bluuebunny/crossref_metadata_2025 huggingface dataset:
Ageing and Later Life: Unsettling Development Assumptions
Authors: Vera-Sanso Penny , Vullnetari Julie , Bastia Tanja
Published: October 2023

This Special Issue brings into focus the topic of ageing and of older people, both of which have been neglected and/or narrowly addressed in development studies and policymaking. As such, this collection of articles seeks to unsettle some of the stereotypes that are commonplace in development debates that portray older people as frail, vulnerable, burdensome and passive. It does so by looking at the process of ageing and the lived experiences of older people across a range of topics and geographical locations. We hope that through this collection we have initiated a conversation around the place of ageing and older people in development from a relational and intergenerational perspective; that is, from a perspective that is focused around interdependence between older people and wider society rather than one restricted to the dependence of the former on the latter.
Peri-procedural decrease in hemoglobin following mechanical thrombectomy for ischemic stroke
Authors: Chen Huanwen , Ahmad Ghasan , Phipps Michael S. , Colasurdo Marco , Miller Timothy R. , Cherian Jacob , Wozniak Marcella A. , Tran Quincy K. , Gandhi Dheeraj , Chaturvedi Seemant , Jindal Gaurav
Published: October 2023

Background

Peri-procedural blood loss and hemodilution occur in patients undergoing mechanical thrombectomy (MT) for ischemic stroke; however, its relationships with thrombectomy passes, procedure times, and clinical outcomes are unknown.

Methods

Consecutive patients undergoing MT for anterior circulation large-vessel occlusion ischemic strokes were identified at a Comprehensive Stroke Center. Clinical information, modified treatment in cerebral ischemia (mTICI) scores, and modified Rankin Scores (mRS) at 90 days were prospectively collected from 2012 to 2021. Hemoglobin measurements before and after MTs were collected retrospectively via chart review, and changes were quantified. Patients with new-onset severe anemia (defined as post-MT hemoglobin less than 10g/dL) were identified. Modified Rankin scale (mRS) at 90 days was used to measure clinical outcomes.

Results

Four-hundred and forty-five patients were identified. Hemoglobin decreased 1.27 ± 1.05 g/dL after MT on average. Greater number of thrombectomy passes and longer procedure times were associated with larger decreases in hemoglobin ( p < 0.001 and p = 0.002, respectively). 11.5% (51 of 445) of patients had new-onset severe anemia, and this incidence was significantly higher with more thrombectomy passes (6.4% for one pass, 11.9% for two passes, and 17.4% for three or more passes; p = 0.010). In multivariable analyses, new-onset severe anemia was associated with significantly higher odds of 90-day poor outcomes (mRS 3-6, OR 2.70 [95%CI 1.12–6.51], p = 0.027) and death (OR 2.73 [95%CI 1.06–7.04], p = 0.037) compared to mild post-MT anemia.

Conclusions

More thrombectomy passes and longer procedure times were significantly associated with larger peri-procedural decreases in hemoglobin. Patients with new-onset hemoglobin less than 10 g/dL are at risk of poor outcomes.
Lekgotla Discussion as a Decolonized Qualitative Methodology: A Lesson From a Workshop Conducted to Formulate and Verify the Strategies in Botlokwa Village, Limpopo, South Africa
Authors: Rasweswe Melitah Molatelo
Published: October 2023

Introduction

This study used Lekgotla discussion with Batlokwa women to formulate and verify the strategies to empower the women with traditional and cultural dysmenorrhea or pain period knowledge. The Lekgotla discussion is an open forum in which indigenous communities in Sub-Saharan Africa use to debate and reach agreements on community raised issues. It has the potential to identify issues that affect community day-to-day lives and reach consensus to effect changes.

Purpose

To present Lekgotla discussion workshop as a decolonized qualitative research methodology.

Methods

The study was qualitative, using a Lekgotla discussion process among women with a variety of experience in both Indigenous and Western dysmenorrhea knowledge. Participants were purposively selected to participate in a Lekgotla discussion. The snowballing was also used, whereby the recruited participants were asked to assist in identifying and referring potential participants to the researcher, who contacted them for potential inclusion in the study. The process was repeated until a required sample was reached. A facilitator was selected by the participants to facilitate the discussion and summarizes the inputs once all the participants have raised their ideas and there was no newer information was shared. The debates and dialogues were analysed by the researcher and experts using content data analysis.

Results

The Lekgotla discussion followed a workshop process and was divided into four steps: 1) Arrival and Welcome, 2) Engaging participants, 3) Reaching consensus on the strategies to empower Batlokwa women with dysmenorrhea knowledge, 4) Verification and refinement of the strategies to empower Batlokwa women with dysmenorrhea knowledge.

Conclusion

The success of applying the process of Lekgotla discussion proved that the indigenous epistemologies are increasingly accepted to achieve research objectives.
Race and Area of Deprivation Index Predict Outcomes of Endoscopic Sinus Surgery for Chronic Sinusitis
Authors: Hentati Firas , Kim Jaehee , Hoying David , D’Anza Brian , Rodriguez Kenneth
Published: October 2023

Objective

The purpose of this study is to characterize the presentation, outcomes, and barriers to care for White and non-White patients undergoing endoscopic sinus surgery (ESS).

