bluuebunny/crossref_metadata_2025 huggingface dataset:
What can multimodal data tell us about online synchronous training: Learning outcomes and engagement of in-service teachers
Authors: Xiao Jun , Jiang Zhujun , Wang Lamei , Yu Tianzhen
Published: January 2023

Teachers’ engagement in online learning is a key factor in improving the effectiveness of online teacher training. This paper introduces a multimodal learning analytics approach that uses data on brain waves, eye movements and facial expressions to predict in-service teachers’ engagement and learning outcomes in online synchronous training. This study analyzed to what extent the unimodal and multimodal data obtained from the in-service teachers (n= 53) predict their learning outcomes and engagement. The results show that models using facial expressions and eye movements data had the best predictive performance on learning outcomes. The performance varied on teachers’ engagement: the multimodal model (integrating eye movements, facial expressions, and brain wave data) was best at predicting cognitive engagement and emotional engagement, while the one (integrating eye movements and facial expressions data) performed best at predicting behavioral engagement. At last, we applied the models to the four stages of online synchronous training and discussed changes in the level of teacher engagement. The work helps understand the value of multimodal data for predicting teachers’ online learning process and promoting online teacher professional development.
Predictors of high school students’ mathematics self-efficacy in Addis Ababa: The importance of educational expectations
Authors: Yesuf Yassin Mohammed , Kebede Sebsibew Atikaw , Zewdu Atinkut , Gebru Dawit Mekonnen
Published: January 2023

In Ethiopia studies on high school students’ mathematics self-efficacy and associated factors are scarce. The present study examined students’ mathematics self-efficacy and associated predictors among high school students in Addis Ababa. Data were collected using adapted questionnaire from 120 students (9th and 10th graders) recruited via multi-stage sampling. Descriptive statistics, independent sample t-test, ANOVA, Chi-square and logistic regressions were utilized to analyze the collected data. In the study it was found that students have more than average mathematics self-efficacy even though significant numbers of students (44.2%) have low mathematics self-efficacy. It was also revealed that differences in grade level [t(118) = 2.545, p < 0.05] and students’ expected grade in the upcoming national exam [F(3,116) = 5.553, p < 0.05] were statistically significant. Living arrangements (AOR = 6.704, 95% CI = 1.598–28.118), expected grade in the upcoming national exam (AOR = 5.808, 95% CI = 1.804–18.696) and expected marks in the semester (AOR = 1.126, 95% CI = 1.055–1.202) are significant predictors of students’ mathematics self-efficacy. Generally educational expectations are important predictors of students’ mathematics self-efficacy. Therefore, researchers and organizations need to gear their attention towards improving students’ mathematics self-efficacy.
An introduction to process tracing as an innovative qualitative research method to explore affective variables in SLA
Authors: Yan Wenxiao
Published: January 2023

When the Complex Dynamic Systems Theory (CDST) enlightened the line of inquiry in education, innovative research methodologies, both quantitative and qualitative, were also introduced. Process tracing, which is among the CDST-compatible qualitative research methods, has just begun to benefit SLA research in the past few years. The present study provides a review of the conceptualization, significance, and procedural features for the implementation of the process tracing analytical method. In doing so, this review suggests a number of practices through which process tracing has been introduced in SLA. Additionally, some practical implications are provided for SLA researchers to enhance their knowledge of this new approach. Finally, future research suggestions for a more advanced use of this method are made in SLA.
Gyrification patterns in first-episode, drug-naïve major depression: Associations with plasma levels of brain-derived neurotrophic factor and psychiatric symptoms
Authors: Natsuyama Tomoya , Okamoto Naomichi , Watanabe Keita , Chibaatar Enkhmurun , Tesen Hirofumi , Hayasaki Gaku , Ikenouchi Atsuko , Kakeda Shingo , Yoshimura Reiji
Published: January 2023

Background and objectives

Cortical structural changes in major depressive disorder (MDD) are usually studied using a voxel-based morphometry approach to delineate the cortical gray matter volume. Among cortical structures, gyrification patterns are considered a relatively stable indicator. In this study, we investigated differences in gyrification patterns between MDD patients and healthy controls (HCs) and explored the association of gyrification patterns with plasma brain-derived neurotrophic factor (BDNF) levels and depressive symptoms in MDD patients.

Methods

We evaluated 79 MDD patients and 94 HCs and assessed depression severity in the patients using the 17-item Hamilton Depression Rating Scale (HAM-D). Blood samples of both groups were collected to measure plasma BDNF levels. Magnetic resonance imaging (MRI) data were obtained using three-dimensional fast-spoiled gradient-recalled acquisition. Differences in plasma BDNF levels between groups were examined using the Mann–Whitney U test. Principal component analysis and orthogonal partial least squares discriminant analysis (OPLS-DA) were conducted to investigate the gyrification patterns which were significantly different between the groups, i.e., those with variable importance in projection (VIP) scores of >1.5 and p-value < 0.05 in multiple regression analyses adjusted for age and sex. Finally, multiple regression analysis was performed on the selected gyrification patterns to examine their association with BDNF levels in the two groups and HAM-D in the patients.

