen-Yu , Xu Zheng-Gang , Li Xiang-Cheng , Wang Ke , Wang Xue-Hao
Published: March 2022

Background

Accurate prognosis assessment is essential for surgically resected intrahepatic cholangiocarcinoma (ICC) while published prognostic tools are limited by modest performance. We therefore aimed to establish a novel model to predict survival in resected ICC based on readily-available clinical parameters using machine learning technique.

Methods

A gradient boosting machine (GBM) was trained and validated to predict the likelihood of cancer-specific survival (CSS) on data from a Chinese hospital-based database using nested cross-validation, and then tested on the Surveillance, Epidemiology, and End Results (SEER) database. The performance of GBM model was compared with that of proposed prognostic score and staging system.

Results

A total of 1050 ICC patients (401 from China and 649 from SEER) treated with resection were included. Seven covariates were identified and entered into the GBM model: age, tumor size, tumor number, vascular invasion, number of regional lymph node metastasis, histological grade, and type of surgery. The GBM model predicted CSS with C-Statistics ≥ 0.72 and outperformed proposed prognostic score or system across study cohorts, even in sub-cohort with missing data. Calibration plots of predicted probabilities against observed survival rates indicated excellent concordance. Decision curve analysis demonstrated that the model had high clinical utility. The GBM model was able to stratify 5-year CSS ranging from over 54% in low-risk subset to 0% in high-risk subset.

Conclusions

We trained and validated a GBM model that allows a more accurate estimation of patient survival after resection compared with other prognostic indices. Such a model is readily integrated into a decision-support electronic health record system, and may improve therapeutic strategies for patients with resected ICC.
A study of SARS-COV-2 outbreaks in US federal prisons: the linkage between staff, incarcerated populations, and community transmission
Authors: Towers Sherry , Wallace Danielle , Walker Jason , Eason John M. , Nelson Jake R. , Grubesic Tony H.
Published: March 2022

Background

Since the novel coronavirus SARS-COV-2 was first identified to be circulating in the US on January 20, 2020, some of the worst outbreaks have occurred within state and federal prisons. The vulnerability of incarcerated populations, and the additional threats posed to the health of prison staff and the people they contact in surrounding communities underline the need to better understand the dynamics of transmission in the inter-linked incarcerated population/staff/community sub-populations to better inform optimal control of SARS-COV-2.

Methods

We examined SARS-CoV-2 case data from 101 non-administrative federal prisons between 5/18/2020 to 01/31/2021 and examined the per capita size of outbreaks in staff and the incarcerated population compared to outbreaks in the communities in the counties surrounding the prisons during the summer and winter waves of the SARS-COV-2 pandemic. We also examined the impact of decarceration on per capita rates in the staff/incarcerated/community populations.

Results

For both the summer and winter waves we found significant inter-correlations between per capita rates in the outbreaks among the incarcerated population, staff, and the community.

Over-all during the pandemic, per capita rates were significantly higher in the incarcerated population than in both the staff and community (paired Student’s t-test p = 0.03 and p < 0.001, respectively). Average per capita rates of incarcerated population outbreaks were significantly associated with prison security level, ranked from lowest per capita rate to highest: High, Minimum, Medium, and Low security.

Federal prisons decreased the incarcerated population by a relative factor of 96% comparing the winter to summer wave (one SD range [90%,102%]). We found no significant impact of decarceration on per capita rates of SARS-COV-2 infection in the staff community populations, but decarceration was significantly associated with a decrease in incarcerated per capita rates during the winter wave (Negative Binomial regression p = 0.015).

Conclusions

We found significant evidence of community/staff/incarcerated population inter-linkage of SARS-COV-2 transmission. Further study is warranted to determine which control measures aimed at the incarcerated population and/or staff are most efficacious at preventing or controlling outbreaks.
The development and validation of the ‘Good Life in the Community Scale’ (GLiCS): a validation study with women migrants living in high income countries
Authors: Van der Boor C. F. , Christiansen P. , Anand P. , White R.
Published: March 2022

Background

To date, few assessment instruments have been developed to quantitatively measure the mental health status of migrant populations specifically. This paper describes the development and preliminary assessment of the ‘Good Life in the Community Scale’ (GLiCS). GLiCS is a wellbeing measure for migrant women in high-income settings that was coproduced with experts by experience across two phases.