Background

ESS is often successful in providing long-term relief for patients suffering from chronic rhinosinusitis (CRS). Literature that uses robust measures of socioeconomic status (SES) and barriers to care to assess ESS outcomes is limited.

Methods

A retrospective matched cohort study of patients who underwent ESS for CRS between 1/1/2015 and 6/1/2021 at a single tertiary care academic center was conducted. White and non-White patients were matched 1-to-1 by sex and age (± 5 years). SES was evaluated using the area of deprivation index (ADI).

Results

Of the 298 patients included in the study, 149 are White and 149 are non-White, 111 (37.2%) have CRS with nasal polyposis (CRSwNP), 141 (47.3%) had allergic rhinitis, 90 (30.2%) had asthma and 22 (7.4%) required revision ESS. Non-White patients were 3.62 times more likely to present with CRSwNP (95% confidence interval [CI] 2.2-5.96) and had 2.87 times increased odds for requiring revision ESS than age and sex-matched White patients (95% CI 1.090-7.545). The median ADI for non-White (6.00) patients was higher than for White patients (3.00) ( P < .001) and 21.5% more non-White patients presented with Medicaid ( P < .001).

Conclusion

Non-White patients undergoing ESS for CRS are more likely to present from areas with fewer resources and be underinsured. Using robust measures of SES, such as ADI, may allow for care to be tailored to patients with barriers to care.
Teamwork doesn’t just happen: Policy recommendations from over half a century of team research
Authors: Grote Gudela , Kozlowski Steve W. J.
Published: October 2023

Teamwork has been at the core of human social organization for millennia and is essential for organizational productivity and innovation. Yet teamwork often is not as effective as it could be. Drawing on extensive research into the factors that enable teams to function well, this article offers policy recommendations for bolstering teamwork capabilities in society at large and in organizations. Our proposals call for teaching teamwork skills as part of the curricula in higher education and in lower grades in school, creating government and industry regulations designed to enhance teamwork, and designing jobs and organizational workflows in ways that prioritize and support teamwork.
The Bohai Sea and Mount Penglai: In search of a maritime religiosity in imperial China
Authors: Po Ronald C.
Published: October 2023

Apart from the history of the Chinese sea goddess Mazu, there are other religious themes that have also been derived from the maritime world that require more of our academic attention. This paper provides a historical overview of a sea-related theological conceptualisation that originated in the Bohai Sea: the maritime and transcultural history of Mount Penglai, a legendary immortal island of Chinese mythology. The history of Penglai is normally treated within a mere Daoist context and is not explored in its theological and philosophical implications in relation to the sea. I will suggest, by contrast, that the history of Penglai offers a unique perspective on Chinese maritime religiosity as it was conceptualised, practiced and imagined by various types of agents and individuals. In its own right, Mount Penglai represents a kind of maritime religiosity that was emanated from various approaches to it being constructed as a mythological space over the longue durée.
Bayesian multilevel multivariate logistic regression for superiority decision-making under observable treatment heterogeneity
Authors: Kavelaars Xynthia , Mulder Joris , Kaptein Maurits
Published: October 2023

Background

In medical, social, and behavioral research we often encounter datasets with a multilevel structure and multiple correlated dependent variables. These data are frequently collected from a study population that distinguishes several subpopulations with different (i.e., heterogeneous) effects of an intervention. Despite the frequent occurrence of such data, methods to analyze them are less common and researchers often resort to either ignoring the multilevel and/or heterogeneous structure, analyzing only a single dependent variable, or a combination of these. These analysis strategies are suboptimal: Ignoring multilevel structures inflates Type I error rates, while neglecting the multivariate or heterogeneous structure masks detailed insights.

Methods

To analyze such data comprehensively, the current paper presents a novel Bayesian multilevel multivariate logistic regression model. The clustered structure of multilevel data is taken into account, such that posterior inferences can be made with accurate error rates. Further, the model shares information between different subpopulations in the estimation of average and conditional average multivariate treatment effects. To facilitate interpretation, multivariate logistic regression parameters are transformed to posterior success probabilities and differences between them.

Results

A numerical evaluation compared our framework to less comprehensive alternatives and highlighted the need to model the multilevel structure: Treatment comparisons based on the multilevel model had targeted Type I error rates, while single-level alternatives resulted in inflated Type I errors. Further, the multilevel model was more powerful than a single-level model when the number of clusters was higher. A re-analysis of the Third International Stroke Trial data illustrated how incorporating a multilevel structure, assessing treatment heterogeneity, and combining dependent variables contributed to an in-depth understanding of treatment effects. Further, we demonstrated how Bayes factors can aid in the selection of a suitable model.