Results

There were no significant differences in plasma BDNF levels between the groups. We found that 108 (71.0%) of 152 total local gyrification indices were MDD < HC. We identified 10 disease-differentiating factors based on critical gyrification features (VIP > 1.5 and p-value adjusted for age and sex < 0.05). However, we found no significant correlations between the 10 gyrification patterns and plasma BDNF levels and no interaction with group. Moreover, no significant correlations were observed between the local gyrification indices and HAM-D total scores.

Conclusion

These results suggest that abnormal early cortical neurodevelopment may mediate vulnerability to MDD, independent of plasma BDNF levels and depressive symptoms.
The moderating effect of the COVID-19 pandemic on the mental wellbeing of health care workers on sustainable employability: A scoping review
Authors: van den Broek Anneloes , van Hoorn Louise , Tooten Yvette , de Vroege Lars
Published: January 2023

Sustainable employability (SE) amongst healthcare workers (HCW) is an important asset for healthcare institutions. However, SE is under strain due to high work pressure, a shortage of employees, and absenteeism amongst employees based on mental problems. These developments had already started before the COVID-19 pandemic. The aim of this review is to explore whether there is a moderating effect of the COVID-19 pandemic on the mental wellbeing of HCW in the context of SE. A double blinded systematic review was conducted for this article in accordance with preferred reporting items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were subjected to quality evaluation and narrative synthesis. The analysis of the selected literature led to the understanding that mental problems amongst HCW were already abundantly present before the COVID-19 pandemic. Mental health problems have increased in prevalence, severity, and variation. In general, a negative relation between (mental) health and SE exists. Our findings show that mental health problems have heavily impacted the SE of HCW: absenteeism has increased and perspective on work has changed. It is time to prioritize the mental health of HCW to prevent acute care capacity from declining even further and ending up in a vicious circle.
The impact of active community-based survey on dementia detection ratio in Taiwan: A cohort study with historical control
Authors: Lu Yun-Ru , Wu Tzy-Haw , Jeng Yachung , Lee Wen-Yuan , Hsu Wei-Chih , Yen Amy Ming-Fang , Pan Shin-Liang , Chen Yen-Ching , Chen Sam Li-Sheng , Chen Hsiu-Hsi , Liou Horng-Huei
Published: January 2023

Background

Although early dementia detection is crucial to optimize the treatment outcomes and the management of associated symptoms, the published literature is scarce regarding the effectiveness of active screening protocols in enhancing dementia awareness and increasing the rate of early detection. The present study compared the detection ratio of an active community-based survey for dementia detection with the detection ratio of passive screening during routine clinical practice. Data for passive screening were obtained from the National Health Insurance (NHI) system, which was prospectively collected during the period from 2000 to 2003.

Design

A population-based cohort study with historical control.

Setting

Taiwan.

Participants

A total of 183 participants aged 65 years or older were involved in a community-based survey. Data from 1,921,308 subjects aged 65 years or older were retrieved from the NHI system.

Measurements

An adjusted detection ratio, defined as a ratio of dementia prevalence to incidence was used.

Results

The results showed that the dementia prevalence during the 2000–2003 period was 2.91% in the elderly population, compared with a prevalence of 6.59% when the active survey was conducted. The incidence of dementia in the active survey cohort was 1.83%. Overall, the dementia detection ratio was higher using active surveys [4.23, 95% confidence interval (CI): 2.68–6.69] than using passive detection (1.45, 95% CI: 1.43–1.47) for those aged 65–79 years. Similar findings were observed for those aged 80 years and older.

Conclusion

The implementation of an active community-based survey led to a 3-fold increase in the detection rate of early dementia detection compared to passive screening during routine practice.
College students' underlying perceptions of COVID-19 threat, healthcare discrimination, and healthcare system inequities associated with self-rated health across racial/ethnic groups in the U.S.
Authors: Fernandez Jessica R. , Sherchan Juliana S. , Cho Yong Ju , Nanaw Judy , Joseph Nataria T. , Forde Allana T.
Published: January 2023

Background

COVID-19-related health perceptions may differentially impact college students' stress, and in turn, their mental and physical health. This study examined racial/ethnic differences in college students' underlying perceptions of COVID-19 threat, healthcare discrimination, and U.S. healthcare system inequities and their associations with self-rated mental and physical health.

Methods

Four-hundred-thirty-two university students completed an online survey (December 2020–December 2021). Latent class analyses identified classes of perceived COVID-19 threat (i.e., severity, susceptibility), healthcare discrimination, and U.S. healthcare system inequities. Regression analyses examined whether class membership varied by race/ethnicity and was associated with self-rated mental and physical health.

Results

Class 1 members (27.3% of the sample) were more likely to identify as Hispanic or Latino, Non-Hispanic Asian, Non-Hispanic Black or African American, and Non-Hispanic Multiracial vs. Non-Hispanic White (vs. Class 4). Class 1 had high perceived COVID-19 threat, medium perceived healthcare discrimination, and high perceived U.S. healthcare system inequities, as well as higher odds of poorer mental and physical health (vs. Class 4).