Methods

The study used a mixed-methods approach and was composed of two phases.Phase I:88 initial items generated using qualitative data collected in a previous study were reduced to 42 through consultation with expert advisory panels, based on whether each item was considered understandable and relevantPhase II:these 42 items were piloted with a sample of migrant women (N = 109). A preliminary exploratory factor analysis was conducted using Oblique rotation. Internal consistency was measured using McDonald’s ω. Convergent validity was tested by correlating the GLiCS with the Oxford Capabilities Questionnaire Mental Health (OxCAP-MH), WHO-5 wellbeing index and Objective Social Outcomes Index (SIX). Incremental validity was tested using hierarchical regression analysis to ascertain the effect on the WHO-5 wellbeing index of: age, migration status, SIX, OxCAP-MH and GLiCS. Known groups validity, the ability a measure has to discriminate between groups likely to differ on the variables of interest, was tested between the different migrant categories using a simple between subjects ANOVA.

Results

Exploratory factor analysis confirmed a 17-item (three-factor: (i) access to resources, (ii) belonging and contributing, (iii) independence) scale with high internal consistency (McDonald’s ω = 0.91). Convergent and incremental validity were also evidenced.

Conclusion

The GLiCS has demonstrable good internal consistency and construct validity, and it presents a promising wellbeing measure for better understanding the experience of migrant women.
Prevalence and associated factors for stunting, underweight and wasting among children under 6 years of age in rural Hunan Province, China: a community-based cross-sectional study
Authors: Li Huixia , Yuan Shan , Fang Hualing , Huang Guangwen , Huang Qun , Wang Hua , Wang Aihua
Published: March 2022

Background

The existing epidemiological data cannot represent the situation of undernutrition among Chinese children, particularly those in rural China. Hence, in this community-based cross-sectional study, the prevalence and associated factors of stunting, underweight and wasting among children (age < 6 years) from rural Hunan Province were analyzed.

Methods

Totally 5529 children aged 0 to 71 months and their caregivers were randomly chosen by multistage stratified cluster sampling from 72 villages from rural Hunan, which were distributed in 24 towns of 12 counties. Data about the children and their mothers, caregivers and family conditions was acquired using unified questionnaire, and the length/height and weight of each child were measured using unified instruments. The prevalence of undernutrition among children was evaluated using the length/height for age, weight for age, weight for length/height, and body mass index for age z scores, which were computed according to the 2006 and 2007 WHO Child Growth Standards.

Results

The prevalence of stunting, underweight, and wasting among the 5529 children were 4.4% (241), 3.9% (217), and 4.0% (221), respectively. The significant associated factors on higher risks of undernutrition in the children were low birth weight, maternal gestational weight gain <10 kg (stunting); low birth weight, maternal gestational weight gain <10 kg, ethnicity of caregivers being minority, large family size (underweight); low birth weight, ethnicity of caregivers being minority, large family size (wasting). High education level of caregivers and high family food expenditure were common protective factors for all three types of undernutrition, except that high family food expenditure was not protective against wasting.

Conclusions

The prevalence of stunting, underweight and wasting is low among rural children under age of 6 years in Hunan. As for the measures, the gestational care and reasonable diet of mothers should be strengthened, and nutritional deficiency during pregnancy be avoided, which will prevent low birth weight. The local economic development and the education level of caregivers need to be further improved, especially for minorities.
Does COVID-19 threat increase xenophobia? The roles of protection efficacy and support seeking
Authors: She Zhuang , Zhou Ningning , Li Dan , Ren Shengtao , Ji Weidong , Xi Juzhe
Published: March 2022

Background

In response to the COVID-19 pandemic, people in many countries have shown xenophobia toward China, where the pandemic began. Within China, xenophobia has also been observed toward the people of Wuhan, the city where the first cases were identified. The relationship between disease threat and xenophobia is well established, but the reasons for this relationship are unclear. This study investigated the mediation role of perceived protection efficacy and moderation role of support seeking in the relationship between perceived COVID-19 risk and xenophobia within China.

Methods

An online survey was administered to a nationally representative sample (N = 1103; 51.7% women; ages 18 to 88) of Chinese adults during the early stage of the COVID-19 pandemic. Participants completed questionnaires about their perceived COVID-19 risk, perceived protection efficacy in reducing risk, support seeking, and xenophobic attitudes toward people of the Wuhan area.

Results

Regression based analyses showed that the perceived COVID-19 risk positively predicted xenophobia. Low perceived protection efficacy partly mediated the relationship between perceived COVID-19 risk and xenophobic attitudes, and this indirect effect was moderated by support seeking. Specifically, the indirect effect was weaker among individuals who sought more social support.