Conclusion

The method is useful in prediction of treatment effects and decision-making within subpopulations from multiple clusters, while taking advantage of the size of the entire study sample and while properly incorporating the uncertainty in a principled probabilistic manner using the full posterior distribution.
Molecular analyses of ADAMTS-1, -4, -5, and IL-17 a cytokine relationship in patients with ulcerative colitis
Authors: Buran Tahir , Batır Muhammet Burak , Çam Fethi Sırrı , Kasap Elmas , Çöllü Fatih , Çelebi Hamide Betül Gerik , Şahin Mustafa
Published: October 2023

Background

Ulcerative colitis (UC) is a chronic inflammatory bowel disease that develops due to the impaired immune response in genetically susceptible individuals, and its etiopathogenesis is not fully elucidated. IL-17 A is a cytokine that is produced by a type of immune cell called Th17 cells and is involved in the immune response and inflammation. On the other hand, ADAMTS-1, -4, and − 5 are enzymes that are involved in the breakdown of extracellular matrix proteins, including proteoglycans, which are important components of the intestinal wall. This study aimed to evaluate the relationship between interleukin 17 (IL-17 A) cytokine, which plays a role in the pathogenesis of ulcerative colitis, and the inflammation-controlled a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-1, -4, and − 5 protein members.

Methods

Bowel tissue samples and blood serum from 51 patients with UC and 51 healthy controls were included in this study. mRNA expression levels of the ADAMTS-1, -4, -5, and IL-17 A were analyzed by RT-qPCR, and immunohistochemical analyses were performed to evaluate ADAMTS-1, -4, -5, and IL-17 A proteins in tissue samples. In addition, ELISA analysis determined serum levels of the ADAMTS-1, -4, -5, and IL-17 A.

Results

RT-qPCR results reveal that the expression of ADAMTS-1, -4, -5, and IL-17 A genes in the UC tissue samples were significantly high according to the control tissue samples. Also, ADAMTS-1, -4, -5, and IL-17 A proteins revealed enhanced expression pattern UC groups according to the control. Also, ADAMTS-1, -4, -5, and IL-17 A protein showed cytoplasmic localization patterns in both control and UC groups. The serum levels of ADAMTS-1,-5, and IL-17 A were significantly higher in UC samples than in the control group.

Conclusions

We observed a positive correlation between the ADAMTS-1, -5 and IL17A cytokine expression in UC samples. These results provide a new understanding of controlling crucial ADAMTS family protein members by IL-17 A cytokines with UC.
Effects of TRAF3 on the proliferation and migration of lung adenocarcinoma depend partly on pyroptosis
Authors: Wang Wangjia , Wang Shiqi , Wang Min , Ma Yamei , Hu Wanting , Wu Binsha , Li Chichi , Zhang Dan
Published: October 2023

Background

Tumor necrosis factor receptor-associated factor 3 (TRAF3) has specific regulatory effects on a wide range of diseases, including tumors. However, the effect and mechanism of TRAF3 on lung adenocarcinoma (LUAD) are still unknown. The aim of the present study was to make clear the role and potential mechanism of TRAF3 in LUAD.

Methods

TIMER2.0 database and western blot were applied to detect the expression of TRAF3 in lung adenocarcinoma tissue. Kaplan-Meier Plotter database was utilized to explore the effect of TRAF3 on the clinical prognosis of lung adenocarcinoma patients. Specific siRNA was used to inhibit the expression of TRAF3 in LUAD cells (A549 and H1299). CCK-8 and EdU assays were performed for assessing LUAD cells proliferation. Wound healing assay and transwell assay were performed for determining cells migration. CCK-8 assay was used to assess the response of the LUAD cells to paclitaxel. TIMER2.0 bioinformatics and western blot were employed to detect the effects of TRAF3 on pyroptosis in LUAD.

Results

TRAF3 was highly expressed in lung adenocarcinoma tissues and cell lines. Patients with TRAF3 hyperexpression had a good prognosis compared to those with lower expression. TRAF3 inhibition notably induced proliferation and migration of LUAD cells. Inhibition of TRAF3 also weakened the sensitivity of LUAD cells to paclitaxel. Moreover, bioinformatics results showed that TRAF3 was positively correlated with the expression of pyroptosis-related genes in LUAD. Western blot assays showed that TRAF3 inhibition visibly decreased the expression of apoptosis-associated speck-like protein (ASC), cleaved caspase-1 and matured- IL-1β.

Conclusions

Inhibition of TRAF3 promotes the proliferation and migration of LUAD cells, and reduces the sensitivity of LUAD cells to paclitaxel. The effects of TRAF3 on LUAD cells were mediated in part by caspase-1-dependent pyroptosis.
Feasibility, acceptability and lessons learned from an infant feeding intervention trial among women living with HIV in western Kenya
Authors: Maltby Ann E. , Odhiambo Belinda C. , Nyaura Maureen , Shikari Rosemary , Tuthill Emily L.
Published: October 2023

Background

The World Health Organization recommends mothers breastfeed exclusively for the first six months of their infant’s life. However, women living with HIV in low resource settings face many barriers to recommended infant feeding practices such as fear of HIV transmission and perceived milk insufficiency. Moreover, current support for breastfeeding in this context is often insufficient to overcome these barriers. To support women’s infant feeding experience, we tested a personalized infant feeding support program among perinatal women living with HIV in Kenya.

Methods

Supporting Healthy Mothers is a theory and evidence-based multilevel intervention designed to address the mental health burden associated with financial and food insecurity and provide personalized support for optimal infant feeding postpartum. As part of the Supporting Healthy Mothers intervention feasibility trial, between February 23, 2022 and November 9, 2022, twenty mothers received five personalized infant feeding support sessions delivered by a local professional lactation specialist from pregnancy until three months postpartum. Through detailed observations of these sessions, clinical notes and repeated team discussions, we aimed to describe and provide a limited evaluation of these sessions. We identified the strengths and limitations of the lactation support sessions as well as areas for future development.