Conclusions

College students' underlying perceptions of COVID-19 threat, healthcare discrimination, and U.S. healthcare system inequities were associated with poorer health. Given that students with these perceptions were more likely to belong to minoritized racial/ethnic groups, concerns over COVID-19 risk and healthcare may partially explain racial/ethnic disparities in college students' health. This study contributes to a limited body of evidence on college students' perceptions of the U.S. healthcare system and suggests important ways that structural inequalities and racial/ethnic disparities in COVID-19 risk, healthcare discrimination, and concerns over U.S. healthcare system inequity may affect college students' health.
Evolution led humans to bipedalism, but we live in a sedentary society: Will “Sunday running” protect us from NCDs at no cost?
Authors: Presta Valentina , Gobbi Giuliana , Condello Giancarlo , Carubbi Cecilia , Masselli Elena , Mirandola Prisco , Vitale Marco
Published: January 2023

Evolution led humans to bipedal stance and movement. However, we live in a sedentary society that strongly challenges our willingness to be physically active. We (mis)understand that being at least a Sunday runner could protect us from sedentary-related diseases, but what if this compromises the healthier life expectancy anyway? Citing Paul Gauguin, we know where we come from and what we are, the question arises about where we are going. And also, how.
Association between global biomarker of oxidative stress and quantitative ultrasound parameters in middle-aged and elderly adults: A cross-sectional study
Authors: Shen Xue , Liu Yawen , Zhao Qianqian , Cheng Haitao , Li Binbin , Vuong Ann M. , Fan Yiliang , Zhang Mengmeng , Yang Shuman
Published: January 2023

Introduction

With the population aging, osteoporosis has become a major public health concern. Elevated oxidative stress is a vital detrimental factor for bone health. Compared to common oxidative stress-related biomarkers, Fluorescent Oxidation Products (FlOPs) reflect the global levels of oxidation from proteins, lipids, and DNA. Nevertheless, whether plasma FlOP levels are related to bone health measured by Quantitative ultrasound (QUS) is unclear. Thus, the present study examined the association between FlOPs and QUS parameters in middle-aged and elderly adults.

Methods

This community-based cross-sectional study was conducted in Changchun, northeast China. Plasma FlOPs were determined by a fluorescent microplate reader at a wavelength of 320/420 nm (excitation/emission). QUS parameters [speed of sound (SOS) and broadband ultrasound attenuation (BUA)] of the calcaneus were assessed by an ultrasound bone densitometer. We used multivariable linear regression to examine the association between FlOPs and QUS parameters.

Results

A total of 491 subjects were included in this study. Their average age was 65.2 years (standard deviation [SD]: 9.7 years). FlOPs were inversely associated with SOS (β for an increase of logarithmic interquartile range = −10.64; P = 0.018). Higher FlOP levels were marginally associated with lower SOS in females (β for an increase of logarithmic interquartile range = −9.68, P = 0.066), but not in males (β for an increase of logarithmic interquartile range = −11.84, P = 0.131). No significant relationship between FlOPs and BUA was observed.

Conclusions

Plasma FlOP levels were inversely associated with SOS, but not with BUA in middle-aged and elderly adults.
Effects of different intervention combined with resistance training on musculoskeletal health in older male adults with sarcopenia: A systematic review
Authors: Carcelén-Fraile María del Carmen , Lorenzo-Nocino María Florencia , Afanador-Restrepo Diego Fernando , Rodríguez-López Carlos , Aibar-Almazán Agustín , Hita-Contreras Fidel , Achalandabaso-Ochoa Alexander , Castellote-Caballero Yolanda
Published: January 2023

Objectives

Nowadays, there is a significant increase in the elderly population in many countries around the world, and sarcopenia is one of the most common consequences of this with resistance training being one of the best treatments. Hence, this systematic review was conducted to determine what are the effects of different combinations of resistance training-based interventions on the musculoskeletal health of older male adults with sarcopenia

Methods

This systematic review was performed following the PRISMA 2020 guidelines. The search was performed between February and August 2022 in three electronic databases: Pubmed (MEDLINE), Web of Science (WOS) and Scopus employing different keywords combined with Boolean operators. Only 13 articles were included out of the initial 1,019.

Results

The articles studied the effects of resistance training combined with other interventions, 6 articles combined it with protein and vitamin supplementation, 4 with protein supplements only, while 3 combined it with aerobic training, finding beneficial results mainly on strength, functionality, and body composition.

Conclusion

Resistance Training combined with Aerobic Training or nutritional supplements has better effects than Resistance Training alone in older male adults with sarcopenia.

Systematic review registration

https://www.crd.york.ac.uk/prospero/#recordDetails, identifier: CRD42022354184.
Community-based intervention via WeChat official account to improve parental health literacy among primary caregivers of children aged 0 to 3 years: Protocol for a cluster randomized controlled trial
Authors: Li Yun , Xiao Qiu-Li , Li Mu , Zhang Yue , Chen Min , Jiang Chun-Hua , Kang Shu-Rong , Zhang Ying , Huang Jun , Jiang Hong
Published: January 2023

Background

Parental health literacy is an important determinant of children's health, especially during the critical window of early development in the first 3 years. As the information communication technology develops, health education via social media is widely used to deliver health information. However, few studies have explored the effect of intervention via social media on parental health literacy.

Objective

This study aims to determine whether a WeChat official account-based health intervention can improve parental health literacy of primary caregivers of children aged 0 to 3 years in Minhang District, Shanghai, China.