Conclusions

Under disease threat, xenophobia can appear within a country that otherwise seems culturally homogeneous. This study extends the extant research by identifying a possible psychological mechanism by which individuals’ perception of disease threat elicits xenophobia, and by addressing the question of why this response is stronger among some people than others. Increasing the public’s perceived efficacy in protecting themselves from infection, and encouraging support seeking, could reduce xenophobic attitudes.
Interaction between trouble sleeping and depression on hypertension in the NHANES 2005–2018
Authors: Cai Yingjie , Chen Manshuang , Zhai Weixia , Wang Chunhui
Published: March 2022

Background

Hypertension, trouble sleeping and depression, as three major public health problems, were closely related. This study evaluated the independent association of trouble sleeping and depression with hypertension and interaction effect between trouble sleeping and depression on hypertension in Americans.

Method

The data of this cross-sectional study was from the 2005–2018 National Health and Nutritional Examination Survey (NHANES) with hypertension, depression, trouble sleeping and confounding factor information. Multivariate logistic regression model and subgroup analyses of depression severity were conducted to assess the relationship between trouble sleeping and depression on hypertension. Relative excess risk due to interaction (RERI), attributable proportion of interaction (AP) and synergy index (S) were utilized to assess the additive interaction.

Results

A total of 30,434 participants (weighted n = 185,309,883) were examined with 16,304 (49.37%) known hypertensive subjects. Compared with participants without trouble sleeping, those with trouble sleeping had a higher risk of hypertension [OR = 1.359 (95% CI: 1.229–1.503)]. We also found the significant association of depression with an increased risk of hypertension [OR = 1.276 (95% CI: 1.114–1.462)], compared with those without depression. Moreover, there was a significant interaction between trouble sleeping and depression on hypertension risk [RERI = 0.528 (95% CI: 0.182–0.873), AP = 0.302 (95% CI: 0.140–0.465), S = 3.413 (95% CI: 1.301–8.951)].

Conclusion

There was a synergistic interaction between trouble sleeping and depression on hypertension, especially the significant synergistic effect between moderate depression and trouble sleeping on hypertension. The results suggested that improving the psychological status and trouble sleeping of patients may be beneficial to the prevention and treatment of hypertension.
Strategies aimed at preventing long-term opioid use in trauma and orthopaedic surgery: a scoping review
Authors: Côté C. , Bérubé M. , Moore L. , Lauzier F. , Tremblay L. , Belzile E. , Martel M-O , Pagé G. , Beaulieu Y. , Pinard A. M. , Perreault K. , Sirois C. , Grzelak S. , Turgeon A. F.
Published: March 2022

Background

Long-term opioid use, which may have significant individual and societal impacts, has been documented in up to 20% of patients after trauma or orthopaedic surgery. The objectives of this scoping review were to systematically map the research on strategies aiming to prevent chronic opioid use in these populations and to identify knowledge gaps in this area.

Methods

This scoping review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. We searched seven databases and websites of relevant organizations. Selected studies and guidelines were published between January 2008 and September 2021. Preventive strategies were categorized as: system-based, pharmacological, educational, multimodal, and others. We summarized findings using measures of central tendency and frequency along with p-values. We also reported the level of evidence and the strength of recommendations presented in clinical guidelines.

Results

A total of 391 studies met the inclusion criteria after initial screening from which 66 studies and 20 guidelines were selected. Studies mainly focused on orthopaedic surgery (62,1%), trauma (30.3%) and spine surgery (7.6%). Among system-based strategies, hospital-based individualized opioid tapering protocols, and regulation initiatives limiting the prescription of opioids were associated with statistically significant decreases in morphine equivalent doses (MEDs) at 1 to 3 months following trauma and orthopaedic surgery. Among pharmacological strategies, only the use of non-steroidal anti-inflammatory drugs and beta blockers led to a significant reduction in MEDs up to 12 months after orthopaedic surgery. Most studies on educational strategies, multimodal strategies and psychological strategies were associated with significant reductions in MEDs beyond 1 month. The majority of recommendations from clinical practice guidelines were of low level of evidence.