Results

Participation in the sessions was high and at three months postpartum all participants reported exclusive breastfeeding as recommended despite experiencing a myriad of challenges. Having face-to-face and frequent early postpartum sessions, being available to field participant concerns between sessions and measuring infant weights at each session were key strengths. Continuing sessions beyond three months postpartum and incorporating family planning and general maternal health counseling topics would enhance these supportive sessions.

Conclusions

The personalized professional infant feeding support sessions were highly acceptable and feasible to implement. In-person sessions, in a clinic setting provided opportunities to evaluate and adjust breastfeeding technique and led to successful exclusive breastfeeding practice. Future interventions should consider integrating with other perinatal care services and offering support on demand and immediately postpartum.

Trial registration

Supporting Healthy Mothers was registered with ClinicalTrials.gov Protocol Registration and Results System, posted on February 2, 2022. Identifiers: NCT05219552 Unique Protocol ID: K23MH116807.
Use of any contraceptive method among women in rural communities in the eastern region of Ghana: a cross-sectional study
Authors: Yeboah Isaac , Agyekum Martin Wiredu , Okyere Joshua , Mensah Ronald Osei , Essiaw Mary Naana , Appiah Hilda , Conduah Andrew Kweku , Koduah Seth Nana Kwabena , Christian Aaron Kobina
Published: October 2023

Background

In Ghana, there is an increase in contraceptive use for traditional and modern methods in rural areas. This study seeks to examine the prevalence and determinants of current use of any contraceptive method among women of reproductive age in the rural Eastern Region of Ghana.

Methods

A community-based cross-sectional study was conducted among women of reproductive age in the rural Eastern region of Ghana. A structured questionnaire was used to interview women in rural Lower Manya and Upper Manya Krobo districts of Eastern region who were selected using a simple random sampling technique. The data were analysed using Stata version 16. A Binary logistic regression was used to examine the determinants of current use of any contraceptive use (traditional and modern methods).

Results

The prevalence of contraceptive use was 27.8%. In the adjusted analysis of binary logistic regression, contraceptive use was significantly lower (aOR = 0.24; 95%CI = 0.10–0.56; p = 0.001) among respondents aged 41–49 years compared to those aged 18–35 years. Contraceptive use was significantly lower among migrants (aOR:0.53; 95%CI:0.28–0.99; p = 0.048) compared with non-migrant.

Conclusion

The prevalence of any contraceptive use among rural women was low. Government and other stakeholders need to create awareness about contraception in the rural areas of Eastern region of Ghana and that would help increase contraceptive methods utilization. In addition, family planning programs should target migrants to design an intervention to increase contraceptive use in rural areas.
Spatiotemporal variations and determinants of overweight/obesity among women of reproductive age in urban India during 2005-2021
Authors: Singh Aditya , Let Subhojit , Tiwari Seema , Chakrabarty Mahashweta
Published: October 2023

Background

India has witnessed rapid urbanization in recent decades, leading to a worrisome surge in non-communicable diseases, particularly overweight/obesity, which now present a critical public health concern. Therefore, this study seeks to examine spatiotemporal variations and determinants of overweight/obesity among women of reproductive age (WRA) in urban India and its states during 2005-2021.

Methods

The study used 44,882, 171,443, and 135,272 WRA aged 15–49 from National Family Health Survey (NFHS)-3 (2005-06), NFHS-4 (2015-16), and NFHS-5 (2019-21), respectively. The outcome variable was overweight/obesity, defined as a Body Mass Index (BMI) of ≥ 25 kg/m2. Chi-squared test and multivariable logistic regression were used to identify the determinants of overweight/obesity.

Results

Overweight/obesity prevalence among WRA in urban India has risen significantly, from 23% in 2005-06 to 33% in 2019-21. This increase is particularly pronounced among SC/ST women and women with lower educational levels. During the study period, overweight/obesity rates in different states exhibited varying increases, ranging from 3 percentage points (pp) in Rajasthan to 22 pp in Odisha. Certain southern (e.g., Tamil Nadu and Andhra Pradesh) and northeastern states saw a significant 15 pp or more increase. In contrast, several northern, central, and eastern states (e.g., Punjab, Haryana, Rajasthan, Madhya Pradesh, Chhattisgarh, Jharkhand, West Bengal) experienced relatively smaller increases ranging from 5 to 8 pp. As of 2019-21, two regions exhibited high prevalence rates of overweight/obesity, exceeding 35%: the southern region (Tamil Nadu, Andhra Pradesh, Kerala, and Karnataka) and the northern region (Punjab, Himachal Pradesh, Uttarakhand, and Haryana). In contrast, the Empowered Action Group states had relatively lower rates (25% or less) of overweight/obesity. Regression results showed that older women [AOR: 5.98, 95% CI: 5.71–6.27], those from the richest quintile [AOR: 4.23, 95% CI: 3.95–4.54], those living in south India [AOR: 1.77, 95% CI: 1.72–1.82], and those having diabetes [AOR: 1.92, 95% CI: 1.83–2.02] were more likely to be overweight/obese.