Methods

The cluster randomized controlled trial includes all 13 community health centers (CHCs) in Minhang District, Shanghai. We take each CHCs as a cluster in the randomization. The CHCs are randomly allocated to the intervention or the control group through random sequence generation. Ninety primary caregivers of children aged 0 to 2 years will be recruited from each CHC, 1170 in total. Caregivers in the intervention group will be provided with a series of video clips and online reading material links on scientific parenting via a WeChat account. Caregivers in the control group will receive printed educational materials with similar contents to the intervention group. All the participants will access routine child health care and be followed up for 9 months. Online assessment of health literacy will be conducted for both groups before and after the intervention. The primary outcome is the change in the total scores of parental health literacy using a validated instrument. The data of secondary outcomes, such as exclusive breastfeeding in the first 6 months, anthropometric measurements, and disease conditions, will be extracted from routine health care records. Generalized linear mixed model (GLMM) will be used for data analyses.

Discussion

Compared with traditional health education, health intervention via WeChat official account could be a feasible and effective solution to improve parental health literacy.

Trial registration

This trial is registered with the Chinese Clinical Trial Registry (ChiCTR): (#ChiCTR2000031711) on April 07, 2020.
Bibliometric and visualization analysis of research trend in mental health problems of children and adolescents during the COVID-19 pandemic
Authors: Guo Zeming , Zhang Yiran , Liu Qin
Published: January 2023

Objectives

To analyze the evolution of research on children and adolescents mental health issues during COVID-19 pandemic and discuss research hotspots and cutting-edge developments.

Methods

The literature obtained from the web of science core collection as of June 28, 2022, was analyzed using Citespace, VOSviewer bibliometric visualization mapping software.

Results

A total of 6,039 relevant papers were found, of which 5,594 were included in the study. The number of literatures is growing since 2020; and the country, institution, and journal publications were analyzed. The co-citation analysis shows that there are more research articles among the highly cited articles and a lack of systematic reviews that use critical thinking for review. In the cluster analysis, mental health and life change were the most representative. The timeline view of the keywords shows that Online learning (#0), Public health (#1), and Mental health (#2) are the three largest clusters and shows the change over time.

Conclusion

This study helped analyze the mental health of children and adolescents during the COVID-19 pandemic and identified hot trends and shortcomings, which are important references for the theoretical basis of future research and decision making and technical guidance for systematic reviews.
Burnout among postgraduate medical trainees in Lebanon: Potential strategies to promote wellbeing
Authors: Yacoubian Aline , Degheili Jad A. , Der-Boghossian Asdghig , Najdi Jad , Andraos Rebecca , Zeineldine Salah
Published: January 2023

Objective

Burnout is a widespread issue in healthcare for many years. Lebanon combatted political and economic crises before the coronavirus disease 2019 (COVID-19) pandemic, in addition to the port explosion in August 2020. The study aimed to identify the determinants of personal burnout, patient-related burnout, and work-related burnout among postgraduate medical trainees (PGMT) and evaluate its relationship with sociodemographic characteristics.

Design

A cross-sectional study utilized the Copenhagen Burnout Inventory (CBI) involving electronic, voluntary, and anonymous survey. The survey was completed by 188 PGMT including residents and fellows from all specialties and all levels of training.

Results

The prevalence rates are 68.6% for personal burnout, 63.3% for work-related burnout, and 35.1% for patient-related burnout.

Conclusion

Results improve our understanding of the phenomenon of burnout, and the role of program leadership in shaping the impact of burnout on training and promoting wellbeing of PGMT. Discussion focuses on providing potential wellbeing strategies for program directors to follow for mitigating burnout.
Prediction of body fat increase from food addiction scale in school-aged children and adolescents: A longitudinal cross-lagged study
Authors: Wang Dan , Zhou Hui , Hu Yuzheng , Che Yanfen , Ye Xian , Chen Junqing , Fu Junfen , Xu Hongzhen
Published: January 2023

Objective

Food addiction (FA) is associated with a higher body mass index z-score (BMIZ) in children and adolescents; however, whether these two aspects evolve interdependently remains unknown. This study aimed to address this question using a cross-lagged study.

Methods

Weight status, including BMIZ, fat content (FC), and visceral fat level (VFL), was determined in 880 children and adolescents (mean age = 14.02 years [range = 8.83–17.52 years]) at two-time points with an interval of 6 months. FA was characterized using the Chinese version of the dimensional Yale Food Addiction Scale for Children 2.0. Furthermore, FC and VFL were measured using direct segmental multi-frequency bioelectrical impedance analysis at each time point.

Results

Higher FA was associated with increased BMIZ, FC, and VFL (P < 0.05). FA at T0 could predict increased FC at T1 (P < 0.05). The characteristics of females, primary students, and living in urban areas may aggravate the adverse effect of FA on weight status over time and age, particularly the increased VFL in participants aged > 14 years.

Conclusion

Children and adolescents with a high FA level were at risk for weight gain attributed to increased FC, and the adverse effect could be aggravated with time and age. Novel FA-targeting interventions may help mitigate the risk of getting obesity.
Mental health status and its associated factors among female nurses in the normalization of COVID-19 epidemic prevention and control in China
Authors: Mao Xiaofei , Dong Wei , Zhang Jianguo , Zhang Fan , Deng Wenxi , Li Ziqiang , Hou Tianya
Published: January 2023

Objective

To investigate mental health status and its associated factors among female nurses in the normalization of COVID-19 epidemic prevention and control in China.