Conclusions

This scoping review advances knowledge on existing strategies to prevent long-term opioid use in trauma and orthopaedic surgery patients. We observed that system-based, educational, multimodal and psychological strategies are the most promising. Future research should focus on determining which strategies should be implemented particularly in trauma patients at high risk for long-term use, testing those that can promote a judicious prescription of opioids while preventing an illicit use, and evaluating their effects on relevant patient-reported and social outcomes.
Antimicrobial potential of four mica drugs and their chemical and mineralogical properties
Authors: Wijenayake Apsara , Abayasekara Charmalie , Pitawala Amarasooriya , Bandara B. M. Ratnayake
Published: March 2022

Background

Mica drugs, a group of herbo-metallic traditional preparations comprising biotite mica as the major mineral ingredient, are prescribed for skin disorders and respiratory ailments and other chronic conditions in South Asian countries, particularly India and Sri Lanka. Mica-based drugs (Abhrak drugs) are subjected to unique and varied preparation procedures and the bioactivity of the drugs can be affected by drug-processing conditions, the ingredients used and the mica composition. The current study aimed to evaluate and compare, on the basis of their physical and chemical characteristics, the antimicrobial potential of two commercial mica drugs AbBb (Abhrak bhashma) and AbCh (Abhrak Chenhuram) and two mica drugs ABL1 (Abhrak Bhasma Laboratory Prepared 1) and ABL2 (Abhrak Bhasma Laboratory Prepared 2) prepared in the laboratory under different conditions.

Methods

Antimicrobial activity of all four drugs was assessed at 10 mg/ml concentration against Pseudomonas aeruginosa, Escherischia coli, Staphylococcus aureus, methicillin-resistant S. aureus (MRSA) and Candida albicans using well diffusion assay, agar dilution assay and Miles and Misra method. Major and trace metal constituents of the drug samples were measured using atomic absorption spectrometry. Mineralogical properties, bacteria-mineral interactions, morphological changes in microbes and the surface characteristics of the drugs were determined using X-ray diffraction (XRD) analysis and scanning electron microscopy (SEM).

Results

The drugs ABL1, ABL2 and AbBh exhibited antimicrobial activity against only Gram-positive organisms (S. aureus and MRSA) when tested with Miles and Misra method (broth method). Mineralogical studies (XRD) revealed that biotite mica was altered into secondary clay minerals and iron oxides in the commercial drug AbCh while the other three drugs had altered mica and iron oxide phases. The essential elements (Na, K, Ca and Mg) required for microbial functions were present in varying extents in all four drugs while they were present in exceedingly high amounts in AbCh having comparatively high cation-exchange capacity, consistent with the observation that AbCh was inactive against all the microbes tested. The three drugs (ABL1, ABL2 and AbBh) showing antimicrobial activity contained comparatively high amounts of Fe, Zn and Cu that are known to display antimicrobial properties at high concentrations. SEM studies revealed that the drug particles adhered and entrapped the bacterial species, presumably modifying the physiochemical characteristics of the bacteria and eventually causing lethality.

Conclusion

Three of the four mica drugs inhibited the tested Gram-negative bacteria and the antibacterial activity of the mica drugs depends on their constituents and the methods of preparation.
Development of learning objectives for a medical assistance in dying curriculum for Family Medicine Residency
Authors: LeBlanc Sarah , MacDonald Susan , Martin Mary , Dalgarno Nancy , Schultz Karen
Published: March 2022

Background

Medical assistance in dying (MAID) became legal across Canada when Bill C-14 was passed in 2016. Currently, little is known about the most effective strategies for providing MAID education, and the importance of integrating MAID into existing curricula. In this study, a set of learning objectives (LOs) was developed to inform a foundational MAID curriculum in Canadian Family Medicine (FM) residency training programs.

Methods

Mixed methods were used to develop LOs based on a published needs assessment from a large, four-site family medicine residency program in southeastern Ontario. Draft LOs were evaluated and revised by faculty and resident leaders using a modified Delphi process and a focus group. LOs were mapped to the existing family medicine residency curriculum, as well as the College of Family Physicians of Canada’s Priority Topics.

Results

Nine LOs were developed to provide a foundational education regarding MAID. While all LOs could be mapped to the Domains of Clinical Care within the departmental curriculum, they mapped inconsistently to departmental Entrustable Professional Activities and the Priority Topics. LOs focused on patient education and identification of patient goals were most readily mapped to existing curricular framework, while LOs with MAID-exclusive content revealed gaps in the current curriculum.

Conclusions

The developed LOs provide a guide to ensure family medicine residents obtain generalist-level knowledge to counsel their patients about MAID. These LOs can serve as a model for developing LOs for both family medicine and specialist residency programs in Canada and in countries where MAID is legal.
The impact of introducing multidisciplinary care assessments on access to rheumatology care in British Columbia: an interrupted time series analysis
Authors: Duncan Ross , Cheng Lucy , Law Michael R. , Shojania Kam , De Vera Mary A. , Harrison Mark
Published: March 2022

Background

In 2011 the British Columbia (BC) Ministry of Health introduced a new fee-for-service billing code that allowed “Multidisciplinary Care Assessment” (MCA). This change has the potential to change access to and quality of care for patients. This study aimed to explore the impact on access to rheumatology services in the province.