Conclusion

Considering the significant increase in overweight/obesity among urban WRA in India, along with substantial disparities across states and socioeconomic groups, it is imperative for the government to formulate state-specific strategies and policies based on determinants to effectively combat overweight/obesity.
Differences in breast and cervical cancer screening between West and East Germany: a secondary analysis of a german nationwide health survey
Authors: Großmann Lena Marie , Napierala Hendrik , Herrmann Wolfram J.
Published: October 2023

Background

Breast cancer and cervical cancer are among the most common cancers in women in Germany. Early detection examinations such as mammography and the cervical smear test (Pap-test) have been shown to contribute to the reduction in the mortality and/or incidence of these cancers and can be utilised free of charge by women in certain age groups as part of national screening programmes. Analyses show that the use of health services varies regionally, especially when comparing the federal states of the former German Democratic Republic (GDR, Eastern Germany) and the Federal Republic of Germany (FRG, Western Germany). This study investigated to what extent the utilisation of mammography examinations and Pap-tests by women differs in federal states of former GDR and FRG.

Methods

For this purpose, we analysed data from the nationwide health survey GEDA14/15 conducted by the Robert Koch Institute (RKI) in 2014 and 2015. We calculated weighted proportions and compared attendance between eastern and western German states by a Chi-Square-test. Additionally, we conducted regression analysis to adjust for socio-economic status, living environment and place of birth.

Results

2,772 female participants aged 20–34 years were analysed for Pap-test attendance in the last two years and 4,323 female participants aged 50–69 years old were analysed for mammography screening attendance in the last two years. 50–69-year-old women in eastern German states were with 78.3% (95%-CI 75.3%, 81.2%) more likely to attend mammography screening than in western Germany with 73.4% (95%-CI 71.8%, 74.9%). Pap-test uptake was statistically significantly higher in the East of Germany with 83.3% (95%-CI 79.6%, 87.1%) compared to 77.5% (95%-CI 75.8%, 79.3%) in the West of Germany. This relationship was robust to adjusting for socio-economic status, living environment and place of birth.

Conclusions

Cultural influences and socialization in the GDR might explain the higher utilisation of these cancer screening examinations at least to some extent. This could have many reasons, for example a higher health awareness through education or a possible greater trust in medical structures and the associated higher compliance of women. These hypotheses should be further explored to increase the uptake of screening examinations by women in Germany.
Healthcare costs attributable to abnormal weight in China: evidence based on a longitudinal study
Authors: Zhao Shiqi , Xu Xinpeng , You Hua , Ge Jinjin , Wu Qifeng
Published: October 2023

Background

The prevalence of abnormal weight is on the rise, presenting serious health risks and socioeconomic problems. Nonetheless, there is a lack of studies on the medical cost savings that can be attained through the mitigation of abnormal weight. The aim of this study was to estimate the impact of abnormal weight on healthcare costs in China.

Methods

The study employed a 4-wave panel data from China Family Panel Studies (CFPS) between 2012 and 2018 (11,209 participants in each wave). Inpatient, non-inpatient and total healthcare costs were outcome variables. Abnormal weight is categorized based on body mass index (BMI). Initially, the two-part model was employed to investigate the impact of overweight/obesity and underweight on healthcare utilisation and costs, respectively. Subsequently, the estimated results were utilised to calculate the overweight/obesity attributable fraction (OAF) and the underweight attributable fraction (UAF).

Results

In 2018, healthcare costs per person for overweight and obese population were estimated to be $607.51 and $639.28, respectively, and the underweight population was $755.55. In comparison to people of normal weight, individuals who were overweight/obese (OR = 1.067, p < 0.05) was more likely to utilise healthcare services. Overweight/obesity attributable fraction (OAF) was 3.90% of total healthcare costs and 4.31% of non-inpatient costs. Overweight/obesity does not result in additional healthcare expenditures for young people but increases healthcare costs for middle-aged adults (OAF = 7.28%) and older adults (OAF = 6.48%). The non-inpatient cost of underweight population was significantly higher than that of normal weight population (β = 0.060,p < 0.1), but the non-inpatient health service utilisation was not significantly affected.

Conclusions

Abnormal weight imposes a huge economic burden on individuals, households and the society. Abnormal weight in Chinese adults significantly increased healthcare utilisation and costs, particular in non-inpatient care. It is recommended that government and relevant social agencies provide a better social environment to enhance individual self-perception and promote healthy weight.
Exploring targeted preventive health check interventions – a realist synthesis
Authors: Christoffersen Nanna Bjørnbak , Nilou Freja Ekstrøm , Thilsing Trine , Larsen Lars Bruun , Østergaard Jane Nautrup , Broholm-Jørgensen Marie
Published: October 2023

Background

Preventive health checks are assumed to reduce the risk of the development of cardio-metabolic disease in the long term. Although no solid evidence of effect is shown on health checks targeting the general population, studies suggest positive effects if health checks target people or groups identified at risk of disease. The aim of this study is to explore why and how targeted preventive health checks work, for whom they work, and under which circumstances they can be expected to work.