Methods

Random cluster sampling was applied to recruit 740 female nurses in China. The respondents completed the survey with mobile devices. Demographic questionnaire, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, and The Impact of Event Scale-Revised were used to assess demographic Information, anxiety, depression, insomnia and PTSD symptoms, respectively. The associated factors of mental health status were identified by binary logistic regression analysis.

Results

The prevalence of anxiety and depression was 7.9 and 17.8%, respectively. Insomnia was an associated factor of anxiety (OR = 6.237, 95%CI = 6.055–23.761, P < 0.001) and depression (OR = 9.651, 95%CI = 5.699–22.370, P < 0.001), while PTSD was an associated factor of anxiety (OR = 11.995, 95%CI = 2.946–13.205, P < 0.001) and depression (OR = 11.291, 95%CI = 6.056–15.380, P < 0.001), Being married was a protective factor of depression (OR = 0.811, 95%CI = 1.309–6.039, P < 0.01).

Conclusion

Female nurses showed problems in mental health. Insomnia, PTSD and marital status were associated with mental health. The hospital management should pay more attention to the unmarried groups, and strive to improve the sleep quality of female nurses and reduce their stress caused by traumatic events.
Using a Dynamic Causal Model to validate previous predictions and offer a 12-month forecast of the long-term effects of the COVID-19 epidemic in the UK
Authors: Bowie Cam , Friston Karl
Published: January 2023

Background

Predicting the future UK COVID-19 epidemic provides a baseline of a vaccine-only mitigation policy from which to judge the effects of additional public health interventions. A previous 12-month prediction of the size of the epidemic to October 2022 underestimated its sequelae by a fifth. This analysis seeks to explain the reasons for the underestimation before offering new long-term predictions.

Methods

A Dynamic Causal Model was used to identify changes in COVID-19 transmissibility and the public's behavioral response in the 12-months to October 2022. The model was then used to predict the future trends in infections, long-COVID, hospital admissions and deaths over 12-months to October 2023.

Findings

The model estimated that the secondary attack rate increased from 0.4 to 0.5, the latent period shortened from 2.7 to 2.6 and the incubation period shortened from 2.0 to 1.95 days between October 2021 and October 2022. During this time the model also estimated that antibody immunity waned from 177 to 160 days and T-cell immunity from 205 to 180 days. This increase in transmissibility was associated with a reduction in pathogenicity with the proportion of infections developing acute respiratory distress syndrome falling for 6–2% in the same twelve-month period. Despite the wave of infections, the public response was to increase the tendency to expose themselves to a high-risk environment (e.g., leaving home) each day from 33–58% in the same period.

The predictions for October 2023 indicate a wave of infections three times larger this coming year than last year with significant health and economic consequences such as 120,000 additional COVID-19 related deaths, 800,000 additional hospital admissions and 3.5 million people suffering acute-post-COVID-19 syndrome lasting more than 12 weeks.

Interpretation

The increase in transmissibility together with the public's response provide plausible explanations for why the model underestimated the 12-month predictions to October 2022. The 2023 projection could well-underestimate the predicted substantial next wave of COVID-19 infection. Vaccination alone will not control the epidemic. The UK COVID-19 epidemic is not over. The results call for investment in precautionary public health interventions.
Estimation of the stage-wise costs of breast cancer in Germany using a modeling approach
Authors: Khan Shah Alam , Hernandez-Villafuerte Karla , Hernandez Diego , Schlander Michael
Published: January 2023

Breast cancer (BC) is a heterogeneous disease representing a substantial economic burden. In order to develop policies that successfully decrease this burden, the factors affecting costs need to be fully understood. Evidence suggests that early-stage BC has a lower cost than a late stage BC. We aim to provide conservative estimates of BC's stage-wise medical costs from German healthcare and the payer's perspective. To this end, we conducted a literature review of articles evaluating stage-wise costs of BC in Germany through PubMed, Web of Science, and Econ Lit databases supplemented by Google Scholar. We developed a decision tree model to estimate BC-related medical costs in Germany using available treatment and cost information. The review generated seven studies; none estimated the stage-wise costs of BC. The studies were classified into two groups: case scenarios (five studies) and two studies based on administrative data. The first sickness funds data study (Gruber et al., 2012) used information from the year 1999 to approach BC attributable cost; their results suggest a range between €3,929 and €11,787 depending on age. The second study (Kreis, Plöthner et al., 2020) used 2011–2014 data and suggested an initial phase incremental cost of €21,499, an intermediate phase cost of €2,620, and a terminal phase cost of €34,513 per incident case. Our decision tree model-based BC stage-wise cost estimates were €21,523 for stage I, €25,679 for stage II, €30,156 for stage III, and €42,086 for stage IV. Alternatively, the modeled cost estimates are €20,284 for the initial phase of care, €851 for the intermediate phase of care, and €34,963 for the terminal phase of care. Our estimates for phases of care are consistent with recent German estimates provided by Kreis et al. Furthermore, the data collected by sickness funds are collected primarily for reimbursement purposes, where the German ICD-10 classification system defines a cancer diagnosis. As a result, claims data lack the clinical information necessary to understand stage-wise BC costs. Our model-based estimates fill the gap and inform future economic evaluations of BC interventions.
Direct analysis of tobacco specific nitrosamines in tobacco products using a molecularly imprinted polymer-packed column
Authors: Mulder Haley A. , Poklis Justin L. , Pearcy Adam C. , Halquist Matthew S.
Published: January 2023