Methods

Fee-for-service rheumatology billings were evaluated for each rheumatologist 2 years before and after use of the MCA code. Numbers of 1) unique patients and 2) services provided per month were used as proxy measures of access to care. A multiple-baseline interrupted time series model assessed the impact of the MCA on levels and trends of the access outcomes.

Results

Our analysis consisted of 82,360 patients cared for by 26 rheumatologists who billed for an MCA. In our primary analysis we observed a sustained increase in the mean number of unique patients of 4.9% (95% CI: 0.0% to 9.9%, p = 0.049) and the mean number of services of 7.1% (95% CI: 1.0% to 13.6%, (p = 0.021), per month provided by a rheumatologist, corresponding to the initial use of MCA.

Conclusion

The introduction of the MCA code was associated with an initial increase in the measures of access, which was maintained but did not increase over time. Our study suggests that the use of Multidisciplinary Care Assessment can contribute to expanding and/or sustaining access to care for people with complex chronic conditions, like rheumatic diseases.
Infant, pediatric and adult well visit trends before and during the COVID-19 pandemic: a retrospective cohort study
Authors: Salas Joanne , Hinyard Leslie , Cappellari Ann , Sniffen Katie , Jacobs Christine , Karius Natalie , Grucza Richard A. , Scherrer Jeffrey F.
Published: March 2022

Background

Adult well visits declined during COVID-19, but literature is inconsistent in regard to whether childhood well visits declined. We determined if the COVID-19 pandemic was associated with a change in well visits among infants, children, adolescents and adults before, compared to during the COVID-19 pandemic, including through the emergence of the Delta variant.

Methods

De-identified electronic health care data came from a multi-state Midwest health care system. Eligible patients (n = 798,571) had ≥ 1 well visit between 7/1/2018 and 6/30/2021. Trends in well visits per month for children (< 1, 1–4, 5–11, 12–17 years) and adults (18–39, 40–64, ≥ 65 years) over 3-years were assessed using Joinpoint regression models and monthly percent change (MPC).

Results

Well visits remained stable for infants (< 1 year of age) (MPC = -0.1; 95% CI = -0.3, 0.1). For children 1–4 years and all adults, visits were stable prior to 2020, decreased from 1/2020 to 4/2020 (MPC range -20 to -40), increased from 4/2020–7/2020 (MPC range 30 to 72), and remained stable after 7/2020. Children 5–17 had seasonal variation in visits where low points occurred in Jan/Feb 2019 and high points in Aug 2019 (start of school year); however, the low point in 2020 occurred in April 2020 and the seasonal variation normalized after this.

Conclusions

In a large Mid-western health care system, infant well visits did not decline at the onset (3/1/2020) of the COVID-19 pandemic. Although well visits for all other ages decreased to a low point in 4/2020, a rapid return to pre-pandemic utilization rates occurred by 7/2020. The brief decrease in preventive care may have had little impact on health.
Targeted therapies for cancer
Authors: Zhou Zhijun , Li Min
Published: March 2022

Targeted therapy is the key for improving overall survival while decreasing the undesirable adverse effects of cancer treatment. Patients who received matched targeted therapies showed dramatically improved overall survival (OS) and progression-free survival (PFS) compared to those without matched therapies. However, each patient responds to targeted therapy differently due to their unique genomic profile. The discrepancy of treatment response between clinical trials and real-world clinical practice highlights an unmet need to develop tailored therapies for individual patients. The development of cutting-edge technologies, such as next-generation sequencing, has enabled us to identify more actionable targets. In this special issue of BMC Medicine, a collection of highly translational and clinical oncology papers presented a series of studies on targeted therapies for a variety of cancer types, aiming to bridge the gap between genomic testing and precision medicine and spark innovations on improving the efficacy of targeted therapies.
Association between triglyceride glucose index and carotid artery plaque in different glucose metabolic states in patients with coronary heart disease: a RCSCD-TCM study in China
Authors: Li Zhu , He Yuanyuan , Wang Shuo , Li Lin , Yang Rongrong , Liu Yijia , Cheng Qi , Yu Lu , Zheng Yanchao , Zheng Hongmei , Gao Shan , Yu Chunquan
Published: March 2022

Background

The triglyceride glucose (TyG) index serves as a surrogate indicator of insulin resistance. However, there is limited evidence on the association between the TyG index and carotid artery plaque (CAP) in patients with coronary heart disease (CHD).