Methods

The study is designed as a realist synthesis that consists of four phases, each including collection and analysis of empirical data: 1) Literature search of systematic reviews and meta-analysis, 2) Interviews with key-stakeholders, 3) Literature search of qualitative studies and grey literature, and 4) Workshops with key stakeholders and end-users. Through the iterative analysis we identified the interrelationship between contexts, mechanisms, and outcomes to develop a program theory encompassing hypotheses about targeted preventive health checks.

Results

Based on an iterative analysis of the data material, we developed a final program theory consisting of seven themes; Target group; Recruitment and participation; The encounter between professional and participants; Follow-up activities; Implementation and operation;Shared understanding of the intervention; and Unintended side effects. Overall, the data material showed that targeted preventive health checks need to be accessible, recognizable, and relevant for the participants’ everyday lives as well as meaningful to the professionals involved.

The results showed that identifying a target group, that both benefit from attending and have the resources to participate pose a challenge for targeted preventive health check interventions. This challenge illustrates the importance of designing the recruitment and intervention activities according to the target groups particular life situation.

Conclusion

The results indicate that a one-size-fits-all model of targeted preventive health checks should be abandoned, and that intervention activities and implementation depend on for whom and under which circumstances the intervention is initiated. Based on the results we suggest that future initiatives conduct thorough needs assessment as the basis for decisions about where and how the preventive health checks are implemented.
Idiopathic hypogonadotropic hypogonadism caused by compound heterozygosity for two novel mutations in the GNRH1 gene: a case report
Authors: Tian Qingqing , Tang Jingjing , Wang Lihong , Liu Jiaojiao , Li Xiangshan , Cao Zhuozhuo , Tian Zhufang
Published: October 2023

Background

Idiopathic hypogonadotropic hypogonadism (IHH) is a rare congenital or acquired genetic disorder caused by gonadotropin-releasing hormone (GnRH) deficiency. IHH patients are divided into two major groups, hyposmic or anosmic IHH (Kallmann syndrome) and normosmic IHH (nIHH), according to whether their sense of smell is intact. Here we report a case of novel compound heterozygous mutations in the GNRH1 gene in a 15-year-old male with nIHH.

Case presentation

The patient presented typical clinical symptoms of delayed testicular development, with testosterone < 3.5 mmol/L and reduced gonadotropin (follicle-stimulating hormone, luteinizing hormone) levels. Two heterozygous variants of the GNRH1 gene were detected, nonsense variant 1: c.85G > T:p.G29* and variant 2: c.1A > G:p.M1V, which disrupted the start codon.

Conclusions

Two GNRH1 mutations responsible for nIHH are identified in this study. Our findings extend the mutational spectrum of GNRH1 by revealing novel causative mutations of nIHH.
Identification and validation of targets of swertiamarin on idiopathic pulmonary fibrosis through bioinformatics and molecular docking-based approach
Authors: Chang Jun , Zou Shaoqing , Xiao Yiwen , Zhu Du
Published: October 2023

Background

Swertiamarin is the main hepatoprotective component of Swertiapatens and has anti-inflammatory and antioxidation effects. Our previous study showed that it was a potent inhibitor of idiopathic pulmonary fibrosis (IPF) and can regulate the expressions of α-smooth muscle actin (α-SMA) and epithelial cadherin (E-cadherin), two markers of the TGF-β/Smad (transforming growth factor beta/suppressor of mothers against decapentaplegic family) signaling pathway. But its targets still need to be investigated. The main purpose of this study is to identify the targets of swertiamarin.

Methods

GEO2R was used to analyze the differentially expressed genes (DEGs) of GSE10667, GSE110147, and GSE71351 datasets from the Gene Expression Omnibus (GEO) database. The DEGs were then enriched with Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis for their biological functions and annotated terms. The protein-protein interaction (PPI) network was constructed to identify hub genes. The identified hub genes were predicted for their bindings to swertiamarin by molecular docking (MD) and validated by experiments.

Results

76 upregulated and 27 downregulated DEGs were screened out. The DEGs were enriched in the biological function of cellular component (CC) and 7 cancer-related signaling pathways. Three hub genes, i.e., LOX (lysyl oxidase), COL5A2 (collagen type V alpha 2 chain), and CTGF (connective tissue growth factor) were selected, virtually tested for the interactions with swertiamarin by MD, and validated by in vitro experiments.

Conclusion

LOX, COL5A2, and CTGF were identified as the targets of swertiamarin on IPF.
Baccalaureate nursing education institutions’ key performance indicators: a review of the existing indicators and qualitative analysis of expert interviews
Authors: Ghofrani Marjan , Valizadeh Leila , Zamanzadeh Vahid , Ghahramanian Akram , Janati Ali , Taleghani Fariba
Published: October 2023

Background

Improvements in nurses’ and midwives’ education will increase workforce quantity and quality. Continual improvement of organization performance is based on continual measuring; Appropriate indicators must be selected to measure and appraise the performances. This study aimed to recognize and categorize key performance indicators (KPIs) for baccalaureate nursing education institutions’ performance measurement.

Methods

This study had two phases: (1) Interview: Seven semi-structured interviews were conducted with faculty members and nurses. (2) Narrative Literature review: schools’ and universities’ reports and web pages were assessed to recognize KPIs. The data analysis method was directed content analysis. The Donabedian Model components were used to guide the data analysis.