Tobacco specific nitrosamines (TSNAs) are highly carcinogenic by-products in tobacco samples, and their presence is regulated by the Food and Drug Administration. Molecularly imprinted polymers (MIPs) are synthetic polymers that have been “imprinted” with a template analyte in a co-polymer system, and can selectively extract analytes from complex matrices. MIPs can be incorporated into online systems, replacing traditional high performance liquid chromatography (HPLC) columns. MIP material specific for TSNAs was packed into an empty HPLC column using a slurry packing technique. The developed method with the MIP-packed HPLC column was validated on a LC-MS/MS system for the quantitation of N-nitrosonornicotine (NNN) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in commercial tobacco products. The method was linear over .1–10 ng/ml (.4–10 μg/g) for NNN and NNK. The limit of detection (LOD) was .03 ng/ml (12 μg/g) and the limit of quantitation (LOQ), .1 ng/ml (.4 μg/g). All column uniformity parameters with the exception of theoretical plate number were within the accepted criteria (%RSD values <15%). Theoretical plate number was <250, owing to the large (50 μm) sized MIP particles. Twenty-six tobacco products contained TSNA concentrations that were consistent with reported literature values. The TSNA-MIP based HPLC column effectively replaced a traditional reverse phase HPLC column, and was used for the direct analysis of nicotine and tobacco products without extensive sample preparation prior to instrumental analysis.
Hydrolyzed whey protein enriched with glutamine dipeptide attenuates skeletal muscle damage and improves physical exhaustion test performance in triathletes
Authors: Peres Fabiano Pinheiro , Levada-Pires Adriana Cristina , Vieira Marcelo , Hatanaka Elaine , Cury-Boaventura Maria Fernanda , Folador Alessandra , Gorjão Renata , Hirabara Sandro Massao , Santos-Silva Paulo Roberto , Deuster Patricia A. , Curi Rui , Pithon-Curi Tania Cristina
Published: January 2023

Purpose

To investigate the effects of hydrolyzed whey protein enriched with glutamine dipeptide on the percentage of oxygen consumption, second ventilatory threshold, duration and total distance covered, and skeletal muscle damage during an exhaustion test in elite triathletes.

Methods

The study was a randomized, double-blinded, placebo-controlled, crossover trial. Nine male triathletes performed a progressive incremental test on a treadmill ergometer (1.4 km h−1·3 min−1) 30 min after ingesting either 50 g of maltodextrin plus four tablets of 700 mg hydrolyzed whey protein enriched with 175 mg of glutamine dipeptide diluted in 250 ml of water (MGln) or four tablets of 700 mg maltodextrin plus 50 g maltodextrin diluted in 250 ml of water (M). Each athlete was submitted to the two dietary treatments and two corresponding exhaustive physical tests with an interval of one week between the interventions. The effects of the two treatments were then compared within the same athlete. Maximal oxygen consumption, percentage of maximal oxygen consumption, second ventilatory threshold, and duration and total distance covered were measured during the exhaustion test. Blood was collected before and immediately after the test for the determination of plasma lactate dehydrogenase (LDH) and creatine kinase (CK) activities and lactate concentration (also measured 6, 10, and 15 min after the test). Plasma cytokines (IL-6, IL-1β, TNF-α, IL-8, IL-10, and IL-1ra) and C-reactive protein levels were also measured.

Results

A single dose of MGln increased the percentage of maximal oxygen consumption, second ventilatory threshold duration, and total distance covered during the exhaustion test and augmented plasma lactate levels 6 and 15 min after the test. MGln also decreased plasma LDH and CK activities indicating muscle damage protection. Plasma cytokine and C-reactive protein levels did not change across the study periods.

Conclusion

Conditions including overnight fasting and a single dose of MGln supplementation resulted in exercising at a higher percentage of maximal oxygen consumption, a higher second ventilatory threshold, blood lactate levels, and reductions in plasma markers of muscle damage during an exhaustion test in elite triathletes. These findings support oral glutamine supplementation's efficacy in triathletes, but further studies require.
Sport4Me: A people focused approach to engaging Australians in sport
Authors: Eime Rochelle , Westerbeek Hans , Pill Shane , Reece Lindsey
Published: January 2023