Methods

The 10,535 CHD patients were divided according to TyG index quartiles (Q1: TyG index < 8.52; Q2: 8.52 ≤ TyG index < 8.93; Q3: 8.93 ≤ TyG index ≤ 9.40; Q4: TyG index > 9.40). The presence or absence of CAP was determined by carotid ultrasonography. Logistic regression was used to analyze the relationship between the TyG index and CAP in CHD patients. The relationship between the TyG index and CAP in according to sex, age groups, and glucose metabolism states were also assessed.

Results

The baseline analysis showed that there were significant differences in related parameters among CHD patients divided into four groups according to the quartile of the TyG index. In the multi-adjusted modles, compared to Q1 of the TyG index, the odds ratios (OR) for Q4 of the TyG index for CAP were 1.37 (95% confidence interval [CI] 1.28–1.47) in CHD patients. The association between the TyG index and CAP in female (OR: 1.35; 95% CI 1.29–1.43) was higher than that in male (OR: 1.20; 95% CI 1.13–1.27). The OR value of middle-aged (≤ 60 years old) patients (OR: 1.34; 95% CI 1.26–1.42) was higher than that in elderly (> 60 years old) patients (OR: 1.16; 95% CI 1.11–1.22). In different glucose metabolism states, the TyG index of CHD patients was significantly related to the risk of CAP, with the highest OR value observed for diabetes (OR: 1.36; 95% CI 1.26–1.46).

Conclusions

The TyG index and CAP showed a significant association in CHD patients. This association between TyG index and CAP in CHD patients is higher in female than in male, and the association in middle-aged and elderly patients is higher than that in elderly patients. In the condition of DM, the association between TyG index and carotid artery plaque in CHD patients is higher.

Graphical abstract
High PPT1 expression predicts poor clinical outcome and PPT1 inhibitor DC661 enhances sorafenib sensitivity in hepatocellular carcinoma
Authors: Xu Jianjun , Su Zhe , Cheng Xiang , Hu Shaobo , Wang Wenjie , Zou Tianhao , Zhou Xing , Song Zifang , Xia Yun , Gao Yang , Zheng Qichang
Published: March 2022

Background

Adaptive resistance and side effects of sorafenib treatment result in unsatisfied survival of patients with hepatocellular carcinoma (HCC). Palmitoyl-protein thioesterase 1 (PPT1) plays a critical role in progression of various cancers. However, its role on prognosis and immune infiltrates in HCC remains unclarified.

Methods

By data mining in the Cancer Genome Atlas databases, the role of PPT1 in HCC were initially investigated. Furthermore, HCC cell lines Hep 3B and Hep 1-6 were treated with DC661 or siRNA against PPT1. The biological function of PPT1 was determined by CCK-8 test, colony formation assay, TUNEL staining, immunofluorescence staining, Western blot test, and PI-Annexin V apoptosis assays in vitro. Animal models of subcutaneous injection were applied to investigate the therapeutic role of targeting PPT1.

Results

We found that PPT1 levels were significantly upregulated in HCC tissues compared with normal tissues and were significantly associated with a poor prognosis. Multivariate analysis further confirmed that high expression of PPT1 was an independent risk factor for poor overall survival of HCC patients. We initially found that PPT1 was significantly upregulated in sorafenib-resistant cell lines established in this study. Upon sorafenib treatment, HCC cells acquired adaptive resistance by inducing autophagy. We found that DC661, a selective and potent small-molecule PPT1-inhibitor, induced lysosomal membrane permeability, caused lysosomal deacidification, inhibited autophagy and enhanced sorafenib sensitivity in HCC cells. Interestingly, this sensitization effect was also mediated by the induction mitochondrial pathway apoptosis. In addition, the expression level of PPT1 was associated with the immune infiltration in the HCC tumor microenvironment, and PPT1 inhibitor DC661 significantly enhanced the anti-tumor immune response by promoting dendritic cell maturation and further promoting CD8+ T cell activation. Moreover, DC661 combined with sorafenib was also very effective at treating tumor models in immunized mice.

Conclusions

Our findings suggest that targeting PPT1 with DC661 in combination with sorafenib might be a novel and effective alternative therapeutic strategy for HCC.