Results

The total number of indicators retrieved was 468; 75 were from interviews with faculty members and nurses and 393 were from the literature review. Indicators were categorized into: Structure (staff; equipment, resources, and facilities; guidelines), Process (education; communication and collaboration; evaluation), and Outcome (survey and accreditation; national and international recognition; satisfaction; sustainability and financial efficiency; students; alumni; knowledge related to the field).

Conclusions

A number of indicators were identified that were categorized into various groups related to the performance of nursing schools. Further investigations are needed with different groups of stakeholders including students, professional associations, healthcare institutions, alumni, and clients. As well in some areas, new or composite indicators may need to be developed. Also, each institution needs to select appropriate indicators based on its context, policy goals, and infrastructure.
Health services for substance use disorders: challenges and future perspectives
Authors: Silva João Pedro
Published: October 2023

Research on the health services’ response to substance use disorders and respective comorbidities holds major relevance due to the increasing prevalence of these ailments. We thus invite contributions to a new Collection of articles launched by BMC Health Services Research titled “Health services for substance use disorders”.
Genetic and cultural adaptations underlie the establishment of dairy pastoralism in the Tibetan Plateau
Authors: Peng Min-Sheng , Liu Yan-Hu , Shen Quan-Kuan , Zhang Xiao-Hua , Dong Jiajia , Li Jin-Xiu , Zhao Hui , Zhang Hui , Zhang Xiaoming , He Yaoxi , Shi Hong , Cui Chaoying , Ouzhuluobu  , Wu Tian-Yi , Liu Shi-Ming , Gonggalanzi  , Baimakangzhuo  , Bai Caijuan , Duojizhuoma  , Liu Ti , Dai Shan-Shan , Murphy Robert W. , Qi Xue-Bin , Dong Guanghui , Su Bing , Zhang Ya-Ping
Published: October 2023

Background

Domestication and introduction of dairy animals facilitated the permanent human occupation of the Tibetan Plateau. Yet the history of dairy pastoralism in the Tibetan Plateau remains poorly understood. Little is known how Tibetans adapted to milk and dairy products.

Results

We integrated archeological evidence and genetic analysis to show the picture that the dairy ruminants, together with dogs, were introduced from West Eurasia into the Tibetan Plateau since ~ 3600 years ago. The genetic admixture between the exotic and indigenous dogs enriched the candidate lactase persistence (LP) allele 10974A > G of West Eurasian origin in Tibetan dogs. In vitro experiments demonstrate that − 13838G > A functions as a LP allele in Tibetans. Unlike multiple LP alleles presenting selective signatures in West Eurasians and South Asians, the de novo origin of Tibetan-specific LP allele − 13838G > A with low frequency (~ 6–7%) and absence of selection corresponds − 13910C > T in pastoralists across eastern Eurasia steppe.

Conclusions

Results depict a novel scenario of genetic and cultural adaptations to diet and expand current understanding of the establishment of dairy pastoralism in the Tibetan Plateau.
RAD51 is a poor prognostic marker and a potential therapeutic target for oral squamous cell carcinoma
Authors: Tsai Yu-Fen , Chan Leong-Perng , Chen Yuk-Kwan , Su Chang-Wei , Hsu Ching-Wei , Wang Yen-Yun , Yuan Shyng-Shiou F.
Published: October 2023

Objectives

RAD51 overexpression has been reported to serve as a marker of poor prognosis in several cancer types. This study aimed to survey the role of RAD51 in oral squamous cell carcinoma and whether RAD51 could be a potential therapeutic target.

Materials and methods

RAD51 protein expression, assessed by immunohistochemical staining, was used to examine associations with survival and clinicopathological profiles of patients with oral squamous cell carcinoma. Lentiviral infection was used to knock down or overexpress RAD51. The influence of RAD51 on the biological profile of oral cancer cells was evaluated. Cell viability and apoptosis after treatment with chemotherapeutic agents and irradiation were analyzed. Co-treatment with chemotherapeutic agents and B02, a RAD51 inhibitor, was used to examine additional cytotoxic effects.

Results

Oral squamous cell carcinoma patients with higher RAD51 expression exhibited worse survival, especially those treated with adjuvant chemotherapy and radiotherapy. RAD51 overexpression promotes resistance to chemotherapy and radiotherapy in oral cancer cells in vitro. Higher tumorsphere formation ability was observed in RAD51 overexpressing oral cancer cells. However, the expression of oral cancer stem cell markers did not change in immunoblotting analysis. Co-treatment with RAD51 inhibitor B02 and cisplatin, compared with cisplatin alone, significantly enhanced cytotoxicity in oral cancer cells.

Conclusion

RAD51 is a poor prognostic marker for oral squamous cell carcinoma. High RAD51 protein expression associates with resistance to chemotherapy and radiotherapy. Addition of B02 significantly increased the cytotoxicity of cisplatin. These findings suggest that RAD51 protein may function as a treatment target for oral cancer.