The traditional model of community club-based sport is fine for those, particularly children and youth, who enjoy the competitive focus and have the skills and commitment to play. But societal preferences during leisure time have changed dramatically over recent decades. However, sport organisations have made limited progress in response to these changes in providing ways in which children and youth can participate outside the traditional competitive structures and environments. In this paper the context of community club-based structures is reviewed leading into an assessment of the associated impact of these structures on sport participation. Children and youth's current motivations to play sport including what makes sport fun to play, are considered. It is then demonstrated that the associations between motivations to play sport and the factors that contribute to fun and enjoyment, are often misaligned for many individuals, with a primary focus on competition-based structures to deliver community club sport. In the final part of the paper a model for community sport organisations where people are put first is proposed - Sport4Me. Sport4Me is about flexible, inclusive, equitable sporting opportunities that focus on friends, fun, physical literacy and play. The model would complement the traditional competitive club-based model and afford participants more choice whilst fostering an environment that promotes lifelong involvement in sport. This model will require structural and cultural changes to the sporting environment and include coaching practices. Sport4Me is an evidence-based model, but it is not radical in its conceptualisation but rather, builds on previously proposed approaches, considers the needs and wants of potential sport participants and widens the scope of sport delivery.
Nutrition and its footprints: Using environmental indicators to assess the nexus between sustainability and food
Authors: Hatjiathanassiadou Maria , Rolim Priscilla Moura , Seabra Larissa Mont'Alverne Jucá
Published: January 2023

Current food systems are associated with the unsustainable use of natural resources; therefore, rethinking current models is urgent and is part of a global agenda to reach sustainable development. Sustainable diets encompass health, society, economy, culture as well as the environment, in addition to considering all the stages that make up the food production chain. This study aimed to perform a review on the importance of using environmental footprints (EnF) as a way of assessing the environmental impacts of food systems. The most used EnF to assess impacts related to the food system was the carbon footprint, followed by the water footprint, and the land use footprint. These EnF usually measured the impacts mainly of the current diet and theoretical diets. Animal-source foods were the ones that most contribute to the environmental impact, with incentives to reduce consumption. However, changing dietary patterns should not be restricted to changing behavior only, but should also involve all stakeholders in the functioning of food systems. We conclude that EnF are excellent tools to evaluate and guide the adoption of more sustainable diets, and can be applied in different contexts of food systems, such as food consumption analysis, menu analysis, food waste, and inclusion of EnF information on food labels.
A population-based investigation: How to identify high-risk T1-2N0 esophageal cancer patients?
Authors: Luo Peng , Wu Jie , Chen Xiankai , Yang Yafan , Zhang Ruixiang , Qi Xiuzhu , Li Yin
Published: January 2023

Purpose

Newly diagnosed T1-2N0 esophageal cancer (EC) is generally deemed as early local disease, with distant metastases (DM) easily overlooked. This retrospective study aimed to describe the metastatic patterns, identify risk factors and established a risk prediction model for DM in T1-2N0 EC patients.

Methods

A total of 4623 T1-2N0 EC patients were identified in the Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2018. Multivariable logistic regression was used to identify risk factors for DM. A nomogram was developed for presentation of the final model.

Results

Of 4623 T1-2N0 patients, 4062 (87.9%) had M0 disease and 561 (12.1%) had M1 disease. The most common metastatic site was liver (n = 156, 47.3%), followed by lung (n = 89, 27.0%), bone (n = 70, 21.2%) and brain (n = 15, 4.5%). Variables independently associated with DM included age at diagnosis, gender, tumor grade, primary site, tumor size and T stage. A nomogram based on the variables had a good predictive accuracy (area under the curve: 0.750). Independent risk factors for bone metastases (BoM), brain metastases (BrM), liver metastases (LiM) and lung metastases (LuM) were identified, respectively.

Conclusions

We identified independent predictive factors for DM, as well as for BoM, BrM, LiM and LuM. Above all, a practical and convenient nomogram with a great accuracy to predict DM probability for T1-2N0 EC patients was established.
Diffuse malignant peritoneal mesothelioma: A review
Authors: Sun Luanbiao , Li Chenguang , Gao Shuohui
Published: January 2023

Diffuse malignant peritoneal mesothelioma (DMPM) is an unusual and life-threatening locally invasive tumor. The morbidity and mortality of the disease are associated with progressive local effects in the abdominal cavity, such as abdominal distention, painful sensations, and early saturation with reduced oral intake, which eventually lead to intestinal obstruction and cachexia. Computed tomography (CT) has been widely used as a first-line diagnostic tool for DMPM. In addition, the most sensitive immunohistochemical markers of DMPM include WT 1, D2-40, and calmodulin. This paradigm has altered with the advancements in the immunohistochemical analysis of BRCA1-Associated Protein 1 (BAP1) the lack of BAP1 expression shows the diagnosis of malignancy. DMPM is resistant to conventional chemotherapies. Therefore, the gold standard for the treatment of DMPM is the combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The overexpression of the phosphatidylinositol 3-kinase (PI3K)/AKT serine/threonine kinase 1 (AKT)/mammalian target of rapamycin (mTOR) signaling pathway drives the malignant phenotype of DMPM, thereby showing promising potential for the treatment of DMPM. The coordinated activities among multiple RTKs are directly involved in the biological processes of DMPM, suggesting that the combined inhibition of the PI3K and mTOR signaling pathways might be an effective measure. This treatment strategy can be easily implemented in clinical practice. However, the combined inhibition of ERBB1(HER1)/ERBB2 (HER2) and ERBB3 (HER3) requires further investigations. Thus, based on these, the discovery of novel targeted therapies might be crucial to improving the prognosis of DMPM patients.
Analysis of survival factors after hepatic resection for colorectal cancer liver metastases: Does the R1 margin matter?
Authors: Ai Xiang-nan , Tao Ming , Wang Hang-yan , Li Jing-lin , Sun Tao , Xiu Dian-rong
Published: January 2023

Introduction

The effect of liver margin on colorectal cancer liver metastases (CRLM) after hepatectomy has been controversial. In this study, we conducted a postoperative follow-up study of 205 patients with CRLM to clarify whether a positive margin is significant and to define the risk factors affecting CRLM survival.