Trial registration

Number: KMUHIRB-E(I)-20190009 Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, approved on 20190130, Retrospective registration.
Injectable biocompatible nanocomposites of Prussian blue nanoparticles and bacterial cellulose as a safe and effective photothermal cancer therapy
Authors: Hong Hwichan , Kim MinKyu , Lee Wooseung , Jeon Miyeon , Lee Chaedong , Kim Hoonsub , Im Hyung-Jun , Piao Yuanzhe
Published: October 2023

Photothermal therapy (PTT) is a novel cancer treatment using a photoabsorber to cause hyperthermia to kill tumors by laser irradiation. Prussian blue nanoparticles (PB NPs) are considered as next-generation photothermal agents due to the facile synthesis and excellent absorption of near-infrared light. Although PB NPs demonstrate remarkable PTT capabilities, their clinical application is limited due to their systemic toxicity. Bacterial cellulose (BC) has been applied to various bio-applications based on its unique properties and biocompatibility. Herein, we design composites with PB NPs and BC as an injectable, highly biocompatible PTT agent (IBC-PB composites). Injectable bacterial cellulose (IBC) is produced through the trituration of BC, with PB NPs synthesized on the IBC surface to prepare IBC-PB composites. IBC-PB composites show in vitro and in vivo photothermal therapeutic effects similar to those of PB NPs but with significantly greater biocompatibility. Specifically, in vitro therapeutic index of IBC-PB composites is 26.5-fold higher than that of PB NPs. Furthermore, unlike PB NPs, IBC-PB composites exhibit no overt toxicity in mice as assessed by blood biochemical analysis and histological images. Hence, it is worth pursuing further research and development of IBC-PB composites as they hold promise as safe and efficacious PTT agents for clinical application.

Graphical Abstract
Development of self-care strategies to promote young Iranian women’s sexual health: an explanatory sequential mixed method study protocol
Authors: Bonyadpour Batool , Maasoumi Raziyeh , Nekoolaltak Maryam
Published: October 2023

Background

In contemporary Iran, the nation's traditional and deeply religious society is currently experiencing swift transformations in its moral, cultural, and social aspects. It is, therefore, not surprising to observe shifts in people's attitudes toward sexuality, largely attributed to the profound impact of widespread social networks, the proliferation of information technology, and increased levels of education. Unmarried young women may potentially face adverse consequences from engaging in extramarital sexual relationships across various aspects of their lives. Acknowledging the pivotal role of self-care in influencing the sexual behaviors of young women, the objective of this study is to compile a comprehensive list of self-care strategies aimed at improving the sexual well-being of young, single Iranian women.

Methods

The research will unfold in three distinct phases: Phase 1: Explanatory Sequential Mixed-Method Study This initial phase encompasses both quantitative and qualitative aspects. It begins with a cross-sectional survey, where we will gather data from 400 unmarried female students aged 18 to 29 years, utilizing a cluster random sampling method at Kerman University of Medical Sciences. Data collection will involve the use of a researcher-designed questionnaire. Subsequently, the qualitative phase will involve conducting in-depth, semi-structured interviews with female students from the University. To analyze this qualitative data, we will employ the content analysis approach. The findings obtained from both phases will be combined. Phase 2: Narrative Review In the second stage of the study, we will conduct an extensive narrative review to explore existing strategies related to the subject matter comprehensively. This review will serve as the foundational basis for our subsequent analysis. Phase 3: Strategy Prioritization In the final phase, we will prioritize the proposed strategies using a nominal group process, soliciting expert advice. This step will result in the definitive list of strategies that emerge from the study.

Discussion

This study pioneers the field of sexual health, with the goal of developing a protocol for creating self-care strategies based on the perspectives of young, unmarried Iranian women. It offers potential evidence-based insights into current developments in the physical, psychological, and social aspects of sexual health within this demographic. Additionally, it aims to furnish essential information to healthcare policymakers regarding the sexual health of young women.
Genomic variant benchmark: if you cannot measure it, you cannot improve it
Authors: Majidian Sina , Agustinho Daniel Paiva , Chin Chen-Shan , Sedlazeck Fritz J. , Mahmoud Medhat
Published: October 2023

Genomic benchmark datasets are essential to driving the field of genomics and bioinformatics. They provide a snapshot of the performances of sequencing technologies and analytical methods and highlight future challenges. However, they depend on sequencing technology, reference genome, and available benchmarking methods. Thus, creating a genomic benchmark dataset is laborious and highly challenging, often involving multiple sequencing technologies, different variant calling tools, and laborious manual curation. In this review, we discuss the available benchmark datasets and their utility. Additionally, we focus on the most recent benchmark of genes with medical relevance and challenging genomic complexity.
MCProj: metacell projection for interpretable and quantitative use of transcriptional atlases
Authors: Ben-Kiki Oren , Bercovich Akhiad , Lifshitz Aviezer , Raz Ofir , Brook Dror , Tanay Amos
Published: October 2023

We describe MCProj—an algorithm for analyzing query scRNA-seq data by projections over reference single-cell atlases. We represent the reference as a manifold of annotated metacell gene expression distributions. We then interpret query metacells as mixtures of atlas distributions while correcting for technology-specific gene biases. This approach distinguishes and tags query cells that are consistent with atlas states from unobserved (novel or artifactual) behaviors. It also identifies expression differences observed in successfully mapped query states. We showcase MCProj functionality by projecting scRNA-seq data on a blood cell atlas, deriving precise, quantitative, and interpretable results across technologies and datasets.