Methods

The data of 205 patients with CRLM who underwent surgical treatment at the Third Hospital of Peking University in the Department of General Surgery from January 2009 to December 2020 were retrospectively analyzed. The general data, surgical data and postoperative follow-up of the patients were statistically analyzed.

Results

There were 130 cases (63.4%) of R0 resection and 75 cases (36.6%) of R1 resection. There were 136 males and 69 females, age 61 ± 11 years, and body mass index (BMI 24.5 ± 3.3 kg/m2). The overall survival rates at 1, 3, and 5 years for the entire cohort were 93.4%, 68.4%, and 45.5% in the R0 resection group vs. 93.2%, 53.7%, and 42% in the R1 resection group, respectively, which were not statistically significant (P = 0.520). The 1-, 3-, and 5-year disease-free survival rates of 63.2%, 33.3%, and 29.7% were significantly better in the R0 resection group than in the R1 resection group of 47.9%, 22.7%, and 17.7% (P = 0.016), respectively. After multivariable analysis, carbohydrate antigen 19-9 (CA19-9) > 39 U/ml (HR = 2.29, 95% CI: 1.39–3.79, P = 0.001), primary tumor perineural invasion (HR = 1.78, 95% CI: 1.01–3.13, P = 0.047), and BMI > 24 kg/m2 (HR = 1.75, 95% CI: 1.05–2.93, P = 0.033) were independently associated with poorer overall patient survival. The number of liver metastases >2 (HR = 1.65, 95% CI: 1.10–2.47, P = 0.016), the maximum diameter of metastases ≥50 mm (HR = 1.67, 95% CI: 1.06–2.64, P = 0.026), and vascular invasion of the primary tumor (HR = 1.65, 95% CI: 1.03–2.64, P = 0.038) were also independently associated with poorer disease-free survival.

Conclusion

In patients undergoing hepatectomy for CRLM, the negative effect of the R1 margin should be downplayed, and although the disease-free survival of the R1 margin is shorter than that of the R0 margin, it has no impact on overall survival. To improve overall survival, extra attention should be given to the factors of preoperative BMI, preoperative CA19-9, and the presence of perineural invasion of the primary tumor.
Comparison of the feasibility and validity of a one-level and a two-level erector spinae plane block combined with general anesthesia for patients undergoing lumbar surgery
Authors: Zheng Shaoqiang , Zhou Yan , Zhang Wenchao , Zhao Yaoping , Hu Lin , Zheng Shan , Wang Geng , Wang Tianlong
Published: January 2023

Background

Spinal surgery causes severe postoperative pain. An erector spinae plane (ESP) block can relieve postoperative pain, but the optimal blocking method has not been defined. The aim of this study is to compare the feasibility of a one-level and a two-level lumbar ESP block and their effect on intraoperative and postoperative analgesia in lumbar spinal surgery.

Methods

A total of 83 adult patients who were scheduled for posterior lumbar interbody fusion were randomly divided into two groups. Patients in Group I (n = 42) received an ultrasound-guided bilateral one-level ESP block with 0.3% ropivacaine, while patients in Group II (n = 41) received a bilateral two-level ESP block. Blocking effectiveness was evaluated, including whether a sensory block covered the surgical incision, sensory decrease in anterior thigh, and quadriceps strength decrease. Intraoperative anesthetic dosage, postoperative visual analogue scale scores of pain, opioid consumption, rescue analgesia, and opioid-related side effects were analyzed.

Results

Of the total number, 80 patients completed the clinical trial and were included in the analysis, with 40 in each group. The time to complete the ESP block was significantly longer in Group II than in Group I (16.0 [14.3, 17.0] min vs. 9.0 [8.3, 9.0] min, P = 0.000). The rate of the sensory block covering the surgical incision at 30 min was significantly higher in Group II than in Group I (100% [40/40] vs. 85.0% [34/40], P = 0.026). The rate of the sensory block in the anterior thigh was higher in Group II (43.8% [35/80] vs. 27.5% [22/80], P = 0.032), but the rate of quadriceps strength decrease did not differ significantly between the groups. The mean effect–site remifentanil concentration during intervertebral decompression was lower in Group II than in Group I (2.9 ± 0.3 ng/ml vs. 3.3 ± 0.5 ng/ml, P = 0.007).There were no significant differences between the groups in terms of intraoperative analgesic consumption, postoperative analgesic consumption, and postoperative VAS pain scores at rest and with movement within 24 h. There were no block failures, block-related complications, and postoperative infection.

Conclusions

Among patients undergoing posterior lumbar interbody fusion, the two-level ESP block provided a higher rate of coverage of the surgical incision by the sensory block when compared with the one-level method, without increasing the incidence of procedure-related complications.

Clinical Trial Registration

www.chictr.org.cn, identifier: ChiCTR2100043596